Analysis of ruptured uterus in Debre Markos Hospital, Ethiopia

Abstract

Objective: To determine the incidence of uterine rupture in a rural hospital and to examine its cause, type and outcome. Design: A prospective study. Setting: Debre Markos Hospital, Ethiopia. Subject. All patients who were admitted and operated on for uterine rupture in the above mentioned hospital over a period of two years. Outcome measures: Parity, weather an attempt was made to deliver them preoperatively, diagnosis at admission, vital sign status on admission and type of operation. Results: There were a total of 1830 deliveries and seventy uterine rupture cases. Frequency of occurrence of uterine rupture was 3.8% or one in 26 deliveries. The peak incidence was between 25 to 29years. Mean parity was 3.6 and grand multiparas (>5) accounted for most (34.2%). Intraoperatively 62 were found to have complete and eight incomplete rupture with 54.3% anterior rupture. Hysterectomy was done for 57 and repair for 13. The postoperative complication rate was 24.3%, sepsis being the most common cause of death. Conclusion: Uterine rupture is relatively common mainly as a result of obstructed labour and multiparity. Improved healthcare delivery, accesss to prenatal care and family planning will improve the situation.