Characteristics and Outcomes Associated with Cesarean Birth as Compared to Vaginal Birth at Mizan-Tepi University Teaching Hospital, Ethiopia.

Margo S Harrison, Ephrem Kirub, Tewodros Liyew, Biruk Teshome, Andrea Jimenez-Zambrano, Margaret Muldrow, Teklemariam Yarinbab
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Abstract

Introduction: The objective of this study was to observe characteristics and outcomes associated with cesarean birth as compared to vaginal birth.

Methods: This study was a prospective hospital-based cross-sectional analysis of a convenience sample of 1, 000 women. Data was collected on admission, delivery, and discharge by trained physician data collectors on paper forms through chart review and patient interview.

Results: Data on mode of delivery was available for 993/1000 women (0.7% missing data), 23.4% of whom underwent cesarean. These women were less likely to have labored (84.5% versus 87.4%), more likely to have been transferred (62.0% versus 45.2%), more likely to have been admitted in early labor (53.0% versus 48.6%), more likely to be in labor for longer than 24 hours (10.7% versus 3.3%) and were less likely to have multiple gestation (7.7% versus 3.9%), p < 0.05. In a Poisson model, history of cesarean (aRR 2.0, p < 0.001), transfer during labor (RR 1.5, p = 0.003), labor longer than 24 hours and larger birthweight (RR 2.7, p 0.001) were associated with an increased risk of cesarean.

Conclusion: Our analysis suggests cesarean birth is being used among women with a history of prior cesarean and in cases of labor complications (prolonged labor or transfer), but fresh stillbirth is still common in this setting.

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埃塞俄比亚Mizan-Tepi大学教学医院剖宫产与阴道分娩的特点和结果比较
前言:本研究的目的是观察剖宫产与阴道分娩的特点和结果。方法:本研究是一项前瞻性的基于医院的横断面分析,样本为1000名妇女。入院、分娩和出院的数据由训练有素的医生数据收集人员通过图表审查和患者访谈收集纸质表格。结果:993/1000名妇女可获得分娩方式数据(0.7%缺失数据),其中23.4%接受剖宫产。这些妇女分娩的可能性较小(84.5%对87.4%),转移的可能性较大(62.0%对45.2%),早期分娩时入院的可能性较大(53.0%对48.6%),分娩时间超过24小时的可能性较大(10.7%对3.3%),多胎妊娠的可能性较小(7.7%对3.9%),p < 0.05。在泊松模型中,剖宫产史(aRR 2.0, p < 0.001)、分娩时转移(RR 1.5, p = 0.003)、分娩时间超过24小时和出生体重较大(RR 2.7, p = 0.001)与剖宫产风险增加相关。结论:我们的分析表明,有剖宫产史和分娩并发症(延长分娩或转移)的妇女正在使用剖宫产,但在这种情况下新鲜死产仍然很常见。
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