Ruptured Uterus At Afikpo, Southeast Nigeria.
Context: Ruptured uterus is an obstetric catastrophe associated with high maternal and perinatal mortality. Objectives: To determine the incidence, causes, management and fetomaternal outcomes of ruptured uterus in Afikpo, Southeast Nigeria. Methods: Delivery records, theatre registers and case notes of all ruptured uterus seen at Mater Hospital Afikpo, between January 2001 and December 2007 were analyzed. Results: Fifty one cases (1.2%) of ruptured uterus occurred out of 4,361 deliveries, giving an incidence ratio of 1:86. Mothers aged 30-34 years, multiparous and un-booked were worse affected. Multiple predisposing factors were noted with obstructed labour, mismanagement, grand multiparity and previous caesarean scars recorded in decreasing order. Uterine repair alone was performed in 88.2% of cases. Maternal mortality was 5.9% and perinatal mortality 84.6%. The incidence appears to be rising. Conclusion: Provision of quality antenatal care and emergency obstetric care in secondary hospitals, and supervision of Traditional Birth Attendants will reduce this menace.
Keywords:Antenatal, Care, emergency, maternal, perinatal, quality.
Ebonyi Medical Journal Vol. 7 (1&2) 2008: pp. 36-41