1095 Cesarean delivery variation across facilities in Uganda

Okolo, Isioma; Lugobe, Henry Mark; Garba, Deen L.; Tibaijuka, Leevan; Byamukama, Onesmus; Ngonzi, Joseph; Boatin, Adeline A.

doi:10.1016/j.ajog.2020.12.1119

Cited by 2 publications

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“…Few studies that have assessed interbirth intervals in Uganda have been conducted in the general population of women of child bearing age and yet women with previous cesarean deliveries have a two to three heightened risk in poor maternal and perinatal outcomes [ 6 , 9 ]. Cesarean delivery rates vary widely across health facilities in Uganda, with regional referral hospitals more likely to have caesarean delivery rates > 30% compared to lower health facilities [ 10 ]. Cesarean delivery rates have increased both at health facility and population levels in Uganda.…”

Section: Introductionmentioning

confidence: 99%

Short interbirth interval and associated factors among women with antecedent cesarean deliveries at a tertiary hospital, Southwestern Uganda

Byamukama

Migisha

Kalyebara

et al. 2022

BMC Pregnancy Childbirth

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Background Women with previous cesarean deliveries, have a heightened risk of poor maternal and perinatal outcomes, associated with short interbirth intervals. We determined the prevalence of short interbirth interval, and associated factors, among women with antecedent cesarean deliveries who delivered at Mbarara Regional Referral Hospital (MRRH), in southwestern Uganda. Methods We conducted a cross-sectional study on the postnatal ward of MRRH from November 2020 to February 2021. We enrolled women who had antecedent cesarean deliveries through consecutive sampling. We obtained participants’ socio-demographic and obstetric characteristics through interviewer-administered structured questionnaires. We defined short interbirth interval as an interval between two successive births of < 33 months. Modified Poisson regression was used to identify factors associated with short interbirth intervals. Results Of 440 participants enrolled, most had used postpartum family planning (PPFP) prior to the current pregnancy (67.5%), and most of the pregnancies (57.2%) were planned. The mean age of the participants was 27.6 ± 5.0 years. Of the 440 women, 147 had a short interbirth interval, for a prevalence of 33% (95%CI: 29–38%). In multivariable analysis, non-use of PPFP (adjusted prevalence ratio [aPR] = 2.24; 95%CI: 1.57–3.20, P < 0.001), delivery of a still birth at an antecedent delivery (aPR = 3.95; 95%CI: 1.43–10.9, P = 0.008), unplanned pregnancy (aPR = 3.59; 95%CI: 2.35–5.49, P < 0.001), and young maternal age (aPR = 0.25 for < 20 years vs 20–34 years; 95%CI: 0.10–0.64, P = 0.004), were the factors significantly associated with short interbirth interval. Conclusion One out of every three womenwith antecedent caesarean delivery had a short interbirth interval. Short interbirth intervals were more common among women with history of still births, those who did not use postpartum family planning methods, and those whose pregnancies were unplanned, compared to their counterparts. Young mothers (< 20 years) were less likely to have short interbirth intervals compared to those who were 20 years or older. Efforts should be made to strengthen and scale up child-spacing programs targeting women with previous cesarean deliveries, given the high frequency of short interbirth intervals in this study population.

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Section: Introductionmentioning

confidence: 99%

Short interbirth interval and associated factors among women with antecedent cesarean deliveries at a tertiary hospital, Southwestern Uganda

Byamukama

Migisha

Kalyebara

et al. 2022

BMC Pregnancy Childbirth

Self Cite

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“…Most CDs are performed in General Hospitals (50.4%) and Regional Referral Hospitals (RRHs) (24.5%) while Heath Centre IVs and Private Not For Profit (PNFP) facilities account for only 18.5%) and 6.7% of the CDs respectively. There is significant variation in CD rates by facility type with RRHs more likely to have CD rates >30% compared to GH and HCIVs [7]. However, the rates of cesarean section at Mbarara Regional Referral Hospital (MRRH) does not support the figures described by Demographic Health Survey.…”

Section: Introductionmentioning

confidence: 96%

Prevalence and Risk Factors for Caesarean Section Delivery Following Labour Induction at Mbarara Regional Referral Hospital

Sandra

2023

IDOSR-JSR

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Labour induction is one of the most common obstetric interventions. According to most current studies, the rate varies from 9-33% of all pregnancies annually. According to American Congress of Obstetricians and Gynecologists, one-fifth of all pregnancies are terminated with the induction method. The aim of induction is to prevent maternal and fetal disorders such as preeclampsia, premature rupture of membranes, intrauterine growth retardation and prolonged pregnancy. Since the purpose of induction is vaginal delivery, a number of authors consider successful induction as vaginal delivery without regarding to the time limits. Induction failure is defined as failure of induction leading to cesarean section. The aim of this study was to determine the relationship between induction and risk of cesarean section delivery for women with term pregnancies who were admitted to Mbarara Regional Referral Hospital. A hospital based retrospective cohort study was conducted using maternally-linked data from MRRH birth registry. The study was restricted to deliveries intervened by labor induction at Mbarara Regional Referral Hospital during the year 2019 to 2021. Study samples size were 180 cases using convenience sampling among eligible pregnant women admitted to MRRH for induction. Data analysis was performed using SPSS version 21. Chi-square and t-test were used to compare groups with significant levels of less than 0.05, and logistic regression test was used to determine odds ratio with 95% confidence level. The mean age of those who underwent induction were 26.7 ± 5.6 years. In terms of education, 63.3 % were at the elementary level, the majorities (94.6%) were housewives or unemployed prior to delivery, and 57.4% were nulliparous. The prevalence of cesarean section was 22.21%. The mean gestational age was 39.3 ± 2.6 weeks and post-term pregnancies (40.63%), and PROM (24.12%) were among the most common causes for induction. Dilatation and birth weight were factors predicting labour induction success. Furthermore, performing Induction in dilatation 3 cm or less was associated with an increased risk of cesarean delivery. The prevalence of caesarean section after induction of labour in this study was 22.1%. Cervical dilatation (3 cm or less) prior to induction and increasing birth weight could be the major factors leading to caesarean section, hence predicting labor induction success. More funding is necessary by the hospital to further give more light to the all-time prevalence of cesarean section following labor induction within MRRH. Keywords: Labour induction, vaginal delivery, Cesarean section, Maternal and fetal disorders, Premature rupture of membranes.

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1095 Cesarean delivery variation across facilities in Uganda

Cited by 2 publications

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Short interbirth interval and associated factors among women with antecedent cesarean deliveries at a tertiary hospital, Southwestern Uganda

Short interbirth interval and associated factors among women with antecedent cesarean deliveries at a tertiary hospital, Southwestern Uganda

Prevalence and Risk Factors for Caesarean Section Delivery Following Labour Induction at Mbarara Regional Referral Hospital

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