Spontaneous Rupture of Unscarred Uterus in Grand Multiparous Women: A Report of 5 Cases

Introduction Uterine rupture is a catastrophic obstetrical emergency associated with a significant foeto-maternal morbidity and mortality. Many risk factors for uterine rupture have been identified, as well as a wide range of clinical presentations. Objectives To analyse the predisposing factors and maternal and foetal outcome of unscarred uterine rupture in grand multiparous women. Methods Retrospective analysis of cases of unscarred uterine rupture was conducted at the Department of Obstetrics and Gynaecology, RIMS, Imphal from October 2013 to March 2015. Results Our case series comprised of 5cases. Out of these all were unbooked cases. Majority of the cases (60 %) were para5-6. Uterine rupture occurred at term in all 5 cases.4 out of 5 cases had history of manipulation by a traditional dai at home and subsequently were referred to a higher centre where as 1 came to the hospital for retained placenta after home delivery. Out of these, only 2 babies (40 %) survived. Maternal mortality was nil. Conclusion Rupture uterus is a high risk category of patients. An unscarred uterus can undergo rupture even without etiological or risk factors. The patients with mismanaged labour, grand multiparous women and obstructed labour must be managed by proper trained personnel at a tertiary care centre to avoid maternal and foetal morbidity and mortality.