Prevalence and factors associated with rupture of gravid uterus and feto-maternal outcome: a one-year retrospective cohort study

ABSTRACT

Background: Uterine rupture remains a significant public health problem contributing to 13% of maternal mortality and 74%-92% for perinatal mortality in developing countries. This study assesses the prevalence and factors associated with rupture of gravid uterus and feto-maternal outcome in Ethiopian mothers with uterine rupture.Methods: A retrospective cohort study was conducted to identify risk factors associated with rupture of gravid uterus and feto-maternal outcomes. The data source included clinical records of patients seen at Dilla University Referral Hospital over a one-year period. The data was collected using a structured data collection form developed for the purposes of the study. The study involved a total 2,498 women with a gravid uterus, gestational age of ≥28 weeks and registered in the labor and delivery registration books in the Obstetrics and Gynecology Department. Bivariate and multivariate regression analyses were carried out at 95% Confidence Interval to identify factors independently associated with uterine rupture.Results: Out of 2,498 reviewed deliveries, 46 cases developed uterine rupture making an overall hospital prevalence of 1.8 % or one in 53 deliveries. Malpresentation (80%), contracted pelvis (47.8%), vertex malposition (10.8%), and previous uterine scar (2.1%) were the causes of uterus ruptures. In multivariate analysis, clients' residence, parity, birth weight, Antenatal Care follow-up and duration of labor were statistically significantly associated with uterine rupture. Maternal and fetal case fatality rates were 8.7% and 97.8%, respectively.Conclusion: Uterine rupture remains an important problem in the study area. Patients with identified risk factor(s) should stay close to the hospital in late pregnancy. Besides, strengthening antenatal care follow-up and referral linkage should be considered