Determinants of Uterine Rupture and Its Management Outcomes among Mothers Who Gave Birth at Public Hospitals of Tigrai, North Ethiopia: An Unmatched Case Control Study.

INTRODUCTION: Uterine rupture is a leading cause of maternal death in Ethiopia. Despite strengthening the health care system and providing basic and comprehensive emergency obstetric care closer to the communities, uterine rupture continues to produce devastating maternal and fetal outcomes. Although risk factors of uterine rupture are context specific, there is lack of clarity in our context towards the contributing factors and untoward outcomes of uterine rupture. This study was conducted to identify the risk factors of uterine rupture and its impacts in public hospitals of Tigrai. OBJECTIVE: This study would identify determinant factors of uterine rupture and its management outcomes among mothers who gave birth in public hospitals in Tigrai region, North Ethiopia. METHOD: A retrospective hospital-based unmatched case control study design was implemented with 135 cases of women with uterine rupture and 270 controls of women without uterine rupture. Cases were enrolled consecutively from case notes of women who gave birth from 1/9/2015 to 30/6/2019, while charts (case note) of women without uterine rupture found following the cases were selected randomly and enrolled. Bivariate and multivariate logistic regression with 95% confidence interval was used to identify the determinants of uterine rupture. RESULT: Mothers referred from remote health institutions (AOR 7.29 (95% CI: 2.7, 19.68)), mothers who visited once for antenatal care (AOR 2.85 (95% CI: 1.02, 7.94)), those experiencing obstructed labor (AOR 13.33 (95% CI: 4.23, 42.05)), and birth weight of a newborn greater than four kilograms (AOR 5.68 (95% CI: 1.39, 23.2)) were significantly associated with uterine rupture. From 135 mothers who develop uterine rupture, 13 (9.6%) mothers died and 101 (74.8%) fetuses were stillborn. Obstetrical complications like abdominal hysterectomy in 75 (55.6%) of mothers and excessive blood loss in 84 (57.8%) were additional untoward outcomes of uterine rupture. CONCLUSION: Referrals from remote health institutions, once-visited antenatal care, obstructed labor, and birth weight of newborns greater than four kilograms were significant determinants of uterine rupture. Maternal death, stillbirth, hysterectomy, and hemorrhage were adverse outcomes. The findings of this study suggest early identification of factors that expose to uterine rupture during antenatal care, labor, and delivery must be attended to and further prospective studies are needed to explore predictors of untoward outcomes. Knowing the determinants of uterine rupture helps prevent the occurrence of a problem in pregnant women, which reduces maternal morbidity and mortality, and would have a tremendous help in identifying the best optional strategies in our current practices. This assertion was added to the abstract concluding session.

Utilization of the partograph and its associated factors among obstetric care providers in the Eastern zone of Tigray, Northern Ethiopia, 2017: a cross-sectional study.

INTRODUCTION: the partograph is a pre-printed paper form used in monitoring the progress labor. It was initially introduced by Philpot; and endorsed by the World Health Organization as a simple and accurate instrument for early recognition of complications of labor. Our study was conducted to evaluate the utilization of the partograph and associated factors among obstetric care providers in the Eastern zone of Tigray, Northern Ethiopia 2017. METHODS: a cross-sectional study was conducted in the Eastern zone of Tigray. Four hundred and fourteen participants were randomly selected from the Eastern zone weredas (districts). Data were collected using a self-administered questionnaire. The data were entered into epi data version 3.5 and exported to SPSS V-20 for analysis. Bivariate and multivariate analysis were done to determine the association between a dependent variable and independent variables at P-value <0.05. RESULTS: of the 406 obstetric care providers, 83% of them had utilized the partograph to monitor labor. In addition, utilization of the partograph were statistically associated with being female (AOR=2.09, 95%CI= (1.11, 3.93), age group of 20-25 (AOR=0.25, 95%CI= (0.07, 0.88), being a diplomat midwives (AOR=0.01, 95%CI= (0.00, 0.28)) and having qualified from pre-service training (AOR=0.01, 95%CI= (0.02, 0.05)). CONCLUSION: participants' utilization of the partograph was generally good. However, most of them were using it incorrectly. Age, gender, level of educational, year of qualification from pre-service training were the variables that showed association with the utilization of the partograph. The provision of on-the-job training on the partograph is recommended to improve partograph utilization.

Knowledge of neonatal danger signs and associated factors among mothers who gave birth during the last 4 months while attending immunization services in Harar town public health facilities, Ethiopia, 2017.

OBJECTIVE: The purpose of this study was to assess knowledge about neonatal danger signs and associated factors among mothers who gave birth in the last 4 months attending immunization services. RESULT: The study recruited 432 mothers to participate. A knowledge score of neonatal danger signs was found [32.9% (95% CI 28.9%, 37%)]. Mothers educated to secondary level were 4.9 times more likely to know about neonatal danger signs [(AOR = 4.9, 95% CI (1.15, 21). Similarly, mothers whose husband educated to college and above [AOR = 4.95, 95% CI (1.15, 21)], and being multipara mother [(AOR = 2.59, 95% CI (1.05, 6.6)], were factors significantly associated with good knowledge of mothers about neonatal danger signs.

Early initiation of breastfeeding and associated factors among mothers of aged less than 12 months children in rural eastern zone, Tigray, Ethiopia: cross-sectional study.

OBJECTIVES: The objectives of this study were to assess early initiation of breastfeeding and associated factors among mothers of aged less than 12 months children in the rural eastern zone, Tigray, Ethiopia. RESULTS: Totally 803 mother-child pairs were participated in this study with a response rate of 99.25%. Out of this, 787 mothers had ever breastfed their children. Four hundred eighty-seven (61.9%) mothers initiated breastfeeding within 1 h after they gave birth. Mothers having an educational status of primary education were about 2 times more likely to initiate breastfeeding within 1 h of birth [AOR: 1.99, 95% CI 1.36-2.92] and those mothers having secondary education and above were 3.23 times more likely to start breastfeeding [AOR = 3.23, 95% CI 1.99-5.26]. Mothers who had mistimed pregnancy were 58% less likely to initiate breastfeeding within 1 h of birth [AOR: 0.42, 95% CI 0.27-0.65]. On the other hand, mothers who had delivered their child vaginally were 4.6 times more likely to start early initiation of breast feeding [AOR: 4.59, 95% CI 1.99-10.56].

Assessment of wasting and associated factors among under five children of Wukro town, Tigray regional, North Ethiopia: a cross sectional study.

INTRODUCTION: Globally, 50 million children under 5 were wasted; of which 16 million were severely wasted. A severely wasted child is at a nine times higher risk of dying. To prevent this problem, it is necessary to determine the magnitude and factors associated with childhood wasting. In Ethiopia specifically Wukro town, Tigray regional state there is no clear information regarding under five wasting. Therefore, the study assessed the prevalence and associated factors of wasting among under five children in Wukro town, North Ethiopia. Objective: to assess the prevalence of wasting and associated factors among under five children of Wukro town, Tigray, North Ethiopia, 2017/2018. METHODS: Community based cross-sectional study design with a single population proportion formula was used with a total sample size of 400 children. Wukro town has three kebele, two kebelle were included in the study through simple random sampling method. There was proportional allocation of subjects to each kebelle and final study subject was selected using systematic method. In case there were more than one child in the household one child was selected randomly. The data were collected by face to face interview and measuring of weight and height after the instrument was pre-tested. The anthropometric results were entered in to Emergency nutritional assessment (ENA) to calculate Z-Score. The collected data and result of Z-score were entered in to Statistical package for social science (SPSS) version 20. Finally, results were presented in texts, graphs and tables. RESULTS: A total of 394 under five children were participated in this study, which gave a response rate of 98.5%. The respondents were females 222 (56.3%) and 106(26.95%) were in the age group of 12-23 month. The overall prevalence of wasting was 28 (7.2%). Out of this 14 (3.6%) were wasted and 14 (3.6%) were severely wasted. Under five children those, whose family does not live together were 3.086 times more likely to be wasted compared to under five children those, whose family live together (P=.038, OR=3.086, & 95% CI= (1.061, 8.970). Under five children those, whose mother did not taken family planning were 2.530 times more likely to be wasted compared to under five children those, whose mother take family planning (P=.038, OR=2.530, & 95% CI= (1.054, 6.074)). CONCLUSION: Significant numbers of mothers were not taken extra food during pregnancy and lactation. There was significant prevalence of wasting of under five children in the study area. Living condition of family and usage of family planning were associated with increased risk of wasting.