413: Severe maternal morbidity as analysed using the Robson Ten Groups: prospective cohort study in a large tertiary level unit

2014 ◽  
Vol 210 (1) ◽  
pp. S209
Author(s):  
Mary Higgins ◽  
Michael Foley ◽  
Vicky O'Dwyer ◽  
Jennifer Hogan ◽  
Michael Robson ◽  
...  
Keyword(s):  
Cohort Study ◽  
Prospective Cohort Study ◽  
Prospective Cohort ◽  
Maternal Morbidity ◽  
Severe Maternal Morbidity ◽  
Tertiary Level

scholarly journals High-risk pregnancies and their association with severe maternal morbidity in Nepal: A prospective cohort study

PLoS ONE ◽  
2020 ◽  
Vol 15 (12) ◽  
pp. e0244072
Author(s):  
Sushma Rajbanshi ◽  
Mohd Noor Norhayati ◽  
Nik Hussain Nik Hazlina
Keyword(s):  
Cohort Study ◽  
High Risk ◽  
Risk Stratification ◽  
Antenatal Care ◽  
Pregnant Women ◽  
Prospective Cohort Study ◽  
Prospective Cohort ◽  
Maternal Morbidity ◽  
Low Risk ◽  
Severe Maternal Morbidity

Background The early identification of pregnant women at risk of developing complications at birth is fundamental to antenatal care and an important strategy in preventing maternal death. This study aimed to determine the prevalence of high-risk pregnancies and explore the association between risk stratification and severe maternal morbidity. Methods This hospital-based prospective cohort study included 346 pregnant women between 28–32 gestational weeks who were followed up after childbirth at Koshi Hospital in Nepal. The Malaysian antenatal risk stratification approach, which applies four color codes, was used: red and yellow denote high-risk women, while green and white indicate low-risk women based on maternal past and present medical and obstetric risk factors. The World Health Organization criteria were used to identify women with severe maternal morbidity. Multivariate confirmatory logistic regression analysis was performed to adjust for possible confounders (age and mode of birth) and explore the association between risk stratification and severe maternal morbidity. Results The prevalence of high-risk pregnancies was 14.4%. Based on the color-coded risk stratification, 7.5% of the women were categorized red, 6.9% yellow, 72.0% green, and 13.6% white. The women with high-risk pregnancies were 4.2 times more likely to develop severe maternal morbidity conditions during childbirth. Conclusions Although smaller in percentage, the chances of severe maternal morbidity among high-risk pregnancies were higher than those of low-risk pregnancies. This risk scoring approach shows the potential to predict severe maternal morbidity if routine screening is implemented at antenatal care services. Notwithstanding, unpredictable severe maternal morbidity events also occur among low-risk pregnant women, thus all pregnant women require vigilance and quality obstetrics care but high-risk pregnant women require specialized care and referral.

scholarly journals Evaluating Midwifery Units (EMU): a prospective cohort study of freestanding midwifery units in New South Wales, Australia

BMJ Open ◽  
2014 ◽  
Vol 4 (10) ◽  
pp. e006252 ◽  
Author(s):  
Amy Monk ◽  
Mark Tracy ◽  
Maralyn Foureur ◽  
Celia Grigg ◽  
Sally Tracy
Keyword(s):  
Cohort Study ◽  
Intensive Care ◽  
Prospective Cohort Study ◽  
Prospective Cohort ◽  
Neonatal Intensive Care ◽  
New South ◽  
Tertiary Level ◽  
South Wales ◽  
Secondary Outcomes ◽  
Freestanding Midwifery Unit

ObjectiveTo compare maternal and neonatal birth outcomes and morbidities associated with the intention to give birth in two freestanding midwifery units and two tertiary-level maternity units in New South Wales, Australia.DesignProspective cohort study.Participants494 women who intended to give birth at freestanding midwifery units and 3157 women who intended to give birth at tertiary-level maternity units. Participants had low risk, singleton pregnancies and were at less than 28+0 weeks gestation at the time of booking.Primary and secondary outcome measuresPrimary outcomes were mode of birth, Apgar score of less than 7 at 5 min and admission to the neonatal intensive care unit or special care nursery. Secondary outcomes were onset of labour, analgesia, blood loss, management of third stage of labour, perineal trauma, transfer, neonatal resuscitation, breastfeeding, gestational age at birth, birth weight, severe morbidity and mortality.ResultsWomen who planned to give birth at a freestanding midwifery unit were significantly more likely to have a spontaneous vaginal birth (AOR 1.57; 95% CI 1.20 to 2.06) and significantly less likely to have a caesarean section (AOR 0.65; 95% CI 0.48 to 0.88). There was no significant difference in the AOR of 5 min Apgar scores, however, babies from the freestanding midwifery unit group were significantly less likely to be admitted to neonatal intensive care or special care nursery (AOR 0.60; 95% CI 0.39 to 0.91). Analysis of secondary outcomes indicated that planning to give birth in a freestanding midwifery unit was associated with similar or reduced odds of intrapartum interventions and similar or improved odds of indicators of neonatal well-being.ConclusionsThe results of this study support the provision of care in freestanding midwifery units as an alternative to tertiary-level maternity units for women with low risk pregnancies at the time of booking.

scholarly journals A Study on Hypcrcalcaemia in Patients with Bronchial Carcinoma: At a Tertiary Level Hospital

2009 ◽  
Vol 22 (2) ◽  
pp. 245-247
Author(s):  
I Mahmood ◽  
MK Rahman ◽  
MA Haque ◽  
MMR Khan ◽  
MMH Chowdhury ◽  
...  
Keyword(s):  
Cohort Study ◽  
Prospective Cohort Study ◽  
Prospective Cohort ◽  
Bronchial Carcinoma ◽  
Tertiary Level ◽  
College Hospital ◽  
Medicine Department ◽  
Common Features ◽  
Medical College ◽  
Level Hospital

Bronchial carcinomas often present with some paraneoplastic features which may present even before the offending tumor has been detected. Hypercalcaemia is one of the most common paraneoplastic sypmtoms. In this prospective cohort study attempts has been made to demonstrate the incidence and pattern of hypercalcaemia in bronchial cancers. The study was undertaken at the Medicine Department of Rajshahi Medical College Hospital, Rajshahi in between July, 2009 to December 2009. In this study hypercalcaemia was found i_n 30.76% cases with anorexia, dyspepsia, nausea, polyuria, polydipsia and constipation being most common features related to it.TAJ 2009; 22(1): 245-247

scholarly journals Postpartum Severe Acute Maternal Morbidity According to Gestational Age at Delivery in Twin Pregnancies: A Prospective Cohort Study

2021 ◽  
Author(s):  
Lola Loussert ◽  
Catherine Deneux-Tharaux ◽  
Aurélien Seco ◽  
Francois Goffinet ◽  
diane korb ◽  
...  
Keyword(s):  
Cohort Study ◽  
Prospective Cohort Study ◽  
Gestational Age ◽  
Prospective Cohort ◽  
Maternal Morbidity ◽  
Population Based ◽  
Severe Acute Maternal Morbidity ◽  
Increased Risk ◽  
Gestational Age At Delivery ◽  
Twin Pregnancies

Objective: To assess the association between gestational age at delivery and postpartum severe acute maternal morbidity (SAMM) in twin pregnancies. Design: Population-based, national, prospective, cohort study Setting: From 02/2014 to 03/2015 in France Population: Women with twin pregnancies who gave birth after 32 weeks of gestation. We excluded women with fetal death or medical termination of either twin, with antepartum SAMM, with antepartum conditions responsible for postpartum SAMM. Methods: Gestational age at delivery was studied as the number of completed weeks of gestation. We assessed the association between gestational age at delivery and postpartum SAMM by using multivariable multilevel modified Poisson regression modelling. Main Outcome Measures: Composite criteria of postpartum severe acute maternal morbidity Results: Among the 7,713 women included, 410 (5.3%) developed postpartum SAMM, mainly (88.5%) postpartum haemorrhage. Compared with the reference category of 37 weeks, the risk of postpartum SAMM was significantly lower for all categories of earlier gestational age at delivery (from aRR=0.34, 95% CI 0.17-0.68 at 32 weeks to aRR=0.71, 95% CI 0.54-0.94 at 36 weeks), and did not differ for later categories. Conclusion: In twin pregnancies, compared with delivery at 37 weeks, delivery at earlier gestational ages is associated with a lower risk of postpartum SAMM. Continuing pregnancy beyond 37 weeks is not associated with an increased risk of postpartum SAMM. Funding: Supported by a grant from the French Ministry of Health (Programme Hospitalier de Recherche Clinique, AOM2012) and a grant from Université Toulouse III. Keywords: severe acute maternal morbidity, twin pregnancy, timing of delivery

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