Review of Management Outcomes of Uterine Rupture in a Facility Providing Free Maternal Health in South West, Nigeria

OBJECTIVES: To determine the prevalence, aetiological factors and fetomaternal outcome of uterine rupture at the Mother and Child Hospital during the period of free maternal health. MATERIALS AND METHODS: A retrospective study of all the cases of uterine rupture managed between January 1, 2013 and December 31, 2015. Case notes of patients who had uterine rupture were retrieved from the record department and their vital information was transcribed into a study proforma. The information was analysed using SPSS version 25 with frequencies and percentage represented by appropriate statistical tables. RESULTS: The total number of deliveries within this period of review was 9217 and 105 were uterine rupture giving a prevalence of 1.1% or 1 in 88 deliveries, 30-34 age group was mostly affected (85%) with majority of them having only primary school education (89%). Combination of aetiological factors was found, mostly inappropriate use of uterotonics with prolonged obstructed labour or inappropriate use of uterotonics with previous scar, all the patients first presented at traditional birth homes where they were given intramuscular uterotonics. There were 12 and 97 maternal and fetal deaths respectively giving a case fatality rate of 11% and perinatal mortality of 10.52. CONCLUSION: In this study, there was reduction in case fatality rate as a result of free maternal health which eliminated phase two and three delays in emergency maternity care during the study period.