Uterine rupture as seen in the University of Calabar Teaching Hospital, Nigeria: a five-year review

Abstract

Eighty-five cases of uterine rupture were seen and managed in the University of Calabar Teaching Hospital, Nigeria, within a 5-year period from 1986 to 1990. The total number of deliveries during the period was 10 247 giving an incidence of 0.83% uterine rupture or 1 in 121 deliveries. About 82% of the cases occurred within the age range of 20-30 years. The highest incidence of uterine rupture was seen in Para 5 and four cases of uterine rupture occurred in primigravida. Abdominal tenderness was the commonest clinical feature in this series. Anterior uterine rupture occurred in almost 60% of the cases managed. Rupture of the unscarred uterus was seen in 58.5% of the cases with the majority being due to cephalopelvic disproportion. Four cases of traumatic rupture were identified; one of which was due to road traffic accident. Repair of uterine rupture with sterilisation following active resuscitation was the commonest surgical procedure employed and was not associated with any maternal mortality. Associated maternal and perinatal mortalities were 9.8% and 85.4% respectively and hypovolaemic shock was the major cause of maternal death.