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. 2005;193:165662. 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. Controls were women who had spontaneous vaginal delivery or who delivered by caesarean section without uterine rupture as a complication. 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 (, ). , MD, Children's Hospital of Philadelphia. statement and Google Scholar. Given that, the incidence of uterine rupture was 194 in 72000 live births (26.9 in 10000 live births) in the study area. Lancet. Uterine rupture is a leading cause of maternal death in Ethiopia. Among cases, it was found that 29 (21.5%) of newborn birth weights were four kilograms as opposed to 18 (6.7%) in the control group (Table 3). Her post-operative stay in hospital was uneventful. 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 0.016-0.030%) compared to facility-based study (0.031, 0.012-2.9%). Egbe T, Dingana T, Halle-Ekane G, Atashili J, Nasah B. Determinants of maternal mortality in Mezam division in the north west region of Cameroon: a community-based case control study. PubMedGoogle Scholar. Conclusion. CAS Lancet. Egbe, T.O., Halle-Ekane, G.E., Tchente, C.N. TOE wrote the manuscript, TOE and JEN did the surgical operation. Having a care team that's prepared for emergencies can prevent these outcomes from happening. The site is secure. 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]. Bethesda, MD 20894, Web Policies 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]. Before performing the multivariable logistic regression, we tested the presence of multicollinearity between independent variables and no multicollinearity was detected. All rights reserved. CAS This is consistent with the studies from Debre Markos and Nigeria [4, 15] but in discordant with a study from Turkey [20]. Determining factors of cesarean delivery trends in developing countries: lessons from point G National Hospital (Bamako-Mali). Though fetal macrosomia is diagnosed retrospectively after birth, antenatal surveillance is mandatory. 1988;332:12771280. Uterine rupture occurs most often along healed scar lines in women who have had prior cesarean deliveries Cesarean Delivery Cesarean delivery is surgical delivery by incision into the uterus. Descriptive statistics were presented. Our patient was administered an unknown dosage of misoprostol that resulted in the rupture. Accessibility The median age of the women in cases and controls was 30 () and 26 (), respectively. Eur J Obstet Gynecol Reprod Biol. Bookshelf All the authors proofread the final manuscript. Academia.edu no longer supports Internet Explorer. Then, finally, statistical significance was declared if value < 0.05. . Uterine rupture is a. pregnancy. Full PDF Package Download Full PDF Package. reported that uterine rupture in the majority of cases is associated with poor and traumatic obstetric practice [31]. The mass was dissected and hemostasis was secured using sutures and electrocoagulation. Studies from Sihul Shire (Ethiopia), Mizan Tepi (Ethiopia), and rural Uganda revealed that obstructed labor was a significant risk factor for uterine rupture [2, 5, 17]. 15, no. This condition is caused by gross uterine distention or uterine scarring; patients who have had a. cesarean delivery. Terms and Conditions, WOMAN HEALTH; . However, uterine ruptures have also been known to occur in some . Uterine rupture is a serious obstetrical condition associated with maternal mortality. J Obstet Gynaecol. The primary outcome was onset of labor which was defined as the presence of spontaneous regular and painful contractions that cause cervical dilation to at least 3 cm or prelabor rupture of membranes. and transmitted securely. 256-257, 2020. Case presentation: Despite strengthening the health care system and provision of basic and comprehensive emergency obstetric care, Ethiopian women continue to face devastating maternal and fetal outcomes, particularly in the study area [14]. Further prospective studies are needed to identify predictors of uterine rupture and predictors with untoward management outcomes. Obstet Gynecol. I. Al-Zirqi, A. K. Daltveit, L. Forsn, B. Stray-Pedersen, and S. Vangen, Risk factors for complete uterine rupture, Obstetric Anesthesia Digest, vol. Preventing Uterine Rupture Unfortunately, a ruptured uterus cannot be completely prevented. 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]. They claimed that the dinoprostone caused the uterine rupture and that defendants deviated from the standard of care in . 2018 May 30;19:e00066. Uterine rupture is a complication of labour, where the muscle layer of the uterus (myometrium) ruptures. 51, no. 8, pp. Some have used other factors like maternal age, weight, inter-delivery period, estimated fetal weight and history of term/preterm cesarean section [4]. Labor and delivery distributions of cases and controls who gave birth at public hospitals of Tigrai, North Ethiopia. An early diagnosis of an interstitial pregnancy diagnosis is extremely important for timely management but challenging because of difficult ultrasound aspects. 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. 29, no. Open J Obstet Gynecol. The majority (77%) had a scarred uterus. A tear in the uterus is a serious condition that can lead to numerous complications, including urologic injury, amniotic-fluid embolism (AFE), the need for a blood transfusion, hysterectomy, maternal death, and perinatal problems including neurological impairment or death of the baby. Privacy BJOG Int J Obstet Gynaecol. Obstet Gynecol. 1988;95:9906. Background: She came to our Department relatively early, about 30min after the incident, and we intervened immediately, aided by the fact that compatible blood was available in the blood bank. Berhe Y, Gidey H, Wall LL. During surgery, we found that there was hemoperitoneum estimated at about 2500mL and the uterus was completely torn posteriorly from the fundus to the isthmus and extending to the left broad ligament with involvement of the ascending branch of the uterine artery (Figs. Uterine rupture in the Douala General Hospital, Cameroon: prevalence, risk factors, management and prognosis. 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]. How is uterine rupture treated? Referrals from remote health institutions, once-visited antenatal care, obstructed labor, and birth weight of newborns greater than four kilograms were significant determinants of uterine rupture. 173-174, 2017. We would like also to thank the data collectors and administrators of the hospitals for their unreserved cooperation and commitment. 495527. 2015;187:804. Uterine overdistention (due to multifetal pregnancy Multifetal Pregnancy Multifetal pregnancy is presence of > 1 fetus in the uterus. 2014;4:77181. A. Al-Jufairi, A. K. Sandhu, and K. A. Al-Durazi, Risk factors of uterine rupture, Saudi medical journal, vol. We want to hear from you. 17, 2013. The odds of developing uterine rupture for women experiencing obstructed labor were 13.33 times higher compared to those who had no experience with obstructed labor (AOR 13.33; 95% CI: 4.23, 42.05). In a study of 32 080 deliveries in JIPMER (India), 93 (0.28%) women had a ruptured uterus. This finding is consistent with studies done in Yirgalem (Southern Ethiopia), Debre Markos (Ethiopia), Mizan Tepi, Uganda, Nigeria, and Yemen [4, 5, 15, 17, 22, 23]. Google Scholar. Though determinant factors for uterine rupture differ across localities due to differences in sociodemographic status, readiness and ease of access to skilled birth attendants, and health system efficacy, previous studies have found that 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 were significantly associated with uterine rupture [2, 5, 8, 1013]. Without treatment, an inverted uterus can lead to severe blood loss, shock and even death. 10, pp. Uterine rupture refers to a full-thickness disruption of the uterine muscle and overlying serosa.The fetus can be extruded from the uterus, resulting in fetal hypoxia and large internal maternal haemorrhage. 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. -, Syed S, Noreen H, Kahloon LE, Chaudhri R. Uterine rupture associated with the use of intra-vaginal misoprostol during second-trimester pregnancy termination. Part of American Journal of Obstetrics and Gynecology. A Case Report and Review of the Literature. The uterine layers are: The first layer is the endometrium (inner epithelial layer). This assertion was added to the abstract concluding session. 1, p. 117, 2017. She remained at the Department of Obstetrics and Gynecology for 5 more days and her hemoglobin level on discharge was 8.1g/dL. JPMA J Pak Med Assoc. Uterine rupture (UR) is an . 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. 3. She underwent a total abdominal hysterectomy and blood transfusion. 2016 Sep-Oct;23(6):862. doi: 10.1016/j.jmig.2016.04.004. This study identified an association between referral status and uterine rupture. 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? The patients stayed between one and 31 days in the hospital with a mean of 10.95.9 days. Obstetric conditions of cases and controls who gave birth at public hospitals of Tigray, North Ethiopia. Keyword : Uterine rupture, Primigravid, Unscarred . Patient was discharged on hematinics and vitamins. Patients with a classical hysterotomy are likely to rupture during pregnancy and studies have shown that they should be delivered by 3637weeks gestation. BMC Res Notes 9, 492 (2016). The abdomen was distended and tender on palpation. Objective. Passcode Required The content you are trying to view is protected by a passcode. Summary. official website and that any information you provide is encrypted 1 -5 It occurs immediately or up to 48 h after delivery of the last neonate, 6,7 and, to facilitate management before accumulation of excessive oedema, contamination and mucosal trauma, should be regarded as an emergency condition. A A uterine rupture typically occurs during labor, but can also occur during antenatal period. 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. Semin Perinatol. You may need surgery. Syed S, Noreen H, Kahloon LE, Chaudhri R. Uterine rupture associated with the use of intra-vaginal misoprostol during second-trimester pregnancy termination. 2021 Nov;21(4):657-659. doi: 10.18295/squmj.4.2021.050. Most cases of uterine rupture occur during labour following . A prior cesarean delivery is the major risk factor for uterine rupture. In some cases, the cyst can break open (rupture). Article The authors declare that they have no competing interests. 2, 2017. 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. With respect to the rupture location, 47 (34.8%) were anterior, 53 (39.25%) posterior, and 35 (25.92%) lateral. BMC Research Notes 151155, 2015. 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. Mothers experiencing uterine rupture outcomes range from 3% to 12.3% vesicovaginal fistulas, 6.1% rectovaginal fistulas, and 16% bladder ruptures; of them were complication of management of ruptured uterus. 22, no. 5, p. 2, 2016. Maternal and perinatal complications with uterine rupture in 142,075 patients who attempted vaginal birth after cesarean delivery: A review of the literature, Prevention and Management of Postpartum Hemorrhage: A Comparison of Four National Guidelines, Adverse Obstetric Outcomes in Women with Previous Cesarean for Dystocia in Second Stage of Labor, Uterine rupture: differences between a scarred and an unscarred uterus, Safety of late second-trimester pregnancy termination by laminaria dilatation and evacuation in patients with previous multiple cesarean sections, Trial of labor and vaginal birth after cesarean section in patients with uterine Mllerian anomalies: a population-based study, Uterine rupture in Mekelle, northern Ethiopia, between 2009 and 2013, Cervical Ripening with Low-Dose Prostaglandins in Planned Vaginal Birth after Cesarean, Modified Bishop's score and induction of labor in patients with a previous cesarean delivery, Risk of uterine rupture in women undergoing trial of labour with a history of both a caesarean section and a vaginal delivery, Serial Membrane Sweeping at Term in Planned Vaginal Birth After Cesarean, Advances in the treatment of postpartum hemorrhage, Uterine rupture in pregnancy: two case reports and review of literature, Toolkit to Support Vaginal Birth and Reduce Primary Cesareans A Quality Improvement Toolkit, Cervical ripening with Foley catheter for induction of labor after cesarean section: a cohort study. However, blood transfusions were very common in studies done in Debre Markos (78%) and Pakistan (83%) [4, 21]. 114, no. Federal government websites often end in .gov or .mil. Bujold E, Mehta SH, Bujold C, Gauthier RJ. There were 14 incomplete cards (missing essential variables and discarded (tear cards)), and 6 case notes (patient cards) were lost. As soon as doctors even suspect uterine rupture, they must immediately . 2015;187:8084. 2002;16:6979. Reports from the study in Mali show that uterine rupture occurred in 87.4% (415/475) of cases in an unscarred uterus vs 12.6% (60/475) in a scarred uterus. Among those who had uterine rupture, 101 (74.8%) of their newborns were stillborn (Table 5). Health personnel are almost forgetting the good practice of using the partogram for labor follow-up. 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. 2021 Dec;25(Suppl 3):S223-S229. Depending on the nature of the rupture and the condition of the patient, the uterus may be either repaired or removed (cesarean hysterectomy). Berghella V, Airoldi J, O'Neill AM, Einhorn K, Hoffman M. BJOG. DEFINITION Uterine rupture It is defined as "dissolution in the continuity of uterine wall any time after 28 weeks of gestation, with or without expulsion of the fetus.". Uterine rupture is a serious obstetrical condition associated with maternal mortality. She was administered misoprostol to effect uterine evacuation of a dead fetus in a primary care centre with no facilities or skilled personnel to carry out a cesarean section. Correspondence to California Privacy Statement, 1988;332:127780. SURGICAL MANAGEMENT: Caesarean Section Laparotomy Hysterectomy 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. 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 doi: 10.1016/j.crwh.2018.e00066. o [ abdominal pain pediatric ] It differs from uterine scar dehiscence which does not involve the visceral peritoneum and the placenta and fetus remains in the uterine cavity. I. S. J. Dhaifalah and H. Fingerova, Uterine rupture during pregnancy and delivery among women attending the Al-Tthawra Hospital in Sanaa City Yemen Republic, Biomedical Papers, vol. Ayder Referral Hospital, Lemlem Karl General Hospital, Adigrat General Hospital, Adwa General Hospital, and Suhul General Hospital were selected. Early clinical diagnosis is paramount to maternal survival. 2, pp. Clipboard, Search History, and several other advanced features are temporarily unavailable. There is a steady decrease in the rate of vaginal birth after cesarean (VBAC) [11]. If a uterine rupture causes major blood loss, surgeons may need to remove a woman's uterus to control her bleeding. -. Uterine rupture was defined as tearing of the uterine wall either partially or complete during pregnancy and labor, diagnosed either clinically and later confirmed at laparotomy. Its magnitude is greater in Asia and Africa than in high-income countries [3]. This unmatched case control study is aimed at identifying the risk factors of uterine rupture and describing maternal and fetal outcomes of uterine rupture. Misoprostol for second trimester pregnancy termination in women with prior caesarean: a systematic review. She underwent a total abdominal hysterectomy and blood transfusion. The second is the myometrium (smooth muscle layer). The proportion of mothers who experience obstructed labor among the case group was 80 (59.3%) and 28 (10.4%) in the control group. required to understand how this surgical approach could impact ipsilateral tubal patency and pregnancy outcomes such as uterine rupture . PubMed Symptoms and signs of uterine rupture include fetal bradycardia, variable decelerations, evidence of hypovolemia, loss of fetal station (detected during cervical examination), and severe or constant abdominal pain. Egbe T, Dingana T, Halle-Ekane G, Atashili J, Nasah B. Determinants of maternal mortality in Mezam division in the north west region of Cameroon: a community-based case control study. 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. Labour outcome of pregnancies with previous lower segment Cesarean section, The ethics of vaginal birth after cesarean, Rupture of Unscarred Pregnant Uterus: A Catastrophic Event: Case series and Review of Literature, Cesarean delivery technique among HIV positive women with sub-optimal antenatal care uptake at the Douala General Hospital, Cameroon: case series report, Fetomaternal Outcome in Post Caesarean Pregnancy, A Study of maternal outcome in uterine rupture in pregnancy at a Tertiary Care Institute, Incidence and factors associated with outcomes of uterine rupture among women delivered at Felegehiwot referral hospital, Bahir Dar, Ethiopia: cross sectional study, MEchanical DIlatation of the Cervix in a Scarred uterus (MEDICS): the study protocol of a randomised controlled trial comparing a single cervical catheter balloon and prostaglandin PGE2 for cervical ripening and labour induction following caesarean delivery, Maternal and neonatal outcome in pregnancy with previous lower segment caesarean section undergoing trial of scar. Landon Mark B, Lynch Courtney D. Optimal timing and mode of delivery after cesarean with previous classical incision or myomectomy: a review of the data. This case stresses the importance of good obstetric practice and the need for qualified medical and paramedical staff. 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. Among women with unscarred uterus, 14 presented with rupture and seven of these women were induced in hospital. 2011;61:399401. eCollection 2022 Jan. Dadhwal V, Garimella S, Khoiwal K, Sharma KA, Perumal V, Deka D. Eurasian J Med. Nguefack CT, Ekane GH, Ngoupeyou EA, Njamen TN, Kamgaing JT, Egbe TO, Priso EB. Result. Before Bujold E, Bujold C, Hamilton EF, Harel F, Gauthier RJ. Epub 2019 Aug 19. Uterine rupture is a complication that can be eliminated under conditions of best obstetric practice. Uterine rupture in the Netherlands: a nationwide population-based cohort study. Wacker et al. Uterine scar dehiscence It is defined as "separation of walls of the uterus along the line of the previous scar.". The risk of recurrence of PAS depends on the procedure used in the treatment performed and the number of treatments. Egbe O Thomas. 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. Ethnicity has been shown to influence not only trial of labor (TOL) rates but also rates of VBAC. 2009 Aug;116(9):1151-7. doi: 10.1111/j.1471-0528.2009.02190.x. This site complies with the HONcode standard for trustworthy health information: verify here. e0169304e0169308, 2017. There was a fluid thrill, shifting dullness and mild vaginal bleeding. The final sample size was 135 cases and 270 controls. 2022 Oct 6;15:551-556. doi: 10.2147/IMCRJ.S383195. 2014;4:771781. To attain this objective, use of misoprostol in primary health facilities should be stopped or proper management of the medication instituted. 2011;35(5):25761. doi: 10.4236/ojog.2014.413107. 37 Full PDFs related to this paper. Introduction. Management of uterine rupture: a case report and review of the literature. 2. At the time of the uterine evacuation, the pregnancy was 24weeks 2days gestation calculated from her last menstrual period. 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. This is an open access article distributed under the. Early clinical diagnosis is paramount to maternal survival. The plaintiff s lawyer claimed that the defendants did not appropriately monitor the plaintiff after the insertion of the dinoprostone and negligently prescribed dinoprostone, misoprostil, and oxytocin to induce labor. In a study in Ghana, a fetal weight greater than 3.45kg tripled the likelihood of having a repeat cesarean delivery (CD), and the probability of having a repeat CD was 50% for a fetal weight of 3.70kg [12, 13]. The fetus was found in the peritoneal cavity completely macerated. Labor and delivery should be supervised by trained health care provider, enabling timely and early detection of prolonged labor by partograph; early identification of fetal macrosomia during antenatal or early labor by ultrasound or other clinical methods of predicting fetal weight should be recommended. You can download the paper by clicking the button above. Cards of mothers, who gave birth from 1/9/2015 to 30/6/2019 in selected public hospitals of Tigrai, were retrieved. The cases were obtained from the labor and delivery ward, operating theatre registers, and from the patients case files retrospectively. The rate of cesarean delivery fluctuates. Moran A, Wahed T, Afsana K. Oxytocin to augment labour during home births: an exploratory study in the urban slums of Dhaka, Bangladesh. For patients with 3 prior cesarean births, classical cesarean birth, 31 percent of repeat cesarean births were performed via a classical hysterotomy . Uterine rupture is a complication that can be eliminated under conditions of best obstetric practice and use of misoprostol in primary health facilities should be stopped or proper management of the medication instituted. . If the fetus has been expelled from the uterus and is located within the peritoneal cavity, fetal and maternal morbidity and mortality increase significantly. The link you have selected will take you to a third-party website. Management is by treating read more , or fetal anomalies), Failure to recognize labor dystocia with excessive uterine contractions against a lower uterine restriction ring. Ekane GEH, Obinchemti TE, Tchente CN, Fokunang LK, Njamen TN, Bechem NN, Njie MM, Latum D. Attainment of the fifth millennium development goal: utopia or reality based on trends in maternal mortality in 12 years in two regional hospitals in fako division, Cameroon? Participants and delivery providers were blinded to the allocated treatment. A copy of the written consent is available for review by the Editor-in-Chief of this journal. Google Scholar. This may be due to delays in reaching health facilities due to long distances and poor road networks; many mothers end up with uterine rupture. Hussein AI, Omar AA, Hassan HA, Kassim MM, Yusuf AA, Osman AA. Timely diagnosis and management plays a crucial role in the prognosis of women suspected of SUUR. 2022 BioMed Central Ltd unless otherwise stated. Therefore, those who have once visited antenatal care may be overlooked in the identification of risk factors contributing to obstructed labor or delaying access to care alternatives (such as caesarian section). 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 Scale=13). 1, 2). Multifetal (multiple) pregnancy occurs in up to 1 of 30 deliveries. Unable to load your collection due to an error, Unable to load your delegates due to an error, Posterior uterine rupture extending from the fundus to the isthmus and affecting the left broad ligament and uterine vessels (See. Uterine perforation at the time of vacuum aspiration is a rare but potentially serious complication, estimated to occur in between 0.1-3 per 1,000 induced abortion procedures (Kerns & Steinauer, 2013; Pridmore & Chambers, 1999). 1. 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). 195, no. PMC Another study in Ethiopia reported a prevalence of 0.9% [10]. 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. Official cooperation letter was written from Tigray Regional Health Bureau to eastern zone woreda health office then to selected kebelles before data collection was started. Authorization was obtained from the Director of the Douala General Hospital and Consent was obtained from the patient to report the case. 3, pp. Maternal and fetal outcomes that develop uterine rupture among mothers who gave birth at public hospitals of Tigrai, North Ethiopia. 12, no. An official website of the United States government. Rupture of a myomectomy site in the third trimester of pregnancy after myomectomy, septoplasty and cesarean section: A case report. One hundred and thirty (96.3%) of the cases and 267 (98.9%) of the controls have Tigrai ethnicity, eighty (59.3%) of the cases and 138 (51.1%) of the controls were housewives, and 109 (80.7%) of the cases and 249 (92.2%) of the controls were Orthodox Tewahedo believers. Five (3.7%) of the cases and 12 (4.4%) of the controls were instrument deliveries. Nguefack et al. Learn more about the MSD Manuals and our commitment to, Abnormalities and Complications of Labor and Delivery. Introduction - Uterine Rupture Definition Uterine rupture is full-thickness loss of integrity of the uterine wall and visceral peritoneum. 2005 Sep-Oct;20(5):469-71. doi: 10.1159/000087115. Chart number of women diagnosed with uterine rupture who met the criteria was enrolled consecutively. Turner MJ. Epub 2021 Nov 25. Alkema L, Chou D, Hogan D, Zhang S, Moller A-B, Gemmill A, Fat DM, Boerma T, Temmerman M, Mathers C, Say L. Global, regional, and national levels and trends in maternal mortality between 1990 and 2015, with scenario-based projections to 2030: a systematic analysis by the UN Maternal Mortality Estimation Inter-Agency Group. Ekane GEH, Obinchemti TE, Tchente CN, Fokunang LK, Njamen TN, Bechem NN, Njie MM, Latum D. Attainment of the fifth millennium development goal: utopia or reality based on trends in maternal mortality in 12 years in two regional hospitals in fako division, Cameroon? 2010;115:10036. 37, no. 2002;186(6):132630. 4 the following primary interventions should occur immediately and simultaneously, for any delay in management can result in 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. With an incomplete rupture, or uterine dehiscence, the uterine serosa (perimetrium) surrounding the uterus remains intact.With a complete rupture, the serosa ruptures along with the myometrium, and the contents of the uterus are released into the peritoneal cavity. A retrospective study. Four hundred and five mothers cards (case notes) were reviewed based on the sampling of 135 cases and 270 controls. The study by Nguefack et al. 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. An emergency positive culdocentesis was done. in Burkina Faso reported 46.6% partogram use [17] while Ogwang et al. After calculating the previous five years admission of mothers in obstetric ward and knowing the total case load in each selected hospital, the sample size was allocated to the hospitals proportionally. Women with a classical incision that run vertically on the corpus uteri run a higher risk of uterine rupture than those with a low uterine segment transverse incision [23]. Although all these factors have been shown to influence VBAC trail outcome in some studies , they have not achieved statistical significance in other studies. 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]. The .gov means its official. Case Rep Womens Health. 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. 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. 2011;61:399401. BMC Res Notes DOI 10.1186/s13104-016-2295-9 CASE REPORT Management of uterine rupture: a case report and review of the literature Copyright 2022 Merck & Co., Inc., Rahway, NJ, USA and its affiliates. It can occur during late pregnancy or active labor. The benefit of multiple antenatal visits (recommended four visits) may be contributed through identifying, in advance, maternal risks to rupture, screening for congenital anomalies of fetus, fetal weight, uterine congenital anomalies, malpresentation, and malposition. 1, pp. Commonly, thresholds of 18 and 24months have been examined. Uterine rupture is rare. Maternal mortality, one of the major concerns of the World Health Organization, remains high in most of sub-Saharan Africa . Dystocia associated with oxytocin and/or traditional medicines labor augmentation has been observed in 12.6% of cases (60/475). Her post-operative stay in hospital was uneventful. -, 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. We have used 5% contingency for the incomplete and missed patients cards, while our final complete records for both cases and controls were 405. We have used an unmatched case control study for frequency and ensured that cases and controls are not identical; however, they are comparable and share the same geographical and social backgrounds. Cases are all mothers diagnosed with uterine rupture during pregnancy and labor and delivery in selected public hospitals of Tigrai. 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. Comparison between modified Misgav-Ladach and Pfannenstiel-Kerr techniques for Cesarean section: review of literature. See this image and copyright information in PMC. Small uterine defects, incomplete ruptures, and silent uterine incision dehiscence were excluded. Turner et al. One referral and four general hospitals were selected randomly from all general and referral hospitals found in Tigrai region. 2015;130:1236. reported that 71% of cases with uterine rupture used misoprostol [9]. Treatment & Management of Uterine Rupture . This study also found maternal death, excessive blood loss, abdominal hysterectomy, and a significant number of stillbirths as untoward outcomes of uterine rupture. Int J Gynecol Obstet. Here, we present 2 cases of non-surgical management of UR following vaginal delivery, which were both treated by uterine transarterial embolization (UAE). 2019 Oct;51(3):262-266. doi: 10.5152/eurasianjmed.2019.18341. This frequency increases with advancing gestational age and when performed by less experienced providers (ACOG, 2019). 4, pp. Mrs. MM aged 25 years, G3P2012, of the Bamileke tribe in Cameroon was admitted to our Department in hypovolemic shock BP = 70/40 mmHg, pulse 120 beats per minute, with altered consciousness (Glasgow Coma Scale = 13). Egbe et al. Graham D, Agrawal N, Roth S. Prevention of NSAID-induced gastric ulcer with misoprostol: multicentre, double-blind, placebo-controlled trial. Schematic presentation of sampling technique to identify determinants of uterine rupture and management outcomes among mothers who give birth in public hospitals of Tigray, 2018/2019. It has been recently used in the treatment of post-partum hemorrhage and complications of abortion [4]. What is a Uterine Rupture Uterine rupture is defined as a full-thickness separation of the uterine wall. 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. To attain this objective, use of misoprostol in primary health facilities should be stopped or proper management of the medication instituted. Five data collectors with a Bachelor of Science in Midwifery degree were recruited. Other predisposing factors include congenital uterine abnormalities, trauma, and other uterine surgical procedures such as myomectomies or open maternal-fetal surgery. doi:10.1016/0020-7292(94)90405-7. Variables with a value < 0.2 at the bivariate logistic regression were entered to multivariable logistic regression to identify the independent predictors of uterine rupture, to control the confounding variables, and to produce adjusted odds ratio with their corresponding confidence limits. 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 incidence of uterine rupture in Africa ranges from 0.5% to 9.5% of births [47]. Although a limited number of successful . . This can c. Health Sci Dis. 7, no. Google Scholar. This paper reports uterine rupture with severe hypovolemic shock managed at the Douala General Hospital, Cameroon. The uterine rupture was a dependent variable. Uterine inversion is a rare but serious complication during childbirth where your uterus turns partially or entirely inside out. Sultan Qaboos Univ Med J. How Long is the Safest InterDelivery Interval in Women with Previous History of Cesarean Delivery? uterine rupture complete transection of the uterus from the endometrium to the serosa partial or complete prior scar - 40%; unscarred - 60% warning signs sharp abdominal pain, foetal distress, unable to palpate presenting part vaginally, maternal shock, abnormal contouring of abdomen. Use for phrases As a result, the rates of uterine rupture have increased noticeably. 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). Referral to a bereavement counselor, peer support group, or mental health professional may be advisable for management of grief and depression. 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. 12081214, 2007. 2007;110:107582. Uterine rupture. Int J Trop Dis Health. 279283, 2006. 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. Use OR to account for alternate terms A scarred uterus is not a necessary pre-condition for uterine rupture. Please enter the related passcode in order to view this content: Invalid passcode Submit 3.3.3 Management See also algorithm. FOIA In addition, we have tried to avoid seasonal impact. The cases were obtained from the labor and delivery ward, operating theatre registers, and from the patients' case files retrospectively. Bujold E, Gauthier RJ. P. K. Mukasa, J. Kabakyenga, J. K. Senkungu, J. Ngonzi, M. Kyalimpa, and V. J. Roosmalen, Uterine rupture in a teaching hospital in Mbarara, western Uganda, unmatched case- control study, Reproductive health, vol. Indian patients have not had a large representation in former studies. 1528, 2014. In bivariate logistic regression, 20 variables showed association with uterine rupture at value of <0.2. Maternal death, stillbirth, hysterectomy, and excessive blood loss were adverse outcomes of uterine rupture. Graham D, Agrawal N, Roth S. Prevention of NSAID-induced gastric ulcer with misoprostol: multicentre, double-blind, placebo-controlled trial. 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 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. Uterine rupture is an obstetric calamity with surgery as its management mainstay. Our patient was not at particular risk for uterine rupture. A rupture may be discovered during a haemorrhage: uterine exploration after delivery of the placenta reveals the rupture. Some of the patients do not have access to optimum antenatal care and they do not have the chance to be timely assessed by a qualified clinician. Therefore, labor induction using a trans-cervical Foley catheter was not associated with an increased risk of uterine rupture [19]. Thirteen (9.6%) mothers with uterine rupture died secondary to different immediate causes. Justus Hofmeyr G, Say L, Metin Glmezoglu A. In some cases - especially if there is uterine rupture - an emergency C-section is necessary in order to prevent permanent harm to the fetus. sharing sensitive information, make sure youre on a federal My Research and Language Selection Sign into My Research Create My Research Account English; Help and support. A retrospective study. 16, pp. This study was conducted in selected public hospitals in Tigrai. In Ethiopia, the prevalence of uterine rupture ranges from 1.244% to 9.5% [4, 7, 8]. HHS Vulnerability Disclosure, Help Support Center Find answers to questions about products, access, use, setup, and administration. Controls are all mothers who gave birth without experiencing uterine rupture in selected public hospitals of Tigrai. Maternal morbidity and mortality has been a major World Health Organization concern over the years, especially in sub-Saharan Africa. Eur J Obstet Gynecol Reprod Biol. Clinicians must remain vigilant for signs and symptoms of uterine rupture. Vaginal birth after cesarean delivery in the West African setting. complication that is life-threatening for the mother and the baby. CAS https://doi.org/10.1186/s13104-016-2295-9, DOI: https://doi.org/10.1186/s13104-016-2295-9. The mothers referred from remote health institutions were 7.29 times more likely to develop uterine rupture compared to those who did not have referrals (AOR 7.29; 95% CI: 2.7, 19.68). Thomas Obinchemti Egbe. Request PDF | Management of uterine rupture during molar pregnancy | Gestational trophoblastic disease (GTD) is rare and encompasses several clinicopathologic forms from pre-malignant to malignant . 60, pp. Cite this article. The study identified referral from health facility, number of antenatal care visits, experienced obstructed labor, and birth weight of newborn to be significantly associated with uterine rupture. 2006;195:11437. 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. Diagnosis of uterine rupture is confirmed by laparotomy. Standard obstetric care was given to all participants. In the short-term plan, assessing and identifying high-risk mothers are mandatory. This prevalence was also higher in less developed countries (sub-Saharan Africa especially) than in the developed countries [7]. Information on management of patients with a uterine dehiscence (incidental She received a further 1000mL of packed cells at the ICU, making a total of 2500mL blood received by the patient. 2016;15:115. Mifepristone Followed by Misoprostol or Ethacridine Lactate and Oxytocin for Second Trimester Abortion: A Randomized Trial. There were 72000 live births in the study area with 194 cases of uterine rupture in five years data extraction from case notes of mothers. 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