scholarly journals Predictive factors of Uterine Rupture

2020 ◽  
pp. 01-05
Author(s):  
Aliou DIOUF ◽  
GUEYE M ◽  
NDIAYE GUEYE ◽  
THIAM O ◽  
MBAYE M ◽  
...  
Keyword(s):  
Risk Factors ◽  
Predictive Factors ◽  
Uterine Rupture ◽  
Demographic Characteristics ◽  
Microsoft Excel ◽  
Obstructed Labor ◽  
Uterine Scar ◽  
Scarred Uterus ◽  
Health Hospital ◽  
Ruptured Uterus

Objectives: To assess the frequency and predictive factors of uterine rupture on no-scar uterus and on scarred uterus in an intermediate level health hospital in Dakar. Method of study: This retrospective was carried out by the Philippe Maguilen Senghor Health Center in Yoff (Dakar) during the period from January 1, 2011 to December 31, 2017. It included all the women who gave birth there'' a single pregnancy after 22 weeks of amenorrhea with a longitudinal fetal presentation or admitted after childbirth. We had studied socio-demographic characteristics and risk factors for uterine rupture. The extracted data was analyzed first on Microsoft Excel 2016 and then on EPI info. Results: Over 7 years, 29,332 deliveries of single pregnancies were recorded in our structure with 54 uterine ruptures, and a frequency of 0.18%. Induction of labor was spontaneous in 47 of the patients who presented with uterine rupture; labor was artificially induced in only 7 patients, with frequencies of 0.17% and 0.36% of all uterine ruptures, respectively. Considering the risk factors of uterine rupture, 5 parameters were discriminating: multiparity (p<0.0001), transfer from another health facility for admission (p<0.0001), type of fetal presentation (p=0.0001), the presence of a uterine scar (p<0.0001) and the age class (p<0.0001). Conclusion: The rate of uterine rupture in our structure is certainly low but should call for more vigilance during labor with a focus on evacuated patients who have started their work in another structure, patients with a uterine scar and multiparous. Childbirth on a scar uterus is a reasonable option after eliminating a potential cause of obstructed labor. Keywords: Ruptured uterus; Scar uterus; Risk factors

scholarly journals Analyzing uterine rupture: A study from tertiary care centre of western Nepal

2017 ◽  
Vol 4 (3) ◽  
pp. 95-99
Author(s):  
Junu Shrestha ◽  
Rami Shrestha
Keyword(s):  
Uterine Rupture ◽  
Tertiary Care ◽  
Operative Management ◽  
Demographic Variables ◽  
Bladder Injury ◽  
Tertiary Care Centre ◽  
Microsoft Excel ◽  
Cross Sectional ◽  
Uterine Scar ◽  
Scarred Uterus

Background: Rupture uterus is a serious obstetric complication which if diagnosed and managed early improves foetomaternal outcome.Objectives: To determine the frequency, causes, management aspects and foeto-maternal outcome of uterine rupture.Methods: This is a cross sectional observational study conducted in Department of Obstetrics and Gynaecology of Manipal Teaching Hospital from July 2012 to June 2015. All cases of rupture uterus, both complete as well as incomplete, diagnosed during surgery were included. Patient’s demographic variables, clinical presentation, risk factors for rupture were studied. Factors related to rupture like the type, nature and site of uterine rupture were noted. The operative management, maternal and neonatal outcome of the patients was reviewed. All the information was entered in the Microsoft Excel chart sheet. Data was analyzed using simple frequencies and percentages.Results: There were 22 cases of uterine rupture and 7987 deliveries during that period giving frequency of 2.8 rupture uterus in every 1000 deliveries. Uterine scar following previous cesarean section was the commonest (72.7%) cause for rupture uterus. Repair was the commonest (86.4%) surgical treatment done. There was no maternal mortality. Blood transfusion was needed two-third of the cases. Other complications were bladder injury (9.1%), paralytic ileus (9.1%), acute renal failure (4.5%) and pneumonia (4.5%). The perinatal mortality was 45.5%.Conclusion: Uterine rupture is a grave obstetric event with maternal and perinatal morbidity and commonly follows pregnancies with scarred uterus.

Role of Decapitation in Management of A Case of Complete Shoulder Dystocia with Rupture Uterus - A Case Report

2021 ◽  
Vol 15 (11) ◽  
pp. 3043-3044
Author(s):  
Nadia Zahid ◽  
Muntiha Sarosh ◽  
Rakhshsanda Toheed ◽  
Mohammad Saa ◽  
Kokab Zia
Keyword(s):  
Uterine Rupture ◽  
Maternal Education ◽  
Bladder Wall ◽  
Time Lapse ◽  
Shoulder Dystocia ◽  
Maternal Complications ◽  
Fetal Head ◽  
Obstructed Labor ◽  
Uterine Scar ◽  
Scarred Uterus

Complete Shoulder dystocia in the presence of scarred uterus is an acute obstetrical emergency and if not properly handled can lead to serious fetal and maternal complications. A G5P4AO previous II cesarean sections, presented in emergency after delivery of fetal head and impacted shoulders, at a small private clinic in a village, four hours back. On laparotomy, there was uterine rupture from the previous uterine scar along with posterior bladder wall rupture . The shoulder dystocia was relieved by decapitation and breech extraction abdominally. Subtotal hysterectomy and repair of the bladder wall was done. This case highlight the dilemma of lack of regular antenatal care and maternal education, malpractices by untrained health professionals and time lapse in referral system that is still a very serious and major issue in developing countries like Pakistan . Keywords: Shoulder dystocia, obstructed labor, and uterine rupture

scholarly journals Fetomaternal outcomes in patients with Uterine Rupture managed at Bugando Medical Centre, Tanzania: 5-year review of cases

2019 ◽  
Author(s):  
Simon Mrema ◽  
Anthony Massinde ◽  
Dismas Matovelo ◽  
Albert Kihunrwa ◽  
Richard Rumanyika ◽  
...  
Keyword(s):  
Risk Factors ◽  
Uterine Rupture ◽  
Case Fatality Rate ◽  
Case Fatality ◽  
Maternal Outcomes ◽  
Fatality Rate ◽  
Obstructed Labor ◽  
Apgar Scores ◽  
Bugando Medical ◽  
Bugando Medical Centre

Abstract Background Uterine rupture is one of the major obstetric complications, associated with adverse fetal and maternal outcomes including hemorrhage, genital urinary injury, low Apgar scores, fetomaternal deaths. There is a paucity of data regarding uterine rupture and its consequences among pregnant women in Mwanza, Tanzania. As a result, it is difficult to know the magnitude of the problem and formulate appropriate measures to reduce its incidence. This study was thus conducted to determine the cumulative incidence, risk factors, fetal and maternal outcomes among women with uterine rupture managed at Bugando Medical Centre (BMC), Mwanza-Tanzania.Methods This was a 5-year (2013 to 2017) retrospective descriptive study of cases of uterine rupture at BMC. The case files were collected from medical records department and maternal demographic information, clinical presentation, risk factors, interventions and feto-maternal outcomes were extracted using a checklist. Data were analyzed using STATA software version 13.Results There were 37,763 deliveries within five years. Caesarean section accounted for a quarter (n=9,136) of these deliveries. During this period 81 cases of ruptured uterus were identified, making a cumulative incidence of 2.2 cases per 1,000 deliveries. Common risk factors for uterine rupture were history of previous caesarean section 54% (n=36), obstructed labor 37% (n=25), grandmultiparity 19.4% (n=13) and use of oxytocin 21% (n=14). Maternal case fatality rate in this study was 1.5% (n=1). More than half of cases had hysterectomy while about a third (n=25) had uterine repair without bilateral tubal ligation (BTL). Over 80% (n=55) of cases required blood transfusion. Sepsis developed in 21% (n=14) of cases and vesicovaginal fistula (VVF) in 12% (n=8). Perinatal case fatality rate was 72% (n=48). Out of the 24 babies who were born alive, 37.5% (n=9) had low Apgar scores and 20.8% (n=5) died before discharge.Conclusion The leading risk factor for uterine rupture seen was previous caesarean scar and obstructed labor associated with high perinatal case fatality rate. Improvement in monitoring of patients in labor is necessary to detect early features of uterine rupture, obstructed labour and fetal compromise. This will contribute to reduced incidence of uterine rupture and improve fetomaternal outcomes.

scholarly journals A case series of uterine rupture: a continuing cause of maternal and fetal morbidity!

2017 ◽  
Vol 4 (7) ◽  
pp. 2247
Author(s):  
Vinu Choudhary ◽  
Surendra Bisu
Keyword(s):  
Risk Factors ◽  
Uterine Rupture ◽  
Spontaneous Rupture ◽  
Case Series ◽  
Neonatal Morbidity ◽  
Uterine Wall ◽  
Full Thickness ◽  
Increased Risk ◽  
Associated Risk Factors ◽  
Ruptured Uterus

Background: Uterine rupture is defined as a full-thickness separation of the uterine wall and the overlying serosa. It is a rare peripartum complication associated with severe maternal and neonatal morbidity and mortality. The objective of this study was to review the incidence of ruptured uterus and evaluate associated risk factors, maternal and fetal complications.Methods: 14 case notes were reviewed for every patient with a ruptured uterus for a period of 4 years, from January 2012 to December 2015.Results: 79% patients had uterine rupture while in labour. Three patients were not in labour (two had a spontaneous rupture at 28/40 and 33/40 weeks respectively and for one patient it was found during an elective C/S). Two out of five patients with 2 previous C/S ruptured at 28 and 33 weeks respectively. Two or more C/S were associated with increased risk of pre- labour rupture uterus as highlighted by the three cases.Conclusions: Challenging diagnosis and cases of pre- labour rupture may necessitate pre- pregnancy counselling and antenatal LUS thickness USS in certain cases.

scholarly journals Uterine Rupture - Risk Factors and Pregnancy Outcome in Bundelkhand Region

2021 ◽  
Vol 10 (27) ◽  
pp. 1961-1965
Author(s):  
Sheela Jain
Keyword(s):  
Risk Factors ◽  
Uterine Rupture ◽  
Fetal Mortality ◽  
Mortality And Morbidity ◽  
Factors Associated ◽  
Uterine Surgery ◽  
Grand Multiparity ◽  
Uterine Scar ◽  
Congenital Uterine Anomaly ◽  
Inter Pregnancy Interval

BACKGROUND Uterine rupture is defined as the tearing of the muscular wall of the uterus during pregnancy or labour.1 Often it occurs from the tearing of previous caesarean scar during labour.2 The other known risk factors for uterine rupture include, maternal age, height, body mass index (BMI), education, birth weight, gestational age, induction of labour, instrumental vaginal delivery, interpregnancy interval, congenital uterine anomaly, grand multiparity, previous uterine surgery, fetal macrosomia, fetal malposition, obstructed labour, uterine instrumentation, attempted forceps delivery, external version, and uterine trauma. 2-6This study was done to find out the prevailing risk factors associated with this grave condition in Bundelkhand region, so that mortality and morbidity associated with it could be prevented. METHODS We have studied 37 cases of uterine rupture, operated in our institution from Jan. 2018 to Oct. 2019. During this period a total of 2986 Caesarean sections (CS) were performed. Of these 37 cases, 5 were Nullipara (13.51 %), 16 primipara (31.25 %) and 16 were grand multipara (31.25 %). 24 cases (64.86 %) had previous uterine scar while 13 (35.13 %) had no scar. RESULTS In our study major risk factors for uterine rupture were found to be previous scars (64.68 %). Obstructive labour (23.07 %), malpresentation (7.69 %), grand multiparity (38.46 %) and prolong labour (30.76 %), were responsible for rupture in unscarred uterus. In all cases we first tried to repair the tear and only 9 (24.32 %) needed hysterectomy. In our study 28 patients (75.67 %) required only repair whereas 24.32 % cases needed hysterectomy. Maternal death was just 1 case (2.7 %) and (51.35 %) babies survived. CONCLUSIONS Majority of uterine rupture cases were found in women who had previous CS. So, first CS should be performed after very careful understanding of its indications. 2.7 % maternal mortality and 51.35 % delivery of live birth babies in our study proves that early detection and proper managing of the case can reduce maternal and fetal mortality in uterine rupture cases. KEY WORDS Uterine Rupture, Previous Scar, Inter-Pregnancy Interval

scholarly journals RUPTURE OF UTERUS (FUNDUS)

2016 ◽  
Vol 23 (01) ◽  
pp. 114-117
Author(s):  
Mubasher Saeed Pansota ◽  
Aisha Ajmal ◽  
Bushra Sher Zaman
Keyword(s):  
Uterine Rupture ◽  
Past History ◽  
Sudden Onset ◽  
Gravid Uterus ◽  
History Of ◽  
Uterine Curettage ◽  
Rupture Of Uterus ◽  
Uterine Scar ◽  
Scarred Uterus ◽  
Uterine Fundus

Rupture of a gravid uterus is a surgical emergency. Predisposing factorsinclude a scarred uterus. Spontaneous rupture of an unscarred uterus during pregnancy is arare occurrence. We hereby present the case of a spontaneous complete uterine rupture at agestational age of 35 weeks 01 day in a 25 years old patient. The case was managed at theCivil Hospital Bahawalpur. She had past history of one uterine curettage for endometrial polypone year back. She presented with mild abdominal pains of sudden onset. After conservativemanagement for 10 hours in hospital she suddenly developed severe abdominal pains with P/Vbleeding. On ultrasound scan, uterine rupture was diagnosed and an emergency laparotomywas done. The ruptured amniotic sac with baby and placenta were found in the peritoneal cavitywith rupture of the uterine funds. Spontaneous uterine fundus rupture usually occurs whenthere is an upper segment uterine scar. This case report shows that past history of curettage isa risk factor for the presence of uterine scar.

scholarly journals Symptomatic Uterine Rupture: A Fifteen Year Review

Medicina ◽  
2020 ◽  
Vol 56 (11) ◽  
pp. 574
Author(s):  
Egle Savukyne ◽  
Raimonda Bykovaite-Stankeviciene ◽  
Egle Machtejeviene ◽  
Ruta Nadisauskiene ◽  
Regina Maciuleviciene
Keyword(s):  
Risk Factors ◽  
Abdominal Pain ◽  
Incidence Rate ◽  
Cesarean Delivery ◽  
Epidural Anaesthesia ◽  
Uterine Rupture ◽  
Acute Abdominal Pain ◽  
Significant Risk ◽  
Uterine Scar ◽  
Previous Cesarean

Background and objectives: To assess the incidence of complete and partial uterine rupture during childbirth in a single tertiary referral centre as well as the significant risk factors, symptoms and peripartum complications. Materials and Methods: A retrospective single-centre study involved all cases of uterine rupture at the Kaunas Perinatal Centre in 2004–2019. Data were from a local medical database complemented with written information from medical records. We included 45,893 women with an intact uterus and 5630 with uterine scars. Women (n = 5626) with scarred uterus’ after previous cesarean delivery. The diagnosis was defined by clinical symptoms, leading to an emergency cesarean delivery, when complete or partial uterine rupture (n = 35) was confirmed. Asymptomatic cases, when uterine rupture was found at elective cesarean section (n = 3), were excluded. The control group is represented by all births delivered in our department during the study period (n = 51,525). The outcome was complete (tearing of all uterine wall layers, including serosa and membranes) and partial uterine rupture (uterine muscle defect but intact serosa), common uterine rupture symptoms. Risk factors were parameters related to pregnancy and labour. Results: 51,525 deliveries occurred in Kaunas Perinatal Centre during the 15 years of the study period. A total number of 35 (0.06%) symptomatic uterine ruptures were recorded: 22 complete and 13 partial, leading to an incidence rate of 6.8 per 10,000 deliveries. The uterine rupture incidence rate after a single previous cesarean delivery is 44.4 per 10,000 births. 29 (83%) cases had a uterine scar after previous cesarean, 4 (11%) had a previous laparoscopic myomectomy, 2 (6%) had an unscarred uterus. The most significant risk factors of uterine rupture include uterine scarring and augmentation or epidural anaesthesia in patients with a uterine scar after cesarean delivery. The most common clinical sign was acute abdominal pain in labour 18 (51%). No maternal, six intrapartum perinatal deaths (17%) occurred, and one hysterectomy (2.8%) was performed due to uterine rupture. Neonatal mortality reached 22% among the complete ruptures. Average blood loss was 1415 mL, 4 (11%) patients required blood transfusion. Conclusions: The incidence rate of uterine rupture (complete and incomplete) at Kaunas Perinatal Centre is 6.8 per 10,000 deliveries. In cases with a scar of the uterus after a single cesarean, the incidence of uterine rupture is higher, exceeding 44 cases per 10,000 births. The most significant risk factors were uterine scar and augmentation or epidural anaesthesia in a previous cesarean delivery. Acute abdominal pain in labour is the most frequent symptom for uterine rupture.

scholarly journals Review of uterine rupture at Paropakar Maternity and Women’s Hospital

2018 ◽  
Vol 13 (1) ◽  
pp. 23-25 ◽  
Author(s):  
Iccha Uprety ◽  
Gehanath Baral ◽  
Shreena Shrestha
Keyword(s):  
Risk Factor ◽  
Uterine Rupture ◽  
Descriptive Study ◽  
Patient Record ◽  
Scarred Uterus ◽  
Ruptured Uterus

Aims: To determine the case profile of uterine rupture.Methods: Retrospective descriptive study from in-patient record file during two years period.Results: Incidence of uterine rupture recorded was 72 per hundred thousand deliveries (1 in 1390), 25% had ruptured uterus antepartum and 60.7% had live baby.Conclusions: Scarred uterus was the commonest risk factor for rupture uterus and antepartum rupture is not uncommon.

scholarly journals Determinants of Uterine Rupture and Its Management Outcomes among Mothers Who Gave Birth at Public Hospitals of Tigrai, North Ethiopia: An Unmatched Case Control Study

2020 ◽  
Vol 2020 ◽  
pp. 1-9
Author(s):  
Meresa Berwo Mengesha ◽  
Desta Abraha Weldegeorges ◽  
Yared Hailesilassie ◽  
Weldu Mammo Werid ◽  
Mulu Gebretsadik Weldemariam ◽  
...  
Keyword(s):  
Risk Factors ◽  
Antenatal Care ◽  
Uterine Rupture ◽  
Case Control Study ◽  
Case Control ◽  
Public Hospitals ◽  
Obstructed Labor ◽  
Health Institutions ◽  
Control Study ◽  
Remote Health

Introduction. Uterine rupture is a leading cause of maternal death in Ethiopia. Despite strengthening the health care system and providing basic and comprehensive emergency obstetric care closer to the communities, uterine rupture continues to produce devastating maternal and fetal outcomes. Although risk factors of uterine rupture are context specific, there is lack of clarity in our context towards the contributing factors and untoward outcomes of uterine rupture. This study was conducted to identify the risk factors of uterine rupture and its impacts in public hospitals of Tigrai. Objective. This study would identify determinant factors of uterine rupture and its management outcomes among mothers who gave birth in public hospitals in Tigrai region, North Ethiopia. Method. A retrospective hospital-based unmatched case control study design was implemented with 135 cases of women with uterine rupture and 270 controls of women without uterine rupture. Cases were enrolled consecutively from case notes of women who gave birth from 1/9/2015 to 30/6/2019, while charts (case note) of women without uterine rupture found following the cases were selected randomly and enrolled. Bivariate and multivariate logistic regression with 95% confidence interval was used to identify the determinants of uterine rupture. Result. Mothers referred from remote health institutions (AOR 7.29 (95% CI: 2.7, 19.68)), mothers who visited once for antenatal care (AOR 2.85 (95% CI: 1.02, 7.94)), those experiencing obstructed labor (AOR 13.33 (95% CI: 4.23, 42.05)), and birth weight of a newborn greater than four kilograms (AOR 5.68 (95% CI: 1.39, 23.2)) were significantly associated with uterine rupture. From 135 mothers who develop uterine rupture, 13 (9.6%) mothers died and 101 (74.8%) fetuses were stillborn. Obstetrical complications like abdominal hysterectomy in 75 (55.6%) of mothers and excessive blood loss in 84 (57.8%) were additional untoward outcomes of uterine rupture. Conclusion. Referrals from remote health institutions, once-visited antenatal care, obstructed labor, and birth weight of newborns greater than four kilograms were significant determinants of uterine rupture. Maternal death, stillbirth, hysterectomy, and hemorrhage were adverse outcomes. The findings of this study suggest early identification of factors that expose to uterine rupture during antenatal care, labor, and delivery must be attended to and further prospective studies are needed to explore predictors of untoward outcomes. Knowing the determinants of uterine rupture helps prevent the occurrence of a problem in pregnant women, which reduces maternal morbidity and mortality, and would have a tremendous help in identifying the best optional strategies in our current practices. This assertion was added to the abstract concluding session.

Letter to Editor: Impact of labor on uterine scar healing

Open Medicine ◽  
2013 ◽  
Vol 8 (4) ◽  
pp. 434-435 ◽  
Author(s):  
Stéphanie Roberge ◽  
Emmanuel Bujold
Keyword(s):  
Risk Factors ◽  
Uterine Rupture ◽  
Complete Healing ◽  
Uterine Scar ◽  
Scar Healing

AbstractUltrasound of uterine scar after cesarean and measurement of its thickness can be used to evaluate its healing and risk factors for scar defect and uterine rupture. However, we believe that a period of up to 6 months after surgery is necessary to achieve complete healing of the scar, especially in cases of cesarean performed during labor.

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