[Uterine rupture in the maternity ward of the Bangui Community Hospital (Central Africa)].

Although now uncommon in developed countries, uterine rupture is among the major obstetrical emergencies dealt on a daily bases in the maternity ward of the Bangui Community Hospital in Central African Republic, which is the national reference facility. Uterine rupture is life-threatening for both the fetus and mother. In view of the relatively high rate of rupture observed in our department in previous years, this cross-sectional study was undertaken in order to determine incidence, identify predisposing factors, evaluate prognosis for the mother and newborn, and propose solutions. From January 1997 to December 1997, all deliveries by the vaginal route or cesarean section including cases involving uterine rupture were recorded. The length of time elapsed between the decision to perform cesarean section and actual performance of the procedure was determined. Risk factors associated with uterine rupture in our department were noted. The outcome of uterine rupture was evaluated in both the mother and fetus. Of a total of 5763 deliveries during the study period, 299 required cesarean section (5.9%). Uterine rupture occurred in 35 cases of the 299 women (11.7%). In 10 cases of uterine rupture, the time lapse for performance of cesarean section was at least 2 hours. The main cause of delay was the lack of funding for cesarean section. Six women died due to irreversible shock (0.1% of deliveries, 2% of cesarean sections and 17.1% of uterine ruptures). The perinatal mortality rate was 80%. In our department, uterine rupture is a common emergency causing high mortality in mothers and newborns. Most of these patients could have been saved.