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Magnitude and associated factors of unintended pregnancy among pregnant women attending antenatal care at saint Paul hospital millennium medical collage, Addis Ababa, Ethiopia
Background:-Unintended pregnancy is defined as unwanted or mistimed. It is an important public health issue in both developing and developed countries, because of its serious consequences for women and ...
Knowledge and Uptake of Preconception Care Among Reproductive Age Women with Chronic Medical Illness Visiting St. Paul’s Millennium Medical College : A Cross sectional Study
Background: Preconception care is the provision of biomedical, behavioral and social health interventions to women before the occurrence of conception to improve their health status. This is particularly ...
Prevalence of Superimposed Preeclampsia and associated factors among Women with Chronic Hypertension who gave birth at Saint Paul’s hospital millennium medical college Addis Ababa, Ethiopia
Introduction: The prevalence of chronic hypertension during pregnancy is on average around 10% worldwide and of this around 25% on average will develop superimposed preeclampsia. Little is known about superimposed preeclampsia in Ethiopia. So, the objective of this study is to determine prevalence of superimposed preeclampsia and associated factors in one of tertiary referral center in Addis Ababa, Ethiopia.
Methodology: A hospital based retrospective cross-sectional study was conducted at Saint Paul’s Hospital Millennium Medical College starting from February 1, 2019 to January 31, 2020. All pregnant women who were diagnosed with chronic hypertension and admitted for delivery were included. The admission data summary was reviewed for data collection. Data was collected using questionnaires, entered and analyzed using SPSS version 23. After bivariate analysis, multivariate logistic regression analysis was carried, we used p=0.05 for stastical significance.
Result: This study indicated that the prevalence of superimposed preeclampsia among pregnant women with chronic hypertension to be 44.1%. This study reveals high risk ANC follow up (AOR-4.5 95% CI 1.5-14) is an independent factor associated factor with development of superimposed preeclampsia. There was no association seen with respect to maternal age, parity, marital status, occupation and GA at diagnosis.
<strong>Conclusion: </strong>The prevalence of superimposed preeclampsia was found to be higher in this study. Most of social-demographic and obstetrics factors were not associated with superimposed preclampsia. Additionally, unfavorable neonatal outcomes were found to be higher among women with superimposed preeclampsia than those with chronic hypertension only....
Burnout, depression and job dissatisfaction among OBGYN and other major department residents at St. Paul’s hospital millennium medical college: a cross sectional comparative study, Addis Ababa, Ethiopia
Background: OBGYN is one of the high burdened fields of studies in Ethiopia. Little is known regarding burnout, depression and job dissatisfaction in practicing residents over the nation....
Hysterosalpingography Findings among Women Undergoing Infertility Workup at St. Paul’s Hospital Millennium Medical College Addis Ababa, Ethiopia: A One Year Patients’ Chart Review
Background: Infertility is a major public health concern in several African countries. The primary investigation modalities for female infertility used widely today is hysterosalpingography, a radiographic ...
A One Year Retrospective Review of Intrauterine Insemination at the Center for Fertility and Reproductive Medicine of Saint Paul’s Hospital Millennium Medical College, Addis Ababa, Ethiopia
Conclusions: As the pregnancy rate found in this study was comparable with other studies and due to its affordability, IUI remains an effective first line method among the available options for infertile ...
Perinatal outcome of non vertex second twin after vaginal delivery of first twin at Saint Paul’s hospital millennium medical college, Addis Ababa, Ethiopia: Retrospective Cohort study
Background: Considering Presentation of the second twin in determining the route of delivery for vertex first twin remains an area of controversy. This study aimed to determine whether presentation of the second twin following vaginal delivery of a vertex first twin affects neonatal outcomes at SPHMMC, Addis Ababa, Ethiopia from January 2016 to January 2020
Methods: Hospital based, Retrospective cohort study design was conducted based on data collected from 429 mothers using a structured data extraction form. 143 women with non vertex second twin were compared with 286 women with vertex second twin that fulfils the inclusion criteria. The ratio of exposed to none exposed was taken as 1: 2. Data was collected by trained residents. Data was entered and analyzed using SPSS version 21. Relationship among the major variable were described by chi-square test (P<0.05). In order to measure the association between an exposure and an outcome relative risk (RR, with 95% CI) was calculated. Logistic regression model (adjusted for perinatal confounders and mode of delivery) were developed to determine odds of adverse outcomes associated with presentation. The perinatal mortality rate was calculated by using S-Statistical soft ware for both exposed and non exposed group and association was checked using chi-square test (P<0.05). P-value<0.05 was considered statistically significant.Result: A total of 429 twin pregnancies were included, 33.3% of these had a non-vertex second twin. Caesarean section was more common in non-vertex presentations (11.2% vs 2.1%, p < 0.001). The odds of Apgar score < 7 at 5th minutes (14% vs 5.6%, OR 2.7444,95%CI 1.375-5.477), still birth (4.2% vs 0.7%, AOR 5.482,95%CI 1.073-27.995) Apgar < 7 at 1st minutes(47.6% vs 23.1%, AOR 2.782,95%CI 1.784-4.338), NICU admission (29.4% vs 27.3%, OR 1.109,95%CI 1.109-1.729) and early neonatal death (18.9% vs 9.1%, AOR 2.355,95% CI 1.331-4.168) were significantly higher among non vertex second twin.
Conclusion: Perinatal mortality rate and Neonatal morbidities such as low 5th minute APGAR score were found to be higher among non vertex second twin after vaginal delivery of the first twin. Vaginal delivery of twin with the non vertex second twin is not a reasonable management option although skill of resident in attending non vertex presentation and gestational age specific outcome is not seen....
Magnitude and Determinants of Safe Second Trimester Abortion in Saint Paul Hospital Millennium Medical College: A Cross-Sectional Study
Background: As compared to first trimester, second trimester abortions disproportionately contribute for increased medical cost, maternal morbidity and mortality. However, 10–15% of terminations of pregnancies globally are still in the second trimester period. Yet, the exact magnitude and the underlying factors and reasons of women for seeking second trimester abortion care are not well known. So, this study determined the magnitude and factors associated with late presentation for safe abortion care at Michu clinic of Saint Paul hospital new millennium medical college (SPHMMC), Addis Ababa, Ethiopia.
Methods: Hospital based cross-sectional study was conducted among pregnant women who requested for safe abortion care at Michu clinic of SPHMMC in 2020. Participants (n=238) were selected using systematic random sampling and data were collected using pretested, structured, and interviewer administer questionnaire. Multivariable logistic regression was used to identify independent factors associated with late request for safe abortion care and the results are presented using adjusted odds ratios (AOR) with their 95% confidence interval (CI).
Results: The prevalence demand for second trimester abortion was 53.4%. The factors that increased the odds of second trimester abortion were young age, <=19 years (AOR= 6.37 [95% CI=1.84-22.06]), decision ambivalence (AOR=5.64 [95% CI=1.71-18.61]), delay to suspect pregnancy (AOR= 8.56 [95% CI=2.11-34.57]), delay to diagnose pregnancy (AOR=3.83 [95% CI=1.51-9.75]), lack of awareness on pregnancy symptoms and symptoms (AOR=4.22 [95% CI=1.58-11.23]), greater one month delay to get the service (AOR =4.42 [95% CI=1.43-13.67]), and lack of information where to get the abortion service (AOR=3.90 [95% CI=1.532-9.965])Conclusion: We found a very high level of demand for second trimester abortion. Improving access to contraception, abortion care, and improving women's reproductive health knowledge can help to prevent late gestation abortion....
Awareness and Perception of Health Professionals and Mothers towards Birth Companions: Mixed Method Study in St. Paul’s Hospital and Millennium Medical College and its Catchment Centers in Addis Ababa, Ethiopia
Introduction: Companion of choice at birth is defined as the continuous presence of support person during labor and birth. Various studies have shown the benefits of companion during child birth. The objective of this study was to assess the knowledge, attitude and practice of health care providers and attitude of mothers towards the involvement of birth companions during child birth in St Paul’s Hospital Millennium Medical College (SPHMMC) and its selected catchment health centers.
Methodology: The study used a cross-sectional study to determine the perception of health care providers and postpartum mothers on the involvement of birth companions during child birth. This finding was supplemented by in depth interview of health care providers who were on practice during the study period in SPHMMC.
Result: The study included a total of 393 postpartum women and 57 health care providers. The finding from the study showed majority of the post-partum women (98.7%) were not allowed to have companions during labor. Among postpartum women 27.3 % has negative attitude towards involvement of birth companions. The commonest reasons mentioned by post-partum women for having negative attitude to this included need for privacy and fear of overburdening family members with stress. The great proportion of health care providers involved in the study (90 %) have positive attitude towards involvement of birth companions but majority 82.4 % didn’t allow labor companions.Conclusion: Since involvement of birth companions is one way we can ensure the quality of care we provide, interventions should be in place to improve the existing situation. Efforts should be made to address difficulties faced with regards to ensuring privacy, accommodating the high burden of laboring women and increasing the awareness of laboring women and health care providers with regards to involvement of birth companions....
Pregnancy outcome of hemolysis elevated liver Enzymes and low platelate count syndrome at teaching hospital, Addis Ababa, Ethiopia
Background: HELLP syndrome is a life-threating complication in pregnancy that occur in 0.5 to 0.9% of all pregnancies and in 10–20% of cases with severe preeclampsia/eclampsia. It is associated with increased rate of both maternal and perinatal complications.
Objectives: The aim of this study was to assess maternal and perinatal outcome of HELLP syndrome at teaching Hospital in Ethiopia.
Methods: This was a 2-year retrospective based chart review of all women diagnosed with HELLP syndrome and delivered at Saint Paul’s Hospital Millennium Medical College in obstetrics and gynecology department in A.A, Ethiopia. Data entry and analysis was made using SPSS version 23 software. Frequency and percentages were calculated and presented in tables. Bivariate and multivariate analysis were used to see association and control confounding variables. Ethical clearance was obtained from the IRB of SPHMMC.
Results: There were 20,111 deliveries during the study period, of which 0.57% (115) of the mothers developed HELLP Syndrome. Among these ,101 women fulfilling the inclusion criteria were included and their records were analyzed retrospectively. 36.6% of the cases were in the age group of 27-31 years. Majority 60.4% of the cases were primiparous while 39.6% of them were multiparous. Most of the mothers,92% were referred cases and 63.4% were from Addis Ababa. 89.1% cases occurred during antepartum and 10.9% after delivery. The mean gestational age was 33.40 ± 4.474 wks. 68% had Partial and 32% of them had complete HELLP syndrome. Caesarean and vaginal delivery rate were 47.5% and 52.5% respectively. There was no maternal death. 30.7% (31/101) of the mothers developed maternal complications. Acute kidney injury was the most frequent maternal complication 24.8%, followed by pulmonary Oedema 11.9%. Mothers with complete HELLP syndrome and when it arises in postpartum period were found to have significant influence on maternal morbidity with p -value of 0.03 for both, AOR= 0.223 (95% CI= 0.018-0.863) and AOR =0.360 (95% CI= 0.144-0.901) respectively. The were 108 infants delivered :70.4% were preterm while 29.6% were term deliveries. Twenty-three (21.3%) babies were IUGR. 78.7 % were born alive,12% were intrapartum deaths and 9.3% were still births. 9.3% were ENDs making over all overall perinatal mortality of 30.6%(33/108).
Conclusion: The incidence of HELLP syndrome in this study was low with significant maternal morbidity and perinatal complications. It needs further prospective study with large sample size in country level....