Rupture of pregnant uterus in Shashemene General Hospital, south Shoa, Ethiopia (a three year study of 57 cases).

This study was carried out to determine the frequency of occurrence and outcome of treatment of uterine rupture in a rural hospital. Fifty seven patients with uterine rupture were admitted to Shashemene General Hospital (SGH) from September 1989 to August 1992. The age, parity, type of operation, outcome of treatment, site of rupture, post operative complications and duration of hospitalization of these cases were analyzed. Two thousand one hundred eighty five deliveries were conducted over the study period. The frequency of occurrence of uterine rupture was 2.6% or 1 in 38 deliveries. There were 9 deaths giving a case fatality rate of 15.8%. The mean duration of hospitalization among those who survived was 13 days (Range: 6 hours to 20 days). Fifty four (94.7%) of the cases were para 3 and above. Left lateral wall rupture was found in 28 (49%) of the cases. The commonest causes of rupture were neglected shoulder presentation (63.2%), brow and face presentations (29.8%). The age of the patients ranged from 16 to 59 years, with a peak incidence (42 (73.7%)) occurring between 25 and 34 years. Three patients had repair operation and fifty four had hysterectomy. The antibiotics used for treatment of associated infections were crystalline penicillin, ampicillin and chloramphenicol since other drugs were not available.