Maternal near‐miss and death among women with rupture of the gravid uterus: a secondary analysis of the Nigeria Near‐miss and Maternal Death Survey

Etuk, Saturday; Abasiattai, AM; Ande, Adedapo; Omo-Aghoja, LO; Bariweni, A C; Abeshi, S E; Enaruna, NO; Oladapo, OT

doi:10.1111/1471-0528.15700

Cited by 12 publications

(7 citation statements)

References 21 publications

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“…The percentage of women reporting receiving any ANC was 67% and women receiving four or more visits was 57% [11]. Further, access to Emergency Obstetric Care (EmOC) in Nigeria is insufficient [14] and financial and geographical access barriers prevail [15,16]. Cultural beliefs and negative attitudes towards CS are other possible explanations for a delay in care-seeking behaviour and low CS rate [17,18].…”

Section: Introductionmentioning

confidence: 99%

Caesarean section rate in Nigeria between 2013 and 2018 by obstetric risk and socio‐economic status

Berglundh

Beňová

Olisaekee³

et al. 2021

Tropical Med Int Health

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objectives Caesarean section (CS) can be life-saving for both mother and child, but in Nigeria the CS rate remains low, at 2.7% of births. We aimed to estimate the rate of CS and early neonatal mortality in Nigeria according to obstetric risk and socio-economic background and to identify factors associated with CS.methods We used the 2018 Nigeria Demographic and Health Survey, encompassing 33 924 live births within the last 5 years, to estimate the CS rate and early neonatal mortality rate (ENMR) by obstetric risk group, informed by the Robson classification. The CS rate and ENMR were assessed within each Robson group and stratified by socio-economic background. Logistic regression analyses were used to explore determinants of CS.results Almost three-quarters (72.4%) of all births were to multiparous women, with a singleton baby of normal birthweight, thus a low-risk group similar to Robson 3, and with a CS rate of 1.0%. CS rates in the two high-risk groups (multiple pregnancy and preterm/low birthweight) were low, 7.1% (95% CI: 5.2-9.7) and 1.8 % (95% CI: 1.4-2.4), respectively. The ENMR was particularly high for multiple pregnancy (175 per 1000 live births; 95% CI: 131-230). Greater number of antenatal visits, unwanted pregnancy, multiple pregnancy, household wealth, maternal education, Christians/Others versus Muslims and referral during childbirth were positively associated with CS.conclusion Inequitable access to CS is not limited to socio-economic determinants, but also related to obstetric risk factors, calling for increased efforts to improve access to CS for high-risk pregnancies.

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Section: Introductionmentioning

confidence: 99%

Caesarean section rate in Nigeria between 2013 and 2018 by obstetric risk and socio‐economic status

Berglundh

Beňová

Olisaekee³

et al. 2021

Tropical Med Int Health

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“…8,10 Other factors responsible for the high incidence in developing countries relate to poverty, low literacy levels, potentially harmful cultural and religious practices, poor transportation and communication systems, not registering for antenatal care and high level of patronage of spiritual churches for pregnancy and child birth care. 7,14,16 These factors continue to increase the incidence of ruptured uterus in developing countries. It was also found that the majority of these patients in this study were unbooked (71.8%), this is comparable to the figures from other parts of the country and other countries in Sub-sahara Africa.…”

Section: Discussionmentioning

confidence: 99%

“…This agrees that ignorance and poverty contribute greatly to the high incidence of ruptured uterus seen in developing countries including Nigeria. 11,14,16 There exist some variations in the aetiological classification of ruptured uterus by different authours. 1 The commonest risk factors for ruptured uterus in this study were obstructed labour without a previous scar 19 (48.7%), followed by obstructed labour due to malpositions malpresentations/foetal macrosomia 9 (23.0%) and previous scar 7 (17.9%).…”

Section: Discussionmentioning

confidence: 99%

Uterine rupture at the University of Calabar Teaching Hospital, Calabar; Nigeria: a six-year review

Odusolu

Uduigwomen

Eyong

et al. 2022

Int J Reprod Contracept Obstet Gynecol

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Background: Ruptured uterus is one of the major complications of labour which contributes significantly to maternal and perinatal morbidity and mortality in low-resource and developing countries. Periodic review is necessary to determine the magnitude, risk factors and feto maternal outcomes to aid to plan prevention reduce maternal and fetal mortality are needed. The objective of the study was to determine the prevalence, risk factors, management options, and feto-maternal outcomes of uterine rupture in University of Calabar Teaching Hospital (UCTH), Calabar.Methods: Records of women with uterine rupture between January 2013 and December 2018 were retrieved. Sociodemographic data, clinical presentations, surgical options, fetal and maternal outcomes were recorded and analysed. Data was presented in frequencies and percentages.Results: During the study period, total number of deliveries was 11,382 with 41 ruptured uterus giving it an incidence of 0.36 percent. Twenty-eight (71.8%) of the patients were unbooked while 11 (28.2%) were booked. The mean age was 28.08 and majority were para 2 and 3 at 10 (25.6%). Obstructed labour was the commonest cause 28 (71.8%). Rupture of scar contributed to 8 cases (20.5%). Commonest presentation was abdominal pain 25 (64.1%). The commonest surgical procedure was uterine repair alone 21 (53.8%), while repair and bilateral tubal ligation was 8 (20.5%) and hysterectomy 9 (23.1%). Maternal mortality was 1 (2.6%) while fetal mortality was 32 (82.05%). The cause of maternal death was anaemic heart failure.Conclusions: Predisposing factors for uterine rupture at UCTH, Calabar are mostly modifiable. As such integrated efforts to prevent occurrence and ensure prompt management to reduce maternal and fetal mortality are needed.

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“…The adverse maternal outcomes of interest in the study were maternal near-miss, massive transfusion, hysterectomy, intensive care unit (ICU) admission, and deaths before discharge, and perinatal outcomes were stillbirth and neonatal deaths before delivery woman discharge. The criteria for maternal near-miss were based on the organ failure criteria recommended by the WHO [29]. Massive transfusion was de ned as transfusion of ≥ 1000 ml of whole blood or ≥ 5 units of red blood cell suspension [30].…”

Section: De Nition Of Variablesmentioning

confidence: 99%

The incidence, associated factors and adverse maternal and perinatal outcomes of uterine rupture among vaginal births after caesarean section: An observational study from the National Maternal Near-Miss Surveillance System in China

Zhou

Chen

et al. 2023

Preprint

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Background The most serious problem during vaginal birth after caesarean section (VBAC) is the risk of uterine rupture but there is controversy regarding important related factors. With the relaxation of birth policy in China, the maternal and perinatal outcomes after uterine rupture during VBAC are a societal concern. The lack of any large-scale study of uterine rupture during VBAC in China underscores the need for more research evidence. Methods We studied singleton pregnant women with VBAC from 2012 to 2019 registered in China’s National Maternal Near-Miss Surveillance System (NMNMSS). First, we calculated the incidence of uterine rupture during VBAC. Second, using a logistic regression model with weighting for the sampling distribution of the population and clustering of births within hospitals, we examined the association of sociodemographic and obstetric characteristics and maternal diseases with uterine rupture during VBAC. With multivariable logistic regression, adjusted odds ratio were estimated using two models. Finally, we compared the risk of adverse maternal and perinatal outcomes in women with and without uterine rupture during VBAC. Results This study included 155774 singleton pregnant women with VBAC, and the incidence of uterine rupture was 0.23%. Characteristics associated with the increased risk of uterine rupture during VBAC included two (aOR = 1.70; 95% CI: 1.06–2.73) and three or more (aOR = 2.59; 95% CI: 0.54–12.44) previous caesarean sections, delivery at 42 weeks or later (aOR = 2.62; 95% CI: 1.58–4.35), and foetal birthweight greater than 4000 g (aOR = 1.93; 95% CI: 1.30–2.87). Compared with those without these conditions, the risk of uterine rupture during VBAC among women with amniotic fluid embolism, severe anaemia, placenta accreta spectrum, placental abruption, preeclampsia or eclampsia, and mild anaemia was 25.7-fold, 15.89-fold, 4.17-fold, 3.96-fold, and 2.49-fold higher, respectively. The incidence of adverse maternal outcomes during VBAC was higher in women with uterine rupture than in women without. Conclusion The incidence of uterine rupture during VBAC is comparable between China and some developed countries. In the clinical medical practice of obstetrics, it is necessary to be vigilant to factors associated with uterine rupture during VBAC and identify uterine rupture as soon as possible to improve maternal and perinatal outcomes.

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Maternal near‐miss and death among women with rupture of the gravid uterus: a secondary analysis of the Nigeria Near‐miss and Maternal Death Survey

Cited by 12 publications

References 21 publications

Caesarean section rate in Nigeria between 2013 and 2018 by obstetric risk and socio‐economic status

Caesarean section rate in Nigeria between 2013 and 2018 by obstetric risk and socio‐economic status

Uterine rupture at the University of Calabar Teaching Hospital, Calabar; Nigeria: a six-year review

The incidence, associated factors and adverse maternal and perinatal outcomes of uterine rupture among vaginal births after caesarean section: An observational study from the National Maternal Near-Miss Surveillance System in China

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