Obstetrics and Gynecology

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Browsing Obstetrics and Gynecology by Author "Abera Bedada"

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    Clinicopathologic Characteristics, Management Out Come and its Associated Factors Among Patients Managed with Uterine Cancer in Tikur Anbessa Specialized Hospital: Addis Ababa Ethiopia: A Retrospective Cohort Study
    (Addis Ababa University, 2024-08-11) Esubalew Berihun; Esayas Birhanu; Abera Bedada
    Background: -: Most cases of endometrial cancer are found at early stage and have a good outcome overall. But about one-third of patients had a diagnosis of advanced disease. Patients who report with advanced stage or aggressive histologic subtypes have a higher rate of recurrence and, consequently, lower survival times, despite favorable outcomes in early-stage cancer. Over the last 20 years, the number of deaths from EC has climbed by more than 100%, with type II EC accounting for up to 40% of cases. The type of treatment was linked to a 36% lower chance of mortality or relapse. Since there is no studies that evaluate the treatment outcome of uterine cancer in our country this study was conducted. Objective: -To assess Clinicopathologic characteristics, management outcome and its associated factors among patients with uterine cancer treated at Tikur Anbessa specialized Hospital: A five years retrospective cohort study, 2024. Method; - Facility based retrospective cohort study design was conducted. Using a 2 months study period a five years data was recruited. 128 uterine cancer cases managed at TASH from Jan 1st 2015 to Dec 30th 2019 were involved. Data was gathered through the perusal of patient charts. Collected data was checked for completeness, consistency, clarity, and missed values and was entered into SPSS version 25 for data management and further statistical analysis. The clinicopathologic characteristic were described using symptoms, signs, and pathological findings related to a specific disease or condition. The management outcome was measured using logistic regression.. 95% confidence intervals were used to correlate the outcome variable with its independent variable. The threshold for statistical significance was established at p-value < 0.05 for all tests. Result: - In this study 128 charts were reviewed and out of this 59(46.1%) of the study participants were in the age group 51-65 years with a mean and SD of 55.5±9.3 years respectively. 117(91.4%) of the participants were menopause and 64(50%) of the participants had presenting signs and symptoms of vaginal bleeding only and 37(28.9%) had vaginal bleeding and discharge. 53(41.4%) of the study participants had a symptom of 6-12 months duration and 19(14.8%) of the participants had ascites based on imaging. The study found that great majority (87.5%) of uterine cancer cases were endometrial cancer, and the rest is smooth muscle and mesenchymal cancer. The average age at diagnosis was 56 and 54 respectively. Metastasis occurred in 20.3% of cases, predominantly in the peritoneum (19.2%). Recurrent metastases were observed in 33 patients, with 57.6% having both distant and local metastases. During the final follow up from 128 cancer cases 22% were were died. The determinant factor of patient death at last hospital follow up outcome were age of >60 years (AOR=1.3, 95%CI=1.11, 16.37), having metastasis (AOR=3.1, 95%CI=1.21, 7.69), tumor size of >2cm (AOR=1.4, 95%CI=1.18, 10.33) and provisional FIGO stage IV (AOR=16.3, 95%CI=1.23, 32.45). Conclusion and recommendation- The study found that great majority (87.5%) of uterine cancer cases were endometrial cancer, and the average age at diagnosis was 56 and 54 respectively. Recurrent metastases were observed in 33 patients, with 57.6% having both distant and local metastases. During the final follow up from 128 cancer cases 22% were were died.Old age, metastasis, increasing tumor size and increasing the stage of disease are statistically significant factor for the death of the study participants. Further study is needed to address the final outcome of patients.
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    Magnitude of long-acting reversible contraceptive use and associated factors after elective Cesarean delivery at three teaching hospitals of Addis Ababa: A cross sectional hospital-based study 2025.
    (Addis Ababa University, 2025) Adugnaw Getachew; Abera Bedada; Ashebir Getachew
    Background: - Cesarean Section (CS) deliveries are becoming increasingly common worldwide, and women who deliver via CS may have unique contraceptive needs and preferences. The immediate postpartum period, particularly during the period of hospital stay following an elective CS, presents a valuable opportunity to counsel and initiate long-acting reversible contraception. Objective: To evaluate the use and utilization of immediate postpartum long-acting reversible contraceptive methods and associated factors among pregnant women who gave birth by elective CS in the three teaching hospitals of Addis Ababa. Methods: A facility-based cross-sectional study design was conducted, and 422 post-elective CS-delivered women were planned by a systematic random sampling method from those delivered by elective cesarean section. Data were collected using a structured questionnaire and entered and analyzed by SPSS version 25 for further analysis. The impact for the uptake of LARC was measured by logistic regression. Those variables having a 𝑃-value < 0.25 in the bivariate logistic analysis were entered into the multivariate logistic regression model to identify the association of independent variables with the outcome variable. In the multivariable analysis, a 𝑃 value of < 0.05 was used to declare the statistical significance, and AOR with 95% CI was calculated to determine association. Results: - Only 22.9% of participants were using immediate postpartum LARCs. Among users (n=95), Implanon was the most common method (64.2%), followed by IUCDs (20%) and Jadelle (15.8%). Multivariate analysis showed that women residing in rural areas were 3.8 times more likely to use LARCs compared to those in urban areas (AOR = 3.8, 95% CI: 1.88–16.57). Women with a college education or higher had 3.1 times higher odds of LARC use compared to those who were illiterate (AOR = 3.1, 95% CI: 1.41–23.56). Additionally, larger family size (>4 members) (AOR = 6.3), grand multiparty (AOR = 8.8), being the main decision-maker for contraception (AOR = 9.6), and having a favorable attitude toward LARCs (AOR = 20.2) were all significantly associated with increased postpartum LARC use. Conclusion: The utilization of immediate postpartum LARCs was low despite their proven benefits. Strengthening education, male involvement, counseling services, and addressing misconceptions are critical to improving postpartum LARC uptake