Rupture of the uterus in Dublin; an update

SummaryIn the 10 years 1979 to 1988, there were 27 cases of ruptured uterus in 78 489 deliveries. There was no case in 27 829 primigravidae. In 48 718 multigravidae with unscarred uteruses there were eight cases (0.02 per cent) and in 2842 multigravidae who had previously had caesarean sections there were 19 ruptured uteruses (0.7 per cent). Postpartum haemorrhage was the commonest presentation of rupture of the unscarred uterus while intrapartum fetal distress was the predominant feature in the majority of cases of rupture of the scarred uterus. Oxytocin administration was the most frequently associated feature in women with a previous uterine scar. There were no maternal deaths. Eight of the 27 patients had a caesarean hysterectomy. There were 12 perinatal deaths (45 per cent). Rupture of the uterus still presents a significant clinical problem which must be identified if the associated risks to maternal and fetal well-being are to be reduced.