Spinal anesthesia for cesarean delivery at two teaching hospitals in Addis Ababa, Ethiopia

Introduction: Either regional or general anesthesia is an acceptable approach to providing anesthesia for cesarean delivery. However, regional anesthesia is the widely preferred option considering its multiple benefits. The aim of this study was to assess the prevalence of spinal anesthesia use, attitude of mothers towards spinal anesthesia, and magnitude of its complications.Methods: This is a hospital-based cross-sectional study conducted from April-June 2014 at Tikur Anbessa Specialized Hospital and Gandhi Memorial Hospital, Addis Ababa, Ethiopia. Data was collected using a pre-tested questionnaire and analyzed using SPSS version 21 statistical software.Result: During the study period, there were 1,713 deliveries, with overall cesarean section delivery prevalence of 32.5%. The overall proportion of cesarean delivery with spinal anesthesia was 68.2%. Only two mothers were given spinal anesthesia in left lateral position. The experience of the anesthetist was the only factor significantly associated with the occurrence of hypotension in a multivariable analysis. Postdural puncture headache after cesarean section with spinal anesthesia was reported in 34.2% of the cases. After the operation, 90.3% of the mothers were happy with the type of anesthesia administration.Conclusion: The rate of spinal anesthesia for cesarean delivery in this study is significantly lower than reports from the developed as well as sub-saharan countries implying a need to increase use of this procedure to achieve the recommended 90-95% target and avail epidural anesthesia as an option for those in need. The current practice in administering spinal anesthesia needs to be revised to minimize such side effects

Outcome of pregnancy with clinically visible/palpable myoma among women who undergo caesarian section in three teaching hospitals, Addis Ababa, Ethiopia: a cross sectional study

Introduction: Myoma is the most common pelvic tumor and an enormous healthcare concern in women. Complications occur in approximately 10-40% of pregnancies with myomatous uterus. This study is conducted to determine the prevalence and obstetric outcome of grossly visible and/or palpable myoma among women who gave birth by caesarean section.Methods: A cross sectional study conducted in three teaching hospitals in Addis Ababa, Ethiopia. Data was collected using a pre-tested questioner.Results: A total of 404 cases were included in the study. The prevalence of myoma was 15.3% (62/404). Only 9.7% (6/62) of the myoma cases were diagnosed preoperatively with ultrasound. The number of myoma per case ranged from 1-to-14 with mean number of 3 ±2.7. The mean diameter of largest single myoma per case was 5.2cm ± 3.4. The commonest location of myoma was subserous being the location in 58.1% (36/62). There was significant association between presence of myoma and age of the woman (P<0.05). The adjusted prevalence of myoma increases as women's age increases, and gestational age and birth weight decreases. In addition, the prevalence of myoma was about two times higher in low (≤6) first and fifth minute APGAR score groups with adjusted prevalences of 22.2% (Vs 14.1% in ≥7 group) and 31.8% (Vs 14.4% in ≥7 group) respectively.Conclusions: The prevalence of myoma during pregnancy in this study is higher than prior reports from similar setups. But, no statistically significant association was observed between the presence of myoma and maternal out come