มดลูกแตกขณะตั้งครรภ์ในโรงพยาบาลพหลพลพยุหเสนา

บทคัดย่อ

A review study of rupture of the pregnant uterus in 5 years from August 1991 to July 1996 in Paholpolpayuhasaena hospital. The objective of the study was to estimate the incidence, possible causes, clinical features, treatment and maternal and fetal outcome. A total of seven cases of uterine rupture were collected. The incidence was 1 per 2021 deliveries. The mean age of patients was 28  years old. Three patients (42.9%) were presented with shock and absence of fetal heart sound on admission. The cause of one was rupture previous cesarean scar. Six patients (85.7%) occurred in patients with previously unscarred uterus, two were uterine anomaly and car accident, the other four were multiparity. Total abdominal hysterectomy was done in four, subtotal hysterectomy in two, only one was repaired. There was one maternal death (14.3%). The fetal death rate was 85.7%. In conclusion most ruptured uterus is preventable if good observation of the process of labor and good antenatal care. Oxytocic stimulation should be used in caution with experienced observer. Oxytocin infusion in multipara is not advised.