Analyzing the Risk factors, Maternal and Fetal outcome of uterine rupture in pregnancy

Dr. R. Sujatha; Dr. Gayatri

Volume : VIII, Issue : IV, April - 2019

Analyzing the Risk factors, Maternal and Fetal outcome of uterine rupture in pregnancy

Dr. R. Sujatha, Dr. Gayatri

Abstract :

Aim : To find the incidence, etiological factors and fetal and maternal outcome of uterine rupture in King George Hospital Visakhapatnam Materials and methods: A study of uterine rupture in third trimester or in term pregnancy during the period of two years in our hospital. Criteria: pregnant women both primi or multigravida with or without scar of Ceasarean operation, myomectomy, Hysterotomy, uterine anomaly. Exclusive criteria : Pregnancy with medical diseases. Results: Out of 12,943 admissions in Labor ward, 43 cases of uterine rupture were seen. 26 cases were multiparous with obstructed labour, 1 was multiparous without obstructed labour. 11cases were with scar rupture, 1 with bicornuate uterus and 1 with rudimentary horn, 1with instrumentation, 2 were malpresentation . Symptoms: 5pateints with mild to moderate bleeding per vaginum,19 patients with hypotension and tachycardia,haematuria in 4 patients, 4 patients presented with none of the symptoms(silent) . Management with fluid resuscitation and blood transfusion, laparotomy done. Out of 43 patients the rent repair was done in 8 patients, Subtotal hysterectomy in 15patients, Total hysterectomy was done in for 18 patients. 3–8 units of blood transfusion was required for all either in intra operative or in post operative period. And also oad spectrum antibiotics were given along with critical care. The patients with rent repair recovered well and discharged on 7th POD. One patient was complicated by sepsis and she was discharged on 23rd POD. Patients of subtotal hysterectomy were discharged between 8th to 15th POD. Nine patients died on immediate to 3rd POD. Fetal outcome: 29 patients had fetal demise,5 babies born with low APGAR 2 – 4, 3 babies were born with prematurity. To conclude all patients were un booked and referred from remote tribal areas. The highest incidence of mortality associated with multiparity with obstructed labor. Next frequent cause was post caesarean pregnancy. The cause could be the delay in transporting the patient to tertiary care centre. And also un identifying the high risk pregnancy such as post caesarean pregnancy