[Uterine rupture in an African environment. 59 cases at the University Hospital Center in Brazzaville]

A retrospective study of 59 uterine ruptures was conducted at the University Hospital in Brazzaville. The frequency fo uterine ruptures in this institution was found to by 0.7% among the 8,138 women who delivered between 28 ans 42 weeks amenorrhoea. The duration of this study was 26 months from 1 September 1989 to 31 October 1991. The mean age of the women was 26.5 years. Most had been transferred from peripheral centres (84.7%). The predominant aetiological circumstances were: multiparity (94.9%), cicatricial uterus (35.6%), poorly controlled use of ocytocic agents (32.2%) and mechanical dystocia (30.5%). The uterine ruptures were often complete (64.4%) and diagnosed in the perpartum period (54.2%). Maternal and foetal outcome was often fatal with 4 maternal deaths (6.7%) and 40 foetal deaths (67.8%). The main effort for prevention and reduction of this dramatic situation in Africa requires personnel training, equipping peripheral centres and improved highway system in order to allow rapid access to well equipped hospitals.