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Determinants of uterine rupture among cases of Adama city public and private hospitals, Oromia, Ethiopia: a case control study

BACKGROUND: Ethiopia is among the ten world countries with highest maternal death rates that accounts for more than 59% of global maternal deaths. Uterine rupture is one of the dangerous obstetric problems with high potential of causing maternal and neonatal morbidity and mortality. The case fatalit...

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Autores principales: Abebe, Fikru, Mannekulih, Ephrem, Megerso, Abebe, Idris, Abdurahman, Legese, Tsegaye
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2018
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6161387/
https://www.ncbi.nlm.nih.gov/pubmed/30261885
http://dx.doi.org/10.1186/s12978-018-0606-4
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author Abebe, Fikru
Mannekulih, Ephrem
Megerso, Abebe
Idris, Abdurahman
Legese, Tsegaye
author_facet Abebe, Fikru
Mannekulih, Ephrem
Megerso, Abebe
Idris, Abdurahman
Legese, Tsegaye
author_sort Abebe, Fikru
collection PubMed
description BACKGROUND: Ethiopia is among the ten world countries with highest maternal death rates that accounts for more than 59% of global maternal deaths. Uterine rupture is one of the dangerous obstetric problems with high potential of causing maternal and neonatal morbidity and mortality. The case fatality rate of uterine rupture is high and hence identifying factors associated with uterine rupture remains important to guide decision makers and practitioners. The study aimed to identify factors associated with uterine rupture among clients managed in Adama city public and private hospitals during January 2011 to December, 2015. METHODS: Unmatched case control study design was employed. The sample size was determined using computer software considering the basic statistical assumptions and accordingly a total of 432 women, (144 with uterine rupture as cases and 288 with spontaneous vaginal delivery as controls) managed in all hospitals during the study period were included in the study. A data collection tool that contains available variables was designed and used to extract data from log books and client cards. Data were entered into EPI-Info-7 and exported to Stata-12 for cleaning and analysis. The study participants were characterized using descriptive statistics. The associations between uterine rupture and independent variables were modeled using binary logistic regression analysis. The association between independent variables and uterine rupture was estimated using odds ratio with 95% confidence intervals. The statistical significance of the association was declared at P-value < 0.05. RESULTS: The odds of having a uterine rupture were found to be more than six times higher among rural residents (AOR = 6.29; 95% CI: 3.39, 11.66) compared to urban. Other independent predictors include gravidity of five or more (AOR = 27.89; 95% CI: 8.42, 92.34), having a history of cesarean section scar (AOR = 9.94; 95% CI: 3.39, 11.66) and not having an antenatal care visit (AOR = 9.64; 95% CI: 4.37, 21.29). CONCLUSION: Rural residence, multigravidas, cesarean section scar and not having an antenatal care visit were independent predictors of uterine rupture in the current study. Therefore, improving access and strengthening essential obstetric care, antenatal and family planning services with complete packages are crucial interventions in the reduction of the odds of having uterine rupture. In addition, the strengthening of the referral system is mandatory for women residing in rural areas.
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spelling pubmed-61613872018-10-01 Determinants of uterine rupture among cases of Adama city public and private hospitals, Oromia, Ethiopia: a case control study Abebe, Fikru Mannekulih, Ephrem Megerso, Abebe Idris, Abdurahman Legese, Tsegaye Reprod Health Research BACKGROUND: Ethiopia is among the ten world countries with highest maternal death rates that accounts for more than 59% of global maternal deaths. Uterine rupture is one of the dangerous obstetric problems with high potential of causing maternal and neonatal morbidity and mortality. The case fatality rate of uterine rupture is high and hence identifying factors associated with uterine rupture remains important to guide decision makers and practitioners. The study aimed to identify factors associated with uterine rupture among clients managed in Adama city public and private hospitals during January 2011 to December, 2015. METHODS: Unmatched case control study design was employed. The sample size was determined using computer software considering the basic statistical assumptions and accordingly a total of 432 women, (144 with uterine rupture as cases and 288 with spontaneous vaginal delivery as controls) managed in all hospitals during the study period were included in the study. A data collection tool that contains available variables was designed and used to extract data from log books and client cards. Data were entered into EPI-Info-7 and exported to Stata-12 for cleaning and analysis. The study participants were characterized using descriptive statistics. The associations between uterine rupture and independent variables were modeled using binary logistic regression analysis. The association between independent variables and uterine rupture was estimated using odds ratio with 95% confidence intervals. The statistical significance of the association was declared at P-value < 0.05. RESULTS: The odds of having a uterine rupture were found to be more than six times higher among rural residents (AOR = 6.29; 95% CI: 3.39, 11.66) compared to urban. Other independent predictors include gravidity of five or more (AOR = 27.89; 95% CI: 8.42, 92.34), having a history of cesarean section scar (AOR = 9.94; 95% CI: 3.39, 11.66) and not having an antenatal care visit (AOR = 9.64; 95% CI: 4.37, 21.29). CONCLUSION: Rural residence, multigravidas, cesarean section scar and not having an antenatal care visit were independent predictors of uterine rupture in the current study. Therefore, improving access and strengthening essential obstetric care, antenatal and family planning services with complete packages are crucial interventions in the reduction of the odds of having uterine rupture. In addition, the strengthening of the referral system is mandatory for women residing in rural areas. BioMed Central 2018-09-27 /pmc/articles/PMC6161387/ /pubmed/30261885 http://dx.doi.org/10.1186/s12978-018-0606-4 Text en © The Author(s). 2018 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
spellingShingle Research
Abebe, Fikru
Mannekulih, Ephrem
Megerso, Abebe
Idris, Abdurahman
Legese, Tsegaye
Determinants of uterine rupture among cases of Adama city public and private hospitals, Oromia, Ethiopia: a case control study
title Determinants of uterine rupture among cases of Adama city public and private hospitals, Oromia, Ethiopia: a case control study
title_full Determinants of uterine rupture among cases of Adama city public and private hospitals, Oromia, Ethiopia: a case control study
title_fullStr Determinants of uterine rupture among cases of Adama city public and private hospitals, Oromia, Ethiopia: a case control study
title_full_unstemmed Determinants of uterine rupture among cases of Adama city public and private hospitals, Oromia, Ethiopia: a case control study
title_short Determinants of uterine rupture among cases of Adama city public and private hospitals, Oromia, Ethiopia: a case control study
title_sort determinants of uterine rupture among cases of adama city public and private hospitals, oromia, ethiopia: a case control study
topic Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6161387/
https://www.ncbi.nlm.nih.gov/pubmed/30261885
http://dx.doi.org/10.1186/s12978-018-0606-4
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