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Belay T, Semahegn A, Mezmur H, Mulatu T. Prevalence of episiotomy and associated factors among women who gave birth at public health facilities in Jigjiga town, eastern Ethiopia: A cross-sectional study. PLOS GLOBAL PUBLIC HEALTH 2024; 4:e0003216. [PMID: 38768152 PMCID: PMC11104620 DOI: 10.1371/journal.pgph.0003216] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/21/2023] [Accepted: 04/16/2024] [Indexed: 05/22/2024]
Abstract
INTRODUCTION Maternal morbidity and mortality has remained a major public health concern worldwide. Basic emergency obstetric care is the primary intervention to prevent obstetric complications and maternal death. Episiotomy is one of the basic obstetrical procedures used to facilitate vaginal delivery, shorten the second stage of labor and prevent complications. However, there is a paucity of evidence on the prevalence and factors associated with episiotomy among women who gave birth in eastern Ethiopia. OBJECTIVE This study aimed to determine the prevalence of episiotomy and its associated factors among women who gave birth at public health facilities in Jigjiga town, eastern Ethiopia. METHODS A facility-based cross-sectional study was conducted among women who gave birth vaginally from May 1 to June 30, 2022. A total of 422 study participants were recruited using systematic random sampling. Data were collected using structured questionnaires through a face-to-face interview supported with standard observational checklist and reviewing medical records. A logistic regression analysis was carried out to examine the association between explanatory variables and episiotomy. An adjusted odds ratio (AOR) at a 95% confidence interval (CI) at a P-value <0.05 was used to declare significant association. RESULTS The prevalence of episiotomy among women was 52.6% (95% CI: 47.8%, 57.0%). Obstetric complications during current pregnancy (AOR:3.92, 95% CI: 1.59, 9.68), birth weight ≥4000 gm (AOR: 4.30, 95% CI: 1.53, 12.04), induction of labor (AOR: 3.10, 95% CI: 1.62, 5.93), meconium-stained amniotic fluid (AOR:2.10, 95% CI: 1.14, 3.88), duration of the second stage of labor ≥90 minutes (AOR:3.09, 95% CI: 1.53, 6.23), instrumental delivery (AOR: 2.69, 95%, CI: 1.39, 5.19), and female genital mutilation (AOR: 2.91, 95% CI: 1.83, 4.64) were factors significantly associated with episiotomy. CONCLUSION Slightly more than half of the women who gave birth at public health facilities in the study area underwent episiotomies. In addition to the common obstetric factors, having a female genital mutilation scar increased the risk of women's experiencing episiotomies. Therefore, intervention should be tailored to address the identified obstetric risk factors and avoid female genital mutilation in the community to reduce women's experiences of episiotomies in the future.
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Affiliation(s)
- Tamene Belay
- Department of Midwifery, College of Medicine and Health Sciences, Jigjiga University, Jigjiga, Ethiopia
| | - Agumasie Semahegn
- School of Nursing and Midwifery, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
- Centre for Innovative Drug Development and Therapeutic Trials for Africa (CDT-Africa), College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
- Department of Population, Family and Reproductive Health, School of Public Health, University of Ghana, Accra, Ghana
| | - Haymanot Mezmur
- School of Nursing and Midwifery, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Teshale Mulatu
- School of Nursing and Midwifery, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
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Ugwuoroko HC, Eleje GU, Okafor CG, Okechukwu ZC, Eke AC, Okoro CC, Okafor LU, Okafor CC, Ogabido CA, Njoku TK, Onyejiaka CC, Egwim AV, Obiagwu HI, Mamah JE, Olisa CL, Onah NL, Udigwe GO. Obstetric Outcome of Induction of Labour in a Tertiary Hospital in Nigeria: A Five-Year Retrospective Cross-Sectional Study. INTERNATIONAL JOURNAL OF INNOVATIVE RESEARCH IN MEDICAL SCIENCE 2023; 8:235-240. [PMID: 37987020 PMCID: PMC10659585 DOI: 10.23958/ijirms/vol08-i07/1706] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/22/2023]
Abstract
Background Induction of labour has remained one of the most valuable interventions in obstetric practice. Over the years, the proportion of women undergoing induction of labour (IOL) has been on a steady increase. The significance to obstetrics practice as well as its maternal and perinatal outcomes are sacrosanct, hence the need for its periodic review. Objective To determine the obstetric outcomes of induction of labour. Methods A five-year retrospective study of all cases of induction of labour at the maternity unit of Nnamdi Azikiwe University Teaching Hospital (NAUTH), Nnewi, Nigeria between January 1st 2017 and 31st December 2021. The labour ward's records were assessed to determine the total number of women who had induction of labour during the study period. Women whose case files could be not retrieved were excluded. The folder numbers of the patients were extracted and their case files retrieved from the medical records department of the hospital. The primary outcomes measures were the indications and the methods of induction of labour, while the secondary outcome measures were the mode of delivery, cause of failed induction, and the perinatal outcome. Data were obtained using proformas and analysed using statistical packages for social sciences (SPSS) version 26.0 IBM corporation. Result A total of 3,638 deliveries were taken during the period under review and 168 patients had induction of labour giving an overall prevalence of 4.6% (46/1000 deliveries). Induction of labour was successful in 71.2% of cases. Misoprostol was used in 90.4% of cases as an induction agent. The commonest indication for induction of labour was postdate pregnancy (53.8%). Failed induction was due to fetal distress, poor progress of labour from cephalopelvic disproportion/malposition and failed cervical ripening. In about 72% of deliveries, there was good perinatal outcome, 10.3% of babies had moderate to severe asphyxia while 1.3% had neonatal death. Conclusion Induction of labour is a safe and beneficial procedure in obstetrics. However, it can be associated with adverse obstetric outcomes.
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Affiliation(s)
- Harrison Chiro Ugwuoroko
- Department of Obstetrics and Gynaecology, Nnamdi Azikiwe University Teaching Hospital, Nnewi, Anambra State, Nigeria
| | - George Uchenna Eleje
- Department of Obstetrics and Gynaecology, Nnamdi Azikiwe University Teaching Hospital, Nnewi, Anambra State, Nigeria
- Department of Obstetrics and Gynaecology, Nnamdi Azikiwe University Awka, Anambra State, Nigeria
| | - Chigozie Geoffrey Okafor
- Department of Obstetrics and Gynaecology, Nnamdi Azikiwe University Teaching Hospital, Nnewi, Anambra State, Nigeria
| | | | - Ahizechukwu Chigoziem Eke
- Division of Maternal and Fetal Medicine, Department of Gynaecology and Obstetrics, Johns Hopkins University School of Medicine, Baltimore, USA
| | | | - Lazarus Ugochukwu Okafor
- Department of Obstetrics and Gynaecology, Nnamdi Azikiwe University Teaching Hospital, Nnewi, Anambra State, Nigeria
| | | | - Chukwudi Anthony Ogabido
- Department of Obstetrics and Gynaecology, Nnamdi Azikiwe University Teaching Hospital, Nnewi, Anambra State, Nigeria
- Department of Obstetrics and Gynaecology, Nnamdi Azikiwe University Awka, Anambra State, Nigeria
| | - Tobechi Kingsley Njoku
- Department of Obstetrics and Gynaecology, Nnamdi Azikiwe University Teaching Hospital, Nnewi, Anambra State, Nigeria
| | | | - Adanna Vivian Egwim
- Department of Obstetrics and Gynaecology, Nnamdi Azikiwe University Teaching Hospital, Nnewi, Anambra State, Nigeria
| | - Hillary Ikechukwu Obiagwu
- Department of Obstetrics and Gynaecology, Nnamdi Azikiwe University Teaching Hospital, Nnewi, Anambra State, Nigeria
| | - JohnBosco Emmanuel Mamah
- Department of Obstetrics and Gynaecology, Alex Ekwueme Federal University Teaching Hospital, Abakiliki, Nigeria
| | - Chinedu Lawrence Olisa
- Department of Obstetrics and Gynaecology, Nnamdi Azikiwe University Teaching Hospital, Nnewi, Anambra State, Nigeria
| | - Nnanyerugo Livinus Onah
- Department of Obstetrics and Gynaecology, Enugu State Teaching Hospital Parklane, Enugu State, Nigeria
| | - Gerald Okanandu Udigwe
- Department of Obstetrics and Gynaecology, Nnamdi Azikiwe University Teaching Hospital, Nnewi, Anambra State, Nigeria
- Department of Obstetrics and Gynaecology, Nnamdi Azikiwe University Awka, Anambra State, Nigeria
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Assemie MA, Mihiret GT, Mekonnen C, Petrucka P, Getaneh T, Ashebir W. Outcomes and Associated Factors of Induction of Labor in East Gojjam Zone, Northwest Ethiopia: A Multicenter Cross-Sectional Study. Obstet Gynecol Int 2023; 2023:6910063. [PMID: 37351527 PMCID: PMC10284654 DOI: 10.1155/2023/6910063] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2022] [Revised: 05/30/2023] [Accepted: 06/05/2023] [Indexed: 06/24/2023] Open
Abstract
Background Induction of labor is the initiation of uterine contractions by artificial methods once the fetus has reached viability and prior to spontaneous onset of labor with the aim of achieving vaginal delivery. Although induction of labor is a critical life-saving intervention that potentially reduces adverse pregnancy outcomes, sometimes it has undesirable consequences for the health of the mother and/or the fetus. Hence, this study aimed to evaluate the outcomes and associated factors of labor induction. Methods An institution-based cross-sectional study was conducted from February 25 to May 25, 2020, among women undergoing induction at East Gojjam zone public hospitals in northwest Ethiopia. A structured interviewer-administered questionnaire was used to collect data from a sample of 411 mothers who were selected using a systematic random sampling technique. Stata/se™ Version 14 statistical software was used to analyze the data. Multivariable binary logistic regression was used to determine the potential factors affecting successful labor induction. Adjusted odds ratios with their 95% CI intervals were used to declare the strength of the association, and a variable with p value <0.05 was considered to have statistical significance. Results The prevalence of successful induction of labor was 70.3% (65.6, 74.7). The favorable Bishop score ((CI 3.90, 1.63-9.29); p value = 0.002), the intermediate Bishop score ((CI 3.53, 2.15-5.82); p value = 0.001), labor induction using oxytocin with cervical ripening ((CI 2.60, 1.21-5.63); p value = 0.015), and urban residence ((CI 0.48, 0.30-0.78); p value = 0.003) were associated with successful induction of labor. Conclusion These findings strongly suggest that cervical conditions are important determinants for the success of labor induction. Therefore, healthcare providers should confirm the favorability of the cervical status (using Bishop score) as a strict prerequisite before actual labor induction, and special consideration should be given to those pregnant women who reside in urban areas.
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Affiliation(s)
- Moges Agazhe Assemie
- Department of Public Health, College of Health Sciences, Debre Markos University, Debre Markos, Ethiopia
| | - Getachew Tilaye Mihiret
- Department of Midwifery, College of Health Sciences, Debre Markos University, Debre Markos, Ethiopia
| | - Chernet Mekonnen
- Department of Midwifery, Debre Markos Comprehensive Specialized Hospital, Debre Markos, Ethiopia
| | - Pammla Petrucka
- College of Nursing, University of Saskatchewan, Saskatoon, Canada
| | - Temesgen Getaneh
- Department of Midwifery, College of Health Sciences, Debre Markos University, Debre Markos, Ethiopia
| | - Wassachew Ashebir
- Department of Public Health, College of Health Sciences, Debre Markos University, Debre Markos, Ethiopia
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Tadesse T, Assefa N, Roba HS, Baye Y. Failed induction of labor and associated factors among women undergoing induction at University of Gondar Specialized Hospital, Northwest Ethiopia. BMC Pregnancy Childbirth 2022; 22:175. [PMID: 35240999 PMCID: PMC8892790 DOI: 10.1186/s12884-022-04476-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2021] [Accepted: 02/15/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Induction of labor is a process of artificially initiating labor to attain vaginal birth. Despite its vital role in the reduction of maternal mortality, the failure rate of induction and its contributing factors were not well studied in Ethiopia; particularly there was a limited study in the study area. This study aimed to assess the prevalence and factors associated with failed induction of labor among women undergoing induction at University of Gondar Specialized Hospital, Northwest Ethiopia. METHODS An institution-based retrospective cross-sectional study was conducted among 743 women undergoing induction at University of Gondar Specialized Hospital. A systematic random sampling method was used to draw a sample and the data were retrieved from the maternity registration books and medical records. Data were cleaned and entered into EpiData version 3.1 and SPSS version 20 used for analysis. Frequencies, proportions, and summary statistics were used to describe the study population and a multivariable logistic regression model was fitted to identify factors contributing to failed induction of labor. Odds ratio with 95% confidence interval computed and level of significance declared at P-value< 5%. RESULTS The prevalence of failed induction of labor was 24.4% (95% CI: 21.4, 27.9). Age ≤ 30 years (AOR = 3.7, 95% CI: 2.2,6.2), rural residence (AOR = 3.7, 95% CI: 2.4,5.8), being nulliparous (AOR = 2.1, 95% CI: 1.2,3.7), 5 or less Bishop Score (AOR = 3.4, 95% CI: 2.2,5.4), premature rupture of membrane (AOR = 2.7, 95% CI: 1.5,4.6), having pregnancy-induced hypertension (AOR = 4.0, 95% CI: 2.3,7.1), and artificial rupture of membrane with oxytocin (AOR = 0.2, 95% CI: 0.1, 0.4) were associated with failed induction of labor. CONCLUSIONS One-fourth of women undergoing induction at University of Gondar Specialized Hospital had failed induction of labor. Age, residence, parity, bishop score, premature-rupture of the membrane, pregnancy-induced hypertension, and method of induction were independent predictors for failed induction of labor. The combination method of ARM with oxytocin, early detection and treatment of pregnancy-induced hypertension and premature rupture of the membrane are highly recommended for reducing failed induction of labor.
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Affiliation(s)
- Tsion Tadesse
- School of Midwifery, College of Medicine and Health Sciences, University of Gondar, P.O.Box: 196, Gondar, Ethiopia.
| | - Nega Assefa
- Department of Public Health, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Hirbo Shore Roba
- Department of Public Health, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Yohannes Baye
- Department of Neonatal and Pediatric Nursing, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
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