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BACKGROUND: Anal incontinence is defined as the involuntary loss of fecal material or flatus. The reported prevalence at 6 weeks postpartum varies from 4% to 39%. It is associated with reduced quality of life, negative psychogenic effects and social stigma. This study was done to assess its prevalence at 6 weeks after vaginal delivery and identify the associated factors. METHODS: This is a cross-sectional descriptive study. Data was collected using questionnaire adapted from International Consultation on Incontinence Questionnaire on Urinary Incontinence-Short Form. Data was analyzed using SPSS version 20.5. RESULT: The prevalence of anal incontinence at 6 weeks after vaginal delivery was 8.6%. The majority of the cases, 28 (84.8%), had only flatus incontinence. Participants of age group 20-35 years had significantly lower odds of having anal incontinence compared to those above age 35 (P < 0.05). The odds of having incontinence compared to spontaneous vaginal delivery was about 5 times higher for forceps (AOR= 4.93 (95%CI:1.48, 16.44)) and vacuum (AOR= 5.53 (95%CI:1.18, 25.96)) deliveries. Second stage of labor duration of >120 minutes had more than 4 times odds of developing incontinence compared to duration of <30 minutes (AOR= 4.79 (95%CI:1.01, 22.82)). Second degree perineal tear was the most significantly associated variable compared to those without tear (AOR= 12.31 (95%CI:3.89, 39.00)). CONCLUSION: The prevalence of anal incontinence at 6 weeks after vaginal delivery was 8.6%. Maternal age, mode of delivery, duration of second stage of labor and perineal tear were the significantly associated factors. [ABSTRACT FROM AUTHOR]

Objective: To determine the predictors of adverse maternal and perinatal outcomes among parturients with prolonged second stage of labor. Methods: This study is a cross‐sectional study of women with prolonged second stage of labor from January 1 to June 30, 2021, in four tertiary hospitals in Ethiopia. Data were collected prospectively using a structured questionnaire. Descriptive statistics were used to analyze baseline characteristics. Bivariate and multivariate logistic regression analyses were applied to determine predictors of adverse maternal and perinatal outcomes. Results: A total of 406 women were included in the study. More than half (25/46, 54%) of the women with a prolonged second stage of 4 h or longer had vaginal delivery, which was lower than the 73% (140/190) of women who had a second stage of 2–3 h and the 63.4% (64/101) of women with a second stage duration of 3–4 h. Duration of second stage of labor was not a predictor of composite adverse maternal outcomes nor was it a predictor of adverse perinatal outcome. Operative vaginal delivery (adjusted odds ratio [aOR] 6.0, 95% confidence interval [CI] 2.41–14.9) and nulliparity (aOR 4.1, 95% CI 1.58–10.41) were predictors of adverse maternal outcome, but nulliparity (aOR 1.8, 95% CI 1.05–3.04) and duration of rupture of membranes greater than 18 h (aOR 2.4, 95% CI 1.21–4.93) were predictors of adverse perinatal outcomes. Conclusion: Under strict fetal and maternal well‐being monitoring, women with a prolonged second stage of labor can labor for an additional 2 h (up to a total of 4 h) without increasing adverse maternal and neonatal outcomes. Synopsis: With strict fetal heart rate and maternal condition monitoring, women with prolonged second stage can labor for an additional 2 h (up to 4 h). [ABSTRACT FROM AUTHOR]

Introduction: Cesarean delivery carries both short term and long-term maternal complications. Eventhough it's being a public burden, the proportion of complications and underlying risk factors are not studied well in our setup. This study aimed to assess the proportion and associated factors of complications of cesarean sections among mothers who delivered at Bahir Dar city public specialized hospitals, Bahir Dar, Ethiopia 2021. Methods: A cross-sectional study was conducted at two specialized Hospitals in Bahir Dar city, Ethiopia. The sample size was 495 mothers who had cesarean section in the time period from January 1, 2020 to December 30, 2020. Checklist was used to retrieve information from the patient medical document. Study population was selected from the operation registration book. Systematic sampling was used after arranging the study frame based on date of operation. Both bivariable and multivariable logistic regression was done. In multivariable logistic regression variables with p value < 0.05 at 95% confidence interval were significantly associated with outcome variable. Result: Overall maternal complication rate was 44.04% (95% CI: 39.6–48.5). Living in rural setting (AOR = 4.247,95%CI: 2.765–6.522), having one or more obstetric complication (AOR = 1.913,95% CI: 1.214–3.015), cesarean section done at Second stage of labor (AOR = 4.358,95%CI: 1.841–10.317), having previous cesarean section (AOR = 3.540,95%CI: 2.121–5.910), emergency operation (AOR = 2.967,95%CI: 1.492–5.901), duration of surgery taking more than 60 min (AOR = 3.476,95%CI: 1.521–7.947) were found to be significantly associated with maternal complications. Conclusion: The magnitude of maternal complication of cesarean section was higher than most studies. Living in rural setting, having obstetric complications, previous cesarean scar, emergency surgeries, operation done in second stage of labor and prolonged duration of surgery are important predictors of maternal complication. Therefore, we recommend timely and adequate progress of labor evaluation, timely decision for cesarean delivery and vigilant care in post-operative period shall be conducted. [ABSTRACT FROM AUTHOR]

Background: An episiotomy is a surgical technique that widens the perineum during the second stage of childbirth. Therefore, the goal of this study was to assess the prevalence of episiotomy and the variables that affect it among women who gave birth in the town of Debre Tabor, in 2021. Methods: In the Debre Tabor municipality's four designated health center regions, 402 women who gave birth were included in a cross-sectional study. Systematic random selection was used to choose the study subjects. In SPSS version 23, data were entered, cleaned up, and analyzed using descriptive and inferential statistics. The use of binary and multivariable logistic regression models allowed the researchers to identify characteristics related to episiotomy magnitude. Using a 0.05 p value, the level of statistically significant variables was also calculated. Result: Out of a total of 402 deliveries for this inquiry, the magnitude of the episiotomy was calculated to be 35.1% of those deliveries. About 127 women, or the bulk of respondents, were between the ages of 25 and 29 (33.1%). Face presentation was 4.7 times more common among primiparous women than breech and vertex presentation, and midwifery professionals and midwifery students were 5.5 times higher than internship medicine and health officer students. The odds of performing an episiotomy were 3.7 times higher among primiparous women compared to multiparous women (AOR = 3.754 (1.382–15.108)). Conclusion: The magnitude of episiotomy in this study was somewhat larger than the World Health Organization's recommendation of 10%.Instrumental delivery, neonatal presentation, experts allocated to the delivery ward, and the mother's parity were all shown to be strongly linked with the practice of episiotomy. [ABSTRACT FROM AUTHOR]

BACKGROUND: Episiotomy was first suggested about two centuries back to prevent perineal tear as well as a fetal head injury. However, there have been controversies about its benefits over its side effects. The magnitude of episiotomy varies across the world. No study was conducted in the study area. This study was aimed at assessing the magnitude and factors associated with episiotomy at public health institutions. SUBJECTS AND METHODS: Institutional-based cross-sectional study design was employed in four public health institutions in Hosaena Town. Data were collected through interviews administered structured questionnaires and supplemented with maternal chart review and anthropometric measurement from May 1st to June 30th, 2019. Study participants were selected using a systematic random sampling technique. EpiData 3.02 and SPSS version 21 software were used for data entry, and analysis, respectively. Descriptive statistics, bivariate and multivariable logistic regression analysis were done. Variables at p -value < 0.2 were transferred to multivariable logistic regression analysis. Then variables at p -value <0.05with 95% CI were considered as statistically significant and AOR was used to interpret factors associated with episiotomy. Tables and graphs have been used to present the results. RESULTS: A total of 410 delivered mothers were included in the study and the magnitude of episiotomy was 57.6%with a mean of 95% CI = 0.53–0.63.Being primiparous (AOR = 16.96, 95% CI: 9.26, 31.05), meconium-stained amniotic fluid (AOR = 3.82, 95% CI: 1.84, 7.96), Second stage of labor lasting more than 2 hours (AOR = 2.43, 95% CI: 1.11, 5.32), births attended by non-midwife professionals (AOR = 2.26, 95% CI: 1.24, 4.14) and newborns head circumference >35 cm (AOR = 5.73, 95% CI: 3.29, 10.00) were factors significantly associated with episiotomy. CONCLUSIONS: Episiotomy was performed in more than half of the mothers included in the study. All the responsible bodies from the administrative to clinical practitioners should be in action to lower the magnitude of episiotomy by assuring that it is practiced restrictively with scientific indications. [ABSTRACT FROM AUTHOR]

An episiotomy is one of the most commonly performed obstetrics surgeries indicated in emergencies during the second stage of labor like fetal distress, dystocia, and tight perineum. As a result, this systematic review and metaanalysis aimed to assess the prevalence of episiotomy practice and associated factors in Ethiopia. Ten cross-sectional studies with a total population of 3718 were included in this study. The search was done using online databases like PubMed, HINARI, Web of Science, other gray, and online repositories of Universities. All the included papers were extracted and appraised using the standard extraction sheet format of JOANNA Briggs Institute. The Cochran Q-test and I2 statistics test were used to test the heterogeneity of studies. To detect the publication bias of the included studies, a funnel plot and Egger’s test were used. The pooled prevalence of episiotomy practice and the odds ratio with a 95% confidence interval were presented using forest plots. The overall pooled prevalence of episiotomy practice was 45.11% (95% CI; 37.04–53.18; I² = 96.3%). Prolonged second stage of labor (OR: 4.79, 95% CI: 3.03, 7.57), face presentation (OR: 4.26, 95% CI: 1.21, 15.07), birth weight > 4000 g (OR: 6.71, 95% CI: 3.14–14.33), instrumental delivery (OR: 4.26, 95% CI 2.95, 6.14), and primiparity (OR: 3.70, 95% CI: 1.90, 7.2) were factors associated with episiotomy practice. The overall prevalence of episiotomy practice was higher in Ethiopia compared to studies conducted in other countries. The prolonged second stage of labor, face presentation, birth weight > 4000 g, instrumental delivery, and primiparity of women were the factors associated with episiotomy practice. Therefore, efforts should be made to prevent routine episiotomy practice through creating awareness, adjusting national guidelines, affecting the World Health Organization episiotomy policy, and monitoring the activities of the health care facilities in executing the protocols. [ABSTRACT FROM AUTHOR]