Uterine Rupture in Third Trimester of Pregnancy in a Tertiary Centre: A Descriptive Observational Study

Document Type : Original Article

Authors

1 Department of Obstetrics and Gynecology, Cairo University, Alsaraya street, Kasr AlAiny, Cairo Egypt

2 Department of Obstetrics and Gynecology, Cairo University, Alsaraya street, Al Kasr Al Ainy, Cairo Egypt

Abstract

Background: Uterine rupture is a rare but serious obstetric complication that can have an adverse impact on the mother and the fetus.
Methods: This is a cross-sectional study conducted in a tertiary care centre over a one-year period, including all cases with uterine rupture occurring at or after 28 weeks of gestation. We collected demographic data, possible causes, diagnosis, management and feto-maternal outcome.
Results: We had 48 cases of uterine rupture in the study period; 42 cases with a scarred uterus, most commonly cesarean section (CS), and 6 cases with unscarred uterus most commonly due to labour-related causes. Adverse outcome included blood transfusion (n=25), hematoma formation (n=6) bladder injury (n=4) and one mortality. The perinatal death rate was 37.8%. Surgical repair of the uterus was possible in 79.2% of the cases. Those with unscarred uteri had significantly more bleeding and hematoma formation with more risk for blood transfusion than those with scarred uteri. No statistically significant differences in the rate of hysterectomy, bladder injury or perinatal death rate between both groups.
Conclusion: In our population, CS represents the most common cause of uterine rupture followed by labour- related causes. Uterine rupture in an unscarred uterus is associated with more bleeding, hematoma formation and more risk for blood transfusion than scarred uterus group. Surgical repair is possible in most cases. Reducing the rate of CS, optimizing care for women with previous CS and careful management of labour can help to reduce the incidence of uterine rupture.

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