Abstract
Objective: To determine the incidence, characteristics of patients and identified the risk factors, and maternal and fetal outcomes of uterine rupture at KAUH. Materials and Methods: Retrospective analysis of 51 cases of uterine ruptures (KAUH), from January 2011 to December 2015. Variables (age, gravidity, height, BMI, risk factors, previous C/S, previous abortion antepartum hemorrhage (APH), postpartum hemorrhage (PPH), gestational diabetes mellitus (GDM), smoking, multiple pregnancies, educational level >12 years, induction and method, mode of delivery, gender, fetal weight, neonatal NICU, and death and maternal outcomes. Ethical approval obtained. Inclusion criteria were all women admitted due to labor that had a ruptured uterus and managed at KAUH. Results: In a total of 20,568 deliveries, uterine rupture occurred in 51 cases (incidence of 0.03%, 1:403), scarred vs. unscarred was 1:514, and 1:1870, respectively. Age was 21 to 46 years, with a mean of 32.69 +/- 5.59 years. There were two primigravida (3.9%), 27 multigravida (52.9%), and 22 grand multigravida (43.3%). Thirty-nine (76.5%) underwent emergency C/S, three (5.9%) delivered by spontaneous vaginal delivery, and 24 patients (47.1%) had received maximum eight units of packed red blood cells. One patient underwent a hysterectomy, and five women were admitted to the ICU. Hospitals stay was from three to nine days. Nine babies had Apgar score <= 6 at one minute, admission to NICU included nine (17.6%) babies. Neonatal death occurred in five (6.1%) babies. Conclusion: Incidence uterine rupture is low 0.03 % in the present institution. Scarred uterus ruptured more frequently than unscarred. Risk factors include age > 35 years, gravidity > 4, past history of C/S, level of education less than 12 years, and significant neonatal morbidity.