SPHMMC Papers Repo
https://spirhr.org:443/xmlui
The SPHMMC digital repository system captures, stores, indexes, preserves, and distributes digital research material.2024-03-28T17:34:24ZCesarean delivery techniques among Obstetricians and Gynecologists in Ethiopia: Review of practice
http://spirhr.org:8080/xmlui/handle/123456789/82
Cesarean delivery techniques among Obstetricians and Gynecologists in Ethiopia: Review of practice
Zekarias, Zekarias
<p><strong>Background </strong></p>
<p>Caesarean section is one of the most commonly performed procedures in the world. Even though there is some standard recommendation, there is a wide variation in the surgical techniques among surgeons in different countries and even in the same countries. The aim of the study was to describe the surgical techniques of caesarean section among Obstetricians and Gynecologists practicing in Ethiopia.</p>
<p><strong>Methods </strong></p>
<p>A cross sectional study design was employed among participants who were registered Obstetricians and Gynecologists practicing in Ethiopia willing to fill out the form through Google Form and printed questionnaire. Participants were approached through their addresses at Ethiopian Society of Obstetricians and Gynecologists. The collected data on antibiotics, pre-operative surgical preparation and surgical techniques related variables from excel spreadsheet of the Google Form and the questionnaire transferred to IBM SPSS Statistics 22 for analysis. Frequencies, percentage and chi-square and corresponding p-values were calculated. The descriptive data was then presented in the form of frequency tables, bar graphs and pie chart.</p>
<p><strong>Results </strong></p>
<p>There were a total of 258 participants among this 251(97.3%) responded and 6(2.7%) did not respond. The commonly used antiseptic for skin preparation was alcohol plus iodine (94%). Pfannestiel abdominal incision was the common during elective cesarean delivery. Controlled cord traction for placenta delivery (92.2%), mopping the uterine cavity (90%), double layer closure of the uterine incision (98.4%) and subcuticular closure of the skin wound (96.4%) was most commonly practiced. Large difference in practice was seen between blunt versus sharp fascia extension (43.3 versus 55.8%), cephalo-caudad versus. lateral uterine incision extension (58 versus 39%), closure and non-closure of the pelvic and parietal peritoneum (57.4 versus 42.6 and 39.8 versus 60.2%). <span>2 </span></p>
<p><strong>Conclusions </strong></p>
<p>There was a major difference in pre-operative and surgical techniques among the Obstetricians practicing in Ethiopia.</p>
<p><strong>Recommendation </strong></p>
<p>It will be good for us to have standardized protocol at least at the institution level and at large at the country level by Ethiopian Society of Obstetricians and Gynecologists through Continuing Medical Education, training, guidelines or protocols by considering the evidence based recommendation to have a consistent practice for the most commonly practiced operation in the world. For some of the techniques which lack strong evidence for recommendation require future studies to evaluate the surgical techniques on substantive short term and long term outcomes.</p>
2021-08-01T00:00:00ZKnowledge, Attitude And Practice Of Health Care Workers Towards Palliative Care In Oncology Patients Among Health Care Workers Working At Saint Paul Hospital Millennium Medical College
http://spirhr.org:8080/xmlui/handle/123456789/81
Knowledge, Attitude And Practice Of Health Care Workers Towards Palliative Care In Oncology Patients Among Health Care Workers Working At Saint Paul Hospital Millennium Medical College
G/Yohanes, Yohana
2021-08-01T00:00:00ZMaternal and Perinatal Outcome of Severe Oligohydramnios Induced at Term in Saint Paul’s Hospital Millennium Medical College
http://spirhr.org:8080/xmlui/handle/123456789/80
Maternal and Perinatal Outcome of Severe Oligohydramnios Induced at Term in Saint Paul’s Hospital Millennium Medical College
Teshome, Yared
<p><strong>Background:</strong> <strong> </strong>Oligohydramnios has been correlated with increased risk of fetal stillbirth, meconium aspiration syndrome, severe birth asphyxia, low Apgar score scores and congenital abnormalities. It is also associated with maternal morbidity due to increased rates of induction and instrumental or operative deliveries. Negative perinatal and maternal outcome is directly related with the severity of oligohydramnios and the gestational age at the occurrence and other medical pregnancy complication.</p>
<p><strong>Objectives: </strong>To assess maternal and perinatal outcome of induction of labor for severe oligohydramnios at term pregnancy and associated factors among pregnant women admitted from April30, 2021 to July 30, 2021 at SPHMMC and, Addis Ababa Ethiopia</p>
<p><strong>Methodology:</strong><strong> </strong>A descriptive cross-sectional study was conducted in SPMMC from April 30, 2021 to august 30, 2021. The pregnant mothers admitted in the labor and delivery unit with a diagnosis of severe oligohydramnios at term singleton pregnancy with known gestation will be included in the study. The data were collected using a structured and pretested questionnaire. It will be entered in EPI Info7.0 and analyzed using SPSS 24.0. Logistic regression analysis will be done to assess any factors associated with severe oligohydramnios.</p>
<p><strong>Result : </strong>From a total of 129 interviewed mothers, 22 of the cases excluded as 8 of them has either unknown or unreliable GA and 14 of them the information was incomplete. 107 cases were analyzed and, at the same time, their neonates’ cards were reviewed and family asked 7<sup>th</sup> day outcome of neonate documented. Severe oligo found in 48.5% of the cases. Among predisposing factors of oligohydramnios, Hypertensive disorder of the pregnancy, IUGR, and others obstetrics complications (abruption of placenta, GDM, ITP, SLE and cardiac disease) occurred in 29(27.1%), 28(26.1), 23(21.4%) respectively. AMO in the form of CD and APNO was 5.626 times and 5.2 times higher in mothers who had severe oligohydramnios than non-severe oligohydramnios [AOR=5.626, 95%CI (2.246, 14.093)] & [AOR=5.223, 95%CI (1.517, 17.984)] respectively.</p>
<p><strong>Conclusion: </strong>There is significantly decreased maternal morbidity in the form of CS in induction of women with severe oligohydramnios but there is slight increased perinatal morbidity. There for, for patient with severe oligohydramnios the decision between vaginal (induction) vs CS should be balanced. PIH, gravidity, IUGR and other obstetrics complications are associated factor for the occurance of oligohydramnios and for maternal and perinatal outcome.</p>
2021-08-01T00:00:00ZKnowledge, Attitude and Practice of Preconceptional care and associated factors among Physicians working at Saint Paul’s Hospital Millennium Medical College, Addis Ababa, Ethiopia.
http://spirhr.org:8080/xmlui/handle/123456789/79
Knowledge, Attitude and Practice of Preconceptional care and associated factors among Physicians working at Saint Paul’s Hospital Millennium Medical College, Addis Ababa, Ethiopia.
Assefa, Worku
<p><strong>Background:</strong> Preconceptional care is comprehensive care given before pregnancy with the aim to reduce the incidences of both short term and long term adverse pregnancy outcomes. It is usually neglected but critical component during treatment of reproductive age women with chronic medical illness. Therefore this study aimed to explore and describe knowledge, attitude and practice of physicians on preconception care of reproductive aged women (15-49years) with chronic medical illness.</p>
<p><strong>Methods</strong>: Institutional based cross sectional study was conducted to comprise all residents and consultants from internal medicine, psychiatric and obstetrics and gynecology department of St. Paul’s Hospital Millennium Medical College through pre- tested, self-administered questionnaire. SPSS version 23 software was used for data entry and analysis. Descriptive statistic were used to report frequencies while bivariate and multivariate logistic regression analysis were used to described association between dependent and independent variables. Statistical significance was declared at P-value of 0.05.</p>
<p><strong>Results:</strong> The findings from the study showed among 272 respondents, 30.9% had poor practice despite of 85.7% of the respondent have good knowledge and 83.1% had positive attitude.<strong> </strong>Having prior training on PCC (AOR=3.3; 95% CI = (1.08-10.6); p=0.036) and having prior exposure to PCC guideline or protocol (AOR=8.1; 95% CI = (2.3-28); p=0.001) had significant association with physicians level of knowledge on PCC. It also showed that having prior training on PCC (AOR=8.6; 95% CI = (2.5-30); p=0.001) significantly affected the level of attitude within the group. There was no association between physicians’ level of PCC practice and variables like working department, level of profession, work experience, having prior PCC training and having prior exposure to PCC guideline or protocol.</p> <strong>Conclusion</strong>: This study reveled that physician’s practice of preconceptional care is low despite of having good knowledge and positive attitude about preconceptional care. The hospital administration and respective departments should facilitate on establishing of preconception care clinic and work together on strengthening multidisciplinary approach. The need for creating community awareness about preconception care, preparing of preconceptional guideline and provision of practical training (simulation) for physicians is also highly important for improving preconceptional care practice.
2021-08-01T00:00:00Z