Obstetrics and Gynecology

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Age at Onset of Natural Menopause and Associated Factors in Women, Addis Ababa, Ethiopia
(Addis Ababa University, 2024-04-29) Belay Betemariam; Eyasu Mesfin
Background: Menopause is defined as 12-month of amenorrhea after the final menstruation. It is the permanent cessation of menstruation. During menopausal period most women experience hot flashes, sleep disorders, sweating, vaginal atrophy and related sexual dysfunctions which all affect woman’s health. Symptoms and relating it to menopause may not be known and most feel embarrassed to draw attention for support and worsen in developing countries. They are at increased risk of developing cardiovascular diseases and osteoporosis in early menopause and breast, endometrial and ovarian cancers in late menopause, respectively. They are also crucial for family well-being in terms of social aspects of life, particularly in Africa. Objectives: The aim of the study was to know the timing of menopause and prevalence of associated symptoms and explore the existing gap of postmenopausal women health needs. Methods: A cross-sectional study was conducted from February to March 2024. Data was collected using pretested standardized questionnaire of menopausal women from four Hospitals in Addis Ababa. Patient visitors and attendants at the four Hospitals age 30 to 60 yrs who fulfill the inclusion criteria were included in the study. Data was analyzed using SPSS version 20. Result: Data was collected from 408 participants who fulfill the eligibility criteria. The mean age of participants was 51.78 ± 5.43 years. The mean age of menopause was 45.05 (±4.65) years. Premature menopause was reported in 10.0% of them. Only 1.5% had late menopause (≥55 yrs) while 47.3% (193) had menopause at ages 45-49 years and 12.5% at age of 50-54 years. Hot flush was the commonest peri-menoausal symptom experienced by almost half, 202 (49.5 %), of the participants. Night sweating 199 (48.8%), mood change 147 (36.0%), history of perimenoausal weight gain 158 (38.7%) and sleep disturbance 128(31.4%) were among the symptoms reported by participants. Although only 56 (27.7%) of those with hot flush were treated all improved after treatment. In the majority of the symptomatic cases only less than one third of cases were seeking treatment from health provider. Multiparity and implant use were significantly associated with age at menopause. Multiparity was associated with 3.4 times iii higher odds of age of menopause of ≥ 45 yrs (AOR= 3.4, 95%CI=1.138-9.796) and also Previous implant contraceptive use (AOR= 2.05, 95%CI=1.033-4.058). Conclusion: The mean age of menopause in our study was 45.05 years. The prevalence of pre mature menopause in the current study was 10.0% which is higher than prior reports. Hot flush was thecommonestmenopausal symptom. Only less than a third of women who had menopausal symptoms sought care from a health provider.Thispotentially is duetolackof knowledge on availability of treatment for menopausal symptoms. Parity and use of Implants D were significantly associated with age at menopause of ≥ 45yrs. Recommendation: Awareness creation on menopause in the populationshould be done to increase their health seeking behavior. Large population based studies are recommended to better identify factors associated with lower mean age at menopause and high prevalence of premature menopause in our set up.
Assessment of Comprehensive Postnatal Care Service Utilization and Associated Factors during Discharge at Three Teaching Hospitals, Addis Ababa, Ethiopia:A Cross Sectional Study,2021.
(Addis Abeba University, 2021-10) Basha Ferhia; Abdella Ahmed ; Fantahun Yitbarek
Background – Comprehensive postnatal care (CPNC) includes full assessment of physical,social and psychological well-being determining the health and survival of the mother and her newborn. Ethiopia is one of the low income countries with high maternal and neonatal mortality and morbidity and low utilization of postnatal care (PNC) services. The inconsistent transition from inpatient to outpatient may end up in missed opportunities to counsel on various healthy behaviors and behaviors with long term health risks and manage postpartum problems early to prevent presenting late with severe complications and even death of the mother and her newborn. Objectives - Assessing CPNC service utilization and associated factors among postpartum women during discharge at 3 teaching hospitals to identify gaps and recommend areas for actions to be undertaken to improve quality of care. Methods - An institution based cross-sectional study was conducted in three teaching hospitals in Addis Ababa, Ethiopia. Medical records and pretested structured questionnaire for interviewing postpartum mothers were used to collect data and convenience sampling method was used to select among postpartum mothers at three teaching hospitals. The collected data was entered and analyzed by Statistical package for social sciences (SPSS) version 25. Results – The study participants were 398. The overall comprehensive postnatal care utilization of all components was 0. Factors that affect comprehensive postnatal care utilization were educational level, ANC, time of information about comprehensive post-natal care utilization,mode of delivery and length of hospital stay. Those who delivered via CD had twice the likelihood of getting good counseling services. Conclusion and recommendations – CPNC utilization according to this study is very low. It is recommended that all postpartum women at any educational level should be informed about postnatal care and those informed during pregnancy are more likely to get full package of the postnatal care and therefore encouraging further effort at the antenatal care services. Additional effort is needed on counseling messages and measures have to be taken at each step to develop minimal standard of quality of care, quality indicators and pre-discharge checklist to avoid too early discharges prior to completion of the care.
Assessment of Knowledge, Attitude, and Practice, and Associated Factors of OBGYN Residents, and Obstetricians & Gynecologists in Tikur Anbessa Specialized Hospital (TASH), and Saint Paul Hospital Millennium Medical College (SPHMMC) towards Provision of Safe Abortion Care, Addis Ababa, Ethiopia
(Addis Abeba University, 2021-07) Mengistu Mekonnen; Demissew Rahel ; Kumbi Solomon
Introduction: The demand for sexual and reproductive health services and education for womenover the globe has increased gradually. Studies show that, 99 % maternal deaths recorded inmiddle, low-income countries are die due to birth, and pregnancy related complications.Abortion is one of the leading causes of maternal death. Unsafe abortion accounts for at least13% of global maternal mortality and 95% of unsafe abortions occur in developing countries where abortion is restricted by laws. Objective: To assess knowledge, attitude and practice, and associated factors towards safe abortion provision among residents, and Obstetricians & Gynecologists in Tikur Anbessa Specialized Hospital and Saint Paul Hospital Millennium Medical College. Method: Cross sectional survey used from March to June, 2021 and using proportional simple random sampling with sample size of 174 (seniors n= 32 and residents, n=142) at Tikur Anbessa Specialized Hospital & Saint Paul Hospital Millennium Medical College Obstetrics &Gynecology residents who were attending their specialty programs and Gynecologists &Obstetricians working in both hospitals. Data collected via self-administered questionnaires with closed ended questions from study participants. Data entered and analyzed by SPSS Version 20.Descriptive frequency & analysis used for socio-demographic characteristics. Binary and multivariable logistic regression analysis conducted to identify associated factors. P-value <0.05,95% confidence level were used to declare statistical significance. Result: The prevalence of good knowledge on safe abortion care was 56.6% and using subgroup analysis 54.2% of residents and 67.8% seniors had good knowledge. Accordingly, the odds ratio OBGYN seniors had much knowledgeable than year one residents. [AOR=4.6 (1.35, 16.56,P<0.05)]. Participants having good practice on safe abortion care had favorable attitude than those who had poor practice on safe abortion care [AOR=4.3 (2.19, 8.37)]. Male had good practice towards safe abortion 2.5times than females (AOR = 2.5, CI = 1.08, 5.62). Providerswho had favorable attitude towards safe abortion had a better practice on SAC (AOR= 4.7, 2.27,9.79). Ninety-four point eight percent (94.83%) were providing post abortion family planning;Implanon was the most common (86.1%). Conclusion: In this, study the overall good knowledge, favorable attitude and good practice of physicians on safe abortion care provision were 56.6%, 57.2% and 54% respectively. Level of education affects knowledge score. Male had good practice towards safe abortion. Had a good practice on safe abortion care had significantly influenced providers’ attitude, towards favorable attitude than those who have poor practice. Based on the study the overall knowledge, attitude and practice score was lower and works to be done to improve residents’ knowledge on safe abortion care through onsite or induction training at the beginning of residency program.
Caesarean Section Rates and Adverse Perinatal Outcomes among Robsons Ten Groups of Women: A Step towards A Multidimensional Audit
(Addis Ababa University, 2025-10-19) Berhan Habtom; Ashebir Getachew; Merga Negeri
Background :Cesarean section (CS) rates are rising globally, with wide variation across populations. The World Health Organization recommends the Robson classification system for standardized monitoring. However, little is known about its association with maternal morbidity and adverse perinatal outcomes (APO) in Ethiopian referral hospitals. Methods: We conducted a hospital-based cross-sectional study among 1,100 deliveries across three referral hospitals in Addis Ababa. Deliveries were classified into the ten Robson groups. Maternal morbidity and APO (including low Apgar score, NICU admission, advanced resuscitation, stillbirth, and early neonatal death) were assessed. Logistic regression was applied to identify independent predictors of APO. Results :Of the 1,100 deliveries, 566 (51.5%) were by CS. Groups 5 (32.2%), 1 (18.9%), 2 (10.6%), 3(9.4) and 10 (8.8%) were the largest contributors. Maternal morbidity occurred in 25.8% of CS deliveries, highest in Group 10 (68.0%) and Group 4 (55.9%). The overall APO rate was 19.3%, with Group 10 (56.0%), Group 6 (47.6%), and Group 8 (36.7%) most affected. In multivariable regression, gestational age was protective (AOR 0.83 per week, 95% CI 0.75–0.92, p<0.001), while hypertensive disorders with intrauterine growth restriction (HDP with IUGR) (AOR 6.19, 95% CI 2.34–16.38, p<0.001) and residence outside Addis Ababa (AOR 4.51, 95% CI 1.3515.07, p=0.02) were significant predictors of APO. Conclusion :The study demonstrates that high CS rates alone do not equate to poor or good outcomes. Instead, prematurity, HDP with IUGR, and delayed referral drive adverse results. Robson Groups 10, 6, and 8 carried the greatest perinatal risks, while Groups 4 and 10 had the highest maternal morbidity. Implementing Robson-based CS audits, strengthening antenatal surveillance for HDP and IUGR, and improving neonatal care and referral systems are critical to reducing adverse outcomes.
Cesearean Section for Intrapartum Non-reassuring Fetal Status and Prediction for Neonatal Acidemia at Birth in Tikur Anbessa Specialized Hospital: A Prospective Observational Study,2021.
(Addis Abeba University, 2021-06) Heyi Jemal ; Fantahun Yitbarek ; Kebede Eskendir
Background: NRFS is leading indication for cesarean section. The risks of maternal morbidity and mortality associated with a caesarean section may not be reasonably justified by the degree of neonatal compromise at birth. Objectives: This study was undertaken to evaluate prediction of clinical diagnosis of intrapartum NRFS for significant neonatal acidemia and short term adverse neonatal outcome. Methods: Facility based prospective observation study where all the deliveries by cesarean section for NRFS over 2 months period were included. Fetal patterns prior to delivery were obtained from labor follow up chart and interpreted. The primary outcome was fetal acidemia(umbilical artery pH 7.20); short term neonatal morbidities were also assessed. Area under the receiver operating characteristic curves was used to assess the test characteristics of individual models for acidemia and neonatal morbidity. Population from historical cohort of similar study was used to calculate predictive ability of NRFS for fetal acidemia. Results: During this study period 228 deliveries occurred at the selected health facility and 98 women by cesarean section. From cesarean section 51% (50 of 98) were emergency and 56% (28 of 50) was done for NFS. Fetal bradycardia was the most common type of NRFS indicating emergency CS constituting 60% (15 of 25) of emergency CS. The mean umbilical artery PH was 7.20±0.09 (SD) (range, 7.01-7.30). Incidence of acidemia was 32% (8 of 25), while pathologic acidemia (PH <7.10) account only for 20% (5 of 25).Although significant association was not found for all patterns of NRFS, fetal bradycardia seems non predictive for fetal acidemia with area under the curve of 0.41(OR 0.42, 95% CI (.075-2.36)P value 0.4) with PPV of 17.22%, while fetal tachycardia (AUC (.62), PPV 30.69) and MSAF(AUC (.68)) appears to have a fair prediction for fetal acidemia. Conclusion: None of NFS pattern had significant association with fetal acidemia and neonatal outcome. This may be due small sample size of this study and further study with large sample size is needed to establish existing association, if any
Client Satisfaction on Antenatal Care and its Associated Factors among Pregnant Women in three Teaching Hospital, Addis Ababa, Ethiopia
(Addis Ababa University, 2025-10-14) Bush Kumbi; Seid Arage; Namus Muhajir
Introducti On-Within The Spectrum Of Maternity Care, Antenatal Carei Giventopregnantmothers.Cli Entsatisfacti Samedicalservice On is used toevaluatethequalityofservi Renderedinrel Ationtotheprovi Der-Cl Ientrel Ationshi P,Theinsti Provider.Thesuccessoftheadoptedpoli Happyclienti Tuti Ces On,Andthehealthcare Cyisde monstrated by client sati Smore likely toad here to medicalprofessi Treatmentplans,Tousethesamefacil Sfac On.AOnals'recommendationsandNthefuture,AndtoreferotherpeoplItyagainiNeedofmedicalcaretothehospitalthattreatedthem. Objective-ToassessthelevelofsatiSfactiOnwithantenatalcareserviAssociated factrsamongpregnantmothersatthreeteachi 2025G.C Ein Cesandits Nghospital,Addi Sababa,In Methods:Fromdecember2024tofebruary2025,325pregnantwomeninthreeteachingHospital Sinaddisababaparticipatedinahospital-BasecrossOnalstudy.Random nateShare AdministeredQuestionnai Re.Thedatawascodedandenteredintospssversion20.BivariateandMultivari Ateanalysiswith95%Ciwasemployed.Variablesfoundtohaveap-Value
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 wasestablished 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 respectively117(91.4%)ofthe participantswere menopause and 64(50%) of the participants had presenting signs andsymptoms ofvaginal 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 localmetastases. 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.
Determinant of Anemia among Pregnant Women Attended Antennal Care Clinic in Selected Public Hospitals, Case Control Study,in Addis Ababa, Ethiopia, 2021
(Addis Abeba University, 2021-07) Seman Asrar; Abdella Ahmed; Mekonnen Endalkachew
Background:Anemia is a common clinical problem contributing to increased maternal and fetalmorbidityand mortality during pregnancy. Anemia can be caused bydifferent factors apart fromknown diseases. The main aim of this study is to identify determinants of anemia amongpregnant women attending antenatal care at the public health facilities of GMH,ZMH andALERT hospitals Objective:-This studyaims to assess the determinantfactors of anemia among pregnant womenattending Antenatal Care (ANC) in three selected public hospitals (GMH, ZMH and ALERThospitals), Addis AbabaEthiopia,case-control study. Methods:-A health facility-basedunmatchedcasecontrolstudydesign wasapplied, among 126cases and 252 controls from JAN,2021-APRIL, 2021G.C in three public hospitals in A.A,Ethiopia. Data were collected using interviewer-administered questionnaires. Controls werepregnant ladieswhosehemoglobinlevel was 11 g/dl and above at their first antenatal care clinic,and cases were pregnant ladies whose hemoglobin level less than 11 g/dl in the first and 3rdtrimester and 10.5g/dl in the second trimester.collected data were entered using SPSS version 25for analysis. First Bi-variable logistic regressions were used to find out determinant factors ofanemia at P–value≤ 0.025, and thenmultivariable logistic regressions were used to control outconfounding variables. Adjusted odds ratio (AOR) with 95% confidence interval (CI) and p-value<0.05 will be used to see the significant association. Result:According to bivariate analysis result;educational level of mothers and occupationalstatusof respondents,family monthly income, those mothers havehistory of abortion,number offamily living together,parity of mothers,thoseothers hadhistory of abortionand thosewomen’shad intestinal parasite parity, were significantly associated with maternal anemia. Aftercontrolling the effect of confounding factors (variables)multiple logistic regression analysisrevealed that:family monthly income between1001–3500 ETB.,werewith (AOR꞊5.252; 95%CI (2.346,11.746), those motherswho had parity four and abovewith (AOR꞊5.623; 95% CI;(2.023, 15.592),and those mothers had History of abortion with (AOR= 1.971, 95% CI(1.124,3.459), had significant association with anemia. Conclusion. monthly family income, having previous history of abortion and parity arepositively associated with anemia in current pregnancy.Early identification of determinants ofanemia and appropriate interventions have paramount importance in fighting anemia to helpmothers enjoy their pregnancy. family planning, hemoglobin determination in all pregnantwomenare valuable
Determinants of Infertility among Married Women Attending Infertility Clinics, at two Teaching Hospitals in Addis Ababa, Ethiopia
(Addis Abeba University, 2021-09) Matewos Seblewongel; Kebede Eskinder ; Bedada Abera
Background: Infertility is a global public health issue affecting approximately 8 to 12% of couples worldwide, with 9% of the global average. In Ethiopia, according to the DHS data,the prevalence of primary and secondary infertility in 2005 was 3.3% 4.6% respectively. The prevalence differs by place of residence, marital status, age of respondent, age at first marriage, and number of unions. The causes of infertility are various, including socioeconomic factors, lifestyle, reproductive history, and childbearing status. In developing societies, childlessness is often highly stigmatized and leads to profound social suffering for infertile women; however, most infertile people in the developing world have virtually no access to effective treatment. Objective: To identify the determinants of infertility among married women attending an infertility clinic at two teaching hospitals in Addis Ababa, Ethiopia Methods: An institution-based unmatched case-control study was conducted at two teaching hospitals, gynecology and obstetrics infertility clinics in Addis Ababa. A total of 234 women was included in the study. Study participants was selected using a systematic random sampling technique for both cases and controls. Data was collected using a pre-tested interviewer-administered structured questionnaire by trained data collectors. The data was checked for completeness, cleaned, entered, and analyzed using SPSS version 24.0. Results: Approximately 52.6% (41 females) of the samples had secondary infertility, while 47.4% had primary infertility (37 females). After logistic regression was made, the determinants of infertility identified were age of women (AOR=4.914; 95%CI: 2.3.60,10.230), menstrual regularity (AOR= 2.859; 95%CI: 1.338, 6.109), history of TB infection(AOR = 8.518; 95%CI: 1.554, 46.702) and frequency of sexual intercourse (AOR= 5.304;95%CI: (2.046, 13.749) Conclusion and recommendations: Secondary infertility accounts for 52.6% of the infertile women, while primary infertility accounts for 47.4% of them. Age of women, menstrual regularity, History of TB infection and frequency of sexual intercourse were found to be determinants of female infertility.
Factors Associated with Success of VBAC in three Teaching Hospitals in Addis Ababa, Ethiopia: A casecontrol study
(Addis Ababa University, 2010-08) Birara Malede; Gebrehiwot Yirgu
Background:Vaginal delivery after previous one cesarean section for a non recurring indication has been described with many evidences as a safe practice and success rate of 60-80%.Hence many centers are offering VBAC for candidates leaving the century old dictum of once cesarean alwayscesarean. But predicting success of VBAC after TOL is still a difficult problem with lack of a validated tool of prediction world wide. Studies on predictors of success are fewand most of them conducted in developed countries and difficult to generalize. Therefore assessing factors associated with successful VBAC is very important to counsel mothers onVBAC.ObjectiveTo assess demographic, past and present obstetric factors associated with successfulVBAC In three teaching HospitalsinA. Methods:A casecontrol studywasconducted to compare the factors associated with successfulVBAC in teaching hospitals in Addis Ababa in one year period. The cases were thosesuccessfully delivered vaginally and the controlswerethose with failed VBAC and delivered byC/S. The sample sizewas101vaginal deliveries and the controls were 103 failed VBAC patientswhich made the case to control ratio of 1:1.In this study the factors associated with success ofVBAC wereprim parity, history of still birth, historyof successful VBAC in thepast, ruptureofmembrane at admission, cervical dilatation at admission, presenceof meconium and presence ofmalposition.Also 66 % of the failed VBAC patients had indications for the second C/S whichcould have been corrected by augmentation if there was no scar.. CONCLUSIONS and RECOMMENDATIONSBit: is possible to prepare a decision tool onthe success of VBAC by taking important past and present obstetric and reproductiveperformance history as predictor..
Factors Associated with Surgical Site Infection After Cesarean Deliveries.
(Addis Ababa Uinverstiy cesarean delivery superficial surgical site infection, 2025) Lulit Fekadu; Yirgu Gebrehiwot
Surgical site infection is a common major complication after cesarean sections worldwide. Post-CS SSI incidence varies the income level of the country. The magnitude of morbidity and mortality related to post-CS SSI still remains major despite improvements in surgical techniques and preventive strategies. Objective: -To determine factors associated with surgical site infection after cesarean deliveries in TASH, ZMH and GMH, Addis Ababa, 2025 G.C. Method: -Hospital based case control study was conducted at three hospitals of Addis Ababa University (TASH, GMH and ZMH). A total of 366 participants were included with 1:2 ration of SSI and non-SSI participants from January1/2024 to May 30/2025.Study participants wereselected using random sampling method. Descriptive statistics were used for determining the associated factors of SSI. Presence and degree of association between outcome and independent variables were computed through bivariate logistic regression analysis. For factors having P value of ≤ 0.05, the multivariate logistic regression analysis were used. Result: -The study identified several significant predictors of SSI. Women who underwent emergency cesarean sections were 3.6 times more likely to develop SSI compared to those whhad elective procedures (AOR = 3.6; 95% CI: 1.97–13.74). Similarly, participants residioutside Addis Ababa had a 2.2-fold increased risk (AOR = 2.2; 95% CI: 1.88–5.62). The presence of maternal comorbidity increased the risk by 3.2 times (AOR = 3.2; 95% CI: 1.50–6.67), while clinical chorioamnionitis was associated with a 6.3-fold rise in SSI risk (AOR = 6.3; 95% CI: 1.06–37.92). Cesarean sections performed during the second stage of labor were 2.6 times more likely to result in SSI (AOR = 2.6; 95% CI: 1.13–6.09). Additionally, women with grade III meconium-stained amniotic fluid had a 10.9 times higher risk of developing SSI compared to those with grade I meconium (AOR = 10.9; 95% CI: 1.97–13.74). Conclusion:Conclusion: Multiple maternal, clinical, and procedural factors were independently associated with increased risk of SSIs following cesarean sections. Targeted interventions focusing on improved intrapartum care, infection control measures, and surgical training are essential to reduce the incidence of SSIs.
Incidence, Perinatal and Maternal Outcome and Associated Factors of Antepartum Hemorrhage at AAU
(Addis Ababa University, 2025-07-16) Biniyam Denekew; Eskinder Kebed; Tesfaye Adem
Background:-Antepartum hemorrhageisanobstetricemergencyoccursin2-5%of pregnancies. itissignificantcontributortoperinatalandmaternalmorbidityand ecauses.mortality.APHtakes30%ofmaternaldeathsofwhich50%ofthedeathsareduetopreventabl Objective:-TomeasureAntepartum hemorrhage’sincidence,perinatalandmother ix outcomes,andcontributingvariablesatAAU,2024/5 Methods:-AProspectivecrosssectionalstudywasusedinAddisAbaba’s3teaching hospitals.Allwomenwhoexperiencedantepartum hemorrhagemettheinclusion criteri awerechoosenunlessthemaximum samplesizeof422isreached.Thedata werecollectedbyinterviewandchartreviewmethod.SPSSversion25.00wasusedfor entryandanalysisofdata.Inordertoidentifyfactorsthathavebeenlinkedtothe dependentvariable,logisticregressionanalysiswasimplemented.Variableswithap valueoflessthan0.05werechosenasstatisticallysignifi interval cantusing the 95%confidence Result:-TheincidenceofAPHwas4.4%.Mostaffectedwomenweremultiparous (66.4%).MajorityoftheAPHwerecausedbyAP(61.2%)followedbyPP(30.4%). Maternalcomplicationsoccurred in 22.2% ofAPH cases,withanemia(76.1%), postpartum hemorrhage(26.1%),andhypovolemicshock(18.1%)beingthemost common.Cesareandeliverywasperformedin78.4%ofcases.Determinantsofpoor maternaloutcomesincludedruralresidence(AOR=1.8),grandmultiparity(AOR=67),hypertensivedisordersduringpregnancy(AOR=1.9),abnormalvitalsignsatadmission5th(AOR=12.2),andmaternalage≥35years(AOR=2.4).Poorcompositeperinataloutcomeswereobservedin36%ofcases.Amongthese,4.5%werestillbirths.FirstandminuteAPGARscorewereLowin11%and2.9%oflivebirths,respectively.Lowbirthweightaffected23.9%ofneonates,and30%requiredNICUadmission,mainlydueto prematurity (40.1%)and low birth weight(39.4%).NICU mortality was12.4%.Determinantsofpoorperinataloutcomesincludedmaternalhypertensivedisorders(AOR=1.6),abnormalmaternalvitalsigns(AOR=6.3),maternalhemoglobin<11g/dL(AOR=2.9),andadversematernaloutcomes(AOR=3.8). Conclusion:APH posesasubstantialrisktobothmaternalandperinatalhealth. Effectivescreeningandearlyintervention,particularlimprovingoutcomes.
Incidence, Perinatal and Maternal Outcome and Associated Factors of Antepartum Hemorrhage at AAU
(Addis Ababa University, 2025-07-10) Biniyam Denekew; Eskinder Kebede; Tesfaye Adem
Background:-Antepartum hemorrhageisanobstetricemergencyoccursin2-5%of pregnancies.itissignifi cantcontributortoperinatalandmaternalmorbidityand ecauses.mortality.APHtakes30%ofmaternaldeathsofwhich50%ofthedeathsaredueto preventabl Objective:-TomeasureAntepartum hemorrhage’sincidence,perinatalandmother ix outcomes,andcontributi ngvariablesatAAU,2024/5 Methods:-AProspectivecrosssectionalstudywasusedinAddisAbaba’s3teaching hospitals.Allwomenwhoexperiencedantepartum hemorrhagemettheinclusion criteriawerechoosenunlessthemaximum samplesizeof422isreached.Thedata werecollectedbyinterviewandchartreviewmethod.SPSSversion25.00wasusedfor entryandanalysisofdata.Inordertoidentifyfactorsthathavebeenlinkedtothe dependentvariable,logisticregressionanalysiswasimplemented.Variableswithapvalueoflessthan0.05werechosenasstatisticallysignifiinterval.cantusingthe 95%confidence Result:-TheincidenceofAPHwas4.4%.Mostaffectedwomenweremultiparous (66.4%).Majori tyoftheAPHwerecausedbyAP(61.2%)followedbyPP(30.4%). Maternalcomplicationsoccurred in 22.2% ofAPH cases,withanemia(76.1%), postpartum hemorrhage(26.1%),andhypovolemicshock(18.1%)beingthemost common.Cesareandeliverywasperformedin78.4%ofcases.Determinantsofpoor maternaloutcomesincludedruralresidence(AOR=1.8),grandmultiparity(AOR=6.7),hypertensivedisordersduringpregnancy(AOR=1.9),abnormalvitalsignsatadmission5th(AOR=12.2),andmaternalage≥35years(AOR=2.4).Poorcompositeperinataloutcomeswereobservedin36%ofcases.Amongthese,4.5%werestillbirths.FirstandminuteAPGARscorewereLowin11%and2.9%oflivebirths,respectively.Lowbirthweightaffected23.9%ofneonates,and30%requiredNICUadmission,mainlyduetoprematurity (40.1%)and low birth weight(39.4%).NICU mortality was12.4%.Determinantsofpoorperinataloutcomesincludedmaternalhypertensivedisorders(AOR=1.6),abnormalmaternalvitalsigns(AOR=6.3),maternalhemoglobin<11g/dL(AOR=2.9),andadversematernaloutcomes(AOR=3.8). Conclusion:APH posesasubstantialrisktobothmaternalandperinatalhealth. Effectivescreeningandearlyintervention,parti cularlimprovingoutcomes
Knowledge, Attitudes and Practices Towards Cervical Cancer Screening among Health Care Professionals in Addis Ababa City Administration;Addis Ababa,Ethiopia ,2021
(Addis Abeba University, 2021-09) Dechasa Tujo; Yigeremu Mahlet ; Andualem Samirawit
Back-ground: Cervical cancer is the commonest gynecologic cancer in the developing world.Over the past several decades, the incidence of cervical cancer has decreased in industrialized countries. This is mainly attributed to increased awareness and more effective screening and prevention strategies employed in these countries. Although there are evidence-based,affordable, fewer resources requiring, feasible interventions to carry out in low-level health facilities, and effective treatment modalities; the utilization of these screening methods is limited in low-income countries like Ethiopia. Prevention of cervical cancer in low-resource settings can be conducted by increasing the knowledge of cervical cancer screening and its practice by primary health care professionals (1, 2) Objective: To assess the knowledge, attitudes, and practice of cervical cancer screening among health professionals working in Addis Ababa City Administration Health Facilities Method: a cross-sectional study was conducted from May 1, 2021- June 15, 2021, amonghealth professionals working in selected health Centers in Addis Ababa . A pre-tested, structured questionnaire and a checklist were used to collect data .The data was collected from 8 randomly selected health centers involving health professionals. Data was analyzed using SPSS version 25. Binary and multiple logistic regression analysis were used to look for an association between cervical cancer screening knowledge and socio-demographic variables. Result: In this study 36% of the participants had good knowledge on cervical cancer screening, , Majority of participants 71(57%) had favoreable attitude towards cervical cancer screening. Untrained, lost to follow up ,and difficulty of doing the screening procedure were some reasons not to do cervical cancer screening practice. Age ≥40 years (AOR=20.8, 95%CI=3.6,118.9), male health provider(AOR=2.3, 95%CI=1.27, 4.22) ,working area,and having functioning Cervical Cancer screening(AOR=5.2, 95%CI=1.71,16.5) were the factors associated with better knowledge of cervical cancer screening. Conclusion : The knowledge of the study participants on cervical cancer screening was low.Even those who had good knowledge on cervical cancer screening, has limited attitude and quite low practice at Work. There is a need to look into the cervical screening services and the health provides role in the Uptake of the service in Addis Ababa.
Knowledge, Attitude and Practice of Health Professionals towards Neonatal Resuscitation in three Teaching Hospitals, Addis Ababa, Ethiopia.
(Addis Abeba University, 2021-09) Eshetu Selam; Teklu Sisay; Worku Dawit
Background: Neonatal mortality is the issue of local, regional, national, continental and global.For example, it is observed in both middle- and low-income countries, especially sub-Saharan Africa including Ethiopia. Neonatal death is multi factorial, but the most important single causes of neonatal deaths were accounted for preterm birth, birth asphyxia, and sepsis. Effective resuscitation, if done timely, can drastically reduce neonatal deaths. Objective: To assess the knowledge, attitude and practice toward neonatal resuscitation among midwives, NICU nurses, Addis Ababa university pediatrics and OBGYN residents in Tikur Anbesa Specialized, Zewditu Memorial and Gandhi Memorial Hospital, Addis Ababa, Ethiopia. Methods: A Cross-Sectional research design was conducted from March – June 2021 and the respondents were selected by using simple random sampling techniques, 204 have returned the questionnaire filled complete (response rate of 98.07%). The data collection tool was closed ended questionnaires. Data was verified, coded, and entered to Epi Data Software version 3.1and was exported into SPSS version 25 Software for analysis. The degree of association between variables was assessed using logistic regression. Finally, p-value less than 0.05 were considered statistically significant. Results: The good knowledge level among midwifes, nurses, pediatrics residents and OBGYN residents were 30.9%, 28.2%, 42.4% and 42.9% respectively. Neonatal resuscitation training and the time training was given, was found to be the only predictor of knowledge score of respondents (AOR = 3.1, 95 % CI: 1.2 - 4.8, P value = 0.003) and (AOR =5.6, 95 % CI: 1.19 -6.72, P value = 0.044) respectively. The majority 58.80% of the participants had good attitude towards neonatal resuscitation. Whereas the good practice score among midwifes, nurses,pediatrics residents and OBGYN residents were 59.8%, 33.3%, 59.6% and 39.4% respectively. The only determining factor associated with poor practice score was lack of availability of resuscitation guideline (AOR=2.55, 95% CI: 1.90-8.28, p=0.004). Having good knowledge were found to be the only predictor to have good attitude level (AOR=0.357, 95% CI: 0.18-0.67,p=0.001). Conclusion and recommendations: Knowledge, attitude and practice of nurses and midwifes to ward neonatal resuscitation were inadequate. Training and the time training given were found to be predictor for knowledge while presence of guideline was predictors for practice.Continuous and regular training for health professionals should be strengthen.
Knowledge, Attitude, and Practice of Emergency Contraception among Female High School Students in Lideta Sub-city, Addis Ababa, Ethiopia, 2020/21 G.C.
(Addis Abeba University, 2021-09) Esayas Binyam; Negash Shiferaw ; G/Hiwot Yirgu; Sultan Semir
Background: Each year, around 210 million women throughout the world get pregnant, of which 21 million girls aged 15–19 years in developing regions become pregnant. More than half of the teenage pregnancy in developing countries are unintended(1, 2). Emergency pregnancy. Despite the existence of different modern and effective contraceptives methods worldwide, the problem of unintended pregnancy is still high (3). Objectives:Toassess knowledge, attitudeandpracticeofEmergency Contraception in female high school students in Lideta sub-city, Addis Ababa, 2020/21 G.C. Methods: A mixed study was used. A cross-sectional, institution-based study was conducted from September 1 to November 30, 2020 E.C., and a systematic sampling technique was used for the quantitative study whereas for the qualitative study, an in-depth interview and purposive sampling techniques was used. Quantitative data were cleaned, coded and entered into, and analyzed using SPSS version 25. Data from in-depth interview was transcribed and translated to English then coded using QDA software, and categorized into similar themes. Descriptive statistics like frequency, measures of central tendencies were used to describe study participants and to summarize the results of the study. The association of the independent variables was done using logistic regression and chi-square test. Variables with P-value of ≤ 0.05 were declared as statistically significant. Result: A total of 257 female students have participated in the study with 100% total response rate. The finding of our study showed that 37.4% of the respondents have good knowledge and47.9% have positive attitude towards the use of EC. The main source of information about EC was TV. Of the total respondents, only 8.2% have ever practiced sexual intercourse at least once in their lifetime. Of those respondents who had sexual intercourse, 66.6% have ever used EC.In the in-depth interview, when asked about the reason “why they don’t take or recommend EC“, most mentioned ineffectiveness of post-pill in preventing pregnancy. Conclusion: The result indicates that most of the respondents have heard about EC but the cumulative knowledge score is low and only around half having positive attitude about EC.Only a few of the respondents have used EC in their lifetime. We recommend a continuous information delivery to high school students and a separate and scaled-up study should be done to assess the knowledge, attitude, and utilization of EC among high school students.
Magnitude and Determinants of Primary Cesarean Section Among Women who Give Birth At 37 & Above Weeks of Gestational Age in three Teaching Hospitals of Addis Ababa University in Addis Ababa, Ethiopia: Cross Sectional Study
(Addis Ababa University, 2024-09-16) Dawit Mekonnen; Mahlet Yigeremu; Dawit Desalegn
Background: The use of cesarean section has expanded to low-, middle-, and high income nations along with notable advancements in clinical obstetric care and better surgical procedure safety. According to Ethiopia Demographic and Health Surveys (DHS), the national population-based cesarean section rate climbed from 0.7 percent in 2000 to 1.9 percent in 2016, with rises throughout seven of the country's eleven administrative areas. Studies done in Addis Ababa public hospitals showed that the rate of cesarean section ranges between 21% and 38%. The rate of primary cesarean sections, however, has never been researched and no data is available. To lower this concerning cesarean section rate, it is crucial to look at decision-making processes and put in place a safe prevention strategy for primary cesarean section practice, as advised by the American College of Obstetricians and Gynecologists and the Society for Maternal-Fetal Medicine in their obstetric care consensus recommendation. Objectives: To assess the magnitude and determinants of primary cesarean section among women who gave birth at term in three teaching hospitals of Addis Ababa University in Addis Ababa, Ethiopia. Methods: A hospital-based cross-sectional study was conducted from January 01 to April 30, 2024. Systematic random sampling was used to select 422 participants. The structured, pretested, and anonymous questionnaire was used, and data were entered into Epi-Data version 3.1 and will be exported analysis to SPSS version 23. Descriptive statistics were performed, and then used tables and figures to present the findings. A P-value of <0.05 will be considered statistical significance. Result: Four hundred twenty-two women’s medical charts were included in this study, making 100% response rate. Our research finding indicates that 25.83% of women underwent a primary cesarean section. The most frequent indications for primary cesarean section were fetal distress (55%), mal-presentation (19.3%), failed induction (11.9%), and CPD (11%). Our research findings indicate that parity, gestational diabetic mellitus, chronic medical disease, fetal presentation, fetal membranes status and liquor status were variable statistically significantly associated with Primary CS with p-value <0.05. Conclusion: The magnitude of primary cesarean section in this study was high. Our study emphasizes the need for careful monitoring and management of women with gestational diabetic mellitus, chronic medical conditions during pregnancy, and the importance of monitoring the status of the fetal membranes during labor. The results indicate that most neonates had favorable outcomes. Furter research could explore interventions that address factors, potentially reducing the overall rates of cesarean deliveries while ensuring safety for both mothers and infants.
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
Maternal Outcome of Women with Cardiac Disease During Intrapartum and Postpartum Periods at TASH, A 3 Years Retrospective Cross-Sectional Study.
(Addis Ababa University, 2024-10-18) Mezgebu Gietnet; Mahlet Yigeremu; Eskinder Kebede
Background: Heart disease affects between 1% and 4% of pregnancies and continues to be a leading cause of maternal death worldwide, affecting women in both highincome and low- to middle-income countries. The maternal mortality rate due to cardiac conditions is approximately 9% in developed nations and 36% in developing regions. However, there is limited research in Ethiopia to fully understand the impact of heart disease on pregnant women and its effect on maternal outcomes. Objective: The purpose of this research is to evaluate how cardiac disease affects maternal outcomes in women with heart conditions during labor, delivery, and the postpartum period up until they are discharged from the hospital. The ultimate goal is to enhance their health and overall well-being. Methods: The study retrospectively enrolled 92/127 women with cardiac illness, who received labor and delivery service at Tikur Anbessa Specialized Hospital, Addis Ababa, Ethiopia, from Jan 1st, 2021 to Dec 31, 2023. Census sampling method was applied to include study participants. The data entered and analyzed using Epi-info version 7.0 and SPSS version 25.0. Bivariable regression done and variables with p-value ≤ 0.25 analyzed withmultivariable logistic regression with a level of significance <0.05. Results: In this study, 92 participants that fulfill the inclusion criteria were enrolled following review of their medical charts. Majority of the study participants (65.2%) found in the age group of 25-34 years with mean ±SD of 28.1±5.2. Almost one-third of the participants were primiparous and 63% were from the rural area. This study shows the significant cause of heart disease is acquired causes (84.8%, n=78). Majority of patients (40.2%, n=37) have a functional status of NYHA class II. Mitral valve is the most commonly affected valve with 80.5% (n=74) contribution. Majority (46.7%, n=43) of deliveries were via operative vaginal deliveries and 34.8% (n=32) were delivered via C/S. Composite adverse maternal outcome was found in 28%, (26/92) participants. Heart failure and pulmonary edema were the two most common acute cardiac events each contributing 10.9% respectively.
Nature and Prevalence of Sexual Harassment Against Female Medical Interns a Study at two Teaching Hospitals, Addis Ababa, Ethiopia 2020GC
(Addis Abeba University, 2021-06) Tesfa Tigist; Hassan Salih ; Alemu Wolela
Background: Violence against women is a deep-rooted problem in the world. For example, a report from the National Academies of Sciences, Engineering, and Medicine (NASEM) found that female medical students were 220% more likely than non-science, technology, engineering, and mathematics (STEM) disciplines to face sexual harassment from faculty or staff. Objective :To determine the prevalence and nature of sexual harassment against female medical interns atTikur Anbessa Specialized Hospital and Saint Paul's Hospital Millennium Medical College in2020 GC Methodology :Mixed concurrent nested qualitative and quantitative study conducted at Tikur Anbessa Specialized Teaching Hospital and St. Paul's Hospital Millennium Medical College, Addis Ababa, Ethiopia from 1 June 2020 GC to 30 June, 2021Gc using the female medical interns as target population and Semi-structured questionnaire for data collection after obtaining ethical clearance and data analysis was done by Statistical Package for Social Sciences (SPSS) version 23.0 program. Result:A total of 76 female medical interns were included in the study. The prevalence of sexual harassment was 96.05%. The most common nature of sexual harassment was a suggestive comment (61 out of 76 respondents), "inappropriate remarks" (59/76 respondents) and "request for dates" (59 out of 76 respondents), and "unwanted physical contact," accounting for 76.31% or 58 out of the 76 respondents. One female medical intern reported attempted rape from TASH,and the perpetrator was "other school staff." Conclusion : There is a high prevalence rate of sexual harassment against female medical interns at TASH and SPHMMC, and experiences of harassment range from subtle comments and suggestive gestures to overt behaviors and attempted rape Perpetrators are primarily institutional insiders (lecturers, supervisors, instructors), classmates,and other school staff; other students, patients, and patient attendants are also perpetrators Sexual harassment awareness-creation trainings at the beginning of the academic year for medical students and school staff. And briefing on how, to whom and where to report incidents isrecommended A large scale research in Ethiopian medical schools for better understanding of the problem is recommended

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