The Prevalence Of Birth Asphyxia And Immediate Outcomes Among Pregnant Women Attending Maternal Health Services At Ishaka Adventist Hospital.

ABSTRACT

Background: Birth Asphyxia is defined by WHO as “the failure to initiate and sustain breathing at birth.” Millions of child deaths and stillbirths are attributable to birth asphyxia, yet limited information is available to high light the burden of the condition to guide policy and practice, particularly at the community level in developing countries like Uganda. This study will compile insight on the prevalence and immediate outcomes of birth asphyxia in pregnant mothers attending maternal health services at Ishaka Adventist hospital.

Method: A descriptive cross sectional study involving a sample size of 310 deliveries obtained from Fisher’s et al, 1990 formula was undertaken to review HMIS records from January 2012 to December 2013 in IAH Theatre, Maternity and Pediatric Ward to determine the prevalence and immediate outcomes of birth asphyxia as determined by Apgar Score < 7/10 in 5 minutes, birth weight >1500grams and gestational age >34 weeks.

Results: An overall prevalence of 4.8% was obtained from this study, out of which more males were asphyxiated with 56.9% in 2012 and 58.3% in 2013 compared to females with 43.1% in 2012 and 41.7% in 2013, giving a male to female ratio of 1.4:1 in the study. Generally, statistics showed that on average 267 deliveries were made from 2012 to 2013 at IAH and an incidence of 48/1000 births and an incidence of 52 deaths per 1000 live births was obtained from the study. Majority of the neonates improved well upon resuscitation with 17cases (38.6%) and 23cases (50%) in 2012 and 2013 respectively. In both years, low Apgar score between 0-3 resulted in poor prognosis and no patient improved following resuscitation. Most cases with Apgar score of 4-7 improved 15 cases in 2012 and 20 cases in 2013, a few cases in the same range thus 12 cases died shortly and 25 cases died later in both years. Both MSB and FSB contributed 60 cases (71.8%) in both years. Important risk factors included; obstructed labor 34 cases (26.2%) in 2012 and 40 cases (22.2%) in 2013, followed by the fetal distress 27 cases (20.8%) in 2012 due to idiopathic intrapartum conditions and prolonged labor, 27 cases (15.0%) in 2013.

Conclusion: There is urgent need to institute appropriate measures to prevent and manage asphyxiated newborns in the hospital and region at large. Lastly, Without more attention to improve obstetric care and advance birth asphyxia research, the millions of deaths related to asphyxia, will remain out of reach of effective care, either by skilled or at community level, for many years to come in Uganda.