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Reappraisal of ruptured uterus in an urban tertiary center in the Niger-delta region of Nigeria

Objective. To determine the incidence of ruptured uterus as well as the clinical profile and management options in a tertiary hospital setting. Methods. Thirty-three cases of ruptured uterus managed at University of Benin Teaching Hospital (UBTH) from 1 January 2003 to 31 December 2007 were identified and retrospectively studied. Results. The incidence of ruptured uterus was 4.2 per 1000 deliveries (0.4%). Majority (87.9%) of the patients were unbooked. Injudicious use of oxytocics (63.7%) and prolonged obstructed labor (60.6%) were the main associated risk factors. All 33 patients had laparotomy and 51.2% had repair of the uterine rupture only. The type of surgery performed was influenced by the site and extent of rupture. There were two cases of maternal deaths in this study, giving a case fatality rate of 6.1%. Conclusion. Rupture of the gravid uterus is still a problem in Nigeria. A proactive approach to preventing prolonged obstructed labor and curbing the injudicious use of oxytocics through education and utilization of modern antenatal and intrapartum care is advocated.