Prevalence and Associated Factors of Uterine Rupture During Labor among Women Who Delivered in Debre Markos Hospital North West Ethiopia Aliyu SA * , Yizengaw TK and Lemma TB Department of Nursing, Jimma University, Ethiopia * Corresponding author: Samuel Abdu Aliyu, Department of Nursing, Jimma University, Ethiopia, Tel: +251928236767; E-mail: samuelabdu2004@gmail.com Received date: June 28, 2016; Accepted date: August 09, 2016; Published date: August 16, 2016 Copyright: © 2016 Aliyu SB, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Abstract Background: Uterine rupture causes high maternal and neonatal mortality in many rural setting in the world. Uterine rupture accounts for about 8% of all maternal deaths. Method and Materials: Facility based cross sectional study design was employed to assess the prevalence and associated factors of uterine rupture. The data were abstracted from the cases registered during 2010 and 2014 in delivery registers, operating theater registers and patients’ case files of obstetrics ward of Debre Markos Referral Hospital North West Ethiopia. A total of 880 cases were selected by using systematic sampling method. Result: A sample size of 880 cases was selected after a review of 5-year patients’ records (approx. 16,100 registered delivery cases) from Debre Markos Referral Hospital maternity ward. Among these selected cases, 854 (97.2%) cases were responded for the study. Prevalence of uterine rupture was identified in 81 (9.5%) cases. Factors associated with uterine rupture includes: attending ante natal care less than two visits (OR 2.5 95% CI 1.25-5.03), no use of partograph on follow up of labor (OR 7.29 95% CI 3.4-15.4), obstructed labor (OR 15.3 95% CI 7.54-31.1), living within >10 km of distance from the hospital (OR 5.26 95% CI 1.8-15.3), increase in one unit of maternal age (OR 8.15 95% CI 0.18-0.82), increase of one gravidity (OR 2.165 95% CI 1.6-2.9) and referred from other facilities (OR 6.5 95% CI 2.5-16.2). Conclusion and Recommendations: Uterine rupture is one of the major causes of maternal morbidity and mortality in Debre Markos Referral Hospital in North West Ethiopia. Majority of uterine ruptures were occurred due to the obstructed labor. The hospital should build strong collaborative and integrative mechanisms with catchment of healthy facility and educative campaign to decrease prevalence of uterine rupture and its impact in the surrounding regions. Keywords: Uterine rupture; Obstetric factors; Obstructed labor Introduction Uterine rupture means tearing of the uterine wall during pregnancy or delivery. Rupture of a previously unscarred uterus is usually a catastrophic event which results in death of the baby, extensive damage to the uterus and sometimes even maternal death can occur due to heavy blood loss. Te damage to the uterus is sometimes beyond repair and in such cases; hysterectomy is required [1]. Worldwide, around 340,000 to half a million women die per annum due to complications of pregnancy and child birth. Te majority of these cases occur in low income countries; Sub-Sahara Africa bears over 90% of the burden of maternal death [2]. Uterine rupture is one of the major obstetric complications of labor and contributes signifcantly to maternal and perinatal mortality and morbidity [3]. WHO systematic review of maternal mortality and morbidity: Te prevalence of uterine rupture in developed countries was 0.92. However, in least developed countries viz., 1.9% in Central Africa, 18% in Burkina Faso and in 25% in Ethiopia [1]. In Ethiopia the top four causes of maternal mortality were obstructed labor and uterine rupture (36%), hemorrhage (22%), hypertensive disorders of pregnancy (19%) and sepsis/infection (13%) [4]. In Ethiopia 52.8% of deliveries were attended at home and the rest 48.2% institution delivery. Phase I delay (delay in decision to seek care) contributed about 25% of maternal deaths [5]. Tis, Federal Ministry of Health has initiated free maternity services at health center and hospital level recently [6]. Uterine rupture was the third common cause of death in Addis Ababa. Tikur-Anbessa hospital is prudent to improve availability, accessibility and utilization of the essential emergency obstetric care services to decrease maternal loss and to turn up the millennium development goal. Skilled attendance of labor coupled with early referral to the next higher level for better and timely intervention is equally important [7]. Several study from Africa and Asia shows that 75% of case of uterine rupture occurred in women with unscarred uterus obstructed labour being the most common cause [8]. A study conducted in Nigeria the main associated factors for uterine rupture were obstructed labour alone 23 (24.2%) and use of oxytocin in already obstructed labor 22 (23.1%), constituted oxytocin use 13 (13.7%), previous uterine scar 12 (12.6%) and intrauterine manipulation by traditional birth attendants 5 (5.3%) [9]. In studies from Nigeria, Ghana, Ethiopia, and Bangladesh, about 75% of cases of uterine rupture occurred in women with an unscarred uterus, with obstructed labor being the most common cause [10-12]. Internal Medicine: Open Access Aliyu et al., Intern Med 2016, 6:4 DOI: 10.4172/2165-8048.1000222 Research Article Open Access Intern Med, an open access journal ISSN:2165-8048 Volume 6 • Issue 4 • 1000222 I n t e r n a l M e d i c i n e - O p e n A c c e s s ISSN: 2165-8048