Uterine rupture: trends and feto-maternal outcome in a Nigerian teaching hospital

Abstract

Objective: To determine the trends, predisposing factors, maternal and fetal outcome of cases of uterine rupture managed at the University of Abuja Teaching Hospital.

Method: A retrospective review of all cases of ruptured uterus managed at the University of Abuja teaching hospital, Gwagwalada, between January 2006 and December 2010 was conducted.

Result: There were 9604 deliveries in the hospital during the period of review out of which 82 were cases ruptured uterus, giving an overall incidence of 0.85% or 1 in 117 deliveries. They were mainly women of low parity with a mean age of 31.8 years. The commonest predisposing factor was injudicious use of oxytocin occurring in 38.7% of cases and was followed closely by previous caesarean section scar (28.0%). Prolonged obstructed labour was the third commonest cause of uterine rupture (18.7%) and occurred only in the unbooked patients. There were 11 maternal deaths which gave a maternal case fatality rate of 14.7%. All the deaths occurred in women who had intrapartum care in places other than the teaching hospital. There were 68 perinatal deaths which gave a fetal case fatality rate of 90.7% and all the babies that survived were in patients that had intrapartum care in the teaching hospital.

Conclusion: Ruptured uterus is a common obstetric emergency in Nigeria's Federal Capital territory and is associated with high maternal and perinatal morbidity and mortality. It is however preventable when the quality of antenatal care, intrapartum care and medical facilities are improved.