Labor Complications Research Articles

Prevalence of stillbirth and associated factors among deliveries attended in health facilities in Southern Ethiopia.

Stillbirth is an unfavorable outcome of pregnancy, which is still prevalent in many countries despite remarkable efforts made to improve the care of pregnant women. While producing estimates consistent with other national reports, all are hindered by limited data and important causes of death are likely to be missed. However; there is a scarcity of data on stillbirth in Ethiopia particularly in the Wolaita zone. To assess the prevalence and associated factors of stillbirth among women giving birth at public hospitals in the Wolaita zone, southern Ethiopia. A facility-based cross-sectional study was conducted in public hospitals in the Wolaita zone. A stratified sampling technique was used to select 737 women. A pre-tested interviewer-administered questionnaire was used for data collection. Data were entered using Epidata version 3.1 and analyzed using SPSS version 20. Bivariate and multiple logistic regression analysis were used and the crude and adjusted odds ratios at a 95% confidence interval with P-value <0.05 were considered to declare the result as statistically significant. This study reported an 8.7% [95% CI: 6.5-10.8] prevalence of stillbirth. Women who lived in rural areas, had pregnancy and labor complications, a high number of pregnancies, a prior history of stillbirth, and a complicated delivery were associated with stillbirth. When compared to urban residents, being a rural resident increased the risk of stillbirth by 2.57 fold [adjusted OR = 2.57, 95% CI: 1.23, 5.40]. When compared to their counterparts, women who experienced complications during pregnancy and labor increased 6.23 fold [AOR = 6.23, 95% CI: 2.67-14.58], having a previous history of stillbirth increased 6.89 fold [AOR = 6.89, 95% CI: 2.57-13.57], and the type of delivery increased 7.13 fold the risk of stillbirth [AOR = 7.13, 95% CI: 2.71-18.73]. The prevalence of stillbirth among women who gave birth in public hospitals in the Wolaita zone was found to be high compared to national and regional figures. Therefore, the federal and regional governments should strengthen inter-sectoral collaboration with health facilities to promote the maternal and health care services utilization. The zonal health department and other concerned bodies should focus on the implementation of the strategies and policies that address and reduce the causes of stillbirth.

Rare causes of genital fistula in nine African countries: a retrospective review

BackgroundMost genital fistulas result from prolonged, obstructed labor or surgical complications. Other causes include trauma (from accidents, traditional healers, or sexual violence), radiation, carcinoma, infection, unsafe abortion, and congenital malformation.MethodsThis retrospective records review focuses on rare fistula causes among 6,787 women who developed fistula after 1980 and sought treatment between 1994 and 2017 in Tanzania, Uganda, Kenya, Malawi, Zambia, Rwanda, Ethiopia, Somalia, and South Sudan. We compare fistula etiologies across countries and assess associations between rare causes and type of incontinence (urine, feces, or both).ResultsRare fistula accounted for 1.12% (76/6,787) of all fistulas, including traumatic accidents (19/6,787, 0.28%), traumatic sexual violence (15/6,787, 0.22%), traumatic injuries caused by traditional healers (13/6,787, 0.19%), unsafe abortion (10/6,791, 0.15%), radiation (8/6,787, 0.12%), complications of HIV infection (6/6,787, 0.09%), and congenital abnormality (5/6,787, 0.07%). Trauma caused by traditional healers was a particular problem among Somali women.ConclusionFistulas attributable to rare causes illuminate a variety of risks confronting women. Fistula repair training materials should distinguish trauma caused by traditional healers as a distinct fistula etiology. Diverse causes of fistula call for multi-pronged strategies to reduce fistula incidence.

Maternal Mortality Risk Factors and the Role of Midwives in First Handling Maternal Emergencies based on Verbal Autopsy of the 2016-2021 Maternal Perinatal Audit Program in Bandar Lampung City

The direct cause of maternal death is more than 90% due to obstetric complications, especially complications of childbirth. Complication is a complication, aggravating circumstances of a disease. Pregnancy complications are obstetric emergencies that can cause death to the mother and fetus. Pregnancy complications include hypertension and preeclampsia, anemia, and placenta previa. Meanwhile, complications of childbirth are the occurrence of difficult labor (dystosia) which causes a disease. Labor complications include premature rupture of membranes, premature labor, abnormalities in fetal position, and others (Roberts &amp; Gammill, 2005). Knowing the risk factors for maternal death based on the main variables of delivery assistance by involving the mother's sociobiological factors, and control efforts based on verbal autopsy Maternal Perinatal Audit (AMP) in Bandar Lampung City. This study used a cross-sectional design.

Feto-Maternal Outcomes of Labouring Patients in Booked and Unbooked Patients

The main factor contributing to poor feto-maternal outcomes is lack of antenatal care and awareness among pregnant ladies for need of booking in hospitals for their delivery management. Up to 39% of all obstetric patients in underdeveloped countries are hospitalized due to complications of labor, and same is case with neonates. Objective: To determine the association between patient booking status and outcomes because high maternal morbidity and mortality rates are indicative of the poor state of health services. Methods: A total of 380 patients, 190 booked patients admitted in emergency and 190 unbooked patients with fetal and maternal problems were included. The demographic data of each patient were recorded to determine the fetomaternal outcomes. Results: Different causes of obstructed labour such as CPD (60.62%), malpresentation (17.98%), and malposition (23.34%) were recorded in patients. In booked patients, 9.47, 3.15, and 5.78% of wound infection, anaemia, and ruptured uterus were recorded, respectively, while 11.05, 4.73, and 6.84%, respectively in unbooked patients. Among booked patients, 80.52% had maternal complications while 95.26% of unbooked had complications. Fetomaternal is a disorder that can be avoided and is common in underdeveloped nations. The majority of patients were unscheduled patients who did not obtain adequate antenatal care and as a result, showed up late in advanced labour with obstructional symptoms. CPD was the most typical reason for labour obstruction. Conclusions: Puerperal pyrexia was the most frequent maternal consequence, followed by PPH and UTI. Birth asphyxia was the most frequent prenatal consequence, followed by neonatal infection.

The effectiveness and usability of electronic partograph for obstetric care: A systematic review

Introduction: Partograph is an instrument used to monitor and prevent labor complications. Unfortunately, a large number of situations where there is limited awareness of how to use a partograph as a labor monitoring tool. One of the efforts made is to develop partographs in the form of electronic partograph (e-partograph) applications. This review aims to analyze the effectiveness and usability of electronic partograph for obstetric care.

Time to pregnancy and perinatal outcomes in a cohort of spontaneous pregnancies

BackgroundObstetric and perinatal outcomes depend not only on care during pregnancy, as there is an increasing evidence of their relationship with preexisting conditions. Woman’s age and time to pregnancy (TTP) have been related to the prognosis in reproductive success, but TTP could influence fetal well-being and newborn. According to the World Health Organization, 48 million couples have subfertility globally. MethodsWe analyzed the relationship between TTP and obstetric (premature labor, preeclampsia…), labor (type of delivery, postpartum hemorrhage…), and neonatal outcomes (low birth weight…) in a cohort of 190 spontaneous gestations. Subfertility is a disease defined by the failure to achieve a pregnancy after 12 months of regular unprotected sexual intercourse. ResultsTTP was >12 months in 23.1 % (95 % CI = 17.57–29.55), however, no correlation was found with the perinatal outcomes (p = 0.24). We observed that 45.2 % of subfertile women had obstetric complications, 13.2 % labor complications, and 34.2 % neonatal complications, whereas non-subfertile women had 29.4 %, 21.0 %, and 21.0 %, respectively. Half of pregnancies have at least one adverse outcome, and obstetric complications were the most frequent. ConclusionSubfertility condition may appear in up to a fifth of our couples. Subfertility may behave as a mild risk factor for adverse perinatal outcomes. Obstetric or perinatal complication may be expected in up to half of the cases. Subfertile women ≥ 35 years of age have a 3-fold increase in their risk of having an obstetric complication when compared to non-subfertile women of the same age.

Postnatal Care Utilization and Associated Factors among Mothers who gave Birth in the Aysaeta District, Northeast Ethiopia: A Community Based Cross-sectional Study.

Postnatal care is given to mothers and newborn babies within 42 days of delivery. It is a period of high maternal and newborn mortality and is also the most neglected in terms of maternal health services in many parts of the world. This study aimed to assess postnatal care and associated factors among mothers who gave birth in the year preceding the survey of the Ayssaeta district. A community-based cross-sectional study was conducted among 406 mothers who gave birth in the year preceding the survey from August 02-30, 2020. Bivariable and multivariable logistic regression analyses were done to identify factors associated with postnatal care utilization. Slightly greater than four out of ten mothers have visited postnatal care units at least once. Living in urban areas, giving birth in a health facility, having complications during labor and after, and getting advice during antenatal care visits were associated with higher odds of postnatal care utilization. Less than half of the mothers received postnatal care following the delivery of their last child. Living in an urban, place of delivery, experiencing labor and postpartum complications, and receiving postnatal care advice during antenatal care have affected the utilization of postnatal care. Promoting skilled delivery and antenatal care with a focus on rural areas can help mothers learn about postnatal care and increase the number of mothers who use it.

Exploring the psychosocial challenges faced by pregnant teenagers in Ditsobotla subdistrict.

Pregnant teenagers usually experience psychosocial challenges such as a great amount of stress when they have to deal with an unwanted pregnancy, unpreparedness for parenthood and a lack of income as well as labour and birth complications. These are further complicated by the stigma from their families, friends and community. Unaddressed psychosocial challenges during teenage pregnancy can adversely affect the health outcomes of both mother and the child. This study explores and describes the psychosocial challenges faced by pregnant teenagers in the Ditsobotla subdistrict. The study was conducted in three health centres in the Ditsobotla subdistrict. A qualitative-exploratory-descriptive and contextual research design was used. Non-probability purposive and convenience sampling techniques were used to select the participants. Semistructured individual interviews through WhatsApp video calls were used to collect data, which were analysed using conventional content analysis. Three themes emerged from the findings of the study, namely psychological challenges, social challenges and suggestions to address psychosocial challenges faced by pregnant teenagers. The findings established that pregnant teenagers in the Ditsobotla subdistrict are faced with psychosocial challenges which negatively impact their psychological health and social life. Suggestions made in this study have the potential to improve the psychosocial well-being of pregnant teenagers in the Ditsobotla subdistrict if implemented. The findings of this study provide important information that may be used to improve the psychosocial well-being of pregnant teenagers in the Ditsobotla subdistrict.

Postpartum Hemorrhage

Postpartum hemorrhage (PPH) is a major cause of maternal morbidity and mortality. The most common cause of maternal death in Korea is complications related to the postpartum period (obstetric embolism), accounting for 37.5%, while complications of labor and delivery (uterine atony, PPH, etc.) were the second most common cause, accouning for 21.9%. The effective treatment of PPH often requires multidisciplinary intervention. When managing PPH, multiple interventions (medical, mechanical, invasive, and nonsurgical and surgical procedures), which require different levels of skill and technical expertise, may be used to control bleeding. The healthcare provider needs to begin resuscitative efforts quickly, establish the cause of the hemorrhage, and possibly enroll the assistance of other care providers, such as an obstetrician, anesthetist or radiologist. Avoiding delays in diagnosis and treatment will have a significantly impact on sequelae and chances of survival. This review discusses the causes, identification, management, prevention and prediction of PPH.

Effectiveness of Participation in Pregnancy Classes to Reduce the Incidence of Obstetric Labor Complications and Cesarean Section

Objective : to assess the effectiveness of participation in pregnancy classes to inform such a prenatal program for physicians and midwives, focusing to reduce the incidence of obstetric labor complications and cesarean section.&#x0D; Methods : This study was done using an analytic observational approach, using a cross-sectional study and consecutive sampling. One hundred and ninety-four participants of this study were women aged 20–35 years who gave birth between January and November 2019 in balarejo sub-district, East Java, Indonesia. The subjects were divided into two groups: participation (four times) and non-participation (less than four times) in the pregnancy classes. The analyzed outcomes are labor complications (prolonged labor, postpartum hemorrhage, postpartum fever, premature rupture of membrane), and cesarean section birth..&#x0D; Results: The results of this study indicate that participants of pregnancy classes have a significantly lower probability of suffering prolonged labor (OR=0.05, 95% CI=0.01-0.23, p&lt;0.05), postpartum hemorrhage (OR=0.20, 95% CI=0.04-0.95, p&lt;0.05), and postpartum fever (OR=0.13, 95% CI=0.16-1.08, p&lt;0.05) compared with non-participants. Also, participating women have a lower chance of undergoing cesarean section (OR=0.08, 95% CI=0.03-0.21, p&lt;0.05).&#x0D; Conclusion : The incidence of obstetric labor complications and cesarean section can be effectively reduced by the participation of pregnant woman class.

Differences in management of pregnant women with obstructing infected ureteral stones: A population-based analysis.

Obstructing ureteral stones complicated by urinary tract infection are urologic emergencies that require prompt decompression. We explore the association of pregnancy with rates of and delays in decompression in a cohort of women of reproductive age. Using the National Inpatient Sample from 2010 to 2015, a cross-sectional, descriptive analysis of women of reproductive age (15 to 44 years old) diagnosed with obstructing ureteral stones and urinary tract infection was performed and stratified by pregnancy status. Survey-weighted regression models were used to assess the association of pregnancy on decompression, delays in decompression, and hospital length of stay. Additional exploratory analyses on the association of timing and type of decompression with maternal-fetal outcomes were performed. A weighted total of 38 783 hospitalizations were identified, with 6.1% of admissions occurring in pregnant women. On multivariable regression, pregnant women with obstructing ureteral stones and urinary tract infection were 38% less likely of undergoing decompression (adjusted OR: 0.62; p < 0.001) compared with nonpregnant women. Among those decompressed, pregnant women had greater odds of delayed decompression (adjusted OR: 2.28; p < 0.001) and longer length of stay (adjusted IRR: 1.11; p=0.007). Delayed decompression among pregnant women was associated with increased rates of C-section, early or threatened labor, fetal distress, and umbilical cord complications. Overall, pregnant women had reduced odds of decompression, as well as increased odds of delayed decompression, when compared with nonpregnant women of reproductive age. Delays in decompression among pregnant women were also associated with increased maternal and fetal complications.

Relation between Body Mass Index and Mode of Delivery

Background: Maternal nutritional status is important for health and quality of life in women and growing fetus. Maternal weight gain in pregnancy can offer a good means of assessing the wellbeing of the pregnant mother and her baby. Inadequate prenatal weight gain is a significant risk factor for intrauterine growth restriction, preterm delivery and low birth weight in infants. Obesity and excessive weight gain on the other hand can lead to adverse maternal and fetal outcomes. Interestingly, to get a good fetomaternal perinatal outcome mode of delivery decision is also changed with BMI. Objective: The aim of the study was to evaluate the effect of maternal BMI on the mode of delivery. Methods: This cross-sectional study was carried out department of obstetrics and gynaecology at Bangabandhu Sheikh Mujib Medical University. A total 100 population of purposive sampling was the methods of choice to select the sample from the hospital admitted patients during the period from August 2016 to December 2017. Results: The mean age of 100 mothers were 28.4 (± 6.2) years. The maximum mothers attended from 3rd trimester were overweight (55.36%) whereas 44.64% from the same trimester were normal BMI mothers. Maximum mothers (27%) were from 25-29 years age group and the minimum mothers (4%) were from &gt;= 40 years. Forty Seven Percent mothers came as primigravida. Primigravid women and multigravida with LSCS and without LSCS showed different mode of deliveries. The more the gravida with history of caesarean section the more frequency of present occasion of CS (p=0.006). The higher BMI showed more frequency of caesarean section than NVD or assisted delivery (p=&lt;0.00001) Multiparous women showed more BMI than the p nulliparous. (p=0.005). Multiparity, maternal age and pre-existing medical conditions revealed more complicated labor. Conclusion: The more BMI of mother showed more frequency of caesarean section, assisted delivery than the normal vaginal delivery.

Resuscitation with Intact Cord Versus Clamped Cord in Late Preterm and Term Neonates: A Randomized Controlled Trial

To compare the effect of intact cord versus clamped cord resuscitation on the physiologic transition of neonates receiving positive-pressure ventilation (PPV) at birth. This open-label, parallel-group, randomized controlled superiority trial was conducted in a tertiary care hospital in India. Neonates born at ≥34weeks of gestation after a complicated pregnancy or labor were randomized just before birth to receive resuscitation according to the Neonatal Resuscitation Program algorithm with either an intact cord (intact cord resuscitation group) or after early cord clamping (early cord clamping resuscitation group). The allocated study intervention was administered if the neonate needed PPV at birth. The primary outcome was expanded Apgar score at 5minutes after birth. Birth weight, gestational age, and the incidence of pregnancy complications were similar in the 2 study groups. The proportion of neonates who received PPV was lower in the intact cord resuscitation group (28.7% vs 36.5%, P=.05; relative risk, 0.79; 95% CI, 0.61-1.01). Among neonates who received PPV, the expanded Apgar score at 5minutes was significantly higher in the intact cord resuscitation group (median, 15 [IQR, 14-15] vs 14 [IQR, 13-15]; P<.001). The expanded Apgar score at 10minutes, Apgar scores at 5 and 10minutes, and oxygen saturation at 1, 5, and 10minutes were also higher in the intact cord resuscitation group. In late preterm and term neonates, resuscitation with an intact cord results in better postnatal physiologic transition than the standard practice of resuscitation after immediate cord clamping. Clinical Trial Registry of India (www.ctri.nic.in); trial registration no. CTRI/2020/02/023379.

Intrapartum spontaneous pneumomediastinum: recognizing and treating a rare entity

A 20-year-old nulliparous woman presented to our obstetric unit in spontaneous labour at 39+1 weeks gestation following an uncomplicated pregnancy. After a short labour she progressed to a spontaneous vaginal delivery of a live male infant. Immediately after delivery she experienced retrosternal chest pain, facial swelling and dyspnoea. On examination her chest was clear to auscultation, but extensive subcutaneous emphysema was noted over the chest, neck and face. She remained a diagnostic dilemma until a plain chest radiograph revealed a large volume pneumomediastinum and a CT chest and barium swallow excluded an oesophageal perforation leading to the diagnosis of Hamman’s syndrome. She responded well to supportive cares and was discharged home on day three postpartum. Spontaneous pneumomediastinum or Hamman's syndrome has been rarely reported in the literature as a complication of labour. Although it runs a benign course it often masquerades as more lethal conditions and clinicians should have a good understanding of its diagnosis and management to ensure good outcomes.

The causes of preterm neonatal deaths in India and Pakistan (PURPOSe): a prospective cohort study

SummaryBackgroundPreterm birth remains the major cause of neonatal death worldwide. South Asia contributes disproportionately to deaths among preterm births worldwide, yet few population-based studies have assessed the underlying causes of deaths. Novel evaluations, including histological and bacteriological assessments of placental and fetal tissues, facilitate more precise determination of the underlying causes of preterm deaths. We sought to assess underlying and contributing causes of preterm neonatal deaths in India and Pakistan.MethodsThe project to understand and research preterm pregnancy outcomes and stillbirths in South Asia (PURPOSe) was a prospective cohort study done in three hospitals in Davangere, India, and two hospitals in Karachi, Pakistan. All pregnant females older than 14 years were screened at the time of presentation for delivery, and those with an expected or known preterm birth, defined as less than 37 weeks of gestation, were enrolled. Liveborn neonates with a weight of 1000 g or more who died by 28 days after birth were included in analyses. Placentas were collected and histologically evaluated. In addition, among all neonatal deaths, with consent, minimally invasive tissue sampling was performed for histological analyses. PCR testing was performed to assess microbial pathogens in the placental, blood, and fetal tissues collected. An independent panel reviewed available data, including clinical description of the case and all clinical maternal, fetal, and placental findings, and results of PCR bacteriological investigation and minimally invasive tissue sampling histology, from all eligible preterm neonates to determine the primary and contributing maternal, placental, and neonatal causes of death.FindingsBetween July 1, 2018, and March 26, 2020, of the 3470 preterm neonates enrolled, 804 (23%) died by 28 days after birth, and, of those, 615 were eligible and had their cases reviewed by the panel. Primary maternal causes of neonatal death were hypertensive disease (204 [33%] of 615 cases), followed by maternal complication of pregnancy (76 [12%]) and preterm labour (76 [11%]), whereas the primary placental causes were maternal and fetal vascular malperfusion (172 [28%] of 615) and chorioamnionitis, funisitis, or both (149 [26%]). The primary neonatal cause of death was intrauterine hypoxia (212 [34%] of 615) followed by congenital infections (126 [20%]), neonatal infections (122 [20%]), and respiratory distress syndrome (126 [20%]).InterpretationIn south Asia, intrauterine hypoxia and congenital infections were the major causes of neonatal death among preterm babies. Maternal hypertensive disorders and placental disorders, especially maternal and fetal vascular malperfusion and placental abruption, substantially contributed to these deaths.FundingBill & Melinda Gates Foundation.

The Neglected Problem of Obesity during Pregnancy in Mexico: Secondary Data Analysis of the 2018 National Survey of Health and Nutrition.

To compare sociodemographic and clinical characteristics among obese and non-obese women in Mexico and analyze the association between obesity and pregnancy complications. We conducted a secondary data analysis of the 2018-2019 Mexican National Survey of Health and Nutrition. We included women aged 20-49 years who had at least one live birth in the five years preceding the survey (n = 1573). We performed a double-weighted (by IP-weights and survey-weights) multilevel multiple logistic regression analysis. Obesity was prevalent in 32% of pregnant women. Obese and non-obese women received similar antenatal care. 42.6% of obese women, compared to 33.6% of non-obese had one or more pregnancy or labor complications. Compared with non-obese women, obese women were older and had more chronic diseases. Obesity was associated with a 48% increase in the probability of complications. Due to the high prevalence of obesity among Mexican women of reproductive age and given the independent association between obesity and complications during pregnancy and labor, the development and implementation of specific clinical guidelines on weight management before conception, during pregnancy, and post-partum for women who are obese is an unmet need in Mexico.

S1449 Prior Bariatric Surgery and Labor/Delivery and Pregnancy Complications

S1449 Prior Bariatric Surgery and Labor/Delivery and Pregnancy Complications

S3054 Interdisciplinary Management of a Complicated Pregnancy in a Patient With Cirrhosis

Introduction: We present a unique case of clotting disorder related cirrhosis leading to pregnancy complications. Case Description/Methods: A 29-year-old Caucasian female with a history of gastrointestinal bleeding, gastroesophageal reflux disease, epistaxis, and alcohol use disorder, goes for a routine gynecologic checkup when the physician notices a concerning enlargement of the caudate lobe on a computed tomography scan. Further evaluation reveals cirrhosis and Budd-Chiari syndrome. The patient starts enoxaparin and warfarin following this diagnosis. Eventually the patient is placed on the liver transplant list with a MELD (model of end-stage liver disease) score of 17 which improves to a score of 7 with sobriety. The patient attempts pregnancy and is unable to conceive. She is told she has early menopause at the age of 34. She undergoes reproductive endocrinology evaluation and achieves a successful in-vitro fertilization with a donor egg at age 36. This starts her high-risk pregnancy. The high-risk nature of this pregnancy revolves around the patient’s complicated past medical history of hemorrhagic stroke of unclear etiology, cirrhosis complicated by esophageal variceal bleeding, coagulopathy, Budd-Chiari syndrome, and thrombocytopenia. The patient has close variceal and hepatic vein thrombosis surveillance, labs, and routine checkup for vaginal bleeding with her increased risk of thrombosis during pregnancy. Endoscopy in the 1 st and 3rd trimesters shows small esophageal varices with no evidence of progression. Abdominal ultrasound displays vasa previa at approximately 28 weeks with velamentous umbilical cord insertion 2.3 cm from the internal os. After careful monitoring, the vasa previa is noted to resolve with umbilical cord insertion increasing to 4.8 cm from internal os in the following weeks. Repeated fetal echocardiograms present concern for the fetus being large for gestational age with estimated fetal weights ranging between the 95th-98th percentiles. The patient undergoes elective cesarean delivery and gives birth to a baby boy at 34 weeks with no labor complications. Discussion: We present a unique case of pregnancy during cirrhosis requiring management with multiple specialists. Although the physiologic changes in pregnancy are well understood, the way in which cirrhosis affects pregnancy and its outcomes are not yet well understood given paucity of published data. Certainly, there is complex interplay and physiology involved with increased potential for pregnancy complications.

PENGARUH JENIS LUKA PERINEUM TERHADAP WAKTU PENYEMBUHAN LUKA PERINEUM

Complications of labor can occur from the first stage to the fourth stage, the presence of complications during labor can cause complications. One of the complications during labor that usually occurs is perineal laceration. The 2018 Indonesian Health Profile shows data that post partum infection cases reach a percentage of 80-90% due to lacerations during the delivery process. The method used in this research is correlation with cross sectional approach and analyzed by statistical test of contingency coefficient. The results of the study concluded that mothers who experienced perineal tears due to episiotomy were almost entirely faster in wound healing time, namely 88.25%, while mothers who experienced spontaneous perineal tears had a longer wound healing time, which was 66.67%. The results of the statistical test of the Contingency Coefficient using the SPSS 18 for windows program so that the value of = 0.05, df = 2, X2count = 12.20, X2table = 5.991. Because X2count &gt; X2table, it can be concluded that H0 is rejected and H1 is accepted, which means that there is an effect of the type of perineal wound on the healing time of the wound. To overcome the above problems, early detection is carried out through routine ANC examinations so that the history of previous deliveries, estimated fetal weight, activity patterns and the mother's psychological condition can be known.

Respectful maternity care among women who gave birth at public hospitals in Hadiya Zone, Southern Ethiopia.

BackgroundA compassionate and respectful care during pregnancy and childbirth is one of the essential components of safe motherhood. However, most of the women in developing countries experience disrespectful and abusive maternity care during childbirth. Hence, this study assessed the status of respectful maternity care and associated factors to bridge the gap.MethodologyFacility-based cross-sectional study was conducted among mothers who delivered in public Hospitals in the Hadiya Zone, South Ethiopia from March 01 to 30, 2020. Data were collected using a pretested questionnaire through face-to-face interviews. Descriptive statistics was computed and multivariable logistic regression was fitted to identify predictors. Adjusted Odds Ratio (AOR) with 95% Confidence Interval was used to show the strength of association and level of significance was declared at P-value < 0.05.ResultThis study showed that 67.8 % (95% CI: 62.4–70.8%) of mothers received respectful maternal care. Being married [AOR: 2.17, 95% CI (1.03–6.93)], Cesarean section delivery [AOR: 2.48, 95% CI (1.03–5.97)], and absence of complications during child birth [AOR: 4.37, 95% CI (1.41–13.56)], were significantly associated with respectful maternity care.ConclusionsThe level of RMC in this study was moderate. Being married, Cesarean section delivery, and absence of complications during child birth were identified predictors of respectful maternity care. Therefore, tailored interventions aimed at improving respectful maternity care should target unmarried women, and women with complications of labor regardless of mode of delivery.