Obstetrics and Gynecology

Characteristics, Management, and Outcome of Gestational Trophoblastic Disease in Jimma Universty Medical Center: Retrospective Cross-Sectional Study

2025-08-11T00:00:00Z

Characteristics, Management, and Outcome of Gestational Trophoblastic Disease in Jimma Universty Medical Center: Retrospective Cross-Sectional Study Felagot zerihun; Fedlu Abdulhay Background: Gestational trophoblastic disease (GTD) is a spectrum of cellular proliferations arising from the placental trophoblast after normal or abnormal fertilization. GTD are either non neoplastic hydatidiform moles (complete and partial) or true gestational trophoblastic neoplasm (GTN) that have the potential for local invasion and metastasis. Although GTDs primarily affect the reproductive age group, with significant effects on maternal fertility and psychology, the overall work done in our setup to halt GTDs is unsatisfactory and post treatment surveillance is dramatically poor. Several studies have been done on GTD in worldwide, but no articles have been published in or near southwest Ethiopia after gynecologic oncology unit establishment. Objective: The objective of this study to determine of the magnitude and treatment outcome of patients with gestational trophoblastic disease Method: A cross-sectional study was conducted on women diagnosed with gestational trophoblastic disease at JUMC from July, 2021 to August 2024. Data was collected from the patient's chart using a structured questionnaire/checklist, then entered and cleaned using Epi-info version 7.0, and analyzed with SPSS version 26 software. Data was analyzed using univariate and multivariate logistic analysis and odds ratio with confidence interval of 95% (P value 0.05) was determined form patient outcome. Result: A total of 245 GTD patients were studied. The magnitude of GTD was 15.3/1000 deliveries in JUMC during the study period. The Diagnosis of GTN was made in 104 (42.45.4%) of the cases and the most common risk factor for development of GTD was age(most patients were with age group) ≥35 (45.7%). About 206 (84.08%) had vaginal bleeding upon presentation. Hydatidiform mole 58 (23.87%) was commonest histopathologically diagnosed GTD, followed by invasive mole 14 (5.76%) and choriocarcinoma 8 (3.29%). Suction and curettage was the most performed procedure for 107 (73.90%) of molar pregnancy while hysterectomy was done for 67 (28.88%) of GTD patients. 2 GTD patients died associated with suction and curettage and about 10.87% (10) GTN patients were dead. FIGO stages III or IV were about 3.5 (95%CI: 1.03 11.9) times more likely to die than women who had been diagnosed with FIGO stages I or II. One quarter of GTD patients had no surveillance with serum β hCG 59 (24.08%). VIII Conclusion: The study found that GTD was prevalent in JUMC with 15.3/1000 deliveries. Age >35years and prior GTD were most common clinical risk factors for GTD development. Hyperthyroidism (36.32%), preeclampsia (11.84%) and anemia (40.4%) were the most common medical comorbidity found owning to the late presentation. Most patients had no post-molar surveillance until remission, which hampered the eventual illness outcome. Patients with advanced FIGO stage and WHO high-risk were more likely to die; hence early diagnosis and management may improve the overall treatment outcome.

Incidence of complicalications for the pelvic organ prolapse reconstructive Surgery in three hospitals in oromia region, Ethiopia

2020-09-01T00:00:00Z

Incidence of complicalications for the pelvic organ prolapse reconstructive Surgery in three hospitals in oromia region, Ethiopia Habtamu Beyene; Demisew Amenu BACKGROUND: Pelvic organ prolapse (POP) is a bulge or protrusion of pelvic organs and their associated vaginal segments into or through the vagina and it may occur in up to 50% of parous women. The lifetime risk of undergoing POP surgery alone varies between 5 and 19%. The most common intraoperative complications following vaginal Hysterectomy fall into three main categories: bleeding, visceral injury and inability to extract the specimen (vagina surgery is difficult and changed to abdominal surgery). Objectives: This study is aimed to determine the incidence of complications of reconstructive pelvic surgery for pelvic organ prolapse at Mada Walabu University Goba Referral hospital, Shanan Gibe hospital and Jima university medical center. Methods: A hospital based cross-sectional study will be used. All patients who will undergo pelvic reconstructive surgery for POP will be included consecutively during the study period. Data will be collected by trained midwife and will be cleaned, edited, coded and entered to computer and analyzed by SPSS version 21. Descriptive statistics will be used to describe demographic profile of the study participants and complications of reconstructive pelvic surgery. Chi-square test with Yate’s correction will be used to determine for any association between different variables. P< 0.05 will be considered as having significant association. Results: The most frequent complications of pelvic organ prolapse reconstructive pelvic surgery during study period was urinary retantions which account for about 20% of the common complications. Urinary retantions was significantly associated whith increased parity (p=0.018) and with colpohysterectomy and posterior myorrphy(p=0.017). Conclusion and recommendation: This study showed higher frequency urinary retantions after reconstructive pelvic surgery and it had significant associations with colpohysterectomy and advance maternal age, so this may need large number of data to this the effect surgery on anterior vaginal wall and colposuspensions.

Prevalence And Determinant Factors Of Survival Among Low Birth Weight Infants In Jimma University Medical

2023-11-01T00:00:00Z

Prevalence And Determinant Factors Of Survival Among Low Birth Weight Infants In Jimma University Medical Lulseged, Tessema; DR. Woubishet, Girma; Mr. Mamo, Nigatu Background: Low birth weight has been defined by the World Health Organization as weight at birth of less than 2,500 grams (5.5 pounds). It is a good summary measure of a multifaceted public health problem that includes long-term maternal malnutrition, ill health and poor pregnancy health care. According to the 2016 EDHS report, only 14% of babies were weighed, and 13% of BW reports were less than 2,500 grams. The objective of this study is to determine the incidence and determinant factors of low birth weight infants’ survival in Jimma Medical Center, Jimma, Ethiopia. Methodology: An Institutional based descriptive and analytical cross sectional study was conducted in Jimma town. The study included all mothers who gave birth to low birth weight infants in Jimma University Medical Center from September 11, 2022 to September 11, 2023. A simple random sampling technique was used to select the sampled mothers. The qualitative results were displayed by using frequency distributions, percentages, tables, charts and figures. Both uni-variate and multivariate logistic regression analyses were undergone to determine associations between dependent and independent variables. Results: From the 243 low birth weight newborns, 25 (10.3%) weighed between 1,000-1499gm and 218 (89.7%) weighed in the range of 1500-2499gm. The overall survival rate is 85.2%; it is 24% for very low birth weight & 92.2% for low birth weight infants, respectively. Low birth weight infants who received routine newborn care have 20 fold higher chance of survival (p-0.001, AOR-20.957) compared to those who required advanced newborn care. The other determinant factors of survival among LBW infants were Apgar score of less than or equal to 7 at fifth minute (P=0.015); being infants with very low birth weight (P=0.007); and admission to neonatal ICU (P=0.041). Conclusion and Recommendations: The prevalence of LBW is low. The overall rate of survival among LBW infants is low. It is recommended to strengthen ANC services and reduce premature deliveries. Education and awareness creation on maternal nutrition needs to be addressed further.

Maternal And Perinatal Outcomes Of Preeclampsia With Severity Features Managed In Jimma Medical Center, Jimma, Ethiopia, 2023gc

2023-11-01T00:00:00Z

Maternal And Perinatal Outcomes Of Preeclampsia With Severity Features Managed In Jimma Medical Center, Jimma, Ethiopia, 2023gc Habtamu, Kifle; Demisew, Amenu Background: Preeclampsia refers to the new onset of hypertension and proteinuria after 20weeks of gestation in a previously normotensive woman. Pregnant women with preeclampsia with severe feature are at an increased risk of adverse maternal and perinatal outcomes. Objective: The objective of this study was to determine and compare perinatal and maternal outcome of women with Preeclampsia with severity features and normotensive women managed and gave birth at JUMC from July to October, 2023G.C Method: A Hospital based prospective cohort study was conducted among pregnant women with Preeclampsia with severity features and normotensive pregnant women who gave birth in Jimma University Medical Center. A pretested English version questionnaire was used to interview patients and reviewing their records which fulfill the inclusion criteria. The sample size was determined using STATCALC Epi info version 7.2.2.6 software and the final sample size required to get a statistically meaningful difference between the two groups was 224. (112 of exposed and 112 of unexposed). The data was collected by using structured questionnaire and checklist (using kobotoolbox) after proper orientation given for data collectors and was analyzed by using SPSS version 27. Chi-square test,Fischer exact test, nonparametric one sample test and independent T-test were used for comparisons, and logistic regression analysis was done. A 95% CI and P value < 0.05 were used to declare the level of statistical significance. Result: This prospective cohort study found out that compared to normotensive women; PE with severe feature is significantly associated with adverse perinatal outcomes such as LBW(39.3% , AOR = 8.5 [1.7, 41.7]), Prematurity (44.6%, AOR = 7.65[3.6 , 16.35]), ENND (17%, AOR =10.35[1.3,84.5] ), 5th minute low APGAR score (10.7%, AOR = 2.26 [0.63,8.2] ), admission to NICU(36.6%, AOR =2.7[1.2,5.9] ), perinatal death (21.4%, AOR = 5[1.3,18.5]) and overall adverse perinatal outcome(38.4%, AOR = 3.2[1.25,8.2]). This study also reveals higher level of adverse maternal outcomes was observed in the PE with severe feature compared to normotensive group. Among these maternal outcomes abruption placenta (10.7%), AKI(6.3%), HELLP syndrome (26.3%), PPH (4.5%) and overall adverse maternal outcome(37.5%) was found to be higher in PE with severe feature as compared to normotensive women, with statistically significant difference ( p<0.05). Conclusion: This study found out PE with severe feature is significantly associated with adverse perinatal and maternal outcomes. Hence, healthcare providers and the health facilities should strengthen prevention, early diagnosis and prompt management of PE with severe feature in order to better improve perinatal and maternal outcomes. Furthermore intervention towards HDP will signify to achieve global and national sustainable development goal (SDG) target to reducing neonatal mortality and maternal mortality.