The-clinical data presented were based on 14 cases of the ruptured gravid uterus among the9429 cases of total deliveries seen in Ewha Woman´s University Hospital, Seoul, during 6 years. period from Jan. 1962 to March 1968.
The summary analysed were as follows.
1. The incidence of uterine rupture was 0.15% or 674:1, among total cases of deliveries: and it seemed to be remaining steady in it´s tendency for the past 6 year´s period.
2. The leading cause- of uterine rupture was abuse of the oxytocin accounting for 36% of the cases and it resulted in mostly by non-obstetrical man or midwives.
3. The occurence of rupture of previous uterine scar were obviously more often (3 out of 4)> in the classical scars rather than in the low cervical scars.
4. Fetal mortality were considered high as 50% of the cases. However, no maternal death encountered.
5. All of the uterine rupture were invariably happened- in the multiparous gravida..
Particularly in the cases with para 1 there showed rather high incidence of uterine ruptures(37.5%) in which means that even one who had a previous vaginal delivery does not necessary guarantee it free of the accident or danger of abusing oxytocin.
6. The common type of uterine rupture was the complete rupture of the uterus (64%) which is a serous one, and it had been found mostly in the area of the low segment.
7. We have treated with immediate total hysterectomy in 5 cases, subtotal hysterectomy in 4 cases and simple repair in 5 cases depend on the reptured site, extension and the patient status. We would like to empasize that the proximal end of the uterine artery concealing in the clots must be identified and ligated for prevention of the possible late bleeding after the clot resolution takes place . 8. It was our hope that the accident of uterine rupture could be greatly reduced to 29.°a of the total cases by the adequate correction of the medical man´s mismanagement such as oxytucin abuse, prolonged labor and technique of Cesarean sections, furthermore, the remaining risk can be prevented to zero by the correction of the patient´s delayed admissions.
|