Alarming Rates of Uterine Rupture in Lubumbashi A Call for Safer Obstetric Care

Introduction

Uterine rupture remains a life-threatening obstetric complication, especially in low-resource settings like Lubumbashi, Democratic Republic of Congo. A recent study from the Clinical Journal of Obstetrics and Gynecology highlights the prevalence, associated risk factors, and devastating maternal and perinatal outcomes of this condition in referral hospitals.
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Key Findings from the Study

• Prevalence: Out of 37,641 deliveries, 186 cases of uterine rupture were recorded a 0.49% prevalence.
• Demographics: Average patient age was 29.5 years; over 60% had high parity (≥4 births).
• Types of Rupture: 81.17% were complete ruptures; 51.27% occurred in the lower uterine segment.
• Management: 93.04% underwent uterine repair, while only 5.06% required hysterectomy.
• Mortality Rates:
  • Maternal mortality: 8.86%
  • Perinatal mortality: 72.04%

Read the full study at: https://doi.org/10.29328/journal.cjog.1001067

Clinical Implications and Global Perspective

The American College of Obstetricians and Gynecologists (ACOG) underscores the importance of early detection, referral, and timely surgical intervention to reduce the risks of uterine rupture. However, this study emphasizes that delayed diagnosis and insufficient prenatal care in Lubumbashi significantly contributed to the poor outcomes.

Complete ruptures and segmento-corporeal lesions were particularly associated with higher perinatal mortality, stressing the need for improved antenatal screening and emergency obstetric readiness.

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Preventive Strategies and Health Policy Recommendations

To combat the high mortality associated with uterine rupture, the study recommends:

• Strengthening referral systems with better transport and communication
• Enhancing midwife training in rural and peripheral centers
• Promoting antenatal visits to detect high-risk pregnancies early
• Investing in emergency obstetric equipment and neonatal resuscitation units

These strategies align with global health goals to reduce maternal and neonatal mortality, especially in underserved regions.

Call-to-Action

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