Three Years Experience in the Management of Uterine Rupture at Al-Battool Teaching Hospital Mosul-Iraq

Abstract

Background: Ruptured uterus is a catastrophic event to both
mother and her fetus. Apart from maternal and fetal mortality
rates, the incidence of rupture of uterus is often taken as an
index of the standard of obstetric care.
Objective: To determine the frequency, causes, management
outcome of ruptured uterus at Al Batool maternity hospital.
Method: The study was conducted in the department of
obstetrics and gynecology at Al Batool maternity hospital
Mosul-Iraq over a period of three years from October 1st 2002
to August 30th 2005. All the cases of uterine rupture presented
during the study period were recorded and managed in the
department. Data was recorded on designed forms.
Results: Thirty nine cases of ruptured uterus out of 44539
deliveries were registered, the incidence was 0.087%. Age
ranged from 15 to45 years. The majority of the patients were
grandmultipara (Para 5 and above), but 7 of the patients were
nulliparous women (17.94%). 26 ruptures (66.66%) occurred
in unscarred uterus and 13 ruptures (33.33%) occurred in
scarred uterus, cephalopelvic disproportion and obstructed
labor were the cause of rupture in 11 cases (28.2%), in
addition to the mentioned causes 11 cases of the uterine
ruptures we registered in our study (28.2%) were mishandled
by the traditional birth attendants, and in 14 cases (35.89%)
there was injudicious use of oxytocin. We had three maternal
deaths (7.69%) out of 39 patients, and only 10 fetuses out of
39(25.64%) were alive.
Conclusion: Rupture uterus is still an important cause of
maternal and perinatal mortality and morbidity in Iraq, it is
not always suspected, and hence increased vigilance is vital.
Further studies may help in the development of preventive
strategies and ensure prompt management to reduce maternal
and perinatal mortality and morbidity