TY  - BOOK
AU  - Mpeli Mwakyelu
AU  - Alphaxard Kajura
AU  -   Richard Kiritta
TI  - Early Versus Late Amniotomy and Associated Fetomaternal Outcomes among Women Delivering at Bugando Medical Centre, Mwanza, Tanzania  
PY  - 2023///
CY  - Mwanza, Tanzania: 
PB  - Catholic University of Health and Allied Sciences [CUHAS – Bugando] :   
KW  -  
N2  - Abstract:

Background: In contemporary obstetric practice, amniotomy is one of the most frequently done procedures, yet preliminary findings do not support its routine application in labor management. Even though amniotomies are frequently performed in hospitals, particularly at Bugando Medical Centre (BMC), there is not much written about the procedure. In this study, women giving birth at BMC, a tertiary care hospital in northwest Tanzania, was compared for early versus late amniotomy and associated feto-maternal outcome.

Methodology: This was cross section study conducted at BMC. A total of 426 delivered women at BMC were enrolled from August 2022 to March 2023. The study was conducted in the Obstetrics labor and postnatal wards of BMC. Data on each patient was collected using pretested questionnaire prepared for the study and analyzed using STATA version 15. Determination and comparison of feto-maternal outcomes with amniotomy were obtained by using X2 while the association between early amniotomy and poor fetal maternal outcomes was determined by using multivariate logistic regression after adjusting possible confounders; p-value of less than 0.05 was considered.

Results: Majority of our participants had age ranging 25-34 years 56.57% in which 67 women had newborns with poor outcomes. Earl Amniotomy were significantly found to be associated with lower segment caesarean section. (OR 4.19; 95% [2.62-6.70]; p=<0.001) and primiparous respectively (OR 1.7; 95% [1.08-2.7]; p-value =0.02

Conclusion and recommendation: Our study findings demonstrated that early amniotomy is one of the most commonly performed procedures in our labour ward. However, early amniotomy was found to be associated with high rate of caesarian section which was found to be significantly higher among primigravida. Since in the third world countries LSCS is associated with maternal morbidity and mortality, it’s important to avoid unnecessary early rupture of membrane during labour management. A randomized clinical trial should be conducted in our setting to assess the effect of early versus late amniotomy on maternal and fetal outcomes the results can generalized in the who population


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