Abstract:
BACKGROUND: Cesarean delivery carries both short term and long-term fetal and maternal complications. Among the complications hemorrhage requiring hysterectomy or blood transfusion, incision extension,surgical site infection, puerperal sepsis, hematoma and maternal mortality are some of them. Even though it is being a public burden the proportion of complications and underlying risk factors are not studied well in our setup. The exact figure and magnitude of association is an area of new study.
OBJECTIVE: 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 from September 1,2021 to December 30,2021 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 were selected from the operation registration book. Systematic sampling was used after arranging the study frame based on date of operation. Having atleast one complication coded as “1” and no complications as “0” was used as the dependent variable. Binary logistic regression, initially with bi-variate analysis was used to determine the association between different factors and the outcome variable. Those variables which were significant on bivariate analysis (P-value <0.2) were entered to multivariable logistic regression analysis. The association between dependent and independent variables was determined using odds ratio (OR) with 95% confidence interval (CI).
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 minutes (AOR=3.476,95%CI: 1.521, 7.947) were found to be significantly associated with maternal complications.
CONCLUSION: The magnitude of maternal complication following cesarean section at public specialized hospitals in Bahir Dar was higher than most previous studies in Ethiopia. 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. Thus, due attention has to be given for closeness of health facilities as international standards. Timely and adequate progress of labor evaluation, timely decision for cesarean delivery and vigilant care in post-operative period should be conducted. Efforts should also be made to decrease the intra-operative blood loss.
KEY WORDS: Maternal complication, cesarean section, Bahir Dar