Incidence and Predictors of Uterine Rupture with Maternal and Perinatal Outcome: A Cross-sectional Study

Area of Science:

• Obstetrics and Gynecology
• Public Health
• Maternal-Child Health

Background:

• Maternal mortality in India has declined, but uterine rupture is re-emerging as a significant obstetric complication.
• The rising incidence of cesarean deliveries is a primary driver of increased uterine rupture cases.
• This study focuses on uterine rupture in Eastern Uttar Pradesh, India, a region with specific healthcare challenges.

Purpose of the Study:

• To evaluate the incidence of uterine rupture in a tertiary care center in Eastern Uttar Pradesh.
• To identify key risk factors associated with uterine rupture.
• To analyze maternal and fetal outcomes in cases of uterine rupture.

Main Methods:

• An observational cross-sectional study was conducted over 12 months (October 2019-September 2020).
• Data included maternal demographics, antenatal/perinatal risk factors, and outcomes for clinically diagnosed and laparotomy-confirmed uterine rupture cases.
• Incidence was calculated from total hospital deliveries; COVID-19 period impact was assessed.

Main Results:

• An incidence of 8.7/1,000 deliveries was reported, significantly higher than the national average.
• Previous cesarean section with unsupervised labor was the leading risk factor.
• Maternal mortality was 6.45%, while perinatal mortality was alarmingly high at 96.77%.

Conclusions:

• Uterine rupture remains a critical cause of maternal and perinatal mortality in rural India.
• Unsafe labor practices and inadequate antenatal care contribute significantly to uterine rupture.
• Strengthening health systems, referral networks, community education, and reducing unnecessary cesarean sections are crucial.