Yibrah Berhe1, L Lewis Wall2. 1. Director of Residency Training and Assistant Professor. 2. Fulbright Scholar and Visiting Professor, Department of Obstetrics & Gynecology, Ayder Referral Hospital, College of Health Sciences, Mekelle University, Mekelle, Ethiopia; and Professor of Obstetrics and Gynecology, Department of Obstetrics & Gynecology, School of Medicine, and Professor of Anthropology, Department of Anthropology, College of Arts and Sciences, Washington University, St Louis, MO.
Abstract
IMPORTANCE: Rupture of the gravid uterus is an obstetric catastrophe associated with high levels of maternal-fetal mortality and morbidity. OBJECTIVE: The aim of this study was to review the clinical experience with uterine rupture in resource-poor countries. EVIDENCE ACQUISITION: A MEDLINE search of the clinical literature since 1960 was carried out using the headings "uterine rupture" and "ruptured uterus," including the Medical Subject Heading "developing countries." Further bibliographic compilation was assisted by hand searches of references from retrieved articles. The available articles were then reviewed, synthesized, and summarized. RESULTS: Uterine rupture remains a major obstetric problem in resource-poor countries. In industrialized, high-resource countries, uterine rupture occurs most often in women who have had a previous cesarean delivery, whereas in resource-poor nations, uterine rupture is more commonly associated with obstructed labor, injudicious obstetric interventions/manipulations (often performed by untrained birth attendants), lack of antenatal care, grand multiparity, and poor access to emergency obstetric care. Uterine rupture after a prior cesarean delivery is becoming more common in these countries as more women gain access to emergency obstetric care. CONCLUSIONS AND RELEVANCE: Uterine rupture afflicts the world's poor women disproportionately. In resource-poor settings, uterine rupture is a reflection of ill-equipped, badly managed, and underresourced health care systems that seem largely indifferent to the reproductive health needs of women. The ultimate success (or failure) of these countries depends in large part upon their commitment to maintaining a healthy and productive female population.
IMPORTANCE: Rupture of the gravid uterus is an obstetric catastrophe associated with high levels of maternal-fetal mortality and morbidity. OBJECTIVE: The aim of this study was to review the clinical experience with uterine rupture in resource-poor countries. EVIDENCE ACQUISITION: A MEDLINE search of the clinical literature since 1960 was carried out using the headings "uterine rupture" and "ruptured uterus," including the Medical Subject Heading "developing countries." Further bibliographic compilation was assisted by hand searches of references from retrieved articles. The available articles were then reviewed, synthesized, and summarized. RESULTS: Uterine rupture remains a major obstetric problem in resource-poor countries. In industrialized, high-resource countries, uterine rupture occurs most often in women who have had a previous cesarean delivery, whereas in resource-poor nations, uterine rupture is more commonly associated with obstructed labor, injudicious obstetric interventions/manipulations (often performed by untrained birth attendants), lack of antenatal care, grand multiparity, and poor access to emergency obstetric care. Uterine rupture after a prior cesarean delivery is becoming more common in these countries as more women gain access to emergency obstetric care. CONCLUSIONS AND RELEVANCE: Uterine rupture afflicts the world's poor women disproportionately. In resource-poor settings, uterine rupture is a reflection of ill-equipped, badly managed, and underresourced health care systems that seem largely indifferent to the reproductive health needs of women. The ultimate success (or failure) of these countries depends in large part upon their commitment to maintaining a healthy and productive female population.
Authors: Alfred Kwesi Manyeh; Alberta Amu; David Etsey Akpakli; John Williams; Margaret Gyapong Journal: BMC Pregnancy Childbirth Date: 2018-10-16 Impact factor: 3.007
Authors: Malavika Prabhu; Linda O Eckert; Michael Belfort; Isaac Babarinsa; Cande V Ananth; Robert M Silver; Elizabeth Stringer; Lee Meller; Jay King; Richard Hayman; Sonali Kochhar; Laura Riley Journal: Vaccine Date: 2017-12-04 Impact factor: 3.641