Background Uterine rupture is a tear in the wall of uterus which carries grave risks to the mother as well as her baby. Objectives To estimate uterine rupture bad outcomes using propensity score and its determinants in Mizan-Tepi University teaching hospital. Methods A case control study on 363 participants, 121 cases and 242 controls, was conducted. Data was analyzed by STATA 14. Propensity score matching analysis was used to see causes. Level of significance of p value is ≤0.05. Results Females who reside in rural areas (AOR = 3.996; 95% CI: 2.011, 7.940) are at higher risk of acquiring uterine rupture. Females who had ANC follow-up (AOR = 0.315; 95% CI: 0.164, 0.606) and preterm gestational age (AOR = 0.135; 95% CI: 0.025, 0.725) are at lower risk of developing uterine rupture. Propensity score matching analysis shows that, from 100 participants who had uterine rupture, 88.4 females lost their fetus (β = 0.884; 95% CI: 0.827, 0.942). From 100 females who develop uterine rupture, 9.1 died (β = 0.091; 95% CI: 0.040, 0.142). From 100 females who develop uterine rupture, 97.5 developed additional obstetric complication (β = 0.975; 95% CI: 0.947, 1.000). Conclusion Residence, ANC follow-up, and gestational age are significant determinants of uterine rupture. Fetal loss, maternal death, and obstetric complications are significant bad outcomes of uterine rupture.

Background: Pregnancy and childbirth remain serious life threatening events for women in low income countries. Reducing maternal morbidity and mortality is a global priority health problem. One of the key strategies for reducing maternal morbidity and mortality is increasing institutional delivery service utilization of pregnant women under the care of skilled birth attendants. Therefore, the aim of this study was to assess the delays in utilizing institutional delivery service and its determinants among women who gave birth at public health institutions in Yem Special Woreda, Southwest Ethiopia.Methods: Health institution based cross-sectional study was conducted in Yem Special Woreda, Southwest Ethiopia. A simple random sampling technique supplemented with Focus Group Discussion was used. Data was collected using pre-tested structured questionnaires. SPSS version 20.0 was used for Bivariate and Multivariate Analysis. Result:The prevalence of delays in delivery service utilization was 76.3%. The mean time delay to utilize institutional delivery service was 5(+3.08) hours. Low educational status of women (AOR= 1.9, 95%CI: 1.09, 3.47), Parity (AOR= 2.9, 95%CI: 1.57, 5.44) and Husbands decision (AOR= 2.08, 95%CI= 1.09, 3.95) were found to be significantly associated with delay to utilize institutional delivery services. Conclusion:Low educational status of women, parity, not being ready to give birth in health facility and husband's decision making were found to be determinants of delay to utilize institutional delivery services.

Background: Antenatal Care (ANC) services utilization during the first trimester is very important for risk identification, and prevention and management of pregnancy-related diseases. However, the ANC services utilization during the first trimester in Ethiopia is very poor. Likewise, there has been no research conducted in Boke Woreda on determinants of ANC services utilization. Therefore, the aim of this study was to identify determinants of ANC services utilization during the first trimester in Boke Woreda, Ethiopia.Methods: A health facility based unmatched case-control study design was conducted in Boke Woreda, Ethiopia. The data was collected using pre-tested and structured questionnaires through interviews. Data analysis was done by SPSS for Windows Version 20.0. Bivariate and multivariate logistic regressions were conducted. P-value <0.05 was used to declare statistically significant variables.Result: All selected pregnant women (339 participants) were interviewed with 100% response rate. ANC services utilization was associated with maternal age at less than 26 years (AOR=3.87,95% CI:1.57,9.51), women travelling at lower than 30 minutes to the health facility (AOR=3.26,95% CI:1.46,7.26), Women who experienced one to two number of pregnancy (AOR=5.01,95% CI:1.74,14.41), Pregnant women who had zero to two birth before (AOR=3.93,95% CI:1.35,11.41), and previous ANC service utilization history (AOR=2.52,95% CI:1.03,6.20). Besides, ANC service utilization was also positively associated with pregnant women who were supported by their family (AOR=3.28, 95%CI: 1.18, 9.06), service waiting time at less than 45 minutes (AOR=6.17, 95% CI: 1.83, 20.73), and pregnant women who were welcomed by health workers (AOR=7.81, 95% CI: 3.19, 19.09). Conclusion:Maternal age, travelling time to the health facilities, client welcomed appreciation, maternal knowledge on ANC services, previous service utilization, parity, gravidity, and service waiting time were found to be the determinants of antenatal care services at first trimester. Therefore; Policy makers and stakeholders in the area have to focus their intervention on the identified factors in order to improve the ANC service utilization in the first trimester.

Background. Primary cesarean birth rates were high among women who were either nulliparous (Group 2) or multiparous (Group 4) with a single, cephalic, term fetus who were induced, augmented, or underwent cesarean birth before labor in our study cohort. Objectives. The objective of this analysis was to determine what risk factors were associated with cesarean birth among Robson Groups 2 and 4. Methods. This study was a prospective hospital-based cross-sectional analysis of a convenience sample of 1,000 women who delivered at Mizan-Tepi University Teaching Hospital in the summer and fall of 2019. Results. Women in Robson Groups 2 and 4 comprised 11.4% (n = 113) of the total population (n = 993). The cesarean birth rate in Robson Group 2 (n = 56) was 37.5% and in Robson Group 4 (n = 57) was 24.6%. In Robson Group 2, of all prelabor cesareans (n = 5), one birth was elective cesarean by maternal request; the intrapartum cesarean births (n = 16) mostly had a maternal or fetal indication (93.8%), with one birth (6.2%) indicated by “failed induction or augmentation,” which was a combined indication. In Robson Group 4, all 4 women delivered by prelabor cesarean had a maternal indication (one was missing data), and 3 of the intrapartum cesareans were indicated by “failed induction or augmentation.” In multivariable modeling of Robson Group 2, having a labor duration of “not applicable” increased the risk of cesarean delivery (RR 2.9, CI (1.5, 5.4)). The odds of requiring maternal antibiotics was the only notable outcome with increased risk (RR 11.1, CI (1.9, 64.9)). In multivariable modeling of Robson Group 4, having a labor longer than 24 hours trended towards a significant association with cesarean (RR 3.6, CI (0.9, 14.3)), and women had a more dilated cervix on admission trended toward having a lower odds of cesarean (RR 0.8, CI (0.6, 1.0)). Conclusion. Though rates of primary cesarean birth among women who have a term, single, cephalic fetus and are induced, augmented, or undergone prelabor cesarean birth are high, those that occur intrapartum seem to be associated with appropriate risk factors and indications, though we cannot say this definitely as we did not perform an audit. More research is needed on the prelabor subgroup as a separate entity.