Uterine rupture in Mekelle, northern Ethiopia, between 2009 and 2013.
OBJECTIVE
To review cases of uterine rupture at a center in northern Ethiopia.


METHODS
In a retrospective chart review, data were assessed for cases of symptomatic uterine rupture treated at Ayder Referral Hospital in Mekelle between January 1, 2009, and December 31, 2013.


RESULTS
In the 5-year study period, there were 5185 deliveries and 47 cases of uterine rupture, giving a rate of one case per 110 deliveries. All patients underwent laparotomy for suspected uterine rupture. Mean parity was 3.6 (range 0-8). The most common predisposing factors were cephalopelvic disproportion (35 [74%] patients), previous cesarean delivery (5 [11%)], and fetal malpresentation (4 [9%]). Hysterectomy was undertaken for 35 (74%) patients; the other 12 (26%) were treated conservatively by simple repair of the rupture. There were 44 (95%) stillbirths and 1 (2%) maternal death.


CONCLUSIONS
Uterine rupture remains an important clinical problem in northern Ethiopia. Changes in the cultural preference for home delivery, better transport and referral systems, and improved obstetric training and hospital management of laboring women are needed.
Department of Obstetrics and Gynecology, Ayder Referral Hospital, College of Health Sciences, Mekelle University, Mekelle, Ethiopia.
Yibrah
Y
Berhe
Department of Obstetrics and Gynecology, Ayder Referral Hospital, College of Health Sciences, Mekelle University, Mekelle, Ethiopia.
Hagos
H
Gidey
Department of Obstetrics and Gynecology, Ayder Referral Hospital, College of Health Sciences, Mekelle University, Mekelle, Ethiopia; Department of Obstetrics and Gynecology, School of Medicine, Washington University in St Louis, St Louis, MO, USA; Department of Anthropology, College of Arts and Sciences, Washington University in St Louis, St Louis, MO, USA. Electronic address: walll@wudosis.wustl.edu.
L Lewis
LL
Wall
D000293:Adolescent; D000328:Adult; D005002:Ethiopia / Q000453:epidemiology; D005260:Female; D006801:Humans; D007044:Hysterectomy; D007813:Laparotomy / Q000379:methods*; D063130:Maternal Death; D008875:Middle Aged; D010298:Parity; D011247:Pregnancy; D011256:Pregnancy Outcome; D012189:Retrospective Studies; D012307:Risk Factors; D050497:Stillbirth / Q000453:epidemiology; D014597:Uterine Rupture / Q000453:epidemiology* / Q000209:etiology / Q000601:surgery; D055815:Young Adult
Ethiopia; Fetal malpresentation; Low-resource countries; Obstructed labor; Uterine rupture