2,4 The predisposing factors of UR in developing countries have been demonstrated as: age 31-35, para (greater than)3, and poor antenatal care, grandmultiparity, obstetric trauma from prolonged or neglected labour, malpresentation, external and internal podalic version
, breech extraction, manual cervical dilatation, and injudicious use of oxytocin, prostaglandins by untrained paramedics and previous unknown corporeal scar.
Though scarred uterus secondary to previous caesarean delivery is one of the commonly recognized risk factors for rupture of uterus, other risk factors are prolonged / obstructed labor, grand multiparity, macrosomic / hydrocephalic fetus, trauma, injudicious use of uterotonic drugs, labor dystocia, intrauterine manipulations such as internal podalic version
and breech extraction, mishandling by trained / untrained TBA, malpresentations and instrumental delivery4.
Any case with presentation other than breech where attempts were made to deliver by internal podalic version
This approach is also useful when breech extraction of a second twin becomes difficult, and in cases involving podalic version
of a second twin.
There are several risk factors for rupture uterus like multi parity (5) uterotonic drugs, placenta percreta (6), CPD, mal position, mal presentation, internal podalic version
, perforation of uterus during MTP, instrumental delivery, and scarred uterus following operations on uterus like caesarean section, myomectomy, utericuloplasty.