scholarly journals Birth preparedness: studying its effectiveness in improving maternal health in urban slums of Jamnagar, Gujarat

Author(s):  
Neha A. Patel ◽  
J. P. Mehta ◽  
Sumit V. Unadkat ◽  
Sudha B. Yadav

Background: Maternal health and healthy outcome of a pregnancy are the core focus of all the programmes related to maternal and child health. Most of the causes of maternal morbidity and mortality are preventable. So we need to introduce new strategies according to the need of beneficiaries to reduce the underlying causes which ultimately lead to morbidities or complications during pregnancy. Birth preparedness is a kind of strategy which can help the mothers to plan out their pregnancy to combat the complications arising during pregnancy, childbirth or puerperium. The aims and objectives were to study the birth preparedness amongst the women, to study effect of various socio demographic determinants on birth preparedness and to find out relation between maternal morbidity and mortality with birth preparedness. Methods: Cross sectional study was conducted in Jamnagar. 450 women were selected by 30 cluster sampling. Data analysis was done with Microsoft office Excel and SPSS 20, Chi square test was applied. Results: 11.33% women were fully prepared, 67.33% were partially prepared while 96 women were not prepared at all. Education, place of delivery, parity and knowledge of danger signs has statistically significant association with birth preparedness in cases of both maternal mortalities, women were not at all prepared. Conclusions: Birth preparedness practices need to be improved. Education, parity, place of delivery, knowledge about danger signs are associated with birth preparedness practices. Birth preparedness can help in decreasing maternal morbidities and mortalities. 

2019 ◽  
Vol 2019 ◽  
pp. 1-9 ◽  
Author(s):  
Melash Belachew Asresie ◽  
Dereje Berhanu Abitew ◽  
Habtamu Wondiye Bekele ◽  
Tadesse Dagget Tesfaye

Background. Birth preparedness and complication readiness strategies aimed to promote the timely utilization of skilled maternal health care. Pregnant mother conference is viewed as one of the needed interventions to reduce delays, by promoting obstetric danger sign awareness, family support, and decision-making power on a choice of place of delivery and the use of maternal health service. Objective. To compare the effect of attending a pregnant mother conference on birth preparedness and complication readiness practice among recently delivered women. Method. A community-based comparative cross-sectional study was conducted from February 15 to March 26, 2017, among mothers who gave birth in the past 12 months. Multistage simple random sampling method was implemented and 896 participants were contacted through a face-to-face interview. Descriptive, binary, and multiple logistic regression analysis was done. Results. Well-preparedness for birth and its complication among women who attended and did not attend the pregnant mother conference were 38.9% and 25.7%, respectively. Among the mothers who did not attend the conference, those who had four or more antenatal care visits (AOR=6.8, 95%CI 1.6, 29.8) and knew two or more danger signs of pregnancy (AOR=4.7, 95%CI:1.4, 15.6) were more likely being well-prepared for birth and its complication readiness, whereas among mothers who attended the conference, those who knew two or more danger signs of pregnancy (AOR=2.1, 95%CI:1.1, 4.3), those who had discussion with partners/families about place of delivery (AOR=11.4, 95%CI:3.1, 42.2), those who had previous delivery at health facility (AOR=2.4, 95%CI:1.2, 4.8), women who lived within one-hour walk to the nearest health facility (AOR=3.6, 95%CI:1.9, 6.9), and age of women within 19-34 years (AOR=6.8, 95%CI:1.7, 26.6) were significantly associated with birth preparedness and its complication readiness. Conclusion. Birth preparedness and complication readiness practice were higher among pregnant mother conference attendant women as compared to nonattendants. The health facility has to ensure encouraging women to participate in pregnant mother conference, promoting the utilization of antenatal care service, and counselling on obstetric danger sign. Moreover, the concerned bodies should promote interventions targeting the predisposing and reinforcing behavioral factors affecting the practice of birth preparedness and its complication readiness.


2015 ◽  
Vol 4 (2) ◽  
Author(s):  
Yunike Veronika ◽  
Joserizal Resudji ◽  
Susila Sastri

AbstrakPreeklampsia dan eklampsia merupakan penyebab utama morbiditas dan mortalitas ibu dan bayi di dunia, dimana terjadi penurunan albumin serum (hipoalbuminemia) sehingga tekanan hipovolemik intravaskular berkurang. Tujuan penelitian ini adalah untuk mengetahui hubungan kadar albumin serum dengan morbiditas dan mortalitas maternal pasien preeklampsia berat dan eklampsia. Penelitian ini bersifat analitik observasional retrospektif dilakukan dengan desain cross sectional study. Populasi penelitian adalah seluruh data rekam medis pasien preeklampsia berat dan eklampsia di RSUP Dr. M. Djamil Padang periode Januari 2012 – Desember 2012. Sampel ditetapkan dengan teknik total sampling sehingga didapatkan sampel sebanyak 133 kasus. Pengolahan data dilakukan secara komputerisasi dan analisis dengan uji chi-square. Hasil penelitian menunjukkan angka kejadian morbiditas maternal adalah 33,8%, mortalitas maternal 3,8% dan 3,8% pasien dengan hipoalbuminemia. Dari hasil analisis, tidak terdapat hubungan yang bermakna antara kadar albumin serum dengan morbiditas dan mortalitas maternal pasien preeklampsia berat dan eklampsia, dimana nilai p=1 untuk hubungan kadar albumin serum dengan morbiditas maternal dan p=0,177 untuk hubungan kadar albumin serum dengan mortalitas maternal pasien preeklampsia berat dan eklampsia (p>0,05).Kata kunci: preeklampsia berat, eklampsia, albumin serum AbstractPreeclampsia and eclampsia are major causes of maternal and fetal morbidity and mortality in the world, in which serum albumin decreases (hypoalbuminemia) so hypovolemic intravascular pressure will be reduced. The objective of this study was to determine the relation between serum albumin levels and maternal morbidity and mortality of severe preeclampsia and eclampsia patients. A retrospective observational analytical research was conducted with a cross sectional study design. The study population was the entire medical records of severe preeclampsia and eclampsia patients in RSUP Dr. M. Djamil Padang, period January 2012 – December 2012. The sample was determined by total sampling technique which obtained a sample of 133 cases. Data processing was computerized and analyzed by chi-square test. The incidence of maternal morbidity was 33.8%, maternal mortality was 3.8%, and 3.8% patients were with hypoalbuminemia. The analysis result obtained there was no significant correlation between serum albumin levels and maternal morbidity and mortality of severe preeclampsia and eclampsia patients, in which p=1 for serum albumin levels correlation with maternal morbidity and p=0.177 for serum albumin levels correlation with maternal mortality of severe preeclampsia and eclampsia patients (p>0.05).Keywords: severe preeclampsia, eclampsia, serum albumin


Author(s):  
Alpana Jacob ◽  
Sunita Goyal ◽  
Tapasya Dhar

Background: Blood transfusion is an essential lifesaving component in obstetrics. Extra blood loss in pregnancy can occur due to various gestational disorders and complications during labour and delivery. Reduction in maternal morbidity and mortality has been observed by increased use of comprehensive emergency obstetrics care in which blood transfusion has achieved recognition as one of the important components. In a developing country like India, the need for well maintained and readily available blood and transfusion services becomes paramount to decrease maternal morbidity and mortality. We wanted to determine the clinical characteristics and indication of blood transfusion in obstetrics and also determine any adverse blood transfusion reaction.Methods: This cross-sectional study was conducted in the department of obstetrics and gynaecology, Christian medical college, Ludhiana for a period of eighteen months from 15th October 2018. The study group included all the antenatal and postnatal patients up to 6 weeks postpartum who were admitted in the obstetric unit, requiring blood or component transfusions. Clinical characteristics, indication of blood transfusion and any adverse blood transfusion reaction were recorded.Results: In our study, about 7.84% of obstetric admission required blood and blood components. Most common indication for blood transfusion was anaemia either during antenatal or during postnatal period (33.91%). Majority of the patients were unbooked antenatally (63.91%) and were multiparous (93.91%). 4 or more blood transfusions were given in 28.26% of cases.Conclusions: Blood transfusion is live saving measure in many obstetric patients. Blood transfusion is an essential component of emergency obstetric care and appropriate blood transfusion significantly reduces maternal mortality. Severe anaemia is the most common condition requiring blood transfusion, which may be chronic due to nutritional deficiency or following acute blood loss, followed by postpartum haemorrhage, placental abruption and placenta previa. Availability of transfusion facility and blood products in obstetric care setting in peripheral health centres can reduce need for referral of patients and indirectly reduce the maternal morbidity and mortality.


2019 ◽  
Vol 26 (05) ◽  
Author(s):  
Fehmida Parveen Memon ◽  
Majida Khan ◽  
Samya Aijaz

Objectives: To determine the thrombocytopenia as marker of maternal sepsis and its related maternal morbidity and mortality at tertiary care Hospital. Study Design: Cross-sectional study. Setting: Gynaecological and Obstetrical department of Liaquat University Hospital, Hyderabad. Period: 6 months from March 2017 to August 2017. Material and Methods: All the pregnant females with diagnosis of sepsis were enrolled in the study. All the females with chronic hepatitis were excluded. After complete clinical examination every women underwent 5cc blood sample for complete blood picture. Thrombocytopenia was characterized as a platelet count below 150.000/mm3. Data regarding maternal mortality and maternal complications was filled in the proforma. Results: Total 120 septic mothers were included in the study, 70 patients had thrombocytopenia and 50 were with normal platelets. Most of the women 71.7% were with age groups of 20-30 years. Out of total women 65.0% were un-booked. According to the maternal morbidity, septic shock was most common 36.7%, multi-organ failure was in 08.3%, prolonged Hospital stay was in 16.7%, ICU admission occurred in 18.3% patients, while renal failure, respiratory failure, hepatic failure, coagulopathy and metabolic acidosis were found with percentage of 09.2%, 02.5%, 10.8%, 10.8% and 03.3% respectively. Mortality rate was found among 8.3% out of total cases. Almost all complications were higher among women with thrombocytopenia as compare to women with normal platelets level, while statistically p-value was quite insignificant. Mortality was significantly high among patients with thrombocytopenia p-value 0.032. Conclusion: It was concluded that thrombocytopenia is a good marker for adverse outcome among septic mothers. Maternal morbidity and mortality was higher among septic women with thrombocytopenia.


BMJ Open ◽  
2019 ◽  
Vol 9 (9) ◽  
pp. e031882 ◽  
Author(s):  
Mi Young Kwak ◽  
Seung Mi Lee ◽  
Hyun Joo Kim ◽  
Sang Jun Eun ◽  
Won Mo Jang ◽  
...  

ObjectivesAccess to a delivery unit is a major factor in determining maternal morbidity and mortality. However, there is little information about the optimal access time to a delivery unit. This study aimed to establish the optimal hospital access time (OHAT) for pregnant women in South Korea.DesignNationwide cross-sectional study.SettingWe used the National Health Insurance System database of South Korea.ParticipantsWe analysed the data of 371 341 women who had experienced pregnancy in 2013.Primary and secondary outcome measuresAccess time to hospital was defined as the time required to travel from the patient’s home to the delivery unit. The incidence of obstetric complications was plotted against the access time to hospital. Change-point analysis was performed to identify the OHAT by determining a point wherein the incidence of obstetric complications changed significantly. As a final step, the risk of obstetric complications was compared by type among pregnant women who lived within the OHAT against those who lived outside the OHAT.ResultsThe OHAT associated with each adverse pregnancy outcomes were as follows: inadequate prenatal care, 41–50 min; preeclampsia, 51–60 min; placental abruption, 51–60 min; preterm delivery, 31–40 min; postpartum transfusion, 31–40 min; uterine artery embolisation, 31–40 min; admission to intensive care unit, 31–40 min; and caesarean hysterectomy, 31–40 min. Pregnant women who lived outside the OHAT had significantly higher risk for obstetric complications than those who lived within the OHAT.ConclusionsOur results showed that the OHAT for each obstetric complication ranged between 31 and 60 min. The Korean government should take the OHAT under consideration when establishing interventions for pregnant women who live outside OHAT to reduce maternal morbidity and mortality.


Author(s):  
Venkatramana K. Sonkar ◽  
Ismailali F. Inamdar ◽  
Rambhau D. Gadekar

Background: As signatory to United Nation’s Sustainable Development Goals, India is striving hard to achieve these goals by end of 2030, especially for goal number 3 with targets related to maternal and child health. Birth-preparedness and complication-readiness (BPCR) is a tool to promote maternal and neonatal survival. This study was conducted to assess the perception and practices of recently delivered women on BPCR with its correlates. Methods: Hospital-based cross-sectional study was conducted at Immuno-prophylaxis centre of Dr. Shankarrao Chavan Government Medical College, Nanded, Maharashtra. Women attending IPC along with their baby within two to four months of delivery for immunization of their babies during the month of March 2014 constituted study subject of this study. After obtaining informed consent, data was obtained on socio-demographic characters like age, caste, religion, education, parity, ANC registration and questions regarding birth preparedness and complications readiness in their last pregnancy. Results: Total 117 women found to be eligible as study subject. Overall BPCR index of the study population was 67.28. Proportion of women who received first antenatal check-up within first trimester, four or more antenatal checkups, saved money for childbirth and had institutional delivery were 87.18%, 86.32%, 51.28% and 100% respectively. Around 23.08% women had knowledge of at least 3 key danger signs of pregnancy while only 19.65% identified blood donor. Awareness regarding danger signs of pregnancy and arrangement for blood donor was found poor in comparison to other indicators in study subject.Conclusion: There is need of increasing awareness regarding BPCR so that perception and practices in the community increased.


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