Rupture of previously scarred uterus

Abstract

Objective: To determine causative factors, find out associated maternal and faetal morbidity and mortality and to discuss preventive measures. Design: A prospective study. Place and duration of study: Department of Obs. And Gynae, Lahore General Hospital, (PGMI). Lahore for a period of four years, Jan. 2002 to Dec. 2003.Subject and methods: This study was conducted on sixty patients, with rupture of previously scarred uterus. Results: Total number of deliveries during these four years was 15,628. Rupture of uterus occurred in 0.47% cases (1: 214). Out of these rupture of previously scarred uterus accured in 82% cases. Most of the patients were between ages 21 - 30 years unbooked illiterate, belonged to poor class. 83% caesarean sections had been done in some peripheral non teaching hospitals. 13% patients had no labour pains at time of admission. The maternal mortality in this study was 3.33% and fetal mortality was 60%. Conclusion: First caesarean section should only be done if genuinely indicated, by some skilled obstetrician, in well equipped hospital. Patients with scarred uterus should be educated to have regular antenatal checkup and hospital delivery in next pregnancy.