scholarly journals The role of parity in the mode of delivery in advanced maternal age women

2021 ◽  
Vol 21 (1) ◽  
pp. 65-75
Author(s):  
Katrini Guidolini Martinelli ◽  
Silvana Granado Nogueira da Gama ◽  
Edson Theodoro dos Santos Neto

Abstract Objectives: to describe the profile of Brazilian Advanced Maternal Age (AMA) women (> 35 years) according to parity, as well as to analyze the role of parity in the relationship between AMA and mode of delivery. Methods: this is a cross-sectional study, based on the “Nascer no Brasil” (Born in Brazil) survey. The data were collected in 2011/2012. The chi-square test was performed to verify the association between parity and maternal, prenatal and delivery characteristics, maternal habits, pre-pregnancy diseases, maternal complications and obstetric history. Results: of the 2,510 puerperal AMA women, 20.2% were nulliparous, 54.4% had one or two previous births and 25.4% had three or more previous births. The nulliparous women had higher schooling, higher economic class and adequate BMI, were white; and had better maternal habits when compared to multiparous. However, they were also more submitted to cesarean section, although without reported complications. Conclusions: one cannot speak of AMA pregnant women as a homogeneous group in Brazil. There are inequalities that can be revealed via parity, since nulliparous women have maternal characteristics, habits and access to prenatal care and childbirth that are more advantageous than multiparous women.

Author(s):  
Sianty Dewi ◽  
Ferry Ferry ◽  
Eddy Toynbee ◽  
Sandhy Prayudhana

Objective: Pregnancy in advanced maternal age (AMA) was classified as high risk. The study aims to provide a better description of pregnancy outcome in AMA. Method: The cross sectional study was to review the demography, medical and obstetrics problems, mode of delivery, maternal and fetal outcome in Tangerang General Hospital as a referral center in Banten. The data were taken from medical records of 35-year-old and above women age who delivered on the period of January to December 2014. Result: The total number of delivery and live birth was 6,107 and 5,926 respectively, including 1,548 (25.36%) pregnancies in AMA. The prevalence of grandmultiparities was 11.4%. The average education level was mostly elementary. The prevalence of hypertension in pregnancy was 34.6%. There was increasing trend of miscarriages from 10.8% in 35-40-year-old group to 25% in above 45- year-old group. Pregnancy complications were higher consisting of 3.2% multifetal, 16.6% malpresentation, and 7.1% placenta previa. Cesarean section rate was 33.6%. Maternal near-missed cases were 56 of 1000 and the maternal mortality rate (MMR) was 932 of 100,000 live births. The prevalence of stillbirth and perinatal mortality were 5.3% and 12.9%; respectively. Conclusion: Adverse maternal and fetal outcome were higher in AMA as it takes special attention and multidiscipline-approached care started from preconception, antenatal, preparation of delivery, and also postpartum care. Keywords: advanced maternal age (AMA), fetal outcome, maternal outcome, pregnancy


2021 ◽  
Vol 15 (7) ◽  
pp. 1513-1515
Author(s):  
Sabahat Gul ◽  
Sumaira Hassan ◽  
Urooj Fatima

Background: Umbilical Cord Knots both true and false are common abnormalities whichobstruct the blood flow and oxygen supply to the fetus and are frequently associated with advanced age and high parity of the mother. Aim: To find the frequency of true and falseumbilical cord knots in 100 samples of placentae (with attached umbilical cords ) and their relation to maternal age and parity. Study design: Descriptive cross sectional study. Place of study: Anatomy Department of (BMSI) Basic Medical Science Institute, JPMC Karachi. Methodology: 100 normal vaginally delivered full term placentae with attached umbilical cords were studied with direct Visual examination of the cords. The study included frequency, type and location of the knots and their relation with maternal age and parity. Data collected was analyzed by SPSS version 23 and presented in the form of tables and figures, cross tabulations of umbilical cord knots with age of mother and parity was done. Chi square test was used as test of significance asvariablesunder study are qualitative in nature. Results: This study showed that frequency of umbilical cord knots in 100 samples of placentae was 14% out of which 10(72%) were false knot and 4(28%) were true knot. Bothtrue and false knots were more frequent in male babies. There was statistically significant relation of knots with advanced maternal age (>30) and high parity (>5). Conclusion: Frequency of true umbilical cord knots is 4%. Most of knots are found in male babies and there is statistically significant relation of umbilical cord knots with advanced maternal age and high parity. Keywords: Umbilical cord, true knots, false knots, fetus.


Author(s):  
Aswathy S. ◽  
Lakshmi M. K.

The study was aimed to assess the breastfeeding practices among mothers of infants in Peringara Gramapanchayat in Kerala. Study was a community based cross-sectional study among mothers of infants in Peringara gramapanchayat using a pretested questionnaire. 142 breastfeeding mothers of infants in Peringara gramapanchayat were studied and mothers who were not present at home during the study were excluded from the study. Study period consisted of 18 days between December 2015 and January 2016. Study variables includes type of delivery, initiation of breastfeeding, breastfeeding practices and role of ASHAs in promoting good breastfeeding practices. Statistical analysis was done using Pearson’s Chi-square test and T test. The study found that exclusive breastfeeding has been done by 68.3% of mothers. There is no practice of giving pre-lacteal feed, 95.8% of mothers have given colostrum to the new born. Statistically significant association was found between the type of delivery and time of initiation of breastfeeding (p less than 0.05). Time of initiation of breastfeeding was prolonged in case of Caesarean section. 49.3% of mothers have breastfed the baby within one hour. 55.6% of mothers were informed about importance of breastfeeding by ASHAs and only 20.4% of mothers were informed about period of exclusive breastfeeding and period of complimentary feeding by ASHAs.


2021 ◽  
Vol 15 (1) ◽  
pp. 1-7
Author(s):  
Raheli Misiko Mukhwana ◽  
Margaret N Keraka ◽  
Meshack Onyambu

Introduction/Aims Focused antenatal care provides individualised counselling, targeted assessment and safe, cost effective, evidence-based intervention. It has been implemented in developing countries as a strategy to improve maternal health. This study aimed to investigate sociodemographic factors associated with maternal complications in selected public county hospitals in Nairobi City County, Kenya. Methods This was a cross-sectional study using a sample of 397 postnatal women who were given a questionnaire, with sections on their sociodemographic and health characteristics. Data analysis was done using the Chi Square test to determine the association between study variables, with P<0.05 considered statistically significant. Results The study found that 30% of respondents reported a maternal complication during their current delivery outcome. Sociodemographic factors significantly associated with maternal complications were age (P=0.002), occupation (P=0.001) and income (P=0.011). The health factors associated with occurrence of maternal complications were number of deliveries (P=0.001) and mode of delivery (P=0.001). Conclusions A number of factors were found to be significantly associated with maternal outcomes, including age and occupation. Further studies to determine why young women do not use focused antenatal care are necessary, as this would help reduce the incidence of birth-associated complications.


2020 ◽  
Vol 10 (3) ◽  
pp. 21-26
Author(s):  
Bashu Dev Pant ◽  
Anjana Rajbhandari ◽  
Resina Pradhan ◽  
Manju Bajracharya ◽  
Surendra Maharjan ◽  
...  

Introduction: Crowding in mandibular arch increases with increasing age and etiology of crowding is multifactorial in nature. Role of mandibular third molar in lower anterior crowding remains a topic of controvery over a period of century. The objective of this study was to assess whether there is any correlation between presence of mandibular third molar position and lower anterior crowding. Materials and Method: On the basis of third molar position one hundred and six sample of pretreatment orthodontic patients aged between 17 to 38 years were divided into erupted, erupting and agenesis group. The study was conducted in Peoples Dental College and Hospital from January 2020 to March 2020 after obtaining ethical approval from the institutional review committee. This cross-sectional study was done on dental casts and orthopantomogram; brass wire was used for measuring arch length and digital vernier caliper for measuring tooth material with modified segmental arch analysis method. Result: Among 106 samples collected 55 (51.88%) were female and 51(48.11%) were male and the mean age was 21.53 ± 3.91 years, Chi square and ANOVA test was used for Statistical analysis. This study showed no statistically significant differences between third molar position and lower anterior crowding on right (P= 0.68) and left side (P = 0.45). The study also showed that association between the third molar position and lower anterior crowding is more on left side compared to right side. Conclusion: Mandibular third molars have not statistically significant difference in lower anterior crowding so, extraction of third molars for relieving the anterior crowding is not justifiable


2017 ◽  
Vol 11 (2) ◽  
pp. 20-23
Author(s):  
Safiur Rahman Ansari ◽  
Gehanath Baral

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.


2020 ◽  
Vol 14 (3) ◽  
pp. 445-451
Author(s):  
Asnuddin Asnuddin ◽  
Asrini Mattrah

Social media use: The role of parents' perceptions about social media impact in early marriageBackground: Early marriage is a marriage that is conducted at adolescence, the factors causing early marriage are socio-cultural factors, economic pressure, level of education, difficulty in getting a job, social media, religion and views and beliefsPurpose: To find out the influence of social media and the role of parents on the incidence of early marriageMethod: A quantitative research using descriptive analytical research method with cross sectional study design with variable use of social media with the criteria for the results "active and inactive". For the variable of the role of parents with 2 outcome criteria, namely "influential and not influential". And for the variable incidence of early marriage, there are 2 criteria, namely age 14-16 years and age 17-19 years, the questionnaire used has been through the validity of previous researchers. Then the results of the data obtained were analyzed in the SPSS program using the Chi Square testResults: From the Chi Square test results for social media variables obtained p value = 0.001, then the value of p = 0.001 <0.05 (α) while the role of parents variable Chi Square test results obtained p value = 0.022, therefore the value of p = 0.022 <0.05 (α).Conclusion: Based on the results of the study it can be concluded that, there is a significant influence between the use of social media and the role of parents in the event of early marriage Keywords: Social media; Parents, Early marriagePendahuluan: Pernikahan usia dini adalah perkawinan yang dilakukan pada usia remaja, faktor penyebab pernikahan usia dini adalah faktor sosial budaya, desakan ekonomi, tingkat pendidikan, sulit mendapat pekerjaan, media sosial, agama serta pandangan dan kepercayaan.Tujuan: Untuk mengetahui pengaruh media sosial dan peran orang tua terhadap kejadian pernikahan dini di Kecamatan Marioriawa Kabupaten Soppeng Metode: Penelitian kuantitatif dengan menggunakan metode penelitian deskriptif analitik dengan rancangan cross sectional study dengan variabel penggunaan media sosial dengan kriteria hasil “aktif dan tidak aktif”. Untuk variabel peran orang tua dengan 2 kriteria hasil yaitu “berpengaruh dan tidak berpengaruh”. Dan untuk variabel kejadian pernikahan dini ada 2 kriteria  yaitu umur 14-16 tahun dan umur 17-19 tahun,  kuesioner yang di gunakan sudah melalui uji validitas peneliti sebelumnya. Kemudian hasil data yang di dapatkan dianalisis di program SPSS dengan menggunakan uji Chi SquareHasil: Dari hasil uji Chi Square untuk variabel media sosial didapatkan nilai p=0,001, maka nilai p=0.001<0.05 (α) sedangkan variabel peran orang tua hasil uji Chi Square didapatkan nilai p=0,022, oleh karena itu nilai p=0.022<0.05 (α).Simpulan: Berdasarkan hasil penelitian dapat di simpulkan bahwa, Ada pengaruh yang signifikan antara penggunaan media sosial dan peran orang tua terhadap kejadian pernikahan dini


2021 ◽  
pp. 205343452110616
Author(s):  
Budi Yanti ◽  
Nurdarlila Armita ◽  
Iskandar Zakaria

Introduction Health workers are at high risk of contracting the disease because they are at the forefront of assisting COVID19 patients. Globally, Indonesia has the worst death toll of health workers. Many previous studies have shown the differences in knowledge, attitudes, and behavior of health workers in handling with the COVID19 pandemic. This study aims to asses the role of knowledge, attitudes, and health workers' preparedness during the COVID-19 pandemic in Aceh Pidie Jaya District. Methods A cross-sectional study and the data were collected by distributing online questionnaires about knowledge, attitudes, behavior, and preparedness related to the COVID-19 at 12 Pidie Jaya District health centers. The knowledge, behavior, and preparedness parameters used Guttman and Likert scales to measure the workers' attitudes. Chi-square test was used to evaluate the relationship between knowledge, attitudes, behavior, and preparedness. Results In this study, 377 health workers were selected, the majority of respondents' education level was diploma, level 3 (257, 76.3%), and one-third of the respondents did not attend training. There are 197 (58.5%) respondents who had good knowledge, 177 (52.5%) positive attitudes, 283 (84%) good behavior, and 173 (51, 3%) well prepared. Furthermore, good knowledge, positive attitude, and good behavior had a significant correlation statistically with well prepared during the pandemic (p < 0.05). Discussion Most of the health workers in Aceh Pidie Jaya have good knowledge, positive attitudes, and good behavior that create adequate preparedness. Even though training is still very limited, educational attainment would remain the cornerstone for preparedness to encounter COVID-19.


2017 ◽  
Vol 34 (10) ◽  
pp. 0974-0981 ◽  
Author(s):  
Christina Gonzalez ◽  
Amanda Allshouse ◽  
Erick Henry ◽  
Sean Esplin ◽  
Torri Metz

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.


Author(s):  
Paras V. Dobariya ◽  
Parul T. Shah ◽  
Hina K. Ganatra

Background: Fetal, Neonatal and Maternal complications associated with pregnancy beyond 40 weeks have always been underestimated. However emerging evidence demonstrates that the incidence of complications increases after 40 weeks of gestation. The present study conducted to find out the fetomaternal outcome of such prolonged pregnancy.Methods: A prospective cross sectional study of 84 patients with uncomplicated prolonged pregnancy fulfilling the inclusion and exclusion criteria and admitted in department of obstetrics and gynecology at a tertiary care hospital. The aim of the study was to know fetomaternal outcome in pregnancy beyond 40 weeks in consideration of spontaneous and induced labour.Results: Out of 84 patients, 58 (69.05%) were in the age group of 20-30 years, 44 (52.38%) were between 41-42 weeks of gestation according to their LMP and 38(45.24%) were between 40-41 weeks of gestation. In 27 (32.14%) patients mode of delivery was caesarean section, in whom most common indication being fetal distress in 48.15% followed by failure to progress in 22.22%. In present study perinatal morbidity like IUFD, neonatal asphyxia, MAS, RDS were 4.76%, 9.52%, 7.14% and 3.57% respectively. Maternal morbidity like prolonged labor, PPH, fever, wound infection were 10.71%, 5.95%, 3.57% and 3.57% respectively.Conclusions: With Regular antenatal check-up, incidence of postdate pregnancy can be decreased and it is important because of definite risk to fetus as pregnancy continuing beyond 40 weeks of gestation is associated with increased perinatal morbidity and mortality especially those who do not come for regular antenatal check-up. Confirmation of diagnosis of exact term of pregnancy is very important as many patients don’t have regular menstrual history and LMP. Diagnosis can be confirmed by first trimester ultrasound which is most important non-invasive method and readily available.


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