scholarly journals A Case Report of Vaginal Delivery at Home Due to Fear of Covid-19

2020 ◽  
Author(s):  
Mahnaz Nosratabadi ◽  
Nasrin Sarabi ◽  
Leila Masoudiyekta
Keyword(s):  
Pregnant Women ◽  
Public Transportation ◽  
Medical Center ◽  
Home Delivery ◽  
Medical Intervention ◽  
Unintended Consequences ◽  
Public Places ◽  
Unsafe Condition ◽  
Protective Methods ◽  
At Home

Introduction: Childbirth can be a normal and nonintervention process, but sometimes the process gets out of normal and requires immediate medical intervention. Thus, home delivery cannot be considered safe without coordination with the treatment staff. Sometimes fear of Covid-19 epidemic prevents mothers to go to the hospital for childbirth and they decide to do it in an unsafe condition, which puts the health of the mother and the neonate at risk. Presentation Case: Our case was a pregnant woman  with a negative blood group (A-)  who did not come to the hospital because of fear of contracting Covid-19 from the hospital and decided to give birth at home without medical and midwifery support. After giving birth at home, she called the midwife who was taking care of her pregnancy. But she was still afraid to go to the medical center for postpartum care. The midwife informed the mother and her husband that they would be transferred to the midwifery clinic for further care and follow-up, with the necessary counseling and assurance of protective care to control Covid 19 transmission. Conclusion: Counseling and training of protective methods during pregnancy can reduce the concerns of pregnant women. It is also recommended that pregnant women avoid unnecessary travel, public places, use of public transportation and contact with sick people, and most importantly, observe personal and public health issues. Some pregnant women may experience severe anxiety and depression during epidemics such as Covid 19, which require educational psychological counseling and continuous psychological support to prevent unintended consequences.

scholarly journals 1462Second hand smoke exposure in pregnant women in Dehradun, Uttrakhand: A Cross Sectional Study

2021 ◽  
Vol 50 (Supplement_1) ◽  
Author(s):  
Twinkle Sharma
Keyword(s):  
Pregnant Women ◽  
Cross Sectional Study ◽  
Smoke Exposure ◽  
Second Hand Smoke ◽  
Sectional Study ◽  
Cross Sectional ◽  
Public Places ◽  
Inadequate Knowledge ◽  
Shs Exposure ◽  
At Home

Abstract Focus of Presentation Tobacco has always been a major public health issue. Being tobacco a major risk factor for so many diseases, it has also become a matter of concern in current situation of the pandemic. Tobacco smoking is not only harmful for the person who is actively smoking but also to ones who are in the vicinity of that smoke. There is plenty of evidence regarding harmful effects of both tobacco and inhaling tobacco smoke passively. This passive smoke is known as Second Hand Smoke. The aim of the study was to estimate percentage and sources of Second Hand Smoke exposure among pregnant women. It was a cross sectional study conducted among pregnant women registered at a Primary health centre. Findings Out of total participants, 62% were exposed to Second hand smoke. 33% participants were exposed to SHS at home only, 24% at public places only and 5 % were the one exposed both at home and public places. More than half (69%) of the participants were having inadequate knowledge about the harms caused by Second hand smoke Conclusions/Implications More than half of the participants were exposed to Second hand smoke. Inadequate knowledge among the participants about adverse effects of SHS exposure and insufficient Key messages Smoke-free homes should be promoted and health-care providers should ask pregnant women about their exposure to SHS and inform about the harms of SHS exposure during anti natal visits.

scholarly journals Place of Delivery among Antenatal Clinic Attendees at a Rural Community in North-Western Nigeria

2020 ◽  
pp. 365-374
Author(s):  
IU Takai ◽  
HG Ali ◽  
RA Attah ◽  
IA Yakasai
Keyword(s):  
Pregnant Women ◽  
General Hospital ◽  
Care Delivery ◽  
Short Interval ◽  
Antenatal Clinic ◽  
Home Delivery ◽  
Place Of Delivery ◽  
Birth Attendance ◽  
Socioeconomic And Demographic Factors ◽  
At Home

In developing countries, most deliveries take place without a skilled birth attendance. This lack of skilled birthattendance could be considered as one of the major factors contributing to maternal and neonatal morbidity and mortality. The use of facility-based delivery system helps to reduce various complications during childbirth, which may be affected by social and cultural norms among several other factors. This study was to assess the proportion of pregnant women delivering at home and the role of socioeconomic and demographic factors affecting the choice of place of delivery among pregnant women attending antenatal, postnatal and Immunization clinic at Rano General Hospital, Kano. This is a cross sectional study carried out between September 2018 to November 2018 among 310 pregnant women who had at least delivered once and are attending antenatal care, post-natal or immunization clinic at the General hospital in Rano local government area of Kano state within the study period. Data was collected using interviewer administered questionnaire which was interpreted to those participants who cannot understand English language. Data obtained was entered into excel spread sheet 2018 and subsequently analyzed using SPSS 2016 version 20. Multivariateregression methods were used for measuring the associations between socio-demographic variables and place of delivery. About 310 questionnaires were distributed of which 100% retrieval rate was achieved. A total of 281 (90.6%) received antenatal services at least once during their previous pregnancy among which 183 (59.03%) of them had home delivery. The respondents were between the ages of 18-37 years with the mean age of 24.9 ± 5.1 years. Minimum age of the respondents was 18 years, while the maximum age was 37 years. The main reasons for home delivery were, previous delivery was at home and complication free, short interval between onset of labor and delivery and also husband and mother in-law's decision. This study has shown that there is still high rate of home delivery among antenatal clinic attendees. This home delivery is usually preferred to hospital delivery by their husbands and mother in-laws as they consider it to be safe and more convenient. There is therefore need to educate women on early signs of labor and address the importance of health care delivery to prevent complications which may increase the maternal mortality rate.

Effects of Self-Service Blood Pressure Measurement in Outpatient Obstetrics Clinics on waiting time, satisfaction of pregnant women in a tertiary hospital: Cross-sectional Survey (Preprint)

2020 ◽  
Author(s):  
Wanhua Xie ◽  
Yunhe Gao ◽  
Weichi Tan
Keyword(s):  
Blood Pressure ◽  
Pregnant Women ◽  
Waiting Time ◽  
Pressure Measurement ◽  
Medical Center ◽  
Blood Pressure Measurement ◽  
Outpatient Service ◽  
The Self ◽  
Clinical Practices ◽  
Self Service

BACKGROUND In the conventional method, the blood pressure values of pregnant women were measured by nurses in the obstetrics outpatient clinics, and then were entered into the computer system.The pregnant women should wait for long time to complete this process.We hypothesized that the self-service blood pressure measurement by pregnant women could be a better option rather than measuring the blood pressure by nurses. OBJECTIVE This study aimed to analyze the effect of self-service blood pressure measurement in obstetrical outpatient clinic on waiting time, satisfaction of pregnant women and outpatient volume, and provide reference for the optimization of outpatient service processes. METHODS This was a cross-sectional study. The waiting time and satisfaction degree of pregnant women, as well as the outpatient volume in the Obstetrics Outpatient Clinic were compared on the use of self-service blood pressure measurement system with the conventional method. A total of 519 pregnant women in the obstetrics outpatient clinics of Guangzhou Women and Children’s Medical Center in China participated in the satisfaction survey. The sample means were compared with t-test. RESULTS Compared to wait a longer queue for blood pressure measured by nurses, after using the self-service blood pressure measurement system, the waiting time of pregnant women for blood pressure measurement was significantly reduced from (18.57±9.68) min to (2.39±1.96) min (P<0.001). In addition, the satisfaction degree of pregnant women was significantly increased (P<0.001), and the monthly outpatient volume was significantly increased (P=0.02,P<0.05). CONCLUSIONS This study showed that after implementation of self-service blood pressure measurement, the waiting time of the pregnant women for blood pressure measurement was decreased significantly, while the satisfactory degree and outpatient flow were increased significantly, improving the cost-effectiveness.Therefore, this method is worth to be popularized in clinical practices. Relevance to clinical practice: How to use medical intelligence in clinical practices, replace manual works by self-service devices to address the high outpatient flow, high work load of medical personnel, and improve the experience of patients in seeking medical services are the most concerned issues by both patients as well as hospital managers.This study demonstrated that the self-service blood pressure measurement as a promising strategy in clinical practices and provided reference for the optimization of outpatient service processes. CLINICALTRIAL This study was approved by the Ethics Committee of the Guangzhou Women and Children’s Medical Center (approval number:SFE-KL-46401; Supplementary file 4). All the pregnant women included in this study signed the informed consent form.

scholarly journals Risk factors associated with physician trainee concern over missed educational opportunities during the COVID-19 pandemic

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Sunny S. Lou ◽  
Charles W. Goss ◽  
Bradley A. Evanoff ◽  
Jennifer G. Duncan ◽  
Thomas Kannampallil
Keyword(s):  
Risk Factors ◽  
Clinical Education ◽  
Medical Center ◽  
Clinical Care ◽  
Academic Medical Center ◽  
Clinical Work ◽  
Educational Opportunities ◽  
Missed Opportunities ◽  
Physician Trainee ◽  
At Home

Abstract Background The COVID-19 pandemic resulted in a transformation of clinical care practices to protect both patients and providers. These changes led to a decrease in patient volume, impacting physician trainee education due to lost clinical and didactic opportunities. We measured the prevalence of trainee concern over missed educational opportunities and investigated the risk factors leading to such concerns. Methods All residents and fellows at a large academic medical center were invited to participate in a web-based survey in May of 2020. Participants responded to questions regarding demographic characteristics, specialty, primary assigned responsibility during the previous 2 weeks (clinical, education, or research), perceived concern over missed educational opportunities, and burnout. Multivariable logistic regression was used to assess the relationship between missed educational opportunities and the measured variables. Results 22% (301 of 1375) of the trainees completed the survey. 47% of the participants were concerned about missed educational opportunities. Trainees assigned to education at home had 2.85 [95%CI 1.33–6.45] greater odds of being concerned over missed educational opportunities as compared with trainees performing clinical work. Trainees performing research were not similarly affected [aOR = 0.96, 95%CI (0.47–1.93)]. Trainees in pathology or radiology had 2.51 [95%CI 1.16–5.68] greater odds of concern for missed educational opportunities as compared with medicine. Trainees with greater concern over missed opportunities were more likely to be experiencing burnout (p = 0.038). Conclusions Trainees in radiology or pathology and those assigned to education at home were more likely to be concerned about their missed educational opportunities. Residency programs should consider providing trainees with research or at home clinical opportunities as an alternative to self-study should future need for reduced clinical hours arise.

scholarly journals A behaviour change intervention to reduce home exposure to second hand smoke during pregnancy in India and Bangladesh: a theory and evidence-based approach to development

2021 ◽  
Vol 7 (1) ◽  
Author(s):  
Veena A. Satyanarayana ◽  
Cath Jackson ◽  
Kamran Siddiqi ◽  
Prabha S. Chandra ◽  
Rumana Huque ◽  
...  
Keyword(s):  
Pregnant Women ◽  
Behaviour Change ◽  
Delphi Survey ◽  
Behaviour Change Techniques ◽  
Evidence Based ◽  
Behaviour Change Intervention ◽  
Behaviour Change Interventions ◽  
Modified Delphi ◽  
Qualitative Interview Study ◽  
At Home

Abstract Background Home exposure to secondhand smoke (SHS) is highly prevalent amongst pregnant women in low- and middle-income countries like India and Bangladesh. The literature on the efficacy of behaviour change interventions to reduce home exposure to SHS in pregnancy is scarce. Methods We employed a theory and evidence-based approach to develop an intervention using pregnant women as agents of change for their husband’s smoking behaviours at home. A systematic review of SHS behaviour change interventions led us to focus on developing a multicomponent intervention and informed selection of behaviour change techniques (BCTs) for review in a modified Delphi survey. The modified Delphi survey provided expert consensus on the most effective BCTs in reducing home exposure to SHS. Finally, a qualitative interview study provided context and detailed understanding of knowledge, attitudes and practices around SHS. This insight informed the content and delivery of the proposed intervention components. Results The final intervention consisted of four components: a report on saliva cotinine levels of the pregnant woman, a picture booklet containing information about SHS and its impact on health as well strategies to negotiate a smoke-free home, a letter from the future baby to their father encouraging him to provide a smoke-free home, and automated voice reminder and motivational messages delivered to husbands on their mobile phone. Intervention delivery was in a single face-to-face session with a research assistant who explained the cotinine report, discussed key strategies for ensuring a smoke-free environment at home and practised with pregnant women how they would share the booklet and letter with their husband and supportive family members. Conclusion A theory and evidence-based approach informed the development of a multicomponent behaviour change intervention, described here. The acceptability and feasibility of the intervention which was subsequently tested in a pilot RCT in India and Bangladesh will be published later.

scholarly journals Inadequate Gestational Weight Gain and Exposure to Second-Hand Smoke during Pregnancy Increase the Risk of Low Birth Weight: A Cross-Sectional Study among Full-Term Infants

2021 ◽  
Vol 18 (3) ◽  
pp. 1068
Author(s):  
Muliana Edi ◽  
Yit Chin ◽  
Fui Woon ◽  
Geeta Appannah ◽  
Poh Lim ◽  
...  
Keyword(s):  
Weight Gain ◽  
Birth Weight ◽  
Pregnant Women ◽  
Medical Records ◽  
Cross Sectional Study ◽  
Second Hand Smoke ◽  
Sectional Study ◽  
Cross Sectional ◽  
Shs Exposure ◽  
At Home

Despite the advancement of the healthcare system, low birth weight (LBW) remains as one of the leading causes of under-five mortality. This cross-sectional study aimed to determine the prevalence of LBW and its associated factors among 483 third trimester pregnant women recruited from six selected public health clinics in the Federal Territory of Kuala Lumpur and the state of Selangor, Malaysia. Pregnant women were interviewed for information on socio-demographic characteristics, smoking behaviour, and second-hand smoke (SHS) exposure at home and in the workplace. Information on the obstetrical history and prenatal care visits history were retrieved from the maternal medical records, while infant’s birth outcomes were retrieved from infant medical records. The prevalence of LBW (<2.5 kg) in infants was 10.4%, with a mean birth weight of 3.0 [standard deviation (SD) 0.4] kg. Results from the multivariable logistic regression model showed that inadequate weight gained during pregnancy [odds ratio (OR) = 2.41, 95% confidence interval (CI) = 1.18–4.90] and exposure to SHS at home (OR = 1.92, 95% CI = 1.03–3.55) were significantly associated with LBW. In conclusion, pregnant women should monitor their rate of weight gain throughout pregnancy and avoid SHS exposure at home to reduce the risk of delivering LBW infants.

scholarly journals AB1010 CLINICAL SPECTRUM AND IMMUNE ANALYSIS OF PATIENTS WITH CRYOPYRIN-ASSOCIATED AUTOINFLAMMATORY SYNDROME IN TAIWAN

2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 1798.1-1798
Author(s):  
C. Y. Wu ◽  
P. S. Chu ◽  
H. Y. Yang
Keyword(s):  
Genetic Variants ◽  
Medical Center ◽  
Laboratory Data ◽  
Systemic Juvenile Idiopathic Arthritis ◽  
Medical Intervention ◽  
Stimulation Test ◽  
Autoinflammatory Diseases ◽  
Missense Mutations ◽  
Autoinflammatory Syndrome ◽  
Nlrp3 Gene

Background:Cryopyrin-associated periodic syndromes (CAPS) are emerging autoinflammatory diseases with available treatment. No reports have yet been reported from Taiwan.Objectives:We reviewed cases suspected with CAPS to identify its existence in Taiwan.Methods:Genomic DNA from one hundred and ten cases with symptom signs suggestive of CAPS(1) between 2016-2019 were sent for NLRP3 gene analysis. Clinical presentations, laboratory data, treatment regimens, as well as inflammasome activities were analyzed among those treated in a tertiary medical center in northern Taiwan.Results:Among the 110 cases sequenced, 16 of them were found to carry missense mutations within the NLRP3 gene. Fourteen cases harbored known pathogenic genetic variants (c.1316C>T; c.1574A>T; and c.907G>C) and two carried novel NLRP3 missense mutations (c.210G>A, c.1371G>T)(2) with unknown pathophysiological roles. Through chart review, chronic urticarial, systemic juvenile idiopathic arthritis, Behcet’s disease and refractory Kawasaki disease were most likely diagnosed before genetic analysis were arranged. As compared to chronic infantile neurological, cutaneous and articular syndrome (CINCA) and Muckle-Wells syndrome (MWS), familial cold autoinflammatory syndrome (FCAS) was the most frequently observed clinical presentation. Plasma serumamyloidA (SAA) and IL-1b were both significantly elevated among the cases diagnosed with CAPS as compared to the controls (p<0.05). IL-18, on the other hand, showed no significant differences between the groups. While the presence of LPS without ATP significantly increased the level of IL-1b in the PBMC stimulation test, IL-18 were significantly elevated in the confirmed CAPS with or without ATP upon LPS stimulation (all p<0.05). Caspase 1 activity were also tested positive among the cases with CAPS. Furthermore, we compared the immune profiles between those CAPS cases harboring pathogenic mutations with the 2 harboring unreported NLRP3 missense mutations and discovered that the PBMC stimulation test in cases with c.210G>A and c.1371G>T mutation did not differ from the healthy controls.Conclusion:The number of NLRP3 gene alterations among patients suspected with CAPS in Taiwan is not low. In order to identify potential patients for proper medical intervention in the future, physician awareness, genetic testing as well as functional analysis are important.References:[1]Kuemmerle-Deschner JB, Ozen S, Tyrrell PN, Kone-Paut I, Goldbach-Mansky R, Lachmann H, et al. Diagnostic criteria for cryopyrin-associated periodic syndrome (CAPS). Ann Rheum Dis. 2017;76(6):942-7.[2]Van Gijn ME, Ceccherini I, Shinar Y, Carbo EC, Slofstra M, Arostegui JI, et al. New workflow for classification of genetic variants’ pathogenicity applied to hereditary recurrent fevers by the International Study Group for Systemic Autoinflammatory Diseases (INSAID). J Med Genet. 2018;55(8):530-7Disclosure of Interests:Chao-Yi Wu Speakers bureau: Abbvie, Boehringer Ingelheim International GmbH, Nestle, Pi-Shuang Chu: None declared, Huang-Yu Yang: None declared

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