A review of 126 cases of ruptured gravid uterus.

Ruptured uterus is a grave obstetric complication, associated with high maternal mortality and morbidity, perinatal mortality and loss of future fertility as hysterectomy is inevitable in many cases. This study reviews the incidence, causes and other factors, to define problem areas and propose preventive measures. During 1979-1988, 126 cases of ruptured uterus occurred in 46,207 deliveries; these 126 cases were retrospectively analyzed in relation to causes, age, parity, maternal mortality and morbidity, perinatal mortality and management. Some of the results were compared with other authors. The incidence was 1/367 (2.7/1000 deliveries), traumatic rupture accounted for 42.86% while spontaneous rupture accounted for 57.14%. Maternal mortality was 21.43% and the perinatal mortality was 73.19%. Supravaginal hysterectomy, repair with sterilization and repair without sterilization were the selected lines of management. Proper quick diagnosis and prompt management will reduce maternal mortality and morbidity. Finally, recommendations to reduce the occurrence of this problem are proposed.