Uterine rupture occurs when the integrity of the uterine wall is lost. The most common risk factor is having had previous uterine surgery, such as a caesarean section. Uterine rupture is not very frequent, but it is a complication of pregnancy or childbirth that in more serious cases (complete or catastrophic uterine rupture) can cause death of both mother and fetus. Objective: This paper aims to study the assessment of quality of life for affected women singleton pregnancies in Iraq and the diagnosis of pregnancy complications. Patients and Methods: In this study, a descriptive cross-sectional study was applied to study assessment of quality of life for affected women singleton pregnancies in Iraq and the diagnosis of pregnancy complications from 4th July 2021 to 11th June 2022. Data were collected for 90 patients different hospitals in Iraq, where the patients were divided into two groups, the first group of patients, which included women singleton pregnancies patient which included (50), and the second group, control group, which include (40) patients. A statistical study was conducted for women singleton pregnancies patient using the SPSS program. Results and Discussion: Uterine rupture occurs when the uterus ruptures because of pressure during pregnancy, labor or delivery. The uterus can rupture in some or all of its layers, compromising the oxygen supply to the fetus and causing severe bleeding in the mother. Also, Uterine rupture occurs most frequently along the scar line in women who have had previous caesarean sections. Other predisposing factors include congenital uterine abnormalities, trauma and other surgical procedures, and other surgical procedures such as myomectomy or open maternal-fetal surgery where This study relied on the Apgar score distribution of women singleton pregnancies patient, where it was divided into two types of degree and Apgar 5 min < 5 and contained 15 with 30% for the group of women singleton pregnancies patient, but the control group included 27 with 67.5% while Apgar 1 min < 5 was 35 and 70% for the singleton pregnancies patient group and 13, which represented 32.5% with the total number of cases. Conclusion: The incidence of uterine rupture is increasing due to the increase in vaginal deliveries after previous cesarean sections. Our study concludes that the control group was more successful and superior to singleton pregnancies patient group, as a result of what the results of the study showed in evaluating the patients' quality of life as well as the complications affecting both groups.


Uterine rupture Vaginal Caesarean section Diabetes


How to Cite
Dr. Faten Salam Naser Al-Shammari, Dr. Shaymaa Hussein Jasim, & Dr. Lina Mohanad Majeed. (2023). Assessment of quality of life for affected women singleton pregnancies in Iraq and the diagnosis of pregnancy complications. Texas Journal of Medical Science, 18, 39–46. Retrieved from https://zienjournals.com/index.php/tjms/article/view/3535


  1. Kaczmarczyk M, Sparén P, Terry P, Cnattingius S. Risk factors for uterine rupture and neonatal consequences of uterine rupture: a population-based study of successive pregnancies in Sweden. BJOG. 2007; 114:1208–14.
  2. Motomura K, Ganchimeg T, Nagata C, Ota E, Vogel JP, Betran AP, et al. Incidence and outcomes of uterine rupture among women with prior caesarean section: WHO Multicountry Survey on Maternal and Newborn Health. Sci Rep. 2017; 7:44093.
  3. Zwart J, Richters J, Öry F, de Vries J, Bloemenkamp K, van Roosmalen J. Uterine rupture in the Netherlands: a nationwide population-based cohort study: Uterine rupture in the Netherlands. BJOG. 2009; 116:1069–80.
  4. Tahseen S, Griffiths M. Vaginal birth after two caesarean sections (VBAC-2)-a systematic review with meta-analysis of success rate and adverse outcomes of VBAC-2 versus VBAC-1 and repeat (third) caesarean sections. BJOG. 2010;117:5–19.
  5. Al-Zirqi I, Stray-Pedersen B, Forsén L, Vangen S. Uterine rupture after previous caesarean section: Uterine rupture. BJOGB. 2010;117:809–20.
  6. Ronel D, Wiznitzer A, Sergienko R, Zlotnik A, Sheiner E. Trends, risk factors and pregnancy outcome in women with uterine rupture. Arch Gynecol Obstet. 2012;285:317–321.
  7. Caughey AB, Cahill AG, Guise J-M, Rouse DJ. Safe prevention of the primary cesarean delivery. Am J Obstet Gynecol. 2014;210:179–193.
  8. Xia X, Zhou Z, Shen S, Lu J, Zhang L, Huang P, et al. Effect of a two-stage intervention package on the cesarean section rate in Guangzhou, China: a before-and-after study. PLoS Med. 2019;16:e1002846.
  9. Al-Zirqi I, Stray-Pedersen B, Forsén L, Daltveit A-K, Vangen S. Uterine rupture: trends over 40 years. BJOG Int J Obstet Gy. 2016;123:780–7.
  10. Liang J, Mu Y, Li X, Tang W, Wang Y, Liu Z, et al. Relaxation of the one child policy and trends in caesarean section rates and birth outcomes in China between 2012 and 2016: observational study of nearly seven million health facility births. BMJ. 2018;360:k817.
  11. Getahun D, Oyelese Y, Salihu HM, Ananth CV. Previous Cesarean Delivery and Risks of Placenta Previa and Placental Abruption. Obstet Gynecol. 2006; 107:771–778.
  12. Daltveit AK, Tolla MC, Irgens LM. Cesarean Delivery and Subsequent Pregnancies. Obstet Gynecol. 2008; 111:1327–1334.
  13. Hu H-T, Xu J-J, Lin J, Li C, Wu Y-T, Sheng J-Z, et al. Association between first caesarean delivery and adverse outcomes in subsequent pregnancy: a retrospective cohort study. BMC Pregnancy Childbirth. 2018; 18:273.
  14. Ananth CV. Ischemic placental disease: A unifying concept for preeclampsia, intrauterine growth restriction, and placental abruption. Semin Perinatol. 2014; 38:131–132.
  15. Brosens I, Pijnenborg R, Vercruysse L, Romero R. The, “Great Obstetrical Syndromes” are associated with disorders of deep placentation. Am J Obstet Gynecol. 2011; 204:193–201.
  16. Eshkoli T, Weintraub AY, Sergienko R, Sheiner E. Placenta accreta: risk factors, perinatal outcomes, and consequences for subsequent births. Am J Obstet Gynecol. 2013;208:219.e1–219.e7.
  17. Gupta N, Gupta A, Green M, Kang HS, Blankstein J. Placenta Percreta at 17 Weeks with Consecutive Hysterectomy: A Case Report and Review of the Literature. Case Rep Obstet Gynecol. 2012;2012:1–4.
  18. Getahun WT, Solomon AA, Kassie FY, Kasaye HK, Denekew HT. Uterine rupture among mothers admitted for obstetrics care and associated factors in referral hospitals of Amhara regional state, institution-based cross-sectional study Northern Ethiopia 2013–2017. PLoS ONE. 2018;13:e0208470.
  19. Vilchez G, Nazeer S, Kumar K, Warren M, Dai J, Sokol R. Contemporary epidemiology and novel predictors of uterine rupture: a nationwide population-based study. Arch Gynecol Obstet. 2017; 296:869–875.
  20. Royal College of Obstetricians and Gynaecogists., A, B, C, D, E, et al. Birth after Previous Caesarean Birth (Green-Top Guideline No. 45). 2015.
  21. American College of Obstetricians and Gynaecologists A, B, C, D, E et al. ACOG Practice Bulletin No. 205: Vaginal Birth After Cesarean Delivery. Obstet Gynecol. 2019;133:e110–27.
  22. Zhu J, Liang J, Mu Y, Li X, Guo S, Scherpbier R, et al. Sociodemographic and obstetric characteristics of stillbirths in China: a census of nearly 4 million health facility births between 2012 and 2014. Lancet Glob Health. 2016;4:e109–e118.
  23. McIntyre HD, Catalano P, Zhang C, Desoye G, Mathiesen ER, Damm P. Gestational diabetes mellitus. Nat Rev Dis Primers. 2019; 5:47.
  24. Tarney CM, Whitecar P, Sewell M, Grubish L, Hope E. Rupture of an Unscarred Uterus in a Quadruplet Pregnancy. Obstet Gynecol. 2013; 121:483–485.
  25. Juan J, Yang H. Prevalence, Prevention, and Lifestyle Intervention of Gestational Diabetes Mellitus in China. Int J Environ Res Public Health. 2020;17: E9517.
  26. Jauniaux E, Collins S, Burton GJ. Placenta accreta spectrum: pathophysiology and evidence-based anatomy for prenatal ultrasound imaging. Am J Obstet Gynecol. 2018; 218:75–87.
  27. Zhu L, Zhang R, Zhang S, Shi W, Yan W, Wang X, et al. Chinese neonatal birth weight curve for different gestational age. Zhonghua Er Ke Za Zhi. 2015; 53:97–103.
  28. Williams R. Using the Margins Command to Estimate and Interpret Adjusted Predictions and Marginal Effects. Stand Genomic Sci. 2012; 12:308–331.
  29. Abebe F, Mannekulih E, Megerso A, Idris A, Legese T. Determinants of uterine rupture among cases of Adama city public and private hospitals, Oromia, Ethiopia: a case control study. Reprod Health. 2018; 15:161.
  30. Al-Zirqi I, Daltveit AK, Forsén L, Stray-Pedersen B, Vangen S. Risk factors for complete uterine rupture. Am J Obstet Gynecol. 2017; 216:165.e1–165.e8.
  31. Fadl HE, Östlund IKM, Magnuson AFK, Hanson USB. Maternal and neonatal outcomes and time trends of gestational diabetes mellitus in Sweden from 1991 to 2003. Diabet Med. 2010; 27:436–441.
  32. Thisted DLA, Mortensen LH, Krebs L. Uterine rupture without previous caesarean delivery: a population-based cohort study