Uterine rupture in Sokoto, Northern Nigeria--are we winning?

All cases of uterine rupture that were managed at the Usmanu Danfodiyo University Teaching Hospital Sokoto from January, 1995 to December, 1997 were reviewed and the findings compared with those of a previous study from the same institution, 10 years ago. Out of 3,106 deliveries within the study period there were 42 cases of ruptured uterus, giving an incidence of 1 in 74 deliveries which is similar to an incidence of 1 in 72 deliveries, a decade ago. Virtually all (41 cases) were illiterate and 93% had no antenatal care. Cephalopelvic disproportion, malpresentation and previous uterine scar were common associated factors as in the previous study. Maternal mortality of 38% and fetal mortality of 98% did not differ significantly from the previous report. The significant changes over the last 10 years were the reduction in the number of booked patients with uterine rupture from 44 to 3 cases (P < 0.05) and the reduction in the number of rupture following obstetric trauma from 32 to just 1 case (P < 0.05). Because illiteracy and poverty are at the root cause, we have now decided to take our research findings directly to the community and religious leaders, hoping that in another 10 years we might see more positive changes.