Ruptured uterus at Sagamu, Nigeria.

Ruptured uterus, the largest contributor to maternal deaths in our center was reviewed to find ways of reducing it and improve the outcome. Sixty cases treated at Ogun State University Teaching Hospital, Sagamu between January 1988 and December 1997 were scrutinised. During the 10 year period, total deliveries were 5,214 giving an incidence of 11.5 per 1,000. 76.7% of cases occurred in patients aged 30 years and more; and 58.6% in para 4 and more. 88.3% were unbooked. The ruptures were spontaneous in 76.7% and lower uterine segment was the most common (80%). Uterine repair with sterilisation was carried out in 46.7%, sub total hysterectomy in 26.7% and repair only in 11.7%. Most of the aetiological factors were preventable by good antenatal care and the outcome improved by early referral and efficient blood transfusion system.