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PL.63 Can We Suspect Scar Dehiscence or Rupture at Early Stages?
  1. S Bhaskar,
  2. W Forson
  1. Royal Maternity Hospital, Belfast, UK

Abstract

Introduction Uterine rupture is amongst the preventable obstetric complication that carries severe risks both to mother and baby

Aim Critically analyse the notes of women with rupture uterus over a period of 11 years and to reflect and learn from the outcome.

Method and Settings Retrospective analysis of case notes of women with confirmed uterine rupture over a period of 11 years from January 2000–December 2011 at Royal Maternity Hospital, Belfast.

Results 17 women had confirmed uterine rupture in the study period of which 4 were preterm. All women except for one, had one or more term caesarean sections in past. The median interval between caesarean section and rupture was 3 years. Only 23% of women had induction of labour. Scar tenderness with or without suspicious CTG was the leading reason to suspect rupture. In nearly 70% of women maternal observations remained stable. Scar rupture was suspected only in 65% of women before the surgical intervention. 8 women (47%) had either scar rupture or dehiscence of varying length while remaining 53% had extensions of scar rupture. Conservative management remained the main stay of management. 35% of babies required neonatal care. The study also considered factors like uterine anomalies and surgeries, labour details including postpartum, staff involved etc.

Conclusion Trial of labour in previous section with successful outcome has long term implication on maternal health, while at the same time staff providing the care should be educated and trained to suspect the scar problems at early stages and intervene appropriately.

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