Introduction
Uterine rupture (UR) is the tearing of the uterine wall and the loss of
its integrity through breaching during pregnancy, delivery or
immediately after delivery1-3. According to the world
health organization, the average incidence of uterine rupture is 5.3 /
l00001. UR is one of the most serious obstetric
emergencies and a life-threatening
event. It is an important cause of morbidity and mortality for mothers
and their newborns4-6. Maternal mortality ranges
between 1% and 13 % and perinatal mortality between 74 % and 92
%1. The determinant factors for maternal and fetal
outcomes of uterine rupture differ across geographical boundaries due to
the difference in socio-demographic status, the availability and
accessibility of skilled birth attendant and health system
effectiveness. Assessing maternal and fetal outcomes of uterine rupture
and factors associated with maternal and fetal death in the study area
is important to design policies and strategies for the prevention and
the clinical management of uterine rupture.
Although the occurrence of uterine rupture is relatively rare, it is
more frequent in low-income compared to high-income
countries7, 8. In high-income countries, the greatest
risk factor is a scarred uterus, typically from a previous cesarean
delivery. Risks for uterine rupture are also related to factors such as
parity, obstructed labor, induction of labor, use of prostaglandins,
and/or breech presentation1, 7, 9. VBAC(vaginal birth
after caesarean section)is an important option to reduce caesarean
section rate. But in China, many hospitals are reluctant to attempt a
TOLAC (trial of labour after caesarean delivery) for increasing the
risks of severe adverse outcomes, such as uterine rupture and fetal or
neonatal death. However, reports on uterine rupture and its maternal and
perinatal outcomes for such delivery are lacking in China. As to scarred
uterus, previous studies have generally concentrated on the outcome of
uterine rupture mostly in patients with previous cesarean section, and
few have described the outcome in patients with other gynecological
surgery history.
The
aim of this study was to review all cases of uterine rupture seen in our
hospital during the period 2013-2020 to assessed the incidence, the
associations with previous caesarean, other gynecological surgery
history, and the maternal and perinatal implications of uterine rupture.