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Farhat IB, Zoukar O, Medemagh M, Slamia WB, Mnajja A, Bergaoui H, Hajji A, Gara M, Toumi D, Faleh R. [Retrospective study of 60 cases of uterine rupture at the Maternity Center of Monastir, Tunisia]. Pan Afr Med J 2024; 47:83. [PMID: 38737224 PMCID: PMC11087285 DOI: 10.11604/pamj.2024.47.83.42188] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2023] [Accepted: 12/11/2023] [Indexed: 05/14/2024] Open
Abstract
Uterine rupture is a life-threatening obstetric complication. The purpose of this study was to investigate the epidemiological features, maternal and foetal prognosis and different treatment options for uterine rupture in healthy and scarred uteri. We conducted a retrospective monocentric descriptive and analytical study of 60 cases of uterine rupture collected in the Department of Gynaecology-Obstetrics of the Center of Maternity and Neonatology, Monastir, from 2017 to 2021. Patients were classified according to the presence or absence of a uterine scar. Sixty patients were enrolled in the study. The majority of cases of rupture occurred in patients with scarred uterus (n=55). The most common clinical sign was abnormal foetal heart rate. No maternal deaths were recorded and perinatal mortality rate was 11%. Mean BMI, fetal macrosomia rate and mean parity were significantly higher in the healthy uterus group than in the scarred uterus group (p=0.033, 0.018, and 0.013, respectively). The maternal complications studied (post-partum haemorrhage, hysterectomy, blood transfusion, prolonged hospitalisation) were significantly more frequent in patients with unscarred uterine rupture (p=0.039; p=0.032; p=0.009; p=0.025 respectively). Uterine rupture is a life-threatening obstetrical event for the foetus and the mother. Fetal heart rate abnormality is the most common sign associated with uterine rupture. Management is based on conservative treatment in most cases. Patients with scarred uterus have a better prognosis.
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Affiliation(s)
- Imen Ben Farhat
- Université de Monastir, Faculté de Médecine de Monastir, Monastir, Tunisie
- Service de Gynécologie Obstétrique du Centre de Maternité et de Néonatologie de Monastir, Monastir, Tunisie
| | - Olfa Zoukar
- Service de Gynécologie Obstétrique du Centre de Maternité et de Néonatologie de Monastir, Monastir, Tunisie
| | - Malak Medemagh
- Service de Gynécologie Obstétrique du Centre de Maternité et de Néonatologie de Monastir, Monastir, Tunisie
| | - Wiem Ben Slamia
- Service de Gynécologie Obstétrique du Centre de Maternité et de Néonatologie de Monastir, Monastir, Tunisie
| | - Amina Mnajja
- Service de Gynécologie Obstétrique du Centre de Maternité et de Néonatologie de Monastir, Monastir, Tunisie
| | - Haifa Bergaoui
- Université de Monastir, Faculté de Médecine de Monastir, Monastir, Tunisie
| | - Ahmed Hajji
- Service de Gynécologie Obstétrique du Centre de Maternité et de Néonatologie de Monastir, Monastir, Tunisie
| | - Mouna Gara
- Service d'Anesthésie Réanimation du Centre de Maternité et de Néonatologie de Monastir, Monastir, Tunisie
| | - Dhekra Toumi
- Service de Gynécologie Obstétrique du Centre de Maternité et de Néonatologie de Monastir, Monastir, Tunisie
| | - Raja Faleh
- Service de Gynécologie Obstétrique du Centre de Maternité et de Néonatologie de Monastir, Monastir, Tunisie
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Sugai S, Yamawaki K, Haino K, Yoshihara K, Nishijima K. Incidence of Recurrent Uterine Rupture: A Systematic Review and Meta-analysis. Obstet Gynecol 2023; 142:1365-1372. [PMID: 37884008 PMCID: PMC10642701 DOI: 10.1097/aog.0000000000005418] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2023] [Revised: 08/18/2023] [Accepted: 08/31/2023] [Indexed: 10/28/2023]
Abstract
OBJECTIVE We aimed to quantify the incidence of recurrent uterine rupture in pregnant women. DATA SOURCES A literature search of PubMed, Web of Science, Cochrane Central, and ClinicalTrials.gov for observational studies was performed from 2000 to 2023. METHODS OF STUDY SELECTION Of the 7,440 articles screened, 13 studies were included in the final review. We included studies of previous uterine ruptures that were complete uterine ruptures , defined as destruction of all uterine layers, including the serosa. The primary outcome was the pooled incidence of recurrent uterine rupture. Between-study heterogeneity was assessed with the I2 value. Subgroup analyses were conducted in terms of the country development status, year of publication, and study size (single center vs national study). The secondary outcomes comprised the following: 1) mean gestational age at which recurrent rupture occurred, 2) mean gestational age at which delivery occurred without recurrent rupture, and 3) perinatal complications (blood loss, transfusion, maternal mortality, and neonatal mortality). TABULATION, INTEGRATION, AND RESULTS A random-effects model was used to pool the incidence or mean value and the corresponding 95% CI with R software. The pooled incidence of recurrent uterine rupture was 10% (95% CI 6-17%). Developed countries had a significantly lower uterine rupture recurrence rate than less developed countries (6% vs 15%, P =.04). Year of publication and study size were not significantly associated with recurrent uterine rupture. The mean number of gestational weeks at the time of recurrent uterine rupture was 32.49 (95% CI 29.90-35.08). The mean number of gestational weeks at the time of delivery without recurrent uterine rupture was 35.77 (95% CI 34.95-36.60). The maternal mortality rate was 5% (95% CI 2-11%), and the neonatal mortality rate was 5% (95% CI 3-10%). Morbidity from hemorrhage, such as bleeding and transfusion, was not reported in any study and could not be evaluated. CONCLUSION This systematic review estimated a 10% incidence of recurrent uterine rupture. This finding will enable appropriate risk counseling in patients with prior uterine rupture. SYSTEMATIC REVIEW REGISTRATION PROSPERO, CRD42023395010.
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Affiliation(s)
- Shunya Sugai
- Department of Obstetrics and Gynecology, Niigata University Medical and Dental Hospital, Niigata, Japan
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Hussein AI, Kurtay S, Omar AA, Yusuf AA, Mohamud RYH. An Analysis of the Rate, Indications, and Associated Maternal Mortality for Cesarean Sections at a Tertiary Care Hospital, First Report from Somalia. Int J Womens Health 2023; 15:225-233. [PMID: 36816454 PMCID: PMC9930581 DOI: 10.2147/ijwh.s383122] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2022] [Accepted: 02/01/2023] [Indexed: 02/12/2023] Open
Abstract
Background There has been an increase in worldwide cesarean section rates, although they remain low in most Sub-Saharan African countries, including Somalia. The present is the first hospital-based study that analyzes the rate, indications, and associated maternal mortality of cesarean deliveries reported from Somalia. Methods This retrospective study reviewed data of all deliveries from 2015 to 2021 using electronic medical records in the hospital information system. Retrieved data include baseline demographic characteristics, mode of delivery, indications and the type of cesarean section, and the documented maternal mortality during the study period. Results During seven years, there were 12,540 total deliveries. Among these, 2703 were cesarean sections giving an overall cesarean section rate of 21.6%. The mean age of the patients was 26.7±7.3 years [14-44 years]. Multiparous mothers constituted 67.7% during the study period. According to cesarean deliveries, nulliparous mothers (55.7%) underwent the maximum number of cesarean sections. Emergency cesarean section was the predominant intervention compared to elective C-sections (59.2% vs 40.8%). Primary CS was the most common predominant, while repeat CS increased timely, 77.7% vs 22.3%, respectively. Overall, previous C-sections and fetal distress were the two most common indications for cesarean delivery (22.3% and 22.1%), respectively. C-sections were predominant in women of younger age, Primiparity, having term deliveries, and did not receive regular antenatal care. The maternal mortality rate was 1.7%, and 61% was due to direct obstetric hemorrhage, including postpartum hemorrhage, Placenta abruption, and uterine rupture. Conclusion The study findings showed a slight increase in cesarean delivery rates during the study period. This rate is higher than the 10-15% recommended by the WHO in developing countries. Policies and efforts to decrease unnecessary cesarean sections should be promoted and implemented at each health facility.
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Affiliation(s)
- Ahmed Issak Hussein
- Obstetrics and Gynecology department, Mogadishu Somalia Turkish Training and Research Hospital, Mogadishu, Somalia
| | - Sabri Kurtay
- Obstetrics and Gynecology department, Mogadishu Somalia Turkish Training and Research Hospital, Mogadishu, Somalia
| | - Abdikarim Ali Omar
- Obstetrics and Gynecology department, Mogadishu Somalia Turkish Training and Research Hospital, Mogadishu, Somalia
| | | | - Rahma Yusuf Haji Mohamud
- Obstetrics and Gynecology department, Mogadishu Somalia Turkish Training and Research Hospital, Mogadishu, Somalia
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Alemu A, Yadeta E, Deressa A, Debella A, Birhanu A, Heluf H, Mohammed A, Ahmed F, Beyene A, Getachew T, Eyeberu A. Survival Status and Predictors of Mortality Among Women with Uterine Rupture at Public Hospitals of Eastern Ethiopia. Semi-Parametric Survival Analysis. Int J Womens Health 2023; 15:443-453. [PMID: 37006639 PMCID: PMC10054622 DOI: 10.2147/ijwh.s402885] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2022] [Accepted: 03/13/2023] [Indexed: 04/04/2023] Open
Abstract
Background Uterine rupture is the most dangerous complication of labor and contributes to high maternal mortality. Despite efforts to improve basic and comprehensive emergency obstetric treatment, women continue to suffer from disastrous maternal outcomes. Purpose This study aimed to assess the survival status and predictors of mortality among women with uterine rupture at public hospitals in the Harari Region, Eastern Ethiopia. Patients and Methods We conducted a retrospective cohort study among women with uterine rupture in public hospitals in Eastern Ethiopia. All women with uterine rupture were followed for 11 years retrospectively. Statistical analysis was conducted with STATA version 14.2. Kaplan-Meier curves together with a Log rank test were used to estimate the survival time and show the presence of differences among groups. Cox Proportion Hazard (CPH) model was used to determine the association between independent variables and survival status. Results There were 57,006 deliveries in the study period. We found that 10.5% (95% CI: 6.8-15.7) of women with uterine rupture have died. The median recovery and death time for women with uterine rupture were 8 and 3 days with interquartile range (IQR) of 7-11 days and 2-5 days, respectively. Antenatal care follow-up (AHR: 4.2, 95% CI: 1.8-9.79), education status (AHR: 0.11; 95% CI: 0.02-0.85), visiting health center (AHR: 4.89; 95% CI: 1.05-22.88), and admission time (AHR: 4.4; 95% CI: 1.89-10.18) were the predictors of survival status of women with uterine rupture. Conclusion One out of ten study participants died due to uterine rupture. Factors including not having ANC follow-up, visiting health centers for treatment, and being admitted during the night time were predictors. Thus, a great emphasis has to be given to the prevention of uterine rupture and the linkage within health institutions has to be smooth to improve the survival of patients with uterine rupture with the help of different professionals, health institutions, health bureaus, and policymakers.
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Affiliation(s)
- Addisu Alemu
- School of Public Health, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Elias Yadeta
- School of Nursing and Midwifery, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Alemayehu Deressa
- School of Public Health, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Adera Debella
- School of Nursing and Midwifery, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Abdi Birhanu
- School of Medicine, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Helina Heluf
- School of Nursing and Midwifery, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Ahmed Mohammed
- School of Medicine, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Fila Ahmed
- School of Public Health, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Andinet Beyene
- School of Medicine, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Tamirat Getachew
- School of Nursing and Midwifery, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Addis Eyeberu
- School of Nursing and Midwifery, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
- Correspondence: Addis Eyeberu, School of Nursing and Midwifery, Haramaya University, 138, Dire Dawa, Harar, Ethiopia, Tel +251910005436, Email
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Feleke G, Tantu T, Zewdu D, Gedefawu A, Wondosen M, Gunta M. Case-control study on determinants of uterine rupture among mothers who gave birth at Hawassa University comprehensive specialized hospital. PLoS One 2023; 18:e0279175. [PMID: 36638128 PMCID: PMC9838871 DOI: 10.1371/journal.pone.0279175] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2022] [Accepted: 12/01/2022] [Indexed: 01/14/2023] Open
Abstract
BACKGROUND Uterine rupture is defined as tearing of the uterine wall during pregnancy or delivery. It can occur during pregnancy or labor and delivery. Rupture of the uterus is a catastrophic event resulting in the death of the baby, and severe maternal morbidity and mortality Despite different interventions done by stakeholders, it remained one of the leading public problems in developing countries like Ethiopia. OBJECTIVE This study assessed the prevalence and determinants of uterine rupture among mothers who gave birth at Hawassa University comprehensive specialized hospital from July 2015 to June 2020G.C. METHOD A case-control study was conducted by reviewing data from a total of 582 patient charts which include 194 cases and 388 controls with a case-to-control ratio of 1:2. Then the data was extracted using a pre-tested and structured data extraction sheet. Data were entered using Epi data 3.1 and exported to SPSS and analyzed using SPSS 20. The association between independent variables and uterine rupture was estimated using an odds ratio with 95% confidence intervals. The statistical significance of the association was declared at P-value < 0.05. RESULT There were a total of 22,586 deliveries and 247 confirmed cases of uterine rupture which makes the prevalence 1.09%. Lack of ANC (Ante-natal care) (AOR = 7.5; 95% CI: 1.9-30.3) inadequate ANC (AOR = 2.45; 95% CI: 1.1-5.57), gravidity ≥5 (AOR = 3.3; 95% CI: 1.36-8.12), obstructed labor (AOR = 38.3; 95% CI: 17.8-82.4) and fetal macrosomia (AOR = 8; 95% CI: 17.8-82.4) are variables which increase the odds of developing uterine rupture. Mothers without additional medical or obstetric conditions are more likely (AOR = 4.2; 95% CI: 2.1-8.65) to develop uterine rupture than mothers with additional medical or obstetric conditions. CONCLUSION The prevalence of uterine rupture is high in the study area. The study also revealed that a decrease in ANC follow-up, gravidity of ≥5, obstructed labor, and fetal weight of >4kg are significantly associated with uterine rupture. Improving the quality of ANC follow-up, intrapartum follow-up and proper estimation of fetal weight are recommended interventions from the study.
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Affiliation(s)
- Getnet Feleke
- Obstetrics and Gynecology in Arbaminch University College of Medicine and Health Sciences, Arbaminch, Ethiopia
| | - Temesgen Tantu
- Obstetrics and Gynecology in Wolkite University College of Medicine and Health Sciences, Wolkite, Ethiopia
- * E-mail:
| | - Dereje Zewdu
- Anesthesia in Wolkite University College of Medicine and Health Sciences, Wolkite, Ethiopia
| | - Abel Gedefawu
- Obstetrics and Gynecology in Hawassa University College of Medicine and Health Sciences, Hawassa, Ethiopia
| | - Mekete Wondosen
- Surgery in Wolkite University College of Medicine and Health Sciences, Wolkite, Ethiopia
| | - Muluken Gunta
- MPH, Wolaita Zone Health Department, Wolaita Sodo, Ethiopia
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Negash BT, Alelgn Y. Proper partograph utilization among skilled birth attendants in Hawassa city public health facilities, Sidama region, Ethiopia, in 2021. BMC Womens Health 2022; 22:539. [PMID: 36550470 PMCID: PMC9773518 DOI: 10.1186/s12905-022-02117-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2022] [Accepted: 12/06/2022] [Indexed: 12/24/2022] Open
Abstract
Abnormalities of labor are the major causes of maternal and fetal mortality and morbidity. Proper partograph utilization is a key intervention to detect labor abnormalities and subsequent initiation of management. Although a great deals of studies were conducted about partograph utilization, they have failed to explore some critical factors which correlate with correct filling of partograph so far. To assess magnitude and factors associated with proper partograph recording among skilled delivery attendants in public health facilities of Hawassa city, Sidama Ethiopia, in 2021. An institution based cross-sectional study was conducted to assess proper partograph filling practice among skilled delivery providers of public health facilities of Hawassa city, Sidama region, Ethiopia from November to December 15, in 2021. Data were collected using self-administered questionnaire, and client chart review. Data were entered, cleaned, and analyzed using SPSS software. Binary and multivariate logistic regression analysis was used to show association between outcome and explanatory variables. Multi-collinearity test was done using VIF. Adjusted Odds Ratio with 95% CI and p value less than 0.05 was taken as cuff of value for statistically significant value at final model. Out of 405 study participants, only 370 study subjects have provided full response for questions making a response rate of 91.4% in this study. The reason of non-responders was evaluated as not related with the issue of the outcome variable. The mean age of study subjects was 28 ± 3.9 years. Magnitude of proper partograph utilization was found to be58.4% (95% CI, 55.8-60.9%) among skilled delivery attendants in this study. Factors associated with partograph uptake were: On job training (AOR = 1.9, 95% CI: (1.1, 3.2), good knowledge (AOR = 3.1, 95% CI: (1.8, 5.3) and supportive supervision (AOR = 4.5, 95% CI, 2.5, 7.9), client took Uterotonics (AOR = 2.3, 95% CI: 1.4, 3.9), and day time admission (AOR = 3.5, 95% CI, 1.9-6.4). These factors were associated positively with proper partograph utilization. In conclusion, magnitude of proper partograph utilization was found to be lower than magnitude of WHO threshold. Hence, on job training should be enhanced about proper partograph utilization. Furthermore, monitoring, supervision and strengthening the human resource of delivery process would be mandatory by managers of delivery units.
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Affiliation(s)
- Berhan Tsegaye Negash
- grid.192268.60000 0000 8953 2273Department of Midwifery Collage of Medicine and Health Science, Hawassa University, Hawassa, Ethiopia
| | - Yitateku Alelgn
- grid.192268.60000 0000 8953 2273Department of Midwifery Collage of Medicine and Health Science, Hawassa University, Hawassa, Ethiopia
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Hussein AI, Omar AA, Hassan HA, Kassim MM, Yusuf AA, Osman AA. Spontaneous Rupture of Unscarred Uterus in a Term Primagravida with Lethal Skeletal Dysplasia Fetus (Thanatophoric dysplasia). A Case Report and Review of the Literature. Int Med Case Rep J 2022; 15:551-556. [PMID: 36225974 PMCID: PMC9549793 DOI: 10.2147/imcrj.s383195] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2022] [Accepted: 09/30/2022] [Indexed: 11/05/2022] Open
Abstract
Background and Importance Spontaneous uterine rupture, especially in an unscarred uterus, is a rare pregnancy complication that can cause severe morbidity and mortality in both the mother and the fetus. The vast majority of uterine ruptures occur in the presence of a previous uterine scar, most commonly from a previous cesarean delivery. To our knowledge, here we reported the first case of spontaneous rupture of unscarred uterus in a term primigravida secondary to lethal skeletal dysplasia fetus (Type 1 Thanatophoric dysplasia) faced by a practicing clinician in an underdeveloped country (Somalia) with a successful outcome. Case Presentation The patient was 24 yrs. Old Primagravida, at 40 weeks gestation by LMP, presented with abdominal pain and active vaginal bleeding; she did not receive antenatal care during pregnancy; after initial abdominal ultrasonography and vaginal examination, laparotomy was performed due to high suspicion of uterine rupture. After dead fresh fetal extraction, the uterine defect was repaired successfully, and the patient was discharged home in good condition after several days. Conclusion Through this case, we would like to highlight the urgent need to focus on and recognize the importance of receiving antenatal care in the community so that the burden of thousands of lives lost each year can be reduced.
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Affiliation(s)
- Ahmed Issak Hussein
- Obstetrics and Gynecology Department, Mogadishu Somalia Turkish Training and Research Hospital, Mogadishu, Somalia,Correspondence: Ahmed Issak Hussein, Mogadishu Somalia Turkish Training and Research Hospital, Mogadishu, Somalia, Tel +252615597479, Email
| | - Abdikarim Ali Omar
- Obstetrics and Gynecology Department, Mogadishu Somalia Turkish Training and Research Hospital, Mogadishu, Somalia
| | - Hodan Abdi Hassan
- Obstetrics and Gynecology Department, Mogadishu Somalia Turkish Training and Research Hospital, Mogadishu, Somalia
| | - Mohamed Mukhtar Kassim
- Pediatric Department, Mogadishu Somalia Turkish Training and Research Hospital, Mogadishu, Somalia
| | | | - Ahmed Adam Osman
- Radiology Department, Mogadishu Somalia Turkish Training and Research Hospital, Mogadishu, Somalia
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Yeshitila YG, Daniel B, Desta M, Kassa GM. Obstructed labor and its effect on adverse maternal and fetal outcomes in Ethiopia: A systematic review and meta-analysis. PLoS One 2022; 17:e0275400. [PMID: 36178921 PMCID: PMC9524671 DOI: 10.1371/journal.pone.0275400] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2022] [Accepted: 09/15/2022] [Indexed: 01/22/2023] Open
Abstract
Background Obstructed labor is one of the five major causes of maternal mortality and morbidity in developing countries. In Ethiopia, it accounts for 19.1% of maternal death. The current review aimed to assess maternal and perinatal outcomes of obstructed labor in Ethiopia. Methods Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guideline was followed for this systematic review and meta-analysis. A literature search was made using PubMed/MEDLINE, CINAHL, Summon country-specific search, and Cochrane Libraries’ online databases. Search terms were adverse outcome, obstructed labor, maternal outcome, fetal outcome, and Ethiopia. The Newcastle-Ottawa scale (NOS), based on a star scoring system, was used to assess the quality of the included studies. The meta-analysis was conducted using STATA 16 software. The pooled prevalence of an adverse maternal outcome, fetal outcome, and association between adverse outcome and obstructed labor was calculated using a random-effects model. Egger’s test and funnel plot were used to evaluate publication bias. Result Eighty-seven studies were included in this review, with an overall sample size of 104259 women and 4952 newborns. The pooled incidence of maternal death was estimated to be 14.4% [14.14 (6.91–21.37). The pooled prevalence of uterine rupture and maternal near-miss was 41.18% (95% CI: 19.83, 62.54) and 30.5% [30.5 (11.40, 49.59) respectively. Other complications such as postpartum hemorrhage, sepsis, obstetric fistula, hysterectomy, bladder injury, cesarean section, and labor abnormalities were also reported. The pooled prevalence of perinatal death was 26.4% (26.4 (95% CI 15.18, 37.7). In addition, the association of obstructed labor with stillbirth, perinatal asphyxia, and meconium-stained amniotic fluid was also demonstrated. Conclusions In Ethiopia, the incidence of perinatal and maternal mortality among pregnant women with obstructed labor was high. The rate of maternal death and maternal near miss reported in this review was higher than incidences reported from high-income and most low and middle-income countries. Uterine rupture, postpartum hemorrhage, sepsis, fistula, hysterectomy, and bladder injury were also commonly reported. To improve the health outcomes of obstructed labor, it is recommended to address the three delay models: enhancing communities’ health-seeking behavior, enhancing transportation for an obstetric emergency with different stakeholders, and strengthening the capacity of health facilities to handle obstetric emergencies.
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Affiliation(s)
- Yordanos Gizachew Yeshitila
- School of Nursing, College of Medicine and Health Science, Arba Minch University, Arba Minch, Ethiopia
- * E-mail:
| | - Beniam Daniel
- School of Nursing, College of Medicine and Health Science, Arba Minch University, Arba Minch, Ethiopia
| | - Melaku Desta
- Department of Midwifery, College of Medicine and Health Science, Debre Markos University, Debre Markos, Ethiopia
| | - Getachew Mullu Kassa
- College of Medicine and Health Science, Debre Markos University, Debre Markos, Ethiopia
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Tesema O, Tilahun T, Kejela G. Determinants of uterine rupture at public hospitals of western Ethiopia: A case-control study. SAGE Open Med 2022; 10:20503121221092643. [PMID: 35492890 PMCID: PMC9047805 DOI: 10.1177/20503121221092643] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2021] [Accepted: 03/17/2022] [Indexed: 11/15/2022] Open
Abstract
Introduction Uterine rupture is a separation of the entire thickness of the uterine wall with the extrusion of fetal parts to the peritoneal cavity. It contributes to high maternal and perinatal mortality in Ethiopia. This study was aimed to identify determinants of uterine rupture among mothers who gave birth at East Wollega Zone public hospitals. Methods A facility-based unmatched case-control study was conducted among 239 samples (47 cases and 192 controls) from 5 June 2019 to 30 September 2019. Cases were those with uterine rupture, and controls were those free from uterine rupture. Cases were selected consecutively, and controls were selected using a systematic sampling method. For analysis, data were entered into Epi-data version 3.1 and exported to SPSS version 20. Descriptive statistics were performed to describe the variables. Binary and multivariable logistic regression were used in the analysis. The outputs were presented using an adjusted odds ratio with 95% confidence intervals. Results Two hundred thirty-nine (47 cases and 192 controls) mothers who gave birth in public hospitals in the East Wollega zone were interviewed, making a response rate of 100%. Living in an urban area (adjusted odds ratio = 0.219, 95% confidence interval: 0.067, 0.717), prolonged labor (adjusted odds ratio = 5.401, 95% confidence interval: 1.825, 15.981), obstructed labor (adjusted odds ratio = 4.333, 95% confidence interval: 1.276, 14.715), previous history of C/S (adjusted odds ratio = 6.5261, 95% confidence interval: 1.889, 22.554), and having no history of female genital cutting (adjusted odds ratio = 0.190, 95% confidence interval: 0.053, 0.682) were predictors of uterine rupture. Conclusion In this study, socio-demographic, maternal nutrition, obstetric, and health system-related factors were identified as risks of uterine rupture. Particular emphasis should be given to modifiable risk factors to reduce maternal morbidity and mortality in the study area.
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Affiliation(s)
- Oliyad Tesema
- Department of Nursing, Nekemte College
of Health Science, Nekemte, Ethiopia
| | - Temesgen Tilahun
- School of Medicine, Institute of Health
Sciences, Wollega University, Nekemte, Ethiopia
| | - Gemechu Kejela
- Department of Public Health, Institute
of Health Sciences, Wollega University, Nekemte, Ethiopia
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Tao J, Mu Y, Chen P, Xie Y, Liang J, Zhu J. Pregnancy complications and risk of uterine rupture among women with singleton pregnancies in China. BMC Pregnancy Childbirth 2022; 22:131. [PMID: 35172764 PMCID: PMC8851699 DOI: 10.1186/s12884-022-04465-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2021] [Accepted: 02/10/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The goal of this study was to investigate whether pregnancy complications are associated with an increased risk of uterine rupture (UR) and how that risk changes with gestational age. METHODS We obtained all data from China's National Maternal Near Miss Surveillance System (NMNMSS) between 2012 and 2018. Poisson regression analysis was used to assess the risk of UR with pregnancy complications (preeclampsia, gestational diabetes mellitus, placental abruption, placenta previa and placenta percreta) among 9,454,239 pregnant women. Furthermore, we analysed the risks of UR with pregnancy complications in different gestational age groups. RESULTS The risk of UR was increased 2.0-fold (1.2-fold to 2.7-fold) in women with pregnancy complications (except for preeclampsia). These associations also persisted in women without a previous caesarean delivery. Moreover, an increased risk of UR before term birth was observed among women with gestational diabetes mellitus, placental abruption and placenta percreta. The risk of UR was slightly higher in women with gestational diabetes mellitus who had a large for gestational age (LGA) foetus, especially at 32 to 36 weeks gestation. CONCLUSIONS The risk of UR is associated with gestational diabetes mellitus, placental abruption, placenta previa and placenta percreta, but varies in different gestational ages.
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Affiliation(s)
- Jing Tao
- National Office for Maternal and Child Health Surveillance of China, West China Second University Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Yi Mu
- National Office for Maternal and Child Health Surveillance of China, West China Second University Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Peiran Chen
- National Office for Maternal and Child Health Surveillance of China, West China Second University Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Yanxia Xie
- National Office for Maternal and Child Health Surveillance of China, West China Second University Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Juan Liang
- National Office for Maternal and Child Health Surveillance of China, West China Second University Hospital, Sichuan University, Chengdu, Sichuan, China.
| | - Jun Zhu
- National Office for Maternal and Child Health Surveillance of China, West China Second University Hospital, Sichuan University, Chengdu, Sichuan, China. .,Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, Chengdu, China.
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11
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Girmay G, Gultie T, Gebremichael G, Afework B, Temesgen G. Determinants of uterine rupture among mothers who gave birth in Jinka and Arba Minch General Hospitals, institution-based case-control study, Southern Ethiopia, Ethiopia, 2019. ACTA ACUST UNITED AC 2021; 16:1745506520961722. [PMID: 32985385 PMCID: PMC7534070 DOI: 10.1177/1745506520961722] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Background: Uterine rupture is a major public health problem in low-income countries including Ethiopia. In Ethiopia, its prevalence is low, but it results in devastative health problems of the mother and her baby. Even though the Ethiopian government and nongovernmental organizations tried to strengthen the health care system, significant adverse maternal and fetal outcome is still associated with uterine rupture. The aim of this study was to identify determinants of uterine rupture in Jinka and Arba Minch General Hospitals. Methods: The study was conducted in Jinka and Arba Minch General Hospitals, and the data collection period was 15 to 30 November 2018. A case–control study design was used with simple random sampling of 1:4. Data were collected using data extraction sheets. Variables with p < 0.25 in bivariate logistic regression were entered into multivariable logistic regression. Variables with p < 0.05 in multivariable logistic regression were used to determine significant association between dependent and independent variables. Result: Uterine rupture occurred in 112 cases with 448 controls. Women referred from health facilities (adjusted odds ratio = 8.0, 95% confidence interval: 3.5–17.8), multiparous women (adjusted odds ratio = 12.7, 95% confidence interval: 4.2–39.0), duration of labor more than 18 h (adjusted odds ratio = 11.5, 95% confidence interval: 5.5–24.1), malpresentation (adjusted odds ratio = 3.5, 95% confidence interval: 1.0–8.0) and gestational age of ⩾37 weeks (adjusted odds ratio = 5.2, 95% confidence interval: 1.4–19.3) were independent factors associated with uterine rupture. Conclusion: Mothers referred from health facilities, multiparous women, duration of labor more than 18 h, gestational age of ⩾37 weeks and malpresentation were significantly associated with uterine rupture. Early referral, encouraging family planning, proper use of partograph, early identification and appropriate intervention for malpresentation are recommended.
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Affiliation(s)
- Goitom Girmay
- Department of Midwifery, Aksum University, Axum, Ethiopia
| | | | | | - Bezawit Afework
- Department of Midwifery, Arba Minch University, Arba Minch, Ethiopia
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12
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Desta M, Kassa GM, Getaneh T, Sharew Y, Alemu AA, Birhanu MY, Yeneabat T, Alamneh YM, Amha H. Maternal and perinatal mortality and morbidity of uterine rupture and its association with prolonged duration of operation in Ethiopia: A systematic review and meta-analysis. PLoS One 2021; 16:e0245977. [PMID: 33886549 PMCID: PMC8062067 DOI: 10.1371/journal.pone.0245977] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2020] [Accepted: 01/11/2021] [Indexed: 11/28/2022] Open
Abstract
Background Uterine rupture is the leading cause of maternal and perinatal morbidity and it accounts for 36% of the maternal mortality in Ethiopia. The maternal and perinatal outcomes of uterine rupture were inconclusive for the country. Therefore, this systematic review and meta-analysis aimed to estimate the pooled maternal and perinatal mortality and morbidity of uterine rupture and its association with prolonged duration of operation. Methods The Preferred Reporting Items for Systematic Reviews and Meta-Analyses checklist was used for this systematic review and meta-analysis. We systematically used PubMed, Cochrane Library, and African Journals online databases for searching. The Newcastle- Ottawa quality assessment scale was used for critical appraisal. Egger’s test and I2 statistic used to assess the check for publication bias and heterogeneity. The random-effect model was used to estimate the pooled prevalence and odds ratios with 95% confidence interval (CI). Results The pooled maternal mortality and morbidity due to uterine rupture in Ethiopia was 7.75% (95% CI: 4.14, 11.36) and 37.1% (95% CI: 8.44, 65.8), respectively. The highest maternal mortality occurred in Southern region (8.91%) and shock was the commonest maternal morbidity (24.43%) due to uterine rupture. The pooled perinatal death associated with uterine rupture was 86.1% (95% CI: 83.4, 89.9). The highest prevalence of perinatal death was observed in Amhara region (91.36%) and the lowest occurred in Tigray region (78.25%). Prolonged duration of operation was a significant predictor of maternal morbidity (OR = 1.39; 95% CI: 1.06, 1.81). Conclusions The percentage of maternal and perinatal deaths due to uterine rupture was high in Ethiopia. Uterine rupture was associated with maternal morbidity and prolonged duration of the operation was found to be associated with maternal morbidities. Therefore, birth preparedness and complication readiness plan, early referral and improving the duration of operation are recommended to improve maternal and perinatal outcomes of uterine rupture.
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Affiliation(s)
- Melaku Desta
- Department of Midwifery, College of Health Science, Debre Markos University, Debre Markos, Ethiopia
- * E-mail:
| | - Getachew Mullu Kassa
- Department of Midwifery, College of Health Science, Debre Markos University, Debre Markos, Ethiopia
| | - Temesgen Getaneh
- Department of Midwifery, College of Health Science, Debre Markos University, Debre Markos, Ethiopia
| | - Yewbmirt Sharew
- Department of Midwifery, College of Health Science, Debre Markos University, Debre Markos, Ethiopia
| | - Addisu Alehegn Alemu
- Department of Midwifery, College of Health Science, Debre Markos University, Debre Markos, Ethiopia
| | | | - Tebikew Yeneabat
- Department of Midwifery, College of Health Science, Debre Markos University, Debre Markos, Ethiopia
- Department of Midwifery, University of Technology Sydney, Sydney, Australia
| | - Yoseph Merkeb Alamneh
- Department of Biomedical Sciences, School of Medicine, Debre Markos University, Debre Markos, Ethiopia
| | - Haile Amha
- Department of Nursing, College of Health Science, Debre Markos University, Debre Markos, Ethiopia
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13
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Lopian M, Kashani-Ligumski L, Cohen R, Assaraf S, Herzlich J, Lessing JB, Perlman S. Twin TOLAC is an independent risk factor for adverse maternal and neonatal outcome. Arch Gynecol Obstet 2021; 304:1433-1441. [PMID: 33877401 DOI: 10.1007/s00404-021-06062-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2020] [Accepted: 03/31/2021] [Indexed: 11/27/2022]
Abstract
PURPOSE To determine factors associated with a successful twin trial of labor after Cesarean delivery (TOLAC). METHODS A retrospective cohort study was conducted at a single medical center in a population highly motivated for TOLAC (> 80%). The effect of maternal demographic and obstetric characteristics on the likelihood of twin TOLAC success was analyzed. Maternal complications and combined adverse outcome (uterine rupture, Apgar < 7 at 5 min, and umbilical cord pH < 7.1) were compared between singleton and twin TOLAC groups. RESULTS Ninety-five women with a twin gestation and one previous Cesarean delivery comprised the study group. Five thousand seven hundred and three women with a singleton gestation and one previous Cesarean delivery comprised the control group. 30.5% and 83% of women with twin and singleton gestation, respectively, underwent a trial of labor. Women in the twin TOLAC group were significantly less likely to succeed and less likely to have a spontaneous unassisted vaginal delivery compared to women in the singleton TOLAC group. Maternal age less than 35 years, parity greater than two, and at least one previous VBAC increased the likelihood of TOLAC success. Statistically significant differences were found between the twin TOLAC and the singleton TOLAC group for uterine rupture, maternal complications, and for combined adverse outcome. CONCLUSIONS Twin TOLAC is not common, even in parturients highly motivated for TOLAC. Our results demonstrate that even in a selected population, women undergoing twin TOLAC are less likely to have a successful spontaneous vaginal delivery and have a higher risk for uterine rupture, maternal complications, and combined adverse perinatal outcome than women undergoing TOLAC with a singleton gestation. Demographic and obstetric risk factors were identified which can aid the attending obstetrician in the counseling of these challenging cases.
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Affiliation(s)
- Miriam Lopian
- Department of Obstetrics and Gynecology, Mayanei Hayeshua Medical Center, 17 Harav Povarski Street, Bnei Bark, Israel. .,Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel.
| | - Lior Kashani-Ligumski
- Department of Obstetrics and Gynecology, Mayanei Hayeshua Medical Center, 17 Harav Povarski Street, Bnei Bark, Israel.,Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Ronnie Cohen
- Department of Obstetrics and Gynecology, Mayanei Hayeshua Medical Center, 17 Harav Povarski Street, Bnei Bark, Israel.,Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Sharon Assaraf
- Department of Obstetrics and Gynecology, Mayanei Hayeshua Medical Center, 17 Harav Povarski Street, Bnei Bark, Israel.,Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Jacky Herzlich
- Department of Pediatrics, Mayanei Hayeshua Medical Center, Bnei Brak, Israel.,Department of Neonatology, Tel Aviv Sourasky Medical Center, Lis Hospital for Women, Tel Aviv, Israel
| | - Joseph B Lessing
- Department of Obstetrics and Gynecology, Mayanei Hayeshua Medical Center, 17 Harav Povarski Street, Bnei Bark, Israel.,Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Sharon Perlman
- Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel.,Department of Obstetrics and Gynecology, Rabin Medical Center, The Helen Schneider Hospital for Women, Petach Tikva, Israel
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14
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Burden of Uterine Rupture and Its Determinant Factors in Ethiopia: A Systematic Review and Meta-analysis. BIOMED RESEARCH INTERNATIONAL 2020. [DOI: 10.1155/2020/3691271] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Background. Uterine rupture is a life-threatening obstetrical emergency, which results in serious undesired maternal and perinatal complications in resource-limited countries, mainly in Ethiopia. The prevalence, determinants, and outcomes of uterine rupture described by different studies were highly inconsistent in Ethiopia. Therefore, this systematic review and meta-analysis is aimed at estimating the pooled prevalence, determinants, and adverse outcomes of uterine rupture in Ethiopia. Methods. Studies were searched from international databases (PubMed/MEDLINE, HINARI, Cochrane library, Google Scholar, and web of science) and Ethiopian universities’ digital libraries (Addis Ababa University, University of Gondar, and Harameya University). All observational studies were included. A total of 15 studies that fulfill the inclusion criteria were included in this meta-analysis. Data were extracted by two reviewers and exported to STATA version 11 for analysis. The
statistics were used to assess heterogeneity across the studies. Publication bias was examined by using Egger’s test and funnel plot. The pooled prevalence of uterine rupture and its outcomes were estimated by using a random effects model. The associations between determinants and uterine rupture were evaluated by using both random and fixed-effect models. Results. In this meta-analysis, a total of 15 studies with 92,394 study participants were involved. The pooled prevalence of uterine rupture was 2.37% in Ethiopia. Obstructed labor (
;
), lack of antenatal care follow-up (
;
), duration of
hours (
;
), grand multipara (
;
), and being rural residency (
;
) were significantly associated with uterine rupture. Conclusion. The overall prevalence of uterine rupture was high in Ethiopia. Obstructed labor, lack of antenatal care follow-up, duration of
hours, grand multipara, and rural residency were determinants of uterine rupture. This study implies the need to develop plans and policies to improve antenatal care follow-up and labor and delivery management at each level of the health system.
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15
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Desta M, Amha H, Anteneh Bishaw K, Adane F, Assemie MA, Kibret GD, Yimer NB. Prevalence and predictors of uterine rupture among Ethiopian women: A systematic review and meta-analysis. PLoS One 2020; 15:e0240675. [PMID: 33137135 PMCID: PMC7605683 DOI: 10.1371/journal.pone.0240675] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2019] [Accepted: 09/30/2020] [Indexed: 11/24/2022] Open
Abstract
Background Uterine rupture has a significant public health importance, contributing to 13% of maternal mortality and 74%-92% of perinatal mortality in Sub-Saharan Africa, and 36% of maternal mortality in Ethiopia. The prevalence and predictors of uterine rupture were highly variable and inconclusive across studies in the country. Therefore, this systematic review and meta-analysis aimed to estimate the pooled prevalence and predictor of uterine rupture in Ethiopia. Methods This systematic review and meta-analysis followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses 2009 checklist. PubMed, Cochrane Library, Google Scholar, and African Journals Online databases were searched. The Newcastle- Ottawa quality assessment tool was used for critical appraisal. I2 statistic and Egger’s tests were used to assess the heterogeneity and publication bias, respectively. The random-effects model was used to estimate the pooled prevalence and odds ratios with a 95% confidence interval. Results Sixteen studies were included, with a total of 91,784 women in the meta-analysis. The pooled prevalence of uterine rupture was 2% (95% CI: 1.99, 3.01). The highest prevalence was observed in the Amhara regional state (5%) and the lowest was in Tigray region (1%). Previous cesarean delivery (OR = 9.95, 95% CI: 3.09, 32.0), lack of antenatal care visit (OR = 8.40, 95% CI: 4.5, 15.7), rural residence (OR = 4.75, 95% CI: 1.17, 19.3), grand multiparity (OR = 4.49, 95% CI: 2.83, 7.11) and obstructed labor (OR = 6.75, 95%CI: 1.92, 23.8) were predictors of uterine rupture. Conclusion Uterine rupture is still high in Ethiopia. Therefore, proper auditing on the appropriateness of cesarean section and proper labor monitoring, improving antenatal care visit, and birth preparedness and complication readiness plan are needed. Moreover, early referral and family planning utilization are the recommended interventions to reduce the burden of uterine rupture among Ethiopia women.
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Affiliation(s)
- Melaku Desta
- Department of Midwifery, College of Health Sciences, Debre Markos University, Debre Markos, Ethiopia
- * E-mail:
| | - Haile Amha
- Department of Nursing, College of Health Sciences, Debre Markos University, Debre Markos, Ethiopia
| | - Keralem Anteneh Bishaw
- Department of Midwifery, College of Health Sciences, Debre Markos University, Debre Markos, Ethiopia
| | - Fentahun Adane
- Department of Biomedical Sciences, School of Medicine, Debre Markos University, Debre Markos, Ethiopia
| | - Moges Agazhe Assemie
- Department of Public health, College of Health Sciences, Debre Markos University, Debre Markos, Ethiopia
| | - Getiye Dejenu Kibret
- Department of Public health, College of Health Sciences, Debre Markos University, Debre Markos, Ethiopia
| | - Nigus Bililign Yimer
- Department of Midwifery, College of Health Sciences, Woldia University, Woldia, Ethiopia
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16
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Alemu AA, Bitew MS, Gelaw KA, Zeleke LB, Kassa GM. Prevalence and determinants of uterine rupture in Ethiopia: a systematic review and meta-analysis. Sci Rep 2020; 10:17603. [PMID: 33077758 PMCID: PMC7572500 DOI: 10.1038/s41598-020-74477-z] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2020] [Accepted: 09/21/2020] [Indexed: 12/02/2022] Open
Abstract
Uterine rupture is a serious public health concern that causes high maternal and perinatal morbidity and mortality in the developing world. Few of the studies conducted in Ethiopia show a high discrepancy in the prevalence of uterine rupture, which ranges between 1.6 and 16.7%. There also lacks a national study on this issue in Ethiopia. This systematic and meta-analysis, therefore, was conducted to assess the prevalence and determinants of uterine rupture in Ethiopia. We followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines for systematic review and meta-analysis of studies. All observational published studies were retrieved using relevant search terms in Google scholar, African Journals Online, CINHAL, HINARI, Science Direct, Cochrane Library, EMBASE and PubMed (Medline) databases. Newcastle–Ottawa assessment checklist for observational studies was used for critical appraisal of the included articles. The meta-analysis was done with STATA version 14 software. The I2 test statistics were used to assess heterogeneity among included studies, and publication bias was assessed using Begg's and Egger's tests. Odds ratio (OR) with a 95% confidence interval (CI) was presented using forest plots. A total of twelve studies were included in this study. The pooled prevalence of uterine rupture was 3.98% (95% CI 3.02, 4.95). The highest (7.82%) and lowest (1.53%) prevalence were identified in Amhara and Southern Nations, Nationality and Peoples Region (SNNPR), respectively. Determinants of uterine rupture were urban residence (OR = 0.15 (95% CI 0.09, 0.23)), primipara (OR = 0.12 (95% CI 0.06, 0.27)), previous cesarean section (OR = 3.23 (95% CI 2.12, 4.92)), obstructed labor(OR = 12.21 (95% CI 6.01, 24.82)), and partograph utilization (OR = 0.12 (95% CI 0.09, 0.17)). Almost one in twenty-five mothers had uterine rupture in Ethiopia. Urban residence, primiparity, previous cesarean section, obstructed labor and partograph utilization were significantly associated with uterine rupture. Therefore, intervention programs should address the identified factors to reduce the prevalence of uterine rupture.
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Affiliation(s)
- Addisu Alehegn Alemu
- College of Health Sciences, Debre Markos University, P.O.Box: 269, Debre Markos, Ethiopia.
| | | | - Kelemu Abebe Gelaw
- College of Health Sciences, Wolita Sodo University, Wolita Sodo, Ethiopia
| | - Liknaw Bewket Zeleke
- College of Health Sciences, Debre Markos University, P.O.Box: 269, Debre Markos, Ethiopia
| | - Getachew Mullu Kassa
- College of Health Sciences, Debre Markos University, P.O.Box: 269, Debre Markos, Ethiopia
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