Sociodemographic, Obstetric And Clinical Determinants Of Uterine Rupture In a Nigerian Tertiary Hospital: A Retrospective Analysis

Abstract

Uterine rupture continues to be a significant obstetric emergency; however, its determinants are not well documented in low-resource settings, including Nigeria. We assessed the sociodemographic, obstetric, and clinical determinants of uterine rupture in Delta State University Teaching Hospital (DELSUTH), Oghara, Nigeria. This study reviewed hospital records of 16 women managed for uterine rupture at the Department of Obstetrics and Gynaecology, DELSUTH, between January 2015 and December 2024. Data on sociodemographic characteristics, obstetric and surgical history, clinical features, and selected haematological parameters were extracted and analyzed. Categorical variables were compared using Chi-square or Fisher's exact test, while continuous variables were analyzed using independent t-tests, with statistical significance set at p < 0.05. The mean maternal age was 36.2 ± 5.4 years. Most women were married 14 (87.5%) and resided in rural areas 13 (81.3%). Grand multiparity was common 10 (62.5%), while 9 (56.3%) were booked for antenatal care. The mean gestational age at rupture was 37.88 ± 2.19 weeks. Half had a previous caesarean section, and 10 (62.5%) had prior obstetric or gynaecological surgery. Major contributing factors included obstructed and prolonged labour, oxytocin use, fetal malpresentation, and rupture during trial of labour after caesarean section. Advanced maternal age was significantly associated with rural residence (p = 0.013), and the mean haemoglobin level was 7.59 ± 2.53 g/dL. Uterine rupture in this setting is linked to advanced maternal age, grand multiparity, prior uterine surgery, and labour complications. Enhanced antenatal care and rural access to skilled obstetric services are essential.