Rupture of the gravid utensis : a 32 years review in Qatar

Abstract EN

Records were reviewed of 81 cases of ruptured gravid uteri seen in the hospitals of Hamad Medical Corporation, Doha, in the 32 years 1977-2008, an overall incidence of 0.025 %, although the incidence 1977-1997 was 0.01 % and that of 1998-2008 was 0.036%.

Grand multiparity was a prominent cause (56.5 %) in the first 21 years but less so in the later period 1998-2008 (10 %) although involvement of a uterine scar from a previous caesarian section was noted more (84 %) in the later period than in 1977-1997 (43.5 %).

Other associated factors were the use of oxytocin or PGE2.

Epidural anesthesia in the later period might have provoked abnormal fetal heart rates.

The need for hysterectomy decreased from 65% to 10%.

Perinatal mortality decreased slightly.

Although we conclude that uterine rupture is rare (0.025 %) it can be catastrophic for mother and newborn and might be prevented by multi-layer uterine hysterotomy closure, a longer interpregnancy interval following a caesarian section, and no or limited use of prostaglandins.