Maternal and Neonatal Outcomes in Women Complicated with Previous Complete Rupture of the Unscarred Gravid Uterus

Background: Uterine rupture during gestation can be lethal for both the mother and the fetus. Unscarred uterine rupture, however rare, is increasingly prevalent compared to scarred uterine rupture and is associated with heightened maternal and neonatal morbidity. Objective: The study was design to evaluate the outcomes for mothers and newborns in women complicated with previous complete rupture of the unscarred gravid Uterus. Methods: A prospective study involving human populations was conducted at the Duhok Obstetrics and Gynaecology Teaching Hospital in Iraqi Kurdistan during a five-year period, from September 2019 to September 2024. Twenty pregnant women with a singleton fetus at ≥28 weeks gestation who had previously experienced a total rupture of the unscarred uterus were included in the study. The study eliminated all cases of uterine dehiscence, abnormal fetus twine pregnancy, previous caesarean delivery, and any surgical procedures performed between rupture repair and the subsequent pregnancy. Every three weeks, women with this history are examined, every woman is admitted to the hospital between weeks 30 and 34 of pregnancy, or sooner if she has uterine contractions prior to receiving a course of corticosteroid medication. At 34 and 36 weeks, elective caesarean deliveries are scheduled. The data was collected from pregnant women included the demographic features, maternal outcomes, neonatal outcomes and characteristics of previous ruptures. Results: The mean maternal age was (29 ± 4.0), with (60%) having a BMI of <25.0and (40%) having a BMI of ≥25.0. Sixteen cases (80%) of pregnancies ended in delivery between weeks 34 and 36, while 4 cases (20%) ended between weeks 28 and 33. Delivery occurred by elective CD. No maternal deaths, repeated uterine ruptures, or intensive care unit admissions were noted. Twenty babies were born. In 16 cases (80%), the baby's sex was male, and in 4 cases (20%), it was female, fourteen (70%) babies had a pgar score at 5 minutes of seven or higher. Among the 20 women, rupture was more common in posterior wall, previous ruptures resulted in 11 (55%) of perinatal deaths. Conclusions: Pregnancies following a complete unscarred uterine rupture proceed without significant maternal or fetal complications, upon intensive clinical observation.