BackgroundHypertensive disorders of pregnancy are a global public health concern both in developed and developing countries. However, evidences regarding the risk factors of hypertensive disorders of pregnancy are limited particularly in Ethiopia. The aim of the study was to assess risk factors associated with hypertensive disorders of pregnancy among mothers in public hospitals of Tigray.MethodsThe study was conducted in seven public hospitals of Tigray region, Ethiopia from June 2017 to November 2017. A facility based matched case-control study was employed to select 110 cases and 220 controls who were pregnant women. Cases and controls were matched by parity status. A case was a mother diagnosed to have hypertensive disorders of pregnancy by an obstetrician in the antenatal period while a control was a mother who did not have a diagnosis of hypertensive disorders of pregnancy. Data were collected by face to face interview technique using a pretested questionnaire and a checklist. Conditional logistic regression analysis was used to identify the independent predictor variables. Adjusted matched odds ratio with its corresponding 95% confidence interval was used and significance was claimed at P-value less than 0.05. Overall findings were presented in texts and tables.ResultsRural residents were at greater odds of suffering from hypertensive disorders (OR = 3.7, 95% CI; 1.9, 7.1). Similarly, mothers who consume less amount of fruits in their diet had 5 times higher odds of developing hypertensive disorders than those who consume fruits regularly (OR = 5.1, 95% CI; 2.4, 11.15). Overweight (BMI > 25 Kg/m2) mothers were also at risk of developing hypertensive disorders of pregnancy as compared with the normal and underweight mothers (AOR = 5.5 95% CI; 1.12, 27.6). The risk of developing hypertensive disorders of pregnancy was 5.4 times higher among diabetic mothers.ConclusionRural residence, less fruit consumption, multiple pregnancy, presence of gestational diabetes mellitus and pre-pregnancy overweight were identified as independent risk factors in this study. It is recommended that health care givers may use these factors as a screening tool for the prediction, early diagnoses as well as timely interventions of hypertensive disorders of pregnancy.Electronic supplementary materialThe online version of this article (10.1186/s12884-018-2106-5) contains supplementary material, which is available to authorized users.

IntroductionCommunity distribution of misoprostol to pregnant women in advance of labor is one of the compelling strategies for preventing postpartum hemorrhage. Concerns have been reported that misoprostol distribution could reduce facility delivery or lead to misuse of the medication. This scoping review was conducted to synthesize the evidence on the effect of community-based misoprostol distribution on rates of facility delivery, and to assess the frequency of mothers taking distributed misoprostol before delivery, and any harmful outcomes of such misuse.MethodsWe included peer-reviewed articles on misoprostol implementation from PubMed, Cochrane Review Library, Popline, and Google Scholars. Narrative synthesis was used to analyze and interpret the findings, in which quantitative and qualitative syntheses are integrated.ResultsThree qualitative studies, seven observational studies, and four experimental or quasi-experimental studies were included in this study. All before-after household surveys reported increased delivery coverage after the intervention: ranging from 4 to 46 percentage points at the end of the intervention when compared to the baseline. The pooled analysis of experimental and quasi-experimental studies involving 7564 women from four studies revealed that there was no significant difference in rates of facility delivery among the misoprostol and control groups [OR 1.011; 95% CI: 0.906–1.129]. A qualitative study among health professionals also indicated that community distribution of misoprostol for the prevention of postpartum hemorrhage is acceptable to community members and stakeholders and it is a feasible interim solution until access to facility birth increases.In the community-based distribution of misoprostol programs, self-administration of misoprostol by pregnant women before delivery was reported in less than 2% of women, among seven studies involving 11,108 mothers. Evidence also shows that most women who used misoprostol pills, used them as instructed. No adverse outcomes from misuse in either of the studies reviewed.ConclusionsThe claim that community-based distribution of misoprostol would divert women who would have otherwise had institutional deliveries to have home deliveries and promote misuse of the medication are not supported with evidence. Therefore, community-based distribution of misoprostol can be an appropriate strategy for reducing maternal deaths which occur due to postpartum hemorrhages, especially in resource-limited settings.

Background: Hypertensive disorders of pregnancy is a common maternal health condition representing a spectrum of disease which is associated with increased risk of both adverse maternal and fetal outcomes. Despite the fact, there is limited evidence on the magnitude and trend of hypertensive disorders of pregnancy in Ethiopia. Objective: This study aimed to describe the pattern of hypertensive disorders of pregnancy in selected hospitals of Tigray region. Methods: The study was done in 6 randomly selected hospitals of Tigray region by reviewing medical records of all mothers admitted to the maternity units with the diagnosis of hypertensive disorders of pregnancy from September 2012 to August 2017. Data were abstracted using a checklist from the client's chart, delivery registration, health management information system Original Research Article

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Introduction : In low-resource settings, most maternal deaths caused by hemorrhage, occur in poorly resourced facilities or outside of health facilities where there is no access to skilled obstetric care. Community distribution of misoprostol is one of the compelling strategies for preventing or treating postpartum hemorrhage to avert maternal deaths. This scoping review was conducted to synthesize existing evidence that shows the negative impact of community distribution of misoprostol on facility delivery and misuse for labor induction or pregnancy termination. Methods: We identified and included all peer-reviewed articles on misoprostol implementation from PubMed, Cochrane Review Library, Popline, and Google Scholars. Narrative synthesis was used to analyze and interpret the findings in which quantitative and qualitative syntheses are integrated. Results: Three qualitative studies, six observational studies, and four experimental or quasi-experimental studies from Africa and Asia are included in this study. All before-after household surveys reported, increased delivery coverage after the intervention: ranging from 4 to 46 percentage points at the end of the intervention when compared to the baseline (5 studies). The pooled analysis of experimental and quasi-experimental involving 7,564 women from four of the studies revealed that there is no significant difference in facility delivery among the misoprostol and control groups [OR 1.011; 95% CI: 0.906-1.129]. A qualitative study among professionals also indicated that community distribution of misoprostol for the prevention of postpartum hemorrhage is acceptable to community members and stakeholders and it is a feasible interim solution until access to facility birth is improved. In the community-based distribution of misoprostol programs, administration of misoprostol before delivery was reported in less than 2% among seven studies involving 11,108 mothers. Evidence also shows that most women used misoprostol pills as instructed. No adverse outcomes from misuse in either of the studies reviewed. Conclusions: The claim that community-based distribution of misoprostol would divert institutional delivery strategies to home deliveries and promote misuse are not supported with evidence. Therefore, community-based distribution of misoprostol can be an appropriate strategy for reducing maternal deaths which occur due to postpartum hemorrhages especially in resource-limited settings where many deliveries take place outside of health facilities.