A 5-Year Review of Uterine Rupture in the Federal Medical Centre, Yenagoa, South-South Nigeria

Abstract

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. Objectives: To determine the incidence of uterine rupture and the maternal and perinatal outcomes associated with it at the Federal Medical Centre, Yenagoa, Bayelsa State, Nigeria over a 5-year period. Materials and Methods: This retrospective survey was carried out between 1st January, 2016 and 31st December, 2020. Data were retrieved, entered into a pre-designed proforma, and analysed using IBM SPSS version 23.0. Results were presented in frequencies and percentages for categorical variables and mean and standard deviation for continuous variables. Results: Thirty-four women presented with uterine rupture out of the 4,571 obstetric patients that were managed in the Centre with an incidence rate of 7.4 per 1,000 pregnancies. Majority (79.4%) of the women were multiparous, and referred (94.1%) from traditional birth attendant (TBA) homes. All the pregnancies were term, unbooked for antenatal care and none of the women had tertiary level of education. There were 3 cases of maternal mortality (case fatality rate of 8.8%) and 28 (82.4%) cases of perinatal mortality. Conclusion: 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.