Citation: Bitew A, Workie A, Seyum T, et al. Utilization of obstetric analgesia in labor pain management and associated factors among obstetric care givers in Amhara Regional State Referral Hospitals, Northwest Ethiopia. A Hospital based cross sectional study. J Biomedical Sci. 2016, 5:2. AbstractBack ground: Labor pain is the most severe form of pain in women' life and it was considered as a punishment given by God. Developed countries use obstetric analgesia routinely but in developing countries including Ethiopia it is not a common practice. The aim of this study was to assess utilization of obstetric analgesia in labor pain management and associated factors among obstetric care givers in Amhara Regional State Referral Hospitals, North West Ethiopia.Method: Institution based cross sectional study was conducted from July 1-15/2014. The study was conducted on all obstetric care givers in Amhara Regional State Referral Hospitals. Self-administered, pre-tested and structured questionnaires was used to collect the data. Data consistency was checked and entered into EpiInfo then exported to SPSS for further analysis. Descriptive analysis done, logistic regression analyses were also used to see the association of dependent and independent variables. Finally Odds ratio and 95% Confidence interval were computed to determine the strength of association. Result:The overall utilization of obstetric analgesia in labour pain management was 40.1% which showed only non-pharmacologic methods. The utilization of pharmacologic obstetric analgesia methods was zero. Multivariate logistic regression showed that professionals with low level qualification (AOR=2.69, 95%CI: 1.13, 6.41) and inadequate knowledge (AOR=2.57, 95%CI: 1.42, 4.65) were statistically associated with utilization of obstetric analgesia. Conclusion:Proportion of obstetric analgesia utilization was very low; highest qualification and inadequate knowledge were significantly associated with obstetric analgesia utilization. Providers need to help labouring mother with analgesia; update and make themselves familiar with obstetric analgesia. The quality and associated factors of obstetric analgesia utilization need to be investigated.

Background: Uterine rupture remains a major obstetric problem particularly in less developed countries. The aim of this study was to identify determinants of uterine rupture among mothers getting delivery services in Dessie Referral Hospital from January 2016 to June 2016, North East Ethiopia.Methods: A prospective unmatched case control study was conducted recruiting 42 mothers with uterine rupture as case group and 168 for control group. Pretested, structured questionnaire was used to collect data.Results: Descriptive statistics and Logistic regression models were utilized considering 95% confidence interval and p-value of 0.05 to determine the presence and strength of association between dependent and independent variables. Majority (94.2%) of cases came from rural areas, 76.2% had obstructed labor and 55% had prolonged labor. Of 85.7% of cases have reported number of pregnancies ≥ 5. Mothers who encountered obstructed labor and previous Caesarean section scar were at higher risk of uterine rupture (AOR=22.2, 95% CI=2.8-4.1 and AOR=13.6, 95% CI=2.16-17.84 respectively). Mothers living in urban area, having Antenatal Care follow-up, shorter labor stay and primi-parity were found to have lower risk of uterine rupture.Conclusions: This study revealed that living in rural areas, absence of Antenatal Care follow-up, prolonged labor, obstructed labor, grand multiparity and previous Caesarean section scar were determinants of uterine rupture. Viable strategies have to be designed and implemented to tackle these determinants of uterine rupture.

Introduction: Globally, cervical cancer is the second most common cancer in women; in 2008 there were an estimated 530,000 new cases and more than 270,000 women die from it [1]. In Ethiopia, cervical cancer is the second most common cancer following breast cancer and the leading cause of death from cancer. Annually, an estimated number of 4648 women develop the cancer and 3,235 die from it. Low-resource countries experience 85% of the global burden and in regions such as Eastern Africa and South-Central Asia. Low perception of risks and lack of awareness about cervical cancer screening amongst women and challenges of access to cervical cancer screening for early detection of disease have been reported amongst factors responsible for increasing incidence and mortality due to cervical cancer in developing countries [2]. Objective: The general objective of this study was to determine the proportions of cervical precancerous lesions and to assess associated factors among women clients (30-49) in Gynecology OPD of Dessie referral hospital and FGAE, 2016. Methods: An institution based cross-sectional study design involving quantitative method was employed. For the quantitative survey 422 women in the age group of 30-49 were participated. The sample size was computed by using single population proportion formula for finite population with 95% confidence level, prevalence of 50% and marginal error of 2%. Pretested and structured questionnaire was used in order to facilitate reliable response. Questionnaires for each item were adapted from previously done similar studies. Pretest was done on five percent of study population. Results: Among 422 study participants who were currently screened, 390(92.4%) were negative for cervical precancerous lesions when tested by visual inspection with acetic acid (VIA), 29(6.9%) were positive for cervical precancerous lesions and 3(0.7%) were suspicious for cancer. The majority (69.9%) of the study subjects did not ever screen for cervical cancer in their life time. Concerning the reasons for not screening, 98(33.3%) of them said that it is painful while 54(18.3%) and 37(12.5%) of them said I am health and it is expensive respectively. Conclusion: The proportion of cervical precancerous lesion was 6.9%. In multivariate regression analysis increased age(>46), high parity(>4), first intercourse at <20 years, having > two sexual partners, positive HIV status, History of Human papilloma virus (HPV) infection, History of sexually transmitted infection (STI), Smoking, History of abortion, nonuse of condom and family history of cervical cancer were significantly associated with the development of cervical precancerous lesions.

ObjectiveThe institutional-based cross-sectional study was designed to assess the magnitude of birth trauma and its associated factors in South Wollo, northeast Ethiopia.SettingThis study was conducted in the public hospitals of South Wollo, northeast Ethiopia. South Wollo is one of the 12 zones in the Amhara regional state with a total population of >3 million. There are 13 hospitals in South Wollo, of these 4 hospitals were selected randomly.ParticipantsA total of 612 mother-newborn pairs were selected to conduct the study. However, data were collected from 594 mother-neonate pairs giving a response rate of 97%. The study participants were selected by applying a simple random sampling technique after proportional allocation of the total sample to each study hospital. Live neonates delivered during the study period were included, whereas stillborn, neonates born with major congenital malformation and neonates whose mothers died during the birth process were excluded.ResultA total of 594 mother-newborn pairs were involved with a response rate of 97%. Seventy-eight newborns 13.13% (95% CI: 10.30 to 16.00) had experienced birth trauma. Prolonged labour (AOR: 5.78, 95% CI: 3.00 to 11.15), birth weight >4 kg (AOR: 9.18, 95% CI: 3.92 to 21.50), vacuum delivery (AOR: 6.74, 95% CI: 2.01 to 22.56), forceps delivery (AOR: 7.36, 95% CI: 1.96 to 27.58) and shoulder dystocia (AOR: 9.83, 95% CI: 4.13 to 23.50) were risk factors of birth trauma.ConclusionThe prevalence of birth trauma was higher than the report from most of the African countries. Prolonged labour, instrumental deliveries, large birth weight and shoulder dystocia were the identified risk factors of birth trauma. The ministry of health and the local healthcare system should give attention to the maternal health services.

Background: Long acting contraception is a human right and is essential to women’s empowerment. It is essential to reduce poverty, promote economic growth, raise female productivity, lower fertility and improve child survival and maternal health. Even though some long acting reversible contraceptive methods are the world’s most prevalent form of reversible contraception, the utilization is very low in sub-Saharan Africa. Study Aim: To assess the prevalence and factors affecting use of long acting contraceptive methods in Akasta Town, North East Ethiopia. Methods: A community based cross-sectional study was conducted on 422 women of reproductive age between March and May 2016 to achieve study aim. The actual respondents were selected by systematic sampling method at household level. Pretested and structured questionnaires were used to collect data. Result: The prevalence of use of long acting contraceptives in the study area was found to be 33.6% and implants were the most commonly used methods. One hundred thirty one (46.8%) of respondents did not use these methods because of inadequate information provided for them. Two hundred eighty one (66.6%) of respondents said that they knew at least one type of long acting methods and implants were widely known which accounts 139 (49.5%) of respondents. Age, husband’s educational status, knowledge of long acting reversible contraceptives and attitude towards these methods were significantly associated with use of these contraceptives. Conclusions: The study showed that the prevalence of long acting reversible contraceptives in the study area was low. Only 33.6% of respondents ever used any type of these methods in their life time and implants were the most commonly used method. In this study, age of women, husband’s educational status, knowledge of long acting reversible contraceptives and attitude were found to be independent determinants for long acting reversible family planning use. As knowledge and practice of long acting contraceptives was low, extensive health information should be provided.