scholarly journals Perinatal Survival and Predictors of Mortality among Mothers with Hypertensive Disorders of Pregnancy at Antenatal care Clinics in Gamo Zone Public Hospitals

2020 ◽  
Vol 30 (6) ◽  
Author(s):  
Samuel Dessu Sifer ◽  
Fikre Bojola ◽  
Zinabu Dawit ◽  
Habtamu Samuel ◽  
Mulugeta Dalbo
Keyword(s):  
Blood Pressure ◽  
Antenatal Care ◽  
Perinatal Mortality ◽  
Blood Pressure Level ◽  
Pressure Level ◽  
Public Hospitals ◽  
Pregnancy Induced Hypertension ◽  
Systolic Blood Pressure Level ◽  
Induced Hypertension

BACKGROUND፡ Pregnancy induced hypertension represents a significant public health problem throughout the world, which may complicate 0.5%–10% of all pregnancies. It is the leading cause of maternal as well perinatal mortality and morbidity worldwide. Pregnancy induced hypertension is a multisystem disorder unique to pregnancy and results in high perinatal mortality. The objective of this study was to determine the survival status, incidence and predictors of perinatal mortality among mothers with pregnancy induced hypertension at antenatal clinics of Gamo Zone public hospitals.METHODS: Facility-based retrospective cohort study was conducted among selected 576(192 exposed and 384 unexposed) antenatal care attendants' record at Gamo Zone public hospitals from 1st January 2018 to 31st December 2018. Data were entered into Epi data version 3.02 and exported to SPSS V 25 for analysis. Kaplan Meier survival curve together with log rank test was fitted to test the survival time. Statistical significance was declared at Pvalue <0.05 using cox proportional hazard model.RESULT: The incidence of perinatal mortality was 124/1000 births. The cumulative proportion of surviving at the end of 4th , 8th, 12th and 16th weeks of follow-up among the exposed groups was 96.9%, 93.5%, 82.1% and 61.6% respectively whereas it was 99.5%, 98.9% and 98.5% at the end of 4th, 8th and 12th weeks of follow-up for the non-exposed groups respectively. Parity of >5(AHR: 6.3; 95%CI: 1.36,10.55), mothers who delivered at<34 weeks of gestation(AHR:7.8; 95%CI: 2.6,23.1), being preterm(AHR:6; 95%CI: 5.3,19.2), perinatal birth weight<2500gm(AHR:6.1; 95&CI: 1.01,37.9), vaginal deliveryn(AHR:2.7; 95%CI:1.13,6.84), maternal highest systolic blood pressure level >160mmHg (AHR: 2.3; 95%CI: 1.02,5.55) and prepartum onset of pregnancy induced hypertension (AHR:6; 95%CI: 5.3,19.2) were statistically significant in multivariable analysis.CONCLUSION: The risk of perinatal mortality was high among the mothers with pregnancy induced hypertension compared to those of pregnancy induced hypertension free mother,s and the perinatal mortality rate was high. High parity, low gestational age, low number of antenatal care visits, low birth weight, vaginal delivery, antepartum onset of pregnancy induced hypertension and highest maternal systolic blood pressure level were the independent predictors of perinatal mortality.

scholarly journals Perinatal Mortality and Associated Factors Among Antenatal Care Attended Pregnant Mothers at Public Hospitals in Gamo Zone, Southern Ethiopia

2020 ◽  
Vol 8 ◽  
Author(s):  
Samuel Dessu ◽  
Zinabu Dawit
Keyword(s):  
Birth Weight ◽  
Antenatal Care ◽  
Perinatal Mortality ◽  
Vaginal Delivery ◽  
Multivariable Analysis ◽  
Public Hospitals ◽  
Southern Ethiopia ◽  
Pregnancy Induced Hypertension ◽  
Spontaneous Vaginal Delivery ◽  
Induced Hypertension

Introduction: Perinatal mortality is the death of a baby between 28 weeks of gestation onwards and before the first 7 days of life. According to WHO, Ethiopia is one of the most commonly noticed country in the world in considering perinatal mortality rate. The overall perinatal mortality rate in Ethiopia was around 66–124 per 1,000 births.Objective: To determine the magnitude of perinatal mortality and associated factors among mothers who attended antenatal care at public hospitals in Gamo Zone, Southern Ethiopia.Methods: A cross-sectional study was conducted at Arba Minch General Hospital and Chencha District Hospital antenatal care attended by pregnant mothers from the 1st of February to the 28th of March 2019, among the mothers enrolled at ANC clinic from the 1st of January to the 30th of December 2018 using a simple random sampling method for the pre-determined 1,820 records. Both bivariate and multivariable logistic regression analysis was conducted. Variables which had a p-value &lt;0.25 in bivariate analysis were considered as a candidate variable for multivariable analysis and variables which had a P-value &lt;0.05 in multivariable analysis were declared as statically significant.Results: The prevalence of perinatal mortality was 12.6% (95% CI: 11.80, 13.40) and grand multiparity (AOR: 7.40; 95% CI: 2.77, 20.26), having one antenatal visit (AOR: 4.40; 95% CI: 1.64, 11.91), spontaneous vaginal delivery (AOR: 0.36; 95% CI: 0.16, 0.82), being pre-term (AOR: 6.78; 95% CI: 2.41, 19.09), birth weight &lt;2,500 gram (AOR: 3.10; 95% CI: 1.48, 6.46), maternal ever hemoglobin level &lt;10 gm/dl (AOR: 4.04; 95% CI: 1.91, 8.57), and pre-partum onset of pregnancy induced hypertension (AOR: 4.01; 95% CI: 2.01, 6.08) were statistically significant in the multivariable logistic regression model.Conclusion: The magnitude of perinatal mortality was high as compared with the Ethiopian Health and Demographic Survey report 2016 and high parity, low in number of antenatal care visits, low gestational age, low birth weight, low maternal hemoglobin level, and pre-partum onset of pregnancy induced hypertension were independent factors which increase the perinatal mortality while spontaneous vaginal delivery reduces the mortality risk. Therefore; the community should be educated to reduce the number of instance of births. In addition; the health care professionals should emphasize on the care provided for the newborns having low birth weight and use spontaneous vaginal delivery as much as possible.

scholarly journals Surgical repair of the moderately dilated ascending aorta combined with bicuspid aortic valve replacement

2019 ◽  
Vol 47 (4) ◽  
pp. 299-309
Author(s):  
V. E. Uspenskiy ◽  
E. G. Malev ◽  
N. D. Gavriliuk ◽  
B. K. Salavatov ◽  
S. A. Ermolov ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Aortic Valve ◽  
Aortic Valve Replacement ◽  
Blood Pressure Level ◽  
Pressure Level ◽  
Increased Risk ◽  
Group 2 ◽  
Group 1

Background: Ascending aortic (AA) dilatation is common in patients with bicuspid aortic valve (BAV). In BAV replacement, surgery of the AA is indicated in the case if AA diameter exceeds 45 mm. Aortic valve replacement combined with an AA intervention is associated with increased risk of complications. The feasibility of the reduction ascending aortoplasty for correction of the dilated AA remains disputable.Aim: To analyze the results of BAV surgical replacement with simultaneous surgical correction of the borderline AA dilatation (45-50 mm) by the reduction aortoplasty (RAP) or supracoronary AA replacement (SPR).Materials and methods: This single center prospective non-randomized study included 53 patients with significant BAV stenosis and AA dilatation (45-50 mm), divided into 2 groups: BAV surgical replacement combined with RAP AA replacement (group 1, 36 patients) and BAV replacement with SPR (group 2, 17 patients). There were no significant differences between the patients of the two groups in their characteristics of the underlying disease, complications and comorbidities.Results: Hospital mortality was 0%. No between-group differences in the early postoperative course were found. At later term, 44 (81.5%) patients were assessed; median (dispersion) of the follow-up was 36 (25; 50) months. Two patients from the group 2 died during the follow-up. The long-term survival was better in the group 1 (p = 0.028). No differences in the combined adverse event rate were observed between the groups (p = 0.633). The median (dispersion) of the AA absolute increment and the rate of dilatation after RAP were 1.0 (0.0; 3.0) mm and 0.24 (0.00; 0.95) mm/year, respectively. The predictor of AA increment rate ≥ 2 mm/year was the baseline blood pressure level (odds ratio 1.321, 95% confidence interval 1.050-1.662; p=0.017). The threshold preoperative blood pressure value for the increased risk of the long-term AA expansion rate was 138 mmHg.Conclusion: The efficacy and safety of RAP and SRP combined with BAV replacement in AA borderline dilatation are similar. Combined BAV surgery and RAP is effective and safe in patients with systolic blood pressure level ≤ 135 mmHg. Combined BAV replacement with SRP seems reasonable in patients with arterial hypertension.

Prediction of blood pressure level and need for antihypertensive medication: 10 years of follow-up

2001 ◽  
Vol 19 (7) ◽  
pp. 1193-1201 ◽  
Author(s):  
Jaana M. Jokiniitty ◽  
Silja K. Majahalme ◽  
Mika A. P. Kähönen ◽  
Martti T. Tuomisto ◽  
Väinö M. H. Turjanmaa
Keyword(s):  
Blood Pressure ◽  
Antihypertensive Medication ◽  
Blood Pressure Level ◽  
Pressure Level

scholarly journals Preterm birth determinants among newborns at six public hospitals in Northeast Amhara, Ethiopia: unmatched case-control study

2020 ◽  
Author(s):  
Mesfin Shiferaw ◽  
Nigusie Birhan Tebeje ◽  
Habtamu Sewunet Mekonnen
Keyword(s):  
Preterm Birth ◽  
Case Control Study ◽  
Folic Acid Supplementation ◽  
Public Hospitals ◽  
Pregnancy Induced Hypertension ◽  
Induced Hypertension ◽  
Iron Folic Acid Supplementation ◽  
Iron Folic Acid ◽  
Control Study

Abstract Background: Preterm birth is a global public health problem. Worldwide, every year about 15 million newborns are born preterm and about 1.1 million of them die due to complications related to prematurity. More than 81% of preterm births were in Asia and Sub-Saharan Africa. Nowadays, preterm birth is the first leading cause of under-five mortality and is one of the limiting factors for achieving a reduction in under-five mortality rate. Therefore, the aim of this study was to identify the determinants of preterm birth at public hospitals in the Northeast Amhara, Ethiopia, 2019.Method: Hospital-based unmatched case-control study was conducted at public hospitals in Northeast Amhara, Ethiopia from March 15th to April 25th, 2019. Data were collected using interviewer-administered structured pre-tested tool and document review for cases and controls. Data were entered in to Epi Info version 7.2.2.6 and exported to SPSS version 23 software for data analysis. Bi-variable and multivariable binary logistic regression were used to measure the association between preterm birth and risk factors. Adjusted Odds ratio (AOR) at 95 % confidence interval (CI) was calculated and P value ≤0.05 declared statistically significant. Result: The study identified that ANC follow up less than four visits [AOR 2.267, Cl (1.205, 4.264)], pregnancy-induced hypertension [AOR 4.453, Cl (1.276, 15.536)], no iron/folic acid supplementation during pregnancy [AOR 4.175, Cl (1.632, 10.680)], anemia during pregnancy [AOR 4.776, Cl (1.492, 15.285)], and birth defect [AOR 6.160, Cl (l.896, 20.013)] were significantly associated determinants of preterm birth.Conclusion: Antenatal care follow up fewer than four visits, pregnancy induced hypertension, no iron/folic acid supplementation during pregnancy, being anemic during pregnancy, and birth defect were important determinants of preterm birth.

Blood Pressure Level and Variability in the Prediction of Blood Pressure After 5-Year Follow-up

Hypertension ◽  
1996 ◽  
Vol 28 (5) ◽  
pp. 725-731 ◽  
Author(s):  
Silja Majahalme ◽  
Väinö Turjanmaa ◽  
Alan B. Weder ◽  
Hong Lu ◽  
Martti T. Tuomisto ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Blood Pressure Level ◽  
Pressure Level

Risk of fatal stroke according to blood pressure level: an 18-year follow-up of the Oslo Study

1995 ◽  
Vol 13 (8) ◽  
pp. 909-913 ◽  
Author(s):  
Lise Lund H??heim ◽  
Ingar Holme ◽  
Ingvar Hjermann ◽  
Paul Leren
Keyword(s):  
Blood Pressure ◽  
Blood Pressure Level ◽  
Pressure Level ◽  
Fatal Stroke

Psychological Stress Tasks in the Prediction of Blood Pressure Level and Need for Antihypertensive Medication: 9-12 Years of Follow-Up.

2005 ◽  
Vol 24 (1) ◽  
pp. 77-87 ◽  
Author(s):  
Martti T. Tuomisto ◽  
Silja Majahalme ◽  
Mika Kähönen ◽  
Mats Fredrikson ◽  
Väinö Turjanmaa
Keyword(s):  
Blood Pressure ◽  
Psychological Stress ◽  
Antihypertensive Medication ◽  
Blood Pressure Level ◽  
Pressure Level

scholarly journals A study of spot urine protein: creatinine ratio as an alternative to 24 hours proteinuria for the diagnosis of pre-eclampsia

2019 ◽  
Vol 9 (1) ◽  
pp. 140
Author(s):  
Ruma Sarkar ◽  
Shilpi Rawat ◽  
Neela Rai Sharma ◽  
Harish Chandra Tiwari
Keyword(s):  
Blood Pressure ◽  
Urine Sample ◽  
Blood Pressure Level ◽  
Protein Detection ◽  
Pressure Level ◽  
Urinary Protein ◽  
Creatinine Ratio ◽  
Urine Protein ◽  
Systolic Blood Pressure Level ◽  
Spot Urine

Background: Preeclampsia is defined as systolic blood pressure level of 140 mmHg or higher or a diastolic blood pressure level of 90 mmHg or higher that occurs after 20 weeks of gestation with proteinuria. Objective of this study was to study the role of spot urine protein: creatinine ratio as an alternative to 24 hours proteinuria for the diagnosis of pre-eclampsiaMethods: This is a prospective observational study conducted in the department of obstetrics and gynaecology, BRD Medical College Gorakhpur, since October 2016 to September 2017 included 120 pregnant women with hypertension of gestational age more than 20 weeks. Ramdom urine sample of all the patient was taken before 12 noon after first voiding. For 24 hours urine sample patient was asked to collect all her urine she voids during 24 hours. The creatinine was estimated by the alkaline picrate method (Jaffe's Reaction) modified by the Bonsnes and Taussky, 1945. Creatinine in a protein free solution reacts with the alkaline picrate and produces red colour complex which is measured colorimeterically. Urinary protein was estimated in all the subjects by the Turbidimetric method. Urinary protein was precipitated by 3% sulphosalicylic acid and turbidity so produced was measured colorimetrically.Results: Protein: creatinine ratio in a random urine sample is better than random urine protein detection by dipstick method in cases of emergency when there is no time for detection of 24 hours urine protein.Conclusions: If cut-off level for urine protein: creatinine ratio in random urine sample is taken as 0.25 or more then sensitivity and specificity become same as 24 hours urine protein.                                 

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