Management of unscarred ruptured uterus
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D. S. Kapoor
Abstract
Aims and objectives: Rupture of an unscarred gravid uterus is a rare and dangerous event. We carried out a postal questionnaire survey of the Fellows of the Royal College of Obstetricians and Gynaecologists (United Kingdom), to ascertain the past and present management policies in such an event. 210 Fellows responded (43.5%) and 85 of them managed at least one case of uterine rupture in previously unscarred gravid uterus.
Results: A total of 108 cases were reported of which 74 (68.5%) were diagnosed during labor. The tear was repaired and the uterus conserved in 56.5% cases. Maternal mortality was 10.2% (95% CI 5.2, 17.5) and perinatal mortality was 34.3% (95% CI 25.4, 44).
When asked how they would manage such a case in the absence of life threatening circumstances in future, 80.8% of Fellows would opt for uterine repair. Fellows with previous hands-on experience of uterine rupture would involve urologists more often in operative management (22% v 8%, OR 3.4, 95% CI 1.2, 10.1). 48% of Fellows felt that in-patient management is indicated in subsequent pregnancies and 91% would perform an elective cesarean section in subsequent pregnancy.
Copyright © 2003 by Walter de Gruyter GmbH & Co. KG
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Articles in the same Issue
- Bioelectrical impedance analysis in the clinical management of preeclamptic women with edema
- Decreasing resistance in the maternal uterine and peripheral arterial system is apparently unrelated to plasma and urinary levels of nitrite/nitrate and cyclic-guanosinmonophosohate during the course of normal pregnancies
- Inducing proliferation of human amnion epithelial and mesenchymal cells for prospective engineering of membrane repair
- Obstetric outcome of excessively overgrown fetuses (≥= 5000 g): a case-control study
- Computerized analysis of fetal heart rate indices during oral glucose tolerance test
- Comparison of perinatal outcome in fetuses with reverse or absent enddiastolic flow in the umbilical artery and/or fetal descending aorta
- Operative fetoscopical management of intrauterine obstructive uropathia by urethral stent
- The impact of intrapartum factors on umbilical cord blood stem cell banking
- Neonatal nucleated red blood cell count and postpartum complications in growth restricted fetuses
- Neonatal outcome of growth discordant twin gestations
- Management of unscarred ruptured uterus
- Lethargy in a newborn: lithium toxicity or lab error?
- Acute ethanol intoxication during pregnancy and consecutive fetal cardiac arrest: a case report
- Acute pancreatitis occurring in the early postpartum period: a case report
- Book Review
- Congress Calendar
