Ruptured Uterus at Abubakar Tafawa Balewa University Teaching Hospital, Bauchi, Nigeria: A 2 Year Review
Background: Rupture of the gravid uterus represents one of the major obstetric emergencies that significantly affect both mother and fetus. It contributes significantly to the high maternal and perinatal morbidities and mortalities in Sub- Saharan Africa.
Method: A retrospective study of pregnant women with ruptured uterus managed at the department of Obstetrics and Gynaecology of Abubakar Tafawa Balewa University st st Teaching Hospital, Bauchi, Nigeria from 1 January2013 to 31 December 2014. Information on the booking status, age, parity, place of intrapartum care, aetiology, maternal and perinatal morbidity and mortality, and other relevant information were extracted and analyzed.
Results: The total number of deliveries was 6,738 and those with ruptured uterus were 54, giving a ratio of 1 in 125 deliveries. Prolonged obstructed labour was the commonest aetiologic factor identified (52.1%). Other factors were grandmultiparity, previous caesarian sections, trauma, abnormal lie and injudicious use of oxytocin. Twelve of the patients (25.0%) had repair of the ruptured uterus alone, 29(60.4%) had repair with bilateral tubal ligation. One patient had total abdominal hysterectomy while 6(12.5%) had subtotal hysterectomies. There were a total of 2 maternal deaths with a case fatality rate of 4.2%. Four (8.3%) babies survived.
Conclusion: The incidence of ruptured uterus in Bauchi was high in this study. The identified risk factors included majorly prolonged obstructed labour, the injudious use of oxytocics and also previous caesarean sections.