Zeteroglu S, Ustun Y, Engin-Ustun Y, Sahin H G, Kamaci M
Department of Obstetrics and Gynaecology, Faculty of Medicine, Yüzüncü Yil University, Van Turkey.
J Obstet Gynaecol. 2005 Jul;25(5):458-61. doi: 10.1080/01443610500160238.
Ruptured uterus is a serious obstetric emergency with a high maternal and perinatal mortality. It is a preventable and common obstetric problem in developing countries. The objective of this study was to review the incidence, methods of diagnosis and maternal and perinatal morbidity and mortality associated with uterine rupture. Case notes were reviewed for all patients with a ruptured uterus at Yüzüncü Yil University Medical Faculty Department of Obstetrics and Gynaecology from January 1995 to August 2003. Relevant data relating to the clinical characteristics of labour, operative procedures, maternal and perinatal outcome were assessed. There were 20 cases of ruptured uteri. The incidence was 0.40%. When patients referred from other hospitals were excluded, the revised ratio was 0.12%. There were 13 (65%) complete and seven (35%) incomplete ruptures. Nine (45%) cases occurred in patients with scarred uteri. Ten (50%) cases were grand multiparous. Subtotal abdominal hysterectomy was performed in five (25%) cases, total abdominal hysterectomy was performed in two (10%) cases and the remaining 13 (65%) cases had uterine rupture repair. There were two (10%) maternal deaths. Both of them were referred from other hospitals. There were seven (35%) perinatal deaths attributable to uterine rupture. Occurrence of uterine rupture is significantly associated with grand multiparity, scarred uterus, lack of antenatal care, unsupervised labour at home and low socioeconomic status of the patients. These factors are largely preventable.
子宫破裂是一种严重的产科急症，孕产妇和围产儿死亡率很高。在发展中国家，这是一个可预防的常见产科问题。本研究的目的是回顾子宫破裂的发生率、诊断方法以及与之相关的孕产妇和围产儿发病率及死亡率。对1995年1月至2003年8月在尤祖恩居勒大学医学院妇产科诊断为子宫破裂的所有患者的病历进行了回顾。评估了与分娩临床特征、手术操作、孕产妇和围产儿结局相关的资料。共有20例子宫破裂病例。发生率为0.40%。排除从其他医院转诊的患者后，校正后的比例为0.12%。其中13例（65%）为完全性破裂，7例（35%）为不完全性破裂。9例（45%）发生于有子宫瘢痕的患者。10例（50%）为经产妇。5例（25%）行次全子宫切除术，2例（10%）行全子宫切除术，其余13例（65%）行子宫破裂修补术。有2例（10%）孕产妇死亡。均为从其他医院转诊而来。有7例（35%）围产儿死亡归因于子宫破裂。子宫破裂的发生与经产妇、子宫瘢痕、缺乏产前检查、在家中无人监管的分娩以及患者社会经济地位低下显著相关。这些因素大多是可以预防的。
