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Determinants of Uterine Rupture and Its Management Outcomes among Mothers Who Gave Birth at Public Hospitals of Tigrai, North Ethiopia: An Unmatched Case Control Study

INTRODUCTION: Uterine rupture is a leading cause of maternal death in Ethiopia. Despite strengthening the health care system and providing basic and comprehensive emergency obstetric care closer to the communities, uterine rupture continues to produce devastating maternal and fetal outcomes. Althoug...

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Autores principales: Mengesha, Meresa Berwo, Weldegeorges, Desta Abraha, Hailesilassie, Yared, Werid, Weldu Mammo, Weldemariam, Mulu Gebretsadik, Welay, Fissaha Tekulu, Gebremeskel, Senait Gebreslasie, Gebrehiwot, Berhanu Gebresilassie, Hidru, Hagos Degefa, Teame, Hirut, Gebremedhin, Haftay, Assefa, Natnael Etsay
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Hindawi 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7641719/
https://www.ncbi.nlm.nih.gov/pubmed/33194231
http://dx.doi.org/10.1155/2020/8878037
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author Mengesha, Meresa Berwo
Weldegeorges, Desta Abraha
Hailesilassie, Yared
Werid, Weldu Mammo
Weldemariam, Mulu Gebretsadik
Welay, Fissaha Tekulu
Gebremeskel, Senait Gebreslasie
Gebrehiwot, Berhanu Gebresilassie
Hidru, Hagos Degefa
Teame, Hirut
Gebremedhin, Haftay
Assefa, Natnael Etsay
author_facet Mengesha, Meresa Berwo
Weldegeorges, Desta Abraha
Hailesilassie, Yared
Werid, Weldu Mammo
Weldemariam, Mulu Gebretsadik
Welay, Fissaha Tekulu
Gebremeskel, Senait Gebreslasie
Gebrehiwot, Berhanu Gebresilassie
Hidru, Hagos Degefa
Teame, Hirut
Gebremedhin, Haftay
Assefa, Natnael Etsay
author_sort Mengesha, Meresa Berwo
collection PubMed
description INTRODUCTION: Uterine rupture is a leading cause of maternal death in Ethiopia. Despite strengthening the health care system and providing basic and comprehensive emergency obstetric care closer to the communities, uterine rupture continues to produce devastating maternal and fetal outcomes. Although risk factors of uterine rupture are context specific, there is lack of clarity in our context towards the contributing factors and untoward outcomes of uterine rupture. This study was conducted to identify the risk factors of uterine rupture and its impacts in public hospitals of Tigrai. OBJECTIVE: This study would identify determinant factors of uterine rupture and its management outcomes among mothers who gave birth in public hospitals in Tigrai region, North Ethiopia. METHOD: A retrospective hospital-based unmatched case control study design was implemented with 135 cases of women with uterine rupture and 270 controls of women without uterine rupture. Cases were enrolled consecutively from case notes of women who gave birth from 1/9/2015 to 30/6/2019, while charts (case note) of women without uterine rupture found following the cases were selected randomly and enrolled. Bivariate and multivariate logistic regression with 95% confidence interval was used to identify the determinants of uterine rupture. RESULT: Mothers referred from remote health institutions (AOR 7.29 (95% CI: 2.7, 19.68)), mothers who visited once for antenatal care (AOR 2.85 (95% CI: 1.02, 7.94)), those experiencing obstructed labor (AOR 13.33 (95% CI: 4.23, 42.05)), and birth weight of a newborn greater than four kilograms (AOR 5.68 (95% CI: 1.39, 23.2)) were significantly associated with uterine rupture. From 135 mothers who develop uterine rupture, 13 (9.6%) mothers died and 101 (74.8%) fetuses were stillborn. Obstetrical complications like abdominal hysterectomy in 75 (55.6%) of mothers and excessive blood loss in 84 (57.8%) were additional untoward outcomes of uterine rupture. CONCLUSION: Referrals from remote health institutions, once-visited antenatal care, obstructed labor, and birth weight of newborns greater than four kilograms were significant determinants of uterine rupture. Maternal death, stillbirth, hysterectomy, and hemorrhage were adverse outcomes. The findings of this study suggest early identification of factors that expose to uterine rupture during antenatal care, labor, and delivery must be attended to and further prospective studies are needed to explore predictors of untoward outcomes. Knowing the determinants of uterine rupture helps prevent the occurrence of a problem in pregnant women, which reduces maternal morbidity and mortality, and would have a tremendous help in identifying the best optional strategies in our current practices. This assertion was added to the abstract concluding session.
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spelling pubmed-76417192020-11-13 Determinants of Uterine Rupture and Its Management Outcomes among Mothers Who Gave Birth at Public Hospitals of Tigrai, North Ethiopia: An Unmatched Case Control Study Mengesha, Meresa Berwo Weldegeorges, Desta Abraha Hailesilassie, Yared Werid, Weldu Mammo Weldemariam, Mulu Gebretsadik Welay, Fissaha Tekulu Gebremeskel, Senait Gebreslasie Gebrehiwot, Berhanu Gebresilassie Hidru, Hagos Degefa Teame, Hirut Gebremedhin, Haftay Assefa, Natnael Etsay J Pregnancy Research Article INTRODUCTION: Uterine rupture is a leading cause of maternal death in Ethiopia. Despite strengthening the health care system and providing basic and comprehensive emergency obstetric care closer to the communities, uterine rupture continues to produce devastating maternal and fetal outcomes. Although risk factors of uterine rupture are context specific, there is lack of clarity in our context towards the contributing factors and untoward outcomes of uterine rupture. This study was conducted to identify the risk factors of uterine rupture and its impacts in public hospitals of Tigrai. OBJECTIVE: This study would identify determinant factors of uterine rupture and its management outcomes among mothers who gave birth in public hospitals in Tigrai region, North Ethiopia. METHOD: A retrospective hospital-based unmatched case control study design was implemented with 135 cases of women with uterine rupture and 270 controls of women without uterine rupture. Cases were enrolled consecutively from case notes of women who gave birth from 1/9/2015 to 30/6/2019, while charts (case note) of women without uterine rupture found following the cases were selected randomly and enrolled. Bivariate and multivariate logistic regression with 95% confidence interval was used to identify the determinants of uterine rupture. RESULT: Mothers referred from remote health institutions (AOR 7.29 (95% CI: 2.7, 19.68)), mothers who visited once for antenatal care (AOR 2.85 (95% CI: 1.02, 7.94)), those experiencing obstructed labor (AOR 13.33 (95% CI: 4.23, 42.05)), and birth weight of a newborn greater than four kilograms (AOR 5.68 (95% CI: 1.39, 23.2)) were significantly associated with uterine rupture. From 135 mothers who develop uterine rupture, 13 (9.6%) mothers died and 101 (74.8%) fetuses were stillborn. Obstetrical complications like abdominal hysterectomy in 75 (55.6%) of mothers and excessive blood loss in 84 (57.8%) were additional untoward outcomes of uterine rupture. CONCLUSION: Referrals from remote health institutions, once-visited antenatal care, obstructed labor, and birth weight of newborns greater than four kilograms were significant determinants of uterine rupture. Maternal death, stillbirth, hysterectomy, and hemorrhage were adverse outcomes. The findings of this study suggest early identification of factors that expose to uterine rupture during antenatal care, labor, and delivery must be attended to and further prospective studies are needed to explore predictors of untoward outcomes. Knowing the determinants of uterine rupture helps prevent the occurrence of a problem in pregnant women, which reduces maternal morbidity and mortality, and would have a tremendous help in identifying the best optional strategies in our current practices. This assertion was added to the abstract concluding session. Hindawi 2020-10-28 /pmc/articles/PMC7641719/ /pubmed/33194231 http://dx.doi.org/10.1155/2020/8878037 Text en Copyright © 2020 Meresa Berwo Mengesha et al. https://creativecommons.org/licenses/by/4.0/ This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Research Article
Mengesha, Meresa Berwo
Weldegeorges, Desta Abraha
Hailesilassie, Yared
Werid, Weldu Mammo
Weldemariam, Mulu Gebretsadik
Welay, Fissaha Tekulu
Gebremeskel, Senait Gebreslasie
Gebrehiwot, Berhanu Gebresilassie
Hidru, Hagos Degefa
Teame, Hirut
Gebremedhin, Haftay
Assefa, Natnael Etsay
Determinants of Uterine Rupture and Its Management Outcomes among Mothers Who Gave Birth at Public Hospitals of Tigrai, North Ethiopia: An Unmatched Case Control Study
title Determinants of Uterine Rupture and Its Management Outcomes among Mothers Who Gave Birth at Public Hospitals of Tigrai, North Ethiopia: An Unmatched Case Control Study
title_full Determinants of Uterine Rupture and Its Management Outcomes among Mothers Who Gave Birth at Public Hospitals of Tigrai, North Ethiopia: An Unmatched Case Control Study
title_fullStr Determinants of Uterine Rupture and Its Management Outcomes among Mothers Who Gave Birth at Public Hospitals of Tigrai, North Ethiopia: An Unmatched Case Control Study
title_full_unstemmed Determinants of Uterine Rupture and Its Management Outcomes among Mothers Who Gave Birth at Public Hospitals of Tigrai, North Ethiopia: An Unmatched Case Control Study
title_short Determinants of Uterine Rupture and Its Management Outcomes among Mothers Who Gave Birth at Public Hospitals of Tigrai, North Ethiopia: An Unmatched Case Control Study
title_sort determinants of uterine rupture and its management outcomes among mothers who gave birth at public hospitals of tigrai, north ethiopia: an unmatched case control study
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7641719/
https://www.ncbi.nlm.nih.gov/pubmed/33194231
http://dx.doi.org/10.1155/2020/8878037
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