Uterine rupture is a leading cause of maternal death in Ethiopia. Despite strengthening the health care system and providing primary and comprehensive emergency obstetric care closer to the communities, uterine rupture produces devastating maternal and fetal outcomes. Although risk factors of uterine rupture are context-specific, there is a lack of clarity regarding the contributing factors and untoward uterine rupture outcomes. This study was conducted to identify the risk factors of uterine rupture and its impacts in public hospitals of Tigrai.
This study would identify determinant factors of uterine rupture and its management outcomes among mothers who gave birth in public hospitals in the Tigrai region, North Ethiopia.
A retrospective hospital-based unmatched case-control study design was implemented with 135 cases of women with uterine rupture and 270 controls of women without uterine rupture. Patients were enrolled consecutively from case notes of women who gave birth from 1/9/2015 to 30/6/2019, while charts of women without uterine rupture found following the cases were selected randomly and enrolled. Bivariate and multivariate logistic regression with a 95% confidence interval was used to identify uterine rupture determinants. Mothers referred from remote health institutions, mothers who visited once for antenatal care, those experiencing obstructed labor, and a newborn’s birth weight of more than four kilograms (AOR 5.68 were significantly associated with uterine rupture. Of 135 mothers who develop uterine rupture, 13 mothers died, and 101 fetuses were stillborn.
Referrals from remote health institutions, once-visited antenatal care, obstructed labor, and newborns’ birth weight of more than four kilograms were significant determinants of uterine rupture. Maternal death, stillbirth, hysterectomy, and hemorrhage were adverse outcomes.