scholarly journals Estimating gestational age and its relation to the anthropometric status of newborns: a study comparing the Capurro and ultrasound methods with last menstrual period

2011 ◽  
Vol 11 (1) ◽  
pp. 51-60 ◽  
Author(s):  
Maria de Fátima Pussick Nunes ◽  
Sandra Maria Conceição Pinheiro ◽  
Fabíola Eloy da Rocha Medrado ◽  
Ana Marlúcia Oliveira Assis

OBJECTIVE: to assess the accuracy of the Capurro somatic and ultrasound methods, taking date of last menstruation as a reference point, for evaluating gestational age and anthropometric classification of term newborns. METHODS: a prevalence study was carried out involving 309 pregnant women and their term newborns, 92 of whom were small for gestational age and 217 appropriate sized for gestational age, at two public maternity hospitals in the Brazilian city of Salvador. The evaluation of the differences between the median gestational age according to the two methods was carried out using the non-parametric "Wilcoxon Signed-Rank Test." The accuracy of the methods for evaluating gestational age for the small for gestational age newborns was estimated by calculating the sensitivity, specificity, positive predictive value, negative predictive value and ROC (Receiver Operating Characteristic) curve. RESULTS: compared to ultrasound, the Capurro method overestimated the gestational age in newbornsof less than 39 weeks and underestimated it in older newborns. Ultrasound underestimated gestational agein newborns with more than 37 weeks. CONCLUSION: ultrasound was found to have greater sensitivity for prediction of small for age newborns (96.6%), while the Capurro method presented greater specificity (75.5%). The highest accuracy was obtained using ultrasound in the 41st gestational week (ROC=77.0%).

2016 ◽  
Vol 40 (3) ◽  
pp. 205-213 ◽  
Author(s):  
Rinat Gabbay-Benziv ◽  
Amir Aviram ◽  
Ron Bardin ◽  
Eran Ashwal ◽  
Nir Melamed ◽  
...  

Objective: To compare the accuracy of various sonographic estimated fetal weight (sEFW) formulas for the prediction of small for gestational age (SGA) neonates. Methods: A retrospective analysis of 6,126 fetal biometrical measurements performed within 3 days of delivery. SGA prediction was evaluated for various sEFW formulas by calculating the sensitivity, specificity, positive/negative predictive value (PPV/NPV), likelihood ratio (+LR/-LR), overall accuracy and area under the receiver operating characteristic curve (AUC). Systematic error, random error, proportion of estimates >10% of birth weights, actual and absolute weight differences were compared between SGA and non-SGA neonates. Results: Overall, 638 (10.4%) neonates were SGA. There was considerable variation among formulas in sensitivity (mean ± SD, 62 ± 14.4%; range, 32.4-91.2), PPV (72.5 ± 10.7%; 45.8-95.6) and +LR (24.2 ± 10.9; 7.2-57.3), mild variation in specificity (96.6 ± 2.7%; 87.4-99.4), NPV (94.6 ± 5.3%; 72.2-98.9) and -LR (0.4 ± 0.1; 0.1-0.7) and minimal variation in AUC (mean, 0.93; range, 0.91-0.93). The majority of formulas had a lower accuracy for the SGA neonates, with systematic error and random error ranging from -4.2 to 14.3% and from 8.4 to 12.9% for SGA, and from -8.7 to 16.1% and from 7.2 to 10.5% for non-SGA, respectively. Conclusion: sEFW formulas differ in their accuracy for SGA prediction. In our population, the most accurate formula for SGA prediction was Hadlock's formula utilizing femur length, abdominal and head circumference.


2019 ◽  
Vol 6 (3) ◽  
pp. 1247
Author(s):  
Satyamanasa Gayatri Vinay S. ◽  
Karthiga K. ◽  
Abhijeet Shrivastava

Background: The incidence of low birth weight babies continues to be high in India at about 30% in contrast to 5-7% in developed countries. Perinatal, neonatal and infant mortality as well as morbidity is associated with low birth weight (LBW) neonates of which, it is the Small for Gestational Age (SGA) neonates that are at increased risk. Henceforth, it becomes important to study the prevalence of SGA babies and to compare various anthropometric measurements among term neonates for assessing as to which of these could be taken as surrogate markers of small for gestational age babies.Methods: It was a cross sectional study conducted over a period of 2 years among 100 term neonates delivered in a private medical college in Puducherry, India.Results: The prevalence of low birth weight babies and small for gestational age was found to be 40% and 30% respectively. Using mid arm circumference as a predictor, the sensitivity, specificity, positive predictive value and negative predictive value of SGA was found to be 100%, 57.14%, 50% and 100% respectively. Using MAC/HC ratio as a predictor, the sensitivity, specificity, positive predictive value and negative predictive value was found to be 46.67%, 100%, 100% and 81.4% respectively.Conclusions: In predicting SGA babies, mid arm circumference has the highest sensitivity whereas MAC/HC ratio has the highest specificity followed by mid arm circumference. Present study concluded that mid arm circumference and ratio of MAC/HC are very helpful in identifying SGA neonates among term neonates.


Author(s):  
Katherine L. Grantz ◽  
Ana M. Ortega-Villa ◽  
Sarah J. Pugh ◽  
Alaina Bever ◽  
William Grobman ◽  
...  

Objective The objective of the study was to determine whether adding longitudinal measures of fundal height (FH) to the standard cross-sectional FH to trigger third trimester ultrasound estimated fetal weight (EFW) would improve small for gestational age (SGA) prediction. Study Design We developed a longitudinal FH calculator in a secondary analysis of a prospective cohort study of 1,939 nonobese pregnant women who underwent serial FH evaluations at 12 U.S. clinical sites. We evaluated cross-sectional FH measurement ≤ –3 cm at visit 3 (mean: 32.0 ± 1.6 weeks) versus the addition of longitudinal FH up to and including visit 3 to trigger an ultrasound to diagnose SGA defined as birthweight <10th percentile. If the FH cut points were not met, the SGA screen was classified as negative. If FH cut points were met and EFW was <10th percentile, the SGA screen was considered positive. If EFW was ≥10th percentile, the SGA screen was also considered negative. Sensitivity, specificity, and positive predictive value (PPV) and negative predictive value (NPV) were computed. Results In a comparison of methods, 5.8% of women were classified as at risk of SGA by both cross-sectional and longitudinal classification methods; cross-sectional FH identified an additional 4.0%, and longitudinal fundal height identified a separate, additional 4.5%.Using cross-sectional FH as an ultrasound trigger, EFW had a PPV and NPV for SGA of 69 and 92%, respectively. After adding longitudinal FH, PPV increased to 74%, whereas NPV of 92% remained unchanged; however, the number of women who underwent triggered EFW decreased from 9.7 to 5.7%. Conclusion An innovative approach for calculating longitudinal FH to the standard cross-sectional FH improved identification of SGA birthweight, while simultaneously reducing the number of triggered ultrasounds. As an essentially free-of-charge screening test, our novel method has potential to decrease costs as well as perinatal morbidity and mortality (through better prediction of SGA). Key Points


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Nouf Abutheraa ◽  
June Grant ◽  
Alexander B. Mullen

Abstract Background This study aimed to assess the predictive power of three different Sepsis Scoring Systems (SSSs), namely maternity Systematic Inflammatory Response Syndrome (mSIRS), quick Sepsis-related Organ Failure Assessment (qSOFA) and Modified Early Warning System (MEWS) in identifying sepsis by comparing them with positive culture. This study also sought to evaluate compliance with using the Sepsis Six Care Bundle (SSCB) operated in an individual health board. Methods A retrospective cohort study was conducted in 3 maternity hospitals of a single Scottish health board that admitted 2690 pregnancies in a 12 weeks period in 2016. Data for study was obtained from medical notes, handheld and electronic health records for women who were prescribed antibiotics with a confirmed or suspected diagnosis of sepsis. Data on clinical parameters was used to classify women according to mSIRS, qSOFA and MEWS as having sepsis or not and this was compared to results of positive culture to obtain sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) and area under Receiver Operating Characteristic curve (AUROC) along with their 95% confidence intervals. Data was also obtained on SSCB compliance. Results A total of 89 women were diagnosed with sepsis, of which 14 had missing data, leaving 75 for final analysis. Sensitivity, specificity, PPV, NPV and AUROC of mSIRS and MEWS were almost similar with AUROC of both being around 50%. Only 33 (37.1%) had identifiable sepsis six sticker displayed on medical notes and only 2 (2.2%) had all elements of SSCB delivered within the recommended one-hour post-diagnosis period. Blood culture and full blood count with other lab tests had been performed for most women (97%) followed by intravenous antibiotics and fluids (93.9%). Conclusions mSIRS and MEWS were quite similar in detecting sepsis when compared to positive culture, with their ability to detect sepsis being close to chance. This underlines the need for creating a valid SSS with high sensitivity and specificity for clinical use in obstetric settings. Clinical use of SSCB was limited despite it being a health board policy, although there is considerable possibility of improvement following detailed audits and removal of barriers for implementing SSCB.


2020 ◽  
Vol 33 (1) ◽  
pp. 15
Author(s):  
Bárbara Marques ◽  
Rosa Martins ◽  
Teresa Rodrigues ◽  
Graça Oliveira ◽  
Margarida Abrantes

Introduction: Birth weight is a major contributor to neonatal morbidity and mortality and is associated with chronic diseases in adulthood. This study aimed to evaluate the use of Intergrowth 21st instead of the Fenton & Kim 2013 growth charts in the diagnosis of small and large for gestational age in a group of Portuguese newborns.Material and Methods: We conducted an analytical and retrospective study to evaluate birth weight of term and preterm newborns using both growth charts. Groups studied: ‘Term-weeks’ and ‘Term-days’ (term newborns with gestational age in weeks and days, respectively), ‘Preterm-weeks’ and ‘Preterm-days’ (preterm newborns with gestational age in weeks and days, respectively).Results: A total of 14 056 newborns were included, 6% preterm. Using the Intergrowth 21st growth charts, the groups ‘Term-weeks’ (n = 12 081), ‘Term-days’ (n = 1118), ‘Preterm-weeks’ (n = 617) and ‘Preterm-days’ (n = 240), classified as small for gestational age according to the Fenton & Kim 2013 growth charts were adequate for gestational age in 52.8%, 57.8%, 37.7% and 9.3% respectively; and 9.2%, 9.2%, 5.9% and 0.6% of adequate for gestational age newborns were large for gestational age, respectively. In the ‘Pretermdays’ group, 7.9% of adequate for gestational age newborns were small for gestational age and 22.2% of large for gestational age newborns were adequate for gestational age, all with gestational age below 231 days.Discussion: The use of the Intergrowth 21st growth charts in this sample resulted in a lower number of newborns being classified as small for gestational age, except in very preterm newborns.Conclusion: Considering the results obtained, we suggest that Portuguese maternity hospitals use the Intergrowth 21st instead of the Fenton & Kim 2013 growth charts. However, more studies are needed to confirm these results.


2019 ◽  
Vol 3 (1) ◽  
pp. 25
Author(s):  
Dewi Nurhanifah ◽  
Desy Noor Latifah Sari ◽  
Rahmawati Rahmawati

Salah satu masalah kesehatan yang sering dialami adalah penyakit gastritis. Gejala yang sering dikeluhkan oleh penderita gastritis adalah mual. Salah satu penatalaksanaan keperawatan yang dapat mengurangi rasa mual adalah tirah baring. Penelitian ini bertujuan untuk mengetahui pengaruh tirah baring terhadap penurunan rasa mual pada klien gastritis di Pelayanan Kesehatan. Metode penelitian menggunakan eksperimental dengan bentuk penelitian one group pretest-posttest design. Populasi dan sampel adalah klien yang mengalami mual di Wilayah Kerja Puskesmas  yang berjumlah 15 orang. Sampel diambil dengan teknik purposive sampling. Alat pengumpul data menggunakan observasi. Analisa data melalui uji Wilcoxon Signed Rank Test. Hasil penelitian menujukkan klien gastritis sebelum tirah baring mengalami mual ringan sebanyak 7 orang (46,7%), sesudah tirah baring mengalami tidak mual sebanyak 7 orang (46,7%). Ada pengaruh tirah baring terhadap penurunan rasa mual pada klien gastritis di Pelayanan Kesehatan (ρ value = 0,001).


2017 ◽  
Vol 5 (1) ◽  
Author(s):  
Ferawato Ferawati

ABSTRAKReumatoid Artritis (RA) merupakan penyakit muscoloskelektal yang sering terjadi pada usia lanjut. Gangguan pada system muscoloskelektal yang ditandai dengan munculnya nyeri sendi dan kekakuan yang mengakibatkan penurunan kemampuan fisiologis atau kualitas hidup lansia. Dampak dari Reumatoid Artritis dapat menimbulkan beberapa keluhan dan dapat menyebabkan kelumpuhan. Untuk menganalisis efektifitas kompres jahe merah hangat dan kompres serai hangat terhadap penurunan intensitas nyeri artitris remauthoid pada lanjut usia.Metode Penelitian: Jenis penelitian adalah quasy experimental dengan two group pre – post test design. Subjek adalah sebagian lansia yang penderita Arthritis Remathoid di Desa Sumberagung Kecamatan Dander Kabupaten Bojonegoro. Subjek dibagi menjadi dua kelompok yaitu kelompok I (n=15) diberi perlakuan kompres jahe hangat dan II (n=15) diberi perlakuan kompres serai hangat. Analisis yang digunakan uji Mann Whitney U Test dan Wilcoxon Signed Ranks Test dengan ingkat kemaknaan α = 0,05.Hasil uji Wilcoxon Signed Rank Test, didapat keduanya mempunyai nilai kemaknaan yaitu ρ value = 0,000. Nilai ρ = 0,031 pada kelompok kompres serai hangat dan kelompok kompres jahe merah ρ value = 0,165. Hasil uji Mann Withney U Test pada Post perlakuan kedua terapi diperoleh selisih nilai nyeri pada kompres jahe ρ= 0,003 dan selisih nilai nyeri kompres serai ρ value = 0,001.Penggunaan kompres jahe merah lebih efektif dibandingkan dengan kompres serai terhadap penurunan intensitas nyeri arthritis remathoid. Kata Kunci: usia lanjut, Reumatoid Artritis (RA), jahe merah, serai, perbedaan efektifitas.    ABSTRACTReumatoid Artritis (RA) is a musculoskeletal which frequently occurs in the elderly. The disorders in the musculoskeletal system are noted by the occurrence of pain in the joints and stiffness which reduces the physiological abilities or life quality of the elderly. The disease causes many such complaints and  consequences of the disease rheumatoid arthritis may experience paralysis. The aims of this study is to analyze the effect of warm red ginger compress therapy and warm lemongrass compress therapy against of  Decreased pain intensity in  the elderly  with  artitris remauthoid. The study was Queasy experimental with two group pre – post test design. Subjects were some elderly people with Arthritis Remathoid in Sumberagung Village, Dander Sub District, Bojonegoro District. Subjects were divided into two groups: group I (n-15) with warm ginger compress therapy, and II (n=15) with warm lemongrass compress therapy. The analyses used in this study were the Mann Whitney U Test and Wilcoxon Signed Ranks Test with α of 0.05. Results of Wilcoxon Signed Rank Test obtained Both have meaning p value of  0.000. ρ value = 0,031 in a warm lemongrass compress therapy group and obtained of warm ginger compress therapy group ρ value = 0,165. The results of Mann Withney U Test on Post treatment second therapy, obtained difference of warm ginger compress therapy with ρ value= 0,003 and difference of warm lemongrass compress therapy with ρ value = 0,001.The use of warm ginger compresses therapy are more effective than a warm lemongrass compress therapy against decreased pain intensity in  the elderly  with  artitris remauthoid.  Keywords: elderly, artitris remauthoid, red ginger, lemongrass, differences in effectiveness


Author(s):  
I Ketut Widana

The working practice of the engineering students is part of the learning process that is irreducible and indispensable. The composition of  lecturing between theoretical and practical one is 40% to 60%. With this condition, the students spend more time at the laboratory. Generally, the students perform in the laboratory work by standing position. The design of research is observational cross-sectional. The method applied is observation, interview and measuring. The subjects of research are practicing students amounting to 21 students. Referring to the analysis of statistical test or Wilcoxon signed ranks test, the difference of effect of work position is significant, namely p < 0.05 towards musculoskeletal disorders (MSDs) before and after working. The quantity of the average complaint after working is score 44.62 ± 9.47. The result of Wilcoxon signed rank test shows that there is significant different effects of standing work position, namely p < 0.05 towards fatigue generally before and after working. The degree of the working pulse is on the average of 110.78  ± 17.80 bpm (beats per minutes) which can be categorized into the medium workload. Using paired t-test, the result is p < 0.05.


2010 ◽  
Vol 1 (1) ◽  
Author(s):  
Sri Sumaryani ◽  
Indri Nurasa

PENGARUH PEMBACAAN DZIKIR PADA IBU MELAHIRKAN TERHADAP TINGKAT NYERI INTRA NATAL DI RUMAH BERSALIN FAJAR YOGYAKARTAEffect of Reading Dhikr Women On The Level Of Birth Pain Intra Christmas At Home Delivery Dawn YogyakartaSri Sumaryani1 & Indri Nurasa21, 2)Program Studi Ilmu Keperawatan Fakultas Kedokteran Universitas Muhammadiyah YogyakartaJl. Lingkar Barat Taman Tirto Kasihan Bantul Yogyakarta 55182*)e-mail: [email protected] atau yang biasa disebut dengan proses persalinan merupakan suatu proses membuka dan menipisnya serviks, dan janin turun ke dalam jalan lahir. Gejala awal persalinan akan menimbulkan nyeri yang sangat hebat karena adanya kontraksi uterus dan otot abdomen. Nyeri intra natal adalah suatu nyeri yang dirasakan saat terjadinya proses persalinan (melahirkan). Saat nyeri persalinan muncul, ada baiknya bagi ibu untuk membaca dzikir. Dzikir adalah mengingat Allah SWT dan menghadirkan apa yang tadinya ada di dalam benak untuk kemudian dilafadzkan atau disebut-sebut yang dapat dilakukan secara lisan dengan menggunakan lidah atau bisa juga diucapkan tanpa adanya keterlibatan lidah, yaitu melalui hati. Penelitian ini bertujuan untuk mengetahui pengaruh pembacaan dzikir pada ibu melahirkan terhadap tingkat nyeri intra natal. Teknik pengambilan sampel menggunakan purposive sampling. Desain penelitian pra eksperimen, dengan rancangan pre test-post test tanpa kelompok kontrol. Sampel penelitian berjumlah 30 responden. Pengumpulan data dilakukan dengan observasi langsung kepada responden untuk mengukur tingkat nyeri. Analisa data menggunakan uji statistik wilcoxon signed rank test dan regresi linier dengan menggunakan SPSS 14. Hasil penelitian menunjukkan bahwa hasil uji statistik untuk nilai pre test dan post test tingkat nyeri diperoleh nilai signifikansi 0,02 dengan p < 0,05.Kata kunci: pembacaan dzikir, melahirkan, nyeri intra natal, tingkat nyeriABSTRACTThe delivery or usually called labor process is a process open and thin the cervix, and descent of the fetus into the way of birth. The early symptom of delivery will be appearing very heavy because there are uterus contraction and abdomen muscle. In partum pain is a pain which feel when delivery process happening (labor). When labor pain appears, there is a good for the mother to read dzikir. Dzikir is remembering Allah SWT and make present what before in the mind and then pronounced or make cal can do spoken by tongue or pronounced without there are involving tongue, by heart. The purpose of this research is to know about the influence of reading dzikir to the delivery mother toward in partum level of pain. Technique sampling used purpose sampling. The research of design pre experiment, with pre test-post test without control group design. The sample in this research’s total is 30 respondents. The manner of data was did by direct observation to the respondents to measure pain level. Data analysis used statistic test wilcoxon signed rank test and regression linier in SPSS 14. The results of research showed that results of the statistic pretest and posttest of pain level show significance value 0,02 with p < 0,05.Keywords: reading dzikir, delivery, in partum pain, pain level


2021 ◽  
Vol 10 (9) ◽  
pp. 1905
Author(s):  
Cristina Peris-Martínez ◽  
María Amparo Díez-Ajenjo ◽  
María Carmen García-Domene ◽  
María Dolores Pinazo-Durán ◽  
María José Luque-Cobija ◽  
...  

(1) Purpose: To assess the main corneal response differences between normal and subclinical keratoconus (SCKC) with a Corvis® ST device. (2) Material and Methods: We selected 183 eyes of normal patients, of a mean age of 33 ± 9 years and 16 eyes of patients with SCKC of a similar mean age. We measured best corrected visual acuity (BCVA) and corneal topography with a Pentacam HD device to select the SCKC group. Biomechanical measurements were performed using the Corvis® ST device. We carried out a non-parametric analysis of the data with SPSS software (Wilcoxon signed rank-test). (3) Results: We found statistically significant differences between the control and SCKC groups in some corneal biomechanical parameters: first and second applanation time (p = 0.05 and p = 0.02), maximum deformation amplitude (p = 0.016), highest concavity radius (p = 0.007), and second applanation length and corneal velocity ((p = 0.039 and p = 0.016). (4) Conclusions: Our results show that the use of normalised biomechanical parameters provided by noncontact tonometry, combined with a discriminant function theory, is a useful tool for detecting subclinical keratoconus.


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