A comparative analysis of uterine rupture in 2 decades

OBJECTIVE: To compare the changing trends of uterine rupture in 2 decades along with the maternal and fetal outcome in scarred and unscarred uterus.

METHODS: The risk factors of the uterine ruptures, which occurred in the Ministry of Health Hospitals in Bahrain in 2 decades, were analyzed. The maternal and the fetal outcome was compared between the 2 decades (1981-2000) and between the scarred and unscarred uterus.

RESULTS: The rise of uterine rupture in the 2nd decade (50) as compared with the first decade (25) was parallel to the increasing rate of cesarean section (CS). Instrumental deliveries and augmentation of labor were the main significant risk factors in the first decade while induction of labor was in the later decade. There was a significant decrease of maternal morbidity in the 2nd decade inspite of the increasing rate of uterine rupture. There was no maternal death; however, there were 11 perinatal deaths in the first group compared to 14 in the 2nd group. The maternal morbidity and perinatal mortality was significantly higher in the uterine ruptures of the intact uterus as compared to those with scarred uterus.

CONCLUSION: Inspite of the high incidence rate of the uterine rupture in the later decade, the morbidity of the mother and the fetus show no increase. The increase in the incidence of the uterine rupture is connected to the increasing rate of CS. The rupture of the intact uterus is more catastrophic as compared to the scarred uterus.