Kilimanjaro Christian Medical Center Kilimanjaro Christian Medical College College

Moshi, Tanzania

Kilimanjaro Christian Medical Center Kilimanjaro Christian Medical College College

Moshi, Tanzania
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Chiwanga E.S.,Kilimanjaro Christian Medical Center Kilimanjaro Christian Medical College College | Massenga G.,Kilimanjaro Christian Medical Center Kilimanjaro Christian Medical College College | Massenga G.,Kilimanjaro Christian Medical UniversityCollege | Mlay P.,Kilimanjaro Christian Medical Center Kilimanjaro Christian Medical College College | And 4 more authors.
Asian Pacific Journal of Reproduction | Year: 2014

Objective: To compare maternal outcome of multiple versus singleton pregnancies at a tertiary hospital in Tanzania. Methods: A case control study was designed using maternally linked data from Kilimanjaro Christian Medical Centre (KCMC) medical birth registry for the period of 2000-2010. A total of 822 multiple gestations (cases) were matched with 822 singletons (controls) with respect to maternal age at delivery and parity. The odds ratio (ORs) with 95% confidence intervals (CIs) for adverse maternal outcome between singleton and multiple gestations were computed in a multivariable logistic regression model. Results: Of the 33 997 births, there were 822 (2.1%) multiples. Compared with singletons, women with multiple gestations had increased risk for preeclampsia (. OR 2.6; 95%. CI: 1.7-3.9), preterm labour (. OR 5.6; 95%. CI: 4.2-7.4), antepartum haemorrhage (. OR 1.6; 95%. CI: 1.1-2.3), anaemia (. OR 2.0; 95%. CI: 1.6-2.6) and caesarean section (. OR 1.5; 95%. CI: 1.4-1.7). In addition, there were six maternal deaths among women with multiple gestations, of which all were attributed to postpartum haemorrhage. This accounted for a case fatality rate of 15.8%. Conclusions: Multiple gestations are associated with adverse maternal outcomes. Close follow-up and timely interventions may help to prevent poor outcomes related to multiple gestations. These findings suggest the needs for clinicians to counsel women with multiple gestations during prenatal care regarding the potential risks. © 2014 Hainan Medical College.


PubMed | Kilimanjaro Christian Medical Center Kilimanjaro Christian Medical College College and Kilimanjaro Christian Medical University College
Type: | Journal: BMC pregnancy and childbirth | Year: 2015

Abruptio placentae remains a major cause of maternal and perinatal morbidity and mortality in developing countries. Little is known about the burden of abruptio placentae in Tanzania. This study aimed to determine frequency, risk factors for abruptio placentae and subsequent feto-maternal outcomes in women with abruptio placentae.We designed a retrospective cohort study using maternally-linked data from Kilimanjaro Christian Medical Centre (KCMC) medical birth registry. Data on all women who delivered live infants and stillbirths at 28 or more weeks of gestation at KCMC hospital from July 2000 to December 2010 (n=39,993) were analysed. Multivariate logistic models were used to calculate odds ratios (OR) and 95% confidence intervals (CIs) for risk factors, and feto-maternal outcomes associated with abruptio placentae.The frequency of abruptio placentae was 0.3% (112/39,993). Risk factors for abruptio placentae were chronic hypertension (OR 4.1; 95% CI 1.3-12.8), preeclampsia/eclampsia (OR 2.1; 95% CI 1.1-4.1), previous caesarean delivery (OR 1.3; 95% CI 1.2-4.2), previous abruptio placentae (OR 2.3; 95% CI 1.8-3.4), fewer antenatal care visits (OR1.3; 95% 1.1-2.4) and high parity (OR 1.4; 95% CI 1.2-8.6). Maternal complications associated with abruptio placentae were antepartum haemorrhage (OR 11.5; 95% CI 6.3-21.2), postpartum haemorrhage (OR 17.9; 95% 8.8-36.4),), caesarean delivery (OR 5.6; 95% CI 3.6-8.8), need for blood transfusions (OR 9.6; 95% CI 6.5-14.1), altered liver function (OR 5.3; 95% CI 1.3-21.6) and maternal death (OR 1.6; 95% CI 1.5-1.8). In addition, women with abruptio placentae had prolonged duration of hospital stay (more than 4 days) and were more likely to have been referred during labour. Adverse fetal outcomes associated with abruptio placentae include low birth weight (OR 5.9; 95% CI 3.9-8.7), perinatal death (OR 17.6; 95% CI 11.3-27.3) and low Apgar score (below 7) at 1 and 5 min.Frequency of abruptio placentae is comparable with local and international studies. Chronic hypertension, preeclampsia, prior caesarean section delivery, prior abruptio placentae, poor attendance to antenatal care and high parity were independently associated with abruptio placentae. Abruptio placentae was associated with adverse maternal and foetal outcomes. Clinicians should identify risk factors for abruptio placentae during prenatal care when managing pregnant women to prevent adverse maternal and foetal outcomes.

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