Fetomaternal Mortality and the Associated Factors in Pregnant Women with Uterine Rupture
Fetomaternal Mortality in Pregnant Women with Uterine Rupture
DOI:
https://doi.org/10.54393/pjhs.v7i1.3332Keywords:
Fetal Mortality, Hemorrhage, Hysterectomy, Maternal Mortality, Ruptured Gravid Uterus, Wound InfectionAbstract
Disruption of all uterine layers in pregnant women can lead to rupture of the uterus. Although it is a rare complication, fetal as well as maternal outcomes can be disastrous. Delay in the diagnosis and management is the reason for adverse outcomes owing to the rare and unexpected nature of the complication. Objective: To determine fetomaternal mortality and its associated factors in pregnant women with uterine rupture. Methods: Total 89 cases with diagnosed ruptured uterus of pregnant women were selected via nonprobability consecutive sampling. Age, body mass index, and gestational age were documented. Outcome variables were fetal and maternal mortality, wound infection, hemorrhage, and hysterectomy. Baseline factors were compared on the basis of fetal or maternal mortality to determine the responsible factors. Results: Mean age of the patients was 31.15±3.83 years. Mean gestational age was 30.32±3.50 weeks, and median parity was 3. Mean BMI was 26.56±1.49 kg/m2. Of all the patients, 34 (38.2%) had a positive history of cesarean section. Wound infection was observed in 38 (42.7%) of the patients. Maternal and fetal mortality occurred in 22 (24.7%) and 59 (66.3%) patients, respectively. Conclusions: Fetal and maternal mortality were high among the patients with a ruptured uterus. Maternal mortality was related to high maternal age and parity, while fetal mortality was related to gestational age and maternal BMI. A previous cesarean section was related to both maternal and fetal demise.
References
Kumara MG, Debelew GT, Ademe BW. Trend, Prevalence, and Associated Factors of Uterine Rupture at Nekemte Specialized Hospital, Oromia Regional State, Western Ethiopia. Scientific Reports. 2024 Oct; 14(1): 25722. doi: 10.1038/s41598-024-77881-x. DOI: https://doi.org/10.1038/s41598-024-77881-x
Chiossi G, D’Amico R, Tramontano AL, Sampogna V, Laghi V, Facchinetti F. Prevalence of Uterine Rupture Among Women with One Prior Low Transverse Cesarean and Women with Unscarred Uterus Undergoing Labor Induction with PGE2: A Systematic Review and Meta-Analysis. PLoS One. 2021 Jul; 16(7): e0253957. doi: 10.1371/journal.pone.0266062. DOI: https://doi.org/10.1371/journal.pone.0253957
Tesema O, Tilahun T, Kejela G. Determinants of Uterine Rupture at Public Hospitals of Western Ethiopia: A Case–Control Study. SAGE Open Medicine. 2022 Apr; 10: 20503121221092643. doi: 10.1177/20503121221092643. DOI: https://doi.org/10.1177/20503121221092643
Ichinose M, Iriyama T, Hiraike O, Sayama S, Hashimoto A, Suzuki K et al. Hysteroscopic Endometrial Defect Following Adenomyomectomy and Incidence of Placenta Accreta Spectrum and Uterine Rupture Complications for Subsequent Pregnancy. Reproductive Sciences. 2025 Feb; 32(2): 467-73.doi: 10.1007/s43032-024-01758-7. DOI: https://doi.org/10.1007/s43032-024-01758-7
Andonovová V, Hruban L, Gerychová R, Janků P, Ventruba P. Uterine Rupture During Pregnancy and Delivery: Risk Factors, Symptoms and Maternal and Neonatal Outcomes-Retrospective Cohort. Ceska Gynekologie. 2019 Jan; 84(2): 121-8.
Finnsdottir SK, Maghsoudlou P, Pepin K, Gu X, Carusi DA, Einarsson JI et al. Uterine Rupture and Factors Associated with Adverse Outcomes. Archives of Gynecology and Obstetrics. 2023 Oct; 308(4): 1271-8. doi: 10.1007/s00404-022-06820-w. DOI: https://doi.org/10.1007/s00404-022-06820-w
D’Asta M, Gulino FA, Ettore C, Dilisi V, Pappalardo E, Ettore G. Uterine Rupture in Pregnancy Following two Abdominal Myomectomies and IVF. Case Reports in Obstetrics and Gynecology. 2022; 2022(1): 6788992. doi: 10.1155/2022/6788992. DOI: https://doi.org/10.1155/2022/6788992
Niazi M, Masood S, Farooq M. Frequency of Fetomaternal Outcome of Ruptured Gravid Uterus. International Journal of Advanced Biotechnology and Research. 2018 Jan; 9(2): 34-7.
Desta M, Kassa GM, Getaneh T, Sharew Y, Alemu AA, Birhanu MY et al. Maternal and Perinatal Mortality and Morbidity of Uterine Rupture and Its Association with Prolonged Duration of Operation in Ethiopia: A Systematic Review and Meta-Analysis. PloS one. 2021 Apr; 16(4): e0245977. doi: 10.1371/journal.pone.0245977 DOI: https://doi.org/10.1371/journal.pone.0245977
Shaikh F. Uterine Rupture After Previous Cesarean Section and Feto-Maternal Outcome. Journal of Surgery Pakistan. 2019 May; 24(1): 46-50. doi:10.21699/jsp.24.1.11.
Astatikie G, Limenih MA, Kebede M. Maternal and Fetal Outcomes of Uterine Rupture and Factors Associated with Maternal Death Secondary to Uterine Rupture. BioMed Central Pregnancy and Childbirth. 2017 Apr; 17(1): 117. doi: 10.1186/s12884-017-1302-z. DOI: https://doi.org/10.1186/s12884-017-1302-z
Abbas AM, A. Shehata M, M. Fathalla M. Maternal and Perinatal Outcomes of Uterine Rupture in a Tertiary Care Hospital: A Cross-Sectional Study. The Journal of Maternal-Fetal & Neonatal Medicine. 2019 Oct; 32(20): 3352-6. doi: 10.1080/14767058.2018.1463369. DOI: https://doi.org/10.1080/14767058.2018.1463369
Sharon N, Maymon R, Pekar-Zlotin M, Betser M, Melcer Y. Midgestational Pre-Labor Spontaneous Uterine Rupture: A Systematic Review. The Journal of Maternal-Fetal & Neonatal Medicine. 2022 Dec; 35(25): 5155-60. doi:10.1080/14767058.2021.1875435. DOI: https://doi.org/10.1080/14767058.2021.1875435
Al‐Zirqi I and Vangen S. Prelabour Uterine Rupture: Characteristics and Outcomes. BJOG: An International Journal of Obstetrics & Gynaecology. 2020 Dec; 127(13): 1637-44. doi: 10.1111/1471-0528.16363. DOI: https://doi.org/10.1111/1471-0528.16363
Adegbola O and Odeseye AK. Uterine Rupture at Lagos University Teaching Hospital. Journal of Clinical Sciences. 2017 Jan; 14(1): 13-7. doi: 10.4103/2468-6859.199163. DOI: https://doi.org/10.4103/2468-6859.199163
Abrar S, Abrar T, Sayyed E, Naqvi SA. Ruptured Uterus: Frequency, Risk Factors and Feto-Maternal Outcome: Current Scenario in a Low-Resource Setup. Plos One. 2022; 17(4): e0266062. doi: 10.1371/journal.pone.0266062. DOI: https://doi.org/10.1371/journal.pone.0266062
Gibbins KJ, Weber T, Holmgren CM, Porter TF, Varner MW, Manuck TA. Maternal and Fetal Morbidity Associated with Uterine Rupture of the Unscarred Uterus. American Journal of Obstetrics and Gynecology. 2015 Sep; 213(3): 382-E1. doi: 10.1016/j.ajog.2015.05.048. DOI: https://doi.org/10.1016/j.ajog.2015.05.048
Rottenstreich M, Rotem R, Hirsch A, Farkash R, Rottenstreich A, Samueloff A et al. Delayed Diagnosis of Intrapartum Uterine Rupture–Maternal and Neonatal Consequences. The Journal of Maternal-Fetal and Neonatal Medicine. 2021 Mar; 34(5): 708-13. doi: 10.1080/14767058.2019.1613366. DOI: https://doi.org/10.1080/14767058.2019.1613366
Tan SQ, Chen LH, Muhd Abdul Qadir DB, Chern BS, Yeo GS. Risk Factors and Outcomes of Uterine Rupture in Singapore: Emerging Trends. Annals of the Academy of Medicine, Singapore. 2021 Jan; 50(1): 5-15. doi: 10.47102/annals-acadmedsg.2020319. DOI: https://doi.org/10.47102/annals-acadmedsg.2020319
Chang YH. Uterine Rupture Over 11 Years: A Retrospective Descriptive Study. Australian and New Zealand Journal of Obstetrics and Gynaecology. 2020 Oct; 60(5): 709-13. doi: 10.1111/ajo.13133. DOI: https://doi.org/10.1111/ajo.13133
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