Maternal and perinatal outcomes of uterine rupture patients among mothers who delivered at mizan aman general hospital, snnpr, South West Ethiopia; a five year retrospective hospital based study

Background: Uterine rupture causes high maternal and perinatal mortality in many rural setting in the world. Ethiopia is one of the less developed countries where maternal and perinatal mortality rates are still very high. Objective: To determine maternal and perinatal outcomes of uterine rupture patients among mothers who delivered at Mizan-Aman General Hospital, South west Ethiopia. Methods: A descriptive hospital based cross sectional study on maternal and perinatal outcome of uterine rupture patients among mothers who delivered at Mizan-Aman General Hospital was done from June 1, 2011 - May 31, 2015. Data on socio demographic, obstetrics, intraoperative, post op complication, maternal and perinatal outcome was collected. The collected data analyzed with SPSS 20.0. Association between dependent and independent variables was done by using binary logistic regression model and P-Value <0.05 at 95% CI was taken as statistically significant. Result: 115 patient cards were included in the study. There were 1(8.3%) intra operative maternal death and 11(91.7 %) post-operative death, making case fatality rate of uterine rupture 10.4 %. The incidence of uterine rupture in the hospital was 1.6%. There were 110(95.6%) of neonatal death and 5(4.6%) of neonate were delivered alive, those delivered with instrument and from previous uterine scar. The common causes of uterine rupture were obstructed labor 57(49.6%) followed by malpresentation and malposition which account 26(22.6%). Of all uterine rupture patients 102(88.7%) were complete rupture, the common site of rupture were 38(33%) anterior transverse lower segment followed by anterior low vertical 22(19.1%). Repair with bilateral tubal ligation in 48(41.7%) followed by repair without bilateral tubal ligation in 34(29.6%) were the common procedures done for ruptured uterus patients. Conclusion:Hemoglobin level, blood transfusion, diagnosis of uterine rupture before operation had strong association with maternal out come and neonatal intensive care unit admission had also strong association with perinatal outcome. The common causes of uterine rupture are obstructed labor followed by malpresentation/ position. Complete uterine rupture and anterior lower segment rupture were by far the commonest patterns of uterine rupture by type and site respectively.