Abstract28Background: Uterine rupture is an obstetrical emergency associated with severe maternal and perinatal morbidity and mortality. It is a rare but potentially dangerous event occurs in 1 of 8,000 to 1 of 15,000 deliveries.1 Factors responsible for uterine rupture can be divided into maternal, fetal and social subtypes. By reviewing cases of uterine rupture we will be able to identify incidence, obstetric risk factors, maternal and perinatal morbidity plus mortality and management modalities of uterine rupture in teaching hospital of Kutch district. We will be able to take measures which can help in preventing uterine rupture and its worst outcome. Methods: This is an observational study conducted over a time period of 3 years, one year retrospectively and two years prospectively. All pregnant females admitted or referred to GKGH with uterine rupture were included in the study. All the cases were analyzed and data regarding their demographic characteristics, clinical presentation, risk factors, management, operative findings, postoperative complications, maternal and fetal outcome were studied. Results: The overall incidence of uterine rupture is 2.13. Among them 83% are multigravida. Out of this 22% cases of rupture were due to previous LSCS. All the cases were referred to GKGH and majority of them were not having ANC visits. Two cases of rupture were due to uterine anomaly and another two cases had gross congenital fetal malformations which led to obstructed labor and ultimately resulted in uterine rupture. In one case conjoint twins were delivered vaginally. Two cases resulted in maternal death. Only 22% of the babies survived rest were brought dead (IUFD). Conclusions: Multigravida is still a leading cause of uterine rupture in Kutch district even in today’s modern era where patients prefer more to go for planned cesarean section. Uterine rupture is a major contributor to foetomaternal morbidity and mortality. Routine antenatal check up with ultrasound, identification of high risk women, prompt clinical diagnosis, timely refer, immediate transfer and optimal management is over emphasized to avoid adverse fetomaternal complication. Awareness regarding maternal and child health, routine antenatal check up, adoption of family planning methods, nutrition level should be spread.
Keywords: Uterine rupture; Multigravida; Previous cesarean; Hysterectomy; Obstructed labor, perinatal morbidity and mortality.