Ruptured uterus in Azare, north eastern Nigeria

Background:-Ruptured uterus is an obstetric emergency and results in significant maternal and perinatal morbidity and mortality in Nigeria. The objective of the review is to determine the incidence, predisposing factors, maternal and foetal outcome in cases of ruptured uterus. Methods:- A 4-year retrospective review of patients that had uterine rupture between July 2003 and June 2007 in Federal Medical Centre, Azare was carried out. Analysis of available records of the cases of ruptured uterus from the labour room, and theatre during the period under review was done. Results:-A total of 75 cases of ruptured uterus and 9015 deliveries were recorded in the period under review. The incidence of uterine rupture is 1 in 120 deliveries. The highest incidence of ruptured uterus was found in the grand multiparous women, 46 (63%). Injudicious use of oxytocin was found in more than half of the cases 41(56.2%). Majority of the rupture (56.3%) occurred in the lower segment. Thirty-two (45.1%) had repair and tubal ligation done. Maternal case fatality was 10.7% while foetal wastage was 86.3%.The commonest complication was anaemia, which occurred in 44% of the patients. Conclusion:-The incidence of uterine rupture is very high in Azare. There should be a multi-sectoral collaboration aimed at improving the utilization of medical services by the populace and the organization of health institutions offering obstetric emergency care. Key Words:-Uterine rupture, Predisposing factors, Management, Outcome, Azare