Risk Factors And Prognosis Of Uterine Rupture In The Second And The Third Trimester Of Pregnancy

OBJECTIVE:To estimate the risk factors of uterine rupture(UR) in the second and the third trimester, and to evaluate the prognosis of UR.METHODS:A total of18UR cases were included, from the year of1990to2015, analyzing all aspects such as risk factors, clinical manifestation, management and prognosis.RESULTS:Among all the18UR cases, scarred uterine was the most common risk factor (66.7%), following by placenta percreta (22.2%), uterine malformation (22.2%), obstetric operation (16.7%), placenta previa (11.1%). Scarred uterine was the most common risk factor in the third trimester (80%), while in the second trimester, top three risk factors ranked as following:scarred uterine (50%), placenta percreta (50%), uterine malformation (37.5%). In half of UR cases, hysterectomia was the final management, while in the other half, uterine was reserved. One patient became pregnant three years after UR, and had a cesarean to deliver a healthy live baby at36weeks of gestation.CONCLUSION:Cautious and detailed consult should be performed among pregnant women with high risk factors of UR. Ultrasound is advised to be applied regularly to estimate the thickness of the lower part of uterine. Anyone who is of extremely high risk of UR is recommended to have a cesarean to terminate pregnancy in time. Under the suspicion of UR, emergency cesarean or exploratory laparotomy is to be applied to confirm the diagnosis. Uterine should be reserved if possible.