Uterine Rupture at Federal Teaching Hospital, Katsina: A Five Year Review

Abstract

Background: Uterine rupture, despite being one of the most devastating obstetric complication associated with significant maternal and perinatal morbidities and mortality, is still prevalent in developing countries. Objectives: To determine the prevalence, aetiologic risk and other contributing factors, complications as well as outcome of Obstetric Uterine rupture at Federal Teaching Hospital, Katsina. Study Design: A Five year retrospective study that reviewed uterine rupture in Obstetrics and Gynaecology department of Federal Teaching Hospital, Katsina from 1st January 2010 to December 31st 2014. Results: There were 42 uterine ruptures out of 9995 deliveries, with an incidence of 4.2 per 1000 deliveries. The mean age of the patients was 31yrs± 0.9. The highest incidence was among unbooked patients (85%). The diagnosis was made pre-operatively in 88.1% of the cases. Major risk factors were prolonged obstructed labour (26.2%), previous caesarean section scar (19%) and Oxytocin infusion in unscarred (14.3%) and scarred Uteri (11.9%) as well as use of Misoprostol (11.9%). Majority of the ruptures occurred anteriorly (52.4%) while scar dehiscence accounted for 23.8% of cases. Repair with bilateral tubal ligation was the most frequent mode of treatment (47.6%), while hysterectomy was done for patients with extensive ruptures (34.3%). The commonest complication was postoperative Anaemia (38.1%). There were two maternal deaths, with a case fatality rate of 4.8%, while the perinatal mortality was 78.6%. Conclusion: Uterine rupture is still a major cause of maternal and perinatal morbidities and mortality in our setting. Antenatal care with skilled facility-based deliveries will reduce its incidence and associated complications.