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Indian Journal of Maternal-Fetal & Neonatal Medicine 5(2):p 131-134, Jul-Dec 2018. | DOI: DOI: http://dx.doi.org/10.21088/ijmfnm.2347.999X.5218
Original Article
A Study on Risk Factors and Fetomaternal Outcome of Rupture Uterus in Tertiary Care Hospital
Kevan Vaishnani, Postgraduate Student, Department of Obstetrics and Gynaecology, Shri M.P. Shah Medical College Guru Gobind Singh Hospital, Jamnagar, Gujarat 361008 , Priti Punatar , Kevan Vaishnani
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Indian Journal of Maternal-Fetal & Neonatal Medicine 5(2):p 131-134, Jul-Dec 2018. | DOI: DOI: http://dx.doi.org/10.21088/ijmfnm.2347.999X.5218
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Abstract
Objective: The aim of the study is to explore the various risk factors for uterine rupture and to evaluate the fetomaternal outcomes in this cases.Methods: This study was conducetd at a tertiary care center during the period of 4 years between 1st January 2014 to 31st December 2017. Cases of uterine rupture were studied retrospectively regarding various risk factors via relavent history and operative findings. Thereafter fetal and maternal outcome were studied retrospectively. Results: Analysis of the study suggest that out of all deliveries during 4 years, 25 cases of rupture uterus were found. Various factors were studied. Study suggests that 52% rupture occurred in age group of 24-30. 88% uterine rupture occurred during gestational age >37 weeks. Highest 56% incidence found in second gravid and least 4% incidence was in primigravida. Previous 1 cs has highest 80% and previous 2 r more CS has lowest 4% incidence of rupture uterus. 64% uterine rupture occurred when labor was induced or augmented. 66.7% incidence found in previous CS without VBAC, 19% in cases with 3 or more VBAC, 9.5% in previous CS with 2 VBAC and least 4.8% incidence found in previous CS with 1 VBAC. Incidence of rupture uterus is highest 57.1% when previous CS before <2 years and the incidence subsequently dicreases with increased duration of prior CS with least 19.1% when previous CS >4 years. There is 8% mortality occurred in cases of ruptured uterus in this study. Out of 25 cases, obstetric hysterectomy was done only in one case which is 4%.28% cases haddeveloped DIC. Out of 25 cases, 24% were stillbirths and 12% were motherside. 64% newborns were admitted to NICU. 40% newborns were discharged heathy and 24% newborns were expired. Overall fetal loss in ruptured uterus is 48%. Conclusion: Incidence is very much high in previous scar labor than in primigravida or previous normal delivery. Chances of rupture increase withearly conception after scar delivery, grand multiparity, induction or augmentation of labor, numbers of VBAC and late gestational age. Age of pregnant womenis not affecting the incidence of uterine rupture. Maternal mortality and incidence of obstetric hysterectomy is rare but fetal mortality and morbidity is high in case of ruptured uterus.
Keywords: Rupture of Uterus; Previous CS; VBAC; Hysterectomy; Maternal Mortality
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DOI: DOI: http://dx.doi.org/10.21088/ijmfnm.2347.999X.5218
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