Evaluation of obstetricians’ surgical decision making in the management of uterine rupture
Abstract Background Uterine rupture is an obstetric calamity with surgery as its management mainstay. Uterine repair without tubal ligation leaves a uterus that is more prone to repeat rupture while uterine repair with bilateral tubal ligation (BTL) or (sub)total hysterectomy predispose survivors to...
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| Format: | Article |
| Language: | English |
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BMC
2017-06-01
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| Series: | BMC Pregnancy and Childbirth |
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| Online Access: | http://link.springer.com/article/10.1186/s12884-017-1367-8 |
| _version_ | 1811228773169758208 |
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| author | Justus Ndulue Eze Okechukwu Bonaventure Anozie Osaheni Lucky Lawani Emmanuel Okechukwu Ndukwe Uzoma Maryrose Agwu Johnson Akuma Obuna |
| author_facet | Justus Ndulue Eze Okechukwu Bonaventure Anozie Osaheni Lucky Lawani Emmanuel Okechukwu Ndukwe Uzoma Maryrose Agwu Johnson Akuma Obuna |
| author_sort | Justus Ndulue Eze |
| collection | DOAJ |
| description | Abstract Background Uterine rupture is an obstetric calamity with surgery as its management mainstay. Uterine repair without tubal ligation leaves a uterus that is more prone to repeat rupture while uterine repair with bilateral tubal ligation (BTL) or (sub)total hysterectomy predispose survivors to psychosocial problems like marital disharmony. This study aims to evaluate obstetricians’ perspectives on surgical decision making in managing uterine rupture. Methods A questionnaire-based cross-sectional study of obstetricians at the 46th annual scientific conference of Society of Gynaecology and Obstetrics of Nigeria in 2012. Data was analysed by descriptive and inferential statistics. Results Seventy-nine out of 110 obstetricians (71.8%) responded to the survey, of which 42 (53.2%) were consultants, 60 (75.9%) practised in government hospitals and 67 (84.8%) in urban hospitals, and all respondents managed women with uterine rupture. Previous cesarean scars and injudicious use of oxytocic are the commonest predisposing causes, and uterine rupture carries very high incidences of maternal and perinatal mortality and morbidity. Uterine repair only was commonly performed by 38 (48.1%) and uterine repair with BTL or (sub) total hysterectomy by 41 (51.9%) respondents. Surgical management is guided mainly by patients’ conditions and obstetricians’ surgical skills. Conclusion Obstetricians’ distribution in Nigeria leaves rural settings starved of specialist for obstetric emergencies. Caesarean scars are now a rising cause of ruptures. The surgical management of uterine rupture and obstetricians’ surgical preferences vary and are case scenario-dependent. Equitable redistribution of obstetricians and deployment of medical doctors to secondary hospitals in rural settings will make obstetric care more readily available and may reduce the prevalence and improve the outcome of uterine rupture. Obstetrician’s surgical decision-making should be guided by the prevailing case scenario and the ultimate aim should be to avert fatality and reduce morbidity. |
| first_indexed | 2024-04-12T10:03:25Z |
| format | Article |
| id | doaj.art-9d7dffa1fa654aba9471b5ad733b3310 |
| institution | Directory Open Access Journal |
| issn | 1471-2393 |
| language | English |
| last_indexed | 2024-04-12T10:03:25Z |
| publishDate | 2017-06-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Pregnancy and Childbirth |
| spelling | doaj.art-9d7dffa1fa654aba9471b5ad733b33102022-12-22T03:37:30ZengBMCBMC Pregnancy and Childbirth1471-23932017-06-011711810.1186/s12884-017-1367-8Evaluation of obstetricians’ surgical decision making in the management of uterine ruptureJustus Ndulue Eze0Okechukwu Bonaventure Anozie1Osaheni Lucky Lawani2Emmanuel Okechukwu Ndukwe3Uzoma Maryrose Agwu4Johnson Akuma Obuna5Department of Obstetrics and Gynaecology, Federal Teaching HospitalDepartment of Obstetrics and Gynaecology, Federal Teaching HospitalDepartment of Obstetrics and Gynaecology, Federal Teaching HospitalDepartment of Obstetrics and Gynaecology, Federal Teaching HospitalDepartment of Obstetrics and Gynaecology, Federal Teaching HospitalDepartment of Obstetrics and Gynaecology, Federal Teaching HospitalAbstract Background Uterine rupture is an obstetric calamity with surgery as its management mainstay. Uterine repair without tubal ligation leaves a uterus that is more prone to repeat rupture while uterine repair with bilateral tubal ligation (BTL) or (sub)total hysterectomy predispose survivors to psychosocial problems like marital disharmony. This study aims to evaluate obstetricians’ perspectives on surgical decision making in managing uterine rupture. Methods A questionnaire-based cross-sectional study of obstetricians at the 46th annual scientific conference of Society of Gynaecology and Obstetrics of Nigeria in 2012. Data was analysed by descriptive and inferential statistics. Results Seventy-nine out of 110 obstetricians (71.8%) responded to the survey, of which 42 (53.2%) were consultants, 60 (75.9%) practised in government hospitals and 67 (84.8%) in urban hospitals, and all respondents managed women with uterine rupture. Previous cesarean scars and injudicious use of oxytocic are the commonest predisposing causes, and uterine rupture carries very high incidences of maternal and perinatal mortality and morbidity. Uterine repair only was commonly performed by 38 (48.1%) and uterine repair with BTL or (sub) total hysterectomy by 41 (51.9%) respondents. Surgical management is guided mainly by patients’ conditions and obstetricians’ surgical skills. Conclusion Obstetricians’ distribution in Nigeria leaves rural settings starved of specialist for obstetric emergencies. Caesarean scars are now a rising cause of ruptures. The surgical management of uterine rupture and obstetricians’ surgical preferences vary and are case scenario-dependent. Equitable redistribution of obstetricians and deployment of medical doctors to secondary hospitals in rural settings will make obstetric care more readily available and may reduce the prevalence and improve the outcome of uterine rupture. Obstetrician’s surgical decision-making should be guided by the prevailing case scenario and the ultimate aim should be to avert fatality and reduce morbidity.http://link.springer.com/article/10.1186/s12884-017-1367-8UterineRuptureMaternalPerinatalMortalitySurgical option |
| spellingShingle | Justus Ndulue Eze Okechukwu Bonaventure Anozie Osaheni Lucky Lawani Emmanuel Okechukwu Ndukwe Uzoma Maryrose Agwu Johnson Akuma Obuna Evaluation of obstetricians’ surgical decision making in the management of uterine rupture BMC Pregnancy and Childbirth Uterine Rupture Maternal Perinatal Mortality Surgical option |
| title | Evaluation of obstetricians’ surgical decision making in the management of uterine rupture |
| title_full | Evaluation of obstetricians’ surgical decision making in the management of uterine rupture |
| title_fullStr | Evaluation of obstetricians’ surgical decision making in the management of uterine rupture |
| title_full_unstemmed | Evaluation of obstetricians’ surgical decision making in the management of uterine rupture |
| title_short | Evaluation of obstetricians’ surgical decision making in the management of uterine rupture |
| title_sort | evaluation of obstetricians surgical decision making in the management of uterine rupture |
| topic | Uterine Rupture Maternal Perinatal Mortality Surgical option |
| url | http://link.springer.com/article/10.1186/s12884-017-1367-8 |
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