Uterine rupture and associated factors among pregnant women at Hoima Regional Referral Hospital.

Abstract

Background:Uterine rupture is a life-threatening obstetric complication, particularly prevalent in low-resource settings like Uganda, where it significantly contributes to maternal and neonatal morbidity and mortality. This condition, characterized by the non-surgical tearing of uterine layers during pregnancy or delivery, demands prompt diagnosis and intervention to avert adverse outcomes This study aimed to identify the factors associated with uterine rupture and assess the outcomes for women delivering at Hoima Regional Referral Hospital (HRRH). Methodology:A case-control study design was employed, utilizing secondary data from patient files. Cases comprised women who experienced uterine rupture and underwent laparotomy, while controls were women who delivered at HRRH without experiencing uterine rupture. Data collection was performed using a structured checklist, and statistical analysis involved descriptive statistics, bivariate, and multivariate analyses to determine the factors associated with uterine rupture. Adjusted Odds Ratios (AOR) with 95% confidence intervals were calculated to measure the strength of associations. Results: The study identified several factors significantly associated with uterine rupture. Pregnant mothers with a previous uterine scar hada higher likelihood of getting uterine rapture (AOR = 5.6; 95% CI: 2.8-11.1), Lack of educational attainment was linked to increased risk, women with primary education attainment were 0.29 times lower compared to those with no formal education (AOR=0.29, 95%Cl: 0.086-0.977), uterine rupture among women with secondary education was 0.16 times lower compared to women with no formal education (AOR=0.16, 95%Cl: 0.047-0.527). Marital status and distance from healthcare facilities also emerged as significant factors; married women (AOR = 2.4; 95% CI: 1.2-4.8) and those living more than 5Kms from a health facility (AOR = 3.7; 95% CI: 1.8-7.6) were at higher risk. The study also found that the use of oxytocin before the third stage of labor was associated with reduced odds of uterine rupture (AOR = 0.4; 95% CI: 0.2-0.8). Conclusion: The findings highlight critical socio-demographic and clinical factors, including previous cesarean scars and delayed access to healthcare, that contribute to the incidence of uterine rupture. To reduce the incidence and improve outcomes, the study recommends enhancing maternal health education during antenatal care, especially regarding the risks of uterine rupture and the importance of timely healthcare access. Strengthening emergency obstetric care, improving referral systems, and ensuring better access to health facilities for women in remote areas are essential strategies for reducing maternal and neonatal morbidity and mortality associated with uterine rupture