Foeto-maternal Outcome in Scarred and Unscarred Rupture Uterus of North Indian Population

Background: Uterine rupture is a rare devastating obstetrical complication that endanger the women life. Objective: To compare the risk factors, complications, 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 2015 to June 2016, data were collected from hospitals records and analyzed. A total of 96 patients were identified with rupture uterus and only 92 women records were analyzed because 4 women died before any intervention. On the basis of records these 92 cases of rupture uterus further 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. 52.2% (48) rupture uterus was found in unscarred uterus and 47.8% (44) in scarred uterus. 70.8% (34) rupture was found at term pregnancy in unscarred uterus and 63.6% (28) in scarred uterus. Complete rupture was more common in unscarred uterus 95.8% (46) as compared to scarred uterus 36 (81.8%). Incomplete rupture was found more in scarred uterus 8 (18.1%) in comparison to unscarred uterus 2 (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 un investigated. Perinatal deaths were 91.30% (84). Conclusion: Morbidity is high with unscarred rupture as compared to rupture of scarred uterus, more hysterectomies performed in unscarred rupture due to involvement of both segment of uterus.