scholarly journals Coexistence and prevalence of obstetric interventions: an analysis based on the grade of membership

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Karina Cristina Rouwe de Souza ◽  
Thales Philipe Rodrigues da Silva ◽  
Ana Kelve de Castro Damasceno ◽  
Bruna Figueiredo Manzo ◽  
Kleyde Ventura de Souza ◽  
...  
Keyword(s):  
Pain Relief ◽  
Skin Color ◽  
Scientific Evidence ◽  
Obstetric Care ◽  
World Health ◽  
Cross Sectional ◽  
Maternity Hospitals ◽  
Oxytocin Infusion ◽  
Grade Of Membership ◽  
Belo Horizonte

Abstract Background Obstetric interventions performed during delivery do not reflect improvements in obstetric care. Several practices routinely performed during childbirth, without any scientific evidence or basis - such as Kristeller maneuver, routine episiotomy, and movement or feeding restriction - reflect a disrespectful assistance reality that, unfortunately, remains in place in Brazil. The aims of the current study are to assess the coexistence and prevalence of obstetric interventions in maternity hospitals in Belo Horizonte City, based on the Grade of Membership (GoM) method, as well as to investigate sociodemographic and obstetric factors associated with coexistence profiles generated by it. Methods Observational study, based on a cross-sectional design, carried out with data deriving from the study “Nascer em Belo Horizonte: Inquérito sobre o Parto e Nascimento” (Born in Belo Horizonte: Survey on Childbirth and Birth). The herein investigated interventions comprised practices that are clearly useful and should be encouraged; practices that are clearly harmful or ineffective and should be eliminated; and practices that are inappropriately used, in contrast to the ones recommended by the World Health Organization. The analyzed interventions comprised: providing food to parturient women, allowing them to have freedom to move, use of partogram, adopting non-pharmacological methods for pain relief, enema, perineal shaving, lying patients down for delivery, Kristeller maneuver, amniotomy, oxytocin infusion, analgesia and episiotomy. The current study has used GoM to identify the coexistence of the adopted obstetric interventions. Variables such as age, schooling, skin color, primigravida, place-of–delivery financing, number of prenatal consultations, gestational age at delivery, presence of obstetric nurse at delivery time, paid work and presence of companion during delivery were taken into consideration at the time to build patients’ profile. Results Results have highlighted two antagonistic obstetric profiles, namely: profile 1 comprised parturient women who were offered diet, freedom to move, use of partogram, using non-pharmacological methods for pain relief, giving birth in lying position, patients who were not subjected to Kristeller maneuver, episiotomy or amniotomy, women did not receive oxytocin infusion, and analgesia using. Profile 2, in its turn, comprised parturient women who were not offered diet, who were not allowed to have freedom to move, as well as who did not use the partograph or who were subjected to non-pharmacological methods for pain relief. They were subjected to enema, perineal shaving, Kristeller maneuver, amniotomy and oxytocin infusion. In addition, they underwent analgesia and episiotomy. This outcome emphasizes the persistence of an obstetric care model that is not based on scientific evidence. Based on the analysis of factors that influenced the coexistence of obstetric interventions, the presence of obstetric nurses in the healthcare practice has reduced the likelihood of parturient women to belong to profile 2. In addition, childbirth events that took place in public institutions have reduced the likelihood of parturient women to belong to profile 2. Conclusion(s) Based on the analysis of factors that influenced the coexistence of obstetric interventions, financing the hospital for childbirth has increased the likelihood of parturient women to belong to profile 2. However, the likelihood of parturient women to belong to profile 2 has decreased when hospitals had an active obstetric nurse at the delivery room. The current study has contributed to discussions about obstetric interventions, as well as to improve childbirth assistance models. In addition, it has emphasized the need of developing strategies focused on adherence to, and implementation of, assistance models based on scientific evidence.

The prevalence of the technocratic model in obstetric care from the perspective of health professionals

2021 ◽  
Vol 74 (suppl 4) ◽  
Author(s):  
Marli Therezinha Stein Backes ◽  
Karini Manhães de Carvalho ◽  
Larissa Nascimento Ribeiro ◽  
Tamiris Scoz Amorim ◽  
Evanguelia Kotzias Atherino dos Santos ◽  
...  
Keyword(s):  
Health Professionals ◽  
Scientific Evidence ◽  
Obstetric Care ◽  
Ethics Committees ◽  
Obstetric Nurses ◽  
Data Collection And Analysis ◽  
Maternity Hospitals ◽  
Theoretical Sampling ◽  
Centered Care ◽  
Nursing Professionals

ABSTRACT Objectives: to identify the reasons for the prevalence of the technocratic model in obstetric care from the perspective of health professionals. Methods: Grounded Theory. Study approved by two Research Ethics Committees and conducted by theoretical sampling, from July 2015 to June 2017. Twenty-nine interviews were conducted with health professionals from two maternity hospitals in the Southern Region of Brazil. Data collection and analysis was performed alternately; and analysis by open, axial, and selective coding/integration. Results: the technocratic model still persists because the assistance is performed in a mechanized way, centered on the professionals. There is a lack of systematization of care, and under-dimensioning of the nursing staff. Final Considerations: obstetric nurses need to review their performance in obstetric centers, the internal organization, the dimensioning of nursing professionals, and become protagonists of care. Investment in academic training/updating the knowledge of midwifery professionals, based on scientific evidence and user-centered care is necessary.

scholarly journals Syphilis in during pregnancy: association of maternal and perinatal characteristics in a region of southern Brazil

2018 ◽  
Vol 26 (0) ◽  
Author(s):  
Camila Padovani ◽  
Rosana Rosseto de Oliveira ◽  
Sandra Marisa Pelloso
Keyword(s):  
Information System ◽  
Skin Color ◽  
Congenital Syphilis ◽  
Perinatal Outcomes ◽  
Cross Sectional Study ◽  
World Health ◽  
Sectional Study ◽  
Cross Sectional ◽  
White Skin ◽  
Characteristics Method

ABSTRACT Objective: To analyze the prevalence of syphilis in during pregnancy and its association with socioeconomic characteristics, reproductive history, prenatal and labor care, and newborn characteristics. Method: A retrospective, cross-sectional study based on gestational and congenital syphilis reports. A (records) linkage was performed in the Brazilian databases: “Information System for Notifiable Diseases” (Sistema de Informação de Agravos de Notificação - SINAN); “Live Births Information System” (Sistema de Informação sobre Nascidos Vivos - SINASC); and “Mortality Information System” (Sistema de Informação sobre Mortalidade - SIM). Results: The prevalence of gestational syphilis was 0.57%. The following associations of syphilis in pregnancy were found: non-white skin color/ethnicity (PR=4.6, CI=3.62-5.76); low educational level (PR=15.4; CI=12.60-18.86); and absence of prenatal care (PR=7.4, CI=3.68-14.9). The perinatal outcomes associated with gestational syphilis were prematurity (PR=1.6 CI=1.17-2.21) and low birth weight (PR=1.6; CI=1.14-2.28). Two deaths from congenital syphilis, one death from another cause and five stillbirths were reported. Conclusion: The results signify a long way until reaching the World Health Organization’s goal of eradicating congenital syphilis.

scholarly journals Assessment of breast-feeding promotion in hospitals and follow-up survey of mother–infant pairs in Germany: the SuSe Study

2002 ◽  
Vol 5 (4) ◽  
pp. 547-552 ◽  
Author(s):  
Mathilde Kersting ◽  
Madeleine Dulon
Keyword(s):  
Breast Feeding ◽  
Feeding Practices ◽  
Postal Questionnaire ◽  
World Health ◽  
Cross Sectional ◽  
Maternity Hospitals ◽  
Health Organization ◽  
Nation Wide Survey ◽  
First Year Of Life

AbstractObjective:To assess breast-feeding promotion in maternity hospitals and breast-feeding prevalences during the first year of life in mother–infant pairs in Germany.Design:Cross-sectional assessment of breast-feeding practices in a random sample of German maternity hospitals by use of a postal questionnaire. Follow-up of mother–infant pairs recruited in the participating hospitals to assess breast-feeding prevalences and infant feeding practices by use of a telephone interview 14 days after birth and food-frequency questionnaires mailed at the end of the 2nd, 4th, 6th, 9th and 12th month of life. Use of indicators for breast-feeding proposed by the World Health Organization (WHO) and the United Nations Children's Fund (UNICEF).Setting:Nation-wide survey.Subjects:One hundred and seventy-seven maternity hospitals, 1717 mother–infant pairs.Results:There were wide variations in breast-feeding promotion in hospitals as evaluated by the practice of the '10 Steps to Successful Breastfeeding' given by WHO and UNICEF for certification as a ‘Babyfriendly Hospital’. Some steps (3, 4, 8) were practised in about 90% of the hospitals, others (steps 7, 9) in only 10%. Prevalences for exclusive (total) breast-feeding as defined by WHO were: 73% (86%) at discharge, 60% (85%) at 14 days, 42% (70%) at 2 months, 33% (59%) at 4 months, 10% (48%) at 6 months, <1% (26%) at 9 months and 0 (13%) at 12 months.Conclusions:By use of indicators proposed by WHO and UNICEF, a differentiated insight into the breast-feeding situation in Germany has become possible. Moderate levels of breast-feeding promotion in hospitals resulted in almost satisfactory early breast-feeding prevalences but were not effective for long-term breast-feeding success in most mothers.

scholarly journals OBSTETRIC VIOLENCE AND THE CURRENT OBSTETRIC MODEL, IN THE PERCEPTION OF HEALTH MANAGERS

2020 ◽  
Vol 29 ◽  
Author(s):  
Enimar de Paula ◽  
Valdecyr Herdy Alves ◽  
Diego Pereira Rodrigues ◽  
Felipe de Castro Felicio ◽  
Renata Corrêa Bezerra de Araújo ◽  
...  
Keyword(s):  
Rio De Janeiro ◽  
Scientific Evidence ◽  
Quality Care ◽  
Obstetric Care ◽  
The State ◽  
Metropolitan Region ◽  
Obstetric Violence ◽  
Maternity Hospitals ◽  
Region Ii ◽  
Health Managers

ABSTRACT Objectives: to understand the perception of managers of public maternity hospitals in the Metropolitan Region II of the state of Rio de Janeiro regarding obstetric violence and the measures to face it aiming at guaranteeing the quality of care. Method: a descriptive, exploratory study with a qualitative approach, conducted with 16 health managers from five maternity hospitals in Metropolitan Region II in the state of Rio de Janeiro. Data were collected through interviews, applied from May 2017 to May 2018, and submitted to content analysis in the thematic modality. Results: the research pointed out thenon-reception, technocratic principles of childbirth, refusal of the companion, disrespect to humanized practices centered on physiology and the choice of women, the need for health training as a guide for the humanization policy and the management of health units, professional unpreparedness for performance and lack of involvement of professionals with longer service time to modify practices in obstetric care. Thus, the need to break away from obstetric violence at the structural/institutional level was evident in order to guarantee quality care for women. Conclusion: it is the responsibility of the managers to provide training to health professionals regarding performance that respects the scientific evidence, the centrality and the axes of policies and recommendations in the area of sexual and reproductive health, especially to women regarding their autonomy.

scholarly journals Incidence of maternal near-miss events in a tertiary care hospital of Gujarat, India

2019 ◽  
Vol 9 (1) ◽  
pp. 145
Author(s):  
Vijay Kansara ◽  
Disha Vaja ◽  
Ajesh Desai
Keyword(s):  
Tertiary Care ◽  
Institutional Care ◽  
Rare Event ◽  
Obstetric Care ◽  
Near Miss ◽  
World Health ◽  
Maternal Near Miss ◽  
Care Hospital ◽  
Cross Sectional ◽  
Life Threatening

Background: Maternal near miss is said to have occurred when women presented with life threatening complication during pregnancy, child birth and within 42 days after delivery, but survive by chance or good institutional care. For identifying near-miss cases five-factor scoring system was used. In 2009 WHO working group has standardized the criteria for selecting these cases. Because maternal mortality is a rare event, it is important to study maternal near-miss as a complement to evaluate and improve the quality of obstetric care. Thus, the study was conducted with the aim of assessing the incidence and causes of maternal near-miss.Methods: A facility-based cross-sectional study was conducted in the department of obstetrics and gynecology in GMERS medical college and hospital, Sola, Ahmedabad from January 1, 2019 to August 31, 2019. All maternal near-miss cases admitted to the hospital during the study period were recruited. World Health Organization criteria were used to identify maternal near-miss cases. The number of maternal near-miss cases over one year per 1000 live births occurring during the same year was calculated to determine the incidence of maternal near-miss. Underlying and contributing causes of maternal near-miss were documented from each participant’s record.Results: During the period of study, 3235 deliveries were done at the institution while 16 cases of near-miss were identified. The prevalence of near-miss case in this study was 0.5%. Near-miss per 1000 delivery was 5%. Maternal death to near miss ratio was 1:2.67. The leading causes of maternal near miss were hypertensive disorders (62%) and haemorrhage (32%) The morbidity was high in un-booked cases.Conclusions: Maternal near miss is good alternative indicator of health care system. Efforts made toward improvement in the management of life-threatening obstetric complications could reduce the occurrence of maternal near-miss problems that occur during hospitalization.

Skilled attendance at delivery: profile of nursing staff in maternity units from Alfenas city, Minas Gerais, Brazil

2010 ◽  
Vol 4 (4) ◽  
pp. 1894
Author(s):  
Eliana Peres Rocha ◽  
Maria José Clapis ◽  
Christianne Alves Pereira Calheiros
Keyword(s):  
Professional Competence ◽  
Obstetric Care ◽  
Structured Interview ◽  
Cross Sectional Study ◽  
Minas Gerais ◽  
Study Data ◽  
World Health ◽  
Cross Sectional ◽  
Health Organization ◽  
Nursing Professionals

ABSTRACTObjective: to identify the profile of nursing professionals providing care to pregnant women in maternity Alfenas-MG. Method: this is about a descriptive cross sectional study from quantitative approach. All nursing professionals (24) who worked in the care of patients participated in this study. Data collection was performed during the period from June to September 2008 using a structured interview. This study was conducted according to ethical principles of research and approved by the Ethics in Research of Universidade Federal de Alfenas/MG, under protocol number3087.001016/2008-98. Results: there was a lack of midwife in the team, keeping workload of 49.17 hours/week, 91.6% being female. As the professional category, the prevailing mid-level professionals with informal training and monitoring at work those with greater experience in the area. Conclusion it is understood that these professionals are not qualified for the obstetric care according to criteria of World Health Organization (WHO), highlighting the need for qualification of this team that assists women in maternity Alfenas, Minas Gerais. Descriptors: nursing; obstetric nursing; delivery; professional competence; qualified attention. RESUMOObjetivo: identificar o perfil dos profissionais de enfermagem que atendem as parturientes em maternidades de Alfenas-MG. Método: estudo descritivo de corte transversal com abordagem metodológica quantitativa. Participaram deste estudo todos os profissionais de enfermagem (24) que atuam na assistência às parturientes. A coleta de dados foi realizada no período de junho a setembro de 2008, utilizando-se um roteiro de entrevista. Este estudo foi conduzido segundo os preceitos éticos da pesquisa e aprovado pelo Comitê de Ética em Pesquisa da Universidade Federal de Alfenas/MG, sob o protocolo nº 23087.001016/2008-98. Resultados: verificou-se a ausência de enfermeira obstétrica na equipe, mantendo carga horária de trabalho de 49,17 horas/semana, sendo 91,6 % do sexo feminino . Quanto à categoria profissional, prevalecem os profissionais de nível médio com treinamento informal e acompanhamento durante o trabalho; os quais possuem maior experiência na área. Conclusão entende-se que esses profissionais não estão qualificados para o atendimento obstétrico segundo os critérios da Organização Mundial de Saúde (OMS), evidenciando-se a necessidade de qualificação dessa equipe que atende as mulheres nas maternidades de Alfenas, Minas Gerais. Descritores: enfermagem; enfermagem obstétrica; parto; competência profissional; equipe de enfermagem.RESUMENObjetivo: identificar el perfil de los profesionales de enfermería que atienden a mujeres embarazadas en la maternidad Alfenas-MG. Método: estudio descriptivo transversal de enfoque cuantitativo. Participaron en este estudio, todos los profesionales de enfermería (24) que trabajan en el cuidado de los pacientes. Los datos fueron recolectados durante el período de junio a septiembre de 2008 utilizando una entrevista estructurada. Este estudio se realizó de acuerdo con los principios éticos de la investigación y aprobado por la Ética en la Investigación de la Universidad Federal de Alfenas - MG, en el marco del Protocolo 23087.001016/2008-98. Resultados Hubo una falta de matrona en el equipo, manteniendo la carga de trabajo de 49,17 horas a la semana, el 91,6% de ser mujer. A medida que la categoría profesional, la vigente de nivel medio profesionales con la formación informal y la supervisión en el trabajo, quienes tienen mayor experiencia en el área. Conclusión: se entiende que estos profesionales no están calificados para la atención obstétrica de acuerdo con los criterios de la Organización Mundial de la Salud (OMS), destacando la necesidad de calificación de este equipo que ayuda a las mujeres en la maternidad Alfenas, Minas Gerais. Descriptores: enfermería; enfermería obstétrica; entrega; competencia profesional. 

scholarly journals Use and resolubility of the oral health public services offered to children in a large municipality

2018 ◽  
Vol 66 (1) ◽  
pp. 60-69
Author(s):  
Andreza Viana Lopes CARDOSO ◽  
Andréa Maria Duarte VARGAS ◽  
João Henrique Lara do AMARAL ◽  
Mara VASCONCELOS ◽  
Kecyanne Malheiros MACHADO ◽  
...  
Keyword(s):  
Socioeconomic Status ◽  
Public Schools ◽  
Oral Health ◽  
Health Services ◽  
Skin Color ◽  
Dental Treatment ◽  
Treatment Needs ◽  
Cross Sectional ◽  
Oral Health Services ◽  
Belo Horizonte

ABSTRACT Objective: To evaluate the effect of caries severity and socioeconomic conditions on use of oral health services and treatment situations (completed treatment, evasion, referral) among children with dental treatment needs, using the Unified Health System. Methods: Cross sectional study performed among children up to six years old, with dental treatment needs, coming from public schools in Belo Horizonte, Brazil, examined by the Oral Health Teams in the annual survey of oral health, in 2014. Variables were collected by consulting the medical records and information systems. Services were used by children who had attended the dental appointment at least once. The severity of caries considered the number of cavitated teeth. The socioeconomic variables were: age, sex, skin color and family socioeconomic classification. Resolubility was assessed by the ratio between completed treatment and first appointment. Evasion was defined by absence in more than two consecutive unjustified appointments. Association was tested by chi-square test and Poisson regression. Results: The frequency of services use was 44.3% and there was greater use by children with treatment needs in 4 to 8 teeth (PR=1.48, 1.23-1.78) and in more than 9 teeth (PR=1.80, 1.32-2.46) and lower in those with very high socioeconomic risk (PR = 0.79, 0.63-0.99). The resolubility was of 49.6% and 5.2% abandoned the treatment. Children with lower socioeconomic status presented lower resolubility and greater avoidance. Conclusion: The results suggested a persistent iniquity, with less use and resolubility of oral health services among children presenting worse socioeconomic status.

scholarly journals Using the Bologna Score to assess normal delivery healthcare

2016 ◽  
Vol 50 (5) ◽  
pp. 741-748 ◽  
Author(s):  
Isaiane da Silva Carvalho ◽  
Rosineide Santana de Brito
Keyword(s):  
Obstetric Care ◽  
Cross Sectional Study ◽  
Northeastern Brazil ◽  
Sectional Study ◽  
Cross Sectional ◽  
Normal Delivery ◽  
Spontaneous Vaginal Delivery ◽  
Maternity Hospitals ◽  
The City ◽  
Primiparous Women

Abstract OBJECTIVE Describing the obstetric care provided in public maternity hospitals during normal labour using the Bologna Score in the city of Natal, Northeastern Brazil. METHOD A quantitative cross-sectional study conducted with 314 puerperal women. Data collection was carried out consecutively during the months of March to July 2014. RESULTS Prenatal care was provided to 95.9% of the mothers, beginning around the 1st trimester of pregnancy (72.3%) and having seven or more consultations (51%). Spontaneous vaginal delivery was planned for 88.2% women. All laboring women were assisted by a health professional, mostly by a physician (80.6%), and none of them obtained 5 points on the Bologna Score due to the small percentage of births in non-supine position (0.3%) and absence of a partogram (2.2%). A higher number of episiotomies were observed among primiparous women (75.5%). CONCLUSION The score obtained using the Bologna Index was low. Thus, it is necessary to improve and readjust the existing obstetrical model.

scholarly journals Obstetric Nursing in best practices of labor and delivery care

2019 ◽  
Vol 72 (suppl 3) ◽  
pp. 235-242 ◽  
Author(s):  
Thales Philipe Rodrigues da Silva ◽  
Érica Dumont-Pena ◽  
Ana Maria Magalhães Sousa ◽  
Torcata Amorim ◽  
Luísa Castanheira Tavares ◽  
...  
Keyword(s):  
Best Practices ◽  
Statistical Difference ◽  
Scientific Evidence ◽  
Cross Sectional Study ◽  
Delivery Care ◽  
Labor And Delivery ◽  
Sectional Study ◽  
Cross Sectional ◽  
Maternity Hospitals

ABSTRACT Objective: to evaluate the association of Obstetric Nursing in the best practices of delivery and birth care in maternity hospitals. Method: a cross-sectional study, with 666 women selected for delivery. Parturition obstetric practices performed by professionals were categorized into: clearly useful practices that should be encouraged, practices that are clearly harmful or ineffective and that should be eliminated and practices used inappropriately at the time of parturition. Results: clearly useful practices were used in greater proportions in the hospitals that had Obstetric Nursing working, while clearly harmful practices and those used inappropriately were practiced in smaller proportions in hospitals that had Obstetric Nursing, both with statistical difference. Conclusion: institutions with Obstetric Nursing adopt better practices of delivery and birth care, based on scientific evidence, when compared to those that do not act.

scholarly journals Utilisation of the partogram among nurses and midwives in selected health facilities in the Eastern Province of Rwanda

Curationis ◽  
2017 ◽  
Vol 40 (1) ◽  
Author(s):  
Oliva Bazirete ◽  
Nomafrench Mbombo ◽  
Oluyinka Adejumo
Keyword(s):  
Data Collection ◽  
Obstetric Care ◽  
Health Facilities ◽  
World Health ◽  
Western Cape ◽  
Validity And Reliability ◽  
Eastern Province ◽  
Cross Sectional ◽  
Service Training ◽  
Nurses And Midwives

Background: Maternal mortality continues to be a global burden, with more than 200 million women becoming pregnant each year and a large number dying as a result of complications of pregnancy or childbirth. The World Health Organisation has recommended use of the partogram to monitor labour and delivery in order to improve healthcare and reduce maternal and foetal mortality rates.Objective: This study described factors affecting utilisation of the partogram among nurses and midwives in selected health facilities of Rwanda.Method: A descriptive quantitative and cross-sectional research design was used. The population comprised 131 nurses and midwives providing obstetric care in 15 health institutions (1 hospital and 14 health centres). Data collection was through a self-administered questionnaire, and a pre-test of the data collection instrument was carried out to enhance validity and reliability. The Statistical Package for Social Sciences (version 21) was used to capture and analyse data. Ethical clearance was obtained from the University of the Western Cape (Republic of South Africa) and from the Institutional Review Board of Kigali Health Institute (Rwanda). Patricia Benner’s model of nursing practice was used to guide the study.Results: It was found that 36.6% of nurses and midwives did not receive any in-service training on how to manage women in labour. Despite fair knowledge of the partogram among nurses and midwives in this study, only 41.22% reported having used the partogram properly, while 58.78% reported not having done so.Conclusion: Nurses’ and midwives’ years of professional experience and training in managing pregnant women in labour were found to be predictors of the likelihood of proper use of the partogram. In-service training of obstetric caregivers in the Eastern Province of Rwanda is recommended to improve use of the partogram while managing women in labour.

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