Incidence and management outcome of uterine rupture in Nekemte referral hospital, oromia regional state, Ethiopia

Abstract

Introduction: Uterine rupture is a serious life threatening obstetric complication during child birth. The extent to which it happened and its management outcome is unknown in NRH Objective: - To assess incidence and management outcomes of ruptured uterus at NRH. Method: A retrospective study conducted to retrieve 213 Cases of uterine rupture from all deliveries managed from September 2003-September 2006 E.C .Data was collected by trained data collectors form maternal records using structured checklist Patient cards and operating room registration books was used to review diagnosis of rupture, surgical intervention and treatment outcome during a period. Data was cleaned, entered & analyzed with SPSS 16.0 statistical packages. Chi square test was done to see the association between the independent and the dependent variables and P-Value <0.05 at 95% CI was taken as statically significant throughout the analysis .Finally data will be presented in tables, figures and texts. Result:-The incidence of uterine rupturewas during the period. Causes of rupture where CPD 113(53.1%) and mal presentation in 89(38.5%) were the leading causes of uterine rupture. Repair was done in 198 (92.8%) 0f cases, Anemia was a leading post operative complication occurred in 116(54.5%)cases Causes of MD were hemorrhagic 18(8.5%)&septic shock6(2.8).62 Septic shock has statistical association with management outcome of uterine rupture. (COR=0.072, 95% CI: 0.010-0.547,P value<0.011&AOR=0.016, 95% CI:,0.001-0.17).Anemia has significant association with management outcome of uterine rupture.(COR=0.092,95% CI:0.046-0.148,P value<0.001& AOD=0.010,95% CI :0.003-0.040,P value<0.001). Conclusion& recommendation Significant numbers of uterine rupture cases seen in NRH with overall incidence rate of 2.9%. almost one-third (66.2%) of mothers with uterine rupture and managed at NRH have poor management outcome. Blood transfusion, Septic shock and anaemia are independent predictors of maternal outcome in uterine rupture in NRH. Finally large scale prospective study is recommended to identify maternal, socio-economical and socio-cultural determinants of uterine rupture