Department of Obstetrics and Gynaecology, Pt. B. D. Sharma Post Graduate Institute of Medical Sciences, 1109/16, Opposite Model School, Delhi Road, Rohtak, 124001 Haryana, India.
Arch Gynecol Obstet. 2011 Mar;283(3):437-41. doi: 10.1007/s00404-010-1357-9. Epub 2010 Jan 28.
Uterine rupture during pregnancy is a rare occurrence that frequently results in high incidence of maternal and fetal morbidity and mortality.
To study the incidence, risk factors, maternal and fetal outcome of uterine rupture.
A retrospective study.
A retrospective study was carried out in the Department of Obstetrics and Gynecology in a tertiary health care center. The cases of uterine rupture whether booked or unbooked that were received and managed in the hospital over a period of 5 years from January 2002 to December 2006, were included in the study.
The total number of uterine rupture cases was 57 out of 33,394 deliveries. The incidence of uterine rupture was 0.17%. Majority of the patients belonged to age group 30-34 years and were multiparas. Most of the cases were due to obstructed and neglected labor (52.63%), 35.08% due to scar rupture and 8.77% were due to uterine trauma. The bladder injuries were found in 8.77%. Repair of the uterine rent was possible in 70.18% (40/57) cases. Hysterectomy was done in 29.82% cases. Stillbirths were observed in 94.74% of women with uterine rupture. There was no maternal mortality.
The leading cause of uterine rupture was found to be neglected and obstructed labor due to mismanagement by local untrained birth attendants. Timely recognition and referral to higher centers can reduce the maternal and fetal morbidity and mortality due to uterine rupture.
妊娠时子宫破裂是一种罕见的情况，常导致产妇和胎儿发病率和死亡率升高。
研究子宫破裂的发生率、危险因素、母婴结局。
回顾性研究。
在一家三级保健中心的妇产科进行了一项回顾性研究。该研究纳入了 2002 年 1 月至 2006 年 12 月期间在该院接受和治疗的 5 年内的所有经产妇或初产妇的子宫破裂病例。
33394 例分娩中共有 57 例子宫破裂。子宫破裂的发生率为 0.17%。大多数患者年龄在 30-34 岁之间，为多产妇。大多数病例是由于梗阻性难产和被忽视的产程（52.63%）、35.08%是由于疤痕破裂，8.77%是由于子宫创伤。8.77%的患者出现膀胱损伤。70.18%（40/57）的患者可以修复子宫裂口。29.82%的患者行子宫切除术。子宫破裂的产妇中有 94.74%发生死胎。无产妇死亡。
导致子宫破裂的主要原因是当地未经培训的接生员管理不当导致的忽视性和梗阻性难产。及时识别和转诊到更高水平的中心可以降低因子宫破裂导致的母婴发病率和死亡率。
