RESUMEN
The purpose of this study was to determine magnitude and associated factors of maternal near miss among women seeking obstetric and gynecologic care. A hospital based cross-sectional study design was implemented in selected public hospitals of Tigrai. Systematic random sampling method was used to select study participants. Data were entered to epi data manager version 4.1 and exported to Statistical Package for social science version 20 for analysis. Bivariate and multivariate logistic regression was used to identify factors associated with maternal near miss. The magnitude of maternal near miss was found to be 7.3%. Regression analysis showed that, mothers who reside in rural area, had distance of greater than 10 km, referred from low level health institution, and mothers had no antenatal care follow up were significantly associated with maternal near miss. Therefore, promoting antenatal care and increasing awareness in rural areas related with maternal health care services is recommended.
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Potencial Evento Adverso , Complicaciones del Embarazo , Embarazo , Femenino , Humanos , Estudios Transversales , Etiopía , Hospitales PúblicosRESUMEN
BACKGROUND: The right to prefer mode of delivery is a crucial component of compassionate and respectful care that fosters both maternal and neonatal well-being as the failure to respect the mother's interest increases to the risk of maternal depression and posttraumatic stress. Thus, the aim of the study was to assess delivery mode preference and associated factors among pregnant women. METHODS AND MATERIALS: The study was conducted in two hospitals and two health centers. We used a cross-sectional study design incorporating 398 pregnant mothers attending an antenatal care follow-up from February to May 2018. The study excluded pregnant mothers with any previous uterine surgery including caesarean delivery from participation due to their restricted chance to prefer their mode of delivery. Data were collected by using a pretested questionnaire. Data were entered to EpiData Manager version 3.1 and exported to Statistical Package for the Social Sciences version 22 for analysis. Besides, the analysis included both the bivariate and multivariable analyses to check the association between dependent and independent variables. Finally, level of statistical significance was declared at P value < 0.05. RESULT: The participant's level of response was 100% (398). The age of the mothers ranges from 15 to 45 years old. The delivery mode preference of the caesarean section (C/S) and spontaneous vertex delivery (SVD) was 115 (28.9%) and 283 (71.1%), respectively. The study revealed that planned 47 pregnancy [AOR, 1.76; CI: 0.89-3.47], young age [AOR, 12.9; CI: 0.23-7.1], and primigravida [AOR, 1.24; CI: 0.29-5.2] were among the variables associated with maternal preference of caesarean section. Conclusion and Recommendation. Nearly one-third of the mothers preferred caesarean delivery as their mode of delivery due to fear of labor pain and repeated vaginal examination by the care providers. This is particularly seen in women who had received higher education level, claim their pregnancy as planned, their choice of delivery at hospital, young aged, pregnant for the first time, and those who had visited antenatal care repeatedly. This implies that policy makers and stakeholders should exert due emphasis to ongoing desire of caesarean delivery as the procedure is not without risk, if it is done without indication. For researchers, we recommend to investigate the preference of mode of delivery in a much broader aspect.
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Cesárea/estadística & datos numéricos , Parto Obstétrico/estadística & datos numéricos , Embarazo/estadística & datos numéricos , Mujeres Embarazadas/psicología , Adolescente , Adulto , Estudios Transversales , Etiopía , Femenino , Hospitales , Humanos , Recién Nacido , Masculino , Persona de Mediana Edad , Madres , Aceptación de la Atención de Salud/estadística & datos numéricos , Prioridad del Paciente , Atención Prenatal , Encuestas y Cuestionarios , Adulto JovenRESUMEN
BACKGROUND: Iron-folic acid supplementation is a central preventive measure for maternal anemia, so considering the factors leading to or deterring from adherence is important. This review aims to establish if there is a correlation between increasing maternal education and adherence to iron-folic acid supplementation in Ethiopia. METHODS: An electronic database search was conducted using PubMed, Google Scholar, Cochrane Library and African Journals Online. Joanna Briggs Institute Meta-Analysis of Statistical Assessment and Review Instrument was used for quality appraisal of the included studies. The extracted data were entered into Microsoft™ Excel sheet and exported to R-software version 3.6.1 for analysis. Maternal education on adherence of iron-folic acid supplementation was analyzed and subgroup analyses of difference between regions and time of study period were conducted. RESULTS: The online search yielded a total of 936 articles, and based on inclusion/exclusion criteria nine were included in this study with a total of 3263 participants. Applying the random effect model, the analysis revealed that the odds of prenatal adherence of iron-folic acid supplementation were 2.89 times higher in mothers with secondary school education and above as compared to those who had not received formal education. CONCLUSION: This review identified that increased maternal education leads to improved adherence of iron-folic acid supplementation amongst women across Ethiopia. This information may inform efforts of government and non-government organizations to encourage maternal education in order to sustained adherence of iron-folic acid supplementation. Further research is required in this critical area at regional, national, and global levels.
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Hierro , Atención Prenatal , Suplementos Dietéticos , Etiopía , Femenino , Ácido Fólico/uso terapéutico , Humanos , EmbarazoRESUMEN
INTRODUCTION: Uterine rupture is a leading cause of maternal death in Ethiopia. Despite strengthening the health care system and providing basic and comprehensive emergency obstetric care closer to the communities, uterine rupture continues to produce devastating maternal and fetal outcomes. Although risk factors of uterine rupture are context specific, there is lack of clarity in our context towards the contributing factors and untoward outcomes of uterine rupture. This study was conducted to identify the risk factors of uterine rupture and its impacts in public hospitals of Tigrai. OBJECTIVE: This study would identify determinant factors of uterine rupture and its management outcomes among mothers who gave birth in public hospitals in Tigrai region, North Ethiopia. METHOD: A retrospective hospital-based unmatched case control study design was implemented with 135 cases of women with uterine rupture and 270 controls of women without uterine rupture. Cases were enrolled consecutively from case notes of women who gave birth from 1/9/2015 to 30/6/2019, while charts (case note) of women without uterine rupture found following the cases were selected randomly and enrolled. Bivariate and multivariate logistic regression with 95% confidence interval was used to identify the determinants of uterine rupture. RESULT: Mothers referred from remote health institutions (AOR 7.29 (95% CI: 2.7, 19.68)), mothers who visited once for antenatal care (AOR 2.85 (95% CI: 1.02, 7.94)), those experiencing obstructed labor (AOR 13.33 (95% CI: 4.23, 42.05)), and birth weight of a newborn greater than four kilograms (AOR 5.68 (95% CI: 1.39, 23.2)) were significantly associated with uterine rupture. From 135 mothers who develop uterine rupture, 13 (9.6%) mothers died and 101 (74.8%) fetuses were stillborn. Obstetrical complications like abdominal hysterectomy in 75 (55.6%) of mothers and excessive blood loss in 84 (57.8%) were additional untoward outcomes of uterine rupture. CONCLUSION: Referrals from remote health institutions, once-visited antenatal care, obstructed labor, and birth weight of newborns greater than four kilograms were significant determinants of uterine rupture. Maternal death, stillbirth, hysterectomy, and hemorrhage were adverse outcomes. The findings of this study suggest early identification of factors that expose to uterine rupture during antenatal care, labor, and delivery must be attended to and further prospective studies are needed to explore predictors of untoward outcomes. Knowing the determinants of uterine rupture helps prevent the occurrence of a problem in pregnant women, which reduces maternal morbidity and mortality, and would have a tremendous help in identifying the best optional strategies in our current practices. This assertion was added to the abstract concluding session.
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Parto Obstétrico , Hospitales Públicos/estadística & datos numéricos , Rotura Uterina/etiología , Adulto , Peso al Nacer , Estudios de Casos y Controles , Etiopía/epidemiología , Femenino , Accesibilidad a los Servicios de Salud , Humanos , Histerectomía , Embarazo , Atención Prenatal , Estudios Retrospectivos , Factores de Riesgo , Mortinato , Resultado del Tratamiento , Rotura Uterina/epidemiología , Rotura Uterina/mortalidad , Rotura Uterina/prevención & control , Adulto JovenRESUMEN
BACKGROUND: Maternal tetanus is defined as tetanus acquired during pregnancy or within 6 weeks after the end of conception. As tetanus is a vaccine-preventable disease, immunization of pregnant mothers with a TT (tetanus toxoid) dose is one of the most effective ways to protect against the disease. Some studies showed that 94% of neonatal mortality reduction could be achieved through immunization of pregnant and childbearing-age mothers with at least two doses of TT vaccination. OBJECTIVE: To assess the uptake of tetanus toxoid vaccine and associated factors among mothers who gave birth in the last 12 months in Errer district, Somali Regional State, Eastern Ethiopia, 2017. METHODS AND MATERIALS: A community-based cross-sectional study design was implemented to study 440 mothers who gave birth in the last 12 months. Participants were selected using the strata and systematic sampling technique after conducting a preliminary survey. Data were collected through a face-to-face interviewer-administered questionnaire. The collected data was entered into EpiData version 3.02 and then exported to Statistical Package for the Social Sciences (SPSS) version 20. Bivariate and multivariate logistic regressions were carried out to see the association between variables at p < 0.05 and 95% confidence interval. Finally, the information was presented by using frequencies, summary measures, and tables. RESULT: The overall tetanus vaccination uptake (≥TT2) doses was found to be 51.8%, 95% CI (47.7%, 56.4%). The total number of mothers who complete the five TT doses was 31 (14.8%). Urban residence [AOR = 6.1, 95% CI: (2.33, 10.43)], multiparity [AOR = 2.3, 95% CI: (1.7, 6.4)], and traveling less than 30 minutes from the home to a health facility [AOR = 4.6, 95% CI: (1.34, 6.72)] were some the factors that were significantly associated with tetanus toxoid vaccination uptake. Conclusion and Recommendation. Although TT immunization is a scientifically proven mechanism to protect against maternal and neonatal tetanus, only half of the district mothers received ≥TT2 doses. Besides, our study revealed that the low vaccine uptake is attributed to long distance travel to reach a health facility, maternal illiteracy, and pastoralist lifestyle of mothers in the district. Thus, the regional stakeholders are required to scale up efforts on mother's awareness creation towards the importance of the vaccine through health education and to arrange outreach TT vaccination campaigns in distant pastoralist communities within the region.
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Programas de Inmunización , Toxoide Tetánico/administración & dosificación , Tétanos/prevención & control , Vacunación , Adolescente , Adulto , Estudios Transversales , Etiopía/epidemiología , Femenino , Humanos , Modelos Logísticos , Persona de Mediana Edad , Madres , Parto , Embarazo , Encuestas y Cuestionarios , Tétanos/epidemiología , Adulto JovenRESUMEN
OBJECTIVES: This study aimed to determine the unfavorable outcomes and to assess factors contribute to the unfavorable management outcomes after cesarean deliveries in Ayder Specialized Comprehensive Hospital, Mekelle, Tigray, Ethiopia, 2017. RESULTS: The unfavorable maternal management outcomes were Adhesion 28 (8.3%), excessive blood loss and blood transfusion 19 (5.6%), cesarean hysterectomy 10 (3%), relaparotomy 5 (1.5%), wound infection and wound dehiscence 23 (6.8%). Unfavorable fetal outcomes were were stillbirth 9 (2.6%), early neonatal death 8 (2.4%), low birth weight 58 (17.2%). women who did not book for Antenatal Care and having a history of previous cesarean delivery were found to be associated with unfavorable maternal outcomes and indications of cesarean delivery as obstructed labor was associated with unfavorable fetal outcomes.
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Cesárea/estadística & datos numéricos , Hospitales Especializados , Resultado del Embarazo , Atención Prenatal/estadística & datos numéricos , Adulto , Cesárea/métodos , Atención Integral de Salud/métodos , Atención Integral de Salud/estadística & datos numéricos , Etiopía , Femenino , Humanos , Histerectomía , Embarazo , Atención Prenatal/métodos , Estudios Retrospectivos , Factores de Riesgo , MortinatoRESUMEN
OBJECTIVE: The purpose of this study was to assess knowledge about neonatal danger signs and associated factors among mothers who gave birth in the last 4 months attending immunization services. RESULT: The study recruited 432 mothers to participate. A knowledge score of neonatal danger signs was found [32.9% (95% CI 28.9%, 37%)]. Mothers educated to secondary level were 4.9 times more likely to know about neonatal danger signs [(AOR = 4.9, 95% CI (1.15, 21). Similarly, mothers whose husband educated to college and above [AOR = 4.95, 95% CI (1.15, 21)], and being multipara mother [(AOR = 2.59, 95% CI (1.05, 6.6)], were factors significantly associated with good knowledge of mothers about neonatal danger signs.