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Study Papers | Obstetrics and Gynecology | India | Volume 13 Issue 3, March 2024 | Popularity: 5.6 / 10

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A Study on Spontaneous Vs Iatrogenic Causes of Uterine Rupture in a Tertiary Care Centre in Eastern India: An Observational Study

Dr. Shreeja Singh, Dr. Ankit Kumar

Abstract: Background and Aim: Uterine rupture is defined as a disruption in the continuity of all the uterine layers (endometrium, myometrium, and serosa) any time beyond 28 weeks of pregnancy. The aim of this study was to evaluate the incidence of rupture uterus, as per age, cause, parity, clinical presentations, risk factors, complications, and management. Methods: This study was conducted over a period from August 2018 to July 2019, in the Department of Gynaecology and Obstetrics, Darbhanga Medical College and Hospital, DMCH, Darbhanga. All cases of uterine rupture, who were either admitted with or who developed this complication in the hospital, were included in the study. Diagnosis was made on history and examination and was confirmed on laparotomy. Data collected in excel sheet. Continuous variables were expressed as Mean (SD) and ranges. Categorical variables were expressed as numbers and percentage. Non normally distributed variables are expressed as mean (SD) and Mann Whitney U test, Chi square test and fisher exact test were applied whereas applicable. Results: The present observation was made on 50 cases of rupture uterus admitted in the department of obstetrics and gynaecology in Darbhanga Medical College and Hospital, DMCH, Darbhanga from August 2018 to July 2019. Result showed that incidence of rupture uterus is more in case of unbooked cases (98%) who has no previous antenatal checkups, more in rural population (92%), ANOVA analysis showed that incidence was higher in parity order 3 or more, parametric tests (student t test) was used to make comparisons in between the cause of rupture uterus with highest incidence seen in spontaneous cases, most frequent site of rupture was in the anterior wall of lower segment, results showed that most cases were managed by hysterectomy, post operative complications were higher in unbooked, spontaneous cases, need for blood transfusion, incidence of overall maternal mortality 4% (paired t test 453.879, p=<0.001). Conclusion: We concluded that Lack of antenatal care, inappropriate counselling of patients with history of previous caesarean section for hospital delivery, delivery by unskilled birth attendant, misuse of oxytocin and delay in seeking management were the main cause of uterine rupture in this study.

Keywords: uterine rupture, scarred uterus, unscarred uterus, fetomaternal

Edition: Volume 13 Issue 3, March 2024

Pages: 1059 - 1062

DOI: https://www.doi.org/10.21275/SR24316083244

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