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概要
Uterine Rupture among Women who Gave Birth at Nekemte Referral Hospital: Case Control Study
Temesgen Tilahun Bekabil
Background: Uterine rupture is an obstetrics complication which is still both clinical dilemma and broader public health problem in developing countries.
Objectives: This study is aimed to establish the magnitude of uterine rupture, predisposing factors, maternal and fetal outcomes, and surgical options of management of uterine rupture at Nekemte referral hospital which is located in western Ethiopia.
Methods: Case control study was conducted on 54 mothers with uterine rupture and 108 mothers for whom cesarean section was done for mechanical reasons or previous scar who were managed in the Obstetrics and Gynecologic ward of the hospital from July 2015 to July 2016. Data were collected from two groups by accessing medical records. Statistical Package for Social Sciences windows version 20 was used for data analysis. The association between uterine rupture and different variables were assessed by using odds ratio (OR) along with 95%CI.
Results: A total of 3,808 deliveries were conducted during the study period. There were 3206 vaginal deliveries, 548 cesarean deliveries and 54 uterine rupture cases. This makes 1 uterine rupture to happen in 70.5 deliveries. Majority, 87%, of uterine rupture occurred in unscarred uterus. The predisposing factors for uterine rupture were parity ≥ 5 (OR=4.37, 95% CI: 1.05, 18.23), lack of antenatal care (OR=7, 95% CI: 1.81, 27.02), lack of formal education (OR=2.38, 95% CI: 1.08, 5.26), household income less than 100 United States’ Dollar OR=14.08, 95% CI: 3.25, 62.5), previous home delivery (OR=9.10, 95% CI: 3.92, 21.11), and intrapartal follow up at health center or private clinics (OR=24.14, 95% CI: 5.60, 104.15). Uterine rupture caries more maternal (1.85% vs. 0%) and neonatal mortalities (96.3% vs. 3.7%) when compared to mothers delivered by cesarean section.
Conclusion: Magnitude of uterine rupture was high in the study area. It carries more maternal and perinatal complications. There were numerous modifiable predisposing factors.