Department of Gynaecology and Obstetrics

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    MAGNITUDE AND OUTCOMES OF INDUCTION OF LABOR: A PROSPECTIVE DESCRIPTIVE CROSS-SECTIONAL STUDY AT MEKELLE PUBLIC HOSPITALS IN NORTHERN ETHIOPIA
    (Mekelle University, 2025-02-25) Welday Abadi
    Background: Induction of labor (IOL) is an artificial initiation of labor after the age of fetal viability and before the onset of spontaneous true labor to achieve vaginal delivery as a therapeutic option when the benefits of expeditious delivery outweigh the risks of continuing the pregnancy. This research aims to assess magnitude of labor induction, associated factors and perinatal/maternal outcomes among mothers delivered at Mekelle public hospitals , Tigray, Northern Ethiopia. Methods: A hospital based cross sectional study was conducted on 308 laboring mothers who delivered after induction of labor, from July 1st, to December 1st, 2024. Using structured questionnaire and quota sampling techniques, all eligible participants were immediately enrolled upon admission until the desired sample size was achieved. SPSS windows version 25.0 was used for analysis and both descriptive and inferential statistics were conducted; statistical significance to declare relationship between the dependent and independent variables was set at p<0.05. Results: 308 of the 5173 women who gave birth in the study area were induced, representing a 5.9% magnitude of induction. Out of this, 236 (76.6%) were delivered vaginally, 3(1%) were operative vaginal deliveries and 69 (22.4%) by Caesarean delivery.The most prevalent indication for Caesarean delivery was NRFHRP 41(59.4%), and 239 (77.6%) of the inductions were successful, while 22 (7.1%) failed. A caesarean section was used to deliver all of the patients with failed induction. Oxytocin 169(54.9%) was the most popular method for inducing labor. Bishop’s score after cervical ripening significantly predicted the success of induction [AOR=3.588(2.793,10.983)].and the two most common indications for induction were prelabor rupture of membrane 174(56.5) and oligohydraminos 39(12.7%). Conclusion: While our successful induction rate (77.6%) is higher than that of similar institutions in Ethiopia but comparable to most African and Asian rates, our failed induction rate (7.1%) is lower than both local and regional settings. Bishop’s score after cervical ripening significantly predicted the success of induction [AOR=3.588(2.793,10.983)]
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    MATERNAL AND NEONATAL OUTCOME OF ADVANCED MATERNAL AGE ADMITTED FOR LABOUR AND DELIVERY IN ACSH AND MGH
    (Mekelle University, 2025-03-28) TEKLEBRHAN G/ANENIA
    Background Advanced maternal age is usually defined as being 35 years or older during pregnancy. AMA, planned or unplanned, are usually regarded as high risk, because they have been associated with an increased risk of adverse pregnancy outcomes. Objective To examine maternal and neonatal outcomes in AMA admitted for labor and delivery at AMA and adult age pregnancy in ACSH and MGH , from July 2024 to October2024 Methodology Hospital based prospective case-control study on 256 pregnancy at AMA(cases) and 256 pregnancy at 20-34yrs(controls) admitted for labor and delivery in Mekelle Public Hospitals was employed. Data was collected by using pretested structured questionnaire. The collected data was entered into EpiData 4024 and exported to SPSS 27 for analysis. The dependent variables were AMA pregnancy, maternal and neonatal outcomes. Statistical significance declared at p<0.05. Result Participants who attended secondary school or above accounted for 144 (56.3%) of cases and 185 (72.3%) of controls. The difference in distribution of educational status between cases and control were statistically significant (p=0.001). Among those who had ANC contacts, 4 plus ANC contact was recorded in 188 (76.1%) of cases and 220 (87.6%) of controls and the difference was statistically significant (p<0.001). Pregnancy was planned in 218 (85.2%) of cases and 248 (96.9%) of controls. The difference in pregnancy plan was statistically significant (p<0.001). Obstetric complications happened in 104 (40.6%) of cases and 70 (27.3%) of controls. The magnitude of obstetric complication was significantly higher in cases group (p=0.002). Caesarean delivery rate was higher in cases (87, 34.0%) than controls (53, 20.7%) and the discrepancy was highly remarkable (p<0.001). The magnitude of low first minute APGAR score (<7) was observed in 27 (10.6%) of cases and 10 (3.9%) of controls. This difference was statistically significant (p=0.011). Conclusion This study has revealed that obstetric complications like antepartum haemorrhage, pre-eclampsia, prolonged labor, and gestational diabetes are higher among older mothers compared to younger mothers. Low First minute APGAR scores were more frequent in older mothers. Caesarean delivery and post-partum haemorrhage (PPH) were significantly higher in mothers aged 35 or above.
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    Maternal Satisfaction with the Process of Informed Consent for Cesarean Delivery in two Public Hospitals in Mekelle City, Ethiopia: A cross-sectional Study
    (Mekelle University, 2025-03-28) Kiros Yirga
    Background Caesarean delivery (CD) is a critical intervention for reducing maternal and neonatal morbidity and mortality. However, the process of informed consent (IC) often remains suboptimal in many low-resource settings. Inadequate time for counselling and limited discussion of procedure details can undermine patient autonomy and satisfaction. This study aimed to assess maternal satisfaction with the informed consent process for Cesarean delivery in two public hospitals in Mekelle City, Ethiopia. Methods A cross-sectional study was conducted among women who underwent Cesarean delivery at Ayder Comprehensive Specialized Hospital and Mekelle General Hospital. A structured questionnaire was administered on the first or second postoperative day, capturing data on sociodemographic characteristics, obstetric factors, components of the consent process, and satisfaction measures. Cronbach’s alpha assessed internal reliability of satisfaction items. Binary logistic regression identified independent predictors of maternal satisfaction, with a significance level of p < 0.05. Results A total of 354 participants were included. The majority (60.2%) were aged 25–34 years, 88.1% lived in urban areas, and 77.1% underwent emergency Cesarean delivery. About 22.6% signed a consent form in their mother tongue, and 64.4% reported receiving less than five minutes of counselling. Overall, 55.7% of mothers were categorized as “satisfied” with the informed consent process (score above the mean). Two factors independently predicted higher satisfaction: having >10 minutes of explanation (adjusted odds ratio [AOR] = 0.3 for <5 minutes vs. >10 minutes) and knowing the surgeon’s name (AOR = 2.5). The model fit was good (Hosmer-Lemeshow p = 0.905) with no multicollinearity issues (maximum VIF = 1.58). Conclusion Just over half of the women were satisfied with their Cesarean consent process, indicating moderate overall performance. Critical gaps include insufficient counselling time and limited interaction or familiarity with the operating surgeon. Strengthening communication—by allocating more time for counselling and ensuring meaningful patient-provider introductions could significantly enhance maternal satisfaction with the informed consent process.
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    MATERNAL & NEONATAL OUTCOMES AND ASSOCIATED FACTORS OF BREECH PRESENTATION AT AYDER COMPREHENSIVE SPECIALIZED HOSPITAL
    (Mekelle University, 2025-03-28) KIBRET HAGOS
    Background: Breech presentation, a longitudinal fetal lie where the buttocks or legs enter the pelvis before the head, is the most common malpresentation, occurring in 3-5% of singleton deliveries at term (37 weeks gestation or later) (1–3). While breech positioning is more frequent earlier in pregnancy due to the similar bulk of fetal poles, its persistence at term is less common and varies globally. Risk factors and prevalence underscore its clinical significance, yet the optimal mode of delivery—vaginal versus cesarean—remains contentious. Evidence suggests cesarean delivery reduces perinatal risks, but a WHO study highlights maternal mortality and severe morbidity rates 3.4 and 2.3 times higher, respectively, compared to vaginal delivery, fueling ongoing debate (4) (1,2,5–7). Objective: To assess maternal and neonatal outcomes of singleton term breech deliveries at Ayder Comprehensive Specialized Hospital from June, December 31, 2024 Methods: Hospital based cross sectional study conducted in Mekelle University at Ayder Comprehensive Specialized Hospital over 6 monthes period from June, December 31, 2024.IBM-SPSS version 27 was used. Descriptive analysis such as frequency, percentage, and mean, median was applied for different factors and outcomes. Logistic regression analysis was applied for statically significant variables with p value<0.05. Results: The prevalence of term breech presentation in this study was 3.2% (136). Majority, 102(75%) of them delivered via cesarean delivery (C/D), and 34 (25%) had vaginal breech delivery. Perinatal mortality rate was 123 per 1000 deliveries and 15 (11.0%) neonates admitted to the NICU. Of these, 5(33.3%) were diagnosed with perinatal asphyxia (PNA), and 5 (33.3%) had respiratory distress (RD) secondary to meconium aspiration syndrome (MAS), 5 (33.3%) had Early neonatal sepsis, 2(1.4%) had soft tissue trauma and hypothermia. Low APGAR scores (<7) were observed in 28 (20.5%) of neonates at 1 minute and 12 (8.8%) at 5 minutes. Maternal complications included postpartum hemorrhage (PPH) in 3 (2.2%) of cases, third-degree perineal tears 1 (0.7%), and wound infections 2 (1.5%).One mother experienced severe adhesions leading to organ injury (iatrogenic bladder injury) and required a hysterectomy. Conclusion: There was significant number of maternal and neonatal complication. Parity, early gestational age at delivery, birth of new born less than 2500gm and unintended pregnancy were associated with maternal and neonatal outcomes of singleton term breech deliveries. There was higher rate of CD (75%) for singleton term breech deliveries when compared to other similar tertiary level hospital. Easier access to effective contraception methods can certainly help to address un intended pregnancy. A protocol for the management of breech delivery and a regular training facility for junior residents to conduct assisted vaginal breech delivery is recommended. Achieving universal coverage of the recommended new WHO ANC contacts model is considered feasible through collaborative efforts among healthcare providers, facilities, and policymakers.
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    Prevalence and determinant factors of postpartum depression among mothers visiting postnatal and immunization clinics in selected public health institutions Mekelle, Tigray; Hospital based cross-sectional study
    (Mekelle University, 2025-03-28) BERIHU KAHSAY
    Background Postpartum Depression (PPD) involves various groups of depressive symptoms and syndromes that take place during the first year following birth. It is recognized as risk period for severe mood disorder that comprises provisional blue, major depression and debilitating psychotic depression. Most of the studies indicate that the magnitude and impact of PPD is higher in developing nations. Worldwide the prevalence ranges 0.5- 60.8 and up-to 3.8% to 69.9% in Africa. Recent institution-based study Addis Ababa, Ethiopia showed prevalence of 25.95%. Despite the high prevalence of PPD in developing countries, there is a paucity of research on postpartum depressive disorders and their predictors particularly in Ethiopia and the Tigray region. This lack of research hinders the development of effective e interventions and policies to address PPD in these regions. Therefore, it is important to study on it, so that we can develop effective interventions and policies to tackle it. Objective To assess the magnitude and associated factors of postpartum Depression among postpartum mothers in selected governmental Hospitals in Mekelle, Tigray Methodology Hospital based cross- sectional study on 326 post-natal mothers who visit Mekelle Public Hospitals was undertaken. Data was collected using pretested prepared questionnaire with structured questions (modified Edinburgh Postnatal Depression Scale) from December 1, 2024 to January 30, 2025 G.C. It was coded on pre- arranged coding sheet and entered into the Epi info version 7.2.6 statistical package then, after checking for completeness and cleaning, analyzed using SPSS version 27. Results The complete response rate was 100%. The magnitude of postpartum depression found to be 26.997%. Living away from husband (AOR 2.975(95%CI :1.16-7.613), working during the postpartum period(AOR 0.221(95%CI :0.07-0.699)), monthly income(AOR,4.045(95%CI: 1.793-9.127)), status of the baby (alive or dead) (AOR,55.852(95%CI :1.937-1610.387)) and whether the mother had negative social life event (AOR 6.031(95%CI :1.009-36.064)) are the factors which has statistically significant association with PPD in this study. Conclusion Postpartum depression is a common mental health problem at the postpartum period. This study also revealed that different factors contributing to the occurrence of postpartum depression, such as living away from husband, working during the postpartum period, monthly income, status of the baby and whether the mother had negative social life event.