• Yasmeen Khooharo
  • Jabeen Zubair Yousfani
  • Sara Haider Malik
  • Aneela Amber
  • Numan Majeed
  • Nimra Haider Malik
  • Hira Pervez
  • Isra Majeed
  • Naeem Majeed


Background: Obstructed labour with ruptured uterus is a serious obstetrical complication with a high incidence of maternal and foetal morbidity and mortality. This study was conducted to find out the incidence of uterine rupture particularly in the patients of obstructed labour (OL), foeto-maternal outcome of such patients, and its management. Methods: This two year descriptive study was conducted in the Department of Obstetrics and Gynaecology Unit-I, at Muhammad Medical College Hospital from 1st January 2007 to 31st December 2008, on 40 diagnosed cases of OL. Patients were admitted through Casualty or were admitted in ward. Patients with previous caesarean section and myomectomy were excluded. Results: Ruptured uterus was found in 8 out of 40 patients of obstructed labour, they were relatively elder and grand-multiparous. Mean age of the patients was 36.5 years, while parity ranged between 5 and 12. Only one (12.5%) patient was primigravida with mean gestational age of 39.15 weeks. Seven (87.5%) patients had abdominal pain and tenderness, 5 (62.5%) vaginal bleeding, and 2 (25%) had shock. All cases were immediately managed with fluid replacement, blood transfusion and surgery. Six (75%) cases were diagnosed as ruptured uterus on clinical features while 2 (25%) with incomplete rupture were diagnosed on caesarean section for obstructed labour. Foetal mortality rate was high (7, 87.5%); 5 (62.5%) were fresh stillbirth and 2 (12.5%) died in nursery. Only 1 (12.5%) baby survived. There was 1 maternal death due to puerperal sepsis. Conclusion: The incidence of rupture uterus in obstructed labour was 20%. Immediate intervention is important factor for successful management of uterine rupture.Keywords: Obstructed labour, rupture uterus, hysterectomy, maternal mortality, foetal mortality


McCarthy M. What’s going on at the World Health Organization? Lancet 2002;360:1108–10.

Mahler H. The safe motherhood initiative: a call to action. Lancet 1987;1:668–70.

World Health Organization. Maternal mortality ratios and rates –A tabulation of available information. 3rd ed. WHO/MCH/MSM/ 91.6 Geneva: WHO; 1991.

World Health Organization Maternal Health and Safe Motherhood Programme. World Health Organization partograph in management of labour. Lancet 1994;343:1399–404.

Luella B, Voogd, Wood, Hamilton B, Powell JR, Dudley V. Ruptured Uterus. Obstetrics and Gynecology 1956;7(1):70–7.

Suner S, Jagminas L, Peipert JF, Linakis J. Fatal spontaneous rupture of a gravid uterus: case report and literature. J Emerg Med 1996;14:181–5.

Konji J, Lapido OA. Nutrition and obstructed labour. Am J Clin Nutr 2000;72:291S–7S.

Sultan MH, Khashaggi T, Adelusi B. Pregnancy following rupture of pregnant uterus. Int J Gynaecol Obstet 1996;52(1):37–42.

Ezechi OC, Mabayoje, Obiesie LO. Rupture uterus in south east Nigeria: a reappraisal. Singapore Med J 2004;45:113–6.

Menihan CA. Uterine rupture in women attempting a vaginal birth following prior caesarean birth. J Perinatol 1998;18:440–3.

Tayab S. Rupture of gravid uterus still an obstetrical problem. A three year clinical analysis. J Coll Physician Surg Pak 1996;6:144–7.

Kongnyuy EJ, Mlava G, van den Broek N. Establishing standards for obstructed labour in a low-income country. Rural and Remote Health 2008;8:1022.

Thompson W, Harper MA. Postpartum hemorrhage and abnormities of the third stage of labour. In: Chamberlain G, Philip J Steer, (Eds). Turnbull’s Obstetrics. (3rd ed). Philadelphia: Churchill Livingstone;2001.p. 619–33.

Begum TJ, Siddique MA. Rupture of gravid uterus. A 3 year review. Professional Med J 2005;12(3):205–12.

Ezegyui HU, Nwogu-lkojo EE. Uterine rupture in Enugu, Nigeria. J Obstet Gynaecol 2005;25:260–2.

Yap OW, Kim ES, Laros RK Jr. Maternal and neonatal outcome after uterine rupture in labour. Am J Obstet Gynecol 2001;184(7):1576–81.

Nabila Hassan, Pushpa Sirichand, Zakia Zaheen, Fouzia Shaik. Uterine rupture at LUMHS: A review of 85 cases. J Liaqat Uni Med Health Sci 2009;8(2):165–8.

Justus Hofmeyr G, Say L, Metin-Gulmezoglu A. WHO systemic review of maternal mortality and morbidity. BJOG 2005;112:1221–8.

Chuni N. Analysis of uterine rupture in a tertiary centre in Eastern Nepal: Lessons for obstetric care. J Obstet Gynaecol Res 2006:32:574–9.

Nahum GG, Pham QK. Uterine rupture in pregnancy 2008. URL:

Miller DA, Goodwin JM Paul RH. Intrapartum rupture of unscarred uterus. Obstet Gynaecol 1997;89:671–3.

Al-Sakka M, Danteh W, Al-Hassani S. Case series of uterine rupture and subsequent pregnancy outcome. Int J Fertil Womens Med 1999;44(6):297–300.

Dhaifalah I, Santavy J, Fingerova H. Uterine rupture during pregnancy and delivery among women attending the Al- tthawara Hospital in Sana’a City Yemen Republic. Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub 2006;150(2):279–83.

Lankoandé J, Ouédraogo CM, Touré B, Ouédraogo A, Akotionga M, Sano D, et al. 80 cases of uterine rupture at maternity service of National Hospital Centre of Ovagadougov, Burkina Faso. J Gynaecol Obstet Bial Reprod Paris 1997;26(7):715–9.



Most read articles by the same author(s)