Fané S, Bocoum A, Traoré SO, Kanté I, Sylla C, Sissoko A, Traoré A, Sima M, Sanogo SA, Kouma A, Sanogo A, Sylla M, Adiawiakoye A, Coulibaly M, Teguété I, Traoré Y, Mounkoro N. [Risk factors and management of uterine rupture in a 1st reference structure in Mali: case of the Bougouni health district].
Mali Med 2022;
37:15-22. [PMID:
38514953]
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Abstract
The objective was to assess the risk factors for and to suggest therapeutic aspects.
MATERIALS AND METHODS
We carried out a case-control study at the Bougouni Reference health center in 2019.
RESULTS
From January to December 31, 2019; out of 1161 deliveries, 43 uterine rupture were recorded, 3.7% corresponding to one uterine rupture for 27 deliveries. Patients 35 years and older were more affected by uterine rupture (44.2%) with ORaIC95% = 6.3 [1.5 - 26.3]. Obstetric evacuations had an ORaIC95% = 25.6 [7.8-83.7]. All of the patients were housewives (97.7%) versus (82.3%) controls with ORaIC95% = 8.9 (1.1-69). Pauciparous and multiparous had an ORaIC95% = 6.2 [1.8 - 20.3] and 4.1 [1.3 - 12.9], respectively. The uterine scar (20.9%) of cases versus 8.1% of controls had a 95% ORaIC95% = 2.9 [1.1 - 8.7]. Indeed the absence of ANC was a risk factor, ORaIC95% = 3.0 [1.3 - 6.9]. The time to uterine rupture was < 6 hours in 95%. In fact 34 complete uterine rupture (79.1%) and 9 incomplete uterine rupture (20.9) were noted. Only 2.3% of cases gave birth vaginally. Treatment of uterine rupture was based on surgery (100%) supplemented by shock (51.2%) of cases and infection (100%) of cases.
CONCLUSION
Uterine rupture is common in our countries under medical care. Its effective prevention involves strategies aimed at acting on risk factors.
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