Early experience on obstetric outcomes of pregnant women who tested positive for COVID-19 in Ethiopia: A case series analysis

Severe acute respiratory syndrome affects all groups of population including pregnant women. Currently, there are limited evidences to show an increased risk of infection or increased mortality among pregnant women than the general population. On the 13th of March 2020, Ethiopian government reported the first case of COVID-19. Since then, until the time of this research compilation, more than 40 pregnant women have been managed at Eka Kotebe General Hospital, which is the first COVID-19 designated center in the country. The aim of this case series is to do an in-depth case review of the first four cases of pregnant women who tested positive for COVID-19. Out of the four cases discussed in this series, there was one maternal death, and three out of the four newborns delivered tested positive for COVID-19

Unmet need for contraception among HIV-positive women attending HIV care and treatment service at Saint Paul's Hospital Millennium Medical College, Addis Ababa, Ethiopia

Background. The emergence of the HIV epidemic is one of the biggest public health challenges the world has ever seen in recent history. Ethiopia is among the countries most affected by the HIV epidemic. The national estimate for the HIV-positive pregnant women was 24,000 for the year 2016, and there were an estimated 3,800 new HIV infections among children. Regardless of their HIV status contraception offers women, their families, and communities a variety of benefits. For HIV-positive women who do not want to become pregnant, contraception has the added benefit of reducing HIV-positive births. Despite its demonstrable contribution, far less attention has been given to prevention of unintended pregnancy as a strategy to PMTCT. Objectives. To determine the level and contributing factors of unmet need for contraception among HIV-positive women in the ART clinic of Saint Paul’s Hospital Millennium Medical College (SPHMMC). Methods. A facility based cross-sectional study was conducted from 1 September 2016 to 30 November 2016. An exit interview of sampled women enrolled at ART clinic of SPHMMC was done using structured and pretested questionnaire. Descriptive, bivariate, and multivariate methods were used to analyze the level of unmet need and its contributing factors. Results. The overall unmet need for contraception was 25.1%. The most common reasons for nonuse were related to perceived low risk of pregnancy. Unmet need was more common in unmarried women and those who did not discuss about contraception with HIV care provider. Making joint decision on contraceptive utilization with partner and having serodiscordant partner were associated with decreased odds of unmet need. Conclusion. The ART clinic represented one of the missed opportunities to initiate and promote contraceptive use. The study also shows broader demand for contraception and the need for new strategies to address the contraceptive needs among HIV-positive clients.Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/151765/1/Abubeker et al 2019.pd

Abortion care in women with underlying medical conditions: The role of multidisciplinary team approach in increasing safety of abortion procedures

Abstract Background There are no clear data driving most clinical recommendations for abortion care in women with underlying medical conditions, such as cardiac disease. Current abortion practice in such women is based on limited retrospective studies, mainly case reports and case series. In our institution (a tertiary center in Ethiopia), we practice a multidisciplinary team approach to abortion care for patients with medical conditions. Objective Describe the value of a multidisciplinary team approach in abortion care in patients with underlying medical conditions. Methods This is a retrospective descriptive analysis of abortion care in women with underlying medical conditions (cardiac and noncardiac medical conditions) over a 5‐year period (November 2016–October 2021) at St. Paul's Hospital Millennium Medical College, in Ethiopia. Data were extracted by reviewing patients’ medical records using a structured questionnaire. Simple descriptive statistics were applied for analysis using SPSS version 23. Results are presented as frequencies and percentages. Results Fifteen induced abortion cases in women with underlying medical conditions were analyzed, out of which 11 were in women who were critically ill. The median gestational age was 20 weeks. Ten subjects, 10/15 (66.7%), had a cardiac condition, whereas the rest 5/15 (33.3%) were noncardiac cases. Ten out of the 11 critically ill patients were managed under multidisciplinary team approach, and there were no complications encountered. Out of these, 7/10 (70%) received medication abortion care between 19 and 25 weeks gestation, including 5 cardiac patients with New York Heart Association‐III and IV conditions. Conclusion In this study, more than three quarters of women with medical conditions who had abortion care were critically ill, and almost all of them were managed with a multidisciplinary team approach. None of the patients suffered a deterioration of their medical conditions, demonstrating the utility of incorporating a multidisciplinary team approach during abortion care for such cases