The treatment of rupture of the pregnant uterus. Analysis of 93 cases treated in a rural hospital in Zambia

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Abstract
Cases (93) of uterine rupture, treated in a rural hospital in Zambia were analyzed. Clinical characteristics and mortality rate were comparable to those reported in other series from developing countries. An attempt was made to compare the outcome of various surgical procedures. No statistically significant differences were found between the mortality rates after repair, subtotal and total hysterectomy (12%, 13% and 28%, respectively). A survey of recent literature on the treatment of uterine rupture in developing countries revealed a wide divergence of opinions and criteria of selection, precluding reliable comparisons. A proposition for individualized treatment is outlined. Repair should be performed when suitable but hysterectomy is preferable when the tear is extensive, bruised and contaminated.

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