Abstract:
Introduction: Uterine rupture represents a critical public health issue, particularly in low- and
middle-income countries such as Ethiopia, where access to adequate maternal healthcare is often
limited. This obstetric emergency poses significant risks, leading to considerable morbidity and
mortality for both mothers and their newborns. Although uterine rupture is relatively rare within
the Ethiopian context, the limited evidence and understanding of the contributing factors during
labor are concerning, particularly in pastoralist and semi-pastoralist communities. Therefore, this
study aimed to identify the determinants of uterine rupture among pastoralist women who gave
birth at Gazer and Jinka Hospitals in Southern Ethiopia.
Methods: An institution-based unmatched case-control study was conducted involving 405
pastoralist women who gave birth between January 1, 2018, and November 1, 2024, at Jinka and
Gazer Hospitals. Among these participants, 144 women experienced uterine rupture and were
classified as cases, while 288 women without uterine rupture served as controls. Data were
collected using a data extraction checklist through the Open Data Kit application, drawing
information from logbooks and client cards. The collected data were subsequently exported to
SPSS version 25.0 for comprehensive analysis. To identify factors associated with uterine
rupture, binary logistic regression was employed. The adjusted odds ratios, accompanied by a
95% confidence interval, were computed to interpret the results effectively. A p-value of less
than 0.05 was deemed statistically significant for the purposes of this study.
Results: The odds of experiencing a uterine rupture were found to be 2.9 times higher among
women with a gravidity of five or more (AOR = 2.9; 95% CI: 1.20, 6.91) compared to those with
a gravidity of four or less. Other independent determinants included referral from other health
facilities, a history of cesarean section scar, and fetal macrosomia.
Conclusion: This study identified significant associations between gravidity, referrals from other
health facilities, previous cesarean sections, and birth weight with the risk of uterine rupture. The
findings highlight the need to improve accessibility to emergency obstetric care and enhance
referral systems, particularly for laboring mothers with prior cesarean deliveries. Targeted
attention to these high-risk individuals can enhance maternal safety and minimize uterine rupture
incidents during child birth.
