Ruptured uterus in Kaduna, Nigeria: a six-year review.

A six year review in a Nigerian University Teaching Hospital revealed that the incidence of ruptured uterus is 1 per 137 deliveries. The mean age of patients was 30.5 years. Ruptured uterus occurred in younger women with a scarred uterus compared with the unscarred group. The incidence of ruptured uterus was highest in women who were para 5 and above. Cephalopelvic disproportion was the most important obstetric factor associated with rupture (63.4%). Abdominal tenderness (46.3%), vaginal bleeding (31.7%) and pallor (31.7%) were the commonest clinical features at presentation. Shock (22%) was commonest in the unscarred group. Repair with tubal sterilisation was the commonest method of treatment. Diarrhoea was the commonest postoperative complication (39%). Maternal and perinatal mortality rates were 22% and 88% respectively. Improving the emergency capability of the hospital and more efforts at educating our women and reducing poverty will go a long way towards reducing the incidence and adverse clinical outcome of ruptured uterus.