Proportion and Associated Factors of Nonreassuring Fetal Heart Rate Patterns in Finote Selam Primary Hospital, North West Ethiopia.

INTRODUCTION: Nonreassuring fetal heart rate patterns (NRFHRP) suggest fetal conciliation or a deteriorating ability to handle the stress of labor. Nearly half of stillbirths occurring worldwide are due to hypoxia which is primarily manifested by NRFHRP. Hence, this study assessed the proportion and associated factors of NRFHRP in the Finote Selam primary hospital, North West Ethiopia. METHODS: An institution-based retrospective cross-sectional study was conducted from March 1 to April 1, 2019, on 364 charts of mothers who gave birth from January 2017 to January 2018 at the Finote Selam primary hospital. A computer-based simple random sampling technique was used to select charts. A secondary data was collected using a structured questionnaire adapted from different literatures. The data was entered and analyzed using Epi Info version 7 and Statistical Package for the Social Sciences (SPSS) version 23.0. Binary logistic regression was executed, and all explanatory variables with p value < 0.2 were entered into multivariable logistic regressions. Multivariable logistic regression was used to control the effect of confounding variables and to identify factors affecting NRFHRP. Odds ratios with 95% confidence intervals were computed, and statistical significance was declared if p < 0.05. RESULT: Out of 364 total deliveries, NRFHRP was detected on 55 (15.1%) fetuses, and the commonest NRFHRP detected was bradycardia 44 (80%). Most NRFHRP (38.18%) occurred on the deceleration phase of labor. There was no identified possible cause for NRFHRP on 34.5% of cases. Referral from nearby health institutions [AOR = 2.832 (95% CI 1.457, 5.503)], primigravida [AOR = 2.722 (95% CI 1.377, 5.381)], augmentation of labor [AOR = 3.664 (95% CI 1.782, 7.534)], and meconium-stained amniotic fluid [AOR = 6.491 (95% CI 3.198, 13.173)] were significantly associated with NRFHRP. CONCLUSION: The proportion of NRFHRP is high. Referral from nearby health institutions, primigravida mothers, augmentation of labor, and meconium-stained amniotic fluid were significantly associated with NRFHRP. Implementing a better referral link and close monitoring during follow-up could minimize NHFHRP.

Factors Associated with Episiotomy Practices in Bahirdar City, Ethiopia: A Cross-Sectional Study.

BACKGROUND: Episiotomy is the surgical enlargement of the vaginal orifice during the last part of the second stage of labor or childbirth by an incision to the perineum. The World Health Organization advises the use of episiotomy on a restricted and selective basis. Indeed, the rate of episiotomy in developed countries is decreasing, but in developing countries, including Ethiopia, it still remains high. Therefore, this study tried to assess the proportion and factors associated with episiotomy among women who gave birth at Felege Hiwot Referral Hospital, Bahir Dar City, North West Ethiopia, 2017. METHODS: An institution-based cross-sectional study was conducted among 411 mothers from February to April 2017. Data were collected through face-to-face interviews and supported by observation using standard checklist with systematic random sampling technique. Data was entered by Epi Info and analyzed by SPSS version 23. The association between variables was analyzed using bivariable and multivariable logistic regression model. P-value <0.05 at 95% CI was considered to be statistically significant. RESULTS: The proportion of episiotomy was 41.1% with 95% CI (36.5%, 46.2%). Multivariable logistic regression showed that primiparity (AOR=6.026, 95% CI (3.542,10.253)), prolonged second stage of labor (AOR=4.612, 95% CI (2.247,9.465)), instrument delivery (AOR =3.933, 95% CI (1.526,10.141)), using oxytocin (AOR=2.608, 95% CI (1.431,4.751)), medical resident attendant (AOR =3.225, 95% CI (1.409,7.382)) and birth weight ≥4000 grams (AOR=5.127,95% Cl (1.106,23.772)) were significantly associated with episiotomy practice. CONCLUSION: The proportion of episiotomy was high. Parity, using oxytocin, second-stage labor duration, instrument delivery, birth weight, and delivery attendant were statistically significant factors for episiotomy practice. Therefore, as per our findings, we suggest awareness creation, and the setting and use of new national guidelines, the practice of routine episiotomy should be abandoned, and selective and restrictive use of episiotomy is highly advised.