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Uterine Rupture: A Seven Year Review at a Tertiary Care Hospital in New Delhi, India

OBJECTIVE: To identify the obstetric risk factors, incidence, and causes of uterine rupture, management modalities, and the associated maternal and perinatal morbidity and mortality in one of the largest tertiary level women care hospital in Delhi. MATERIALS AND METHODS: A 7-year retrospective analy...

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Autores principales: Sinha, Maruti, Gupta, Ridhima, Gupta, Pushpender, Rani, Rekha, Kaur, Ramanjeet, Singh, Rahil
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Medknow Publications & Media Pvt Ltd 2016
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4746953/
https://www.ncbi.nlm.nih.gov/pubmed/26917873
http://dx.doi.org/10.4103/0970-0218.170966
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author Sinha, Maruti
Gupta, Ridhima
Gupta, Pushpender
Rani, Rekha
Kaur, Ramanjeet
Singh, Rahil
author_facet Sinha, Maruti
Gupta, Ridhima
Gupta, Pushpender
Rani, Rekha
Kaur, Ramanjeet
Singh, Rahil
author_sort Sinha, Maruti
collection PubMed
description OBJECTIVE: To identify the obstetric risk factors, incidence, and causes of uterine rupture, management modalities, and the associated maternal and perinatal morbidity and mortality in one of the largest tertiary level women care hospital in Delhi. MATERIALS AND METHODS: A 7-year retrospective analysis of 47 cases of uterine rupture was done. The charts of these patients were analyzed and the data regarding demographic characteristics, clinical presentation, risk factors, management, operative findings, maternal and fetal outcomes, and postoperative complications was studied. RESULTS: The incidence of rupture was one in 1,633 deliveries (0.061%). The vast majority of patients had prior low transverse cesarean section (84.8%). The clinical presentation of the patients with rupture of the unscarred uterus was more dramatic with extensive tears compared to rupture with scarred uterus. The estimated blood loss ranged from 1,200 to 1,500 cc. Hemoperitoneum was identified in 95.7% of the patient and 83% of the patient underwent repair of rent with or without simultaneous tubal ligation. Subtotal hysterectomy was performed in five cases. There were no maternal deaths in our series. However, there were 32 cases of intrauterine fetal demise and five cases of stillbirths. CONCLUSIONS: Uterine rupture is a major contributor to maternal morbidity and neonatal mortality. Four major easily identifiable risk factors including history of prior cesarean section, grand multiparity, obstructed labor, and fetal malpresentations constitute 90% of cases of uterine rupture. Identification of these high risk women, prompt diagnosis, immediate transfer, and optimal management needs to be overemphasized to avoid adverse fetomaternal complications.
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spelling pubmed-47469532016-02-25 Uterine Rupture: A Seven Year Review at a Tertiary Care Hospital in New Delhi, India Sinha, Maruti Gupta, Ridhima Gupta, Pushpender Rani, Rekha Kaur, Ramanjeet Singh, Rahil Indian J Community Med Original Article OBJECTIVE: To identify the obstetric risk factors, incidence, and causes of uterine rupture, management modalities, and the associated maternal and perinatal morbidity and mortality in one of the largest tertiary level women care hospital in Delhi. MATERIALS AND METHODS: A 7-year retrospective analysis of 47 cases of uterine rupture was done. The charts of these patients were analyzed and the data regarding demographic characteristics, clinical presentation, risk factors, management, operative findings, maternal and fetal outcomes, and postoperative complications was studied. RESULTS: The incidence of rupture was one in 1,633 deliveries (0.061%). The vast majority of patients had prior low transverse cesarean section (84.8%). The clinical presentation of the patients with rupture of the unscarred uterus was more dramatic with extensive tears compared to rupture with scarred uterus. The estimated blood loss ranged from 1,200 to 1,500 cc. Hemoperitoneum was identified in 95.7% of the patient and 83% of the patient underwent repair of rent with or without simultaneous tubal ligation. Subtotal hysterectomy was performed in five cases. There were no maternal deaths in our series. However, there were 32 cases of intrauterine fetal demise and five cases of stillbirths. CONCLUSIONS: Uterine rupture is a major contributor to maternal morbidity and neonatal mortality. Four major easily identifiable risk factors including history of prior cesarean section, grand multiparity, obstructed labor, and fetal malpresentations constitute 90% of cases of uterine rupture. Identification of these high risk women, prompt diagnosis, immediate transfer, and optimal management needs to be overemphasized to avoid adverse fetomaternal complications. Medknow Publications & Media Pvt Ltd 2016 /pmc/articles/PMC4746953/ /pubmed/26917873 http://dx.doi.org/10.4103/0970-0218.170966 Text en Copyright: © 2016 Indian Journal of Community Medicine http://creativecommons.org/licenses/by-nc-sa/3.0 This is an open access article distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 3.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as the author is credited and the new creations are licensed under the identical terms.
spellingShingle Original Article
Sinha, Maruti
Gupta, Ridhima
Gupta, Pushpender
Rani, Rekha
Kaur, Ramanjeet
Singh, Rahil
Uterine Rupture: A Seven Year Review at a Tertiary Care Hospital in New Delhi, India
title Uterine Rupture: A Seven Year Review at a Tertiary Care Hospital in New Delhi, India
title_full Uterine Rupture: A Seven Year Review at a Tertiary Care Hospital in New Delhi, India
title_fullStr Uterine Rupture: A Seven Year Review at a Tertiary Care Hospital in New Delhi, India
title_full_unstemmed Uterine Rupture: A Seven Year Review at a Tertiary Care Hospital in New Delhi, India
title_short Uterine Rupture: A Seven Year Review at a Tertiary Care Hospital in New Delhi, India
title_sort uterine rupture: a seven year review at a tertiary care hospital in new delhi, india
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4746953/
https://www.ncbi.nlm.nih.gov/pubmed/26917873
http://dx.doi.org/10.4103/0970-0218.170966
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