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FOETO-MATERNAL OUTCOME IN SCARRED AND UNSCARRED RUPTURE UTERUS OF SOUTHERN PUNJAB POPULATION

Dr Ayesha hanif, Dr Sidra Naeem, Dr Affaf Shaukat

Background: Uterine rupture is a rare devastating obstetrical complication that endanger the women life. Objective: To explore and compare risk factors and complications of foetal and maternal outcome in cases of uterine rupture either unscarred or scarred uterus. Material and Methods: Retrospective study was carried out in Department of Obstetrics and Gynaecology at tertiary teaching hospital. Records of all pregnant women who were admitted for delivery during a follow up period of January 2017 to June 2018, data were collected from hospitals records and analysed. 96 patients were included in the study who were identified with rupture uterus in total and only 92 records were analysed the remaining 4 women died before investigation. The remaining subjects were categorized into two groups, group one consisted of unscarred rupture uterus and group two were comprised of scarred uterus with dehiscence. Results: Rupture uterus was found in 0.74% pregnant women in our study. Rupture uterus was found in unscarred uterus 52.2% and 47.8%in scarred uterus whereas 70.8% rupture was found at term pregnancy in unscarred uterus and 63.6% in scarred uterus. Complete rupture was found incurring commonly in unscarred uterus 95.8% and scarred uterus (81.8%). Incomplete rupture was found more in scarred uterus (18.1%) in comparison to unscarred uterus (4.1%) (p<0.044). Uterus repair with bilateral tubal ligation was performed more in scarred 25% (11) as compared to unscarred uterus 4 (8.3%) (p<0.047). Total maternal deaths were 9.37% (9) but 4 died without investigation. Perinatal deaths were 91.30% (84). Conclusion: Morbidity remained high in unscarred rupture in comparison with rupture of scarred uterus, more hysterectomies performed in unscarred rupture due to involvement of both segment of uterus.

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