Review of Maternal and Fetal Mortality Associated with Uterine Rupture at a Tertiary Maternity Center in Lagos, Nigeria

Maternal and Fetal Mortality Associated with Uterine Rupture

  • KEHINDE SHARAFADEEN OKUNADE Department of Obstetrics and Gynaecology, College of Medicine, University of Lagos
  • FATAI OLAWALE OBA Department of Obstetrics & Gynaecology, Lagos University Teaching Hospital
  • TEMITOPE OJO Department of Obstetrics & Gynaecology, Federal Medical Center, Ebute-meta, Lagos
  • OLUSANJO EBENEZER MOSES Department of Obstetrics & Gynaecology, Lagos Island Maternity Hospital
Keywords: Caesaren section, Incidence, Multiparous, Stillbirths


Background: More than 90% of maternal deaths and stillbirths occur in developing countries, and ruptured uterus is a major contributor. This study was aimed to review the current incidence of uterine rupture and the associated maternal and fetal mortality in Lagos, Nigeria over a 13-year period. 

Methods: This was a descriptive retrospective review of all cases of uterine rupture at a tertiary maternity center in Lagos, Nigeria over a 13-year period. The case notes of all women were retrieved from the Medical records Department and relevant information extracted. Descriptive statistics were computed for all quantitative data and statistical analysis was done using Epi info version 7.2 statistical packages for windows.

Results: A total of 18,188 deliveries were conducted during the review period and out of which 91 cases of uterine rupture occurred giving an incidence of 5.0 per 1,000 deliveries. Maternal and fetal deaths were recorded in 6.6% and 73.6% of cases. Most of the cases of uterine rupture in this study (51.7%) were treated by uterine repair with or without bilateral tubal ligation

Conclusion: Uterine rupture still remains a common problem in Nigeria and is associated with severe maternal and perinatal mortality. Effective measures to reducing the high maternal and perinatal mortality associated with uterine rupture should include health education of the masses, proper antenatal care, early referral of at-risk patients, and increased access to supervised hospital delivery.


1. Adanu RM, Obed SA. Ruptured Uterus: a seven years review of cases from Accra, Ghana. J Obstet Gynaecol can. 2003; 25(3): 225-30.
2. Al-Jufairi ZA, Sandhu AK, Al-Durazi KA. Risk factors of uterine rupture. Saudi Med J. 2001; 22(8): 702-4.
3. Chen LH, Tan KH, Yeo GS. A ten year review of uterine rupture in modern obstetric practice. Ann Acad Med Singapore 1995; 24:830-5.
4. Cowan RK, Kinch RA, Ellis B, Anderson R. Trial of labour following caesarean delivery. Obstet Gynaecol. 1994; 83(6): 933-6.
5. Ezechi O, Mabayoje P, Obiesie L. Ruptured uterus in South Western Nigeria: a reappraisal. Singapore Medical Journal. 2004; 45(3): 113-116
6. Fabamwo A, Akinola O, Tayo A, Akpan E. Rupture of the Gravid Uterus: A Never-Ending Obstetric Disaster! The Ikeja Experience. The Internet Journal of Gynecology and Obstetrics. 2008; 10(2): 1-5
7. Gyamfi-Bannerman C, Gilbert S, Landon MB, Spong CY, Rouse DJ, Varner MW, et al. Risk of Uterine Rupture and Placenta Accreta With Prior Uterine Surgery Outside of the Lower Segment. Obstetrics and Gynecology. 2012; 120(6): 1332-7.
8. Gregory KD, Korst LM, Cane P, et al. vaginal birth after cesarean and uterine rupture rates in California. Obstet Gynecol. 1999; 94(6): 985-9.
9. Guèye M, Mbaye M, Ndiaye-Guèye MD, Kane-Guèye SM, Diouf AA, Niang MM, et al. Spontaneous Uterine Rupture of an Unscarred Uterus before Labour. Case Rep Obstet Gynecol. 2012; 2012: 598356.
10. Igwegbe AO, Eleje GU, Udegbunam OI. Risk factors and perinatal outcome of uterine rupture in a low–resource setting. Niger Med J. 2013; 54: 415-9.
11. Kadowa I. Ruptured uterus in rural Uganda: prevalence, predisposing factors and outcomes. Singapore Medical Journal. 2010; 51(1): 35-8
12. Konje JC, Odukoya OA, Ladipo OA. Ruptured uterus in Ibadan – a twelve year review. Int J Gynaecol Obstet 1990; 32:207-13.
13. Kulkarni S, Patol S, Budihal D, Seetaram S. Rupture uterus: a 10-year review. J Obstet Gynaecol (India). 1997; 47: 344-52.
14. Laveriano W, Redondo C. Obstetric outcomes in the second birth of women with a previous caesarean delivery: a retrospective cohort study from Peru. Revista Brasileira de Ginecologia e Obstetrícia. 2013: 35(4): 148-52.
15. Leung AS, Leung EK, Paul RH. Uterine rupture after previous cesarean delivery: maternal and fetal consequences. Am J. Obstet Gynecol.1993; 169(4): 945-50.
16. Mokgokong ET, Marivate M. treatment of the ruptured uterus. S Afri Med J. 1976; 50(41): 1621-4
17. Nagarkatti RS, Ambiye VR, Vaidya PR. Rupture uterus: changing trends in etiology and management. Journal of Postgraduate Medicine. 1991; 37(3): 136-9.
18. Nyengidiki TK, Allagoa DO. Rupture of the gravid uterus in a tertiary health facility in the Niger delta region of Nigeria: A 5-year review. Niger Med J. 2011; 52(4): 230–234.
19. Ola R, Olamijulo SA. Rupture of the uterus at the Lagos University Teaching Hospital. West Afr. J. Med. 1998; 17(3): 188-193
20. Saritha K, Sowjanya R, Sireesha V. Rupture of Uterus – a Five Year Prospective Study in a Teaching Hospital. Journal of Evidence based Medicine and Healthcare. 2015; 2(44): 8096-8103
21. Schrinsky CD, Benson CR. Rupture of the pregnant uterus. A review Obstet. Gynaecol.Survey.1978; 33: 217-232.
22. Smith A. Uterine rupture in labour. British Medical Journal. 1975; 2(5968): 446.
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