Management outcome of uterine ruptures in attat Hospital south nation, nationalities and people region, Ethiopia.

Abstract

Background: - Even though uterine rupture is infrequent event it is a common cause of maternal and prenatal mortality and morbidity. It can either occur in women with unscarred uterus or a uterus with a surgical scar from previous surgery. The occurrence of ruptured uterus varies in different parts of the world. In the developed world the frequency has dropped significantly whereas it is still a major public health problem in developing countries in general and Africa in particularly. Objective: -To determine management outcome of uterine rupture in Attat hospital, South Nation, Nationalities and People Region, Ethiopia. Method:-A retrospective study was done in Attat Hospital, from January 1, 2012, to December 30, 2014 to determine management outcome of uterine rupture. The data were collected from patients’ medical record charts and operation registration book of patients admitted to Gyn obst ward with the diagnosis of uterine rupture during study period from February 1-30, 2015. A total of 65 patient’s cards were reviewed and 60 of them fulfill inclusion criteria. SPSS version 20.0 was used for data processing and analysis. Descriptive statistic and binary logistic regression were used for analyses. RESULT: - Out of the total 5370 deliveries conducted in Attat Hospital during the study period 60(1.1%) were cases of uterine rupture. Twenty two (36.7%) of the cases were in the age group of 30-34 years, 50(83.3%) of patients were married, 40(66.7%) of cases were Para I-IV and 35(58.3%) of cases were stayed in labor for more than 24hours. The major causes of rupture were cephalopelvic disproportion 30(50%) followed by malpresentation and malposition 14(23.3%) of the cases. There were 7(11.7%) maternal death and 53(88.3%) of stillbirth among patients with uterine rupture. Out of 60 with uterine rupture 16(26.7%) of patients stayed in hospital before operation for <1 hour and 44(73.3%) patients stayed for >=1 hour in hospital before operation. Twenty seven (45%) of patients were with hemoglobin above or equal to 11mg/dl, 16(26.7%) of patient with hemoglobin below 7g/dl, 11(18.3%) of patients were with hemoglobin in the range of 7g/dl-9.99g/dl, and 6(10%) of patients were in the range of 10- 10.99g/dl hemoglobin before operation. CONCLUSSIONS AND RECCOMENDATIONS: - The maternal morbidity, mortality and perinatal mortality associated with uterine rupture were very high. Among patients with uterine rupture, 5(8.3%) of patients had previous history of Cesearean section. This higher morbidity and mortality were calls for an integrated effort to prevent its causes.