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.