Perinatal Outcomes of Pregnancies Complicated by Hypertensive Disorders of Pregnancy in Late Preterm in three Teaching Hospitals in Addis Ababa, Ethiopia
| dc.contributor.advisor | Dr.Haile, Sofanit(MD, Ass. Prof. OBGYN ) | |
| dc.contributor.advisor | Dr.Yigeremu, Mahlet(MD, Ass. Prof. OBGYN, Fellow REI) | |
| dc.contributor.advisor | Dr.Negash, Shiferaw (MD, Ass. Prof. OBGYN, Gynecology Oncologist) | |
| dc.contributor.author | Girma, Getinet | |
| dc.date.accessioned | 2022-01-11T12:10:39Z | |
| dc.date.accessioned | 2025-01-08T14:27:18Z | |
| dc.date.available | 2022-01-11T12:10:39Z | |
| dc.date.available | 2025-01-08T14:27:18Z | |
| dc.date.issued | 2021-09 | |
| dc.description.abstract | Background: Hypertensive disorders of pregnancy (HDP) are multisystem diseases known to increase the risk of perinatal mortality worldwide, with a significant proportion of these deaths occurring in low income countries. However, little is known about the obstetric and treatment predictors of perinatal mortality in women with HDP. Until now, only few studies focused on the management of women with hypertensive disorders between 34 0/7 and 36 6/7 weeks of gestational age in Ethiopia. General objective: To investigate the perinatal outcomes of late preterm pregnancies complicated by hypertensive disorders in low resource settings Methods: Hospital based cross sectional descriptive study was conducted on 274 newborns delivered from December 15, 2020 to June 15, 2021 at the three teaching hospitals. Structured and pretested questionnaire were used to collect socio-demographic data and medical records were reviewed. Neonatal status was checked every other day through phone call till 7 days after delivery date. Descriptive statistics were used to describe parameters collected from the files. Bivariate and multiple logistic regressions were done to determine factors associated with unfavorable perinatal outcome. A P-value of less than 0.05 was considered statistically significant. Result: Among 10,129 deliveries during the study period, 952 (9.4%) were preterm. Of these preterm deliveries 680 were late preterm and 274 neonates fulfill the inclusion criteria and analyzed. About 83(30.3%) neonates were delivered 34+0-34+6 weeks, 45 (16.4%) at 35+035+6 weeks and the majority 146 (53.3%) at 36+0-36+6 weeks. Cesarean section was the most common mode of delivery 191 (69.7%) followed by SVD, 74 (27%) and 6 (2.2%) by AVD. About 173 (63.1%) newborns were LBW (1500-2499 grams), 76 (27.8%) were NBW and the remaining 25(9.1%) were VLBW. Fifty eight (21.5%) of neonates need resuscitations at delivery. Hundred forty eight (55.2%) of these neonates were referred to NICU and 102 (68.9%) of them required NICU admission. On day seven neonatal assessment the cumulative survival was 93.7%. The survival rate of late preterm neonates is 87.7%, 90.9% and 97.9% at 34, 35, and 36 weeks respectively. The perinatal mortality rate in late preterm pregnancy in hypertensive disorders of pregnancy in this study was 76.6/1000 live births. Over half, 9/17 (52.9%) of neonatal deaths occurs within the first 48 hours while majority (76.5%) of neonatal deaths occurs with in the first 3 days. In this study one fourth (25.9%) of women had at list one maternal complication. Fetal weight at birth, gestational age during delivery and Apgar score at delivery found to be independent predictors of perinatal survival. Conclusion and Recommendation: During the study period the rate of late preterm birth was 71.4%. This study shows preeclampsia as the most common cause for late preterm birth (84.7%) from hypertensive disorders of pregnancy. Late preterm neonates are at higher risk for neonatal morbidities and mortality contrary to the belief that they are nearly mature. Neonatal birth weight and Apgar score during delivery were the important predictors for the neonatal survival. Critical attention should be paid on the first 72 hours of newborn life to reduce factors contributing to high neonatal loss at this particular time. | en_US |
| dc.identifier.uri | https://etd.aau.edu.et/handle/123456789/29494 | |
| dc.language.iso | en_US | en_US |
| dc.publisher | Addis Abeba University | en_US |
| dc.subject | Pregnancies,Complicated, Hypertensive disorders | en_US |
| dc.title | Perinatal Outcomes of Pregnancies Complicated by Hypertensive Disorders of Pregnancy in Late Preterm in three Teaching Hospitals in Addis Ababa, Ethiopia | en_US |
| dc.type | Thesis | en_US |