scholarly journals Discrimination by parity is a prerequisite for assessing induction of labour outcome – cross-sectional study

2020 ◽  
Author(s):  
Branko Denona ◽  
Michael Foley ◽  
Rhona Mahony ◽  
Michael Robson

Abstract Background: To demonstrate that studies on induction of labour should be analyzed by parity as there is a significant difference in the labour outcome among induced nulliparous and multiparous women Methods: Obstetric outcome, specifically caesarean section rates, among induced term nulliparous and multiparous women without a previous caesarean section were analyzed in this cross-sectional study [BD1] using the Robson 10 group classification2 for the year 2016.Results: In the total number of 8851 women delivered in 2016[BD2] , the caesarean section rates among nulliparous women in spontaneous and induced labour, Robson groups 1 and 2A, were 7.8% (151/1925) and 32.6% (437/1339) respectively and among multiparous (excluding those women with a previous caesarean section), Robson group 3 and 4A were 1%(24/2389) and 4.4% (44/1005), respectively. Pre labour caesarean rates for nulliparous and multiparous women, Robson groups 2B and 4B2 were 3.9% (133/3397) and 2.8% (100/3494), of the respective single cephalic cohort at term.Conclusion: The data suggests that studies on induction of labour should be analyzed by parity as there is a significant difference between nulliparous and multiparous women.

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Branko Denona ◽  
Michael Foley ◽  
Rhona Mahony ◽  
Michael Robson

Abstract Background To demonstrate that studies on induction of labour should be analyzed by parity as there is a significant difference in the labour outcome among induced nulliparous and multiparous women. Methods Obstetric outcome, specifically caesarean section rates, among induced term nulliparous and multiparous women without a previous caesarean section were analyzed in this cross-sectional study using the Robson 10 group classification for the year 2016. Results In the total number of 8851 women delivered in 2016, the caesarean section rates among nulliparous women in spontaneous and induced labour, Robson groups 1 and 2A, were 7.84% (151/1925) and 32.63% (437/1339) respectively and among multiparous (excluding those women with a previous caesarean section), Robson group 3 and 4A were 1%(24/2389) and 4.37% (44/1005), respectively. Pre labour caesarean rates for nulliparous and multiparous women, Robson groups 2B and 4B (Robson M, Fetal Matern Med Rev, 12; 23–39, 2001) were 3.91% (133/3397) and 2.86% (100/3494), of the respective single cephalic cohort at term. Conclusion The data suggests that studies on induction of labour should be analyzed by parity as there is a significant difference between nulliparous and multiparous women.


2019 ◽  
Author(s):  
Branko Denona ◽  
Michael Foley ◽  
Rhona Mahony ◽  
Michael Robson

Abstract Objective: To demonstrate that studies on induction of labour should be analyzed by parity as there is a significant difference in the labour outcome among induced nulliparous and multiparous women Methods: Obstetric outcome, specifically caesarean section rates, among induced term nulliparous and multiparous women without a previous caesarean section were analyzed using the Robson 10 group classification 2 for the year 2016. Results: The caesarean rates among nulliparous women in spontaneous and induced labour, Robson groups 1 and 2A, were 7.8% (151/1925) and 32.6% (437/1339) respectively and among multiparous (excluding those women with a previous caesarean section), Robson group 3 and 4A were 1%(24/2389) and 4.4% (44/1005), respectively. Pre labour caesarean rates for nulliparous and multiparous women, Robson groups 2B and 4B 2 were 3.9% (133/3397) and 2.8% (100/3494), of the respective single cephalic cohort at term. Conclusion: The data strongly suggests that studies on induction of labour should be analyzed by parity and should probably be confined to nulliparous women.


2015 ◽  
Vol 43 (2) ◽  
Author(s):  
Mechthild M. Gross ◽  
Andrea Matterne ◽  
Silvia Berlage ◽  
Annette Kaiser ◽  
Nicholas Lack ◽  
...  

AbstractRegional and interinstitutional variations have been recognized in the increasing incidence of caesarean section. Modes of birth after previous caesarean section vary widely, ranging from elective repeat caesarean section (ERCS) and unplanned repeat caesarean section (URCS) after trial of labour to vaginal birth after caesarean section (VBAC). This study describes interinstitutional variations in mode of birth after previous caesarean section in relation to regional indicators in Germany.A cross-sectional study using the birth registers of six maternity units (n=12,060) in five different German states (n=370,209). Indicators were tested by χThe percentages of women in the six units with previous caesarean section ranged from 11.9% to 15.9% (P=0.002). VBAC was planned for 36.0% to 49.8% (P=0.003) of these women, but actually completed in only 26.2% to 32.8% (P=0.66). Depending on the indicator, the units studied deviated from the regional data by up to 32% [relative risk 0.68 (0.47–0.97)] in respect of completed VBAC among all initiated VBAC.There is substantial interinstitutional variation in mode of birth following previous caesarean section. This variation is in addition to regional patterns.


2020 ◽  
Author(s):  
Victoria Bam ◽  
Alberta Yemotsoo Lomotey ◽  
Abigail Kusi-Amponsah Diji ◽  
Hayford Isaac Budu ◽  
Dorothy Bamfo-Ennin ◽  
...  

Abstract Background Elective caesarean section rates are on the rise and socioeconomic status, perceptions of safety, cultural and social influences are contributory factors. Inspite of the benefits of medically-indicated caesarean section, some women refuse this due to a complexity of factors. This study aimed at determining the factors that influence women to accept medically-indicated caesarean section in a district hospital in Ghana.MethodsA descriptive cross-sectional study was conducted among 163 purposively-sampled postnatal women in a hospital. A questionnaire was used for data collection after the women gave their consent to participate. Data was analyzed using SPSS version 25.0, Chi-square test was done to determine the association between the factors that facilitated respondents’ acceptance of caesarean section and the duration of decision-making. ResultsMajor factors influencing their decision-making process were support from their husbands/relatives (39.3%), their baby’s life being at risk (24.5%), history of previous caesarean section and knowledge about the procedure (19.6%). Age (R2 = 0.19, p< 0.001); previous caesarean section (R2 = 0.14, p<0.001) are the major predictors of the duration of the decision-making process.ConclusionMost women will make decisions to accept elective caesarean section within a week’s duration based on consultation with relatives. There is the need to involve relatives during the antenatal care period in order for younger women in particular to be readily supported to make the decision early to avoid any complications and allay their fears.


Author(s):  
Mercè Balasch-Bernat ◽  
Sofía Pérez-Alenda ◽  
Juan J. Carrasco ◽  
Begoña Valls-Donderis ◽  
Lirios Dueñas ◽  
...  

Widening of the inter-rectus distance (IRD) is highly prevalent among postpartum women and can lead to dysfunction of abdominopelvic muscles. The aim of this study was to evaluate the differences in IRD and abdominopelvic function between nulliparous, primiparous and multiparous women. A cross-sectional study was conducted on 75 women (25 nulliparous, 25 primiparous and 25 multiparous at 6 months postpartum). The participants underwent ultrasound assessment under three conditions (at rest, abdominal draw-in maneuver (ADIM) and curl-up) at two locations (2 cm above and 2 cm below the umbilicus). Furthermore, abdominopelvic muscle function was determined by prone, supine and side bridge tests. In all conditions and locations, the IRD were significantly higher (p < 0.05) in the primiparous and multiparous women than in the nulliparous. The multiparous women presented greater (p > 0.05) IRD at rest and during ADIM compared to the primiparous women. Regarding abdominopelvic muscle function, differences were only significant (p < 0.05) between the nulliparous with primiparous women in prone and supine conditions. These findings suggest that parity influences IRD: women at 6 months postpartum present greater IRD compared to nulliparous women; multiparous women present greater IRD at rest and during the activation of deep abdominal muscles than primiparous women; and primiparous women exhibit worse abdominopelvic muscle function than nulliparous women.


2020 ◽  
Vol 15 (1) ◽  
pp. 68-71
Author(s):  
Madhu Shrestha ◽  
Shanti Shrestha

Aim: To determine the incidence and indication of caesarean section. Method: It is a retrospective cross sectional study conducted at Paropakar Maternity and Women’s Hospital for three months. The data was retrieved from the medical record of operation theatre. Results: During the study period, 31.1% (1,592 out of 5,120) of women underwent caesarean section. Eighty eight percent (n-1,402) of them were emergency caesarean section while 12 % were elective (n-190). Majority of the women (70.3%) belonged to 20-29 years and half of them were primigravida. Around 89.2% caesarean sections were performed at 37-42 weeks of gestation. The four leading indications were fetal distress (31.5%), previous caesarean section (19.7%), cephalo -pelvic disproportion (13.4%) and abnormal presentation (7.9%). Conclusions: In this study, incidence of caesarean section is more than WHO recommendation. It may be mainly due to the referral of complicated cases from the periphery of the country. Key words: caesarean section, indication


BMJ Open ◽  
2021 ◽  
Vol 11 (6) ◽  
pp. e046265
Author(s):  
Shotaro Doki ◽  
Shinichiro Sasahara ◽  
Daisuke Hori ◽  
Yuichi Oi ◽  
Tsukasa Takahashi ◽  
...  

ObjectivesPsychological distress is a worldwide problem and a serious problem that needs to be addressed in the field of occupational health. This study aimed to use artificial intelligence (AI) to predict psychological distress among workers using sociodemographic, lifestyle and sleep factors, not subjective information such as mood and emotion, and to examine the performance of the AI models through a comparison with psychiatrists.DesignCross-sectional study.SettingWe conducted a survey on psychological distress and living conditions among workers. An AI model for predicting psychological distress was created and then the results were compared in terms of accuracy with predictions made by psychiatrists.ParticipantsAn AI model of the neural network and six psychiatrists.Primary outcomeThe accuracies of the AI model and psychiatrists for predicting psychological distress.MethodsIn total, data from 7251 workers were analysed to predict moderate and severe psychological distress. An AI model of the neural network was created and accuracy, sensitivity and specificity were calculated. Six psychiatrists used the same data as the AI model to predict psychological distress and conduct a comparison with the AI model.ResultsThe accuracies of the AI model and psychiatrists for predicting moderate psychological distress were 65.2% and 64.4%, respectively, showing no significant difference. The accuracies of the AI model and psychiatrists for predicting severe psychological distress were 89.9% and 85.5%, respectively, indicating that the AI model had significantly higher accuracy.ConclusionsA machine learning model was successfully developed to screen workers with depressed mood. The explanatory variables used for the predictions did not directly ask about mood. Therefore, this newly developed model appears to be able to predict psychological distress among workers easily, regardless of their subjective views.


BMJ Open ◽  
2021 ◽  
Vol 11 (3) ◽  
pp. e043814
Author(s):  
Mesfin Tadese ◽  
Andargachew Kassa ◽  
Abebaw Abeje Muluneh ◽  
Girma Altaye

ObjectivesThe study aimed to provide an association between dysmenorrhoea and academic performance among university students in Ethiopia. Further, the study attempts to determine the prevalence and associated risk factors of dysmenorrhoea.Design and methodInstitution-based cross-sectional study was conducted from 1 April to 28 April 2019. A semistructured and pretested self-administered questionnaire was used to collect data. Binary logistic regression analysis and one-way analysis of variance were performed to model dysmenorrhoea and academic performance, respectively.Setting and participantsEthiopia (2019: n=647 female university students).OutcomesThe primary outcome is dysmenorrhoea, which has been defined as painful menses that prevents normal activity and requires medication. The self-reported cumulative grade point average of students was used as a proxy measure of academic performance, which is the secondary outcome.ResultsThe prevalence of dysmenorrhoea was 317 (51.5%). The educational status of father (adjusted OR (AOR) (95% CI) 2.64 (1.04 to 6.66)), chocolate consumption (AOR (95% CI) 3.39 (95% 1.28 to 8.93)), daily breakfast intake (<5 days/week) (AOR (95% CI) 0.63 (0.42 to 0.95)), irregular menstrual cycle AOR (95% CI) 2.34 (1.55 to 3.54)) and positive family history of dysmenorrhoea AOR (95% CI) 3.29 (2.25 to 4.81)) had statistically significant association with dysmenorrhoea. There was no statistically significant difference in academic performance among students with and without dysmenorrhoea (F (3611)=1.276, p=0.28)).ConclusionsDysmenorrhoea was a common health problem among graduating University students. However, it has no statistically significant impact on academic performance. Reproductive health officers should educate and undermine the negative academic consequences of dysmenorrhoea to reduce the physical and psychological stress that happens to females and their families.


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Abeer Alharbi ◽  
Joharah Alzuwaed ◽  
Hind Qasem

Abstract Background The Ministry of Health in Saudi Arabia is expanding the country’s telemedicine services by using advanced technology in health services. In doing so, an e-health application (app), Seha, was introduced in 2018 that allows individuals to have face-to-face visual medical consultations with their doctors on their smartphones. Objective This study evaluated the effectiveness of the app in improving healthcare delivery by ensuring patient satisfaction with the care given, increasing access to care, and improving efficiency in the healthcare system. Methods A cross-sectional study design was used to assess the perceptions of users of the Seha app and non-users who continued with traditional health services. The data were collected using an online survey via Google Forms between June 2020 and September 2020. Independent t tests and chi-square (χ2) tests were conducted to answer the research questions. Results There was a significant difference between users and non-users in terms of ease of access to health services (t =  − 9.38, p < 0.05), with app users having a higher mean score (4.19 ± 0.91) than non-users (3.41 ± 1.00); satisfaction with health services (t =  − 6.33, p < 0.05), with users having a higher mean score (3.96 ± 0.91) than non-users (3.45 ± 0.94); and efficiency (only one visit needed for treatment) (t =  − 3.20, p < 0.05), with users having a higher mean score (3.71 ± 0.93) than non-users (3.45 ± 0.93). There were significant associations between the use of the Seha app and age (χ2 = 8.79, p < 0.05), gender (χ2 = 22.19, p < 0.05), region (χ2 = 19.74, p < 0.05), and occupation (χ2 = 22.05, p < 0.05). There were significant relationships between the three items (on access, satisfaction, and efficiency) and experiencing technical issues (t = 4.47, t = 8.11, and t = 3.24, respectively, p < 0.05), with users who faced technical problems having significantly lower mean scores for all three items. Conclusion This study provided evidence that the Seha app improved the delivery of healthcare in Saudi Arabia. Users of the app had a better health experience in terms of their perceived ease of access to healthcare services; their satisfaction with healthcare services; and the efficiency of the system, measured by the number of required doctor visits. Other factors that appeared to influence the use of the app included age, gender, usual source of care, and technical difficulties.


2019 ◽  
Vol 90 (3) ◽  
pp. e31.1-e31
Author(s):  
T Samuel ◽  
K Aquilina ◽  
W Dawes

ObjectivesTo investigate the current understanding parents have of concussion in their rugby-playing children aged 9–17.DesignCross-sectional studySubjects86 parents from four clubs completed an online questionnaireMethodsAreas covered (1) Parental experience of concussion (2) Rate of viewing of the RFU concussion educational video (RFUCEV), (3) Identification of symptoms of concussion (4) Understanding of the risk of concussion. Each participant was given a composite score, out of 19, based on their performance in symptom identification and true/false questions. Independent-sample two-tailed t-tests were conducted to analyse scores, primarily controlling for viewing of the RFUCEVResultsThere was a significant difference in the scores between the group that had viewed the RFUCEV (n=32, M=14.75, SD=2.55) and those who had not (n=54, M=13.05, SD=2.87); t(84)=2.75, p=0.00721. Additionally, over 25% of parents reported that their child had suffered a concussion, and this was also found to significantly improve the awareness score (p=0.04678)ConclusionsStatistically significant improvement in composite scores after viewing the RFUCEV makes it reasonable to require compulsory parental education prior to signing up a child to play rugby. This would build on the protocol changes made by the RFU in 2014 and further progress the safety of the sport. We suggest the video be improved to emphasise the areas highlighted as inadequately understood, including the increased risk of concussion in under-18s compared to adults.


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