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. 2025 Jul 2;25(1):703.
doi: 10.1186/s12884-025-07817-4.

Time to death and its predictors among women with uterine rupture admitted to jimma town public hospitals, South West Ethiopia: retrospective cohort study

Lidetu Ababa Kenea  1 , Chaltu Fikru Biyana  1 , Buzuneh Tasfa Marine  2
Affiliations

Time to death and its predictors among women with uterine rupture admitted to jimma town public hospitals, South West Ethiopia: retrospective cohort study

Lidetu Ababa Kenea et al. BMC Pregnancy Childbirth. .

Abstract

Background: Uterine rupture is a public health issue in resource-limited countries, evidenced to account for 36% of maternal deaths in Ethiopia. This problem has not been studied in the study area, and little is known about the survival of women with uterine rupture. Therefore, this study aimed to assess time to death and its predictors among women with uterine rupture admitted to Jimma Town public Hospitals.

Method: An institution-based retrospective cohort study was conducted on all 405 eligible women with uterine rupture admitted to Jimma Town Public Hospitals. Data were collected by using structured questions developed in the Kobo toolbox and analyzed using Stata version 17. The Kaplan-Meier curve was used to estimate the median time to death, and a log-rank test was employed to assess statistically significant survival differences between groups. The Cox-proportional hazards model was fitted to identify predictors of the time to death. A hazard ratio with a 95% significance level and a P-value < 0.05 was considered to declare significant variables.

Results: From the total of 405 women followed for 4217 person-days, 38(9.4%) of them have died, leading to an incidence rate of 9 per 1000 women-days. The median survival time was 20 days. Hypovolemic shock (AHR: 3.87 (95%CI: 1.75, 8.53)), severe anemia (AHR: 3.56 (95%CI: 1.39, 9.12)), Not having ANC follow-up (AHR: 2.95 (95%CI: 1.02, 8.59)), admission at night time(AHR: 2.89(95%CI: 1.16, 7.76)), labour duration of ≥ 24 h (AHR: 2.69 (95%CI: 1.26, 5.78)) and having urine bladder rupture (AHR: 2.29(95%CI: 1.08, 4.91)) were predictors of time to death.

Conclusion: This study highlights the urgent need for improved healthcare interventions to address the issue of maternal death from uterine rupture and mitigate its impact on national maternal mortality rate. Timely and appropriate medical interventions are crucial in addressing the effects of factors such as hypovolemic shock, severe anemia, lack of ANC follow-up, labour duration of ≥ 24 h, night-time admissions, and urine bladder ruptures on maternal time to death when uterine rupture happens.

Keywords: Predictors; Time to death; Uterine rupture; Women.

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Conflict of interest statement

Declarations. Ethical approval and consent to participate: Ethical clearance was obtained from the Institutional Review Board (IRB) of Jimma University Institute of Health on May 30, 2024 with reference number (Ref.No. JU/IH/IRB/536/24) and permission was taken from the Chief clinical directors of Jimma Town public Hospitals. The study was conducted in accordance with relevant guidelines and regulations. Due to retrospective nature of the study Institutional Review Board (IRB) of Jimma University Institute of Health, waived the need of obtaining informed consent. The information obtained from the study participants will be treated confidentially, and our data extraction tools are programmed to prevent the display of private information. The study adhered to the guiding principles of the Declaration of Helsinki throughout its execution. Consent for publication: Not applicable. No individual person’s personal details, images, or videos are being used in this study. Competing interests: The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
Case selection flow diagram of ruptured uterine women admitted to Jimma town Public Hospitals from May 01, 2019 to April 30, 2024
Fig. 2
Fig. 2
Pie-chart showing the residence of the women with uterine rupture admitted to Jimma Town Public Hospitals, SW Ethiopia, May 01, 2019, to April 30, 2024
Fig. 3
Fig. 3
Histogram for anemia among women with uterine rupture admitted to Jimma Town Public Hospitals SW Ethiopia, May 01, 2019, to April 30, 2024
Fig. 4
Fig. 4
Survival status of the women with uterine rupture admitted to Jimma Town Public Hospitals, SW Ethiopia, May 01, 2019, to April 30, 2024
Fig. 5
Fig. 5
Overall Kaplan Meier survival graph for women with uterine rupture admitted to Jimma Town public Hospitals from May 01, 2019, to April 30, 2024
See this image and copyright information in PMC

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