Ola E R, Olamijulo J A
Dept of Obstetrics & Gynaecology, College of Medicine University of Lagos, Idiaraba.
West Afr J Med. 1998 Jul-Sep;17(3):188-93.
Rupture of the gravid uterus remains one of the most disastrous complications of labour. Eighty cases of uterine rupture managed at Lagos University Teaching Hospital, Lagos over an eight year period were therefore reviewed to evaluate the characteristic of ruptured uterus in Lagos. The incidence of ruptured uterus was 5.01 per 1000 deliveries and unbooked patients accounted for 80%. Spontaneous rupture occurred in 73.8% while traumatic rupture was responsible for 26.3%. Diagnosis was not made in 25% of the cases until surgery. Poor antenatal care, foeto-pelvic disproportion, previous Caesarean section scar, grand-multiparity were major aetiological factors. Repair of the rupture with or without sterilization was carried out in 70% of the cases. Booking status and the type of surgical procedure did not significantly affect the maternal outcome. Ruptured uterus was responsible for 16.9% of the total maternal deaths in the period of review. The commonest cause of death in this series was hypovolaemic shock (64.3%). The overall perinatal mortality was 86.3% but the registered patients fared better. It was concluded that the incidence of ruptured uterus is still very high and probably on the increase in Lagos. Suggestions are made to improve the situation since the identified aetiological factors are largely preventable.
妊娠子宫破裂仍然是分娩最严重的并发症之一。因此，回顾了拉各斯大学教学医院在八年期间处理的80例子宫破裂病例，以评估拉各斯子宫破裂的特点。子宫破裂的发生率为每1000例分娩中有5.01例，未登记的患者占80%。73.8%为自发性破裂，26.3%为创伤性破裂。25%的病例直到手术时才确诊。产前护理差、胎儿骨盆比例失调、既往剖宫产瘢痕、多产是主要病因。70%的病例进行了破裂修补术，有或没有绝育。登记状态和手术方式对产妇结局没有显著影响。在所审查期间，子宫破裂占孕产妇死亡总数的16.9%。本系列中最常见的死亡原因是低血容量性休克（64.3%）。围产儿总死亡率为86.3%，但登记患者的情况较好。结论是，在拉各斯，子宫破裂的发生率仍然很高，而且可能在上升。鉴于已确定的病因在很大程度上是可以预防的，因此提出了改善这种情况的建议。
