Background Emergency cesarean section is a commonly performed surgical procedure in pregnant women with life-threatening conditions of the mother and/or fetus. According to the Royal College of Obstetricians and Gynecologists and the American College of Obstetricians and Gynecologists, decision to delivery interval for emergency cesarean sections should be within 30 min. It is an indicator of quality of care in maternity service, and if prolonged, it constitutes a third-degree delay. This study aimed to assess the decision to delivery interval and associated factors for emergency cesarean section in Bahir Dar City Public Hospitals, Ethiopia. Method An institution-based cross-sectional study was conducted at Bahir Dar City Public Hospitals from February to May 2020. Study participants were selected using a systematic random sampling technique. A combination of observations and interviews was used to collect the data. Data entry and analysis were performed using Epi-data version 3.1 and SPSS version 25, respectively. Statistical significance was set at p < 0.05. Result Decision-to-delivery interval below 30 min was observed in 20.3% [95% CI = 15.90–24.70%] of emergency cesarean section. The results showed that referral status [AOR = 2.5, 95% CI = 1.26–5.00], time of day of emergency cesarean section [AOR = 2.5, 95%CI = 1.26–4.92], status of surgeons [AOR = 2.95, 95%CI = 1.30–6.70], type of anesthesia [AOR = 4, 95% CI = 1.60–10.00] and transfer time [AOR = 5.26, 95% CI = 2.65–10.46] were factors significantly associated with the decision to delivery interval. Conclusion Decision-to-delivery intervals were not achieved within the recommended time interval. Therefore, to address institutional delays in emergency cesarean section, providers and facilities should be better prepared in advance and ready for rapid emergency action.

Background Addressing sustainable development goals to reduce neonatal mortality remains a global challenge, and it is a concern in Ethiopia. As a result, the goal of this study was to assess the incidence and determinants of neonatal mortality in the first 3 days among babies delivered in the referral hospitals of the Amhara National Regional State. Methods A hospital-based prospective cohort study was conducted among 810 neonates in the first 3 days of delivery between March 1 and August 30, 2018. The neonates were followed up from the time of admission to 72 h. Interviewer-administered questionnaires and medical record reviews were conducted for data collection. Data were entered into Epi-data manager version 4.4 and analysed using STATA™ version 16.0. The neonate’s survival time was calculated using the Cox-Proportional hazards model. Results The overall incidence of neonatal mortality in this study was 151/1000 births. Neonatal mortality was significantly higher among neonates whose mothers came between 17 and 28 weeks of gestation for the first visit; among those whose mothers labour was not monitored with a partograph, mothers experienced postpartum haemorrhage and developed a fistula first 24 h, and experienced obstructed labour. However, 39% were less risky among neonates whose mothers were directly admitted and whose mothers had visited health facilities in less than 1-h, both. Conclusions This study revealed that approximately 1 in 7 neonates died within the first 3 days of life. The determinants were the timing of the first antenatal visit, quality of labour monitoring, maternal complications, and delay in seeking care. Thus, scaling up evidence-based interventions and harmonising efforts to improve antenatal care quality, promote institutional deliveries, provide optimal essential and emergency obstetric care, and ensure immediate postnatal care may improve neonatal survival.

Objective: The study aimed to determine proportion and risk factors for maternal complication related to forceps and vacuum delivery among mother who gave birth at Felege Hiwot Comprehensive Specialized Hospital (FHCSH). Results: Records of 406 mothers managed with instrumental vaginal delivery were reviewed and 97% of the reviewed card had complete documentation. The proportion of maternal complications related to instrumental delivery was 12.1%. A major complication of forceps assisted delivery was 2nd-degree perineal tear (7.4%), 3rd-degree perineal tear (1.5%), cervical tear (1.5%) and episiotomy extension (1%). However, the complication of vacuum-assisted vaginal delivery was only cervical tear (0.5%) and episiotomy extension (0.5%). Episiotomy during instrumental delivery reduce maternal complication by 86% [AOR=0.14, 95%CI=0.07-0.3]. Forceps assisted vaginal delivery had 3.4 times more risk for maternal complication compared to vacuum-assisted vaginal delivery [AOR=3.4, 95%CI=1.08-10.67] and the same is true for primiparity that primipara women who gave birth by the help of instrument had 3.5 times more risk for maternal complication compared to a multipara women [AOR=3.5, 95%CI=1.26-9.98]. Keywords: maternal complication, instrumental delivery, northwest, Ethiopia

Objective: The study aimed to determine proportion and risk factors for maternal complication related to forceps and vacuum delivery among mother who gave birth at Felege Hiwot Comprehensive Specialized Hospital (FHCSH). Results: Records of 406 mothers managed with instrumental vaginal delivery were reviewed and 97% of the reviewed card had complete documentation. The proportion of maternal complications related to instrumental delivery was 12.1%. A major complication of forceps assisted delivery was 2nd-degree perineal tear (7.4%), 3rd-degree perineal tear (1.5%), cervical tear (1.5%) and episiotomy extension (1%). However, the complication of vacuum-assisted vaginal delivery was only cervical tear (0.5%) and episiotomy extension (0.5%). Episiotomy during instrumental delivery reduce maternal complication by 86% [AOR=0.14, 95%CI=0.07-0.3]. Forceps assisted vaginal delivery had 3.4 times more risk for maternal complication compared to vacuum-assisted vaginal delivery [AOR=3.4, 95%CI=1.08-10.67] and the same is true for primiparity that primipara women who gave birth by the help of instrument had 3.5 times more risk for maternal complication compared to a multipara women [AOR=3.5, 95%CI=1.26-9.98]. Keywords: maternal complication, instrumental delivery, northwest, Ethiopia

Objective: the aim of the study was to assess the proportion of maternal complication related to instrumental vaginal delivery and its associated factors among mothers who gave birth in Felege Hiwot comprehensive specialized hospital, northwest Ethiopia. Results: Records of 406 mothers managed with instrumental vaginal delivery were reviewed and 97% of reviewed card had complete documentation. The proportion of maternal complications due instrumental vaginal delivery was found to be 12.1%. A mother who had an episiotomy [AOR=0.14, 95%CI=0.07-0.3], Forceps assisted vaginal delivery [AOR=3.4, 95%CI=1.08-10.67] and primiparity [AOR=3.5, 95%CI=1.26-9.98] were found to be associated with maternal complications related to instrumental vaginal delivery. Keywords: maternal complication, instrumental delivery, Felege hiwot, Bahir Dar