Abstract
PREVALENCE AND FACTORS ASSOCIATED WITH CERVICAL INCOMPETENCE AMONG WOMEN WITH HISTORY OF SECOND TRIMESTER ABORTION AT TERTIARY HOSPITAL IN SOUTH WESTERN UGANDA

Baraka Munyanderu Albin*, Lapat Jolly Joe, Manyang Antony Deng Kuany, Abesiga Lenard and Kanyesigye Hamson

ABSTRACT

Background: Cervical incompetence is one of the causes of second trimester abortion. It is of clinical and epidemiological interest because of its potential for significant consequences for women’s health and, by extension, to the well-being of families and society. But follow up of these mothers who have aborted is not routinely done to MRRH to find out whether they could be having cervical incompetence. To improve outcomes for mothers with clinically suspected cervical incompetence, cervical assessment is mandatory to first confirm the diagnosis. Than counselling and cervical cerclage can be done for the next pregnancy to prevent subsequent pregnancy loss and improve overall maternal morbidity and perinatal outcomes. Objective: To determine the prevalence and identify factors associated with cervical incompetence among women with second trimester spontaneous abortions attending gynecology outpatient clinic at Mbarara Regional Referral Hospital. Methodology: This was a Cross-sectional study carried out from 1st November 2017 to 30th March 2018 on patients with a history of second trimester abortion in at least 6 preceding weeks prior to the study. A total of 121 none pregnant patients with history of pregnancy were consented, interviewed, cervix assessed and diagnosis of cervical incompetence was made if a cervix freely admitted Hegars dilator size 8 and above. Data was collected on socio-demographics, medical conditions, obstetrics and gynecological factors and entered in Excel and analyzed using STATA 13. Multivariate analyses were done to determine the factors associated with cervical incompetence having statically significant level (CI <= 0.05). Results: The prevalence of cervical incompetence among second trimester abortion was 21.5% (26/121). Factors that had a significant relationship with cervical incompetence included number of abortions, specifically more than 2 (aOR 6.8; CI: 1.7-26.8; p=0.006), and cervical tear (aOR 17.1; CI:4.2-69.12; p=0.000). Conclusion: The Prevalence of cervical incompetence among second trimester abortion as diagnosed by Hegars dilator test was at a high of 21.5%. Number of abortions and previous cervical tear were independently associated with cervical incompetence.

Keywords: Abortion, cervical incompetence, second trimester abortion, recurrent abortion.


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