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Prevalence of pregnancy-related complications and course of labour of surviving women who gave birth in selected health facilities in Rwanda: a health facility-based, cross-sectional study

Artikel i vetenskaplig tidskrift
Författare J. P. S. Sengoma
Gunilla Krantz
M. Nzayirambaho
C. Munyanshongore
K. Edvardsson
I. Mogren
Publicerad i Bmj Open
Volym 7
Nummer/häfte 7
ISSN 2044-6055
Publiceringsår 2017
Publicerad vid Institutionen för medicin, avdelningen för samhällsmedicin och folkhälsa
Språk en
Länkar dx.doi.org/10.1136/bmjopen-2016-015...
Ämnesord risk-factors, obstructed labor, disorders, services, uganda, urban, care, General & Internal Medicine
Ämneskategorier Folkhälsovetenskap, global hälsa, socialmedicin och epidemiologi

Sammanfattning

Objectives This study estimated health facility-based prevalence for pre-eclampsia/eclampsia, postpartum haemorrhage and caesarean section (CS) due to prolonged labour/dystocia. The background characteristics of Rwandan pregnant women, the course of labour and the level of healthcare were investigated in relation to pregnancy and delivery outcomes. Methods This is health facility-based study and data were collected in 2014-2015 through structured interviews and medical records (n=817) in Kigali and Northern Province, Rwanda. Frequencies and prevalence were used to describe participants' background factors, labour and deliveryrelated characteristics. Bivariable and multivariable logistic regression models were performed for different background factors and pregnancy/delivery outcomes. Results Pre-eclampsia/eclampsia, postpartum haemorrhage and CS due to prolonged labour/dystocia represented 1%, 2.7% and 5.4% of all participants, respectively. In total, 56.4% of the participants were transferred from facilities with low levels to those with higher levels of healthcare, and the majority were transferred from health centres to district hospitals, with CS as the main reason for transfer. Participants who arrived at the health facility with cervical dilation grade of <= 3 cm spent more hours in maternity ward than those who arrived with cervical dilatation grade of <= 4 cm. Risk factors for CS due to prolonged labour or dystocia were poor households, nulliparity and residence far from health facility. Conclusions The estimated health facility-based prevalence of pregnancy-related complications was relatively low in this sample from Rwanda. CS was the main reason for the transfer of pregnant women from health centres to district hospitals. Upgrading the capacity of health centres in the management of pregnant women in Rwanda may improve maternal and fetal health.

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