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Adverse pregnancy outcomes and associated factors among mothers who had operative vaginal delivery in Amhara Region Comprehensive Specialized Hospitals: multicentre cross-sectional study

Por: Misker · A. D. · Melesew · A. A. · Gobezie · N. Z. · Wubet · H. B. · Diress · G. M. · Abuhay · A. G. · Demite · D. G. · Tadesse · M. A. · Mihretie · G. N. · Abate · A. T. · Asmare · T. B. · Goshu · Y. A. · Siyoum · T. M. · Mekuriaw · B. Y. · Gedefaw · G. D. · Kebede · S. D. · Demissie
Objective

Assess the magnitude of adverse pregnancy outcomes and associated factors among mothers who had operative vaginal delivery in Amhara Region Comprehensive Specialized Hospitals, 2024.

Study design

A cross-sectional study was conducted from 1 November 2024 to 20 February 2025.

Study setting

Seven comprehensive specialised hospitals were included in the study.

Participants

The study was employed on 389 mothers who had operative vaginal delivery.

Methods

Systematic sampling was used. Data were collected via questionnaires, chart reviews and observation. Data were entered into Epi Data V.4.6 and analysed using V.25 statistical package of social sciences. Variables with p

Outcome

Adverse pregnancy outcomes of operative vaginal delivery.

Results

Adverse pregnancy outcomes of operative vaginal delivery were 42.2%. Among them, 46 (11.8%) had only maternal complications, 55 (14.1%) had only neonatal complications and 63 (16.2%) had both maternal and neonatal complications. Perineal tear 29 (7.5%) and episiotomy extension 31 (8%) were the most common maternal complications, while caput succedaneum 45 (11.6%) was the most neonatal complication. The most common indication of operative vaginal delivery was prolonged second stage 203 (52.2%). Vacuum-assisted delivery (AOR 0.53; 95% CI 0.29 to 0.96), two tractions (AOR 2.19; 95% CI 1.23 to 3.90), birth weight less than 2.5 kg (AOR 1.85; 95% CI 1.21 to 2.83) and mid fetal station (AOR 2.9; 95% CI 1.49 to 5.64) were significantly associated with adverse pregnancy outcomes.

Conclusions

Adverse pregnancy outcomes following operative vaginal delivery were high. Type of instrumental vaginal delivery, number of tractions, fetal birth weight and fetal station were significantly increased risks. Therefore, operators should minimise traction attempts during operative vaginal delivery to reduce adverse outcomes.

Incidence and predictors of delirium in patients admitted to intensive care unit at comprehensive specialised hospitals in Amhara region, northwest Ethiopia: a multicentre prospective observational study

Por: Asmare · T. B. · Wubet · H. B. · Gobezie · N. Z. · Deress · G. M. · Belete · K. G. · Tadesse · M. A. · Abuhay · A. G. · Demissie · B. · Melesew · A. A. · Afework · W. A. · Alle · Y. F. · Demite · D. G. · Teshome · D. · Mossie · K. D. · Kassa · B. D. · Gedefaw · G. D.
Objective

To assess the incidence of delirium and its predictors among adult patients admitted to the intensive care units of comprehensive specialised hospitals in the Amhara region of northwest Ethiopia from 18 October 2024 to 20 February 2025.

Design

A multicentre prospective observational study was conducted.

Setting

Four comprehensive specialised hospitals in the Amhara region of northwest Ethiopia, from 18 October 2024 to 20 February 2025.

Participants

A total of 351 patients were included in the final analysis during the study period.

Outcome measures

The primary outcome measure of this study was the incidence of delirium. Additionally, the study investigated the factors associated with delirium incidence among adult patients admitted to intensive care units.

Results

The incidence of delirium among adult patients in intensive care units was 42.17% (95% CI: 37.08 to 47.42). Pain (adjusted HR (AHR) = 4.74; 95% CI: 2.38 to 9.44), mechanical ventilation (AHR = 2.96; 95% CI: 1.56 to 5.63), age 65 years or older (AHR = 2.18; 95% CI: 1.48 to 3.21) and agitation (Richmond Agitation-Sedation Scale (RASS) ≥1) (AHR = 3.26; 95% CI: 2.09 to 5.09) were statistically significant factors associated with delirium.

Conclusion and recommendation

In the present study, more than one-third of patients developed delirium. Pain, mechanical ventilation, age 65 or older and agitation (RASS≥1) were significantly associated with delirium occurrence. To reduce the incidence of delirium, the current study recommends treating or preventing pain and agitation. Additionally, special attention should be given to patients receiving mechanical ventilation and those aged 65 or older during care.

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