Characteristics of Obstetric and Iatrogenic Urogenital Fistulas in Burkina Faso: A Cross-Sectional Study

Objective. To compare the sociodemographic, clinical, and therapeutic characteristics of obstetric urogenital fistulas (OF) and iatrogenic urogenital fistulas (IF) treated in seven centers in Burkina Faso. Material and Methods. We carried out a cross-sectional study over a seven years’ period (January 1, 2010 to December 31, 2016). We considered as iatrogenic all urogenital fistulas (UGF) occurred after elective caesarean section, gynecologic surgery (hysterectomy, myomectomy, and prolapse repair), or induced abortion. UGF following vaginal delivery after prolonged labor without obstetric maneuvers or caesarean section were considered as obstetric. UGF caused by other mechanisms (emergency caesarian section, congenital, and traumatic) were excluded from this study. The statistical analysis was carried out using version 14 of the STATA software. A logistic regression model was used to compare the two groups. Results. 310 cases of UGF were included. IF accounted for 25.8% (n = 80) versus 74.2% (n = 230) for OF. The median age was 35 years for IF and 35.38 years for OF. The vesicovaginal fistulas were predominant (74.5%) in the two groups. All circumferential fistulas were found in the OF group. OF were frequently associated with residence in rural areas (OR = 1.8; CI = [1.05–3.1]), low level of education (OR = 5.4; CI = [2.3–12.9]), and a height under 158 cm (OR = 3.4 CI = [1.7–6.6]). Vaginal sclerosis was less common among IF (OR = 2.2; CI = [1–4.6]). The failure of surgical treatment after 3 months was more associated with OF (OR = 4.7; CI = [1.1–20.5]). Conclusion. OF were the most common, frequently affecting short women living in rural area and with low level of schooling. Fistulas were also more severe in the OF group. IF gave better results after surgical repair.

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Factors influencing decision-making to accept elective caesarean section: A descriptive cross-sectional study

Heliyon ◽

10.1016/j.heliyon.2021.e07755 ◽

2021 ◽

pp. e07755

Author(s):

Victoria Bam ◽

Alberta Yemotsoo Lomotey ◽

Abigail Kusi-Amponsah Diji ◽

Hayford Isaac Budu ◽

Dorothy Bamfo-Ennin ◽

...

Keyword(s):

Decision Making ◽

Caesarean Section ◽

Elective Caesarean Section ◽

Cross Sectional Study ◽

Sectional Study ◽

Cross Sectional ◽

Factors Influencing

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Readiness of district and regional hospitals in Burkina Faso to provide caesarean section and blood transfusion services: a cross-sectional study

BMC Pregnancy and Childbirth ◽

10.1186/1471-2393-14-158 ◽

2014 ◽

Vol 14 (1) ◽

Cited By ~ 10

Author(s):

Georges Dayitaba Compaoré ◽

Issiaka Sombié ◽

Rasmané Ganaba ◽

Sennen Hounton ◽

Nicolas Meda ◽

...

Keyword(s):

Caesarean Section ◽

Blood Transfusion ◽

Burkina Faso ◽

Cross Sectional Study ◽

Sectional Study ◽

Cross Sectional ◽

Regional Hospitals

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Perinatal determinants of D-dimer levels in a cross-sectional study of low risk pregnant women

Obstetric Medicine ◽

10.1177/1753495x15625547 ◽

2016 ◽

Vol 9 (2) ◽

pp. 78-82

Author(s):

NM Murphy ◽

AS Khashan ◽

DI Broadhurst ◽

O Gilligan ◽

K O’Donoghue ◽

...

Keyword(s):

Caesarean Section ◽

Pregnant Women ◽

Vaginal Delivery ◽

Elective Caesarean Section ◽

Mode Of Delivery ◽

Cross Sectional Study ◽

Sectional Study ◽

Cross Sectional ◽

D Dimer ◽

In Pregnancy

Background To examine perinatal determinants of the antenatal levels of D-dimers. Methods Cross-sectional study of 760 low risk pregnant women recruited into five gestational groups. Variables examined in antenatal groups included maternal age, body mass index, parity, smoking, family history venous thromboembolism (VTE) and previous use of the oral contraceptive pill (OCP). Onset of labour and mode of delivery were also examined in the post-natal group. Results D-dimer levels in group 4 (38–40 + 6) were significantly lower in the women with a history of taking the OCP when compared to those that had not taken it in the past ( P = 0.027). In the day 2 post-natal group, the median level of D-dimer was significantly higher in primparous when compared to multiparous women ( P = 0.015). The median D-dimer levels were significantly lower in the elective Caesarean section group in comparison to spontaneous onset ( P = 0.003) and induction of labour ( P = 0.016). When the mode of delivery was examined, the median D-dimer levels were significantly lower in those that had an elective Caesarean section when compared to normal vaginal delivery ( P = 0.008) and instrumental vaginal delivery ( P = 0.007). Women post elective Caesarean section had a significantly lower D-dimer than those after emergency Caesarean section ( P = 0.008). Discussion There are some significant differences in D-dimer levels when certain perinatal determinants are examined. This work is potentially beneficial to the future diagnosis of VTE in pregnancy as it supports previously published recommended D-dimer levels for the diagnosis of VTE in pregnancy.

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Factors influencing decision-making to accept elective caesarean section in a hospital in Ghana: A descriptive cross-sectional study

10.21203/rs.3.rs-48023/v1 ◽

2020 ◽

Author(s):

Victoria Bam ◽

Alberta Yemotsoo Lomotey ◽

Abigail Kusi-Amponsah Diji ◽

Hayford Isaac Budu ◽

Dorothy Bamfo-Ennin ◽

...

Keyword(s):

Decision Making ◽

Caesarean Section ◽

Elective Caesarean Section ◽

Cross Sectional Study ◽

Decision Making Process ◽

Previous Caesarean Section ◽

Sectional Study ◽

Chi Square ◽

Cross Sectional ◽

Factors Influencing

Abstract Background Elective caesarean section rates are on the rise and socioeconomic status, perceptions of safety, cultural and social influences are contributory factors. Inspite of the benefits of medically-indicated caesarean section, some women refuse this due to a complexity of factors. This study aimed at determining the factors that influence women to accept medically-indicated caesarean section in a district hospital in Ghana.MethodsA descriptive cross-sectional study was conducted among 163 purposively-sampled postnatal women in a hospital. A questionnaire was used for data collection after the women gave their consent to participate. Data was analyzed using SPSS version 25.0, Chi-square test was done to determine the association between the factors that facilitated respondents’ acceptance of caesarean section and the duration of decision-making. ResultsMajor factors influencing their decision-making process were support from their husbands/relatives (39.3%), their baby’s life being at risk (24.5%), history of previous caesarean section and knowledge about the procedure (19.6%). Age (R2 = 0.19, p< 0.001); previous caesarean section (R2 = 0.14, p<0.001) are the major predictors of the duration of the decision-making process.ConclusionMost women will make decisions to accept elective caesarean section within a week’s duration based on consultation with relatives. There is the need to involve relatives during the antenatal care period in order for younger women in particular to be readily supported to make the decision early to avoid any complications and allay their fears.

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Clinical Characteristics of Urogenital Fistulas in PMCH Nawabshah: A Cross-sectional Study

Journal of Pharmaceutical Research International ◽

10.9734/jpri/2021/v33i31a31676 ◽

2021 ◽

pp. 157-163

Author(s):

Aneela Tehzeen ◽

Hazooran Lakhan ◽

Shazia Awan ◽

Mona Rani ◽

Shahida Baloch ◽

...

Keyword(s):

Surgical Procedure ◽

Clinical Characteristics ◽

Elective Caesarean Section ◽

Educational Status ◽

Cross Sectional Study ◽

Gynecologic Surgery ◽

P Value ◽

Sectional Study ◽

Cross Sectional ◽

The Many

Objective: To analyze the clinical characteristics of urogenital fistulas reported at PMCH Nawabshah. Methodology: A cross-sectional study, concluded in three years from January 2018 to December, 2020 in all ages patients with urogenital fistulas (UGF). The referred cases of UGF to gynecology and Urology Departments of the PMCH Nawabshah. The females with UGF results after elective caesarean section and gynecologic surgery including hysterectomy, prolapse repair and myomectomy were included whereas patients with UGF results due to other operative measures which includes emergency caesarian section, traumatic and congenital were excluded from this study. The data were analyzed thru SPSS version 22.0. Results: Total 247 patients were included in present study. The age of patients were 20 years to 66 years with mean age 38.99+SD7.992. Frequency and percentages of different variables that were included in this study were for the demographic and co morbidities. Majority of patients were from rural setup, house wives having low education profile, belonging to low socioeconomically and educational status. DM and HTN were the common co-morbidities observed in study population. The different frequencies and percentages were calculated for the different surgical procedure adopted before the development of fistulas, UVF and OF was assessed in different procedures. Hysterectomies was most common surgical procedure than C/S and others. P value was statistically insignificant here 0.696. Wound infections were also seen in post operated cases with high ratios due to contaminations; wound infection was present in 20.6% cases, which was very high. Conclusion: Present study revealed that the many of urogenital fistulas treated and repaired patients at our hospital setup, associated with iatrogenic obstetric origin and no any patients of UGF associated with obstructed laboras it is contrasting with other developing countries. Recorded fistulas were cured after the first surgical repair.

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Characteristics of Confidence and Preparedness in Paramedics in Metropolitan, Regional, and Rural Australia to Manage Mental-Health-Related Presentations: A Cross-Sectional Study

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph18041882 ◽

2021 ◽

Vol 18 (4) ◽

pp. 1882

Author(s):

Kate Emond ◽

Melanie Bish ◽

Michael Savic ◽

Dan I. Lubman ◽

Terence McCann ◽

...

Keyword(s):

Mental Health ◽

Rural Areas ◽

Cross Sectional Study ◽

Categorical Variables ◽

Considerable Proportion ◽

Sectional Study ◽

Cross Sectional ◽

Health Related ◽

Manage Mental ◽

Manage Mental Health

Mental-health-related presentations account for a considerable proportion of the paramedic’s workload in prehospital care. This cross-sectional study aimed to examine the perceived confidence and preparedness of paramedics in Australian metropolitan and rural areas to manage mental-health-related presentations. Overall, 1140 paramedics were surveyed. Pearson chi-square and Fisher exact tests were used to compare categorical variables by sex and location of practice; continuous variables were compared using the non-parametric Mann–Whitney and Kruskal–Wallis tests. Perceived confidence and preparedness were each modelled in multivariable ordinal regressions. Female paramedics were younger with higher qualifications but were less experienced than their male counterparts. Compared to paramedics working in metropolitan regions, those working in rural and regional areas were generally older with fewer qualifications and were significantly less confident and less prepared to manage mental health presentations (p = 0.001). Compared to male paramedics, females were less confident (p = 0.003), although equally prepared (p = 0.1) to manage mental health presentations. These results suggest that higher qualifications from the tertiary sector may not be adequately preparing paramedics to manage mental health presentations, which signifies a disparity between education provided and workforce preparedness. Further work is required to address the education and training requirements of paramedics in regional and rural areas to increase confidence and preparedness in managing mental health presentations.

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Factors Influencing HIV Drug Resistance among Pregnant Women in Luanda, Angola: Findings from a Cross-Sectional Study

Tropical Medicine and Infectious Disease ◽

10.3390/tropicalmed6010029 ◽

2021 ◽

Vol 6 (1) ◽

pp. 29

Author(s):

Cruz S. Sebastião ◽

Joana Morais ◽

Miguel Brito

Keyword(s):

Drug Resistance ◽

Pregnant Women ◽

Rural Areas ◽

Cross Sectional Study ◽

Drug Resistant ◽

Sectional Study ◽

Cross Sectional ◽

Hiv Drug Resistance ◽

Hiv 1 ◽

High Educational

The increase in HIV infection and drug-resistant strains is an important public health concern, especially in resource-limited settings. However, the identification of factors related to the propagation of infectious diseases represents a crucial target offering an opportunity to reduce health care costs as well as deepening the focus on preventing infection in high-risk groups. In this study, we investigate the factors related to drug resistance among HIV-infected pregnant women in Luanda, the capital city of Angola. This was a part of a cross-sectional study conducted with 42 HIV-positive pregnant women. A blood sample was collected, and HIV-1 genotyping was carried out using an in-house method. Multivariate analyses were performed to determine the interaction between sociodemographic characteristics and drug resistance. HIV drug resistance was detected in 44.1% of the studied population. High probabilities of drug resistance were observed for HIV-infected pregnant women living in rural areas (AOR: 2.73; 95% CI: 0.50–14.9) with high educational level (AOR: 6.27; 95% CI: 0.77–51.2) and comorbidities (AOR: 5.47; 95% CI: 0.28–106) and infected with a HIV-1 non-B subtype other than subtype C (AOR: 1.60; 95% CI: 0.25–10.3). The present study reports high HIV drug resistance. Furthermore, older-age, rural areas, high educational levels, unemployed status, having comorbidities, and HIV-1 subtypes were factors related to drug resistance. These factors impact on drug susceptibility and need to be urgently addressed in order to promote health education campaigns able to prevent the spread of drug-resistant HIV strains in Angola.

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