scholarly journals Anaemia in Labour: A Prospective Assessment of Women in Rivers State University Teaching Hospital, Nigeria

Blood ◽  
2019 ◽  
Vol 134 (Supplement_1) ◽  
pp. 4804-4804
Author(s):  
Paul L Kua ◽  
Hannah E Omunakwe ◽  
Afam C Okafor ◽  
George Monima Williams
Keyword(s):  
Antenatal Care ◽  
Pregnant Women ◽  
Postpartum Hemorrhage ◽  
Conflicts Of Interest ◽  
Mode Of Delivery ◽  
Healthcare Delivery ◽  
University Teaching ◽  
Health Concern ◽  
Severe Anemia ◽  
Study Participants

Background: Anemia in any phase of pregnancy is associated with much morbidity and risk of mortality to the mother and the fetus, it is a global health concern and is quite prevalent in Africa. About 58% of pregnant women in Nigeria are said to be anemic and earlier reports from this study site showed that 69.6% of women initiating antenatal care were anemic, it was commoner in women of teen-age and the hematocrit was lower as the gestational age at booking increased. Methods: We assessed 464 consenting consecutive pregnant women who presented to our labour ward between November 2017 and July 2018 to know their age, booking status, haematocrit at late pregnancy and followed on to know the mode of delivery as well as the occurrence of postpartum bleeding. The data were analysed using IBM Statistical Package for Social Sciences version 23. Results: A total of 462 consenting women were included in the study, majority of study participants were between the age of 26-35 years 299 (64.7%) with a minimum age of 15 years and maximum age of 47 years and mean age was 31.2 ± 5.2 years. The majority had moderate to severe anemia 335 (70.3%) and were booked for antenatal care with trained personnel 402 (87.2%) and 47 (10.2%) of them developed post-partum haemorrhage. A significantly higher proportion of the study participants who were un-booked presented with severe anemia (χ2 =14.3; p=0.001); developed PPH (χ2 =13.9; p<0.001) Table 1. The highest proportion of persons who developed postpartum hemorrhage was found in persons with severe anaemia. This difference was significant. (χ2 =87.1; p<0.001). Hematocrit was found to be the strongest determinant of the occurrence of postpartum hemorrhage among the study participants. The adjusted regression analysis showed that for every one-unit increase in hematocrit of study participants, there was a 16% reduction in the probability of occurrence of PPH and this probability was statistically significant (p<0.001). Booking status was also found to be a predictor of PPH such that un-booked women were 2.3 times more likely to experience PPH than booked women in the study population. This was found to be significant (p=0.04). Table 2 This data supports earlier findings that anaemia worsens the outcome of pregnancy. Unbooked mothers are more at risk of dire outcomes such as postpartum haemorrhage which is the leading cause of maternal mortality. There is a need for guidelines and enforcement of such at all levels of healthcare delivery especially in unorthodox centres where women go for care, as is common in developing countries. The need for health education and active prevention and management of anaemia in the early stages of pregnancy is advocated. Disclosures No relevant conflicts of interest to declare.

scholarly journals Visual impairment and associated factors among pregnant women attending antenatal care units at health institutions in Gondar City Administration, Northwest Ethiopia

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Mengistie Diress ◽  
Yitayeh Belsti ◽  
Mihret Getnet ◽  
Sofonias Addis Fekadu ◽  
Baye Dagnew ◽  
...  
Keyword(s):  
Logistic Regression ◽  
Antenatal Care ◽  
Visual Impairment ◽  
Pregnant Women ◽  
Associated Factors ◽  
Northwest Ethiopia ◽  
Health Concern ◽  
City Administration ◽  
Health Institutions ◽  
Study Participants

Abstract Background Visual impairment is a major public health concern among women of reproductive age groups in Ethiopia, which is getting worse during pregnancy. Though visual impairment has lots of serious consequences across the life course of pregnant women, there is no previous study on this topic in Ethiopia. Thus, this study determined the prevalence of visual impairment and identified associated factors among pregnant women attending antenatal care units at the governmental health institutions in Gondar City Administration, Northwest Ethiopia. Methods An institution-based cross-sectional study was conducted. A systematic random sampling technique was used to recruit the study participants. We used an interviewer-administered questionnaire comprising of socio-demographic, clinical and pregnancy-related variables to collect the required data. Snellen’s illiterate “E” chart was used to determine visual impairment. EpiData 3 and Stata 14 were used for data entry and statistical analysis, respectively. Both bivariable and multivariable binary logistic regression analyses were executed to identify associated factors of visual impairment. Variables with a p-value ≤0.05 in the multivariable logistic regression analysis were declared as statistically significant with visual impairment. Results A total of 417 (response rate = 98.6%) participants were involved in this study, with a median age of 27 years. The overall prevalence of visual impairment was 22.5% (95% CI: 18.5–26.6). Thirty (7.2%) and thirty-two (7.7%) of the study participants had moderate to severe visual impairments in their right and left eyes, respectively. Participants aged from 31 to 49 years (AOR = 2.1; 95% CI: 1.1–4.0), being 3rd trimester (AOR = 2.4; 95% CI: 1.3–4.5), multi & grand multipara (AOR = 2.3; 95% CI: 1.2–4.6), and history of contraceptive use (AOR = 2.7; 95% CI: 1.2–6.3) had higher chance of visual impairment. Conclusion The magnitude of visual impairment among pregnant women was high in the study area. Therefore, routine screening and evaluation of pregnant women for visual condition during antenatal care visits is recommended. Further investigations of visual changes, particularly as a result of pregnancy, are warranted.

scholarly journals On demand caesarean section: What’s women’s attitude?

1970 ◽  
Vol 2 (2) ◽  
pp. 12-15
Author(s):  
Nira S Shrestha ◽  
Sumita Pradhan
Keyword(s):  
Caesarean Section ◽  
Pregnant Women ◽  
Vaginal Delivery ◽  
Caesarean Delivery ◽  
Mode Of Delivery ◽  
University Teaching ◽  
Normal Vaginal Delivery ◽  
On Demand ◽  
Assisted Delivery ◽  
The Right

Objectives: To evaluate the knowledge and attitude of Nepalese women towards mode of delivery and caesarean on demand. Study design: Hospital based cross sectional descriptive study where 200 pregnant women after 37 completed weeks of gestation were recruited randomly and interviewed, and their answers were analyzed. Results: Of the 200 interviewed pregnant women, all of them knew about normal vaginal delivery and caesarean delivery, but only 30% knew about instrumentally assisted delivery and 9% had heard about painless labour. Vaginal delivery was the preferred mode in 93% and 7% preferred caesarean delivery. Only 35% of the interviewed women believed that women should have the right to demand a caesarean section Conclusion: Knowledge assessment of two hundred women regarding the mode of delivery clearly indicates the need for strengthening counseling aspect of antenatal care and awareness program regarding mode of delivery. In Nepal on demand caesarean section is not provided in the University Teaching Hospital. However one third of women still felt that women should have the right to choose caesarean section on demand. Key words: Attitude, mode of delivery, Caesarean on demand. doi:10.3126/njog.v2i2.1448 N. J. Obstet. Gynaecol 2007 Nov-Dec; 2 (2): 12 - 15

scholarly journals Analysis of Pregnancy Characteristics and Perinatal Outcome of Mediastinal Uterus in China

2021 ◽  
Author(s):  
Na Zhang ◽  
Ying Wang ◽  
Li Zhang ◽  
Chanyun Xiao
Keyword(s):  
Preterm Birth ◽  
Pregnant Women ◽  
Postpartum Hemorrhage ◽  
Mode Of Delivery ◽  
Premature Delivery ◽  
Targeted Prevention ◽  
Premature Rupture Of Membranes ◽  
Premature Rupture ◽  
Neonatal Asphyxia ◽  
Fetal Position

Background: To analyze the complications and outcome of mediastinal uterine pregnancy, and put forward targeted prevention and treatment measures. Methods: A total of 248 pregnant women with mediastinal uterus treated were enrolled from Jan 2015 to Dec 2018 in the Maternal and Child Health Hospital of Hubei Province, China. The data, including complications of pregnancy, gestational weeks, mode of delivery, postpartum hemorrhage, placental condition and perinatal prognosis, were collected and analyzed. Results: There were 12 cases with abnormal fetal position in the previous cesarean section. The total number of cases with abnormal fetal position was 99(49.75%). For women with abnormal fetal position during mediastinal uterine pregnancy, there was a significant increase in the incidence of placental abruption (P<0.05). The average gestational age at termination of pregnancy was 37+5weeks. There were 55 cases (22.18%) of premature and 49 cases (19.75%) of premature rupture of membranes, including 29 cases of abnormal fetal position and premature rupture of membranes, mediastinal uterus preterm birth, premature rupture of membranes (P<0.05). There were 13 cases (5.24%) of postpartum hemorrhage, natural birth without neonatal asphyxia, five cases (2.02%) of neonatal asphyxia, preterm birth, and 51 cases (20.56%) of placental adhesion. Of these, 37 cases were cesarean, 13 were spontaneous production, and 71 were fetal umbilical cord winding. Conclusion: The pregnancy induced spontaneous abortion, premature delivery, premature rupture of membranes and abnormal fetal position in mediastinal uterus are significantly higher than normal pregnancy. The complications during delivery are significantly higher than in normal pregnant women.

scholarly journals Knowledge and Myths about Preeclampsia and Eclampsia and its influence on Antenatal Service Utilization among pregnant women and their male partners  in Mtwara Region-Tanzania: A Cross Sectional Analytical Study.

2020 ◽  
Author(s):  
Aziza Shaibu Machenje ◽  
Stephen M. Kibusi ◽  
Nyasiro Gibore ◽  
Athanase Lilungulu ◽  
Fabiola V. Moshi
Keyword(s):  
Antenatal Care ◽  
Pregnant Women ◽  
Service Utilization ◽  
Analytical Study ◽  
Care Utilization ◽  
Male Partners ◽  
Cross Sectional ◽  
Major Health Problem ◽  
Adequate Knowledge ◽  
Study Participants

Abstract Background : Pregnancy induced hypertension, including preeclampsia and eclampsia are the major health problem and the main cause of the maternal and perinatal morbidity and mortality in Tanzania. The aim of this study was to assess knowledge and myths about preeclampsia and eclampsia and its influence in Antenatal Clinics (ANC) utilization among pregnant women and their male partiners in Mtwara region. Method : A community based cross-sectional analytical study conducted in Mtwara Region, a random sampling procedure was employed to obtain a sample size of 384 pregnant women and their male partners a total of 768 participants (male=384 and female =384). Interviewer structured questionnaire was used for data collection and Statistical package for social science (SPSS v.20) software was used for data entry and analysis. Descriptive statistics, cross tabulation, Principal component analysis (PCA) was conducted and inferential statistics were used to test association between variables obtained. Results: Among 768 participants, male partners 167(43.5%) and pregnant women 171 (44.5%) had adequate knowledge about preeclampsia and eclampsia. More than a half 396(51.6%) of study respondents had weak myths while 372(48.4%) had strong myths on pre-eclampsia and eclampsia. Furthermore, pregnant women 244 (64%) had adequate antenatal care utilization. Study participants who had adequate knowledge on pre-eclampsia and eclampsia were almost 3 times more likely to utilize antenatal care services (AOR = 2.827; CI = 1.719 – 4.651; p<0.001). Study participants who had weak myth on pre-eclampsia and eclampsia were less likely to have adequate antenatal care attendance (AOR= 0.370; CI= 0.229; p< 0.001) Conclusion : The overall knowledge of preeclampsia and eclampsia was low. Majority of the female had adequate antenatal service utilization. Majority of respondents had weak myths. Government and stakeholders should ensure that community is equipped with knowledge about preeclampsia and eclampsia and the available Myths should be dispelled.

scholarly journals Malaria-Associated Factors among Pregnant Women in Guinea

2019 ◽  
Vol 2019 ◽  
pp. 1-9
Author(s):  
Almamy Amara Touré ◽  
Abdoulaye Doumbouya ◽  
Abdourahamane Diallo ◽  
Gaspard Loua ◽  
Abdourahim Cissé ◽  
...  
Keyword(s):  
Antenatal Care ◽  
Pregnant Women ◽  
Associated Factors ◽  
Placental Malaria ◽  
Community Support ◽  
Classification And Regression Tree ◽  
Health Concern ◽  
Insecticide Treated Nets ◽  
Cross Sectional Survey ◽  
District Hospitals

Introduction. Malaria is the leading cause of consultation in Guinea health facilities. During pregnancy, it remains a major health concern causing considerable risks for mother, fetus, and newborn. However, little is known about the epidemiology of malaria among pregnant women in Guinea. We aimed to provide information on malaria-associated factors in parturients. Methods. It was a cross-sectional survey in two regional hospitals and two district hospitals. 1000 parturients and their newborns were surveyed. All patients were interviewed, and thick and thin blood smears were examined. To determine the predictive factors of malaria in parturients, the Classification and Regression Tree (CART) was first performed by using peripheral and placental malaria as dependent variables and sociodemographic and antenatal characteristics as independent variables; then, explanatory profile variables or clusters from these trees were included in the logistic regression models. Results. We found 157 (15.8%) and 148 (14.8%) cases of peripheral and placental malaria, respectively. The regular use of long-lasting insecticide-treated nets (LLINs) before delivery was 53.8%, and only 35.5% used sulfadoxine-pyrimethamine doses ≥3. Factors significantly associated with malaria were as follows: women from Forécariah and Guéckédou who did not regularly use LLINs and accomplished less than four antenatal care visits (ANC <4) and primigravid and paucigravid women who did not regularly use LLINs. Similarly, the odds of having malaria infection were significantly higher among women who had not regularly used LLINs and among primigravid and paucigravid women who had regularly used LLINs compared to multigravida women who had regularly used LLINs. Conclusion. This study showed that pregnant women remain particularly vulnerable to malaria; therefore, strengthening antenatal care visit strategies by emphasizing on promoting the use of LLINs and sulfadoxine-pyrimethamine, sexual education about early pregnancies, and family or community support during first pregnancies might be helpful.

scholarly journals Proportion of Immediate Postpartum Anaemia and Associated Factors among Postnatal Mothers in Northwest Ethiopia: A Cross-Sectional Study

Anemia ◽  
2020 ◽  
Vol 2020 ◽  
pp. 1-10
Author(s):  
Asenake Abebaw ◽  
Temesgen Worku Gudayu ◽  
Bayew Kelkay
Keyword(s):  
Logistic Regression ◽  
Associated Factors ◽  
Mode Of Delivery ◽  
Sampling Technique ◽  
Cross Sectional Study ◽  
Northwest Ethiopia ◽  
Health Concern ◽  
Sectional Study ◽  
Cross Sectional ◽  
Study Participants

Background. Anaemia is a major global health problem, especially in developing countries. Postpartum anaemia hurts both maternal and newborn baby health. Anaemia in pregnancy is sufficiently emphasized; however, very little attention has been paid to postpartum anaemia in Ethiopia. Therefore, this study aimed to investigate the proportion of immediate postpartum anaemia and associated factors among postpartum mothers in Debre Markos Referral Hospital. Methods. Institutional-based cross-sectional study was conducted among 424 study participants from August 1st to October 30th, 2019. A systematic random sampling technique was employed to select the study participants. Data were collected through both face-to-face interview and maternal chart review by using a pretested questionnaire. Data were cleaned, coded, and entered using Epi Data version 4.6.0.0 and then exported to SPSS version 24 for analysis. First, binary logistic regression was applied to identify candidate variables for multivariable regression. Then, variables at p value <0.2 were entered into a multivariable logistic regression to control possible confounders. Finally, variables at p value <0.05 were considered as statistically significant. Results. The proportion of immediate postpartum anaemia was 24.3%. Frequency of antenatal care (ANC) visits <4 times [AOR = 2.40; 95% CI (1.29, 4.43)], antepartum haemorrhage (APH) [AOR = 5.08; 95% CI (1.91, 13.55)], postpartum haemorrhage (PPH) [AOR = 4.47; 95% CI (2.25, 8.88)], giving birth assisted by instruments (vacuum or forceps) [AOR = 3.99; 95% CI (1.42, 11.23)], poor adherence to iron and folic acid (IFA) [AOR = 2.52; 95% CI (1.06, 6.04)], and midupper arm circumference (MUAC) <23 cm [AOR = 3.25; 95% CI (1.87, 5.65)] were the predictors. Conclusion. The proportion of immediate postpartum anaemia was a moderate public health concern. ANC, APH, PPH, mode of delivery, adherence to IFA supplementation, and MUAC measurement were the factors affecting the magnitude of anaemia. Therefore, interventions that would address the above mentioned factors need to be implemented.

scholarly journals Thai national guidelines for the prevention of motherto- child transmission of HIV: March 2010

2010 ◽  
Vol 4 (4) ◽  
pp. 529-540 ◽  
Author(s):  
Nittaya Phanuphak ◽  
Rangsima Lolekha ◽  
Kulkanya Chokephaibulkit ◽  
Nipunporn Voramongkol ◽  
Sarawut Boonsuk ◽  
...  
Keyword(s):  
Single Dose ◽  
Antenatal Care ◽  
Pregnant Women ◽  
Transmission Rate ◽  
Elective Caesarean Section ◽  
Mode Of Delivery ◽  
Hiv Treatment ◽  
Cd4 Count ◽  
Child Transmission ◽  
Term Care

Abstract Thailand has been one of the leading developing countries to implement a national program to prevent mother-to-child transmission (MTCT) of HIV. Although the recent transmission rate has been low, the goal is to eliminate MTCT altogether. The Thai National HIV Guidelines Working Group issued treatment guidelines to prevent MTCT in Thailand in March 2010. These guidelines will be implemented nationwide within a year. The most important aspects of these new guidelines are as follows: Treatment in HIV-infected pregnant women who have not been on antiretroviral treatment prior to pregnancy. Antepartum treatment is recommended for all pregnant women regardless of CD4 count with highly active antiretroviral therapy (HAART) containing zidovudine (AZT) + lamivudine (3TC) + lopinavir/ritonavir (LPV/r). Treatment should be started immediately irrespective of gestational age in women with CD4 count <350 cells/ mm3, and as early as 14 weeks of gestation in those with CD4 count >350 cells/mm3. After delivery, women with baseline CD4 count <350 cells/mm3 are referred for long-term care and HAART according to the National Adult HIV Treatment and Care Guidelines 2010. Women with CD4 count >350 cells/mm3 do not need HAART and can stop all drugs after delivery. The treatment in infants includes AZT syrup for four weeks and exclusive formula feeding. Treatment in HIV-infected pregnant women who conceive while on HAART. Women who are stable on HAART should continue the treatment during the whole period of pregnancy. Those who are taking efavirenz (EFV) and present during the first trimester should have EFV switched to another drug. Whenever possible, AZT should be used during pregnancy. Treatment in infants is similar to the above scenario. Treatment in women who present in labor without antenatal care. Single-dose nevirapine (SD-NVP) 200 mg must be given immediately along with oral AZT 300 mg every three hours until delivery, or oral AZT 600 mg given as a single dose. The tail therapy of AZT + 3TC + LPV/r for four weeks should be given unless these women have a CD4 count of <350 cells/mm3 and therefore require life-long HAART. SD-NVP should not be given if the women are to deliver within two hours. The infants in this situation should receive AZT + 3TC + NVP for four weeks. Treatment during delivery and mode of delivery. During labor, oral AZT 300 mg every three hours or oral AZT 600 mg given as a single dose is recommended regardless of antepartum antiretroviral (ARV) regimen or the woman’s history of AZT resistance. Elective caesarean section is suggested in women who did not receive HAART (including those without antenatal care), received HAART for less than four weeks prior to delivery, had poor adherence, or had incomplete viral suppression at 36 weeks of gestation.

scholarly journals Prevalence and Knowledge of Hepatitis B Virus Infection among Pregnant Women in the Ningo-Prampram District, Ghana

2020 ◽  
Vol 2020 ◽  
pp. 1-9
Author(s):  
Precious Kwablah Kwadzokpui ◽  
Elliot Elikplim Akorsu ◽  
Albert Abaka-Yawson ◽  
Solomon Sosu Quarshie ◽  
Stephen Adomako Amankwah ◽  
...  
Keyword(s):  
Hepatitis B Virus ◽  
Virus Infection ◽  
Hepatitis B ◽  
Antenatal Care ◽  
Pregnant Women ◽  
Health Facility ◽  
Hbv Infection ◽  
Hepatitis B Virus Infection ◽  
B Virus ◽  
Study Participants

Background. Hepatitis B virus (HBV) infection has been suggested to play a role in various adverse birth outcomes. The study determined the prevalence as well as knowledge of hepatitis B virus infection among pregnant women in the Ningo-Prampram District of the Greater Accra Region of Ghana. Materials and Methods. A cross-sectional study using simple random sampling technique was used to recruit 213 pregnant women receiving antenatal care in three different health facilities (Prampram Polyclinic (PPC), Dangme Community Hospital (DCH), and Old Ningo Health Center (ONHC)) in the Ningo-Prampram District of Ghana from November 2018 to January 2019. A semi-structured questionnaire was used to collect data which included participants’ HBsAg test results, sociodemographic and gynaecological characteristics, and their level of knowledge on HBV infection. Knowledge of the participants on HBV infection was classified as either excellent, good, or poor based on their cumulative percentage scores from the questionnaire according to Al Rubaish system of classification. Results. Overall low-intermediate prevalence of HBV infection was 3.3%; however, PPC recorded the highest prevalence of 4.0% while DCH and ONHC recorded 2.82% and 2.50%, respectively. Statistically significant association was observed between HBV infection and the health facility. Majority (77.40%) of the study participants had poor knowledge on HBV infection while only 14 (6.57%) had excellent knowledge on HBV. Regarding excellent knowledge, 8 (11.0%) among the participants were demonstrated by the majority of those who received antenatal care from DCH. Generally, knowledge on HBV and the infection was poor among the study participants. Knowledge on HBV infection was found to be associated with residential status (p=0.006), educational level (p<0.001), occupation (p<0.001), and gestational period (p<0.001). Participant’s knowledge was also significantly associated with the health facility (p=0.027). Conclusion. HBV infection among pregnant women is prevalent in the Ningo-Prampram District even though the prevalence is not very high. The majority of pregnant women in the Ningo-Prampram District inadequate knowledge on HBV infection and it mode of transmission. Intensive public health education on the HBV infection is required in the district to help prevent and manage future transmissions as well as inform the population about the negative side effects of the virus and the need to prevent it by way of vaccination.

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