Hypertensive disorders of pregnancy (HDP) are the most common maternal and perinatal health challenges. Globally, the incidence of HDP increased from 16.30 million to 18.08 million, with a total increase of about 10.9...Hypertensive disorders of pregnancy (HDP) are the most common maternal and perinatal health challenges. Globally, the incidence of HDP increased from 16.30 million to 18.08 million, with a total increase of about 10.9% from 1990 to 2019. Umbilical Doppler study in hypertensive disorders of pregnancy helps to predict neonatal outcomes and prevent neonatal and maternal morbidity and mortality. Objective: This study aims to determine the incidence of abnormal umbilical Doppler among hypertensive pregnant women, to identify the adverse neonatal outcomes associated with abnormal umbilical Doppler, and also to detect the diagnostic predictive values of umbilical Doppler to neonatal outcomes at KCMC. Material and methods: A hospital-based prospective cohort study included women with hypertensive disorders of pregnancy from the gestational age of 28 weeks and above, followed up to delivery during the study period from August 2022 to March 2023. Multivariate logistic regression analysis was used to determine the association between AUD and neonatal outcomes. Results: Out of 112 women with HDP, the incidence of abnormal umbilical Doppler was 38 (33.93%). Abnormal umbilical Doppler was associated with neonates with low birth weight aOR (95% of CI) of 4.52 (1.59 - 12.83) p = 0.005 and neonatal ICU admission 9.71 (2.90 - 32.43) p Conclusion: The incidence of abnormal umbilical Doppler is high in hypertensive disorders of pregnancy which is associated with an increase in neonatal low birth weight and neonatal ICU admissions, the sensitivity of abnormal umbilical Doppler in prediction of low birth weight and neonatal ICU admission is significant hence the routine use of umbilical Doppler assessment among hypertensive pregnant women is crucial.展开更多
Introduction: Caesarean section (CS) causes some complications. We here attempted to determine the rate of CS complications, characterize their timing, and identify their risk factors among women delivered at Kilimanj...Introduction: Caesarean section (CS) causes some complications. We here attempted to determine the rate of CS complications, characterize their timing, and identify their risk factors among women delivered at Kilimanjaro Christian Medical Center (KCMC). Methods: Patients who underwent CS in KCMC were interviewed and analysed. Risk factors were expressed with Odds ratio (OR) and 95% CI. Results: Of 386 deliveries, 106 (27.5%) had one or more complications. Common early complications (24 - 72 hours after CS) were puerperal sepsis, anaesthesia-related complications, blood transfusion and ICU admission. Longer duration of surgery was significantly associated with all complications (aOR 2.90;95% CI: 1.02 - 8.50). Grand multiparity was significantly associated with blood transfusion (7.0;1.40 - 34.35) and PPH (6.4;1.5 - 24.24) while pre-operative anaemia was significantly associated with blood transfusion (4.34;1.90 - 9.45). Conclusion: Longer duration of surgery, grand multiparity and pre-operative anaemia are associated with complications. Physicians should be aware that these are risk factors for CS-complications.展开更多
文摘Hypertensive disorders of pregnancy (HDP) are the most common maternal and perinatal health challenges. Globally, the incidence of HDP increased from 16.30 million to 18.08 million, with a total increase of about 10.9% from 1990 to 2019. Umbilical Doppler study in hypertensive disorders of pregnancy helps to predict neonatal outcomes and prevent neonatal and maternal morbidity and mortality. Objective: This study aims to determine the incidence of abnormal umbilical Doppler among hypertensive pregnant women, to identify the adverse neonatal outcomes associated with abnormal umbilical Doppler, and also to detect the diagnostic predictive values of umbilical Doppler to neonatal outcomes at KCMC. Material and methods: A hospital-based prospective cohort study included women with hypertensive disorders of pregnancy from the gestational age of 28 weeks and above, followed up to delivery during the study period from August 2022 to March 2023. Multivariate logistic regression analysis was used to determine the association between AUD and neonatal outcomes. Results: Out of 112 women with HDP, the incidence of abnormal umbilical Doppler was 38 (33.93%). Abnormal umbilical Doppler was associated with neonates with low birth weight aOR (95% of CI) of 4.52 (1.59 - 12.83) p = 0.005 and neonatal ICU admission 9.71 (2.90 - 32.43) p Conclusion: The incidence of abnormal umbilical Doppler is high in hypertensive disorders of pregnancy which is associated with an increase in neonatal low birth weight and neonatal ICU admissions, the sensitivity of abnormal umbilical Doppler in prediction of low birth weight and neonatal ICU admission is significant hence the routine use of umbilical Doppler assessment among hypertensive pregnant women is crucial.
文摘Introduction: Caesarean section (CS) causes some complications. We here attempted to determine the rate of CS complications, characterize their timing, and identify their risk factors among women delivered at Kilimanjaro Christian Medical Center (KCMC). Methods: Patients who underwent CS in KCMC were interviewed and analysed. Risk factors were expressed with Odds ratio (OR) and 95% CI. Results: Of 386 deliveries, 106 (27.5%) had one or more complications. Common early complications (24 - 72 hours after CS) were puerperal sepsis, anaesthesia-related complications, blood transfusion and ICU admission. Longer duration of surgery was significantly associated with all complications (aOR 2.90;95% CI: 1.02 - 8.50). Grand multiparity was significantly associated with blood transfusion (7.0;1.40 - 34.35) and PPH (6.4;1.5 - 24.24) while pre-operative anaemia was significantly associated with blood transfusion (4.34;1.90 - 9.45). Conclusion: Longer duration of surgery, grand multiparity and pre-operative anaemia are associated with complications. Physicians should be aware that these are risk factors for CS-complications.
