Determinants Of Uterine Rupture Among Women Who Gave Birth In Public Hospitals Of West Shoa Zone,Oromia,Ethiopia: Retrospective Case-Control Study

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.