Woman health; uterus rupture, its complications and management in teaching hospital bannu, pakistan.

Objectives: To evaluate risk factors, management, maternal and fetal outcomes of ruptured uterus at Women and Children Teaching Hospital Bannu, Pakistan.

Study Design: The prospective observational study was designed from January 2009 to December 2009. A total 64 patients were found with ruptured uterus evaluated in Women and Children Teaching Hospital Bannu, Pakistan. The aim of the study was to evaluate risk factors, management, maternal and fetal outcomes.

Results: Frequency of ruptured uterus in hospital was found in 9/ 1000 deliveries, higher than most other studies. Amongst etiological factors the most important were great multiparity 27 (42.2%), injudicious use of Oxytocin 33 (51.6%), obstructed labour 8 (12.5%) and previous caesarean section 12 (18.8%). Of the total number of patients, 49 (76.6%) underwent abdominal hysterectomy (either subtotal or total), 3.1% of them needed bladder repair and 15.6% underwent repair of uterus. 5 (7.8%) died either due to irreversible shock or disseminated intravascular coagulation, 4% of patients had incontinence of urine, 53 (82.8%) of cases delivered dead babies and 9 (14.1%) had severe birth asphyxia needing neonatal intensive care.

Conclusion: Uterine rupture is amongst the preventable obstetric complication that carries severe risks both to the mother as to the baby. Health education of people, training and supervision of health personal may reduce incidence especially in remote areas.