Maternal Neonatal and Nursing

SURVIVAL STATUS AND PREDICTORS OF MORTALITY AMONG LOW-BIRTH-WEIGHT NEONATES ADMITTED TO NEONATAL INTENSIVE CARE UNITS IN SELECTED PUBLIC HOSPITALS OF DIRE DAWA CITY ADMINSTRATION AND HARARI REGIONAL STATE , EASTERN ETHIOPIA, 2024.

Mon, 01 Jul 2024 00:00:00 GMT

SURVIVAL STATUS AND PREDICTORS OF MORTALITY AMONG LOW-BIRTH-WEIGHT NEONATES ADMITTED TO NEONATAL INTENSIVE CARE UNITS IN SELECTED PUBLIC HOSPITALS OF DIRE DAWA CITY ADMINSTRATION AND HARARI REGIONAL STATE , EASTERN ETHIOPIA, 2024. Mekonine Tegenegn (BSC); Mr Teshale Mulatu(MSc, Assistant Professor); Mr Yohannes Baye (MSc, Assistant Professor) Background: Low-Birth-Weight is a serious public health concern in low- and middle-income countries. Globally, more than 20.5 million neonates were born as low-birth-weight and more than 96% of these Low-Birth-Weight newborns are born in developing countries. Although the World Health Assembly targeted to reduce Low-Birth-Weight by 30% by the end of 2025, a little success has been achieved in Ethiopia. Objective: To assess the survival status and predictors of neonatal mortality among low birth weight neonates admitted to neonatal intensive care units in public hospitals of Dire Dawa city administration and Harari regional state, eastern Ethiopia, in 2023. Methods: An institution-based retrospective follow-up study was conducted among 560 low birth-weight neonates admitted to the neonatal intensive care unit, by reviewing chart from January1, 2020-December 30, 2022.proportional allocation to sample size was made for each hospital and then simple random sampling by computer generating method was used to select neonatal charts. A checklist was used to extract pertinent information. Epi-data version 4.6 was used for data entry, and then exported to Stata14 software for analysis. To estimate the cumulative survival time and compare the probability of survival time among variables, the Kaplan-Meier survival curve, and the Log-rank test was used. Bivariable and multivariable Cox proportional hazard model was used to identify predictor variables. Model goodness-of-fit was checked by Cox Snell residuals & an assumption was checked by using Schoenfeld residual test. Results: The overall incidence density was 67.85 per 1000 person-day observations (95%CI: 59.15, 78.21) with 2932 person-days observation and median survival time of 12 days. Being born from a mother living outside the city (rural resident) [AHR= 1.5(1.05, 1.99)]. Unable to breast feeding [2.3(AHR: 2.3 (95%, CI: 1.38, 2.79)], lack of Kangaroo-Mather Care [AHR: 1.6 (95%, CI: 1.015, 2.43)], neonatal sepsis [(AHR: 1.6 (95% CI: (1.15,2.25)], Perinatal asphyxia [AHR:2.2(95% CI:1.48,1.15)], and Necrotizing Enter colitis [AHR:2.7 (95% CI:1.53, 1.70)] were found to be significant predictors of death among low-birth-weight. Conclusion and recommendation: The incidence rate of LBW neonatal mortality was high and continues as a public health issue. The median survival time of the neonate was 12 days. Therefore, an intervention that focuses on the identified predictors could have a paramount effect in reducing low birth weight neonatal death. 68

PREGNANCY OUTCOME AMONG WOMEN WITH OLIGOHYDRAMNIOS AT TERM IN TWO TEACHING HOSPITALS IN HARAR, ETHIOPIA

Mon, 01 Jul 2024 00:00:00 GMT

PREGNANCY OUTCOME AMONG WOMEN WITH OLIGOHYDRAMNIOS AT TERM IN TWO TEACHING HOSPITALS IN HARAR, ETHIOPIA DR. SEMIR SULTAN (OBGYN SPECIALIST, MATERNAL FETAL MEDICINE FELLOW); YeshiwasSewagegn(Maternal Fetal Medicine Subspecialist); Abera Kenay(PhD): Background: Oligohydramnios is defined in clinical practice as amniotic fluid index of less than 5 cm or single deepest pocket of less than 2cm when measured by ultrasound. As there is no clear national or institutional guideline addressing oligohydramnios, women with oligohydramnios are managed differently in the different hospitals.Although it is a frequently occurring condition in pregnant women managed in the two teaching hospitals in Harar, Ethiopia, there are no studies done so far to assess its impact on maternal and neonatal outcomes in these setups. The information generated by study serves as a baseline. Objective: To assess the pregnancy outcome among women with oligohydramnios at term in two teaching Hospitals in Harar, Ethiopia from 1st of January 2022 to 31th of December 2023. Data was collected from May 1st to 30th, 2024. Methodology: Institutions based retrospective cross-sectional study was done at the teaching hospitals in Harar. Two hundred eleven women with oligohydramnios at term having singleton fetus presenting to the outpatient departments was included using whole population sampling. These women were followed for their pregnancy outcomes till discharge from the hospitals. The association between variables was done using chi square, Kruskal Wallis test, t test/One way ANOVA, and logistic regression analysis Result: There were 211 (2.1%) women, whose pregnancies were complicated with oligohydrmnios at or beyond 37 weeks of gestation among 9910 deliveries at the two hospitals during the study period from the 1st of January 2022 to 31th of Dec, 2023. Over all cesearen rate was 144(68.2%). Among those women who had trial of labor, the c/s rate was 54(44.6%). The gross perinatal mortality rate and corrected perinatal mortality rate in this study were 52.1 in 1000 and 35.2 per 1000 deliveries respectively Conclusions: Oligohydramnios at term was a common condition in the teaching hospitals. Women with oligohydramnios had high neonatal morbidities and mortalits. Women with oligohydramnios had also high caesarean section deliveries. 68

DETERMINANTS OF (PRE) ECLAMPSIA AMONG WOMEN WHO GAVE BIRTH AT HIWOT FANA COMPREHENSIVE SPECIALIZED UNIVERSITY HOSPITAL, EASTERN ETHIOPIA: A CASE-CONTROL STUDY

Fri, 01 Dec 2023 00:00:00 GMT

DETERMINANTS OF (PRE) ECLAMPSIA AMONG WOMEN WHO GAVE BIRTH AT HIWOT FANA COMPREHENSIVE SPECIALIZED UNIVERSITY HOSPITAL, EASTERN ETHIOPIA: A CASE-CONTROL STUDY Tadesse Gure (MD, OBGYN); Solomon Berhe (MD, OBGYN, MFM); Abera Kenay (PhD, Assistant professor) Background: Pre-eclampsia (a new onset of hypertension and proteinuria, or end organ damage after 20 weeks of gestation with or without proteinuria) and eclampsia (occurrence of new onset, generalized, tonic-clonic seizures or coma in a patient with preeclampsia ) are the second causesof maternal mortality and morbidity. It is not only the commonest of cause of maternal problems but also results in high perinatal mortality and morbidity. Since eclampsia is preceded by preeclampsia and shows the progression of the disease, they share the same pathogenesis and determining factors.While the basic etiology of (pre)-eclampsia remained a mystery of medicine, knowledge of the basic determinants is essential for itsprevention and/or its associated consequences.In this study all types of preeclampsia(severe vs non severe) and eclampsia are considered as a case. Objective: To identify determinants of (pre-)eclampsia among women who gave birth in Hiwot Fana Comprehensive Specialized University Hospital from June1, 2020 to August 31, 2023. Methods: An unmatched case-control study was conducted at Hiwot Fana Comprehensive Specialized University Hospital from September 1 to 30, 2023. All women who gave birth at the hospital were considered a source population, while women who gave birth during study period(June1, 2020 to August 30, 2023) constitute study population. Among study populations, women who had (pre)eclampsia were considered as a case, while those without (Pre)eclampsia are considered as a control.The final sample size calculated using EPI Info version 7 for a case control study using the following assumptions: 95% confidence interval, power of 80%, case-to control ratio of 1:2, and 5% non-response rate was 305. Data was collected through chart review filled on Google forma, down loaded with excel format and directly transported to SPSS version 26. Those variables with p value of <0.25 on binary logistic was entered into multivariable logistic regression to identify significant association. Variables with p value of <0.05 was considered as significant and their association was explained using odd ratio and 95% confidence interval. Results:A total of 300 women (100 cases and 200 controls) with a mean age of 24.4 (+SD) years were included in the study. Rural residence (AOR = 2.04, 95% CI = 1.10–3.76), age less than 20 years (AOR = 3.04, 95% CI = 1.58–5.85), history of hypertensive disorders of pregnancy(AOR = 5.52, 95% CI = 1.76–17.33), and no antenatal care(AOR = 2.38, 95% CI = 1.19–4.75) were found to be the determinants of (pre-)eclampsia. x | P a g e Conclusion; We found that living in a rural areas, previous history of (pre)eclampsia, no antenatal care, and <20 years of age were significantly associated with (pre)eclampsia. Younger women and rural residents should be prioritized in (pre)eclampsia screening and/or management. 53

PREVALENCE, ASSOCIATED FACTORS AND OUTCOMES OF CESAREAN DELIVERY AMONG MOTHERS WHO GAVE BIRTH AT PUBLIC HOSPITALS OF HARARI REGION, EASTERN ETHIOPIA

Wed, 01 May 2024 00:00:00 GMT

PREVALENCE, ASSOCIATED FACTORS AND OUTCOMES OF CESAREAN DELIVERY AMONG MOTHERS WHO GAVE BIRTH AT PUBLIC HOSPITALS OF HARARI REGION, EASTERN ETHIOPIA Haftom Tsegay; (Assist Profe) Teshale Mulatu; (Assis Pro) Genanaw Atnafe Cesarean section refers to the delivery of a fetus, placenta and membrane through the abdominal and uterine incision after 28 weeks of gestation. Currently the rate of cesarean section is increased above WHO recommendation level both in developed and developing countries including Ethiopia. Though there are studies done on prevalence and associated factors of cesarean section in Ethiopia, there is paucity of evidence on the maternal and fetal outcome of cesarean section in Eastern part of Ethiopia. Objective: To assess prevalence, factors associated and outcomes of cesarean delivery among mothers who gave birth in public hospitals in Harari region, from August 15- October 15/2023. Methodology: An institutional-based cross sectional study was conducted among 399 postpartum mothers who gave birth in public hospitals of Harari region from August 15, 2023 to October 15, 2023. Systematic random sampling method was used to select study participants. Data was collected through face to face interview using pretested semi-structured questionnaire and reviewing maternal chart. The data was entered into Epi-Data version 4.6 and analyzed using SPSS version 26. Bivariable and multivariable logistic regression analysis were computed to identify predictors of cesarean section. Adjusted odds ratio with 95% confidence interval was used to describe the association of explanatory variables with the outcome variable and level of significance was set at p<0.05. Results: The overall prevalence of cesarean delivery was 43.6% (95% CI: 38.72, 48.50). History of previous cesarean section [AOR=7.07; 95% CI (2.01, 25.45)], non-cephalic fetal presentation [AOR=3.83; 95% CI (1.09, 13.48)] and prolonged rupture of membrane [AOR=5.38; 95% CI (1.27, 22.83)] were significantly associated with cesarean delivery. Among the women with cesarean delivery, 19.5% of them had adverse maternal outcomes and 24.7% of neonates developed adverse outcomes following cesarean delivery. Conclusion: The prevalence of cesarean delivery in this study was high. History of previous cesarean section, non-cephalic fetal presentation and prolonged rupture of membrane were found to be significantly associated. Therefore, emphasis on clear indications, enlighten mothers concerning to risks and benefits of cesarean section and encouraging mothers to have Vaginal Birth After Cesarean Section is highly advised to minimize cesarean delivery and its adverse maternal and fetal outcome. 99p.