scholarly journals Prevalence and Outcome of Obstructed Labour at a Tertiary Institution

2021 ◽  
Vol 04 (09) ◽  
Author(s):  
Elizabeth Nionzima ◽  
Keyword(s):  
Caesarean Section ◽  
Neonatal Intensive Care ◽  
Mode Of Delivery ◽  
Retrospective Chart Review ◽  
Tertiary Hospital ◽  
Sub Saharan Africa ◽  
Tertiary Institution ◽  
Obstructed Labour ◽  
Sub Saharan ◽  
Prolonged Hospital

Obstructed labour is a common preventable causes of both maternal and perinatal morbidity and mortality in developing countries affecting 3-6% labouring women globally and accounts for an estimated 8% of maternal deaths in Sub-Saharan Africa and South Asia. Objective: To determine the prevalence and outcome of obstructed labour in the Gynaecology and Obstetrics Department at a tertiary hospital in Northern Uganda. Method: This was a retrospective chart review of pregnant women admitted in labour and delivered by caesarean section from 1st January 2016 to 31st December 2017 at a Lira Regional Referral Hospital, a tertiary institution in Lango Sub region. Data was analysed using Statistical Package for Social Sciences version 16.0. Results: A total of 808 medical charts of mothers with obstructed labour were retrieved, evaluated and included in this review out of 12,189 deliveries during the study period, giving a prevalence of 6.6%. Majority (77%; 622/808) mothers admitted with diagnosis of obstructed were referred in from peripheral facilities. Over half (53.4%) of the women were in the age group of 20 to 29 years. Over 53%, were prime gravidae and were twice more likely to undergo C/S due to obstructed labour than multigravidas (OR 1.8; 95% CI 1.5-2.2). Only 49.2% had documented cause of obstructed labour, with Cephalo-pelvic disproportion being most common (17.5%), malposition/mal-presentation (14.6%), and macrosomia (3.6%). Partograph was used in only 46.6% (374) women who had obstructed labour. The commonest maternal complication observed were Sepsis (11%), PPH (5.2%), uterine rupture (4%) and burst abdomen (3%) which led to prolonged hospital stay and loss of fertility to some. Mode of delivery in the 808 reviewed charts was caesarean section, 90.3% of babies were born alive, while 8.5% (69) were born dead, (1.2%) had early neonatal, and 40.2% were referred Paediatric Neonatal Intensive Care Unit (NICU) because of low APGAR score. Conclusion: The prevalence of obstructed labour among women delivered by Caesarean section was high compared to the global average. Majority of the women were referrals from the peripheral health centres and associated with life threatening complications and even death. Young age and prime gravida is associated with obstructed labour and high caesarean section rates. The obstruction in multigravida could be due to secondary cephalo-pelvic disproportion as majority of the babies were in normal range weight. Low use of Partograph to monitor labour was evident among women who had obstructed.

Risk factors for Caesarean sections in Ghana: evidence from the Ghana Maternal Health Survey

2020 ◽  
pp. 1-18
Author(s):  
Emmanuel Banchani ◽  
Eric Y. Tenkorang
Keyword(s):  
Risk Factors ◽  
Maternal Health ◽  
Caesarean Section ◽  
Health Survey ◽  
Elective Caesarean Section ◽  
Sub Saharan Africa ◽  
Maternal Complications ◽  
Obstructed Labour ◽  
Sub Saharan ◽  
Using Data

Abstract A Caesarean section can be a life-saving intervention in case of pregnancy complications or difficult labour. The prevalence of Caesarean section continues to increase, especially in sub-Saharan Africa, yet the reasons for this remain largely unexplored. This study investigated risk factors contributing to the decision to perform Caesarean sections in Ghana using data from 8645 women aged 15–49 years from the 2017 Ghana Maternal Health Survey. The data were analysed by applying complementary log-log and logit models. The majority of Ghanaian women (about 87%) reported preferring vaginal delivery to Caesarean section. Of those who had undergone a Caesarean section for their most recent birth, about 55% had an elective rather than an emergency section. Women with labour complications (prolonged/obstructed labour) were significantly more likely to have a Caesarean section (OR=4.09, 95% CI=3.10–5.41). Furthermore, women with maternal complications, particularly prolonged/obstructed labour, were less likely to have an elective Caesarean section than those who had no such complications (OR=0.25, 95% CI=0.14–0.46). Compared with poorer women, wealthy women were significantly more likely to have an elective Caesarean section (OR=1.84, 95% CI=1.08–3.14). The findings suggest that beyond maternal complications, women’s socioeconomic and demographic characteristics are important risk factors for undergoing a Caesarean section in Ghana.

scholarly journals Association between Maternal Origin, Pre-Pregnancy Body Mass Index and Caesarean Section: A Nation-Wide Registry Study

2021 ◽  
Vol 18 (11) ◽  
pp. 5938
Author(s):  
Fatou Jatta ◽  
Johanne Sundby ◽  
Siri Vangen ◽  
Benedikte Victoria Lindskog ◽  
Ingvil Krarup Sørbye ◽  
...  
Keyword(s):  
Body Mass Index ◽  
Caesarean Section ◽  
Body Mass ◽  
Normal Weight ◽  
Sub Saharan Africa ◽  
Asia Pacific ◽  
Adjusted Relative Risk ◽  
Maternal Origin ◽  
Length Of Residence ◽  
Sub Saharan

Aims: To explore the association between maternal origin and birthplace, and caesarean section (CS) by pre-pregnancy body mass index (BMI) and length of residence. Methods: We linked records from 118,459 primiparous women in the Medical Birth Registry of Norway between 2013 and 2017 with data from the National Population Register. We categorized pre-pregnancy BMI (kg/m2) into underweight (<18.5), normal weight (18.5–24.9) and overweight/obese (≥25). Multinomial regression analysis estimated crude and adjusted relative risk ratios (RRR) with 95% confidence intervals (CI) for emergency and elective CS. Results: Compared to normal weight women from Norway, women from Sub-Saharan Africa and Southeast Asia/Pacific had a decreased risk of elective CS (aRRR = 0.57, 95% CI 0.37–0.87 and aRRR = 0.56, 0.41–0.77, respectively). Overweight/obese women from Europe/Central Asia had the highest risk of elective CS (aRRR = 1.42, 1.09–1.86). Both normal weight and overweight/obese Sub-Saharan African women had the highest risks of emergency CS (aRRR = 2.61, 2.28-2.99; 2.18, 1.81-2.63, respectively). Compared to women from high-income countries, the risk of elective CS was increasing with a longer length of residence among European/Central Asian women. Newly arrived migrants from Sub-Saharan Africa had the highest risk of emergency CS. Conclusion: Women from Sub-Saharan Africa had more than two times the risk of emergency CS compared to women originating from Norway, regardless of pre-pregnancy BMI.

scholarly journals Impact of cesarean section on transient tachypnea of the newborn: a longitudinal study

2021 ◽  
Vol 8 (3) ◽  
pp. 467
Author(s):  
Keziah Joseph ◽  
Bhargavi B. ◽  
C. S. Jain ◽  
Dasaradha Rami Reddy
Keyword(s):  
Caesarean Section ◽  
Respiratory Distress ◽  
Neonatal Intensive Care ◽  
Clinical Course ◽  
Mode Of Delivery ◽  
Normal Vaginal Delivery ◽  
Medical Sciences ◽  
Benign Condition ◽  
Term Neonates ◽  
Early Onset Sepsis

Background: Transient tachypnea of the new born is a benign condition. The aim of the study is to find any correlation between the mode of delivery and occurrence of transient tachypnea of newborn.Methods: Study is proposed to assess the risk factor like caesarean section and its relationship with occurrence of TTN in term neonates and the clinical course of TTN cases admitted in Neonatal intensive care unit (NICU), Department of Pediatrics, Kamineni Institute of Medical Sciences, Narketpally, Nalgonda, Telangana.Results: During the study period, total number of deliveries in our hospital was 4576. Of 356 term neonates with respiratory distress admitted in NICU, the most common cause was found to be early onset sepsis i.e 168 of 356 cases accounting for 47.19%, followed by transient tachypnea of newborn i.e., 68 of 356 cases accounting for 19.10%.Conclusions: The mode of delivery i.e caesarean section has a significant impact on transient tachypnea of newborn (TTN) with a relative risk of 3.78 compared to normal vaginal delivery. The majority of cases had mild respiratory distress and were relieved of symptoms within 3 days of hospital stay.

scholarly journals Incidence Density Rate of Neonatal Mortality and Predictors in Sub-Saharan Africa: A Systematic Review and Meta-Analysis

2020 ◽  
Vol 2020 ◽  
pp. 1-14
Author(s):  
Zebenay Workneh Bitew ◽  
Ayinalem Alemu ◽  
Ermias Getaneh Ayele ◽  
Desalegn Abebaw Jember ◽  
Michael Tamene Haile ◽  
...  
Keyword(s):  
Intensive Care ◽  
Neonatal Mortality ◽  
Intensive Care Units ◽  
Neonatal Intensive Care ◽  
Sub Saharan Africa ◽  
Incidence Density ◽  
Neonatal Intensive Care Units ◽  
Sub Saharan ◽  
Incidence Density Rate ◽  
Density Rate

Background. Neonatal mortality in Sub-Saharan countries is remarkably high. Though there are inconsistent studies about the incidence density rate of neonatal mortalities (IDR) and predictors in Sub-Saharan Africa, they are inconclusive to policymakers and program planners. In this study, the IDR of neonatal mortalities and predictors was determined. Methods. Electronic databases (Web of Science, PubMed, EMBASE (Elsevier), Scopus, CINAHL (EBSCOhost), World Cat, Google Scholar, and Google) were explored. 20 out of 818 studies were included in this study. The IDRs and predictors of neonatal mortality were computed from studies conducted in survival analysis. Fixed and random effect models were used to compute pooled estimates. Subgroup and sensitivity analyses were performed. Results. Neonates were followed for a total of 1,095,611 neonate-days; 67142 neonate-days for neonates treated in neonatal intensive care units and 1,028,469 neonate-days for community-based studies. The IDRs of neonatal mortalities in neonatal intensive care units and in the community were 24.53 and 1.21 per 1000 person-days, respectively. The IDRs of early and late neonatal mortalities neonatal intensive care units were 22.51 and 5.09 per 1000 neonate-days, respectively. Likewise, the IDRs of early and late neonatal mortalities in the community were 0.85 and 0.31, respectively. Not initiating breastfeeding within one hour, multiple births, rural residence, maternal illness, low Apgar score, being preterm, sepsis, asphyxia, and respiratory distress syndrome were independent predictors of time to neonatal mortality in neonatal intensive care units and male gender, perceived small size, multiple births, and ANC were predictors of neonatal mortality in the community. Conclusion. The incidence density rate of neonatal mortality in Sub-Saharan Africa is significantly high. Multiple factors (neonatal and maternal) were found to be independent predictors. Strategies must be designed to address these predictors, and prospective studies could reveal other possible factors of neonatal mortalities.

scholarly journals Mastalgia: Prevalence at a Sub-Saharan African Tertiary Hospital

2014 ◽  
Vol 2014 ◽  
pp. 1-3
Author(s):  
T. Makumbi ◽  
M. Galukande ◽  
A. Gakwaya
Keyword(s):  
Tertiary Hospital ◽  
Cross Sectional Study ◽  
Sub Saharan Africa ◽  
Western World ◽  
African Countries ◽  
Breast Clinic ◽  
Cross Sectional ◽  
Ethical Approval ◽  
Sub Saharan ◽  
Cyclical Mastalgia

Introduction. Mastalgia is a common breast condition among women referred to breast clinics worldwide. Whereas the prevalence is known in the Western world and Asia, the prevalence of the disease is unknown in many African countries. The aim of this study therefore was to determine the prevalence and describe factors associated with mastalgia among women attending a tertiary hospital in sub-Saharan Africa. Methods. A cross-sectional study was done in Kampala, Uganda. Mastalgia was defined as self-reported breast pain (unilateral or bilateral) for a period not less than two months. A pretested questionnaire was used to collect the data and statistical analysis was performed using SPSS version 11. Ethical approval was obtained. Results. Out of the 1048 women who presented to the breast clinic during the study period, 168 (16%) were diagnosed with mastalgia in the absence of breast cancer. Noncyclical and cyclical mastalgia were 22/168 (13%) and 5/168 (3%), respectively. The onset of noncyclical category as compared to the cyclical type of mastalgia was observed to manifest before 24 years of age (P=0.006). Conclusion. Mastalgia was a common condition among women in this sub-Saharan African setting as is elsewhere. The early onset mastalgia in this sub-Saharan African study requires further exploration for determination of its risk factors.

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