Abstract:
Background-Uterine rupture is the disruption of the uterine wall during gestation or labor,
resulting in serious obstetric complications. It is still a significant public health importance and
deadly health problem causing maternal and neonatal mortality in Ethiopia. Despite the high
burden there has been scarcity of information about determinants of uterine rupture in Ethiopia.
Objective of the study: - The objectives of this study is to identify determinants of uterine
rupture among women who gave birth in public hospitals of west shoa zone
Method: -Facility-based unmatched case-control study was conducted from march 10-31 ,2023
among 264 women 66 cases and 198controls (1:3 ratios).The samples from each hospital was
taken by Proportional allocation, cases were selected by simple random sampling and 3 controls
were selected consecutively. Check list was used to collect information from mothers chart and
data were entered to epi info version 7, analysed using SPSS version 20. Hosmer and
Lemeshow’s goodness of fit test was used for model fitness. Multicolliniarity was assessed by
Variance Inflation Factor. On bivariable analysis, variables with p-value <0.25 were kept in
multivariable analysis and those with P-value<0.05were declared as statistically significant. The
odds ratio with a 95% CI was used to measure the strength of association.
Result
The Response rate was 100%). Majority of cases 59(89.4%) and morethan half of controls 101
(51%) were multiparous. Twenty four (36.4%) of cases and 177(89.4%) of controls were
engaged in Antenatal care. Previous caesarian section scar (AOR=4.24, 95%CI 1.67, 10.7), No
ANC follow up (AOR=9.2, 95%CI 3.6, 22.5), Referral history from other health facility
(AOR=3.1, 95% CI=1.17, 7.68), being multiparous (AOR=7.1; 95CI: 2.1, 23.4), malpresentation
(AOR = 6.3; 95% CI: 1.9, 13.46) and not being followed with partograph(AOR=3.5; 95CI: 1.4,
8.86) were independently identified as determinants of uterine rupture.
Conclusion
Having previous cesarean section, referral from other health facility, malpresentation, being
multiparous, not being followed with partograph and no ANC follow up were determinants of
uterine rupture. All pregnant mothers should be told about the importance of ANC as these
contribute to full risk assessment and screening opportunities for the mothers and mothers with
previous cesarean delivery should be advised about the risk of uterine rupture.
