Obstetric morbidity and socio-cultural predictors of ruptured uterus among women in Southeast Nigeria.
This study determined the incidence, obstetric morbidity and the socio-cultural factors associated with ruptured uterus. A 6-year prospective review of ruptured uterus and an enquiry into socio-cultural barriers to specialised care was conducted. The incidence of ruptured uterus was 12 per 1000 deliveries. Occurrence was common in uneducated (78/116; 67.2%), unbooked (110/116; 94.8%) and rural women (112/116; 96.6%). The major causes were prolonged obstructed labour (104/116; 89.7%) and injudicious use of oxytocics (90/116; 77.6%). The maternal and perinatal case fatality rates were 18.1% and 96.6%, respectively. Complications resulted from haemorrhage and sepsis. Lack of birth plan (97/116; 79.3%) and unskilled birth attendance (110/116; 94.8%) were major socio-cultural risk factors. There was an association between education (p = 0.001), parity (p = 0.002), residence (<0.001), type of birth attendance (<0.001) and ruptured uterus. Women in low-income settings face threats of complications and death from uterine rupture, owing to preventable socio-cultural barriers of accessing specialised obstetric care.
a Department of Obstetrics and Gynaecology , Federal Teaching Hospital Abakaliki , Abakaliki , Ebonyi State , Nigeria.
Lucky Osaheni
LO
Lawani
b Department of Obstetrics and Gynaecology , University of Nigeria Teaching Hospital , Enugu , Enugu State , Nigeria.
Chukwuemeka Anthony
CA
Iyoke
b Department of Obstetrics and Gynaecology , University of Nigeria Teaching Hospital , Enugu , Enugu State , Nigeria.
Peter Onubiwe
PO
Nkwo
a Department of Obstetrics and Gynaecology , Federal Teaching Hospital Abakaliki , Abakaliki , Ebonyi State , Nigeria.
Robinson Chukwudi
RC
Onoh
a Department of Obstetrics and Gynaecology , Federal Teaching Hospital Abakaliki , Abakaliki , Ebonyi State , Nigeria.
Paul Olisaemeka
PO
Ezeonu
c Department of Obstetrics and Gynaecology , Niger Delta University , Amassoma , Bayelsa State , Nigeria.
Isa Ayuba
IA
Ibrahim
D000328:Adult; D004420:Dystocia / Q000453:epidemiology* / Q000209:etiology; D004522:Educational Status; D005260:Female; D006801:Humans; D015994:Incidence; D009017:Morbidity; D009549:Nigeria / Q000453:epidemiology; D010120:Oxytocics / Q000008:administration & dosage / Q000009:adverse effects; D011247:Pregnancy; D011446:Prospective Studies; D012307:Risk Factors; D012959:Socioeconomic Factors; D014597:Uterine Rupture / Q000453:epidemiology* / Q000209:etiology*
D010120:Oxytocics
Maternal mortality; Nigeria; obstetric morbidity; perinatal mortality; ruptured uterus; socio-cultural predictors