Background Antenatal care (ANC) is imperative to decreasing adverse pregnancy outcomes and their related maternal mortality. However, in sub-Saharan Africa, increases in ANC coverage have not correlated well with improved maternal and fetal outcomes suggesting the quality of ANC received could be the missing link. This study assessed ANC quality and its effect on adverse pregnancy outcomes among women who delivered at Komfo Anokye Teaching Hospital. Methods A cross-sectional study was conducted among women who delivered at Komfo Anokye Teaching Hospital within the study period. Women were selected through systematic sampling and interviewed using a pretested structured questionnaire as well as review of their medical records. Data were collected on their sociodemographic and reproductive characteristics, care provided during ANC and delivery outcomes. Categorical variables were compared using the χ2 test. Factors associated with quality of ANC and adverse pregnancy outcomes were assessed using univariate and multivariate logistic regression to generate crude and adjusted odds ratios (ORs) with 95% confidence intervals (CIs). Statistical analyses were performed using SPSS and GraphPad Prism. P-values of < 0.05 were considered statistically significant. Results 950 women were recruited into the study with mean age of 30.39±5.57 years. Less than one-tenth (7.6%) of the women received good quality ANC, 63.4% had average quality ANC, and 29.0% received poor quality ANC. Increasing educational level and initiating ANC in the first trimester [aOR 0.2; 95%CI 0.08–0.68; p<0.001] increased the odds of receiving good quality ANC while being unemployed decreased the odds of receiving good quality ANC [aOR 0.3; 95% CI 0.12–0.65; p = 0.003]. Receiving poor and average quality of ANC were significantly associated with increased likelihood of developing anaemia during pregnancy, preeclampsia with severe features or delivering a low birth weight baby. Conclusion Most women did not receive good quality ANC. High quality ANC should be provided while the women are encouraged to comply with the recommendations during ANC.

Inadequate postpartum family planning counseling and referrals during maternity care were recorded, suggesting that a comprehensive educational intervention is required to improve uptake.

Background: This retrospective descriptive cross-sectional study was aimed at determining indications, surgical outcomes, complications and challenges of elective non-oncological hysterectomies performed at a tertiary referral centre over a 2-year period (1st December 2018 to 31st December 2019).Methods: With ethical approval, the medical records of all eligible women were retrieved, reviewed and analyzed. Measures of central tendencies, frequencies and percentages were used to compute the variables.Results: During the 2-year study period, a total of 245 elective non-oncological hysterectomies were performed. The age of the women ranged from 33 to 80 years with a mean age of 49.08 years; [standard deviation (SD): 8.88]. Women in the 40-49 year-old-age group constituted the majority 55.51% (n=136/245). Main indications were multinodular fibroid uterus (without menorrhagia), fibroid uterus with menorrhagia and genital prolapse. There was no case of laparoscopic hysterectomy. Majority (98.78%; n=242/245) of the hysterectomies were total hysterectomies. The commonest additional procedures performed was bilateral salpingo-oophorectomy (31.84%; n=78/245). Intra-operative complication rates were low: (0.40%; n=1/245) for bowel injury, bladder injury and bleeding from an ovary. Regional anaesthesia was the commonest type of anaesthesia (71.84%; n=176/245). The primary surgeon was above the level of a specialist in 99.19% (n=243/245) of cases.Conclusions: Most women had hysterectomy for non-oncological indications in their fourth and fifth decades of life on account of fibroid-related conditions and genital prolapse. There was no uptake of laparoscopic hysterectomy. Hysterectomies are generally safe in the hands of an experienced and skilled surgical team.