scholarly journals Risk of Severe Adverse Maternal and Neonatal Outcomes in Deliveries with Repeated and Primary Cesarean Deliveries versus Vaginal Deliveries: A Cross-Sectional Study

2020 ◽  
Vol 2020 ◽  
pp. 1-7
Author(s):  
Kiattisak Kongwattanakul ◽  
Rungroj Thamprayoch ◽  
Chumnan Kietpeerakool ◽  
Pisake Lumbiganon

Objective. To determine risks of severe adverse maternal and neonatal outcomes in women with repeated cesarean delivery (CD) and primary CD compared with those with vaginal delivery (VD). Methods. Data of this cross-sectional study were extracted from 2,262 pregnant women who gave birth between August 2014 and December 2016, at Srinagarind Hospital, Khon Kaen University. Severe maternal outcomes were categorized based on the World Health Organization criteria. Adjusted odds ratio (aOR) and 95% confidence intervals (CI) were calculated to indicate the risk of severe adverse maternal and neonatal outcomes among women underwent CD compared with those who underwent VD. Results. There were no cases of maternal death in this study. CD significantly increased risk of severe adverse maternal outcomes (SMO) (aOR 10.59; 95% CI, 1.19-94.54 for primary CD and aOR 17.21; 95% CI, 1.97-150.51 for repeated CD) compared with women who delivered vaginally. When compared with vaginal delivery, the risks of neonatal near miss (NNM) and severe adverse neonatal outcomes (SNO) were significantly higher in primary CD group (aOR 1.71; 95% CI 1.17-2.51 and aOR 1.66; 95% CI 1.14-2.43), respectively. For repeated CD, the risks were borderline significant (aOR, 1.58; 95% CI, 0.98-2.56 for NNM and aOR, 1.61; 95% CI, 0.99-2.60 for SNO). Conclusion. Primary and repeated CD significantly increased the risk of SMO compared with VD. Risks of NNM and SNO were also significantly increased in women with primary CD. The risks of NNM and SNO for repeated CD trended toward a significant increase.

Author(s):  
Tufan Oge ◽  
Vehbi Tokgöz ◽  
Yusuf Cakmak ◽  
Melih Velipasaoglu

Aim: The aim of the study was to compare the outcomes of emergent and planned peripartum hysterectomy. Methods: This retrospective cross-sectional study was conducted in two hospitals. Maternal and neonatal outcomes were compared according to the emergent and planned peripartum hysterectomy. Results: Totally 34020 deliveries were evaluated retrospectively and 66 peripartum hysterectomy cases were analyzed. Of these patients, 31 cases were planned surgery and 35 cases were emergent surgery. The patients who underwent planned peripartum hysterectomy had lower rate of blood transfusion (83.9% vs. 100%, p=0.014), higher postoperative hemoglobin levels (9.9±1.3 vs. 8.3±1.3, p<0.001) compared with the emergent hysterectomy group. The birth weight was lower although the apgar scores were higher in the planned surgery compared with the emergent cases. Conclusion: The planned peripartum hysterectomy with a experienced team provide less need for transfusion and improved neonatal outcomes in regard to the emergent peripartum hysterectomy.


BMJ Open ◽  
2019 ◽  
Vol 9 (7) ◽  
pp. e027685 ◽  
Author(s):  
Jing Li ◽  
Meiwen Yu ◽  
Ya-wen Wang ◽  
Jia-an Zhang ◽  
Mei Ju ◽  
...  

IntroductionPsoriasis is a chronic inflammatory skin disease which could lead to serious complications and increased risk of cardiovascular diseases. Psoriasis was recognised as a serious non-communicable disease with important public health impact by member states in the World Health Assembly resolution in 2014. However, data on psoriasis epidemiology are scarce worldwide, especially from low-income and middle-income countries. Only a few epidemiological studies on psoriasis have been conducted in parts of China, mostly without appropriate sampling design and data analysis.AimThis study aims to obtain the prevalence of psoriasis in China and relevant risk factors through a nationwide, population-based study with adequate statistical design.Methods and analysisThis is a cross-sectional study to be conducted in 60 sites across China. A multistage, cluster random sampling design is used. Participants should have local household registration or be residing in the survey area for at least 6 months during the past year. The presence of psoriasis is ascertained independently by two certified dermatologists. If any discrepancies in the diagnosis occur, consensus will be met via discussion. All participants will be interviewed with a questionnaire to collect sociodemographic and disease information. The field survey will be implemented from October 2018 to June 2019. All statistical analyses will be conducted using survey procedures in SAS V.9.2 software to adjust for the complex sample design.Ethics and disseminationThe study has been reviewed and approved by the ethics committee of the Institute of Dermatology, Chinese Academy of Medical Sciences and Peking Union Medical College (Nanjing, China). A written informed consent will be obtained from all participants before the questionnaire survey. Findings of the study will be disseminated through publications in peer-reviewed journals.


Author(s):  
Nagaraj Patil ◽  
K. V. Jagadeesh ◽  
K. Yamini Priyanka ◽  
Annapurna Kari ◽  
Mubashir Angolkar

Background: World Health Organization (WHO) has defined ‘Adolescence’ as a period between 10 and 19 years. Anemia is a condition characterized by reduction in the number of red blood cells and/or hemoglobin concentration. Adolescent girls are at increased risk of anemia due to rapid growth and developmental process. The objectives of the study were to estimate the prevalence of anemia among adolescent girls in one of the schools in North Karnataka.Methods: A cross sectional study was conducted among adolescent girls in one of the CBSE Schools of north Karnataka. In 347 adolescent girls, data collection was carried out in the month of August 2017 through hematological assessment. All the adolescent girls between grade 7 and 12 were included in the study. Statistical analysis was conducted using statistical package for social sciences (SPSS) software version 20.0.Results: Out of 347 adolescent girls enrolled more than half 196 (56.5%) were mid adolescent with a mean age of 14.34±1.8. 54 (15.6%) were showing mild thinness and 14 (4.0%) were overweight. Overall prevalence of anemia was 44.4% (n=154). Where in 35.2% (n=122) were mild anemic followed by 8.9% (n=31) moderate anemia. Among the anemic girls, 79.8% (n=123) had attained their menarche and 6.5% (n=10) were reported passing worms in stools.Conclusions: Prevalence of anemia among school adolescent girls was found to be less. Among anemic girls, majority were showing mild anemia.


Author(s):  
Seyedeh Hajar Sharami ◽  
Zahra Abbasi Ranjbar ◽  
Fatemeh Alizadeh ◽  
Ehsan Kazemnejad

Background: Concentrations of plasma lipids levels during pregnancy clearly increases. According to some studies, dyslipidemia is effective in the incidence of preeclampsia and insulin resistance. Objective: This study aimed to examine the relationship between hyperlipidemia and maternal and neonatal outcomes in pregnant women. Materials and Methods: This is a cross-sectional study which was conducted on two groups of pregnant women with hyperlipidemia and normal ones to assess maternal and neonatal outcomes. Maternal data including gestational age, mother’s age, body mass index, and maternal weight gain during pregnancy, gestational diabetes mellitus, preeclampsia, cholestasis, and delivery method. Also, birth weight and Apgar score were gathered as the neonatal outcomes. Results: The results showed that the prevalence of abnormal lipid parameters increased with increasing gestational age. In pregnant women with dyslipidemia in combination with increased triglyceride, cholesterol and Low-density lipoprotein, and decreased High-density lipoprotein, the incidence rates of gestational diabetes (p < 0.001), preeclampsia (p < 0.001), cholestasis (p = 0.041), fetal growth retardation (p < 0.001), and macrosomia (p < 0.001) were statistically higher. Conclusion: Dyslipidemia was associated with some adverse effects of pregnancy and harmful fetal outcomes. Therefore, it seems that adding laboratory assessment of lipid profiles before and during pregnancy can be effective in early diagnosis of dyslipidemia. Key words: Dyslipidemias, Gestational diabetes, Preeclampsia, Fetal macrosomia.


2020 ◽  
Vol 15 ◽  
Author(s):  
Solomon Hambisa ◽  
Rediet Feleke ◽  
Ameha Zewudie ◽  
Mohammed Yimam

Background:: Rational drug use comprises aspects of prescribing, dispensing and patient use of medicines for different health problems. This study is aimed to assess drug prescribing practice based on the world health organization prescribing indicators in Mizan-Tepi University teaching hospital. Methods:: An institutional based retrospective cross sectional study was conducted to evaluate prescribing practices in Mizan-Tepi University teaching hospital. Data were collected based on World health organization drug use indicators using prescription papers. 600 prescriptions dispensed through the general outpatient pharmacy of the hospital were collected by systematic random sampling method from prescriptions written for a 1-year time in Mizan-Tepi University teaching hospital. Results:: The present study found that the average number of drugs per prescription was 2.04 ± 0.87 in Mizan-Tepi University teaching hospital with a range between 1 and 5. Prescribing by generic name was 97.6 % and 47.8% of prescriptions contained antibiotics in the hospital. 27.7% of prescriptions contained at least one injectable medication in Mizan-Tepi University teaching hospital. From prescribed drugs, 96.7% of them were prescribed from Ethiopian essential drug list. Conclusion:: Present study indicated that the average number of drugs prescribed per encounter, the percentage of generic prescribing and prescribing from the EDL were close to optimal value. However, the percentage of encounters with antibiotics and injections prescribed were found be very high. Thus, the study highlights some improvements in prescribing habits, particularly by focusing on the inappropriate consumption of antibiotics and injections.


Thorax ◽  
2020 ◽  
Vol 75 (12) ◽  
pp. 1089-1094 ◽  
Author(s):  
Adrian Shields ◽  
Sian E Faustini ◽  
Marisol Perez-Toledo ◽  
Sian Jossi ◽  
Erin Aldera ◽  
...  

ObjectiveTo determine the rates of asymptomatic viral carriage and seroprevalence of SARS-CoV-2 antibodies in healthcare workers.DesignA cross-sectional study of asymptomatic healthcare workers undertaken on 24/25 April 2020.SettingUniversity Hospitals Birmingham NHS Foundation Trust (UHBFT), UK.Participants545 asymptomatic healthcare workers were recruited while at work. Participants were invited to participate via the UHBFT social media. Exclusion criteria included current symptoms consistent with COVID-19. No potential participants were excluded.InterventionParticipants volunteered a nasopharyngeal swab and a venous blood sample that were tested for SARS-CoV-2 RNA and anti-SARS-CoV-2 spike glycoprotein antibodies, respectively. Results were interpreted in the context of prior illnesses and the hospital departments in which participants worked.Main outcome measureProportion of participants demonstrating infection and positive SARS-CoV-2 serology.ResultsThe point prevalence of SARS-CoV-2 viral carriage was 2.4% (n=13/545). The overall seroprevalence of SARS-CoV-2 antibodies was 24.4% (n=126/516). Participants who reported prior symptomatic illness had higher seroprevalence (37.5% vs 17.1%, χ2=21.1034, p<0.0001) and quantitatively greater antibody responses than those who had remained asymptomatic. Seroprevalence was greatest among those working in housekeeping (34.5%), acute medicine (33.3%) and general internal medicine (30.3%), with lower rates observed in participants working in intensive care (14.8%). BAME (Black, Asian and minority ethnic) ethnicity was associated with a significantly increased risk of seropositivity (OR: 1.92, 95% CI 1.14 to 3.23, p=0.01). Working on the intensive care unit was associated with a significantly lower risk of seropositivity compared with working in other areas of the hospital (OR: 0.28, 95% CI 0.09 to 0.78, p=0.02).Conclusions and relevanceWe identify differences in the occupational risk of exposure to SARS-CoV-2 between hospital departments and confirm asymptomatic seroconversion occurs in healthcare workers. Further investigation of these observations is required to inform future infection control and occupational health practices.


BMJ Open ◽  
2021 ◽  
Vol 11 (7) ◽  
pp. e049967
Author(s):  
Karen Sól Saevarsdóttir ◽  
Hildur Ýr Hilmarsdóttir ◽  
Ingibjörg Magnúsdóttir ◽  
Arna Hauksdóttir ◽  
Edda Bjork Thordardottir ◽  
...  

ObjectiveTo test if patients recovering from COVID-19 are at increased risk of mental morbidities and to what extent such risk is exacerbated by illness severity.DesignPopulation-based cross-sectional study.SettingIceland.ParticipantsA total of 22 861 individuals were recruited through invitations to existing nationwide cohorts and a social media campaign from 24 April to 22 July 2020, of which 373 were patients recovering from COVID-19.Main outcome measuresSymptoms of depression (Patient Health Questionnaire), anxiety (General Anxiety Disorder Scale) and posttraumatic stress disorder (PTSD; modified Primary Care PTSD Screen for DSM-5) above screening thresholds. Adjusting for multiple covariates and comorbidities, multivariable Poisson regression was used to assess the association between COVID-19 severity and mental morbidities.ResultsCompared with individuals without a diagnosis of COVID-19, patients recovering from COVID-19 had increased risk of depression (22.1% vs 16.2%; adjusted relative risk (aRR) 1.48, 95% CI 1.20 to 1.82) and PTSD (19.5% vs 15.6%; aRR 1.38, 95% CI 1.09 to 1.75) but not anxiety (13.1% vs 11.3%; aRR 1.24, 95% CI 0.93 to 1.64). Elevated relative risks were limited to patients recovering from COVID-19 that were 40 years or older and were particularly high among individuals with university education. Among patients recovering from COVID-19, symptoms of depression were particularly common among those in the highest, compared with the lowest tertile of influenza-like symptom burden (47.1% vs 5.8%; aRR 6.42, 95% CI 2.77 to 14.87), among patients confined to bed for 7 days or longer compared with those never confined to bed (33.3% vs 10.9%; aRR 3.67, 95% CI 1.97 to 6.86) and among patients hospitalised for COVID-19 compared with those never admitted to hospital (48.1% vs 19.9%; aRR 2.72, 95% CI 1.67 to 4.44).ConclusionsSevere disease course is associated with increased risk of depression and PTSD among patients recovering from COVID-19.


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