Decision-intervention interval in ruptured uteri in Ile-Ife, Nigeria.

OBJECTIVE

To determine the decision-intervention interval in ruptured uterus with a view of overhauling the management strategy thereby improving the maternal and perinatal outcome.

DESIGN

Cross-sectional survey based on secondary data done between 1990-1999.

SETTING

Obafemi Awolowo University Teaching Hospital Complex, Ile-Ife, Nigeria.

SUBJECTS: One hundred and two consecutive women who had uterine rupture.

RESULTS

The decision-surgical intervention interval ranged from 30 minutes to 4.5 hours. The major reason for delay was unavailability of compatible blood (88.2%), followed by lack of electricity (4.9%), unsterile instruments (3.9%), waiting for ambulance to get senior obstetricians (2.9%), delay in arrival of anaesthetist (1.9%) and neonatologists (1.9%). The peri-natal mortality rate (PNMR) was 843 per 1000 total births and maternal mortality rate (MMR) 4902 per 100,000 births.

CONCLUSION

The maternal and perinatal outcome in uterine rupture would be improved by early diagnosis and avoidance of preoperative delay through availability of essential obstetric services.