Determinants of uterine rupture among pregnant mothers who gave birth at University of Gondar comprehensive specialized Hospital, Northwest Ethiopia: unmatched case control study

BACKGROUND: Uterine rupture is a tear in the wall of the uterus that commonly occurs in its lower segment. Despite it being the most preventable obstetric complication and different interventions being done by stakeholders, the prevalence of uterine rupture is high, and it remains one of the leading public health problems in developing countries, including Ethiopia. It is also a leading cause of severe maternal morbidity and mortality. Although risk factors for uterine rupture are context-specific, there is a lack of clarity in our context regarding the contributing factors and untoward outcomes of uterine rupture. Therefore, this study aimed to identify determinants of uterine rupture among pregnant mothers who gave birth at the University of Gondar Specialized and Comprehensive Hospital, Northwest Ethiopia. METHODS AND MATERIALS: An institutional-based unmatched case-control study was conducted on 450 women (150 cases and 300 controls) from 2018 to 2022. A data collection tool containing variables was designed to extract data from log books and client cards. Data were entered into EpiData 6.7 and exported to Stata-16 software for cleaning and analysis. In bivariate analysis, p-values < 0.2 were entered into multivariable analysis, and statistical significance was declared at p-value < 0.05 with AOR reported. RESULTS: In this study, being in a rural residence (AOR = 4.8, 95% CI: (1.15,11)), distance from the hospital (AOR = 11.2, 95% CI: (2.6,47.3)), self-referral case (AOR = 0.17, 95% CI: (0.04,0.7)), had not Antenatal Care follow-up (AOR = 3.7, 95% CI: (1.2,16)), no Cephalopelvic Disproportion (AOR = 0.01, 95% CI: (0.02,0.1)), and had not used partograph (AOR = 3.9, 95% CI: 1.2,12)) were significantly associated with uterine rupture. CONCLUSION: In this study, being a rural resident, distance from the hospital, referral from a health center, ANC follow-up, CPD, and use of a partograph were independent determinants of uterine rupture. Therefore, we provide client-centered counseling on birth preparedness and complication readiness plan and encourage women to use maternal waiting areas to avoid uterine rupture.