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      Pregnancy outcomes at Mizan-Tepi University Teaching Hospital: A Comparison to the Ethiopian Demographic and Health Surveys

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          Abstract

          Background:

          To compare outcomes at Mizan-Tepi University Teaching Hospital to national and regional data and to plan quality improvement and research studies based on the results.

          Methods:

          This study was a prospective hospital-based cross-sectional analysis of a convenience sample of 1, 000 women who delivered at Mizan-Tepi University Teaching Hospital.

          Results:

          Our convenience sample was young (median age 24 years) with a primarily school level or less of education (68.6%). Only about 5% of women had a history of prior cesarean birth, 2.1% reported they were human immunodeficiency virus seropositive, and the median number of prenatal visits was four. Women were commonly admitted in spontaneous labor (84.5%), transferred from another facility (49.2%; 96.8% of which were referred from a health center), and had their fetal heart rate auscultated on admission (94.7%). Only 5.2% of women did not deliver within twenty-four hours and the cesarean birth prevalence was 23.4%. Many women were delivered by midwives (73.2%; all unassisted vaginal births), 89.2% were term deliveries, and 92.5% of neonatal birthweights were 2500 grams or heavier. Less than five percent of women delivered stillbirths (4.3%) and 5.7% of livebirths experienced neonatal death by the day of discharge. There were no maternal deaths in the cohort.

          Conclusion:

          The prevalence of stillbirth and neonatal death were the most notable findings, while there was no maternal death in the cohort.

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          Most cited references18

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          WHO Statement on Caesarean Section Rates.

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            Relationship Between Cesarean Delivery Rate and Maternal and Neonatal Mortality.

            Based on older analyses, the World Health Organization (WHO) recommends that cesarean delivery rates should not exceed 10 to 15 per 100 live births to optimize maternal and neonatal outcomes.
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              Contemporary patterns of spontaneous labor with normal neonatal outcomes.

              To use contemporary labor data to examine the labor patterns in a large, modern obstetric population in the United States. Data were from the Consortium on Safe Labor, a multicenter retrospective study that abstracted detailed labor and delivery information from electronic medical records in 19 hospitals across the United States. A total of 62,415 parturients were selected who had a singleton term gestation, spontaneous onset of labor, vertex presentation, vaginal delivery, and a normal perinatal outcome. A repeated-measures analysis was used to construct average labor curves by parity. An interval-censored regression was used to estimate duration of labor, stratified by cervical dilation at admission and centimeter by centimeter. Labor may take more than 6 hours to progress from 4 to 5 cm and more than 3 hours to progress from 5 to 6 cm of dilation. Nulliparous and multiparous women appeared to progress at a similar pace before 6 cm. However, after 6 cm, labor accelerated much faster in multiparous than in nulliparous women. The 95 percentiles of the second stage of labor in nulliparous women with and without epidural analgesia were 3.6 and 2.8 hours, respectively. A partogram for nulliparous women is proposed. In a large, contemporary population, the rate of cervical dilation accelerated after 6 cm, and progress from 4 cm to 6 cm was far slower than previously described. Allowing labor to continue for a longer period before 6 cm of cervical dilation may reduce the rate of intrapartum and subsequent repeat cesarean deliveries in the United States.
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                Author and article information

                Journal
                101778175
                50570
                Obstet Gynecol Res
                Obstet Gynecol Res
                Obstetrics and gynecology research
                2637-4560
                1 May 2021
                14 April 2021
                2021
                01 January 2022
                : 4
                : 2
                : 62-80
                Affiliations
                [1 ]University of Colorado School of Medicine, Aurora, Colorado, USA
                [2 ]Village Health Partnership, Denver, Colorado, USA
                [3 ]Mizan-Tepi University Teaching Hospital, College of Health Sciences, Mizan-Aman, Ethiopia
                Author notes

                Author Contributions

                MSH, EK, TW, and BT designed the study and the data collection forms with oversight and review from MM and TY. AJZ built the electronic forms and assisted with data management, quality, and analysis. MSH performed the analysis and wrote the manuscript with edits and oversight from all authors.

                [* ] Corresponding Author: Margo S Harrison, University of Colorado School of Medicine, Mail Stop B198-2, Academic Office 1, 12631 E. 17th Avenue, Rm 4211, Aurora, Colorado 80045, USA, Tel: 303.724.2938
                Article
                NIHMS1694391
                10.26502/ogr056
                8136690
                34027413
                eeb28c4a-686d-4248-873f-e6f1e005f283

                This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC-BY) license 4.0

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                Categories
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                pregnancy outcomes,ethiopia,sub-saharan africa
                pregnancy outcomes, ethiopia, sub-saharan africa

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