Episiotomy related morbidities measured using redness, edema, ecchymosis, discharge and apposition scale and numerical pain scale among primiparous women in Mulago National Referral Hospital, Kampala, Uganda

Introduction: episiotomy induced inflammatory signs like redness, edema, ecchymosis and pain may remain beyond the period of hospitalization and can be objectively measured using redness, edema, ecchymosis, discharge and apposition (REEDA) scale. Pain in the postpartum period is a common problem and can be measured using the numerical pain scale (NPS). Episiotomy is normally poorly executed and poorly repaired with little attention to the subtle pain-free scar. Postpartum perineal pain has been found to affect more people with episiotomy compared to spontaneous perineal tears or contusion in the first two weeks. This study was aimed at comparing NPS and REEDA scores in the first two weeks of postpartum among primiparous parturients with or without episiotomy in Mulago National Referral Hospital. Methods: a prospective cohort study conducted by recruiting primiparous women systematically on the first postnatal day and categorizing them into episiotomy and no episiotomy group. NPS and REEDA scale were taken at baseline and 2 weeks postpartum. Results: the mean total REEDA score for primiparous women among the episiotomy group was significantly higher both on day 1 and day 14 with p-values <0.0001 and <0.0001 respectively as well as the day 14 mean NPS p-value 0.001. Conclusion: episiotomy, a traumatic obstetric procedure, that heals slowly and with persistent perineal pain compare to spontaneous perineal contusion or tears

Early discontinuation of long-acting reversible contraceptives and associated factors among women discontinuing long-acting reversible contraceptives at national referral hospital, Kampala-Uganda; a cross-sectional study

Abstract Background High levels of unmet need for contraception and unwanted pregnancies are high in developing countries despite efforts to reduce them. Long-acting reversible contraceptive (LARC) methods are more than 99% effective in preventing pregnancy. Discontinuation of LARC within the first year of initiation contributes to the high levels of unmet need. This study aimed to determine the prevalence and factors associated with the first-year discontinuation of LARC at Kawempe National Referral hospital. Methods A facility-based cross-sectional study was conducted from February 2020 to June 2021. We consecutively recruited 354 participants who discontinued a LARC (intrauterine device {IUD} and sub-dermal implant) during the study period after informed written consent. Data on duration of use, reasons for discontinuation, and factors associated were collected using a face-to-face interviewer-administered questionnaire and review of client records. Early LARC discontinuation was defined as the termination of the contraception within the first 12 months of use. Data were entered using SPSS version 14/0 and analyzed in STATA version 15. Prevalence was expressed as a proportion while logistic regression was used to assess factors associated with early LARC discontinuation. Variables with a p-value of < 0.05 were considered statistically significant. Results The proportion of first-year discontinuation of LARC was 29%. Women Age less than 25 years (OR = 5.07; 95% CI: 1.1–24.8) and those who desired a family size of fewer than four children (OR = 3.19; 95%CI: 1.2–8.7 ) were more likely to discontinue the LARC within 12 months of initiation after multivariate analysis. Method-related reasons for removal were painful menstrual cramps for implants, recurrent infections for IUDs, and a non-side effect reason was the desire to get pregnant. Conclusion A high proportion of women discontinue LARC within 12 months following initiation. Young adults and those who desire small families are more likely to have first-year discontinuation of LARC. We recommend age-specific counseling for patients receiving the LARC and further studies looking at the depth analysis of reasons for the first-year discontinuation

Additional file 1 of Early discontinuation of long-acting reversible contraceptives and associated factors among women discontinuing long-acting reversible contraceptives at national referral hospital, Kampala-Uganda; a cross-sectional study

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