Anaesthesia for uterine rupture in a Nigerian teaching hospital: maternal and fetal outcome (original) (raw)
Related papers
Uterine rupture: trends and feto-maternal outcome in a Nigerian teaching hospital
Nigerian journal of medicine : journal of the National Association of Resident Doctors of Nigeria
To determine the trends, predisposing factors, maternal and fetal outcome of cases of uterine rupture managed at the University of Abuja Teaching Hospital. A retrospective review of all cases of ruptured uterus managed at the University of Abuja teaching hospital, Gwagwalada, between January 2006 and December 2010 was conducted. There were 9604 deliveries in the hospital during the period of review out of which 82 were cases ruptured uterus, giving an overall incidence of 0.85% or 1 in 117 deliveries. They were mainly women of low parity with a mean age of 31.8 years. The commonest predisposing factor was injudicious use of oxytocin occurring in 38.7% of cases and was followed closely by previous caesarean section scar (28.0%). Prolonged obstructed labour was the third commonest cause of uterine rupture (18.7%) and occurred only in the unbooked patients. There were 11 maternal deaths which gave a maternal case fatality rate of 14.7%. All the deaths occurred in women who had intrapar...
International Journal of Reproduction, Contraception, Obstetrics and Gynecology, 2020
Background: The aim of the work was to study post-operative maternal morbidity and mortality after caesarean delivery and laparotomy for uterine failure, to describe the main causes and to analyze the risk factors.Methods: It was a descriptive, comparative and analytical study lasting 2 years with data collection in 2 phases, one of which was a retrospective study lasting one year from July 2018 to June 2019 and the other a prospective study also lasting one year, from July 2019 to June 2020. It concerned all pregnant women who had been caesarized or had had a laparotomy for uterine rupture with complications and those who had not developed any complications. The parameters studied were types of complications, risk factors and maternal mortality. The Chi-square test was used to compare the two populations with a significance level p=0.05.Results: During the study period, 6141 hospitalizations were recorded among which 5682 surgical procedures were performed, i.e. 92.52% of hospitali...
Nigerian Medical Journal, 2011
This is different in developed countries where efficient antenatal and intrapartum care had almost eradicated this obstetric catastrophy. 3,4,7 Most cases of uterine rupture in previous studies in this environment are due to rupture of the unscarred uterus secondary to neglected obstructed labor as against the backdrop of previous caesarean section scar rupture in developed countries. 8-11 The magnitude of this preventable obstetric complication is enormous; thus it is imperative to evaluate periodically its impact and identify institutional problems that might compound its occurrence. Various national studies have been done regarding uterine rupture 1-3,5-7 but recent literature is replete in this region. MATERIALS AND METHODS A 5-year retrospective study of all cases of rupture of the INTRODUCTION Rupture of the pregnant uterus is a major contributor to the high maternal morbidity and mortality seen in developing countries. 1-3 Regional variation occurs in the incidence of uterine rupture and is a reflection of the standard of obstetric care. Widespread poverty, low educational status, cultural constraints that underscore utilization of orthodox care, inadequate health facilities, poor transport system, poor communication facilities, and substandard health facilities are contributory factors in developing countries. 2,4,5 It is therefore not surprising that most cases of ruptured uterus
Rupture Of The Gravid Uterus: A Never-Ending Obstetric Disaster! The Ikeja Experience
The Internet Journal of Gynecology and Obstetrics, 2009
Ruptured uterus is a major obstetric emergency that exposes the mother and child to grave danger and contributes to the high maternal and perinatal mortality and morbidity in Nigeria. This study was carried out to determine the incidence, predisposing factors, the maternal and fetal outcomes of patients with uterine rupture in Lagos State University Teaching Hospital (LASUTH). A 4-year retrospective study of patients with uterine rupture in LASUTH between January 2000 and December 2003 was carried out. There were 56 cases of uterine rupture giving an incidence of 5.38 per 1000 deliveries. 95% of the patients were not followed antenatally. Most cases involved spontaneous ruptures. The interval between arrival in the hospital and intervention was greater than 6 hours in 30% of patients. Uterine repair was the most common surgical treatment. Case fatality was about 30%. Perinatal mortality exceeded 90%. The incidence of rupture uterus is still very high. Suggestions are made to reduce the incidence and mitigate this tragedy.
Uterine rupture at a secondary hospital in Afikpo, Southeast Nigeria
Singapore medical journal
Introduction: Uterine rupture is an obstetric catastrophe that is associated with high maternal and perinatal mortality rates. Its incidence is high in developing countries. In Nigeria, the incidence of uterine rupture continues to increase due to poverty, illiteracy, ignorance, the lack of quality obstetric care and bad governance.
Uterine rupture at the University of Calabar Teaching Hospital, Calabar; Nigeria: a six-year review
International Journal of Reproduction, Contraception, Obstetrics and Gynecology
Background: Ruptured uterus is one of the major complications of labour which contributes significantly to maternal and perinatal morbidity and mortality in low-resource and developing countries. Periodic review is necessary to determine the magnitude, risk factors and feto maternal outcomes to aid to plan prevention reduce maternal and fetal mortality are needed. The objective of the study was to determine the prevalence, risk factors, management options, and feto-maternal outcomes of uterine rupture in University of Calabar Teaching Hospital (UCTH), Calabar.Methods: Records of women with uterine rupture between January 2013 and December 2018 were retrieved. Sociodemographic data, clinical presentations, surgical options, fetal and maternal outcomes were recorded and analysed. Data was presented in frequencies and percentages.Results: During the study period, total number of deliveries was 11,382 with 41 ruptured uterus giving it an incidence of 0.36 percent. Twenty-eight (71.8%) o...
Open Journal of Obstetrics and Gynecology, 2019
Objectives: The objectives of this work were to calculate the frequency of the uterine rupture, to describe the epidemiological profile, to identify the etiologies and to establish the maternal prognosis and foetal. Methodology: It was about a descriptive survey with compilation of the data in two phases: a retrospective spreading on one period of 6 years and the other forecasting of 1 one year achieved to the service of Obstetric Gynecology of the hospital National Donka, Fallen from Conakry, Guinea. Results: We recorded 24.030 childbirths of which 188 cases of uterine rupture either a frequency of 0.78, which represents an uterine rupture for 128 childbirths. The epidemiological profile was the one of a woman of 24 to 28 years (31.91%), housewives (69.14%), without prenatal follow-up (47.87%), big multipare (37.76%) and évacuées (78.78%). The motives of consultation have been dominated by the hémorragie (95.74%). The rupture was of transverse type in the majority of the cas (63.82%). The hysterorraphy was the most performed surgical procedure which is 85.10% followed by the total sub hysterectomy in 10.63%. The newborns of birth weight superior or equal to 4000 g represent 25.53%. The maternal morbidity has been dominated by the anemia of the postpartum (60%). We recorded a rate of maternal létalité of 12.76%. The maternal deaths were due to the hemorrhage in 78.57%. The living newborns endured a respiratory distress in 9.57% and those stillborn represent 87.23%. The etiologies of uterine rupture were dominated by fetal-pelvic disproportions 48.
Ruptured uterus in South Western Nigeria: a reappraisal
Singapore medical journal
Rupture of the gravid uterus is a grave obstetric complication that is associated with high maternal and perinatal mortality rates. In Nigeria, the incidence remains high and continue to increase because of poverty, illiteracy, unavailability of manpower, poor supply of medical equipment and consumables, and dwindling health care funding. A 10-year retrospective review of all cases of ruptured uterus seen at the Obafemi Awolowo University teaching hospital complex in Ile Ife, Nigeria was conducted. A total of 61 cases of ruptured uterus from 16,683 deliveries were recorded, giving a ratio of 1 in 273. Predisposing or aetiological factors for rupture were: prolonged labour (91.8 percent), grand multiparity (50.8 percent), injudicious use of oxytocin (41.0 percent), uterine scar (26.2 percent), obstetric manipulation (4.9 percent) and abnormal lie (14.8 percent). Fifty-six patients had surgery, of which 14 (25.0 percent) had total abdominal hysterectomy, 16 (28.6 percent) had subtotal...
BMC Pregnancy and Childbirth
Background: The occurrence of uterine rupture has dropped significantly in high income countries. It continues, however, to be a major public and clinical health problem in low income countries including Ethiopia. Aim of this study was to assess management outcomes of uterine rupture and associated factors in Yirgalem General and Teaching Hospital in South Ethiopia. Methods: Institution-based cross-sectional study was conducted to examine medical records of women with uterine rupture between January 1, 2012, and Decem"ber 31, 2017. Data were collected based on a checklist. Descriptive statistics and logistic regression analyses were performed. Results: Incidence of uterine rupture was 345 in 13,500 live births (25.5 in 1000 live births) in the study period. Of these, 331 cases were included. Poor maternal outcome occurred in 224 (67.7%) women. There were 13 (3.7%) maternal deaths and 320 (96.7%) stillbirths. Wound site infection (131; 39.6%) and anemia (129; 39%) were the most common post-operative complications. Prolonged duration of labor (more than 24 h) (adjusted odds ratio (aOR) 3.6; 95% CI 1.7-7.4), women with sepsis on admission (aOR 2.9; 95% CI 1.4-6.1), hemoglobin level < 7 g/dl prior to surgical intervention (aOR 4.5; 95% CI 1.1-17.8), delayed surgical intervention after hospitalization (4 h or more before surgery) (aOR 3.8; 95% CI 1.8-8), women who did not receive blood transfusion (aOR 4.0; 95% CI 2.1-7.9) and prolonged intraoperative time (aOR 5.5; 95% CI 2.8-10.8) were all factors associated with poor maternal outcome of uterine rupture. Conclusion: Poor maternal outcome of uterine rupture was high in the study area as compared to other studies. Proper management of anemia, prompt surgical treatment, proper labor progress monitoring, surgical skills, improved infection prevention, maximizing blood transfusion availability and improving the quality of maternal healthcare all play a significant role in reducing uterine rupture and enhancing the chance of good outcomes.