scholarly journals Adverse Neonatal Outcome are More Common among Babies Born by Cesarean Section than Naturally Born Babies at Public Hospitals in Eastern Ethiopia: A Comparative Prospective Follow-Up Study at Eastern Ethiopia

2021 ◽  
Vol 8 ◽  
pp. 2333794X2110183
Author(s):  
Maleda Tefera ◽  
Nega Assefa ◽  
Kedir Teji Roba ◽  
Letta Gedefa
Keyword(s):  
Cesarean Section ◽  
Vaginal Delivery ◽  
Neonatal Outcome ◽  
Birth Asphyxia ◽  
Public Hospitals ◽  
Obstructed Labor ◽  
Eastern Ethiopia ◽  
Adverse Neonatal Outcome ◽  
Follow Up Study

The adverse neonatal outcome is defined as the presence of birth asphyxia, respiratory distress, birth trauma, hypothermia, meconium aspiration syndrome, neonatal intensive care admission, and neonatal death. It is a major concern in developing countries, including Ethiopia. This study tried to identify predictors of adverse neonatal outcomes at selected public hospitals in Eastern Ethiopia. A hospital-based prospective follow-up study was conducted in three public hospitals in Eastern Ethiopia from June to October 2020. A total of 2,246 laboring women and neonates born at the hospitals were enrolled in the study. Data were collected through interviews, observation checklists, and clinical chart review. Reports were presented in relative risks with 95% CIs. The overall magnitude of adverse neonatal outcome was 20.97% (95% CI: 19.33- 22.71%). It was 24.3% for babies born through cesarean section (95% CI: 21.3%, 27.5). The presence of meconium in the amniotic fluid increased the risk for neonates delivered via cesarean section (ARR, 1.52 95% CI; 1.04, 2.22). Among neonates born via vaginal delivery, the risk of adverse neonatal outcome was higher among nullipara women (ARR, 1.42 95% CI; 1.02, 1.99) and among women diagnosed with abnormal labor or pregnancy such as APH, pre-eclampsia, obstructed labor, fetal distress, and mal-presentation at admission (ARR, 1.30 95%CI; 1.01, 1.67). The risk of adverse neonatal outcome was higher among babies born through the cesarian section than those born via vaginal delivery. Abnormal labor or pregnancy and being primiparous increased the risk of adverse neonatal outcome in vaginal delivery.

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 Cause and Predictors of Neonatal Mortality among Neonates admitted to Neonatal Intensive Care Units of Public Hospitals in eastern Ethiopia: Facilities based Prospective follow-up study

2020 ◽  
Author(s):  
Assefa Desalew ◽  
Yitagesu Sintayehu ◽  
Nardos Teferi ◽  
Firehiwot Amare ◽  
Bifitu Geda ◽  
...  
Keyword(s):  
Intensive Care ◽  
Neonatal Mortality ◽  
Intensive Care Units ◽  
Neonatal Death ◽  
Neonatal Intensive Care ◽  
Public Hospitals ◽  
Neonatal Intensive Care Units ◽  
Eastern Ethiopia ◽  
Follow Up Study

Abstract Background: The first month is the most crucial period for child survival. Neonatal mortality is stagnated in sub-Saharan Africa including Ethiopia. And the trend in reduction is slower than infant and child mortality. The facilities-based cause and predictor of neonatal death in the neonatal intensive care unit were not well documented in this study setting. Hence the aim of this study was to determine the cause and predictors of neonatal mortality among neonates admitted in neonatal intensive care units in eastern Ethiopia. Method: Facilities-based prospective follow-up study was conducted among neonates admitted in neonatal intensive care units of public hospitals in eastern Ethiopia from November to December 2018. Data were collected using pre-tested, structured questionnaire and follow-up checklist. The main outcomes, cause of death was set by senior pediatricians and residents. Epi-Data 3.1 and SPSS 25 version software were used for entry and analysis. Binary logistic regression was used to find out the predictors of facilities-based neonatal mortality.Result: The proportion of facilities-based neonatal mortality was 20%. The top five cause of death was a complication of prematurity 49%, birth asphyxia 37.8%, infection 32.6%, meconium aspiration syndrome 17.3% and congenital malformation 6.1%. Low birth weight, preterm births, length of stay, low 5thminutes Apgar score, hyperthermia and initiation of feeding were predictors of neonatal death among Neonates admitted in neonatal intensive care units in public hospitals, eastern Ethiopia.ConclusionIn summary, the proportion of facilities-based Neonatal death was unacceptably high. The main causes of death were preventable and treatable. Hence, early detection, anticipating high-risk newborns and timely intervention is very essential. Furthermore, early initiation of feeding and a better referral linkage to tertiary facilities could contribute for reduction of neonatal death in this setting.

scholarly journals Cause and Predictors of Neonatal Mortality among Neonates admitted to Neonatal Intensive Care Units of Public Hospitals in eastern Ethiopia: Facilities based Prospective follow-up study

2019 ◽  
Author(s):  
Assefa Desalew ◽  
Yitagesu Sintayehu ◽  
Nardos Teferi ◽  
Firehiwot Amare ◽  
Bifitu Geda ◽  
...  
Keyword(s):  
Intensive Care ◽  
Neonatal Mortality ◽  
Intensive Care Units ◽  
Neonatal Death ◽  
Neonatal Intensive Care ◽  
Public Hospitals ◽  
Neonatal Intensive Care Units ◽  
Eastern Ethiopia ◽  
Follow Up Study

Abstract Background: The first month is the most crucial period for child survival. Neonatal mortality is stagnated in sub-Saharan Africa including Ethiopia. And the trend in reduction is slower than infant and child mortality. The facilities-based cause and predictor of neonatal death in the neonatal intensive care unit were not well documented in this study setting. Hence the aim of this study was to determine the cause and predictors of neonatal mortality among neonates admitted in neonatal intensive care units in eastern Ethiopia. Method: Facilities-based prospective follow-up study was conducted among neonates admitted in neonatal intensive care units of public hospitals in eastern Ethiopia from November to December 2018. Data were collected using pre-tested, structured questionnaire and follow-up checklist. The main outcomes, cause of death was set by senior pediatricians and residents. Epi-Data 3.1 and SPSS 25 version software were used for entry and analysis. Binary logistic regression was used to find out the predictors of facilities-based neonatal mortality. Result: The proportion of facilities-based neonatal mortality was 20%. The top five cause of death was a complication of prematurity 49%, birth asphyxia 37.8%, infection 32.6%, meconium aspiration syndrome 17.3% and congenital malformation 6.1%. Low birth weight, preterm births, length of stay, low 5 th minutes Apgar score, hyperthermia and initiation of feeding were predictors of neonatal death among Neonates admitted in neonatal intensive care units in public hospitals, eastern Ethiopia. Conclusion In summary, the proportion of facilities-based Neonatal death was unacceptably high. The main causes of death were preventable and treatable. Hence, early detection, anticipating high-risk newborns and timely intervention is very essential. Furthermore, early initiation of feeding and a better referral linkage to tertiary facilities could contribute for reduction of neonatal death in this setting. Keywords: Facilities based study, Neonatal mortality, predictors, NICU, Ethiopia

scholarly journals Women's Birth Experience and Neonatal Outcomes, Study Design and Methodology with Baseline Characteristics. A Hospital-Based Maternal Follow-up Study

2021 ◽  
Author(s):  
Maleda Tefera ◽  
Nega Assefa ◽  
Kedir Teji Roba ◽  
Letta Gedefa
Keyword(s):  
Study Design ◽  
Neonatal Outcome ◽  
Comprehensive Evaluation ◽  
Mode Of Delivery ◽  
Structured Interview ◽  
Neonatal Outcomes ◽  
Birth Experience ◽  
Eastern Ethiopia ◽  
Follow Up Study

Abstract Background: Giving birth is a joyful, unique event and a highly individual experience in a woman's life. Childbirth experience has a significant role in developing self-confidence and positive feelings for the newborn. This experience is affected by many factors, including the mode of delivery. This paper tries to depict the experience of labor, delivery, and neonatal outcomes observed during the implementation of labor and delivery outcome study at selected hospitals in Eastern Ethiopia hospitals. Method: A hospital-based follow-up study was implemented in Hiwot Fana and Jegula Hospital in Harar, Bisidimo hospital in Eastern Hararghe, Oromia, and Dil-Chora Hospital in Dire Dawa from June 2020 to October 2020. A total of 2246 women with labor experience visited the hospitals were followed from delivery until discharge to document their experience and neonates' outcomes. Data were collected through a face-to-face interview using a structured pre-tested questionnaire. A Phenomenological approach qualitative study design will also be employed from April to May 2021. The women who give birth to normal single-term newborns through vaginal or a cesarean section will be included in the study. Women with stillbirth twin, preterm and congenital malformation, serous ill neonates, and who admitted to for more than one week will be excluded because those women will be extreme or deviant cases. In-depth interviews coupled with tape recording and note-taking will be to collect the data. A semi-structured interview guide will consider four domains of the Roy adaptation theory: an open-ended question (physiological, self-concept, role and function, and interdependence). Translated files will be transferred to open code software in a plain text format. Coding and categorization will be done on a system to generate a synthesized theme. Discussion The study will provide a comprehensive evaluation of the birth experience and its neonatal outcome in Eastern Ethiopia. Understanding women's birth experience and neonatal outcome based on birth can help health professionals look inside themselves. It will form the foundation and development of a new guideline to improve maternity care.

scholarly journals Neonatal Mortality and its Determinates in Public Hospitals of Gamo and Gofa Zones, Southern Ethiopia: Prospective Follow up Study

2019 ◽  
Author(s):  
Abera Mersha ◽  
Agegnehu Bante ◽  
Shitaye Shibiru
Keyword(s):  
Mortality Rate ◽  
Neonatal Mortality ◽  
Goodness Of Fit ◽  
Neonatal Period ◽  
Birth Asphyxia ◽  
Public Hospitals ◽  
Southern Ethiopia ◽  
Neonatal Mortality Rate ◽  
Follow Up Study

Abstract Background The neonatal period is the most vulnerable time for a child survival. The declines in the neonatal mortality rate have been slower than post-neonatal under-five mortality rate in the majority of countries. This this trend is also similar in Ethiopia, that neonatal mortality was high as compare to post neonatal mortality rate. A large proportion of neonatal deaths occur during the 48 hours after delivery. Different studies was conducted in assessing determinates for neonatal mortality but there is a need to assess the immediate post-partum (within two days following delivery) cause of neonatal mortality that the majority of deaths occurred that time. So, this study is to fill those gaps of aforementioned studies, in assessing the determinate factors affecting neonatal mortality in public hospitals of Gamo and Gofa Zones, Southern Ethiopia. Methods A prospective follow up study was conducted among 6,986 study participants from April 5, 2018 to March 5, 2019. Data on causes of neonatal death were collected by using structured verbal autopsy questionnaire. Data were entered in to Epi data version 3.1 and exported to Stata version 15 for analysis. Crude and adjusted estimate β with 95%CI was calculated in the binary logistic regression model. The goodness of fit was tested by log likelihood ratio (LR). In this study P-value < 0.05 was considered to declare a result as statistically significant association. Results In this study neonatal mortality incidence ratio was 9.6 (95%CI: 7.5%, 12.2%) per 1000 live births. Age of the mother, number of antenatal care, hemorrhage, sex of the neonate, presentation, gestational age and birth weight were identified as the significant determinates for neonatal mortality cases. Prematurity, infection and birth asphyxia were the most common causes of neonatal mortality cases. Conclusions This study indicated that a significant number of neonates were died during neonatal period. Both maternal and neonatal factors were identified. Therefore, early identification of obstetric complications and immediate interventions, strengthening the provision of quality antenatal and postnatal care services are recommended.

scholarly journals Cause and Predictors of Neonatal Mortality among Neonates Admitted to the Neonatal Intensive Care Units of Public Hospitals in Eastern Ethiopia: Facilities Based Prospective Follow-up Study

2020 ◽  
Author(s):  
Assefa Desalew ◽  
Yitagesu Sintayehu ◽  
Nardos Teferi ◽  
Firehiwot Amare ◽  
Bifitu Geda ◽  
...  
Keyword(s):  
Intensive Care ◽  
Neonatal Mortality ◽  
Intensive Care Units ◽  
Neonatal Death ◽  
Neonatal Intensive Care ◽  
Causes Of Death ◽  
Public Hospitals ◽  
Neonatal Intensive Care Units ◽  
Eastern Ethiopia

Abstract Background The first month is the most crucial period for child survival. Neonatal mortality continues to remain high with little improvement over the years in Sub-Saharan Africa including Ethiopia. This region shows the least progress to reducing neonatal mortality and it continues to be a significant public health issue. The facilities-based causes and predictors of neonatal death in the neonatal intensive care unit are not well documented in this study setting. Hence, the aim of this study was to determine the causes and predictors of neonatal mortality among infants admitted to the neonatal intensive care units in Eastern Ethiopia. Methods Facilities-based prospective follow-up study was conducted among neonates admitted to the neonatal intensive care units of public hospitals in Eastern Ethiopia from November to December 2018. Data were collected using a pre-tested, structured questionnaire and a follow-up checklist. The main outcomes and causes of death were set by pediatricians and medical residents. Epi-Data 3.1 and Statistical Package for Social Sciences Version 25 software were used for data entry and analysis respectively. Multivariable logistic regression was used to find out the predictors of facilities-based neonatal mortality. Results The proportion of facilities-based neonatal mortality was 20%(95% CI: 16.7-23.8%) The causes of death were complications of preterm birth 28.58%, birth asphyxia 22.45%, infection 18.36%, meconium aspiration syndrome 9.18%, respiratory distress syndrome 7.14% and congenital malformation 4.08%. Low birth weight, preterm births, length of stay in NICU, low 5 minute Apgar score, hyperthermia and initiation of feeding were predictors of neonatal death among infants admitted to the neonatal intensive care units in public hospitals, Eastern Ethiopia. Conclusion The proportion of facilities-based neonatal deaths was unacceptably high. The main causes of death were preventable and treatable. Hence, improving timing and quality of ANC is essential for early detection, anticipating high-risk newborns and timely interventions. Furthermore, early initiation of feeding and a better referral linkage to tertiary facilities could lead to a reduction of neonatal death in this setting.

scholarly journals Delivery of Twin Gestation (≥ 32.0 Weeks): The Vaginal Route as a Practicable and Safe Alternative to Cesarean Section

2020 ◽  
Vol 80 (10) ◽  
pp. 1033-1040
Author(s):  
Anne Dathan-Stumpf ◽  
Katharina Winkel ◽  
Holger Stepan
Keyword(s):  
Cesarean Section ◽  
Vaginal Delivery ◽  
Neonatal Outcome ◽  
Neonatal Outcomes ◽  
University Hospital ◽  
Delivery Mode ◽  
Safe Alternative ◽  
Vaginal Deliveries ◽  
Twin Pregnancies ◽  
Second Twin

Abstract Objective The appropriate delivery mode for twins is discussed controversially in the literature. The aim of this study was to investigate delivery modes and short-term neonatal outcomes of twin pregnancies delivered in University Hospital Leipzig. Material and Methods A total of 274 twin pregnancies (32.0 to 39.4 weeks of gestation) delivered between 2015 and 2017 were analyzed retrospectively with regard to the planned and final delivery mode as well as neonatal outcomes. The inclusion and exclusion criteria for vaginal delivery were comparable to those of the Twin Birth Study. Results The spontaneous birth rate for births planned as vaginal deliveries was 78.5%; the rate of secondary cesarean section was 19.4%. The final total cesarean rate was 58.8%, and the rate of vaginal deliveries was 41.2%. Vertex or non-vertex position of the second twin had no significant effect on neonatal outcome or mean delivery interval between the birth of the first and second twin. Chorionicity, neonatal weight and gender had no significant impact on delivery mode. However, successful vaginal delivery was associated with higher gestational age and both fetuses in vertex position. The combined neonatal outcome for both twins was significantly worse if they were delivered by cesarean section compared to spontaneous birth. In addition, the leading twin in monochorionic/diamniotic (MC/DA) pregnancies was intubated more frequently after cesarean delivery and had significantly lower Apgar scores. Conclusion Vaginal delivery in twin pregnancies is a practicable and safe option in specific defined conditions and when the appropriate infrastructure and clinical experience is available.

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