scholarly journals A retrospective analysis of emergency hysterectomy intervention strategy in obstetrics

2022 ◽  
Vol 38 (3) ◽  
Author(s):  
Zhuanji Fang ◽  
Huale Zhang ◽  
Shuisen Zheng ◽  
Lingling Weng ◽  
Jianying Yan
Keyword(s):  
Child Health ◽  
Blood Loss ◽  
Intervention Strategy ◽  
Surgical Indications ◽  
Total Hysterectomy ◽  
Subtotal Hysterectomy ◽  
Significant Difference ◽  
Emergency Hysterectomy ◽  
And Child Health ◽  
Health Hospital

Objectives: To investigate the indications of obstetric emergency hysterectomy and analyze the clinical effects of subtotal hysterectomy and total hysterectomy. Methods: We included 247 hospitalized women who had undergone abdominal hysterectomy due to obstetric reasons in Fujian Province Maternity and Child Health Hospital (a provincial class-A hospital) and Ningde People’s Hospital (a primary Class-B hospital) between January 2002 and December 2018. We identified surgical indications and clinical characteristics of the patients. Furthermore, the patients from Fujian Provincial Maternity and Child Health Hospital were subdivided into subtotal hysterectomy group and total hysterectomy group to examine general operation conditions, and postoperative complications. Results: The main surgical indications for emergency obstetric hysterectomy in Fujian Maternity and Child Health Hospital were placental implantation (49.6%) and uterine weakness (31.9%), while uterine weakness (37.5%) was the most important indication in Ningde People’s Hospital. No differences were found in operation time, hospitalization time, intraoperative blood loss, postpartum blood loss, and intraoperative fresh frozen plasma transfusion between the subtotal hysterectomy group and the total hysterectomy group. Postoperative test parameters, including postoperative prothrombin time (PT), thrombin time (TT), activated partial thromboplastin time (APTT), hemoglobin (HGB), and hematocrit (HCT), were not significantly different between the two groups. No significant difference was noted in postoperative vesicoureteral injury, pelvic hematoma, infection, and disseminated intravascular coagulation (DIC) incidence, but renal failure incidence was different (P=0.040). Conclusion: The treatment effect of subtotal hysterectomies for the cases without placenta accreta and placenta previa was similar in the two hospitals. There is no statistically significant difference in therapeutic effect between total hysterectomy and subtotal hysterectomy. doi: https://doi.org/10.12669/pjms.38.3.5335 How to cite this:Fang Z, Zhang H, Zheng S, Weng L, Yan J. A retrospective analysis of emergency hysterectomy intervention strategy in obstetrics. Pak J Med Sci. 2022;38(3):---------. doi: https://doi.org/10.12669/pjms.38.3.5335 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

scholarly journals Increasing uptake of maternal, newborn, and child health interventions through a group-based health education and microfinance program: a prospective matched cohort study in western Kenya

2019 ◽  
Author(s):  
Lauren Yu-Lien Maldonado ◽  
Julia J. Songok ◽  
John W. Snelgrove ◽  
Christian B. Ochieng ◽  
Sheilah Chelagat ◽  
...  
Keyword(s):  
Cohort Study ◽  
Health Education ◽  
Child Health ◽  
Pregnant Women ◽  
Matched Cohort ◽  
Western Kenya ◽  
Newborn And Child Health ◽  
Matched Cohort Study ◽  
Significant Difference ◽  
And Child Health

Abstract Background We launched Chamas for Change (Chamas), a group-based health education and microfinance program for pregnant women and their infants, to address inequities contributing to high rates of maternal and neonatal mortality in western Kenya. In this prospective matched cohort study, we evaluated Chamas’ impact on improving uptake of evidence-based maternal, newborn and child health (MNCH) interventions. Methods We prospectively compared MNCH intervention uptake between a cohort of Chamas participants and controls matched for age, parity, and prenatal care location. Between October-December 2012, government-sponsored community health volunteers (CHV) recruited pregnant women in Busia county attending their first antenatal care (ANC) visit to participate in Chamas and enroll in this study. Upon joining, women agreed to attend bi-monthly group health education and optional microfinance sessions for 12 months. We selected controls among non-Chamas participants who attended the same ANC clinics. We collected baseline sociodemographic and reproductive health data at study enrollment. We used descriptive analyses and adjusted multivariable logistic regression models to compare outcomes across cohorts at 6-12 months postpartum, with α set to 0.05. Results Compared to controls (n=115), a significantly higher proportion of Chamas participants (n=211) delivered in a facility with a skilled birth attendant (84.4% vs. 50.4%, p<0.001), attended at least four ANC visits (64.0% vs. 37.4%, p<0·001), exclusively breastfed to six months (82.0% vs. 47.0%, p<0·001), and received a CHV home visit within 48 hours postpartum (75.8% vs. 38.3%, p<0·001). In our adjusted models, Chamas participants were nearly five times as likely as controls to deliver in a health facility (OR 5.07, 95% CI 2.74-9.36, p<0.001). Though not statistically significant, Chamas participants experienced fewer stillbirths than non-participants (n=2 vs. n=6, p=0.083). Our sensitivity analyses revealed no significant difference in the odds of facility delivery based on microfinance participation. Conclusions Chamas participation was associated with increased uptake of MNCH interventions among pregnant women in western Kenya. Our findings demonstrate this program’s potential to achieve population-level maternal and infant health benefits; however, a larger study is needed to validate this observed effect.

scholarly journals Risk Factors Associated with Preterm Birth in a Brazilian Maternal and Child Health Hospital

2018 ◽  
Vol 5 (6) ◽  
Author(s):  
Medeiros Bianca Karenina Brito de ◽  
Cornetta Maria da Conceição ◽  
Crispim Janaína de Oliveira ◽  
Cobucci Ricardo Ney
Keyword(s):  
Risk Factors ◽  
Preterm Birth ◽  
Child Health ◽  
Maternal And Child Health ◽  
Factors Associated ◽  
And Child Health ◽  
Health Hospital

scholarly journals Acute fatty liver of pregnancy cases in a maternal and child health hospital of China

Medicine ◽  
2020 ◽  
Vol 99 (29) ◽  
pp. e21110
Author(s):  
Ling Wang ◽  
Quan Gan ◽  
Shuguo Du ◽  
Yun Zhao ◽  
Guoqiang Sun ◽  
...  
Keyword(s):  
Child Health ◽  
Fatty Liver ◽  
Maternal And Child Health ◽  
Acute Fatty Liver ◽  
And Child Health ◽  
Health Hospital

scholarly journals Efficacy of adjunctive azithromycin versus single-dose cephalosporin prophylaxis for caesarean scar defect: study protocol for a randomised controlled trial

BMJ Open ◽  
2020 ◽  
Vol 10 (1) ◽  
pp. e032379
Author(s):  
Yanqing Cai ◽  
Hongjie Pan ◽  
Jian Zhang ◽  
Weiwei Cheng ◽  
Yiru Shi ◽  
...  
Keyword(s):  
Single Dose ◽  
Child Health ◽  
Protective Effect ◽  
Controlled Trial ◽  
Transvaginal Ultrasound ◽  
International Peace ◽  
Caesarean Scar ◽  
Caesarean Scar Defect ◽  
And Child Health ◽  
Health Hospital

IntroductionPerioperative infections may be considered predictors of caesarean scar defect (CSD), and multidose antibiotics have a protective effect against CSD. However, the ability of adjunctive azithromycin combined with cephalosporin to reduce the prevalence of CSD remains unclear. The planned study aims to clarify the protective effect of antibiotics against CSD and to assess the effectiveness of adjunctive azithromycin prophylaxis for CSD.Methods and analysisThis study is a double-blind, parallel-control randomised clinical trial that will be carried out at the International Peace Maternity and Child Health Hospital. A total of 220 eligible patients will be randomised (1:1) to receive either adjunctive azithromycin or single-dose cephalosporin 30 min before the incision. The evaluation criteria are the prevalence and characteristics of CSD as assessed by transvaginal ultrasound (TVU) and saline infusion sonohysterography (SIS) at 42 days, 6 months and 12 months after delivery. The primary outcome will be the prevalence of CSD, and the characteristics of CSD will be assessed by TVU and SIS 42 days after delivery; all other outcomes are secondary.Ethics and disseminationThis protocol received authorisation from the Medical Research Ethics Committee of International Peace Maternity and Child Health Hospital on 25 April 2018 (approval no. GKLW2017-84). The findings will be reported in peer-reviewed publications and presentations at international scientific meetings.Trial registration numberChiCTR-INR-17013272.

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