Uterine rupture - the current scenario in the south Assam
Objective: To find out the incidence of complete uterine rupture in Silchar Medical College and to evaluate its causes and the assessment of maternal and perinatal outcome. Methodology: All the patients diagnosed and treated as a case of rupture uterus from June 2014 to May 2015 in the department of Obstetrics and Gynaecology in Silchar Medical College and Hospital were taken. Information of cases under study was arranged in a systematic manner in MS- Excel sheet. Appropriate statistical analysis was carried out using SPSS software. Result: There were a total of 37 cases of uterine rupture, giving an incidence of 1 in 267 (0.37%). The majority of the cases were unbooked (75.65%). Nineteen (51.35%) ruptured occurred in unscarred uterus and 18 (48.64%) occurred in scarred uterus. In unscarred uterus majority 68.42% ruptured is due to malpresentation leading to obstructed labour. Spontaneous ruptures were more in 4th gravid and above (41.17%). Rent repair with or without tubal ligation was possible in 61.25% of scar rupture, 29.4% of unscarred uterine ruptures. The need of subtotal hysterectomy was higher in unscarred uterine rupture (64.70%). Bladder injury occurred in 3 cases where repair was done. Out of the 3 cases, 2 developed VVF and one recovered. There were 2 (5.40%) maternal death. Out of 37 cases 75.67% were IUD and 16.21% were live births. There was 100% IUD in rupture of unscarred uterus. Conclusion: The timely decision to do caesarean in cases of previous scar uterus and obstructed labour can reduce the rupture rates.