Uterine rupture in Ekiti State University Teaching Hospital, Ado-Ekiti: a review of presentation and outcome of managementOlusola Peter Aduloju1, Akinyemi Akinsoji Akintayo1, Tolulope Aduloju2
1Department of Obstetrics and Gynecology, Ekiti State University, Ado-Ekiti, Nigeria
22Department of Medical Social Services, Ekiti State University Teaching Hospital, Ado-Ekiti, Nigeria
International Medicine 2020; 2(1): 28-36 | DOI: 10.5455/im.66216 PDF
Background: Uterine rupture is a potential life-threatening obstetric emergency associated with massive hemorrhage and is a major cause of maternal and perinatal morbidity and mortality. This study reviewed cases of uterine rupture to determine prevalence, management and outcome.
Methods: This study was a retrospective analysis of cases of women managed for uterine rupture in Ekiti State University Teaching Hospital, Ado-Ekiti between 1st July, 2008 and 30th June, 2018. Relevant data on sociodemographic characteristics, presentation, management and maternal and perinatal outcomes were obtained using a structured questionnaire and analyzed with SPSS software.
Results: There were 16,495 deliveries and 64 cases of uterine rupture with a prevalence of 0.39% or 1 in 258 deliveries. The mean age of the women was 27.30 ± 4.53 years and the median parity was 3 while the majority (71.69%, 38/53) of them were unbooked. About 66.03% (35/53) of the patients with uterine rupture had previous uterine scar while the other 33.96% (18/53) occurred in the unscarred uterus. The booking status, pre-operative packed cell volume, blood loss, units of blood received and admission into special care baby unit differed significantly among women with scarred and unscarred uterus, p=0.046; 0.010; 0.041, 0.001 and 0.027, respectively. The mean age, parity, gestational age at rupture and duration of hospital stay were not significantly different between them, p=0.546; 0.069; 0.634 and 0.075, respectively. Acute renal failure was the commonest complication among women with uterine rupture. The case fatality rate among the women was 18.87% (10/53) while the perinatal mortality rate was 849.05/1000 births (45/53).
Conclusions:Uterine rupture remains an obstetric catastrophe with grave consequences on both the mother and the fetus. Good referral system, antenatal education and supervised deliveries in well-equipped health facilities will reduce its occurrence.
Keywords: maternal mortality, Nigeria, perinatal mortality, uterine rupture