scholarly journals Contribution of the Elevated Thrombosis Risk of Males to the Excess Male Mortality Observed in COVID-19: An Observational Study

2021 ◽  
Author(s):  
Kenneth R Cohen ◽  
David Anderson BSAE ◽  
Sheng Ren ◽  
David J. Cook
Keyword(s):  
Mortality Rate ◽  
Observational Study ◽  
P Value ◽  
Male Mortality ◽  
Thrombotic Risk ◽  
Biological Sex ◽  
Thrombosis Risk ◽  
Exposure Variable ◽  
Hospital Systems ◽  
Risk For Thrombosis

Abstract Background: The mortality rate of COVID-19 is elevated in males compared to females.Objective: Determine the extent that the elevated thrombotic risk in males relative to females contributes to excess COVID-19 mortality in males.Design: Observational study.Setting: Data sourced from electronic medical records from over 200 US hospital systems.Participants: 60,877 patients hospitalized with COVID-19.Exposure: Exposure variable: biological sex; key variable of interest: thrombosis.Main outcome measures: Primary outcome was COVID-19 mortality. We measured: 1) mortality rate of males relative to females, 2) rate of thrombotic diagnoses occurring during hospitalization for COVID-19 in both sexes, and 3) mortality rate when evidence of thrombosis was present.Results: The COVID-19 mortality rate of males was 29.9% higher than that of females. Males had a 35.8% higher rate of receiving a thrombotic diagnosis compared to females. The mortality rate of all patients with a thrombotic diagnosis was 40.0%— over twice that of COVID-19 patients without a thrombotic diagnosis (adjusted OR 2.50 [2.37 to 2.64], p-value < .001). When defining thrombosis as either a documented thrombotic diagnosis or a D-dimer level ≥ 3.0 μg/mL, 16.4% of the excess mortality in male patients could be explained by increased thrombotic risk. Conclusions and Relevance: Our findings suggest the higher COVID-19 mortality rate in males may be significantly accounted for by the elevated risk for thrombosis among males. Understanding the mechanisms that underlie increased male thrombotic risk may allow for the advancement of effective anticoagulation strategies that reduce COVID-19 mortality in males.

scholarly journals How we approach thrombosis risk in children with COVID-19 infection

2021 ◽  
Author(s):  
Anjali Sharathkumar ◽  
E. Vincent Faustino ◽  
Clifford Takemoto
Keyword(s):  
Severe Disease ◽  
Acute Infection ◽  
Thrombotic Risk ◽  
Thrombosis Risk ◽  
Clinical Scenarios ◽  
Knowledge Deficits ◽  
Risk For Thrombosis ◽  
Inflammatory Syndrome ◽  
Pediatric Providers ◽  
Large Vessels

Thrombosis within the microvasculature and medium to large vessels is a serious and common complication among critically ill individuals with COVID-19. While children are markedly less likely to develop severe disease than adults, they remain at risk for thrombosis during acute infection and with the post-acute inflammatory illness termed multisystem inflammatory syndrome in children. Significant knowledge deficits in understanding COVID-19 associated coagulopathy and thrombotic risk pose clinical challenges for pediatric providers who must incorporate expert opinion and personal experience to manage individual patients. We discuss clinical scenarios to provide framework for characterizing thrombosis risk and thromboprophylaxis in children with COVID-19.

EFEKTIFITAS KONSELING LAKTASI PADA IBU HAMIL TRIMESTER III TERHADAP PELAKSANAAN MENYUSUI

2019 ◽  
Vol 11 (1) ◽  
pp. 41-50
Author(s):  
Heni Purwaningsih ◽  
Umi Aniroh ◽  
Eko Mardiyaningsih
Keyword(s):  
Mortality Rate ◽  
Pregnant Women ◽  
Body Position ◽  
Development Program ◽  
Optimal Growth ◽  
Infant Mortality Rate ◽  
P Value ◽  
Time Data ◽  
Emotional Bonding ◽  
Post Test

Program pembangunan kesehatan di Indonesia masih berfokus pada upaya peningkatan derajat kesehatan ibu dan anak terutama pada masa prenatal. Hal ini disebabkan masih tingginya Angka Kematian Ibu (AKI) dan Angka Kematian Bayi (AKB). ASI yang diberikan sejak usia dini dan dilanjutkan dengan ASI eksklusif selama 6 bulan dapat menurunkan angka kesakitan dan angka kematian bayi serta meningkatkan tumbuh kembang bayi secara optimal.  Penelitian ini bertujuan untuk mengetahui efektifitas pemberian konseling laktasi terhadap pelaksanaan menyusui pada ibu hamil trimester III. Desain penelitian menggunakan quasi eksperimen dengan rancangan One Group Pre-test dan  Post-test Desain. Populasi dalam penelitian ini adalah ibu hamil trimester III dan sampel yang diambil adalah 18 ibu hamil. Alat penggumpulan data menggunakan lembar observasi BREAST (body position, respons, emotional bonding, anatomy dan sucking time). Analisis data menggunakan wilcoxon.Hasil penelitian didapatkan pelaksanaan menyusui sebelum dilakukan konseling laktasi dalam kategori kurang (72,2%) sedangkan pelaksanaan menyusui setelah dilakukan konseling laktasi (77,8%) dalam kategori baik. Konseling laktasi efektif dilakukan untuk meningkatkan pelaksanaan menyusui denganp-value 0,003 (p<0,005).Konseling laktasi seharusnya diberikan pada masa prenatal sehingga pada saat postpartum, ibu sudah mampu memberikan asi secara maksimal. Pendampingan terhadap ibu hamil juga berperan dalam pelaksanaan pemberian ASI.   Kata kunci : Konseling laktasi, ASI, pelaksanaan menyusui   THE EFFECTIVENESS OF LACTATION COUNSELING IN THE 3rd TRIMESTER PREGNANT WOMEN ON BREASTFEEDING IMPLEMENTATION   ABSTRACT Indonesia's health development program still focuses on improving mother and child health, especially at the prenatal stage. It is due to the high maternal mortality rate (MMR) and Infant Mortality Rate (IMR). Breastmilk given from an early age and continued with exclusive breastfeeding for six months can reduce infants morbidity and mortality rate and increase their optimal growth. The purpose is to investigate the effectiveness of lactation counseling to the implementation of breastfeeding in third-trimester. The study design used quasi experiments with one group pre-test and post-test. Population was the 3rd-trimester pregnant mothers, and the samples were 18 mothers. The data collection tool used BREAST observation sheets (body position, response, emotional bonding, anatomy and sucking time). Data analysis used Wilcoxon. The result of the research shows that breastfeeding before lactation counseling is in less category (72,2%) while breastfeeding after lactation counseling (77,8%) is in a goodcategory. Effective lactation counseling is performed to improve the implementation of breastfeeding with p-value 0.003 (p <0.005). Lactation counseling should be given during the prenatal period so that at the time of postpartum, the mother has been able to give breastmilk maximally. Mentoring for pregnant women also plays a role in the implementation of breastfeeding Keywords: lactation counseling, breast milk, breastfeeding implementation

FAKTOR-FAKTOR YANG BERHUBUNGAN DENGAN KEJADIAN BBLR DI RUMAH SAKIT UMUM DAERAH PALEMBANG BARI TAHUN 2013

2019 ◽  
Vol 4 (2) ◽  
Author(s):  
Juliana Widyastuti Wahyuningsih Juliana Widyastuti Wahyuningsih
Keyword(s):  
Birth Weight ◽  
Mortality Rate ◽  
Low Birth Weight ◽  
Random Sampling ◽  
Maternal Age ◽  
Univariate Analysis ◽  
Infant Mortality Rate ◽  
Survey Method ◽  
P Value ◽  
Chi Square

ABSTRACT   Low birth weight (LBW) infants with birth weight is less than 2500 grams, regardless of gestational age. Statistically showed 90 % incidence of LBW obtained in developing countries with a mortality rate 35 times higher tinggi.Di South Sumatra Province Infant Mortality Rate ( IMR ) is 29 per 1,000 live births. In Palembang BARI hospitals incidence of LBW in 2013 amounted to 317 cases . The purpose of this study is to determine is there a relationship between the factors of age, education, and parity with the incidence of Low Birth Weight in Palembang BARI hospitals in 2013. This study used survey method crosss sectional analytic approach. The study population was all women who gave birth and was admitted to hospital obstetrics Palembang BARI installations in 2013 amounted to 901. This research was conducted in February 2014. Samples were taken with a random sampling method sistematic. Analyze data using statistical test Chi - Square. Results of univariate analysis of this study showed that 193 (69.4 %) of the respondents had low birth weight, and 85 (30.6 %) respondents had BBLN. 63 (22.7 %) of respondents with a high risk of maternal age and 215 (77.3 %) of respondents with a low risk of maternal age. 157 (56.5 %) respondents with low education mothers and 121 (43.5 %) of respondents with higher education mothers. 48 (17.3 %) respondents with high parity mothers and 230 (82.7 %) respondents with low parity mothers. So the bivariate analysis showed no significant association between maternal age with the incidence of LBW with P value = 0.035, no significant association between education and the incidence of LBW with P value = 0.006, and no significant relationship between the incidence of low birth weight with parity P value = 0.041. It is recommended for health care workers (midwives) hospital in order to be used as material information regarding the occurrence of LBW and as an input as well as the evaluation of success in good health or when needed to do counseling and care of LBW, especially to mothers who give birth to low birth weight baby.   ABSTRAK Berat badan lahir rendah (BBLR) adalah bayi dengan berat lahir kurang dari 2500 gram tanpa memandang masa gestasi. Secara statistik menunjukkan 90% kejadian BBLR didapatkan di negara berkembang dengan angka kematiannya 35 kali lebih tinggi.Di Propinsi Sumatera Selatan Angka Kematian Bayi (AKB) sebesar 29 per 1.000 kelahiran hidup. Di RSUD Palembang BARI Tahun 2013 angka kejadian BBLR berjumlah 317 kasus. Tujuan Penelitian ini adalah untuk mengetahui adakah hubungan antara faktor umur, pendidikan, dan paritas dengan kejadian Berat Badan Lahir Rendah di RSUD Palembang BARI Tahun 2013. Penelitian ini menggunakan metode survey analitik dengan pendekatan crosss sectional. Populasi penelitian ini adalah semua ibu yang melahirkan dan dirawat inap di instalasi kebidanan RSUD Palembang BARI Tahun 2013 berjumlah 901. Penelitian ini dilakukan pada bulan Februari 2014. Sampel penelitian diambil dengan metode sistematic random sampling. Analisa data menggunakan uji statistik Chi – Square. Hasil penelitian analisis univariat ini menunjukkan bahwa 193 (69,4%) responden mengalami BBLR, dan 85 (30,6%) responden mengalami BBLN. 63 (22,7%) responden dengan umur ibu resiko tinggi dan 215 (77,3%) responden dengan umur ibu resiko rendah. 157 (56,5%) responden dengan ibu pendidikan rendah dan 121 (43,5%) responden dengan ibu pendidikan tinggi. 48 (17,3%) reponden dengan ibu paritas tinggi dan 230 (82,7%) responden dengan ibu paritas rendah. Sehingga analisa bivariat menunjukkan ada hubungan yang bermakna antara umur ibu dengan kejadian BBLR dengan P value = 0,035, ada hubungan yang bermakna antara pendidikan dengan kejadian BBLR dengan P value = 0,006 dan ada hubungan yang bermakna antara paritas dengan kejadian BBLR dengan P value = 0,041. Disarankan bagi petugas kesehatan (bidan) rumah sakit agar dapat dijadikan sebagai bahan informasi mengenai terjadinya BBLR dan sebagai bahan masukan serta evaluasi keberhasilan dalam pelayanan kesehatan yang baik atau bila perlu dilakukannya penyuluhan serta asuhan  tentang BBLR khususnya kepada ibu yang melahirkan Bayi dengan BBLR.  

scholarly journals POS0441 DEVELOPMENT OF RHEUMATOID ARTHRITIS AMONG ANTI-CITRULLINATED PROTEIN ANTIBODIES POSITIVE ASYMPTOMATIC INDIVIDUALS: A PROSPECTIVE OBSERVATIONAL STUDY

2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 449.1-449
Author(s):  
S. Mizuki ◽  
K. Horie ◽  
K. Imabayashi ◽  
K. Mishima ◽  
K. Oryoji
Keyword(s):  
Rheumatoid Arthritis ◽  
Risk Factors ◽  
Observational Study ◽  
Rheumatoid Factor ◽  
Prospective Observational Study ◽  
Enzyme Linked Immunosorbent Assay ◽  
P Value ◽  
Healthy Population ◽  
Asymptomatic Individuals ◽  
Citrullinated Protein

Background:In the idividuals with genetic and enviromental risk factors, immune events at mucosal surfaces occur and may precede systemic autoimmunity. Anti-citrullinated protein antibodies (ACPA) are present in the serum for an average of 3-5 years prior to the onset of rheumatoid arthritis (RA) during an asymptomatic period. In ACPA-positivite individuals, the additional presence of RA-related risk factors appears to add significant power for the development of RA. To date, there have been few reports in which clinical courses of ACPA-positive asymptomatic individuals were investigated prospectively.Objectives:To observe the clinical time course of ACPA-positive healthy population for the development of RA.Methods:Healthy volunteers without joint pain or stiffness, who attended the comprehensive health screening of our hospital, were enrolled in this prospective observational study. The serum ACPA levels were quantified by Ig-G anti-cyclic citrullinated peptide enzyme-linked immunosorbent assay with levels > 4.4 U/mL considered positive. ACPA-positive subjects were followed by rheumatologists of our department clinically or a questionnaire sent by mail for screening to detect arthritis.Results:5,971 healthy individuals without joint symptons were included. Ninty-two (1.5%) were positive for ACPA. Of these, 19 (20.7%) developed RA and two were suspected as RA by mail questionnaire. Their average age were 58-years, and women were 68%. The average duration between the date of serum sampling and diagnosis was 10.7 months. ACPA-positive individuals who developed to RA had higher serum ACPA and Ig-M rheumatoid factor levels than ACPA-positive individuals who did not (P value by Mann-Whitney U test: 0.002, 0.005, respectively).Conclusion:Among ACPA-positive asymptomatic individuals, 20% developed RA. The higher titer of ACPA and Ig-M rheumatoid factor levels are risk factors for devoloping RA.Disclosure of Interests:None declared

scholarly journals Sex Differences in Circadian Clock Genes and Myocardial Infarction Susceptibility

2021 ◽  
Vol 8 (5) ◽  
pp. 53
Author(s):  
Ivana Škrlec ◽  
Jasminka Talapko ◽  
Martina Juzbašić ◽  
Robert Steiner
Keyword(s):  
Myocardial Infarction ◽  
Cardiovascular Disease ◽  
Circadian Rhythm ◽  
Single Nucleotide Polymorphisms ◽  
Clock Genes ◽  
P Value ◽  
Nucleotide Polymorphisms ◽  
Single Nucleotide ◽  
Biological Sex ◽  
Significant Difference

The growing body of evidence shows a significant difference in the circadian rhythm of cardiovascular disease based on biological sex. The incidence of cardiovascular disease varies between women and men. Additionally, biological sex is vital for the timely application of therapy—chronotherapy, which benefits both sexes. This study aimed to examine the potential difference of single nucleotide polymorphisms (SNPs) of the circadian rhythm genes ARNTL, CLOCK, CRY2 and PER2 in women and men with myocardial infarction. A cross-sectional study was conducted, including 200 patients with myocardial infarction. Altogether, ten single nucleotide polymorphisms in the ARNTL, CLOCK, CRY2 and PER2 genes were analyzed. The Chi-square test yielded statistically significant differences in CLOCK gene rs11932595 polymorphism in a recessive genotype model between women and men with a p-value of 0.03 and an odds ratio 2.66, and a corresponding 95% confidence interval of 1.07 to 6.66. Other analyzed polymorphisms of the circadian rhythm genes ARNTL, CRY2, and PER2 did not significantly differ between the sexes. According to the study’s current results, the CLOCK gene’s genetic variability might affect myocardial infarction concerning biological sex.

scholarly journals Helicobacter pylori eradication in patients with type 2 diabetes mellitus: Multicenter prospective observational study

2019 ◽  
Vol 7 ◽  
pp. 205031211983209 ◽  
Author(s):  
Seung-Joo Nam ◽  
Sung Chul Park ◽  
Sang Hoon Lee ◽  
Dong Wook Choi ◽  
Sung Joon Lee ◽  
...  
Keyword(s):  
Helicobacter Pylori ◽  
Observational Study ◽  
Prospective Observational Study ◽  
Eradication Rate ◽  
Laboratory Data ◽  
P Value ◽  
Diabetic Patients ◽  
Multicenter Prospective Observational Study ◽  
H Pylori

Objective: To compare Helicobacter pylori ( H. pylori) eradication rate of type 2 diabetic patients with non-diabetic subjects. Methods: In this multicenter prospective observational study, H. pylori-infected subjects were enrolled from three university-affiliated hospitals. Eradication regimen was triple therapy with standard dose of proton pump inhibitors (b.i.d), amoxicillin (1.0 g b.i.d), and clarithromycin (500 mg b.i.d) for 7 days. Urea breath test was performed 4 weeks after treatment. Various clinical and laboratory data were collected for identification of factors associated with successful eradication. Results: Totally, 144 subjects were enrolled and 119 (85 non-diabetic and 34 diabetic patients) were finally analyzed. Eradication rate was 75.6% and there was no difference between diabetic patients and non-diabetic subjects (73.5% vs 76.5%, p value: 0.814). Adverse drug reactions were reported in 44.5% of patients. In multivariate analysis for predicting H. pylori eradication in diabetic patients, HbA1c (⩾7.5%) was a significant factor affecting eradication rate (adjusted odds ratio: 0.100, 95% confidence interval: 0.011–0.909, p value: 0.041). Conclusion: Diabetes itself is not a major factor affecting H. pylori eradication. However, poor glucose control may harmfully affect H. pylori eradication.

Prospective observational study of prevalence, assessment and treatment of pancreatic exocrine insufficiency (PEI) in patients with advanced pancreatic cancer (aPC): PanDA.

2021 ◽  
Vol 39 (28_suppl) ◽  
pp. 196-196
Author(s):  
Angela Lamarca ◽  
Lindsay Carnie ◽  
Dinakshi Shah ◽  
Kate Vaughan ◽  
Zainul Abedin Kapacee ◽  
...  
Keyword(s):  
Pancreatic Cancer ◽  
High Risk ◽  
Observational Study ◽  
Breath Test ◽  
Cox Regression ◽  
Pancreatic Enzyme ◽  
Palliative Therapy ◽  
Advanced Pancreatic Cancer ◽  
P Value ◽  
Screening Methods

196 Background: PEI in patients with advanced pancreatic cancer is well documented, but there is a lack of consensus regarding optimal screening. Methods: Eligible patients for this observational study (NCT03616431) were those diagnosed with aPC referred for consideration of palliative therapy who consented to evaluation by a research dietitian. In addition to symptom and full dietetic assessment (including Mid-Upper Arm Circumference (MUAC), handgrip and stair climb test), full nutritional blood panel, faecal elastase (FE) and 13C mixed triglyceride breath test (for diagnostic cohort (DiC)) were performed. Primary objectives: prospective assessment of PEI prevalence (dietitian-assessed; demographic cohort (DeC)), and to design (using breath test as gold standard; DiC) and validate (follow-up cohort (FuC)) the most suitable screening tool for PEI in patients with aPC. Logistic and Cox regression were used for statistical analysis (Stat v.12). Results: Between 1st July 2018 and 30th October 2020, 112 eligible patients [50 (DeC), 25 (DiC), 37 (FuC)]. Prevalence of PEI in the DeC was 64.0% (PEI-related symptoms were flatus (84.0%), weight loss (84.0%), abdominal discomfort (50.0%) and steatorrhea (48.0%)); 70.0% of patients required pancreatic enzyme replacement therapy and 74.0% had anorexia (low appetite); 44.0% and 18.0% had low vitamin D and vitamin A levels, respectively. Designed PEI screening panel (DiC; 19 patients with breath test completed) included FE [normal/missing (0 points); low (1 point)] and MUAC [normal/missing ( > percentile 25 for age/gender) (0 points); low (2 points)] and identified patients at high-risk (2-3 total points) of PEI [vs. low-medium risk (0-1 total points)]. When patients from DeC and DiC) were analysed together, those classified as “high-risk of PEI” according to the screening panel had shorter overall survival (multivariable Hazard Ratio (mHR) 1.86 (95% CI 1.03-3.36); p-value 0.040) when adjusted for other prognostic factors, including presence of PEI symptoms (mHR 2.28 (95% CI 1.19-4.35); p-value 0.013). The screening panel was tested in the FuC; 78.38% were classified as patients at “high-risk of PEI”; of these, 89.6% were confirmed to have PEI by the dietitian. The panel was feasible for use in clinical practice, (64.8% of patients completed fully the assessments required) and acceptability was high (87.5% of patients would do it again). The majority of patients (91.3%) recommended that all future patients with aPC should have dietitian input. Conclusions: PEI is present in the majority of patients with aPC, and early dietetic input is important to provide a holistic nutritional overview, including, but not limited to, PEI. This proposed screening panel could be used to prioritise patients at higher risk of PEI requiring urgent dietitian input. Its prognostic role needs further validation. Clinical trial information: NCT03616431.

scholarly journals A Review of Brooke Army Medical Center Chaplaincy Service During the SARS-COV2 Pandemic: Implications for Service Structure and Patient Needs

2021 ◽  
Author(s):  
Zaith Bauer ◽  
Joseph Sherwin ◽  
Stanley Smith ◽  
Jason Radowsky
Keyword(s):  
Mortality Rate ◽  
End Of Life ◽  
Medical Center ◽  
Well Being ◽  
Primary Study ◽  
P Value ◽  
Inpatient Setting ◽  
Spiritual Support ◽  
Army Medical ◽  
Brooke Army Medical

ABSTRACT Introduction We aimed to evaluate the effect of the SARS-COV2 pandemic on chaplain utilization at Brooke Army Medical Center. Our hypothesis was that multiple pandemic-related factors led to a care environment with increased mental and spiritual stress for patients and their families, leading to an increased need for adjunct services such as chaplaincy. Materials and Methods This was a single-institution retrospective chart review study that evaluated the records of 10,698 patients admitted between July 1, 2019, and January 31, 2020, or between July 1, 2020, and January 31, 2021. Our primary study outcomes included the number of chaplain consultations, the number of visits per consultation, and the time of visits between the two study cohorts. Secondary outcomes included inpatient mortality and the number of end-of-life visits. We also isolated a subgroup of patients admitted with COVID-19 and compared their outcomes with the two larger cohorts. Statistical analysis included t-test or chi-squared test, based on the variable. This study was reviewed and approved by the Brooke Army Medical Center Institutional Review Board (IRB ID C.2021.010e). Results Fewer consults were performed during the study period affected by the SARS-COV2 pandemic (4814 vs. 5884, P-value &lt;.01). There were fewer individual visits per consult during the study period affected by the SARS-COV2 pandemic (1.44 vs. 1.64, P-value &lt;.01), which led to fewer overall time spent per consult (37.41 vs. 41.19 minutes, P-value &lt;.01). The 2020 cohort (without COVID-19 cases) demonstrated a higher mortality rate than the 2019 cohort (2.8% vs. 1.9%, P-value &lt;.01). The COVID-19 diagnosis cohort demonstrated a much higher mortality rate compared to other patients in the 2020 cohort (19.3% vs. 2.8%, P-value &lt;.01). We demonstrated the relative need for EOL consults by presenting the ratio of EOL consults to inpatient deaths. This ratio was highest for the COVID-19 diagnosis cohort (0.76) compared to the 2020 cohort (0.50) and the 2019 cohort (0.60). Conclusions This study demonstrates that factors related to the SARS-COV2 pandemic resulted in fewer chaplaincy consults in our inpatient setting. We did not find other reports of a change in the rate of chaplaincy consultation, but available reports suggest that many centers have had difficulty balancing the spiritual needs of patients with local exposure guidelines. Although fewer individual chaplain consults occurred during the SARS-COV2 pandemic, our chaplain service innovated by utilizing various phone, video, and web-based platforms to deliver spiritual support to our community. Our study also suggests that the patients most greatly affected by the pandemic have an increased need for spiritual support, especially at the end of life. Future studies in this subject should examine the effect of various types of chaplain services as they relate to the health and well-being of hospitalized patients.

scholarly journals Evaluation of maternal and fetal outcome in pregnancies complicated by jaundice-an observational study

2021 ◽  
Author(s):  
Ruchi Kishore ◽  
Neha Thakur ◽  
Mitali Tuwani
Keyword(s):  
Mortality Rate ◽  
Observational Study ◽  
Maternal Mortality ◽  
Viral Hepatitis ◽  
Hellp Syndrome ◽  
Fetal Outcome ◽  
Maternal Outcome ◽  
Fetal Mortality ◽  
Maternal Mortality Rate ◽  
In Pregnancy

Background: The spectrum of jaundice in pregnancy varies from a benign condition with good maternal and fetal outcome to a severe form resulting in liver failure and maternal and fetal mortality. Jaundice may complicate 3-5% of pregnancies. Present study was aimed to analyze the cause, course and impact of jaundice during pregnancy so as to have better understanding and hence better feto-maternal outcome. The present study aimed to analyze the various causes of hepatic dysfunction in pregnancy, maternal and fetal outcome in pregnancies complicated by jaundice and various hematological and liver function variables for predicting maternal and fetal outcome.Methods: The present study was an observational study conducted in the department of obstetrics and gynecology, Pt. JNM medical college and associated Dr. BRAM hospital, Raipur (CG) over period of 2 year from September 2018 to September 2020.Results: Total 0.72% pregnancies were complicated by jaundice. HELLP syndrome was the commonest cause of jaundice in pregnancy (36.7%), followed by viral hepatitis (32.7%). Hepatitis E was the most common type of viral hepatitis (91.8%). Hemolytic jaundice presented with best maternal outcome (maternal mortality rate 8.6%). Worst maternal outcome was seen in AFLP (maternal mortality rate 100%). Best fetal outcome was seen in viral hepatitis (live birth rate 67.6%), whereas worst noted with AFLP (fetal death rate 66.6%). Higher total serum bilirubin, higher serum AST, anemia and deranged INR had significant correlation with maternal mortality.Conclusions: HELLP syndrome and viral hepatitis are preventable causes of jaundice yet it contributed to significant proportion of maternal deaths in 26.5 and 18.5% cases respectively. AFLP is often under diagnosed and had a fulminant course in pregnancy causing maternal and fetal mortality.

scholarly journals PELAYANAN DAN FASILITAS KESEHATAN, BIAYA PERSALINAN, DAN KEBIJAKAN DI TEMPAT BERSALIN MEMPENGARUHI IBU DALAM MEMILIH TEMPAT BERSALIN DI KELURAHAN KEMIRI MUKA, KECAMATAN BEJI, DEPOK

2020 ◽  
Vol 2 (2) ◽  
pp. 61-68
Author(s):  
Nourmayansa Vidya ◽  
Efa Apriyanti ◽  
Ayunda Nia Agustina ◽  
Maharaufa Fathmanda
Keyword(s):  
Mortality Rate ◽  
Return Rate ◽  
Infant Mortality Rate ◽  
P Value ◽  
Chi Square ◽  
Cross Sectional ◽  
Live Births ◽  
Factors Associated ◽  
Birth Place ◽  
Chisquare Test

  ABSTRAK Salah satu indicator derajat kesehatan suatu Negara adalah angka kematian ibu dan bayi. 52.4% ibu-ibu di Indonesia memiliki akses ke pelayanan maternal. Angka Kematian Ibu (AKI) di Indonesia tahun 2008 menurut Survei Demografi Kesehatan Indonesia adalah 307 per 100.000 kelahiran hidup, jauh dari target yang seharusnya yaitu 110 per 100.000 kelahiran hidup. Tujuan umum penelitian ini adalah untuk mengetahui faktor-faktor berhubungan dengan keputusan ibu memilih tempat bersalin, diantaranya adalah pelayanan kesehatan, fasilitas kesehatan, biaya persalinan, dan kebijakan di tempat bersalin. Sample penelitian adalah ibu-ibu yang berada di kelurahan Kemiri Muka – Depok berjumlah 125 orang. Penelitian ini menggunakan kuesioner dan Return rate = 100%. Penelitian ini menggunakan metode cross sectional dan analisa data univariat menggunakan distribusi frekuensi serta bivariat menggunakan chi-square. Hasil penelitian menunjukan adanya hubungan bermakna antara dan fasilitas kesehatan (p Value = 0.033; = 0.05) dengan pilihan tempat bersalin. Kata Kunci: faktor, ibu, Kemiri Muka, pemilihan tempat bersalin   ABSTRACT One indicator of a country's health status is the maternal and infant mortality rate. 52.4% of mothers in Indonesia have access to maternal services. Maternal Mortality Rate (MMR) in Indonesia in 2008 according to the Demographic Health Survey of Indonesia is 307 per 100,000 live births, its far from the supposed target of 110 per 100,000 live births. The general objective of this study was to determine the factors associated with mother's decision when choosing a birth place, including the choice of giving birth. The factors that affect mother's decision when choosing a birth place are characteristic of the respondents and distance delivery and home place. Research sample is mothers residing in RW 03 Kelurahan Kemiri Muka - Depok totaling 125 people. This study uses a questionnaire and return rate = 100%. This study uses cross sectional data analysis using univariate and bivariate frequency distribution using the chisquare test. The results showed that there was a significant relationship between respondent’s education (p-value = 0.009; = 0.05), the husband's income & (pvalue = 0.046; = 0.05), and health facilities (p -value = 0.033; = 0.05) with a choice of place of birth. Key words: factor, mother, Kemiri Muka, choosing a birth place

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