Risk Factors Associated With Uterine Rupture

Objective: To ascertain the risk factors associated with uterine rupture. Methodology: This study was carried out at the Department of Obstetrics & Gynaecology, Jinnah Hospital, Lahore from 1st March 2008 to 30th August 2008. A total of 60 patients were recruited for the study. 30 presented with uterine rupture and 30 age-matched parturient women who did not have uterine rupture were selected. Demographic data, socioeconomic status, details regarding the most probable predisposing factor, type of rupture, management, maternal and fetal outcome was recorded. Results: In the current study, mean age of patients was 28.23 +/- 6.3 and 29.00 +/- 4.7 in cases and controls, respectively. Previous history of caesarean section was found to be significantly higher in cases than controls (odds ratio= 5.68). Previous history of myomectomy was also found to be significantly higher in cases than controls (odds ratio= 10.5). Injudicious use of oxytocin was significantly increased in cases as compared to controls (odds ratio= 33.1) and a prolonged period of obstructed labour was also found to be a significant factor for uterine rupture (odds ratio= 3.22). Conclusion: The findings of this study show that uterine rupture though uncommon, is a life threatening condition for both the mother and fetus. Among the various risk factors, previous caesarian section is the most common risk factor, followed by injudicious use of oxytocin. Previous history of myomectomy and obstructed labour are also significant risk factors. So all labours should be carried out under supervision of a trained obstetrician with ready access to well equipped theatre facilities for caesarian section, should the need arise.