International Journal of Gynecology & Obstetrics
SynopsisPerinatal morality due to umbilical cord prolapse found in our study is comparable to tha... more SynopsisPerinatal morality due to umbilical cord prolapse found in our study is comparable to that in high‐income settings.
BACKGROUND: The World Health Organization (WHO) Safe Childbirth Checklist (SCC) is a 29-item chec... more BACKGROUND: The World Health Organization (WHO) Safe Childbirth Checklist (SCC) is a 29-item checklist designed to address the primary cause of maternal death, intrapartum stillbirth, and early neonatal death. The objective of this review was to locate literature reporting on the effect of utilizing the WHO safe childbirth checklist on maternal and perinatal death. METHODS: We searched MEDLINE, google scholar, Cochrane Central Register of Controlled Trials (CENTRAL), met-Register of Controlled Trials (m-RCT) (www.controlled-trials.com), ClinicalTrials.gov (www. clinicaltrials.gov) and the WHO International Clinical Trials Registry Platform (ICTRP) (www.who.int/stop/search/ en) to retrieve all available comparative studies published in English after 2008. Two reviewers did study selection, critical appraisal, and data extraction independently. We did a random or fixed-effect meta-analysis to pool studies together and effect estimates were expressed as an odds ratio. Quality of evidence for major outcomes was assessed using the Grading of Recommendations, Assessment, development, and evaluation (GRADE). RESULTS: We retained two cluster randomized trials and three pre-and-post intervention studies reporting on WHO SCC's. The WHO SCC utilization reduced still birth (OR =0.92[95% CI 0.87-0.96]). However, the utilization of the checklist had no impact on early neonatal death (OR=1.07[95%CI [1.01-1.13]) and maternal death (OR =1.06[95% CI 0.77-1.45]). CONCLUSION: WHO SCC was effective in reducing stillbirth. Moderate quality of evidence indicates that WHO SCC reduce stillbirth, whereas low and very low quality of evidence suggests that WHO SCC has no impact on maternal and early neonatal death, respectively. A lot of things might contribute to perinatal and maternal death. Therefore, it is imperative to contextually modify the checklist (WHO safe childbirth checklist) to address major events contributing to intrapartum maternal death, still birth and early neonatal death.
Background: Provider-patient miscommunication in the health care setting can have fatal consequen... more Background: Provider-patient miscommunication in the health care setting can have fatal consequences. It is especially a common occurrence in multilingual countries like Ethiopia. Yet, providers in such settings tend to rely on untrained ad hoc interpreters with no systemic solution in place designed to solve the problem. Our quality improvement project aims to evaluate one such intervention deployed in a high-volume tertiary hospital, Saint Paul's Hospital Millennium Medical College (SPHMMC). Method: A baseline assessment was conducted to assess the language mix of patients presenting to the hospital. Medical Afaan Oromoo (MAO) project was then designed to teach Afaan Oromoo to health care professionals in a 3-month period. The effectiveness of the project was evaluated with standardized pre and post training assessment tools. Findings: The baseline assessment showed the majority of patients seeking care at the hospital speak Afaan Oromoo (56.1%). And more than half of these patients (55.4%) were unable to speak Amharic (the working language). Only 8.9% of health care providers were able to communicate with Afaan Oromoo. The language training project was able to improve language proficiency from a baseline of Interagency Language Roundtable (ILR) scale level 0 to level 2 in 96% of trainees. Conclusion: There was a substantial discrepancy in self-reported Afaan Oromoo language communication ability between providers and patients at the hospital. Although the language training program brought about a significant change in language proficiency (Level 0 to 2 in 96% of trainees), further research is needed to ascertain its impact in actual Afaan Oromoo language incongruous clinical setting.
ABSTRACTINTRODUCTION: Perinatal Mortality is a sensitive indicator of the quality of service prov... more ABSTRACTINTRODUCTION: Perinatal Mortality is a sensitive indicator of the quality of service provided to pregnantwomen and their newborns. Although data is lacking from community studies, hospital log books can help toget useful information. Some of the risk factors for PNM are avoidable if they are known with carefully controlledstudies.OBJECTIVE: To assess determinants of perinatal mortality Gandhi Memorial Hospital and determine theprobable causes of death.METHODS: This study was done in 2011. The study design was unmatched case control study to compare themultiple risk factors between perinatal deaths and their sampled live birth controls in Gandhi Memorial Hospital.The sample size for cases was 220 while for controls 440.RESULT: In this study PNM was found to be 50.8/1000 live births. Preterm delivery was 35%, LBW was 45%and Malpresentation 24.6% among cases and these were significantly higher than the controls. Maternal bookingstatus, malpresentation, vaginal route delivery, prematurity and LBW were important determinants of PNM.Most of the deaths didn’t have explainable cause of death. Of the known causes congenital malformation andmechanical cause are the most common. Parity and multiple gestations were not found to be predictors of perinataldeaths.CONCLUSION& RECOMMENDATIONS: LBW and preterm deliveries were important determinants ofPNM. Thus the delivery unit in the hospital should make improvements in the neonatal care services. Improveddocumentation of obstetric information is important to reduce the number of unexplained causes of death. ImprovedANC and intrapartum care can play important role to reduce PNM in Gandhi memorial hospital(GMH.)KEY WORDS: Perinatal mortality, Gandhi memorial Hospital, Ethiopia, Determinants(Ethiopian Journal of Reproductive Health 2016; 8:20--29)
Ethiopian Journal of Reproductive Health, Feb 15, 2018
Abstract Background: Perinatal mortality of a country is often used as a measure of the adequacy ... more Abstract Background: Perinatal mortality of a country is often used as a measure of the adequacy of obstetric and neonatal services. Several classification systems have been in use with their own advantages and disadvantages. Studies have reported Wigglesworth classification to be simple and reproducible. There are no reports regarding its use and feasibility in Ethiopia. Objective: The aim of this study was to review perinatal deaths at Saint Paul’s hospital millennium medical college and see the feasibility of Wigglesworth classification. Methods: A one-year review of perinatal deaths at Saint Paul’s Hospital millennium medical college from January 2014 to December 2014 was conducted. The deaths were analyzed using Wigglesworth classification. Result: Perinatal mortality rate was found to be 70.1/1000 live births. Majority of the perinatal mortality were still births (72%). According to Wigglesworth classification of the perinatal deaths 47% were Macerated still births, 25.7% perinatal asphyxia. Other causes mortality was; lethal congenital malformations (10%), prematurity (10.7%) and septicemia (5.7%) were mortality. Wigglesworth classification was found to be feasible at SPHMMC. Conclusion Macerated stillbirths and perinatal mortality were leading causes of perinatal mortality at SPHMMC. Wigglesworth classification is a simple and feasible system to be applied in Ethiopian hospitals. Key words: Perinatal mortality, Wigglesworth classification, Ethiopia (Ethiopian Journal of Reproductive Health 2018;10:49-55)
In the last three to four decades, the increasing caesarean delivery rate has contributed to seve... more In the last three to four decades, the increasing caesarean delivery rate has contributed to several fold increment in the incidence of placenta accreta spectrum disorders globally. Placenta accreta spectrum with its subtypes (accreta, increta and percreta) is one of the devastating obstetric complications. As a result, it is the commonest indication for peripartum hysterectomy and common cause of severe maternal morbidity. However, in recent years, there is a growing interest in and practice of expectant management either to minimize emergency hysterectomy related maternal complications or to preserve the fertility potential of a woman with an intact uterus. A large body of observational research findings has demonstrated the success rate of expectant management in many of well selected cases. Similarly, the experience on delayed hysterectomy was encouraging in order to have less hemorrhage. For the best success of placenta accreta spectrum management, multidisciplinary team approach, antenatal diagnosis and managing such cases in a hospital with center of excellence has been strongly recommended. This literature review provides a robust synthesis of up-to-date knowledge and practice on the challenges and successes of placenta accreta spectrum disorders management. The currently practiced management options in the high and middle income countries are also summarized under seven categories. Therefore, the purpose of this review was to shed light on the applicability of the PAS disorder management modalities in our setup.
International Journal of Gynecology & Obstetrics
ObjectiveTo determine the predictors of adverse maternal and perinatal outcomes among parturients... more ObjectiveTo determine the predictors of adverse maternal and perinatal outcomes among parturients with prolonged second stage of labor.MethodsThis study is a cross‐sectional study of women with prolonged second stage of labor from January 1 to June 30, 2021, in four tertiary hospitals in Ethiopia. Data were collected prospectively using a structured questionnaire. Descriptive statistics were used to analyze baseline characteristics. Bivariate and multivariate logistic regression analyses were applied to determine predictors of adverse maternal and perinatal outcomes.ResultsA total of 406 women were included in the study. More than half (25/46, 54%) of the women with a prolonged second stage of 4 h or longer had vaginal delivery, which was lower than the 73% (140/190) of women who had a second stage of 2–3 h and the 63.4% (64/101) of women with a second stage duration of 3–4 h. Duration of second stage of labor was not a predictor of composite adverse maternal outcomes nor was it a p...
Background Provider-patient miscommunication in the health care setting can have fatal consequenc... more Background Provider-patient miscommunication in the health care setting can have fatal consequences. Our quality improvement project aims to evaluate an intervention deployed to overcome patient provider language barrier at Saint Paul’s Hospital Millennium Medical College (SPHMMC).Method A baseline assessment was conducted to assess the language mix of patients presenting to the hospital. Medical Afaan Oromoo (MAO) project was then designed to teach Afaan Oromoo to health care professionals in a 3-month period. The effectiveness of the project was evaluated with standardized pre and post training assessment tools.Results Most patients seeking care at the hospital speak Afaan Oromoo (56%), while only 8.9% of health care providers were able to communicate in Afaan Oromoo. The language training project was able to improve language proficiency from a baseline of Interagency Language Roundtable (ILR) scale Level 0 to Level 2 in 96% of trainees. Conclusions The tailored language training ...
Ethiopian Journal of Reproductive Health, Apr 30, 2021
BACKGROUND: The World Health Organization (WHO) Safe Childbirth Checklist (SCC) is a 29-item chec... more BACKGROUND: The World Health Organization (WHO) Safe Childbirth Checklist (SCC) is a 29-item checklist designed to address the primary cause of maternal death, intrapartum stillbirth, and early neonatal death. The objective of this review was to locate literature reporting on the effect of utilizing the WHO safe childbirth checklist on maternal and perinatal death. METHODS: We searched MEDLINE, google scholar, Cochrane Central Register of Controlled Trials (CENTRAL), met-Register of Controlled Trials (m-RCT) (www.controlled-trials.com), ClinicalTrials.gov (www. clinicaltrials.gov) and the WHO International Clinical Trials Registry Platform (ICTRP) (www.who.int/stop/search/ en) to retrieve all available comparative studies published in English after 2008. Two reviewers did study selection, critical appraisal, and data extraction independently. We did a random or fixed-effect meta-analysis to pool studies together and effect estimates were expressed as an odds ratio. Quality of evidence for major outcomes was assessed using the Grading of Recommendations, Assessment, development, and evaluation (GRADE). RESULTS: We retained two cluster randomized trials and three pre-and-post intervention studies reporting on WHO SCC's. The WHO SCC utilization reduced still birth (OR =0.92[95% CI 0.87-0.96]). However, the utilization of the checklist had no impact on early neonatal death (OR=1.07[95%CI [1.01-1.13]) and maternal death (OR =1.06[95% CI 0.77-1.45]). CONCLUSION: WHO SCC was effective in reducing stillbirth. Moderate quality of evidence indicates that WHO SCC reduce stillbirth, whereas low and very low quality of evidence suggests that WHO SCC has no impact on maternal and early neonatal death, respectively. A lot of things might contribute to perinatal and maternal death. Therefore, it is imperative to contextually modify the checklist (WHO safe childbirth checklist) to address major events contributing to intrapartum maternal death, still birth and early neonatal death.
ABSTRACTINTRODUCTION: Perinatal Mortality is a sensitive indicator of the quality of service prov... more ABSTRACTINTRODUCTION: Perinatal Mortality is a sensitive indicator of the quality of service provided to pregnantwomen and their newborns. Although data is lacking from community studies, hospital log books can help toget useful information. Some of the risk factors for PNM are avoidable if they are known with carefully controlledstudies.OBJECTIVE: To assess determinants of perinatal mortality Gandhi Memorial Hospital and determine theprobable causes of death.METHODS: This study was done in 2011. The study design was unmatched case control study to compare themultiple risk factors between perinatal deaths and their sampled live birth controls in Gandhi Memorial Hospital.The sample size for cases was 220 while for controls 440.RESULT: In this study PNM was found to be 50.8/1000 live births. Preterm delivery was 35%, LBW was 45%and Malpresentation 24.6% among cases and these were significantly higher than the controls. Maternal bookingstatus, malpresentation, vaginal route delivery, p...
Background: Perinatal mortality of a country is often used as a measure of the adequacy of obstet... more Background: Perinatal mortality of a country is often used as a measure of the adequacy of obstetric and neonatal services. Several classification systems have been in use with their own advantages and disadvantages. Studies have reported Wigglesworth classification to be simple and reproducible. There are no reports regarding its use and feasibility in Ethiopia. Objective: The aim of this study was to review perinatal deaths at Saint Paul’s hospital millennium medical college and see the feasibility of Wigglesworth classification. Methods: A one-year review of perinatal deaths at Saint Paul’s Hospital millennium medical college from January 2014 to December 2014 was conducted. The deaths were analyzed using Wigglesworth classification. Result: Perinatal mortality rate was found to be 70.1/1000 live births. Majority of the perinatal mortality were still births (72%). According to Wigglesworth classification of the perinatal deaths 47% were Macerated still births, 25.7% perinatal asp...
Background: External cephalic version (ECV), which is now routinely offered in developed countrie... more Background: External cephalic version (ECV), which is now routinely offered in developed countries, is not a popular procedure in the developing regions, such as Sub-Saharan Africa (9). There is also scarce data on success rate of ECV from this developing region of Africa. The aim of this study was to determine the success rate of ECV and it’s associated factors in an Ethiopian setting.Methods: A total of 152 ECVs performed at the St. Paul’s Hospital Millennium Medical College, Addis Ababa, Ethiopia from June 1, 2018 up to March 30, 2019 were analyzed, using a cross-sectional study design. Patients with breech presentation were recruited at 36 weeks of gestation or more during antenatal consultations and ECV procedures were provided by Maternal-Fetal-Medicine (MFM) specialist or MFM fellow at Ultrasound room. Data was analyzed using SPSS version 21. Chi-square test of association was done for categorical data analysis. Multivariate logistic regression analysis was used to determine ...
Introduction: During pandemics there is uncertainty and information overload. Policy makers and h... more Introduction: During pandemics there is uncertainty and information overload. Policy makers and health professionals prefer to use summarized evidence of practice recommendations. The aim of this scoping review is therefore to identify available best guidelines, consensus statements, standard of practice and practice recommendations on contraception and safe abortion care service provision during the COVID-19 pandemics.Methods: We searched guideline databases and websites of professional associations and international organizations working on sexual and reproductive health to locate guidelines, protocols, consensus statements and practice recommendations on sexual reproductive health services (SRH) during COVID-19 pandemics. Additionally, we searched: MEDLINE, EMBASE and Google Scholar. We included English records labelled guideline, or recommendation, or consensus, or practice parameter, or position papers on contraception and safe abortion care service practice during the COVID-19...
In the last three to four decades, the increasing caesarean delivery rate has contributed to seve... more In the last three to four decades, the increasing caesarean delivery rate has contributed to several fold increment in the incidence of placenta accreta spectrum disorders globally. Placenta accreta spectrum with its subtypes (accreta, increta and percreta) is one of the devastating obstetric complications. As a result, it is the commonest indication for peripartum hysterectomy and common cause of severe maternal morbidity. However, in recent years, there is a growing interest in and practice of expectant management either to minimize emergency hysterectomy related maternal complications or to preserve the fertility potential of a woman with an intact uterus. A large body of observational research findings has demonstrated the success rate of expectant management in many of well selected cases. Similarly, the experience on delayed hysterectomy was encouraging in order to have less hemorrhage. For the best success of placenta accreta spectrum management, multidisciplinary team approa...
Obstetrics & Gynecology International Journal, 2016
Ilio-adnexal knotting is one of the rarest causes of intestinal obstruction. In fact, we have yet... more Ilio-adnexal knotting is one of the rarest causes of intestinal obstruction. In fact, we have yet to find a single paper describing the phenomenon. The commonly (common in its relative sense) described types of knottings are Ilio-Ileal, Ilio-sigmoid and Ilio-ceccal, which can cause acute abdomen and intestinal obstruction.
International Journal of Gynecology & Obstetrics
SynopsisPerinatal morality due to umbilical cord prolapse found in our study is comparable to tha... more SynopsisPerinatal morality due to umbilical cord prolapse found in our study is comparable to that in high‐income settings.
BACKGROUND: The World Health Organization (WHO) Safe Childbirth Checklist (SCC) is a 29-item chec... more BACKGROUND: The World Health Organization (WHO) Safe Childbirth Checklist (SCC) is a 29-item checklist designed to address the primary cause of maternal death, intrapartum stillbirth, and early neonatal death. The objective of this review was to locate literature reporting on the effect of utilizing the WHO safe childbirth checklist on maternal and perinatal death. METHODS: We searched MEDLINE, google scholar, Cochrane Central Register of Controlled Trials (CENTRAL), met-Register of Controlled Trials (m-RCT) (www.controlled-trials.com), ClinicalTrials.gov (www. clinicaltrials.gov) and the WHO International Clinical Trials Registry Platform (ICTRP) (www.who.int/stop/search/ en) to retrieve all available comparative studies published in English after 2008. Two reviewers did study selection, critical appraisal, and data extraction independently. We did a random or fixed-effect meta-analysis to pool studies together and effect estimates were expressed as an odds ratio. Quality of evidence for major outcomes was assessed using the Grading of Recommendations, Assessment, development, and evaluation (GRADE). RESULTS: We retained two cluster randomized trials and three pre-and-post intervention studies reporting on WHO SCC's. The WHO SCC utilization reduced still birth (OR =0.92[95% CI 0.87-0.96]). However, the utilization of the checklist had no impact on early neonatal death (OR=1.07[95%CI [1.01-1.13]) and maternal death (OR =1.06[95% CI 0.77-1.45]). CONCLUSION: WHO SCC was effective in reducing stillbirth. Moderate quality of evidence indicates that WHO SCC reduce stillbirth, whereas low and very low quality of evidence suggests that WHO SCC has no impact on maternal and early neonatal death, respectively. A lot of things might contribute to perinatal and maternal death. Therefore, it is imperative to contextually modify the checklist (WHO safe childbirth checklist) to address major events contributing to intrapartum maternal death, still birth and early neonatal death.
Background: Provider-patient miscommunication in the health care setting can have fatal consequen... more Background: Provider-patient miscommunication in the health care setting can have fatal consequences. It is especially a common occurrence in multilingual countries like Ethiopia. Yet, providers in such settings tend to rely on untrained ad hoc interpreters with no systemic solution in place designed to solve the problem. Our quality improvement project aims to evaluate one such intervention deployed in a high-volume tertiary hospital, Saint Paul's Hospital Millennium Medical College (SPHMMC). Method: A baseline assessment was conducted to assess the language mix of patients presenting to the hospital. Medical Afaan Oromoo (MAO) project was then designed to teach Afaan Oromoo to health care professionals in a 3-month period. The effectiveness of the project was evaluated with standardized pre and post training assessment tools. Findings: The baseline assessment showed the majority of patients seeking care at the hospital speak Afaan Oromoo (56.1%). And more than half of these patients (55.4%) were unable to speak Amharic (the working language). Only 8.9% of health care providers were able to communicate with Afaan Oromoo. The language training project was able to improve language proficiency from a baseline of Interagency Language Roundtable (ILR) scale level 0 to level 2 in 96% of trainees. Conclusion: There was a substantial discrepancy in self-reported Afaan Oromoo language communication ability between providers and patients at the hospital. Although the language training program brought about a significant change in language proficiency (Level 0 to 2 in 96% of trainees), further research is needed to ascertain its impact in actual Afaan Oromoo language incongruous clinical setting.
ABSTRACTINTRODUCTION: Perinatal Mortality is a sensitive indicator of the quality of service prov... more ABSTRACTINTRODUCTION: Perinatal Mortality is a sensitive indicator of the quality of service provided to pregnantwomen and their newborns. Although data is lacking from community studies, hospital log books can help toget useful information. Some of the risk factors for PNM are avoidable if they are known with carefully controlledstudies.OBJECTIVE: To assess determinants of perinatal mortality Gandhi Memorial Hospital and determine theprobable causes of death.METHODS: This study was done in 2011. The study design was unmatched case control study to compare themultiple risk factors between perinatal deaths and their sampled live birth controls in Gandhi Memorial Hospital.The sample size for cases was 220 while for controls 440.RESULT: In this study PNM was found to be 50.8/1000 live births. Preterm delivery was 35%, LBW was 45%and Malpresentation 24.6% among cases and these were significantly higher than the controls. Maternal bookingstatus, malpresentation, vaginal route delivery, prematurity and LBW were important determinants of PNM.Most of the deaths didn’t have explainable cause of death. Of the known causes congenital malformation andmechanical cause are the most common. Parity and multiple gestations were not found to be predictors of perinataldeaths.CONCLUSION& RECOMMENDATIONS: LBW and preterm deliveries were important determinants ofPNM. Thus the delivery unit in the hospital should make improvements in the neonatal care services. Improveddocumentation of obstetric information is important to reduce the number of unexplained causes of death. ImprovedANC and intrapartum care can play important role to reduce PNM in Gandhi memorial hospital(GMH.)KEY WORDS: Perinatal mortality, Gandhi memorial Hospital, Ethiopia, Determinants(Ethiopian Journal of Reproductive Health 2016; 8:20--29)
Ethiopian Journal of Reproductive Health, Feb 15, 2018
Abstract Background: Perinatal mortality of a country is often used as a measure of the adequacy ... more Abstract Background: Perinatal mortality of a country is often used as a measure of the adequacy of obstetric and neonatal services. Several classification systems have been in use with their own advantages and disadvantages. Studies have reported Wigglesworth classification to be simple and reproducible. There are no reports regarding its use and feasibility in Ethiopia. Objective: The aim of this study was to review perinatal deaths at Saint Paul’s hospital millennium medical college and see the feasibility of Wigglesworth classification. Methods: A one-year review of perinatal deaths at Saint Paul’s Hospital millennium medical college from January 2014 to December 2014 was conducted. The deaths were analyzed using Wigglesworth classification. Result: Perinatal mortality rate was found to be 70.1/1000 live births. Majority of the perinatal mortality were still births (72%). According to Wigglesworth classification of the perinatal deaths 47% were Macerated still births, 25.7% perinatal asphyxia. Other causes mortality was; lethal congenital malformations (10%), prematurity (10.7%) and septicemia (5.7%) were mortality. Wigglesworth classification was found to be feasible at SPHMMC. Conclusion Macerated stillbirths and perinatal mortality were leading causes of perinatal mortality at SPHMMC. Wigglesworth classification is a simple and feasible system to be applied in Ethiopian hospitals. Key words: Perinatal mortality, Wigglesworth classification, Ethiopia (Ethiopian Journal of Reproductive Health 2018;10:49-55)
In the last three to four decades, the increasing caesarean delivery rate has contributed to seve... more In the last three to four decades, the increasing caesarean delivery rate has contributed to several fold increment in the incidence of placenta accreta spectrum disorders globally. Placenta accreta spectrum with its subtypes (accreta, increta and percreta) is one of the devastating obstetric complications. As a result, it is the commonest indication for peripartum hysterectomy and common cause of severe maternal morbidity. However, in recent years, there is a growing interest in and practice of expectant management either to minimize emergency hysterectomy related maternal complications or to preserve the fertility potential of a woman with an intact uterus. A large body of observational research findings has demonstrated the success rate of expectant management in many of well selected cases. Similarly, the experience on delayed hysterectomy was encouraging in order to have less hemorrhage. For the best success of placenta accreta spectrum management, multidisciplinary team approach, antenatal diagnosis and managing such cases in a hospital with center of excellence has been strongly recommended. This literature review provides a robust synthesis of up-to-date knowledge and practice on the challenges and successes of placenta accreta spectrum disorders management. The currently practiced management options in the high and middle income countries are also summarized under seven categories. Therefore, the purpose of this review was to shed light on the applicability of the PAS disorder management modalities in our setup.
International Journal of Gynecology & Obstetrics
ObjectiveTo determine the predictors of adverse maternal and perinatal outcomes among parturients... more ObjectiveTo determine the predictors of adverse maternal and perinatal outcomes among parturients with prolonged second stage of labor.MethodsThis study is a cross‐sectional study of women with prolonged second stage of labor from January 1 to June 30, 2021, in four tertiary hospitals in Ethiopia. Data were collected prospectively using a structured questionnaire. Descriptive statistics were used to analyze baseline characteristics. Bivariate and multivariate logistic regression analyses were applied to determine predictors of adverse maternal and perinatal outcomes.ResultsA total of 406 women were included in the study. More than half (25/46, 54%) of the women with a prolonged second stage of 4 h or longer had vaginal delivery, which was lower than the 73% (140/190) of women who had a second stage of 2–3 h and the 63.4% (64/101) of women with a second stage duration of 3–4 h. Duration of second stage of labor was not a predictor of composite adverse maternal outcomes nor was it a p...
Background Provider-patient miscommunication in the health care setting can have fatal consequenc... more Background Provider-patient miscommunication in the health care setting can have fatal consequences. Our quality improvement project aims to evaluate an intervention deployed to overcome patient provider language barrier at Saint Paul’s Hospital Millennium Medical College (SPHMMC).Method A baseline assessment was conducted to assess the language mix of patients presenting to the hospital. Medical Afaan Oromoo (MAO) project was then designed to teach Afaan Oromoo to health care professionals in a 3-month period. The effectiveness of the project was evaluated with standardized pre and post training assessment tools.Results Most patients seeking care at the hospital speak Afaan Oromoo (56%), while only 8.9% of health care providers were able to communicate in Afaan Oromoo. The language training project was able to improve language proficiency from a baseline of Interagency Language Roundtable (ILR) scale Level 0 to Level 2 in 96% of trainees. Conclusions The tailored language training ...
Ethiopian Journal of Reproductive Health, Apr 30, 2021
BACKGROUND: The World Health Organization (WHO) Safe Childbirth Checklist (SCC) is a 29-item chec... more BACKGROUND: The World Health Organization (WHO) Safe Childbirth Checklist (SCC) is a 29-item checklist designed to address the primary cause of maternal death, intrapartum stillbirth, and early neonatal death. The objective of this review was to locate literature reporting on the effect of utilizing the WHO safe childbirth checklist on maternal and perinatal death. METHODS: We searched MEDLINE, google scholar, Cochrane Central Register of Controlled Trials (CENTRAL), met-Register of Controlled Trials (m-RCT) (www.controlled-trials.com), ClinicalTrials.gov (www. clinicaltrials.gov) and the WHO International Clinical Trials Registry Platform (ICTRP) (www.who.int/stop/search/ en) to retrieve all available comparative studies published in English after 2008. Two reviewers did study selection, critical appraisal, and data extraction independently. We did a random or fixed-effect meta-analysis to pool studies together and effect estimates were expressed as an odds ratio. Quality of evidence for major outcomes was assessed using the Grading of Recommendations, Assessment, development, and evaluation (GRADE). RESULTS: We retained two cluster randomized trials and three pre-and-post intervention studies reporting on WHO SCC's. The WHO SCC utilization reduced still birth (OR =0.92[95% CI 0.87-0.96]). However, the utilization of the checklist had no impact on early neonatal death (OR=1.07[95%CI [1.01-1.13]) and maternal death (OR =1.06[95% CI 0.77-1.45]). CONCLUSION: WHO SCC was effective in reducing stillbirth. Moderate quality of evidence indicates that WHO SCC reduce stillbirth, whereas low and very low quality of evidence suggests that WHO SCC has no impact on maternal and early neonatal death, respectively. A lot of things might contribute to perinatal and maternal death. Therefore, it is imperative to contextually modify the checklist (WHO safe childbirth checklist) to address major events contributing to intrapartum maternal death, still birth and early neonatal death.
ABSTRACTINTRODUCTION: Perinatal Mortality is a sensitive indicator of the quality of service prov... more ABSTRACTINTRODUCTION: Perinatal Mortality is a sensitive indicator of the quality of service provided to pregnantwomen and their newborns. Although data is lacking from community studies, hospital log books can help toget useful information. Some of the risk factors for PNM are avoidable if they are known with carefully controlledstudies.OBJECTIVE: To assess determinants of perinatal mortality Gandhi Memorial Hospital and determine theprobable causes of death.METHODS: This study was done in 2011. The study design was unmatched case control study to compare themultiple risk factors between perinatal deaths and their sampled live birth controls in Gandhi Memorial Hospital.The sample size for cases was 220 while for controls 440.RESULT: In this study PNM was found to be 50.8/1000 live births. Preterm delivery was 35%, LBW was 45%and Malpresentation 24.6% among cases and these were significantly higher than the controls. Maternal bookingstatus, malpresentation, vaginal route delivery, p...
Background: Perinatal mortality of a country is often used as a measure of the adequacy of obstet... more Background: Perinatal mortality of a country is often used as a measure of the adequacy of obstetric and neonatal services. Several classification systems have been in use with their own advantages and disadvantages. Studies have reported Wigglesworth classification to be simple and reproducible. There are no reports regarding its use and feasibility in Ethiopia. Objective: The aim of this study was to review perinatal deaths at Saint Paul’s hospital millennium medical college and see the feasibility of Wigglesworth classification. Methods: A one-year review of perinatal deaths at Saint Paul’s Hospital millennium medical college from January 2014 to December 2014 was conducted. The deaths were analyzed using Wigglesworth classification. Result: Perinatal mortality rate was found to be 70.1/1000 live births. Majority of the perinatal mortality were still births (72%). According to Wigglesworth classification of the perinatal deaths 47% were Macerated still births, 25.7% perinatal asp...
Background: External cephalic version (ECV), which is now routinely offered in developed countrie... more Background: External cephalic version (ECV), which is now routinely offered in developed countries, is not a popular procedure in the developing regions, such as Sub-Saharan Africa (9). There is also scarce data on success rate of ECV from this developing region of Africa. The aim of this study was to determine the success rate of ECV and it’s associated factors in an Ethiopian setting.Methods: A total of 152 ECVs performed at the St. Paul’s Hospital Millennium Medical College, Addis Ababa, Ethiopia from June 1, 2018 up to March 30, 2019 were analyzed, using a cross-sectional study design. Patients with breech presentation were recruited at 36 weeks of gestation or more during antenatal consultations and ECV procedures were provided by Maternal-Fetal-Medicine (MFM) specialist or MFM fellow at Ultrasound room. Data was analyzed using SPSS version 21. Chi-square test of association was done for categorical data analysis. Multivariate logistic regression analysis was used to determine ...
Introduction: During pandemics there is uncertainty and information overload. Policy makers and h... more Introduction: During pandemics there is uncertainty and information overload. Policy makers and health professionals prefer to use summarized evidence of practice recommendations. The aim of this scoping review is therefore to identify available best guidelines, consensus statements, standard of practice and practice recommendations on contraception and safe abortion care service provision during the COVID-19 pandemics.Methods: We searched guideline databases and websites of professional associations and international organizations working on sexual and reproductive health to locate guidelines, protocols, consensus statements and practice recommendations on sexual reproductive health services (SRH) during COVID-19 pandemics. Additionally, we searched: MEDLINE, EMBASE and Google Scholar. We included English records labelled guideline, or recommendation, or consensus, or practice parameter, or position papers on contraception and safe abortion care service practice during the COVID-19...
In the last three to four decades, the increasing caesarean delivery rate has contributed to seve... more In the last three to four decades, the increasing caesarean delivery rate has contributed to several fold increment in the incidence of placenta accreta spectrum disorders globally. Placenta accreta spectrum with its subtypes (accreta, increta and percreta) is one of the devastating obstetric complications. As a result, it is the commonest indication for peripartum hysterectomy and common cause of severe maternal morbidity. However, in recent years, there is a growing interest in and practice of expectant management either to minimize emergency hysterectomy related maternal complications or to preserve the fertility potential of a woman with an intact uterus. A large body of observational research findings has demonstrated the success rate of expectant management in many of well selected cases. Similarly, the experience on delayed hysterectomy was encouraging in order to have less hemorrhage. For the best success of placenta accreta spectrum management, multidisciplinary team approa...
Obstetrics & Gynecology International Journal, 2016
Ilio-adnexal knotting is one of the rarest causes of intestinal obstruction. In fact, we have yet... more Ilio-adnexal knotting is one of the rarest causes of intestinal obstruction. In fact, we have yet to find a single paper describing the phenomenon. The commonly (common in its relative sense) described types of knottings are Ilio-Ileal, Ilio-sigmoid and Ilio-ceccal, which can cause acute abdomen and intestinal obstruction.
Uploads
Papers by Tadesse Urgie