Masters of Obstetrics and Gynecology

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https://testir.kiu.ac.ug/handle/20.500.12306/3212

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    BACTERIAL URINARY TRACT INFECTIONS IN PREGNANT WOMEN
    (Kampala International University, 2023-03) SANDE, GEORGE BINNA
    Urinary tract infection is widespread among pregnant women and is accompanying adverse maternal, fetal, and neonatal outcomes. Even so, no data exist regarding this problem in Bushenyi, the catchment area for KIUTH to guide specific management and thus to avert the adverse consequences. The aims is to assess the urinary tract infection among pregnant women attending ANC in KIUTH first trimester and its associated risk factors and to investigate the most common antibacterial agent used by infected pregnant women, in a total of about 350 pregnant women who attend the obstetrics and gynecology clinic with the inclusion criteria are to be included. The clinical symptoms such as frequency of micturition, dysuria, lower abdominal pain, urine color change, painful burning sensation, incomplete bladder evacuation will be utilized among the infected women. Since the symptoms are a good predictor for urinary tract infection during pregnancy, so early screening for pathogens and proper treatment for infected cases should be instituted.
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    Factors and common bacterial pathogens associated with post-caesarean wound sepsis at Hoima regional referral hospital, Uganda
    (Kampala international international: School of Health Sciences, 2019-03) Ismael, Muhumuza
    Background: Post-caesarean wound sepsis is among the most common problem for patientswho undergo caesarean section. It remains a common and widespread problem contributing to morbidity and mortality; this could be due to an increase in antimicrobial resistant bacterial pathogens. Therefore, a study to identify and document the factors associated with wound sepsis and common bacterial pathogens can provide solution to prevent incidence and establish microbiological mapping, and this is the intension for this research. Objectives: To determine prevalence, identify factors, common bacterial pathogens from post-caesarean wounds and antibacterial susceptibility pattem at Hoima Regional Referral Hospital.Research methods: This was a cross-sectional study conducted among patients with postcaesareanwound sepsis in the post-natal wards at Hoima Regional Referral Hospital. Consecutive enrolment of 303 participants who consented to participate was done daily until a required sample size was realized from July to September, 2018. Structured questionnaires were used to collect data on associated factors and wound swabs were done. Culturing for colony characteristics followed by Gram stain was used for provisional identity of pathogenic bacteria. Further identification was done by a set of biochemical tests. Antibacterial susceptibility pattem of isolated bacterial pathogens was determined by Kirby Bauer disc diffusion method. Data was analyzed using STAT A VERSION 14.2. Results: The wound sepsis rate was 16.8%. Being educated, multiple vaginal examination, hygiene, previous caesarean sections and HIV seropositivity were all significantly associated with wound sepsis (P value <0.05). Majority of the wound swab specimen yielded Staphylococcus aureus, and the least-prevalent pathogen was Proteus mirabilis. Coliforms showed high susceptibility to Imipenem followed by Staphylocccocus aureus to ciprofloxacin. Resistance was highest for coliforms and Staphylococcus aureus against, ciprofloxacin, gentamycin, ceftriaxone and cotrimoxazole. Conclusions and recommendations: The rate of caesarean wound sepsis is high at Hoima Regional Refenal Hospital. Being educated, multiple vaginal examination, hygiene, previous caesarean sections and HIV sero-positivity are significantly associated with wound sepsis. Staphylococcus au reus is the commonest organism isolated from exudates of septic wounds after caesarean section. Health workers should be informed about the high prevalence, the identified associated factors and common pathogens for proper management and also rational use of antibiotics to combat resistance.
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    Outcomes of Medical Versus Surgical Management of First Trimester Incomplete Abortion Among Women Admitted at Kampala International University Teaching Hospital
    (Kampala International University, School of Health Sciences, 2019-04) Victor, Tetty Otieno
    Background: Outcomes of surgical versus medical management of first trimester incomplete abortion are poorly documented in Uganda and it is important to guide clinical practice. Objectives: To compare the effectiveness, secondary outcomes and satisfaction level between surgical and medical management of first trimester incomplete abortion among women admitted at Kampala International University Teaching Hospital. Methodology: Prospective open labelled randomized clinical trial of 100 consecutively recruited participants, using investigator administered questionnaire conducted from June to September, 2018. Ethical clearance was obtained from Research and Ethics Committee of Kampala International University Teaching Hospital (UG REC 023). Results: The effectiveness of surgical management was statistically significantly higher than that of medical management (RRR=1 1.7%; p=O.043). Majority in the medical arm reported mild pain (64% versus 4%; p)
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    Missed opportunities for human immunodeficiency virus testing among mothers delivering at Kampala International University Teaching Hospital, Uganda
    (Kampala International University. School of Health Sciences Western Campus, 2019-04) Farhiya, Mohammed
    Background: Although HTV testing should be routinely offered during Antenatal care, the proportion of women giving birth without knowing their HIV status in Uganda is still significant despite attending antenatal clinics therefore highlighting the significance of testing these women during labour. Objectives: To determine the prevalence of missed opportunities for HIV testing and associated factors among mothers delivering at KIUTH. Methodology: A cross-sectional study of 218 consecutively enrolled participants using investigator questionnaire conducted from June to September 2018. Results: The prevalence of missed opportunities for HIV testing was 11% and age was significantly associated with missed opportunities for HIV testing (P=0.040). The prevalence of HIV seropositive results was found to be 4.2%. This was also a seroconversion prevalence. The major factors associated with missed opportunities for HIV testing were multiparity, obtaining PMTCT information from VHTs and mothers who don’t attach any sociomarital consequences to a positive HIV test result. Conclusion: A significant proportion of mothers who delivered were found to have missed opportunities for HTV testing during labor. There was evidence of HIV seroconversion and possible mother to child transmission noted. Multiparity, obtaining MTCT information from VHTs and mothers who don’t attach any sociomarital consequences to a positive HP! test result are significant factors contributing to missed opportunities for HIV testing. Recommendations: Equipping labour wards with HIV rapid tests and sensitizing medical personnel in identification of women with missed opportuinities for HIV testing during labor. To advocate for effective conselling after HIV testing for women who are found negative in antenatal clinics so as to increase their risk perception for HIV infection even during pregnancy to reduce seroconversion rates. Studies to help us further our understanding how multiparity, the role of VHTs as a source of PMTCT information and not attaching any sociomarital consequenses to a positive HP! test result by the mother brings about missed opportunities for HP! testing during labor and even pregnancy. xi