Prevalence, Immediate Maternal Complications and Factors Associated with Thrombocytopenia among Women Delivering at Kampala International University Teaching Hospital, Western Uganda

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Table of contents

Declaratiori .•..................................................................................................................................... i

Approval ......................................................................................................................................... ii

Dedication ...................................................................................................................................... iii

Acknowledgement ................................ : ........................... , ............................................................ iv

List of Abbreviations ...................................................................................................................... v

Operational definitions ......................... : ........................... : ............................................................. vi

Table of contents ........................................................................................................................... vii

List of figures .............................................................................................. xi

List of tables ..................................................... xii

Abstract: ..................................................... xiii

Chapter One: Introduction .............................................................................................................. 1

1.1Background'ofthe study ............................................................................................................ I

1.2 Problem statement. .................................................................................................................... 5

1.3 Purpose of the.study .................................................................................................................. 5

1.4 Specific objectives .................................................................................................................... 6

1.5 Research questions ..................................................................................................................... 6

1.6 Justification of the study ........................................................................................................... 6

1. 7 Significance of the study ........................................................................................................... 7

1.8 Conceptual framework .............................................................................................................. 8

1. 9 Study scope ................................................................. 9

1. 9.1 Content scope ......................................................................................................................... 9

1.9.2 Geographical. scope ................................................................................................................. 9

1.9.3 Time scope : ........................................... 9

Chapter Two: Literature Review .................................................................................................. 10

2.0 Introduction ........................................................... 10 

2.1 Prevalence of thrombocytopenia in pregnancy ....................................................................... 10

2.2 hnmediate maternal complications and their relationship with thrombocytopenia ................ II

2.3 Social demographic, obstetrics and medical factors as.sociated with thrombocytopenia in pregnancy ...................... 13

Chapter Three: Methodology ........................................................................................................ 16

3.1 Study Design ........................................................................................................................... 16

3.2 Study· site and setting ........ : ..................................................................................................... 16

3.3 Studypopulation ..................................................................... : ............................................... 16

3.4 Selection criteria ..................................................................................................................... 16

3.4.1 Inclusion criteria .................................................................................................................. 16 . 3.4.2 Exclusion criteria ................................................................................................................. 16

3.5 Sample size ............................................................................................................................. 17

3.5.1 Sample size determination .................................................................................................... 17

3.6 Sampling technique ................................................................................................................. 17

Figure 2: Flow Chat for the participant recruitment and data collection ...................................... 18

3.7 Data collection instruments ............. , ....................................................................................... 19

3.8 Procedure ................................................................................................................................ 19

3.8.2.1 History taking .................................................................................................................... 19

3.8.2.2 Examination .............................•........................................................................................ 19

3.9 Validity of data ~ollection i,nstruments ................................................................................... 20

3.10 Reliability o( data collection instruments· ............................................................................. 2()

3.11 Sample processing and analysis ............................................................................................ 20

3.12 Data an.alysis plan ................................................................................................................. 20

3.13 Fea,sibility.ofthe study ........................................................ : ................................................. 21

3.14 Quality control ...................................................................................................................... 21

3.15 Ethical considerations ........................................................................................................... 21

3.15 .1 Informed consent and respect for participants ................................................................... 21

3.15.2 Risk and adverse event to study participants ......... ~ ........................................................... 21

3.15.3 Benefits ofthe research ...................................................................................................... 22 

3.15.4 Privacy and confidentiality .................................... ." ........................................................... 22

3.15.5 Sampling technique ............................................................................................................ 22

3.15.6 Incentives and reimbursement ........................................................................................... 22

3.15. 7 Approval procedure ........................................................................................................... 22

3.15. 8 Respect for community ~d feedback ................................................................................ 23

Chapter Four: Presentation and Interpretation ofResults ............................................................. 24

4.1 Participants Characteristics ..................................................................................................... 24

4.1.1 Social demographic characteristics of study participants .. : ................................................. 24

4.1.2 Obstetrics and medical characteristic of study participants ................................................. 25

4.2 The overall prevalence, age specific prevalence and severity of thrombocytopenia among women who delivered at KIU-11I .................. 26

4.3 The relationship between immediate maternal complications and thrombocytopenia among women delivering at KIU -11I ........................ 27

4.4 Bivariate analysis of social demographic, obstetrics and medical factors associated with thrombocytopenia among women delivering at KIU -11I ... 28

4.5 Multivariate analysis of social demographic, obstetrics and medical factors associated with thrombocYtopenia among women delivering at KIU-11I ................ 31

CHAPTER FIVE:· Discussion, Conclusions and Recommendations ........................................... 32

5.0 Introduction ............................................................... 32

5.1 Discussion., ................................................................... 32

5 .1 .1 The prevalence of thrombocytopenia among women delivering at KIU-11I ...................... 32

5.1.2 The relationship between immediate maternal complications and thrombocytopenia among women delivering at KIU-11! .............. 33

5.1.3 Social demographic, obstetrics and medical factors associated with thrombocytopenia among women delivering at KIU-TH ..... 34

5.3.3.1 Age ............................................................. 34

5.3.3.2 Hypertension in pregnancy ................................. 34

5.3.3.4 HIV· .................................................35

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