College of Health Sciences, Debre Markos University, P.O.Box: 269, Debre Markos, Ethiopia.
College of Health Sciences, Wolita Sodo University, Wolita Sodo, Ethiopia.
Sci Rep. 2020 Oct 19;10(1):17603. doi: 10.1038/s41598-020-74477-z.
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 I 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.
子宫破裂是一个严重的公共卫生问题，在发展中国家导致了高孕产妇和围产儿发病率和死亡率。在埃塞俄比亚进行的少数研究表明，子宫破裂的患病率差异很大，范围在 1.6%至 16.7%之间。埃塞俄比亚也缺乏关于这个问题的全国性研究。因此，进行了这项系统和荟萃分析，以评估埃塞俄比亚子宫破裂的患病率和决定因素。我们遵循系统评价和荟萃分析的首选报告项目 (PRISMA) 指南进行研究。使用相关搜索词在 Google Scholar、African Journals Online、CINHAL、HINARI、Science Direct、Cochrane Library、EMBASE 和 PubMed (Medline) 数据库中检索所有已发表的观察性研究。使用 Newcastle-Ottawa 评估清单对纳入的文章进行批判性评估。使用 STATA 版本 14 软件进行荟萃分析。I 检验统计量用于评估纳入研究之间的异质性，使用 Begg 和 Egger 检验评估发表偏倚。使用森林图呈现优势比 (OR) 和 95%置信区间 (CI)。共有 12 项研究纳入本研究。子宫破裂的总患病率为 3.98%（95%CI 3.02, 4.95）。最高（7.82%）和最低（1.53%）患病率分别在阿姆哈拉和南方各族人民国家地区（SNNPR）发现。子宫破裂的决定因素包括城市居住（OR=0.15（95%CI 0.09, 0.23））、初产妇（OR=0.12（95%CI 0.06, 0.27））、既往剖宫产（OR=3.23（95%CI 2.12, 4.92））、梗阻性分娩（OR=12.21（95%CI 6.01, 24.82））和产程图的使用（OR=0.12（95%CI 0.09, 0.17））。在埃塞俄比亚，几乎每 25 位母亲中就有 1 位发生子宫破裂。城市居住、初产、既往剖宫产、梗阻性分娩和产程图的使用与子宫破裂显著相关。因此，干预计划应针对确定的因素，以降低子宫破裂的患病率。
