Patterns And Outcome Of Operative Deliveries In Nekemte Referral Hospital Nekemte Town, East Wollega Zone, Oromia Region, Ethiopia.

Abstract

Background: The expectation of every pregnant woman is to undergo a spontaneous vaginal delivery with minimal or no resort to operative procedures at the end of pregnancy. For the majority of women this expectation becomes a reality. For some however, assistance is required either in the form of caesarean section or operative vaginal procedures in order to avert adverse maternal and fetal outcome . However there is no information on the pattern and outcome of operative deliveries in the study area. Thus, this study is aimed to fill the paucity of information in the study area that play vital role to reduce maternal and neonatal morbidity and mortality. Objective: the objective of this study is to assess pattern and outcome of operative deliveries among mothers who give birth in Nekemt Referral Hospital from December 1/2012-April 30/2013. Methods: A hospital based prospective cross-sectional study was conducted on 384 mothers who had operative deliveries at Nekemt Referral Hospital from December 1/2012-April 30/2013GC. The data were collected by trained data collectors using structured interview questionnaire and medical records review format. The data were cleaned, entered, processed and analyzed using SPSS for windows version 16.0. Statistical test for significance was employed where appropriate at the level of significance of 5%. Result : The prevalence of operative deliveries was 33.1% and the rate of operative vaginal delivery and cesarean section were 71 ( 18.5%) and 279 (72.5%) respectively . The major indications of cesarean section were obstructed labour 58 ( 20.7%), fetal distress (NRFHRP) 47(17.9%) and CPD 40 (14.3%). The commonest cause for instrumental vaginal delivery was fetal distress ( NRFHRP) 33 ( 57.9) followed by prolonged second stage of labour 23 (40.3%). With regard to maternal and fetal outcome, about 53( 13.8% ) mothers had complication including maternal death after operative deliveries within the first 24 hours and 162(41.9%) had bad neonatal outcome. Conclusion and recommendation: Parity ,ANC and type of operative delivery are significant factors associated with maternal and neonatal outcome. Special attention should be given to laboring mothers with grand multiparty parity and non ANC attendants to minimize the possible post operative complications by health care providers in Nekemet Referral Hospital. Furthermore; the federal ministry of health in collaboration with Oromiya Health bureau should encourage the primary health care provider to carry out expensive community based mobilization on birth spacing and standard ANC utilization.