ABSTRACT
Background: Uterine rupture is a rare occurrence but has catastrophic complications during pregnancy. The incidence is relatively higher in scarred uteri because there is a promotion of labor after cesarean section. There is a scarcity of evidence from low-income countries regarding the predictors of uterine rupture after trial labor. Objective: To assess factors determining uterine rupture during labor after the previous cesarean section among mothers delivered at Hawassa University Comprehensive Specialized Hospital from September 2017 to September 2022. Methods: A facility-based unmatched case-control study was done by reviewing 105 patients, which included 35 cases and 70 controls in a 1:2 case-to-control ratio. The association between dependent and independent variables was sought with running binary and multivariate analyses by using the cut point of a p value < 0.05 and 95% CI. Results: The prevalence of uterine rupture is 1.6%. The factors significantly associated with uterine rupture after trial of labor are fetal weight >3.8 kg (AOR: 5.21), antenatal care 4 (AOR: 3.6), labor duration >15 hours (AOR: 10.7), and previous successful vaginal delivery (AOR: 3.4). Poor fetal-maternal outcomes like 91.4% fetal death, 29 hysterectomies, 22 blood transfusions, and 1 death. Conclusion: The prevalence is relatively higher than in developed countries. The number of antenatal care, labor duration, and lower fetal weight are not common findings associated with uterine rupture after trial of labor across the literature, so large-scale studies are needed to develop guidelines for the Ethiopian setup. Improving the quality of obstetrics care given in each level of health system.
ABSTRACT
Purpose: Teenage pregnancy is estimated to be common in Somaliland. It is linked with adverse perinatal outcomes. However, no study has been conducted in the country on this subject. Therefore, this study intended to assess the magnitude and factors associated with teenage pregnancy in Somaliland. Patients and Methods: Data from the 2020 Somaliland Health and Demographic Survey (SLHDS); were used in the current analysis. A total sample of 3,786 women in reproductive age groups were involved as participants. The survey used a two-level cluster sampling design, which included initial selection of enumeration areas followed by selection of households. To identify associated factors, binary logistic regression analysis was applied. Results: The magnitude of teenage pregnancy was 47.2% (95%CI: 45.5-48.9%). Being a nomadic resident (AOR: 1.26; 95%CI: 1.12-1.71), being in the lowest wealth quintiles (AOR: 1.34; 95%CI: 1.01-1.77), being in the Sanaag region (AOR: 1.95;95%CI: 1.54-2.46) and having lower educational attainment (AOR: 2.29; 95%CI: 1.08-4.83) were significantly associated with teenage pregnancy. Conclusion: Teenage pregnancy is highly prevalent in Somaliland and associated with a lower educational level, lower wealth quintiles and nomadic residence. Hence, governmental and non-governmental organizations should work on educating and financially empowering women by giving particular focus to nomadic people.
