el Mansouri A
Service de Gynécologie-Obstétrique Hôpital Bawafi, Casablanca, Maroc.
Rev Fr Gynecol Obstet. 1995 Apr-May;90(4):208-14.
The author reports 50 cases of rupture of the uterus among 11,060 labors i.e. one rupture per 220 labors. This study shows that rupture of the uterus occurs in women in poor socio-economic circumstances. Uterine scarring seems to be a more important factor than age and multiparity. Traumatic rupture is also common, resulting from obstetric procedures but above all from abdominal expression, most often performed outside hospital. Rupture of the uterus may present in many different ways. It was diagnosed in 32 cases before delivery while in 18 cases it was discovered during cesarean section or extraction of retained placenta. The lower segment was the elective site of rupture. With regard to treatment, suture was possible in 42 cases while hysterectomy proved necessary in the other 8 cases in view of the poor local tissue state. The prognosis remains gloomy, with a high risk of maternal death and, above all, a 58% fetal death rate.
