Hussein AI, Omar AA, Hassan HA, Kassim MM, Yusuf AA, Osman AA. California Privacy Statement, 2005;112:12218. She remained at the Department of Obstetrics and Gynecology for 5 more days and her hemoglobin level on discharge was 8.1g/dL. In a study of 32 080 deliveries in JIPMER (India), 93 (0.28%) women had a ruptured uterus. https://doi.org/10.1186/s13104-016-2295-9, DOI: https://doi.org/10.1186/s13104-016-2295-9. Tayade S, Chadha A, Khandelwal S, Makhija N, Tilva H, Madaan S. Cureus. This study would identify determinant factors of uterine rupture and its management outcomes among mothers who gave birth in public hospitals in Tigrai region, North Ethiopia. 161202. Despite strengthening the health care system and providing basic and comprehensive emergency obstetric care closer to the communities, uterine rupture continues to produce devastating maternal and fetal outcomes. Terms and Conditions, To attain this objective, use of misoprostol in primary health facilities should be stopped or proper management of the medication instituted. -, Syed S, Noreen H, Kahloon LE, Chaudhri R. Uterine rupture associated with the use of intra-vaginal misoprostol during second-trimester pregnancy termination. 15, no. The second is the myometrium (smooth muscle layer). T. L. Dadi and T. E. Yarinbab, Estimates of uterine rupture bad outcomes using propensity score and determinants of uterine rupture in Mizan-Tepi University teaching hospital: case control study, Journal of pregnancy, vol. If a uterine rupture causes major blood loss, surgeons may need to remove a woman's uterus to control her bleeding. doi: 10.1016/S0140-6736(88)92892-9. Similar to this study, referred mothers from remote health institutions were associated with uterine rupture in Arbaminch (Southern Ethiopia), Mbarara, Uganda, and Debre Markos, Ethiopia [7, 13, 16]. MeSH terms Adult Blood Transfusion Female Fetal Death / etiology Fluid Therapy Humans Incidence Obstetric Labor Complications / epidemiology* Obstetric Labor Complications / therapy* Pregnancy Stillbirth Uterine Rupture / diagnosis Article Springer; 2014. pp. Mrs. MM aged 25years, G3P2012, of the Bamileke tribe in Cameroon was admitted to our Department in hypovolemic shock BP=70/40mmHg, pulse 120 beats per minute with altered consciousness (Glasgow Coma Score=13). Patients who developed their first incident of uterine rupture were identified. Thirteen (9.6%) mothers with uterine rupture died secondary to different immediate causes. This paper reports uterine rupture with severe hypovolemic shock managed at the Douala General Hospital, Cameroon. Screening tools consider the relative effect of multiple factors to predict an individuals likelihood of vaginal delivery [3]. Copyright 2020 Meresa Berwo Mengesha et al. Total abdominal hysterectomy was done in 47 (34.8%) of the women, subtotal hysterectomy in 28 (20.74%), uterine repair with bilateral tubal ligation (BTL) in 26 (19.25%), and uterine repair without BTL in 34 (25.2%). Disclaimer, National Library of Medicine The proportion of mothers who did not engage in antenatal care in the cases and controls was 22 (16.3%) and 13 (4.8%), respectively. How Long is the Safest InterDelivery Interval in Women with Previous History of Cesarean Delivery? 17, no. PubMed There are 14 general hospitals and two referral hospitals in Tigrai. More than half (59.3%) of the cases had obstructed labor. This occurs when the uterus undergoes more strain than it is capable of sustaining during contractions and pregnancy. Having a care team that's prepared for emergencies can prevent these outcomes from happening. What is a uterine scar rupture? o [ pediatric abdominal pain ] Therefore, labor induction using a trans-cervical Foley catheter was not associated with an increased risk of uterine rupture [19]. A Case Report and Review of the Literature. Eur J Obstet Gynecol Reprod Biol. We want to hear from you. Our appreciation goes to Adigrat University for the financial support. government site. Int J Gynecol Obstet. Maternal death, stillbirth, hysterectomy, and hemorrhage were adverse outcomes. To browse Academia.edu and the wider internet faster and more securely, please take a few seconds toupgrade your browser. Article The goodness of fit of the model was checked by the Hosmer-Lemeshow test. . One hundred and eight (80%) and 67 (24.8%) of the mothers were referred from remote health facilities aligned with cases and controls, respectively (Table 1). An ovarian cyst is a fluid-filled sac that forms on or inside an ovary. 2002;16:6979. To attain this objective, use of misoprostol in primary health facilities should be stopped or proper management of the medication instituted. -. An early diagnosis of an interstitial pregnancy diagnosis is extremely important for timely management but challenging because of difficult ultrasound aspects. 2011;61:399401. Those whose birth weight of newborns was four and above kilograms were 5.68 times more likely to have uterine rupture than those who had newborns less than four kilograms (AOR 5.68; 95% CI: 1.39, 23.2) (Table 4). Management of uterine rupture: a case report and review of the literature. Use for phrases Adjusted odds ratios range from 2.5 to 3 for an increased rate of uterine rupture in the women with less time between deliveries. Mothers who had only one prenatal care visit were 2.85 times more likely to develop uterine rupture compared to those who had four visits or more antenatal care visits with AOR 2.85 (95% CI: 1.02, 7.94). 2022 Oct 6;15:551-556. doi: 10.2147/IMCRJ.S383195. Springer Nature. With the advent of misoprostol, a prostaglandin E1 analog is cheap and accessible to most health facilities in Cameroon and most countries in sub-Saharan Africa. Accessibility Uterine rupture was defined as tearing of the uterine wall either partially or completely during pregnancy and labor, diagnosed clinically and later confirmed at laparotomy by the attending physician. 495527. This site complies with the HONcode standard for trustworthy health information: verify here. Out of 135 mothers who develop uterine rupture, intraoperative findings found that 75 (55.5%) had a complete uterine rupture. Bujold E, Gauthier RJ. 2016 Sep-Oct;23(6):862. doi: 10.1016/j.jmig.2016.04.004. Among all demographic factors analyzed ethnicity has shown to have a significant impact on the outcome of trail. Ugeskr Laeger. Uterine prolapse is a relatively uncommon complication of parturition, occurring infrequently in cats and rarely in dogs. 279283, 2006. Does Misoprostol for Induction of Labor Increase the Risk of Uterine Rupture? Uterine rupture in the Netherlands: a nationwide population-based cohort study. -, Marret H, Simon E, Beucher G, Dreyfus M, Gaudineau A, Vayssire C, Lesavre M, Pluchon M, Winer N, Fernandez H, Aubert J. Overview and expert assessment of off-label use of misoprostol in obstetrics and gynaecology: review and report by the Collge national des gyncologues obsttriciens franais. Uterine rupture is a complication that can be eliminated under conditions of best obstetric practice. Sample size was calculated using Epi-info Version 7 based on the following assumptions: 95% level of confidence, 80% power, taking two to one ratio of controls to case (2:1). Then, finally, statistical significance was declared if value < 0.05. Rupture was defined as full thickness uterine wall defect with bleeding necessitating operative intervention. 14, no. Health care providers should encourage mothers to complete the recommended four visits as these contribute to full risk assessment and screening opportunities for the mom and the fetus. Forty-eight (11.9%) of the cases had postoperative hemoglobin value (HGB) of <7g per dl; 34 (8.4%) cases have HGB value of 7-11g/dl, and 53 (13.1%) cases have postoperative HGB value of >11g/dl. 2, pp. In the five years survey, there were 72000 deliveries without uterine rupture (control) and 194 cases in Adwa General Hospital (, ), Ayder Referral Hospital (, ), Suhul Shire General Hospital (, ), Lemlem Karl Hospital (, ), and Adigrat General Hospital (, ). The cases were obtained from the labor and delivery ward, operating theatre registers, and from the patients' case files retrospectively. Summary This chapter discusses the implications, diagnostic signs and management strategies for uterine rupture. 2, pp. Obstetrical complications like abdominal hysterectomy in 75 (55.6%) of mothers and excessive blood loss in 84 (57.8%) were additional untoward outcomes of uterine rupture. In the current study, 13 (9.6%) of the mothers with uterine rupture died secondary to different immediate causes, and among those who had uterine rupture, 101 (74.8%) of the newborns were stillbirths. You may need to take pain medicine. Syed S, Noreen H, Kahloon LE, Chaudhri R. Uterine rupture associated with the use of intra-vaginal misoprostol during second-trimester pregnancy termination. S. A. Alyu and T. B. Lema, Prevalence and associated factors of uterine rupture during labour among women who delivered in Debremarkos hospital, Internal Medicine, vol. Conservative management of infected postpartum uterine dehiscence after cesarean section. 24, pp. She underwent a total abdominal hysterectomy and blood transfusion. 6, no. Our patient was administered an unknown dosage of misoprostol that resulted in the rupture. B. Lindtjrn, D. Mitiku, Z. Zidda, and Y. Yaya, Reducing maternal deaths in Ethiopia: results of an intervention programme in southwest Ethiopia, PLoS One, vol. Marret H, Simon E, Beucher G, Dreyfus M, Gaudineau A, Vayssire C, Lesavre M, Pluchon M, Winer N, Fernandez H, Aubert J. Overview and expert assessment of off-label use of misoprostol in obstetrics and gynaecology: review and report by the Collge national des gyncologues obsttriciens franais. eCollection 2018 Jul. Horse owners and managers can help by assisting with dystocia or quickly seeking veterinary help, especially in older mares. Uterine vessel rupture can be a devastating occurrence and no prevention is known. Fetal condition contraindicating expectant management including chorioamnionitis, placental abruption, intrauterine fetal demise, non-reassuring fetal heart rate at the time of randomization; Cervical dilation > 5 cm; Iatrogenic rupture caused by amniocentesis or trophoblast biopsy; Major fetal anomaly GEHE: Consultant Obstetrician and Gynecologist and Senior lecturer, Faculty of Health Sciences, University of Buea, Cameroon. PubMed WOMAN HEALTH; . Nayki U, Taner CE, Mizrak T, Nayki C, Derin G. Fetal Diagn Ther. Uterine overdistention (due to multifetal pregnancy Multifetal Pregnancy Multifetal pregnancy is presence of > 1 fetus in the uterus. When physicians use labor-enhancing drugs, they must carefully monitor the fetus for signs of distress and be prepared to promptly respond if tachysystole occurs. The funding organization has no role in the design of the study and collection, analysis, and interpretation of data and in writing the manuscript; this was the role of the authors. Management options are often surgical and limited to either fertility sparing versus complete loss of reproductive function. Zwart J, Richters J, ry F, de Vries J, Bloemenkamp K, van Roosmalen J. Ethnicity has been shown to influence not only trial of labor (TOL) rates but also rates of VBAC. In some cases - especially if there is uterine rupture - an emergency C-section is necessary in order to prevent permanent harm to the fetus. BMC Res Notes 9, 492 (2016). 2016;17(1):16. Open J Obstet Gynecol. Before performing the multivariable logistic regression, we tested the presence of multicollinearity between independent variables and no multicollinearity was detected. CONCLUSION: Serial membrane sweeping at term in women who planned VBAC has no significant effect on the onset of labor, pregnancy duration, induction of labor, or repeat cesarean delivery. Case presentation: Full PDF Package Download Full PDF Package. Prual A, Bouvier-Colle M-H, de Bernis L, Breart G. Severe maternal morbidity from direct obstetric causes in West Africa: incidence and case fatality rates. Sociodemographic characteristics of cases and controls who gave birth at public hospitals of Tigrai, North Ethiopia. The proportion of women who had previous caesarean delivery in the cases and controls was 26 (19.3%) and 7 (2.6%), respectively, while 16 (11.9%) of the cases and 2 (0.7%) of the controls, who had previous caesarean delivery, had interpregnancy intervals of less than twelve months. J Obstet Gynaecol. Uterine rupture is rare. This is often the case in the sense of unsupervised or undersupervised labor in poorly equipped settings, failing detection of prolonged labor by partograph, inadequacy of skilled care providers to detect and give timely, vigilant management for fetal-pelvic disproportion, and overlooked obstructed labor which may lead to rupture due to exhaustion of uterine layers integrity. BJOG Int J Obstet Gynaecol. The data were entered into Epi data Version 3.5.1 and exported to the Statistical Package for the Social Sciences (SPSS) Version 20 software for further analysis. Obstetric conditions of cases and controls who gave birth at public hospitals of Tigray, North Ethiopia. Knowing the determinants of uterine rupture helps prevent the occurrence of a problem in pregnant women, which reduces maternal morbidity and mortality, and would have a tremendous help in identifying the best optional strategies in our current practices. Maternal and fetal outcomes that develop uterine rupture among mothers who gave birth at public hospitals of Tigrai, North Ethiopia. Four hundred and five mothers cards (case notes) were reviewed based on the sampling of 135 cases and 270 controls. If the fetus has been expelled from the uterus and is located within the peritoneal cavity, fetal and maternal morbidity and mortality increase significantly. in the Bamenda Health District, Cameroon, showed that 58.2% deliveries were followed up with the partogram, only 1% of which were filled to standard [16]. The uterine rupture was a dependent variable. Turner et al. Ltd., Swathi Bhat, International Journal of Reproduction, Contraception, Obstetrics and Gynecology, Indonesian Journal of Obstetrics and Gynecology, Gynecology and Obstetrics Research - Open Journal, International Journal of Maternal and Child Health and AIDS (IJMA), Journal of South Asian Federation of Obstetrics and Gynaecology, The role of maternal body mass index in outcomes of vaginal births after cesarean, Serial Membrane Sweeping at Term in Planned Vaginal Birth After Cesarean: A Randomized Controlled Trial. Another study in Ethiopia reported a prevalence of 0.9% [10]. Indian J Crit Care Med. METHODS: Women at term with one transverse lower segment cesarean delivery who were suitable for and who planned VBAC were approached to participate. Other predisposing factors include congenital uterine abnormalities, trauma, and other uterine surgical procedures such as myomectomies or open maternal-fetal surgery. Analyzing uterine rupture: A study from tertiary care centre of western Nepal, Use of the Partogram in the Bamenda Health District, North-West Region, Cameroon: A Cross-Sectional Study, The current management of vaginal birth after previous caesarean delivery, Prevention and Management of Postpartum Hemorrhage, Oxytocin Versus Misoprostol Plus Oxytocin in the Prevention of Postpartum Hemorrhage at a Semi-Urban Hospital in sub-Saharan Africa: A Retrospective Cohort Study, Factors Associated with Successful Vaginal Birth After a Primary Cesarean Section in Women with an Optimal Inter-Delivery Interval, Mode de dclenchement du travail et conduite du travail en cas dutrus cicatriciel. 60, pp. Spontaneous Rupture of Unscarred Uterus in a Term Primagravida with Lethal Skeletal Dysplasia Fetus (Thanatophoric dysplasia). It cautions that medications like oxytocin and prostaglandins should be manipulated under specialized care and, finally, that health establishments should not handle deliveries unless they are equipped for the complications of labour and delivery. 1, pp. This type of practice should be discouraged because it is associated with obstetric and neonatal complications such as uterine rupture [15]. volume9, Articlenumber:492 (2016) The most important factors in the treatment and management of uterine rupture are (a) timely recognition and a presumptive diagnosis of the rupture; and (b) immediate intervention to deliver the baby as quickly as possible. Definition Uterine rupture is a tear in the muscle of the uterus (womb). Uterine rupture was defined as tearing of the uterine wall either partially or completely during pregnancy and labor, diagnosed clinically and later confirmed at laparotomy by the attending physician. I. Kadowa, Ruptured uterus in rural Uganda: prevalence, predisposing factors and outcomes, Singapore Medical Journal, vol. Uterine rupture in the Douala General Hospital, Cameroon: prevalence, risk factors, management and prognosis. PubMed Q. QAZI, Z. AKHTAR, K. KHAN, and A. H. KHAN, Woman health; uterus rupture, its complications and management in Teaching Hospital bannu, pakistan, Pakistan Mdica - a Journal of Clinical Medicine, vol. Systematic review: who systematic review of maternal mortality and morbidity: the prevalence of uterine rupture. 3. These low rates of partogram use could have obstetric consequences, especially given the high likelihood that, under such circumstances, parturients are administered oxytocin or prostaglandins and are not properly followed up by hourly or two-hourly examinations. Laparoscopic cornuostomy for the surgical management of interstitial pregnancy, as opposed to cornual wedge resection, should be considered, particularly in stable patients with intact ectopic pregnancy. Please enter the related passcode in order to view this content: Invalid passcode Submit The authors declare that they have no competing interests. In a study of patients with a prior cesarean being induced with the trans-cervical foley bulb, the rate of uterine rupture was 1.1% with spontaneous labor, 1.2% with induction with amniotomy, and 1.6% with use of a trans-cervical Foley bulb. The documented immediate causes of maternal deaths were hypovolemic shock [8], septic shock [2], and other causes like pulmonary edema [1] and acute renal failure [1]. It can occur during late pregnancy or active labor. CAS Federal government websites often end in .gov or .mil. Introduction and Who Guideline applies to This document sets out the procedures and processes to follow in the event of a uterine rupture with the intention of providing safe and effective care to this patient group. A prior cesarean delivery is the major risk factor for uterine rupture. Cookies policy. Treatment of uterine rupture is immediate laparotomy with cesarean delivery and, if necessary, hysterectomy. 150, no. 2018 May 30;19:e00066. This is an open access article distributed under the. PubMedGoogle Scholar. This study was conducted in selected public hospitals in Tigrai. Observed risk factors for primary uterine rupture included: contracted pelvis, 12.0% (57/475); fetal macrosomia 9.7% (46/475); contracted pelvis associated with macrosomia 3.4% (16/475). Use OR to account for alternate terms TOE wrote the manuscript, TOE and JEN did the surgical operation. Early clinical diagnosis is paramount to maternal survival. o [ abdominal pain pediatric ] 112, no. Wacker et al. Eur J Obstet Gynecol Reprod Biol. Assessment of individual risks and the likelihood of VBAC can help determine appropriate candidates for trial of labor. PubMed in Rukungiri District in Uganda reported 30% use [18]. Careers. The findings of this study suggest early identification of factors that expose to uterine rupture during antenatal care, labor, and delivery must be attended to and further prospective studies are needed to explore predictors of untoward outcomes. 10, pp. 2006;195:11437. Uterine rupture is a devastating obstetric condition that put the life of the mother and the baby at risk [2]. Dystocia associated with oxytocin and/or traditional medicines labor augmentation has been observed in 12.6% of cases (60/475). The abdomen was distended and tender on palpation. Other methods of controlling bleeding during a uterine rupture, after the baby has been delivered, include: Abdominal packing- sponges and towels should be packed into the uterus and abdomen to control bleeding via pressure Uterine artery ligation or internal iliac artery ligation Other methods of hemostasis like flowseal Cahill AG, Stamilio DM, Odibo AO, Peipert JF, Ratcliffe SJ, Stevens EJ, Sammel MD, Macones GA. Is vaginal birth after cesarean (VBAC) or elective repeat cesarean safer in women with a prior vaginal delivery? Int Med Case Rep J. Furthermore, a single-layer closure of the previous lower segment incision is the most influential factor and is associated with a fourfold increase in the risk of uterine rupture compared with a double-layer closure [25]. doi: 10.7759/cureus.21076. Bookshelf Labor and delivery distributions of cases and controls who gave birth at public hospitals of Tigrai, North Ethiopia. Among patients in the reproductive age who have not completed their desired family size, such a procedure could be unacceptable. To attain this objective, use of misoprostol in primary health facilities should be stopped or proper management of the medication instituted. Part of Five data collectors with a Bachelor of Science in Midwifery degree were recruited. 2015;130:1236. . -. Uterine rupture occurs most often along healed scar lines in women who have had prior cesarean deliveries . The rate of cesarean delivery fluctuates. doi:10.1053/j.semperi.2011.05.008. Authorization was obtained from the Director of the Douala General Hospital and Consent was obtained from the patient to report the case. In a systematic review by Justus Hofmeyr et al., uterine rupture was reported to be lower in a community-based study (median 0.053%, range 0.0160.030%) compared to facility-based study (0.031, 0.0122.9%). S. Gebre and A. Negassi, Risk factors for uterine rupture in Suhul General Hospital case control study, Electronic Journal of Biology, vol. 2021 Dec;25(Suppl 3):S223-S229. Our special gratitude also goes to Professor Pammla Petrucka (University of Saskatchewan Canada, College of Nursing) (through Academics without Borders) for helping us on language and grammar editing and reviewing the whole manuscript. Management of uterine rupture: a case report and review of the literature, https://doi.org/10.1186/s13104-016-2295-9, http://creativecommons.org/licenses/by/4.0/, http://creativecommons.org/publicdomain/zero/1.0/. Introduction. Uterine rupture is an obstetric calamity with surgery as its management mainstay. This fact should be considered when counseling women for VBAC [13]. As soon as doctors even suspect uterine rupture, they must immediately . In another population-based study in the Netherlands, the incidence of uterine rupture was comparable with other Western countries. Lancet. Cases were enrolled consecutively from case notes of women who gave birth from 1/9/2015 to 30/6/2019, while charts (case note) of women without uterine rupture found following the cases were selected randomly and enrolled. Charts (case note) of women diagnosed with uterine rupture who met the criteria were enrolled consecutively, while charts (case note) of women without uterine rupture (control) found following the cases were selected randomly and enrolled. 12211228, 2005. 2016;387:46274. Brought to you by Merck & Co, Inc., Rahway, NJ, USA (known as MSD outside the US and Canada) dedicated to using leading-edge science to save and improve lives around the world. Classical versus low-segment transverse incision for preterm caesarean section: maternal complications and outcome of subsequent pregnancies. The survival of patients after uterine rupture. It has recently increased, partly read more . 2016;15:115. Uterine rupture is a. pregnancy. e0169304e0169308, 2017. factor for uterine rupture, and this is similar to the findings of reported research (19). Anyone you share the following link with will be able to read this content: Sorry, a shareable link is not currently available for this article. During this period, the anesthesiologist had been called who secured an intravenous line with a 14 G catheter, obtained blood for Full blood count, coagulation studies, typing and cross match. Clinicians must remain vigilant for signs and symptoms of uterine rupture. Multifetal (multiple) pregnancy occurs in up to 1 of 30 deliveries. We do not control or have responsibility for the content of any third-party site. Usually, destruction to the uterus is not correctable and the outcome is often a hysterectomy [1]. We carried out a total abdominal hysterectomy and peritoneal toileting. An emergency positive culdocentesis was done. To address this, uterine resection of localized disease has . Studies in patients attempting VBAC have shown that the highest rate of maternal complications occur in patients who have a failed attempt at VBAC, intermediate in those who have an elective repeat cesarean section and lowest in those who have a successful VBAC[1]. Sociodemographic factors claimed in the literatures to determine uterine rupture were maternal age, occupation, referral status, residence, and pregnancy and labor and delivery-related factors including labor induction, grand multiparity, lack of ANC follow-up, history of previous caesarian section (C/S), prolonged labor, obstructed labor, lack of partograph utilization, and instrumental delivery. A copy of the written consent is available for review by the Editor-in-Chief of this journal. The reason might be failing of detecting fetal macrosomia during antenatal care which contributes to fetal-pelvic disproportion and may lead to prolonged and neglected obstructed labor. 1, p. 117, 2017. Chart number of women diagnosed with uterine rupture who met the criteria was enrolled consecutively. Semin Perinatol. Graham D, Agrawal N, Roth S. Prevention of NSAID-induced gastric ulcer with misoprostol: multicentre, double-blind, placebo-controlled trial. reported that 71% of cases with uterine rupture used misoprostol [9]. However, uterine ruptures have also been known to occur in some . She has a history of missed abortion at 19weeks gestation diagnosed by ultrasonography 3 days prior to admission at our Department, and an attempt to evacuate the uterus with an unknown dose of misoprostol before she went into shock. sharing sensitive information, make sure youre on a federal Uterine rupture. FOIA BMC Research Notes OBJECTIVE: To estimate the effect of serial membrane sweeping on the onset of labor in women who planned vaginal birth after cesarean (VBAC). Learn more about the MSD Manuals and our commitment to Global Medical Knowledge. 12081214, 2007. Ultrasound diagnosis of a uterine rupture postdelivery is rarely described in the literature. While there is increased maternal and perinatal morbidity associated with the failure of trial of vaginal birth after cesarean section (VBAC), a successful trial of VBAC reduces the risk of complications in future pregnancies, associated with a repeat cesarean section. For example, during rainy seasons, women in rural areas do not come to seek obstetric care at a higher facility due to the unavailability of transportation. The survival of patients after uterine rupture depends on the time interval between rupture and intervention, and the availability of blood products for transfusion. 1, pp. eCollection 2022. See this image and copyright information in PMC. Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. There was a fluid thrill, shifting dullness and mild vaginal bleeding. Misoprostol is a prostaglandin E1 analog that was originally used for the prevention and treatment of peptic ulcer disease [3]. In some cases, the cyst can break open (rupture). Descriptive statistics were presented. This Paper. HHS Vulnerability Disclosure, Help Y. Berhan and A. Berhan, Causes of maternal mortality in Ethiopia: a significant decline in abortion related death, Ethiopian journal of health sciences, vol. MEDICAL MANAGEMENT:Immediate stabilization of maternal hemodynamics and immediate caesarean delivery Oxytocin is given to contract the uterus and the replacement .After surgery, additional blood, and fluid replacement is continued along with antibiotic theory. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated. In conclusion, this study found that referrals from remote health institutions, antenatal care visit once, obstructed labor, and birth weight of newborns were significant determinants of uterine rupture. However, blood transfusions were very common in studies done in Debre Markos (78%) and Pakistan (83%) [4, 21]. The reasons for this may be lack of capacity to recognize and manage abnormal pattern of labor at district, primary hospitals and health centers; despite the governments health policy that envisioned decentralizing emergency and comprehensive obstetric services to the community, still many women referred to referral and tertiary hospitals. Purpose Stillbirth is one of the most common adverse pregnancy outcomes, occurring in 1 in 160 deliveries in the United States. CAS Enter search terms to find related medical topics, multimedia and more. - Measure heart rate and blood pressure; assess the severity of the bleeding. Namazov A, Grin L, Volodarsky M, Anteby E, Gemer O. J Minim Invasive Gynecol. 1988;332:127780. is probably the best way to measure LUS thickness: In a study conducted by Gotoh et al.35 , it was found that transabdominal ultrasound can detect scar defects located there may be incomplete uterine rupture at . Patients with a classical hysterotomy are likely to rupture during pregnancy and studies have shown that they should be delivered by 3637weeks gestation. 2000;78:593602. [Uterine rupture during second trimester abortion induced with misoprostol]. The mass was dissected and hemostasis was secured using sutures and electrocoagulation. This study revealed that hysterectomy had been performed in more than half of the women who develop uterine rupture. 2009;116:106980. BJOG Int J Obstet Gynaecol. A retrospective hospital-based unmatched case control study design was implemented at public hospitals in Tigrai region, from cards (case notes) of mothers who gave birth from 1/9/2015 to 30/6/2019. Rupture of a myomectomy site in the third trimester of pregnancy after myomectomy, septoplasty and cesarean section: A case report. 8600 Rockville Pike This study was conducted to identify the risk factors of uterine rupture and its impacts in public hospitals of Tigrai. Risk factors for multiple pregnancy include Ovarian stimulation read more , polyhydramnios Polyhydramnios Polyhydramnios is excessive amniotic fluid; it is associated with maternal and fetal complications. Obstet Gynecol. How is uterine rupture treated? in a case fatality study of maternal morbidity from 23 West African countries and 20326 pregnant women between 32 and 36weeks amenorrhea during delivery and up to 60days post partum reported that uterine rupture accounted for 0.12 per 100 live births [8]. Management is by treating read more , or fetal anomalies), Failure to recognize labor dystocia with excessive uterine contractions against a lower uterine restriction ring. Such variance may relate to the differences in the hemodynamic state of patients and the availability of blood for transfusion. Diagnosis is by ultrasonographic measurement of amniotic fluid volume. The magnitude of fetal mortality is very high with 1.7% to 7% of babies surviving after uterine rupture; 93% to 98.3% of them were stillbirths [4, 5, 7]. Emergency exploratory laparotomy with cesarean delivery accompanied by fluid and blood transfusion are indicated for the management of uterine rupture. 37, no. A retrospective study. This study is aimed at addressing determinant factors of uterine rupture and its adverse maternal and fetal management outcomes in public hospitals of Tigrai. Though fetal macrosomia is diagnosed retrospectively after birth, antenatal surveillance is mandatory. This can c. You may need surgery. 3, no. Although the magnitude is relatively low, it accounts for 18.8% to 36% of maternal mortality [9] and more than 35% of registered maternal deaths were due to uterine rupture [4]. The median age of the women in cases and controls was 30 () and 26 (), respectively. Small uterine defects, incomplete ruptures, and silent uterine incision dehiscence were excluded. Am J Obstet Gynecol. We are reporting a case of uterine rupture for second trimester evacuation of a dead fetus that was managed at the department of Obstetrics and Gynecology, Douala General Hospital, Cameroon. Further prospective studies are needed to identify predictors of uterine rupture and predictors with untoward management outcomes. J Med Ultrasound [serial online] 2018 [cited 2022 Dec 3];26:59-61. . Among those who had uterine rupture, 48 (11.9%) of the mothers received blood transfusions. Academia.edu no longer supports Internet Explorer. Uterine repair without tubal ligation leaves a uterus that is more prone to repeat rupture while uterine repair with bilateral tubal ligation (BTL) or (sub)total hysterectomy predispose survivors to psychosocial problems like marital disharmony. Would you like email updates of new search results? 3, pp. Indian patients have not had a large representation in former studies. 22, no. statement and Finally, uterine rupture is a complication that can be eliminated if best obstetric practice is ensured. D. L. A. Thisted, L. H. Mortensen, and L. Krebs, Uterine rupture without previous caesarean delivery: a population-based cohort study, European Journal of Obstetrics & Gynecology and Reproductive Biology, vol. On examination, the conjunctivae were pale and the pulse rate 120 beats per minute. Studies from Sihul Shire, Ethiopia, Mizan Tepi, Ethiopia, and Mbarara, Uganda [2, 13, 17] have shown that uterine rupture is highly related with antenatal care attendance, consistent with the findings of this study. Objective: Spontaneous unscarred uterine rupture (SUUR) is a catastrophic obstetric complication. The biologic plausibility of this effect is related to the amount of time required for the uterine scar to heal completely and to nutritional Factors [20,21,22]. BJOG Int J Obstet Gynaecol. The study by Nguefack et al. Data were collected using a structured checklist adapted from the literature, selecting data from delivery registers, operating theatre registers, and patients case files, which include sociodemographic variables, pregnancy condition variables, labor and delivery variables, and maternal and fetal management outcomes [2, 4, 5, 13, 15]. Ethical approval was obtained from a research and ethical approval committee of the College of Health Sciences of Adigrat University with a code number AGU/CMHS/084/11. Department of Obstetrics and Gynecology, Douala General Hospital, Douala, Cameroon, Thomas Obinchemti Egbe,Gregory Edie Halle-Ekane,Charlotte Nguefack Tchente&Eugene Belley-Priso, Faculty of Health Sciences, University of Buea, Buea, Cameroon, Thomas Obinchemti Egbe&Gregory Edie Halle-Ekane, Faculty of Medicine and Pharmaceutical Sciences, University of Douala, Douala, Cameroon, Operating Theatre, Douala General Hospital, Douala, Cameroon, Faculty of Medicine and Biomedical Sciences, University of Yaounde 1, Yaound, Cameroon, You can also search for this author in Please enable it to take advantage of the complete set of features! Ethiop J Health Dev. The survival of patients after uterine rupture depends on the time interval between rupture and intervention, and the availability of blood products for transfusion. The third is the perimetrium (outer surface). Immediate intervention is important factor for successful management of uterine rupture. 4 the following primary interventions should occur immediately and simultaneously, for any delay in management can result in Management often entails removal of the uterus. The site is secure. Article The patient would have lost her life had intervention not been prompt. Wacker J, Utz B, Kyelem D, Lankoande J, Bastert G. Introduction of a simplified round partogram in rural maternity units: seno province, Burkina Faso, West-Africa. The possible explanation could be the differences in health care providers skills, severity of cases, time for securing hemostasis, the need for fertility and individualized decision-making, and protocols. The risk of recurrence of PAS depends on the procedure used in the treatment performed and the number of treatments. 1994;46(3):259373. 1, 2). Uterine rupture is rare. Uterine rupture occurs when the three layers of the uterus break open into the abdominal cavity. Gestational age at delivery (mean +/- standard deviation) of 39.6 +/- 1.0 weeks for the membrane sweeping group compared with 39.6 0.9 weeks for the control group (P=.84) was no different. This study also showed obstructed labor to be the strongest significant risk factor for uterine rupture. The parameters influencing TOL available on admission from history and examination can collectively be evaluated to help guide the clinician and estimate the probability of success of TOL after previous one cesarean section. Uterine rupture (UR) is an . BMC Research Notes, 2016. CAS This topic will review clinical findings, risk factors, prediction, and management of uterine rupture in patients attempting TOLAC. Laparoscopic Management of Uterine Rupture After Early Second-Trimester Medical Abortion in a Patient With a Prior Cesarean Section. doi:10.1016/0020-7292(94)90405-7. For 127 (94.1%) of the cases and 269 (99.6%) of the controls, delivery was at one of the hospitals. Maternal mortality, one of the major concerns of the World Health Organization, remains high in most of sub-Saharan Africa . G. Girmay, T. Gultie, G. Gebremichael, B. Afework, and G. Temesgen, Determinants of uterine rupture among mothers who gave birth in Jinka and Arba Minch general hospitals, institution-based casecontrol study, southern Ethiopia, Ethiopia, 2019, Women's Health, vol. At the time of the uterine evacuation, the pregnancy was 24weeks 2days gestation calculated from her last menstrual period. A. M. Abasiattai, A. J. Umoiyoho, N. M. Utuk, E. C. Inyang-Etoh, and O. P. Asuquo, Emergency peripartum hysterectomy in a tertiary hospital in southern Nigeria, The Pan African Medical Journal, vol. The uterine layers are: The first layer is the endometrium (inner epithelial layer). Grand multiparity (7 deliveries in obstetric history) accounted for 12.4% (59/475) of all uterine ruptures while short inter-pregnancy interval has been observed in 12.0% of all uterine ruptures (57/475) [28]. This is consistent with the studies from Debre Markos and Nigeria [4, 15] but in discordant with a study from Turkey [20]. After this procedure, a woman can no. Finally, health facility, number of antenatal visits, experience of obstructed labor, and birth weight of newborn were found to be statistically associated with uterine rupture. Privacy Conclusion. MB was the principal investigator who contributed to the conception and design of the study; collected, entered, analyzed, and interpreted the data; prepared the manuscript; and acted as a corresponding author. Augustin G. Spontaneous uterine rupture. Early clinical diagnosis is paramount to maternal survival. Am J Obstet Gynecol. Following the conservative treatment of PAS, there is a risk of uterine synechiae and amenorrhea, and the risk of uterine rupture is predicted in pregnancies following the treatment . Open J Obstet Gynecol. A scarred uterus is not a necessary pre-condition for uterine rupture. In the particular case of Mezam Division, Cameroon, the leading causes are Postpartum Hemorrhage (30.43%), unsafe abortion (26.09%), and pregnancy-induced hypertension (14.49%) [1, 2]. It differs from uterine scar dehiscence which does not involve the visceral peritoneum and the placenta and fetus remains in the uterine cavity. Bujold E, Bujold C, Hamilton EF, Harel F, Gauthier RJ. Berhe Y, Gidey H, Wall LL. Google Scholar. 2014;4:77181. Ogwang S, Karyabakabo Z, Rutebemberwa E. Assessment of partogram use during labour in rujumbura health Sub district, Rukungiri district, Uganda. With respect to the rupture location, 47 (34.8%) were anterior, 53 (39.25%) posterior, and 35 (25.92%) lateral. 151155, 2015. 2. In the particular case of Mezam Division, Cameroon, the leading causes are Postpartum Hemorrhage (30.43%), unsafe abortion (26.09%), and pregnancy-induced hypertension (14.49%) . M. Kaczmarczyk, P. Sparn, P. Terry, and S. Cnattingius, Risk factors for uterine rupture and neonatal consequences of uterine rupture: a population-based study of successive pregnancies in Sweden, BJOG: An International Journal of Obstetrics & Gynaecology, vol. Cases of gestational trophoblastic neoplasia (GTN) with uterine rupture are often catastrophic owing to profuse bleeding, which could be potentially lethal. 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