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Meta-Analysis
. 2020 Oct 19;10(1):17603.
doi: 10.1038/s41598-020-74477-z.

Prevalence and determinants of uterine rupture in Ethiopia: a systematic review and meta-analysis

Addisu Alehegn Alemu  1 , Mezinew Sintayehu Bitew  2 , Kelemu Abebe Gelaw  3 , Liknaw Bewket Zeleke  2 , Getachew Mullu Kassa  2
Affiliations
Meta-Analysis

Prevalence and determinants of uterine rupture in Ethiopia: a systematic review and meta-analysis

Addisu Alehegn Alemu et al. Sci Rep. .

Abstract

Uterine rupture is a serious public health concern that causes high maternal and perinatal morbidity and mortality in the developing world. Few of the studies conducted in Ethiopia show a high discrepancy in the prevalence of uterine rupture, which ranges between 1.6 and 16.7%. There also lacks a national study on this issue in Ethiopia. This systematic and meta-analysis, therefore, was conducted to assess the prevalence and determinants of uterine rupture in Ethiopia. We followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines for systematic review and meta-analysis of studies. All observational published studies were retrieved using relevant search terms in Google scholar, African Journals Online, CINHAL, HINARI, Science Direct, Cochrane Library, EMBASE and PubMed (Medline) databases. Newcastle-Ottawa assessment checklist for observational studies was used for critical appraisal of the included articles. The meta-analysis was done with STATA version 14 software. The I2 test statistics were used to assess heterogeneity among included studies, and publication bias was assessed using Begg's and Egger's tests. Odds ratio (OR) with a 95% confidence interval (CI) was presented using forest plots. A total of twelve studies were included in this study. The pooled prevalence of uterine rupture was 3.98% (95% CI 3.02, 4.95). The highest (7.82%) and lowest (1.53%) prevalence were identified in Amhara and Southern Nations, Nationality and Peoples Region (SNNPR), respectively. Determinants of uterine rupture were urban residence (OR = 0.15 (95% CI 0.09, 0.23)), primipara (OR = 0.12 (95% CI 0.06, 0.27)), previous cesarean section (OR = 3.23 (95% CI 2.12, 4.92)), obstructed labor(OR = 12.21 (95% CI 6.01, 24.82)), and partograph utilization (OR = 0.12 (95% CI 0.09, 0.17)). Almost one in twenty-five mothers had uterine rupture in Ethiopia. Urban residence, primiparity, previous cesarean section, obstructed labor and partograph utilization were significantly associated with uterine rupture. Therefore, intervention programs should address the identified factors to reduce the prevalence of uterine rupture.

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Conflict of interest statement

The authors declare no competing interests.

Figures

Figure 1
Figure 1
PRISMA diagram showing studies utilized for systematic and meta-analysis of uterine rupture in Ethiopia.
Figure 2
Figure 2
A forest plot describing the pooled prevalence of uterine rupture in Ethiopia.
Figure 3
Figure 3
A forest plot shows the subgroup prevalence analysis of uterine rupture by study region.
Figure 4
Figure 4
A forest plot describing the association of residence and parity with uterine rupture.
Figure 5
Figure 5
A forest plot describing the associations of obstructed labor, previous C/S, and partograph utilization with uterine rupture.
See this image and copyright information in PMC

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