Poor maternal health outcomes and associated factors among women undergoing cesarean section in Southern Ethiopia.

BACKGROUND

Cesarean section is the most commonly performed major surgical procedure in obstetrics and gynecology worldwide. Despite advancements in surgical techniques, cesarean section is still associated with higher maternal morbidity and mortality compared to vaginal delivery. Adverse maternal outcomes following cesarean section includes hemorrhage, infections, hysterectomy, uterine rupture, and pronged hospital stay. However, studies on maternal health outcomes following cesarean section are yet well studied in Ethiopia. Therefore, this study aimed to assess poor maternal health outcomes and associated factors among women who delivered by cesarean section in public hospitals of Gamo, Gofa and South Omo Zones in Southern Ethiopia.

METHODS AND MATERIALS: An institutional-based cross-sectional study was conducted among 354 women who delivered by cesarean section between March 1 and April 30, 2022, at public hospitals in the Gamo, Gofa and South Omo Zones. Participants were selected using systematic random sampling method. Data were collected though interviewer-administered questionnaires and chart reviews using Open Data Kit (ODK) tools. Statistical analysis was performed using SPSS version 25. Both bivariable and multivariable logistic regression analyses were conducted to identify factors associated with poor maternal health outcomes. A P-value of < 0.05 was considered statistically significant.

RESULTS

The prevalence of poor maternal outcome was 19.5% [95% CI: 15.67-23.97). A hematocrit level of < 30% (AOR = 3.17; 95% CI: 1.28, 7.86), being referred from other institutions AOR = 3.00; 95% CI: 1.36, 6.62), and presence of medical illness (AOR = 2.87; 95% CI: 1.20, 6.79) were associated with increases odds of poor maternal outcomes. Moreover, delivering in primary hospitals (AOR = 5.11; 95% CI: 2.28, 11.47), having no ANC follow-up (AOR = 4.04; 95% CI: 1.42, 11.46) and undergoing surgery under general anesthesia (AOR = 5.16; 95% CI: 2.03, 12.06) were also independently associated with poor maternal health outcomes.

CONCLUSION

Magnitude of poor maternal outcomes following cesarean section in the study area was found to be high. Implementing blood loss controlling techniques during and after cesarean birth, along with adequate screening, early diagnosis, and management of non-communicable disease during antenatal care could significantly improve maternal health outcomes.