scholarly journals Influence of maternal age and hospital characteristics on the mode of delivery

2020 ◽  
Vol 73 (suppl 4) ◽  
Author(s):  
Thales Philipe Rodrigues da Silva ◽  
Bruna Luiza Soares Pinheiro ◽  
Karolina Yukari Kitagawa ◽  
Renato Camargo Couto ◽  
Tânia Moreira Grillo Pedrosa ◽  
...  
Keyword(s):  
Hospital Stay ◽  
Maternal Age ◽  
Diagnosis Related Groups ◽  
Mode Of Delivery ◽  
Length Of Hospital Stay ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Public And Private ◽  
Public Care ◽  
Vaginal Deliveries

ABSTRACT Objectives: to analyze the relationship between maternal age and the source of healthcare payment with mode of delivery in public and private national hospitals between the years 2012 to 2017, and the length of hospital stay. Methods: cross-sectional study of 91,894 women who had children in public and private hospitals between 2012 and 2017. Data were collected from the Diagnosis-Related Groups Brazil system and a comparative analysis was performed between patients in public care and those in supplementary healthcare. Results: in public care, the majority were vaginal deliveries and the reverse occurred in supplementary health. The proportion of cesarean sections was higher in the age group 31 to 40 years old in both services. The hospital stay was longer among women who underwent a cesarean section. Conclusions: high maternal age and the source of healthcare payment influence the mode of delivery, which interfere with the length of hospital stay.

scholarly journals Multiple Factors Affecting Length of Hospital Postpartal Care in Eclampsia Patients

2016 ◽  
pp. 75-80
Author(s):  
Gita Dianty
Keyword(s):  
Renal Failure ◽  
Hospital Stay ◽  
Mode Of Delivery ◽  
Length Of Hospital Stay ◽  
Cross Sectional Study ◽  
Short Stay ◽  
Cross Sectional ◽  
Factors Affecting ◽  
Significant Difference ◽  
Group A

Objective: To identify any factors that could cause longer care at hospitals in eclampsia patients. Methods: It was a retrospective, cross sectional study design and conducted in Dr. Mohammad Hoesin Hospital Palembang from January 2005 to December 2009. This research conducted in 176 samples divided into 2 groups namely short-stay group (1-5 days) with 92 patients and longer stay group (≥ 5 days) with 87 patients, with mean length of hospital stay 5.41±3.43 days. Results: The most common mode of delivery in the group who stayed ≥ 5 days was cesarean section (44.8%), while the most common delivery route in the group who stayed < 5 days was forceps extraction (43.5%). The mean thrombocytes count in the longer stay group was lower than in the short-stay group (213459.77±108391.81 vs 258945.65±92213.24 mm3), which was significantly different (p=0.003). Ureum and LDH concentration in longer stay group was higher, and statistic test was found to be significantly different (p<0.05), while renal failure complication was mostly experienced by the longer stay group (20.7%). Conclusions: Thrombocytes count, LDH, acute renal failure and ICU has significant difference and greater in postpartal eclampsia group that is longer treated. [Indones J Obstet Gynecol 2012; 36-2: 75-80] Keywords: complication, eclampsia, length of hospital stay

scholarly journals Association of Maternal Hemoglobin and Birth Weight at Paropakar Maternity and Women’s Hospital, Kathmandu

2017 ◽  
Vol 11 (2) ◽  
pp. 20-23
Author(s):  
Safiur Rahman Ansari ◽  
Gehanath Baral
Keyword(s):  
Birth Weight ◽  
Negative Correlation ◽  
Strong Correlation ◽  
Neonatal Death ◽  
Maternal Age ◽  
Pearson Correlation ◽  
Mode Of Delivery ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Cross Sectional

Aims: To examine the association between maternal hemoglobin with birth weight.Methods: Cross sectional study of obstetrics database at Paropakar Maternity and Women’s Hospital. Hospital delivery of over 18 years of age women tested for Pearson correlation using SPSS-17.Results: Total of 2085 cases analyzed. There was mean hemoglobin value of 12.05 ± 1.30 (95% CI=11.992-12.103) g/dL and no any significant impact on mode of delivery (p=0.15) and neonatal death (p=0.736). There was a small but a significant correlation (p<0.01) of maternal age with hemoglobin (r = 0.106) and birth weight (r = 0.093); but a very small negative correlation between maternal hemoglobin and birth weight.Conclusions: Optimal maternal hemoglobin during labor rules out any strong correlation with birth weight.

scholarly journals Factors associated with the length of hospital stay of women undergoing cesarean section

2019 ◽  
Vol 53 ◽  
pp. 65
Author(s):  
Samire Lopes Pereira ◽  
Thales Philipe Rodrigues da Silva ◽  
Alexandra Dias Moreira ◽  
Taiane Gonçalves Novaes ◽  
Milene Cristine Pessoa ◽  
...  
Keyword(s):  
Cesarean Section ◽  
Hospital Stay ◽  
Gestational Hypertension ◽  
Diagnosis Related Groups ◽  
Age Groups ◽  
Length Of Hospital Stay ◽  
Hypertensive Disorder ◽  
Age Group ◽  
Cross Sectional ◽  
Discharge Data

OBJECTIVE: To evaluate whether age group, complications or comorbidities are associated with the length of hospitalization of women undergoing cesarean section. METHODS: A cross-sectional study was carried out between June 2012 and July 2017, with 64,437 women undergoing cesarean section and who did not acquire conditions during their hospital stay. Hospital discharge data were collected from national health institutions, using the Diagnosis-Related Groups system (DRG Brasil). The DRG referring to cesarean section with additional complications or comorbidities (DRG 765) and cesarean section without complications or associated comorbidities (DRG 766) were included in the initial diagnosis. The influence of age group and comorbidities or complications present at admission on the length of hospital stay was assessed based on the means of the analysis of variance. The size of the effect was verified by Cohen’s D, which allows evaluating clinical relevance. The criticality levels were identified using the Duncan test. RESULTS: The longest length of hospital stay was observed in the age group from 15 to 17 years old and among those aged 45 years old or more. The hospital stay of women with complications or comorbidities at the time of admission was also longer. Moreover, it was noted that the increase in criticality level was associated with an increase in the mean length of hospital stay. CONCLUSIONS: The length of hospital stay of women is higher among those belonging to the age group ranging from 15 to 17 years old and for those aged 45 years old or more. The presence of associated comorbidities, such as eclampsia, pre-existing hypertensive disorder with superimposed proteinuria and gestational hypertension (induced by pregnancy) with significant proteinuria increase the length of hospital stay. This study enabled the construction of distinct criticality level profiles based on the combination of age groups and the main comorbidities, which were directly related to the length of hospital stay.

Influence of Patient-Level Factors on Mode of Delivery among Operative Vaginal Delivery Candidates in Modern Practice

2017 ◽  
Vol 34 (10) ◽  
pp. 0974-0981 ◽  
Author(s):  
Christina Gonzalez ◽  
Amanda Allshouse ◽  
Erick Henry ◽  
Sean Esplin ◽  
Torri Metz
Keyword(s):  
Vaginal Delivery ◽  
Gestational Age ◽  
Maternal Age ◽  
Mode Of Delivery ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Cross Sectional ◽  
Second Stage ◽  
Patient Level ◽  
Operative Vaginal Delivery

Objective We aimed to evaluate which patient-level factors influence mode of delivery among candidates for operative vaginal delivery. Study Design Cross-sectional study of candidates for operative vaginal delivery from 18 hospitals over 8 years. Probabilities of mode of delivery were estimated using hierarchical logistic modeling adjusting for clustering within physician and hospital. Results Total 3,771 (64%) women delivered with forceps, 1,474 (25%) vacuums, and 665 (11%) cesareans. Odds of forceps versus vacuum were higher with induction (OR = 2.16, 95% CI: 1.76–2.65), nulliparity (OR = 2.06, 95% CI: 1.59–2.66), epidural (OR = 2.05, 95% CI: 1.19–3.56), maternal indication (OR = 1.53, 95% CI 1.16–2.02), older maternal age (OR 1.18, 95% CI 1.06–1.31 per 5 years), and longer second stage (OR = 1.10, 95% CI: 1.01–1.20 per hour).Odds of cesarean versus operative vaginal delivery were higher with maternal indication (OR = 9.0, 95% CI: 7.23–11.20), a perinatologist (OR = 2.51, 95% CI: 1.09–5.78), longer second stage (OR = 1.79, 95% CI: 1.65–1.93 per hour), older gestational age (OR = 1.10, 95% CI: 1.01–1.20 per week), and longer labor (OR = 1.02, 95% CI: 1.01–1.04 per hour). Conclusion Patient-level factors influence the decision to proceed with an operative vaginal delivery and the choice of instrument, thereby emphasizing the importance of maintaining availability of both forceps and vacuums.

scholarly journals Predictors of Length of Hospital Stay, Mortality, and Outcomes Among Hospitalised COVID-19 Patients in Saudi Arabia: A Cross-Sectional Study

2021 ◽  
Vol Volume 14 ◽  
pp. 839-852
Author(s):  
Hassan Alwafi ◽  
Abdallah Y Naser ◽  
Sultan Qanash ◽  
Ahmad S Brinji ◽  
Maher A Ghazawi ◽  
...  
Keyword(s):  
Saudi Arabia ◽  
Hospital Stay ◽  
Length Of Hospital Stay ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Cross Sectional

scholarly journals Prevalence and Outcome of Induction of Labor in a Tertiary Care Center of Kathmandu, Nepal

2019 ◽  
Vol 14 (2) ◽  
pp. 54-56
Author(s):  
Dhan Bahadur Shrestha ◽  
Rosy Malla ◽  
Reeta Manandhar ◽  
Ratna Khatri ◽  
Cimona Shrestha ◽  
...  
Keyword(s):  
Care Center ◽  
Tertiary Care ◽  
Mode Of Delivery ◽  
Cross Sectional Study ◽  
Induction Of Labor ◽  
Maternity Unit ◽  
Tertiary Care Center ◽  
Maternal Complications ◽  
Cross Sectional ◽  
Vaginal Deliveries

Aim: To study the prevalence of induction of labor and obstetric and neonatal outcome among delivery cases in the maternity unit of a tertiary care center. Methods: This is a prospective cross-sectional study conducted on pregnant ladies presenting to maternity unit of Shree Birendra Hospital, Chhauni over a period of six months from March to August 2017. All pregnant ladies in labor during the study period were enrolled. Induction of labor, mode of delivery, perinatal outcome (gestational age at delivery, birth weight), and maternal complications if any were recorded. Results: Among 497 deliveries in the study period, induction of labor was performed in 117 (23.5%) cases with post-date pregnancy being the most common indication. Induction was successful with vaginal deliveries in 82(70.1%) cases, while in the rest, IOL failed. Among the induced cases, 17 (14.5%) neonates had poor APGAR at 5 minutes and there was significant association of IOL with low APGAR. There was normal post-natal recovery in 108 (92.3%) induced cases while 9 (7.7%) cases developed some maternal complications. IOL has no significant association with maternal and neonatal complications or perineal injury (p>0.05). Conclusions: The prevalence of induction in this center is slightly higher than other centers. The IOL has significant association with low APGAR at 5 minutes but no significant association with the neonatal and maternal complications.

scholarly journals A study on peripartum hysterectomy in a tertiary referral government hospital

2019 ◽  
Vol 8 (12) ◽  
pp. 4971
Author(s):  
Chaithra M. ◽  
Tejeswini K. K. ◽  
Savitha C.
Keyword(s):  
Caesarean Section ◽  
Postpartum Haemorrhage ◽  
Mode Of Delivery ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Peripartum Hysterectomy ◽  
Obstetrics And Gynaecology ◽  
Vaginal Deliveries ◽  
Life Threatening ◽  
Emergency Peripartum Hysterectomy

Background: Emergency peripartum hysterectomy (EPH) is a major surgical venture invariably performed in the setting of life-threatening haemorrhage during or immediately after abdominal and vaginal deliveries. Aim of the study was to study the frequency and indications for peripartum hysterectomy and to assess the maternal outcome of peripartum hysterectomy.Methods: Cross sectional study was done in the department of obstetrics and gynaecology, Vanivilas hospital, Bangalore from September 2018 to august 2019. This study consists of 24 cases of emergency peripartum hysterectomy within 24 hours of delivery, operated at Vanivilas hospital.Results: The frequency of peripartum hysterectomy was 1.102/1000 deliveries and following caesarean section and vaginal deliveries are 3.544/1000 deliveries and 0.248/1000 deliveries respectively. Among 24 cases who had peripartum hysterectomy, 16 cases were delivered by caesarean section and 4 cases delivered by vaginal route while another 4 cases delivered by laparotomy for rupture uterus. 22 cases (91.67%) survived with major number of cases having morbidities and there were 2 (8.33%) maternal death.Conclusions: The most common mode of delivery before peripartum hysterectomy was Caesarean section. The most common indication was atonic postpartum haemorrhage. Better protocols for induction and augmentation of labour will decrease the necessity of peripartum hysterectomies.

Correlation of Clinical Score and Serum Acetylcholinesterase Level as a Predictor of Outcome among Patients with Acute Organophosphate Poisoning Admitted in Emergency Ward of a Tertiary Hospital

2019 ◽  
Vol 2 (2) ◽  
pp. 19-27
Author(s):  
R Chaudhary ◽  
R Bhandari ◽  
G Malla ◽  
M. Poudel ◽  
M Lamsal
Keyword(s):  
Hospital Stay ◽  
Length Of Hospital Stay ◽  
Clinical Score ◽  
Tertiary Hospital ◽  
Cross Sectional Study ◽  
Organophosphate Poisoning ◽  
Emergency Ward ◽  
Cross Sectional ◽  
Spearman's Rho ◽  
Spearman’S Rho

Background: Monitoring a patient's serum acetylcholinesterase (AChE) status after clinical score of organophosphate poisoning enables the verification of exposure to anticholinesterase agents. Methods: A cross-sectional study was conducted among the patients fulfilling the inclusion criteria and was categorized according to POP (Peradeniya Organophosphorus Poisoning) score. The study was conducted at a tertiary hospital for one year in the period of Jan 2016 to Dec 2016. POP score was applied and serum acetylcholinesterase level was determined in the lab. Spearman’s rho coefficient method was applied for correlation. Results: Seventy four patients survived in emergency ward who presented within (4.1 ± 2.9; 95% confidence interval [CI], 3.43- 4.80; P= 0.021) hours of ingestion of OP compounds, POP score 3 (Q1, Q3, 2, 4), serum AChE 2221 (Q1, Q3, 768.5, 4703.5) IU/L with 9 ( Q1,Q3, 8.75, 34.75) mg of atropine used, 94% received PAM for 5 (Q1, Q3, 3, 7) days of hospital stay. Four patients died within (7.5 ± 5.4; 95% CI, -1.16- 16.16; P= 0.021) hours of presentation, POP score of 4 (Q1, Q3, 4, 7.75), serum AChE 588 (Q1, Q3, 173, 1912) IU/L, atropine used 170 (Q1, Q3, 152.5, 297) mg, 5.1% received PAM for 3.5 (Q1, Q3, 1, 11.25) days of hospital stay. Spearman’s rho coefficient showed well correlation between POP score and serum AChE level (coefficient -0.356; P= 0.001), POP score for the need of atropine (coefficient= 0.536; P= 0.001). Serum AChE also correlated with the length of hospital stay (coefficient= 0.414; P= 0.001) compared to POP score (coefficient= 0.420; P= 0.001). Conclusions: The higher degree of POP score correlated to higher degree of serum acetylcholinesterase derangement, need for atropine, PAM and length of hospital stay. Thus, it enhances in the prediction of outcome among patients with acute organophosphate poisoning at index visit.

scholarly journals Treatment Outcome and Associated Factors among Type 1 Diabetic Children<15 Years Admitted With DKA in Bahir Dar City Public Referral Hospital, North West, Ethiopia: A retrospective Cross Sectional Study

2021 ◽  
Author(s):  
Fentahun Meseret
Keyword(s):  
Treatment Outcome ◽  
Mortality Rate ◽  
Hospital Stay ◽  
Length Of Hospital Stay ◽  
Cross Sectional Study ◽  
Referral Hospital ◽  
Sectional Study ◽  
Cross Sectional ◽  
North West ◽  
North West Ethiopia

Abstract Background: Length of hospital stay and overall in hospital mortality of diabetic keto acidosis during management are the foremost primary out comes that should be measured. Because, it is highly trusted on the improvement of diabetic keto acidosis related complication management. However, data associated to length of stay, mortality rate due to diabetic keto acidosis remains to be limited in Ethiopia.In addition to this, Nonfiction is much scarce in relation to factors associated with treatment outcome starting from its initial presentation and the overall management process. Objective: To assess treatment outcome of children<15 years old admitted with diabetic keto acidosis at Felege Hiwot comprehensive referral hospital, North West, Ethiopia, 2021Methods: Retrospective cross sectional study was conducted at Felege Hiwot comprehensive referral hospital among randomly selected sample of 176 children admitted with diabetic keto acidosis from 2016 to 2021.Data were collected by using data abstraction tool. Then it was coded, enter, cleaned and stored into Epi-data version 4.2 and was exported into STATA 14.0 statistical software for analysis. Categorical variables were described using proportions and compared using Chi-square test; whereas continuous parametric variables with mean and standard deviation and compared using parametric (t-test). Model goodness-of-fit and assumptions were checked. Finally, association between independent variables and length of hospital stay were assessed using binary logistics regression and Variables with p-value < 0.05 were considered as statistically significant.Result: The mean length of hospital stay was 9.5±6.2 days. About 59.3% of had long hospital stay (>7days).Majority of the clients (97.5%) were improve and discharged with 14.2% management complication and 4(2.5%) died in the hospital. Factors that affect long hospital stay were residence(AOR=4.31;95CI=1.25-14.80),family history of diabetes (AOR=0.12; 95%CI=0.02-0.64),glycaemia at admission (AOR=1.01;95%CI=1.00-1.02),insulin skipping (AOR=0.08;95%CI=0.01-0.98),abdominal pain(AOR=4.28;95%CI=1.11 -15.52), time in which the patient get out of diabetic keto acidosis(AOR=6.39;95%CI=1.09-37.50).Conclusion and Recommendation: Majority of clients were showed improvement and discharged to their home after longer hospital stay and with very low mortality rate followed by complication (14.2%).The time with in which the majority of the clients get out of DKA were found in between 24-48 hours. Thus, to achieve the intended treatment out come early in time, modification of the approach by emphasizing the above predictors is mandatory with the recommendation of multicenter study in this regard.

scholarly journals Older adults hospitalized in a teaching hospital: clinical characteristics and outcomes

2017 ◽  
Vol 11 (12) ◽  
pp. 4938
Author(s):  
Camilla Christina Rodrigues ◽  
Rita de Cássia Helú Mendonça Ribeiro ◽  
Claudia Bernardi Cesarino ◽  
Daniela Comelis Bertolin ◽  
Renato Mendonça Ribeiro ◽  
...  
Keyword(s):  
Hospital Stay ◽  
Older Adult ◽  
Average Length ◽  
Descriptive Analysis ◽  
Length Of Hospital Stay ◽  
Gastrointestinal Diseases ◽  
Cross Sectional Study ◽  
Chi Square ◽  
Cross Sectional ◽  
Sample Characterization

RESUMOObjetivo: investigar as causas de internação dos idosos hospitalizados, o perfil demográfico, o perfil clínico e o desfecho. Método: estudo quantitativo, transversal de análise de 14.892 prontuários eletrônicos, no período de 12 meses. Foi realizada uma análise descritiva das variáveis de caracterização amostral e aplicação do teste associativo pela estatística qui-quadrado. Resultados: a maioria dos pacientes avaliados era do sexo masculino, com grau de instrução fundamental, com companheiro, do lar, brancos, católicos e com doenças cardiovasculares, seguidas de neoplasias e doenças gastrointestinais em ambos os sexos.  A idade dos pacientes apresentou média de 72,1 anos e a média da permanência hospitalar foi de 5,9 dias. Houve associação significativa entre as doenças diagnosticadas, o sexo (p <0,001) e a etnia (p = 0,023) dos pacientes. O desfecho mais comum foi a alta dos pacientes. Conclusão: as doenças crônicas foram as principais causas de hospitalização dos idosos, acarretando mais tempo na hospitalização. A investigação destes fatores fornece subsídios para identificação dos problemas e realizar melhores ações de enfermagem. Descritores: Idoso; Hospitalização; Evolução Clínica.ABSTRACT Objective: to investigate the causes of older adult hospitalizations, demographic and clinical profiles, and patient outcome. Method: quantitative cross-sectional study conducted with 14,892 electronic medical records during 12 months. We carried out a descriptive analysis of the variables of the sample characterization, and an associative test using chi-square statistics. Results: most patients assessed were male, had primary education, lived with a partner, were white and Catholics, and had cardiovascular diseases, followed by neoplasms and gastrointestinal diseases in both sexes. The average age of the patients was 72.1 years, and the average length of hospital stay was 5.9 days. There was a significant association between diagnosed diseases, sex (p <0.001), and ethnicity (p = 0.023) of the patients. The most common outcome was hospital discharge. Conclusion: chronic diseases were the main causes of older adult hospitalizations and led to increased length of hospital stay. The assessment of these factors provides subsidies for identifying problems and performing best nursing interventions. Descriptors: Older Adult; Hospitalization; Clinical Evolution.RESUMEN Objetivo: investigar las causas de hospitalización de adultos mayores, perfil demográfico, perfil clínico y desenlaces. Método: estudio cuantitativo transversal con análisis de 14.892 registros médicos electrónicos de un período de 12 meses. Se realizó un análisis descriptivo de las variables de caracterización de la muestra y se aplicó la prueba chi-cuadrado. Resultados: la mayoría de los pacientes evaluados eran hombres, con educación primaria, vivían en pareja, eran blancos, católicos y tenían enfermedades cardiovasculares, seguidas de neoplasias y enfermedades gastrointestinales en ambos sexos. El promedio de edad de los pacientes fue de 72,1 años y de la estancia hospitalaria fue de 5,9 días. Hubo una asociación significativa entre enfermedades diagnosticadas, sexo (p <0.001) y etnia (p = 0.023) de los pacientes. El resultado más común fue el alta hospitalaria. Conclusión: las enfermedades crónicas fueron las principales causas de hospitalización de los adultos mayores, llevando a un tiempo más prolongado de internación. La investigación de estos factores proporciona subsidios para identificación de problemas y realizar mejores intervenciones de enfermería. Descritores: Adulto Mayor; Hospitalización; Evolución Clínica.

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