OG2_OA_K P Ranjan

Background: Uterine rupture in pregnancy is a deadly obstetrical emergency endangering the life of both mother and fetus. Methods: The present prospective study was conducted to analyse the various types of rupture uterus, changing trends of uterine rupture and surgical management along with maternal morbidity, mortality and perinatal outcome in these cases. Results: In this study, total cases were 42,205 of deliveries and 179 cases of rupture uterus giving incidence as 0.42 % that is 1 per deliveries. Complete uterine rupture are mush common i.e. (77.71 %) than incomplete rupture. Postnatal rupture was found in 11 cases. Uterine / scar repair was done in 53.11 % while obstetric hysterectomy was done in 46.89 % of cases. Most common additional surgical procedure was repair of rupture bladder i.e. 13 cases. Cervical / vaginal / perennial tear repair was performed in cases of rupture uterus from obstructed labour. A total 13 mortality occurred in cases of rupture uterus. Most common cause of maternal mortality is haemorrhagic shock, accounting for 61.23% of total maternal mortality. Majority of babies i.e. 71.9 % were still born and only 21.2 % were born alive and healthy. Neonatal death occurred in 6.7 % of cases. Fetal mortality in cases of uterine rupture is very high. Conclusion: It is concluded that due to changing obstetric practices and with liberalization of practices of caesarean section, the incidence of scar rupture is on a rise and will further increase in near future therefore pregnant woman with previous scar should be given trial after proper risk assessment and only in set up where 24 hrs emergency services for caesarean section.