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Study of cases of rupture uterus and its maternal and perinatal outcome in a tertiary care institute

Background: Rupture of the pregnant uterus refers to complete disruption of all uterine layers, 
including the serosa. It is a life-threatening obstetric emergency and a major cause of maternal and perinatal morbidity and mortality. In India, in advanced setups the incidence of rupture preceded by obstructed labour is decreasing, in rural parts where there is inadequate care, lack of communication and transport, home deliveries by untrained dais incidence of rupture uterus is still high. So, the study is to evaluate the etiological factors, incidence, management modalities and maternal and perinatal outcome. Methods: A hospital based prospective cross-sectional study of 201 cases of rupture uterus and maternal and Perinatal outcome was conducted in the department of Obstetrics and Gynecology in government tertiary reference center, Kolkata, West Bengal India from March 2020 to April 2021. Total 201 cases of rupture uterus fulfilling the inclusion criteria were included in the study. Template was generated in MS excel sheet and analysis was done on SPSS software. Results: Majority of the patients 180 (89.55%) have incomplete rupture and only 21 (10.45%) have complete rupture. In regard to treatment done 64 (31.84%) treated with total hysterectomy, 60 (29.85%) treated with subtotal hysterectomy, 51 (25.37%) treated with repair with BLTL and 26 (12.94%) treated with repair without BLTL. All mothers 201 (100%) were repeated transfusion followed by Bladder Injury 18 (8.96%), Wound Sepsis 15 (7.46%). Maximum fetal complication was Perinatal Asphyxia 96 (47.76%) followed by Sepsis 7 (3.48%), Jaundice 14 (6.97%). Conclusions: Uterine rupture is still a major public health problem in the developing countries, that has a high potential for causing perinatal and maternal morbidity and mortality. Behavioural change strategies should be employed in educating women and their spouse through peer education, group engagement and culturally sensitive and acceptable strategies on the need to attend antenatal clinics, and have their deliveries in hospitals equipped with trained and skilled personnel to supervise pregnancy, labour and delivery.