Decision-intervention interval in ruptured uteri in Ile-Ife, Nigeria

Abstract

Objective: To determine the decision-intervention interval in ruptured uterus with a view of overhauling the management strategy thereby improving the maternal and perinatal outcome. Design: Cross-sectional survey based on secondary data done between 1990-1999. Setting: Obafemi Awolowo University Teaching Hospital Complex, Ile-Ife, Nigeria. Subjects: One hundred and two consecutive women who had uterine rupture. Results: The decision-surgical intervention interval ranged from 30 minutes to 4.5 hours. The major reason for delay was unavailability of compatible blood (88.2%), followed by lack of electricity (4.9%), unsterile instruments (3.9%), waiting for ambulance to get senior obstetricians (2.9%), delay in arrival of anaesthetist (1.9%) and neonatologists (1.9%). The peri-natal mortality rate (PNMR) was 843 per 1000 total births and maternal mortality rate (MMR) 4902 per 100,000 births. Conclusion: The maternal and perinatal outcome in uterine rupture would be improved by early diagnosis and avoidance of preoperative delay through availability of essential obstetric services.