Contribution of scarred uterus to ruptured uterus in rural Nigeria

Abstract

Background: Ruptured Uterus is one of the worst obstetric catastrophes that cause maternal and perinatal morbidity and mortality. Though surgical incisions on the uterus are thought to contribute to this catastrophe, no work had been done in our environment to find out how scarred uterus had been contributing to uterine rupture in our area of practice hence the need for this work.Methods: This is a retrospective study involving all the cases of ruptured uterus managed at Mater Misericordiae Hospital, Afikpo in Ebonyi State of Nigeria over 10 years.Results: During the ten years under review, the incidence of ruptured uterus was 0.66% or 1 in 151 deliveries. Of the 74 cases of ruptured uterus, 28 or 37.8% occurred in those with scarred uterus. This translates to 1 uterine rupture caused by scarred uterus in every 2.6 cases of uterine rupture. Previous cesarean section was the commonest scar followed by previous uterine rupture and cornual ectopic pregnancy. There was no rupture from a myomectomy scar.Conclusions: Scarred uterus is a significant cause of uterine rupture, every effort must be made to reduce uterine scars and our women should be encouraged to utilize available health services.