scholarly journals Determinants of prenatal health care utilisation by low-risk women: A prospective cohort study

2015 ◽  
Vol 28 (2) ◽  
pp. 87-94 ◽  
Author(s):  
Esther I. Feijen-de Jong ◽  
Danielle E.M.C. Jansen ◽  
Frank Baarveld ◽  
Agatha W. Boerleider ◽  
Evelien Spelten ◽  
...  
Keyword(s):  
Health Care ◽  
Cohort Study ◽  
Prospective Cohort Study ◽  
Prospective Cohort ◽  
Health Care Utilisation ◽  
Low Risk ◽  
Prenatal Health ◽  
Care Utilisation ◽  
Prenatal Health Care ◽  
Low Risk Women

scholarly journals Prospective cohort study of water immersion for labour and birth compared with standard care in an Irish maternity setting

BMJ Open ◽  
2020 ◽  
Vol 10 (12) ◽  
pp. e038080
Author(s):  
Paula L Barry ◽  
Lean E McMahon ◽  
Ruth AM Banks ◽  
Ann M Fergus ◽  
Deirdre J Murphy
Keyword(s):  
Cohort Study ◽  
Birth Outcomes ◽  
Prospective Cohort Study ◽  
Prospective Cohort ◽  
Standard Care ◽  
Water Immersion ◽  
Low Risk ◽  
Perineal Tears ◽  
Significant Difference ◽  
Low Risk Women

ObjectiveTo examine the birth outcomes for women and babies following water immersion for labour only, or for labour and birth.DesignProspective cohort study.SettingMaternity hospital, Ireland, 2016–2019.ParticipantsA cohort of 190 low-risk women who used water immersion; 100 gave birth in water and 90 laboured only in water. A control group of 190 low-risk women who received standard care.MethodsLogistic regression analyses examined associations between water immersion and birth outcomes adjusting for confounders. A validated Childbirth Experience Questionnaire was completed.Main outcome measuresPerineal tears, obstetric anal sphincter injuries (OASI), postpartum haemorrhage (PPH), neonatal unit admissions (NNU), breastfeeding and birth experiences.ResultsCompared with standard care, women who chose water immersion had no significant difference in perineal tears (71.4% vs 71.4%, adj OR 0.83; 95% CI 0.49 to 1.39) or in OASI (3.3% vs 3.8%, adj OR 0.91; 0.26–2.97). Women who chose water immersion were more likely to have a PPH ≥500 mL (10.5% vs 3.7%, adj OR 2.60; 95% CI 1.03 to 6.57), and to exclusively breastfeed at discharge (71.1% vs 45.8%, adj OR 2.59; 95% CI 1.66 to 4.05). There was no significant difference in NNU admissions (3.7% vs 3.2%, adj OR 1.06; 95% CI 0.33 to 3.42). Women who gave birth in water were no more likely than women who used water for labour only to require perineal suturing (64% vs 80.5%, adj OR 0.63; 95% CI 0.30 to 1.33), to experience OASI (3.0% vs 3.7%, adj OR 1.41; 95% CI 0.23 to 8.79) or PPH (8.0% vs 13.3%, adj OR 0.73; 95% CI 0.26 to 2.09). Women using water immersion reported more positive memories than women receiving standard care (p<0.01).ConclusionsWomen choosing water immersion for labour or birth were no more likely to experience adverse birth outcomes than women receiving standard care and rated their birth experiences more highly.

scholarly journals Normal renal sonogram identifies renal colic patients at low risk for urologic intervention: a prospective cohort study

CJEM ◽  
2015 ◽  
Vol 17 (1) ◽  
pp. 38-45 ◽  
Author(s):  
Justin W. Yan ◽  
Shelley L. McLeod ◽  
Marcia L. Edmonds ◽  
Robert J. Sedran ◽  
Karl D. Theakston
Keyword(s):  
Cohort Study ◽  
Prospective Cohort Study ◽  
Medical Records ◽  
Prospective Cohort ◽  
Renal Colic ◽  
Tertiary Care ◽  
Low Risk ◽  
Ureteric Stone ◽  
Tertiary Care Centre ◽  
Imaging Department

AbstractIntroductionDetermining which patients with ureterolithiasis are likely to require urologic intervention is a common challenge in the emergency department (ED). The objective was to determine if normal renal sonogram could identify low-risk renal colic patients, who were defined as not requiring urologic intervention within 90 days of their initial ED visit and can be managed conservatively.MethodsThis was a prospective cohort study involving adult patients presenting to the EDs of a tertiary care centre with suspected renal colic over a 20-month period. Renal ultrasonography (US) was performed in the diagnostic imaging department by trained ultrasonographers, and the results were categorized into four mutually exclusive groups: normal, suggestive of ureterolithiasis, visualized ureteric stone, or findings unrelated to urolithiasis. Electronic medical records were reviewed to determine if patients received urologic intervention within 90 days of their ED visit.ResultsOf 610 patients enrolled, 341 (55.9%) had US for suspected renal colic. Of those, 105 (30.8%) were classified as normal; none of these patients underwent urologic intervention within 90 days of their ED visit. Ninety (26.4%) US results were classified as suggestive, and nine (10%) patients received urologic intervention. A total of 139 (40.8%) US results were classified as visualized ureteric stone, and 34 (24.5%) patients had urologic intervention. Seven (2.1%) US results were classified as findings unrelated to urolithiasis, and none of these patients required urologic intervention. The rate of urologic intervention was significantly lower in those with normal US results (p<0.001) than in those with abnormal findings.ConclusionA normal renal sonogram predicts a low likelihood for urologic intervention within 90 days for adult ED patients with suspected renal colic.

scholarly journals SARS-CoV-2–Specific Neutralizing Antibody Responses in Norwegian Health Care Workers After the First Wave of COVID-19 Pandemic: A Prospective Cohort Study

2020 ◽  
Author(s):  
Mai-Chi Trieu ◽  
Amit Bansal ◽  
Anders Madsen ◽  
Fan Zhou ◽  
Marianne Sævik ◽  
...  
Keyword(s):  
Health Care ◽  
Cohort Study ◽  
Prospective Cohort Study ◽  
Health Care Workers ◽  
Prospective Cohort ◽  
Neutralizing Antibodies ◽  
Rt Pcr ◽  
Patient Exposure ◽  
Specific Antibodies ◽  
Care Workers

Abstract Background During the coronavirus disease 2019 (COVID-19) pandemic, many countries experienced infection in health care workers (HCW) due to overburdened health care systems. Whether infected HCW acquire protective immunity against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is unclear. Methods In a Norwegian prospective cohort study, we enrolled 607 HCW before and after the first COVID-19 wave. Exposure history, COVID-19–like symptoms, and serum samples were collected. SARS-CoV-2–specific antibodies were characterized by spike-protein IgG/IgM/IgA enzyme-linked immunosorbent and live-virus neutralization assays. Results Spike-specific IgG/IgM/IgA antibodies increased after the first wave in HCW with, but not in HCW without, COVID-19 patient exposure. Thirty-two HCW (5.3%) had spike-specific antibodies (11 seroconverted with ≥4-fold increase, 21 were seropositive at baseline). Neutralizing antibodies were found in 11 HCW that seroconverted, of whom 4 (36.4%) were asymptomatic. Ninety-seven HCW were tested by reverse transcriptase polymerase chain reaction (RT-PCR) during follow-up; 8 were positive (7 seroconverted, 1 had undetectable antibodies). Conclusions We found increases in SARS-CoV-2 neutralizing antibodies in infected HCW, especially after COVID-19 patient exposure. Our data show a low number of SARS-CoV-2–seropositive HCW in a low-prevalence setting; however, the proportion of seropositivity was higher than RT-PCR positivity, highlighting the importance of antibody testing.

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