scholarly journals Active management of the third stage of labour: knowledge and challenges of obstetric caregivers in selected health facilities in Fako Division, Cameroon

2021 ◽  
Author(s):  
William Ntchompbopughu Tih ◽  
Egbe Obinchemti Thomas ◽  
Tendongfor Nicholas
Keyword(s):  
Maternal Mortality Ratio ◽  
Logistic Models ◽  
Cross Sectional Study ◽  
Health Facilities ◽  
Active Management ◽  
Good Knowledge ◽  
Cross Sectional ◽  
The Third ◽  
Third Stage ◽  
Mortality Ratio

Abstract Background: In Cameroon, the decrease in MMR (Maternal Mortality Ratio) from PPH (Postpartum Haemorrhage) despite reported use of the Active Management of the Third Stage of Labour (AMTSL) is slower than required to achieve the Third Sustainable Development Goal (SDG3) hence the need to question obstetric caregivers’ competence in AMTSL, as well as the factors hindering its proper useWe therefore aimed to assess obstetric caregivers’ knowledge about AMTSL, as well as the determinants and barriers of AMTSL in selected hospitals in Fako Division, Cameroon.Methods: This was a hospital-based cross-sectional study of 150 participants recruited in 27 health facilities in Buea, Limbe and Tiko health districts from January 15, 2020, to March 31, 2020. Participants’ socio-demographic and qualification characteristics, knowledge and challenges, and the references guiding their practice of AMTSL were collected using a structured questionnaire. AMTSL knowledge was categorized as poor or good and the determinants of good AMTSL knowledge were evaluated. The data was analyzed in SPSS version 25.0. Results: Of the 150 caregivers interviewed, only 48.7% had good knowledge of AMTSL. In logistic models, participants’ use of AMTSL increased Good knowledge of AMTSL (AOR: 12.96, CI: 1.12 -150.3, p=0.04). Unavailability of drugs and/or equipment, insufficient staff coverage and lack of knowledge and training of the staff were the major challenges reported. Conclusion: Obstetric caregivers in Fako division have knowledge gaps and face numerous challenges in AMTSL use, which could account for the consistently high MMR from PPH. Filling this knowledge gap and mitigating the challenges of these caregivers would certainly accelerate progress towards the achievement of SDG3.

scholarly journals Student midwives’ knowledge, skills and competency in relation to the active management of the third stage of labour: A correlational study

Curationis ◽  
2020 ◽  
Vol 43 (1) ◽  
Author(s):  
Fungai Muzeya ◽  
Hester Julie
Keyword(s):  
Survey Design ◽  
Maternal Mortality Ratio ◽  
The Self ◽  
Active Management ◽  
Knowledge And Skills ◽  
The Third ◽  
Third Stage ◽  
Mortality Ratio ◽  
Quantitative Descriptive ◽  
Descriptive Survey

Background: Lesotho has been experiencing health challenges as indicated by its high maternal mortality ratio of 620 per 100 000 live births for the year 2010, which has been linked to its limited human resources.Objectives: The knowledge and skills of final-year student nurse-midwives related to the active management of the third stage of labour were determined.Method: A quantitative, descriptive survey design was used to conduct this study with 99 final-year midwifery students at four nursing schools in Lesotho using stratified sampling. The structured questionnaire collected data on the knowledge and self-reported competency. Subsequently, the controlled cord traction marks, extracted from the objective structured clinical examination (OSCE), were compared to the self-reported competency of these midwifery students using R software version 3.4.0.Results: The mean score for knowledge and the OSCE was 73.8% (n = 99) and 77.2% (n = 99), respectively. The majority of respondents (95.2%, n = 99) rated themselves highly in terms of the active management of the third stage of labour competency. There was no correlation between the self-reported competency and knowledge (r = 0.08, p = 0.4402), and self-reported competency and OSCE scores (r = −0.004, p = 0.01).Conclusion: The high mean scores for the knowledge and the OSCE indicate that the theoretical component of the curriculum on the active management of the third stage of labour was effective in equipping final-year midwifery students with knowledge and skills to carry out this competency.

The factors associated with the length of the third stage of labour: A descriptive-analytical study

2021 ◽  
Vol 17 ◽  
Author(s):  
Mansoureh Refaei ◽  
Soodabeh Aghababaei ◽  
Mansoureh Yazdkhasti ◽  
Farideh Kazemi ◽  
Fatemeh Farahmandpour
Keyword(s):  
Cross Sectional Study ◽  
Study Data ◽  
Cross Sectional ◽  
Factors Associated ◽  
The Third ◽  
Third Stage ◽  
History Of ◽  
Mother’S Age ◽  
And Gender ◽  
The Relationship

Background: Several risk factors have been identified for postpartum hemorrhage, one of which being the duration of the third stage of labour. This stage refers to the interval between the expulsion of the fetus to the expulsion of the placenta. Some bleeding occurs in this stage due to the separation of the placenta Objective: This study aimed to identify the factors associated with the length of the third stage of labour. Methods: In this cross-sectional study, 300 women hospitalized for vaginal birth were selected via convenience sampling. The study data were collected using a researcher-made questionnaire. Then, the data were analyzed using univariate and multivariate linear regression analyses. Results: The mean (SD) age of the participants was 26.41 (6.26) years. Investigation of the relationship between the study variables and the time of placental separation indicated that a minute increase in the length of membranes rupture caused a 0.003minute decrease in the time of placental separation. However, this time increased by 2.75, 6.68, and 2.86 minutes in the individuals without the history of abortion, those with the history of stillbirth, and those who had not received hyoscine, respectively. The results of multivariate analysis indicated that suffering from preeclampsia or hypertension, history of stillbirth, not receiving hyoscine, and not receiving misoprostol increased the length of the third stage by 4.40, 8.55, 2.38, and 6.04 minutes, respectively. Conclusion: Suffering from preeclampsia and having the history of stillbirth increased and using hyoscine and misoprostol decreased the length of the third stage of labour. However, no significant relationship was found between the length of the third stage of labour and mother’s age, gestational age, parity, mother’s body mass index, mother’s chronic disorders, history of manual placenta removal, length of the first and second stages, membranes rupture, induction, amount of oxytocin after delivery, and infant’s weight and gender.

scholarly journals Variability of Clinical Practice in the Third Stage of Labour in Spain

2019 ◽  
Vol 8 (5) ◽  
pp. 637 ◽  
Author(s):  
Inmaculada Ortiz-Esquinas ◽  
Juan Gómez-Salgado ◽  
Ana I. Pascual-Pedreño ◽  
Julián Rodríguez-Almagro ◽  
Juan Miguel Martínez-Galiano ◽  
...  
Keyword(s):  
Clinical Practice ◽  
Work Environment ◽  
Clinical Management ◽  
Active Management ◽  
Odds Ratios ◽  
Cross Sectional ◽  
Environment Factors ◽  
The Third ◽  
Third Stage ◽  
Work Environment Factors

Clinical practice guidelines recommend the active management of the third stage of labour, but it is currently unknown what practices professionals actually perform. Therefore, the aim of this study was to determine the variability of professional practices in the management of the third stage of labour and to identify any associated professional and work environment factors. A nationwide cross-sectional study was performed with 1054 obstetrics professionals between September and November 2018 in Spain. A self-designed questionnaire was administered online. The crude odds ratios (OR) and adjusted odds ratios (ORa) were estimated using binary logistic regression. The main outcome measures were included in the clinical management of the third stage of labour and they were: type of management, drugs, doses, routes of administration, and waiting times used. The results showed that 75.3% (783) of the professionals used uterotonic agents for delivery. Oxytocin was the most commonly administered drug. Professionals who attend home births were less likely to use uterotonics (ORa: 0.23; 95% confidence interval (CI): 0.12–0.47), while those who completed their training after 2007 (ORa: 1.57 (95% CI: 1.13–2.18) and worked in a hospital that attended >4000 births per year (ORa: 7.95 CI: 4.02–15.72) were more likely to use them. Statistically significant differences were also observed between midwives and gynaecologists as for the clinical management of this stage of labour (p < 0.005). These findings could suggest that there is clinical variability among obstetrics professionals regarding the management of delivery. Part of this variability can be attributed to professional and work environment factors.

scholarly journals Prevalence and Determinants of Maternal Mortality in Southeastern Iran (2013 - 2017): A Retrospective Cross-Sectional Study

2021 ◽  
Vol 10 (1) ◽  
Author(s):  
Marzieh Ghasemi ◽  
Narjes Noori ◽  
Ghazaleh Parnian ◽  
Erfan Ayubi ◽  
Farangis Narouei
Keyword(s):  
Maternal Mortality ◽  
Maternal Death ◽  
Maternal Mortality Ratio ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Cross Sectional ◽  
Common Cause ◽  
Elevated Liver Enzymes ◽  
Mortality Ratio ◽  
Pregnant Mothers

Background: Recognizing the factors affecting maternal death can lead to the adoption of strategies to prevent similar deaths. Objectives: This study was performed to investigate the prevalence and causes of pregnant mothers' death in the population covered by Zahedan University of Medical Sciences. Methods: In this retrospective, descriptive, cross-sectional study, the files of 126 pregnant mothers who died during 2013 - 2017 were evaluated. Demographic and obstetrics information and variables related to maternal mortality, such as maternal mortality ratio (MMR), the cause of mother’s death, the time of mother’s death, and place of death, were evaluated in general and separately in each city (i.e., Zahedan, Khash, Saravan, and Chabahar) based on descriptive statistics and according to the nature of the variables. Results: Maternal mortality ratio in Zahedan was 174.96 per 100,000 case, in Khash 190.56 per 100,000 cases, in Saravan 371.87 per 100,000 cases, and in Chabahar 384.03 per 100,000 cases. Bleeding was the most common cause of death (42.53%), 61.9% of pregnant women were living in rural areas, 80.2% died in the third trimester of pregnancy, and 42.9% died in first 24 hours after delivery. The most common underlying disease was hypertension, 70.6% of mothers died in hospitals, and 47.6% were illiterate. The most common cause of maternal death in Zahedan was cardiac disease, in Khash it was hemolysis, elevated liver enzymes and low platelets (HELLP) syndrome, eclampsia, and preeclampsia, and in Saravan and Chabahar the leading cause was bleeding. Conclusions: Maternal mortality ratio was high in Sistan and Baluchestan. The investigation of the causes of maternal deaths showed that some of these deaths are avoidable. It is also necessary to improve midwifery emergencies management with intensive monthly courses to increase team capabilities for making the best use of golden time measures.

scholarly journals A Comparative Study of Oxytocin & Misoprostol in Active Management of Third Stage of Labour

2015 ◽  
Vol 12 (1) ◽  
pp. 22-24
Author(s):  
N Ansari ◽  
CR Das
Keyword(s):  
Blood Loss ◽  
College Teaching ◽  
Cross Sectional Study ◽  
Active Management ◽  
Cross Sectional ◽  
Medical College ◽  
Significant Difference ◽  
Third Stage ◽  
Group A ◽  
Group B

Introduction: The third stage of labour is the period which follows the completed delivery of the foetus and consists of delivery of the placenta and its attached membranes.Aims and objectives: Comparison of oxytocin & misoprostol in active management of third stage of labour.Material and Methods: This is a comparative cross-sectional study was conducted in Nepalgunj Medical College Teaching Hospital, Kohalpur from March 2013 to March 2014. Group A - Oxytocin 10 IU IV bolus in 100 patients and Group B - Misoprostol 600 micro gram rectally. The collected were subjected to statistical analysis using SPSS 15.Results: After active management with bolus oxytocin, the blood loss was grossly reduced being 40-100ml in 84% cases and only 7% had blood loss more than 100ml. blood loss between 200-300ml were only 6% and only 3% had PPH, after misoprostol 80% of cases had blood loss within 40 – 100 ml., 6% cases had blood loss within 100 – 200 ml. and larger amount of blood loss i.e. between 200 – 300 ml. was observed in 7% cases, in 3% cases blood loss was between 300 – 400 ml. and 4% of women in this group had PPH.Conclusion: There was no statistically significant difference in the efficacy of oxytocin and misoprostol in reducing amount of blood loss and duration of labour rd in 3 stage of labour.Journal of Nepalgunj Medical College Vol.12(1) 2014: 22-24

Preference of place of delivery and its determinants: a cross-sectional study in Chukha district, Bhutan

2015 ◽  
Vol 1 (1) ◽  
pp. 23-29
Author(s):  
Kencho Wangdi ◽  
Mongal S. Gurung ◽  
Dorji Pelzom ◽  
Tashi Dema ◽  
Sonam Wangdi
Keyword(s):  
Maternal Mortality ◽  
Health Facility ◽  
Rural Areas ◽  
Maternal Mortality Ratio ◽  
Cross Sectional Study ◽  
World Health ◽  
Sectional Study ◽  
Cross Sectional ◽  
Mortality Ratio ◽  
At Home

Introduction: The estimated global maternal deaths in 2013 was 289000. In Bhutan, Maternal Mortality Ratio has remarkably declined from 770 deaths per 100,000 live births in 1984 to 86 in 2012. However, the maternal mortality ratio still remains high and a high proportion of delivery still take place at homes (26%) despite of adopting 100%institutional delivery policy ever since 2005. This study was carried out to determine the important factors that prevent women from coming to the health facilities for safe delivery. Methods: A cross-sectional study among the women who delivered in Chukha District in 2013 was carried out after seeking ethical approval from Research Ethics Board of Health and World Health Organization. Chukha is a district with the second highest number of population in Bhutan where 55.7% of the people live in rural villages. Results: Out of 899 eligible listed women, 78.1% participated in the study and among the participants 11.5% had delivered at home. The number of home deliveries was higher in rural areas, 17.3%, as compared to urban places, 6.4%. Women who were delivering for third or more times are 2.42 times more likely to give birth at home compared to women who were delivering for the first time. Women residing at places more than three hours away from the health facility were 2.58 times more likely to give birth at home compared to women residing less than three hours away. During their last pregnancy, 99.4% of the participants have sought at least one ANC. Conclusions: This study suggests that the two most important factors associated with home delivery are the distance to health facility from their residences and the parity.

scholarly journals Maternal Mortality in an Iraqi Tertiary Hospital: Lessons From the Years of the Crisis

2020 ◽  
Vol 8 (4) ◽  
pp. 362-367
Author(s):  
Reshed Zeki Obeid ◽  
Dina Akeel Salman ◽  
Zainab Abdul Ameer Jaafar
Keyword(s):  
Maternal Mortality ◽  
Cause Of Death ◽  
Causes Of Death ◽  
Maternal Mortality Ratio ◽  
Tertiary Hospital ◽  
Cross Sectional Study ◽  
Islamic State ◽  
Care Provision ◽  
Cross Sectional ◽  
Mortality Ratio

Objectives: Maternal mortality is a crucial indicator of health care provision within a nation, particularly during the periods of instability. This study aimed to assess the maternal mortality ratio in one of the largest hospitals in Baghdad over eight years including the time of the threat of the so-called Islamic State of Syria and Iraq. Materials and Methods: A cross-sectional study was undertaken by reviewing the records of mothers who passed away in the hospital from February 2011 to February 2018. The gathered data included the patients’ demographic features as well as obstetrical and medical conditions and causes of death each year. Results: During the eight years, the total live births numbered 95 800 while 52 mothers died for a maternal mortality ratio of 58.12 per 105 . Most of the deceased mothers aged between 30 and 39 years (P = 0.0015), were multiparous and from rural residence (P = 0.000), booked no antenatal care (P = 0.0014), and completed delivery via a cesarean section (P = 0.0184). The majority died in the postpartum period (P = 0.000) within the first 12 hours of admission (P = 0.000). Finally, the major presentation and cause of death were often obstetrical hemorrhage. Conclusions: The maternal mortality was high and obstetrical hemorrhage was the main cause of death. In addition, the majority of patients died within the first 12 hours of admission, which is attributed to delays in access to the hospital and the lack of needed facilities during that critical period of time.

PENGARUH MOBILISASI DINI TERHADAP PENYEMBUHAN LUKA POST OPERASI SECTIO CAESARIA DI RS SYAFIRA PEKANBARU TAHUN 2015

2018 ◽  
Vol 4 (2) ◽  
Author(s):  
WIWIEK DELVIRA ◽  
FATMI AGUS
Keyword(s):  
Wound Healing ◽  
Maternal Mortality ◽  
Maternal Mortality Ratio ◽  
Early Mobilization ◽  
Developed Countries ◽  
Cross Sectional Study ◽  
Sectio Caesarea ◽  
P Value ◽  
Cross Sectional ◽  
Mortality Ratio

Maternal mortality used as a measure of success towards achieving the MDG's targets, namely the 75% reduction in maternal mortality ratio. In developing countries the frequency of maternal deaths reported to range between 0.3-0.7%, while in developed countries the figure is smaller, which 0.05-0.1% (Widjanarko, 2008). In accordance with the health paradigm without abandoning efforts to restore the health of patients, the need for early mobilization gradually for sectio caesarea postoperative patients while in hospital. The purpose of this study was to determine the effect of early mobilization on wound healing post sectio caesarea in RS Syafira Pekanbaru. The benefits of this research are as fulfilling the Minimum Service Standards (MSS) for the hospital that can be used as eviden based practice in the provision of nursing services independently. This study was conducted in inpatient obstetric in RS Syafira Pekanbaru on October-November 2015 with a sample of 20 respondents. The research methodology used is the cross-sectional study design. Analysis of the data used in the analysis of univariate and bivariate (t test dependent), the data were processed using a computerized program. The results obtained from this research that the influence of early mobilization with postoperative wound healing secsio Caesaria with P value (0.007).

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