scholarly journals Determinants of maternal near-miss in private hospitals in eastern Ethiopia: A nested case–control study

2021 ◽  
Vol 17 ◽  
pp. 174550652110619
Author(s):  
Shegaw Geze Tenaw ◽  
Sagni Girma Fage ◽  
Nega Assefa ◽  
Abera Kenay Tura
Keyword(s):  
Antenatal Care ◽  
Near Miss ◽  
Maternal Near Miss ◽  
Eastern Ethiopia ◽  
Private Hospitals ◽  
Near Misses ◽  
Medical Disorders ◽  
History Of ◽  
Sub Saharan ◽  
Nested Case Control

Objective: Maternal near-miss refers to a woman who nearly died but survived complications in pregnancy, childbirth, or within 42 days of termination of pregnancy. The study of maternal near-miss has become essential for improving the quality of obstetric care. The objective of this study was to identify the determinants of maternal near-miss among women admitted to major private hospitals in eastern Ethiopia. Method: An unmatched nested case–control study was conducted in major private hospitals in eastern Ethiopia from 5 March to 31 March 2020. Cases were women who fulfilled the sub-Saharan African maternal near-miss criteria and those admitted to the same hospitals but discharged without any complications under the sub-Saharan African maternal near-miss tool were controls. For each case, three corresponding women were randomly selected as controls. Factors associated with maternal near-misses were analyzed using binary and multiple logistic regressions with an adjusted odds ratio along with a 95% confidence interval. Finally, p-value < 0.05 was considered as a cut-off point for the significant association. Results: A total of 432 women (108 cases and 324 controls) participated in the study. History of prior cesarean section (AOR = 4.33; 95% CI = 2.36–7.94), anemia in index pregnancy (AOR = 4.38; 95% CI = 2.43–7.91), being ⩾ 35 years of age (AOR = 2.94; 95% CI = 1.37–6.24), not attending antenatal care (AOR = 3.11; 95% CI = 1.43–6.78), and history of chronic medical disorders (AOR = 2.18; 95% CI = 1.03–4.59) were independently associated with maternal near-miss. Conclusion: Maternal age ⩾ 35 years, had no antenatal care, had prior cesarean section, being anemic in index pregnancy, and have history of chronic medical disorders were the determinants of maternal near-miss. Improving maternal near-misses requires strengthening antenatal care (including supplementation of iron and folic acid to reduce anemia) and prioritizing women with a history of chronic medical illnesses. Interventions for preventing primary cesarean sections are crucial in this era of the cesarean epidemic to minimize its effect on maternal near-miss.

scholarly journals Maternal near miss among women admitted in major private hospitals in eastern Ethiopia: a retrospective study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Shegaw Geze Tenaw ◽  
Nega Assefa ◽  
Teshale Mulatu ◽  
Abera Kenay Tura
Keyword(s):  
Retrospective Study ◽  
Cesarean Section ◽  
Antenatal Care ◽  
Termination Of Pregnancy ◽  
Near Miss ◽  
Maternal Near Miss ◽  
Chronic Hypertension ◽  
Eastern Ethiopia ◽  
Private Hospitals ◽  
Live Births

Abstract Background Since maternal mortality is a rare event, maternal near miss has been used as a proxy indicator for measuring maternal health. Maternal near miss (MNM) refers to a woman who nearly died but survived of complications during pregnancy, childbirth or within 42 days of termination of pregnancy. Although study of MNM in Ethiopia is becoming common, it is limited to public facilities leaving private facilities aside. The objective of this study was to assess MNM among women admitted in major private hospitals in eastern Ethiopia. Methods An institution based retrospective study was conducted from March 05 to 31, 2020 in two major private hospitals in Harar and Dire Dawa, eastern Ethiopia. The records of all women who were admitted during pregnancy, delivery or within 42 days of termination of pregnancy was reviewed for the presence of MNM criteria as per the sub-Saharan African MNM criteria. Descriptive analysis was done by computing proportion, ratio and means. Factors associated with MNM were assessed using binary logistic regression with adjusted odds ratio (aOR) along with its 95% confidence interval (CI). Results Of 1214 pregnant or postpartum women receiving care between January 09, 2019 and February 08, 2020, 111 women developed life-threatening conditions: 108 MNM and 3 maternal deaths. In the same period, 1173 live births were registered, resulting in an MNM ratio of 92.1 per 1000 live births. Anemia in the index pregnancy (aOR: 5.03; 95%CI: 3.12–8.13), having chronic hypertension (aOR: 3.13; 95% CI: 1.57–6.26), no antenatal care (aOR: 3.04; 95% CI: 1.58–5.83), being > 35 years old (aOR: 2.29; 95%CI: 1.22–4.29), and previous cesarean section (aOR: 4.48; 95% CI: 2.67–7.53) were significantly associated with MNM. Conclusions Close to a tenth of women admitted to major private hospitals in eastern Ethiopia developed MNM. Women with anemia, history of cesarean section, and old age should be prioritized for preventing and managing MNM. Strengthening antenatal care and early screening of chronic conditions including hypertension is essential for preventing MNM.

scholarly journals Severe Hypertensive Disorders of Pregnancy in Eastern Ethiopia: Comparing the Original WHO and Adapted sub-Saharan African Maternal Near-Miss Criteria

2020 ◽  
Vol Volume 12 ◽  
pp. 255-263
Author(s):  
Abera Kenay Tura ◽  
Sicco Scherjon ◽  
Jelle Stekelenburg ◽  
Jos van Roosmalen ◽  
Thomas van den Akker ◽  
...  
Keyword(s):  
Near Miss ◽  
Maternal Near Miss ◽  
Hypertensive Disorders Of Pregnancy ◽  
Eastern Ethiopia ◽  
Hypertensive Disorders ◽  
Sub Saharan

scholarly journals Applicability of the WHO maternal near miss tool in sub-Saharan Africa: a systematic review

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Abera Kenay Tura ◽  
To Lam Trang ◽  
Thomas van den Akker ◽  
Jos van Roosmalen ◽  
Sicco Scherjon ◽  
...  
Keyword(s):  
Systematic Review ◽  
Near Miss ◽  
Sub Saharan Africa ◽  
Maternal Near Miss ◽  
Sub Saharan

scholarly journals Predictors of success of trial of labor after cesarean section: A nested case–control study at public hospitals in Eastern Ethiopia

2021 ◽  
Vol 17 ◽  
pp. 174550652110619
Author(s):  
Maleda Tefera ◽  
Nega Assefa ◽  
Kedir Teji Roba ◽  
Letta Gedefa
Keyword(s):  
Cesarean Section ◽  
Cesarean Delivery ◽  
Vaginal Birth ◽  
Public Hospitals ◽  
Vaginal Birth After Cesarean ◽  
Eastern Ethiopia ◽  
Trial Of Labor ◽  
History Of ◽  
Nested Case Control

Background: One of the primary reasons for an increase in cesarean sections is obstetricians’ uncertainty about labor trial safety following a previous cesarean section. The success rate of vaginal birth after cesarean section with a single cesarean scar is greater than 50%. However, to the best of our knowledge, there is a scarcity of information on the determinants of vaginal birth after cesarean delivery in the study area. As a result, the purpose of this study was to identify predictors of successful vaginal birth after cesarean delivery in public hospitals in Eastern Ethiopia. Methods: A nested case–control study design was used within a prospective follow-up study conducted from June to October 2020. A total of 220 women who tried vaginal birth after cesarean delivery was included, 110 cases and 110 controls. Cases were women with one previous cesarean section scar and successfully proceed with vaginal delivery. The controls were those with an earlier cesarean section scar and delivered by emergency cesarean section after trial of labor. A pre-tested structured questionnaire was used to gather the information. Multiple logistic regression is used to identify the determinants for the success of vaginal birth after cesarean section; odds ratio with its 95% CI are used to report the findings. Results: We found that living in rural areas (AOR = 2.28; 95% CI (1.85, 12.41)), having a current antenatal care follow-up (AOR = 3.20; 95% CI (1.15, 8.87)) and partograph monitoring of labor (AOR = 4.26; 95% CI (1.90, 9.57)) had a positive association with successful vaginal birth after cesarean section. In contrast, the presence of meconium-stained amniotic liquor (AOR = 0.10; 95% CI (0.01, 0.75)) and history of stillbirth (AOR = 0.07; 95% CI (0.02, 0.53)) reducing the chance of success of the trial. Conclusion: Past obstetric history, such as stillbirth, history of labor trial after primary cesarean section, and prior vaginal birth, were significant predictors for achieving vaginal birth after cesarean section. Antenatal care visit, and partograph follow-up were the current obstetric characteristics positively associated with the trial of labor.

scholarly journals Magnitude of maternal near misses and the role of delays in Ethiopia: a hospital based cross-sectional study

2019 ◽  
Vol 12 (1) ◽  
Author(s):  
Mulugeta Dile Worke ◽  
Habtamu Demelash Enyew ◽  
Maru Mekie Dagnew
Keyword(s):  
Antenatal Care ◽  
Health Care Access ◽  
Cross Sectional Study ◽  
Near Miss ◽  
Sectional Study ◽  
Cross Sectional ◽  
Near Misses ◽  
Care Access ◽  
Referral Hospitals

Abstract Objectives This study was aimed to assess the magnitude of maternal near misses and the role of delays including other risk factors. A Hospital based cross sectional study was conducted at three referral hospitals of Amhara region on 572 mothers who came to obtain obstetrics care services from February 01 to July 30, 2018. Results The magnitude of maternal near miss was 26.6% (95% CI 23, 30). With regards to delays, 83 (14.5%), 226 (39.5%), and 154 (26.9%) of women delayed in the decision to seek care, in reaching care, and in receiving care respectively. Women who had no antenatal care [AOR = 3.16; CI (1.96, 5.10)], who stayed in hospital 7 days or more [AOR = 2.20; CI (1.33, 3.63)] and those who had delay in reaching health facility [AOR = 1.99; CI (1.10, 3.61)] were more likely to be near miss. While, women whose husband was able to read and write [AOR = 0.29; CI (0.09, 0.96)] and those with monthly household income between 2001 and 3000 ETB [AOR = 0.35; CI (0.18, 0.70)] were 71% and 65% less likely to be near misses respectively. Promoting antenatal care and increasing maternal health care access could have significant impact in reducing maternal near misses.

scholarly journals The impact of antenatal care on maternal near-miss events in Ethiopia: A systematic review and meta-analysis

2020 ◽  
Vol 13 ◽  
pp. 100246
Author(s):  
Ebisa Turi ◽  
Ginenus Fekadu ◽  
Bedasa Taye ◽  
Gemechu Kejela ◽  
Markos Desalegn ◽  
...  
Keyword(s):  
Systematic Review ◽  
Antenatal Care ◽  
Meta Analysis ◽  
Near Miss ◽  
Maternal Near Miss ◽  
The Impact

scholarly journals Factors associated with neonatal near-miss in selected hospitals of Gamo and Gofa zones, southern Ethiopia: nested case-control study

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Abera Mersha ◽  
Agegnehu Bante ◽  
Shitaye Shibiru
Keyword(s):  
Antenatal Care ◽  
Case Control Study ◽  
Case Control ◽  
Near Miss ◽  
Southern Ethiopia ◽  
Factors Affecting ◽  
Factors Associated ◽  
Nested Case Control ◽  
Control Study ◽  
Neonatal Near Miss

Abstract Background To scale up a comprehensive way of implementation to reduce neonatal mortality evaluation of factors for neonatal near-miss cases is very important. Certain studies were done in assessing near-miss cases, but they failed in identifying the proximate factors affecting profoundly. So, this study is to fill those gaps in the aforementioned studies, in assessing the factors affecting neonatal near-miss cases. Methods A nested case-control study was conducted in selected three Hospitals of Gamo and Gofa Zones, Southern Ethiopia from April 5, 2018, to March 5, 2019. The structured standard tool was used to identify neonatal near-miss cases. Data were entered into Epi data version 3.1 and exported to Stata version 15 for analysis. A conditional logistic regression model was used to identify factors associated with near-miss cases. The goodness of fit was tested by a log-likelihood ratio (LR). In this study P-value < 0.05 was considered to declare a result as a statistically significant association. Results In this study 121 neonatal near-miss cases, and 363 controls were involved. The identified factors that affect neonatal near-miss were multiparty (AOR = 3.81, 95%CI: 1.72, 8.42), antenatal care follow up (AOR = 0.02, 95%CI: 0.01, 0.05), premature rupture of membrane (AOR = 3.40, 95%CI: 1.53, 7.55), non-vertex presentation (AOR = 2.83, 95%CI: 1.44, 5.58), and cesarean delivery (AOR = 4.89, 95%CI: 2.34, 10.24). Conclusions Those identified factors are better should be intervened. Strengthening antenatal care services by providing appropriate information for the mother and counseling about the consequences of multiparty and providing information on family planning. There is a need to identify, screen and critical follow high-risk mothers and give immediate and appropriate intervention as early as possible.

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