Ruptured uterus: an ongoing tragedy of motherhood.

This study aimed to determine the frequency of ruptured uterus, possible aetiologic factors, foetomaternal out come and changes in obstetric care proposed to reduce this catastrophy. From September 1994 to September 1999 in Dhaka Medical College Hospital 39,782 deliveries occurred. All delivery records were reviewed and rupture uterus cases were identified. The result was compared with studies carried out in home and abroad. During the five years period among 39,782 deliveries 424 cases were of rupture uterus with a frequency of 1/93 deliveries. Eighty three percent rupture occurred in intact uterus and 17% occurred in uteri scarred by caesarian section. Common contributing factors were -prolonged/obstructed labour, grand multiparity, injudicious use of uterine stimulants, mismanaged labour by traditional birth attendant, delayed referral to well equipped centre, poor communication, poverty and ignorance.