Objectives This study estimated health facility-based
prevalence for pre-eclampsia/eclampsia, postpartum
haemorrhage and caesarean section (CS) due to prolonged
labour/dystocia. The background characteristics of Rwandan
pregnant women, the course of labour and the level of
healthcare were investigated in relation to pregnancy and
delivery outcomes.
Methods This is health facility-based study and data were
collected in 2014–2015 through structured interviews and
medical records (n=817) in Kigali and Northern Province,
Rwanda. Frequencies and prevalence were used to describe
participants’ background factors, labour and deliveryrelated
characteristics. Bivariable and multivariable logistic
regression models were performed for different background
factors and pregnancy/delivery outcomes.
Results Pre-eclampsia/eclampsia, postpartum haemorrhage
and CS due to prolonged labour/dystocia represented 1%,
2.7% and 5.4% of all participants, respectively. In total,
56.4% of the participants were transferred from facilities
with low levels to those with higher levels of healthcare,
and the majority were transferred from health centres to
district hospitals, with CS as the main reason for transfer.
Participants who arrived at the health facility with cervical
dilation grade of ≤3cm spent more hours in maternity
ward than those who arrived with cervical dilatation grade
of ≥4cm. Risk factors for CS due to prolonged labour or
dystocia were poor households, nulliparity and residence far
from health facility.
Conclusions The estimated health facility-based prevalence
of pregnancy-related complications was relatively low in
this sample from Rwanda. CS was the main reason for the
transfer of pregnant women from health centres to district
hospitals. Upgrading the capacity of health centres in the
management of pregnant women in Rwanda may improve
maternal and fetal health.