EC Gynaecology

Background: Uterine rupture is an Obstetric emergency that contributes significantly to maternal mortality and morbidity, as well as perinatal mortality. Uterine rupture is a serious obstetric complication, where the uterus tears. Most often during pregnancy, labor or immediately after delivery, with associated severe hemorrhage. It is commoner in low-resource countries like Nigeria, with incidence ranging from 0.3% - 1.2% (1 in 333 to 1 in 83 deliveries) compared to developed countries (1 in 5,000 to 7,000 deliveries).

Objective: The aim of this study is to highlight the risk factors and predisposing factors of uterine rupture, in order to increase awareness and then reduce the incidence of uterine rupture.

Materials/Method: This was a retrospective study of patients with uterine rupture at the Rivers State University Teaching Hospital within a 5-year period, January 2020 to December 2024. The folders of patients were retrieved from the medical records department of the hospital. With the help of a pre-designed proforma, relevant data were collected from the patient’s folders. Data were analyzed using IBM SPSS (Statistical Product and service solution) version 26 for Windows^®.

Result: A total of 5,779 deliveries took place within the study period. Of these, 34 patients had uterine rupture. The prevalence of uterine rupture from this study was 0.59%. There were 4 maternal deaths out of the 34 cases reviewed, giving a case fatality rate of 11.8%. Perinatal mortality was 94.1%. The identified major risk factors and predisposing factors for uterine rupture were: unbooked status, 22 (64.7%), injudicious use of uterotonic drugs in labor, 21 (61.8%), previous uterine scar, 20 (58.8%) and management of labour by unskilled attendants (especially in the presence of a previous scar).The lax abdomen and lax uterus in grand multiparous women also predisposes them to ruptured uterus especially with injudicious use of oxytocics.

Conclusion: Increased awareness of these risk factors, and necessary pro-active measures taken to prevent these risk factors, will eventually reduce the incidence of uterine rupture of our women.

 Keywords: Uterine Rupture; Uterine Scar; Uterotonic; Unbooked Status

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