4. STUDY OF RISK FACTORS & MANAGEMENT IN CASES OF RUPTURED UTERUS

Heena Rajput, Hafsa Vohra, Nilesh A. Shah

ABSTRACT

Background: Rupture of the uterus is a dire emergency where the life of the mother& fetus is in danger. Incidence varies by institution depending on the level of obstetric care. This study aims to help in identifying the high risk pregnancies and planning preventive methods. Objective: To evaluate the risk factors associated with type and site of rupture uterus, different modes of management, maternal and fetal outcome and to study risk factors for implementation of preventive strategies. Method: A prospective study for one year was done to describe the frequency, causes, treatment, complications, and maternal & fetal mortality associated with ruptured uterus. Results: A total of 15 cases of ruptured uterus were observed over the one year span at our Institute, Civil Hospital, Ahmadabad, Gujarat. Most of the women with rupture uterus were in the age group of 20-25years (46.6%) and it was commonest in para 2 (66.6%). The most common etiology of rupture uterus was rupture of previous caesarean scar (66.6%). In majority of the cases, lower uterine segment was affected. There were no maternal deaths, but fetal demise seen in every case. Conclusion: Leading cause of rupture uterus is changing from obstructed labor to caesarean section scar rupture, but recent advance in obstetrics, availability of broad spectrum antibiotics, advances in anesthesia and availability of blood transfusion have given major surgical procedures a great degree of safety, hence reduced maternal mortality in cases with a rupture uterus to a considerable extent. So extra efforts to educate women about institutional delivery, especially after caesarean section should be considered.

Key Words : Previous LSCS, Rupture Uterus, Hysterectomy.

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