Obstetrics and Gynecology

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Browsing Obstetrics and Gynecology by Author "Ahmed Abdella"

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    Prevalence and Associated Factors of Postural Puncture Headache After Spinal Anesthesia for Cesarean Section at Three Teaching Hospitals in Addis Ababa, Ethiopia; 2024/25 G.C
    (Addis Ababa University, 2025) Tadiwos Mekonnen; Ahmed Abdella
    Background: - Post-Dural puncture headache (PDPH) is one of the major complications of spinal anesthesia. It occurs in 32% of patients carrying a considerable morbidity. Also, the associated symptoms last for several days, at times severe enough to impair patient’s quality of life. Several risk factors contribute for the development of post-Dural puncture headache which varies with characteristics of individual patients, the type of spinal needle and the technique or approach used. Objective: - To assess the prevalence and associated factors of post-Dural puncture headache after spinal anesthesia for caesarean section at three teaching hospital in Addis Ababa, Ethiopia. Method: - An institution based cross-sectional study was conducted at 3 teaching hospitals of Addis Ababa university. Consecutive sampling technique was used to include 904 study participants of post-operative women during the study periods of December 15, 2024 G.C. – May 31, 2025 G.C. The data were coded, entered, and analysed by using SPSS version 25. Descriptive statistics were used to describe the study variables. Logistic regression analysis was used to assess associated factors of post-Dural puncture headache. A p-value of < 0.05 was considered statistically significant. Results: PDPH was observed in 38.4% of patients (n=347), with the majority reporting a mild headache (76.9%). Most headaches developed within the first 1–2 days post-procedure (72.3%). Associated symptoms included neck stiffness (85.9%) and tinnitus (38.3%). Significant risk factors identified included age ≥35 years (AOR: 2.7), ASA class III status (AOR: 1.9), previous spinal anesthesia (AOR: 3.1), high gravidity (≥5), and emergency cesarean section (AOR: 2.7). Technical factors such as increased number of cerebrospinal fluid drops (AOR for three drops: 3.3) and multiple puncture attempts (AOR for three attempts: 31.6) greatly increased PDPH risk. Procedures performed by residents and anesthesiologists were also associated with higher PDPH incidence. Conclusion: More than one-third of the study participants developed post-Dural puncture headache (PDPH) following spinal anesthesia. Younger age, previous PDPH, higher gravidity, emergency cesarean section, multiple cerebrospinal fluid drops, repeated puncture attempts, and anesthesia administered by less experienced providers were independently associated with increased risk.
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    Success rate, Maternal and Perinatal outcome, and Associated factors of induction for Prelabour rupture of membrane in three teaching hospitals.
    (Addis Ababa Uinverstiy, 2025) Samson Kehali; Ahmed Abdella; Salih Hassen
    Prelabour rupture of membranes refers to the loss of integrity of fetal membranes prior to the onset of clinically apparent labour contractions. The major issue in managing a woman with PROM at term is whether to follow her expectantly or proceed for delivery. Among the factors to consider are possibility of failed induction, caesarean delivery, length of labour, cost, length of hospitalization and risk of maternal and neonatal complications. Objective: the objective of the study is to assess the success rate, maternal and perinatal outcomes, and factors affecting of induction for prelabour rupture of membrane in the three teaching Hospitals of Addis Ababa University. Methods: Facility based cross-sectional study was employed in the three affiliate teaching hospitals of Addis Ababa University. The study subjects were recruited sequentially until the calculated sample size of 374 is achieved. The data were collected by interview & reviewing participants‘ clinical records. The data were entered, clearing and analysis by SPSS version 25. Logistic regression analyses were employed to identify factors associated with the outcome variable. Using 95% CI, variables with a p-value <0.05 were identified as statistically significant factors. Result: Sixty seven percent (n= 250) of 374 participants with PROM had a successful induction of labor. Multiparity (Odd‘s ratio= 14.0, 95% CI: 3.78, 52.16), term PROM (Odd‘s ratio= 4.9, 95% CI: 1.04, 23.29), and absence of intrapartum complications (Odd‘s ratio= 15.0, 95% CI: 13.37, 65.13) were significantly associated with higher odds of successful induction. Maternal complications occurred in 6.4% (n= 24) of participants, mainly postpartum hemorrhage (n= 21, 5.6%) and surgical site infection (n= 3, 0.8%). Poor perinatal outcomes were observed in 18% (n= 67) of neonates, with 16% (n= 59) requiring NICU admission and a neonatal mortality of 2.7% (n= 10). Multiparous women had a better perinatal outcomes (Odd‘s ratio= 0.39, 95% CI: 0.17, 0.92), while hypertensive disorders (Odd‘s ratio= 13.4, 95% CI: 1.03, 44.92) and non-spontaneous deliveries, OVD (Odd‘s ratio= 28.2, 95% CI: 2.73, 91.31) and CS (Odd‘s ratio= 6.2, 95% CI: 2.58, 14.96) significantly increased the risk. Conclusion and recommendation: The success of induction was good, and is comparable to the findings of studies done in other centers. Multiparity, term PROM, and absence of intrapartum complications were associated with successful induction. Strengthen antenatal risk assessment to identify women at higher risk for poor outcomes; those with hypertensive disorders and primigravidity is important to improve the outcome.