scholarly journals STUDY ON STILL BIRTH: A CATASTROPH FOR PATIENT AND NIGHTMARE FOR THE OBSTETRICIAN

2020 ◽  
Vol 8 (10) ◽  
pp. 249-253
Author(s):  
Somya Saxena ◽  
◽  
Veena Gupta ◽  
Nidhi Sachan ◽  
◽  
...  

Introduction: Still Birth is a catastrophic event for both treating doctor and the patient.World wide in 2015, for every 1000 total births, 18.4 babies were stillborn, mostly in low and middle income countries. India has the highest number of stillbirths, with an estimated 592 100 deaths per year Aim : To evaluate the still birth rate of our institution and to assess the sociodemographic factors contributing to it, and to predict the maximum risk period for still birth. Material and Methods: All patients who gave consent and delivered a baby either vaginally or by caeserian section after 28 weeks of gestation during the study period(july 2019-June 2020) were included in the study.Still Birth was defined as a baby born after 28 completed weeks of gestation or weighing more than 1 kg,with no signs of life .Total no of patients during the study period were 2629, with 5 sets of twins. So total no of birth during the study period was 2634. Epidemiological data were compared between still birth and total births.Causes of still births were analysed and period of maximum risk for still birth was predicted. Statistical Analysis :Descriptiveanalytes were expressed in proportion. Chi square test was used to assess the significance level and p value of <.05 was taken as significant. Result: Total no. of births by either vaginal route or caesarean section during june 2019 to july 2020 were 2634 foetuses. among which,137 fetus were still born. So still birth rate was 52/1000 live births.Maximum no of still births were in the age group of 20-25 years 69(50.3%), were primigravida 46(33.5%), belonged to low socioeconomic status 95(69.3%), came from rural areas79(57.6%) and were unbooked 94(68.6%).There was statistically significant difference(p=.0012) in unbooked cases when still births and total births were compared. No cause could be attributable to still birth in 15(10.9%) of cases, whereas 81(59.1%) had maternal causes,17(12.4%) had fetal causes, 19(13.8%) had placental causes while 5(3.6%) had other reasons like acute infections or thermal burns. Major reason of StillBirth amongst the maternal causes, was labour complications 38(37.7%), whereas intra uterine growth restriction was the leading cause 8(5.8%) amongst the fetal factors.36-40 week was the gestational age during which maximum still births occured.95(69.31%) of still birth cases were delivered by vaginal route Conclusion:Majority of still births were in unbooked cases and labourcomplications were the leading cause of still births overall. Hence antenatal care and delivery by skilled attendant is of paramount importance. Routine antenatal care would also lead to early recognition of maternal and fetal high risk factors and their management.

Author(s):  
Sujatha Thankappan Lakshmi ◽  
Uma Thankam ◽  
Preetha Jagadhamma ◽  
Anuja Ushakumari ◽  
Nirmala Chellamma ◽  
...  

Background: The study of the risk factors contributing to still birth is imperative in our attempts to bring about a decline in the still birth rate.  By identifying the risk factors, we can understand the areas where specific interventions may be applied to bring about a reduction in the still birth rate. The aim of the present study was to identify the risk factors for stillbirth among the mothers attending Sri Avittom Thirunal Hospital, TrivandrumMethods: This was a prospective hospital based case control study conducted from March 2014- September 2015. Sample size was calculated as 100 cases and 200 controls. Odds ratios with 95% confidence interval were calculated using multi variate logistic regression.Results: The major risk factors associated with still births were maternal age, socio economic status, and obesity, sleep position during pregnancy, primi parity, hypertension and febrile illness during pregnancy. The risk of still birth was 3 times higher among mothers with hypertension compared to the control group.  Although the prevalence of diabetes slightly more in the case group it was not statistically significant. By analyzing all the risk factors in preparing a model 42% of the risk for still birth was contributed by these factors.Conclusions: The modifiable risk factors seen in this study to prevent still births are maternal sleep position during pregnancy, diabetes, hypertension and febrile illness especially urinary tract infection. By better antenatal care we can detect complications like diabetes, hypertension and manage appropriately thereby preventing complications. By screening for urinary tract infections in every trimester morbidity can be reduced.


2020 ◽  
Vol 9 (1) ◽  
pp. 12-16
Author(s):  
Qurat ul Ain Khalid ◽  
Imran Mahmood Khan ◽  
Wajeeha Amber ◽  
Aqmal Laeeq Chishti ◽  
Khawaja Amjad Hassan

Background: Goal of the expanded program on immunization (EPI) is to ensure full immunization of children under one year of age to globally eradicate poliomyelitis, tetanus, measles-related deaths and to extend all new vaccines and preventive health interventions to children in all parts of the world. Demographic and health survey 2012-13 showed that in Pakistan complete immunization coverage is very low (54%) to achieve this goal. The objective of this study was to assess any improvement in terms of vaccination coverage in Pakistan in the last 3-4 years.Material and Methods: This descriptive cross-sectional study was carried out at outpatient department of Pediatric Medicine of Mayo Hospital Lahore from May, 2016 till November, 2016. The non-probability purposive sampling technique was used to include patients after taking informed consent. Demographic details were collected and parents were questioned about different vaccinations received and confirmed through vaccination card. Data analysis was done through SPSS version 20 and results were presented as frequencies and percentages. Chi-square test was applied for association among categorical variables.Results: Complete coverage of expanded program on immunization was achieved in 86% children. A statistically significant difference was noted between mother’s education and immunization coverage of children (P-value 0.013).Conclusions: Education of mother and socioeconomic status were two significant factors affecting immunization coverage. In order to meet target of 95% immunization coverage rate set by WHO, more awareness should be created among people with low socioeconomic status along with improvement of immunization facilities in these areas.Key words: Children, Expanded Program on Immunization, Immunization Coverage


2021 ◽  
Author(s):  
Melese ◽  
Sisay

Abstract Background: The cause of stillbirth is often unknown, but can be attributable to various causes; hypertensive disorders and obstetric factors supposed to complicate pregnancy and may cost the life of the fetus. It is the series pregnancy problem not precisely known and only available few research findings are inconsistent & not well established.Objectives: The aim of this study is to assess the association between Stillbirth and hypertensive disorder and obstetric factors.Methods: Facility based unmatched case-control study design was employed from January2018 to June2019, (287 cases and 574 controls) was selected using systematic random sampling methods. Double population proportions formula with 1:2 case to control ratio was used to calculate sample size with 95% confidence interval and 80% power. The data was collected from clinical records of mother’s a using data collecting checklist. Epi data version 4.4.2.1 was used for data entry, and analysis was done by SPSS version 21 statistical software. Descriptive analysis such as frequency, percentage and chi-square test were done. For the inferential analysis, a multivariable analysis was done. Statically significant was used at a p-value <0.05 both for the univarible and multivariable analysis.Result: Women who had hypertensive disorder were 1.76 times at risk to have stillbirth than no hypertensive disorder (AOR: 1.76: 95%CI :( 1.06, 2.9). In addition, women who had first antenatal care at third trimester were 4 times at higher risk to have still birth than women, who had first antenatal care at first trimesters (AOR: 4, 95%CI: (1.54, 11). Women who had more than four children were 2.6 times at higher risk of having still birth compared with women one child (AOR: 2.6, 95%CI: (1.2, 5.7). Furthermore, the odds of having still birth was found to be higher in women, who had blood group O than blood group A (AOR: 1.7: 95%CI: (1.057, 2.8).Conclusion: According to the findings of this study, we conclude that a hypertensive disorders and obstetric factors were risk factors for stillbirth. Therefore, it is significant to give special attention to women with hypertensive disorder and multipara women.


2016 ◽  
Vol 11 (3) ◽  
Author(s):  
Aqila Fazil ◽  
Fareed Zafar ◽  
Al Asifa ◽  
Noreen Akmal ◽  
Attiya Karim

Aims and objectives; To analyse the prevalence and perinatal mortality in cord prolapse. Study design: All cases of cord prolapse managed in gynae unit 3 at Sir Ganga Ram Hospital were identified. Period: From 20 March 2004 to 20 March 2005. Results: 23 patients of cord prolapse and presentation were identified During this time 5408 births took place giving a prevalence of I in 235 total births which comes upto 0.42%. There were 6 cases of cord presentation (0.11%) and 17 cases of cord prolapse (0.31%).19 cases were born alive(82.6%). There were 4 still births giving a still birth rate of 17.4% or 174/1000 births with cord prolapse and presentation. One neonatal death occurred among 19 live born babies giving a rate of 5.21% or 52.1/1000 live births . The uncorrected perinatal mortality was 217/1000 births or 21.7% with cord prolapse and presentation. Conclusion: : Cord prolapse and presentation occur with prevalence of 0.43% The perinatal mortality rate in this series was 21.7% of births with cord prolapse and presentation.


2020 ◽  
Vol 30 (3) ◽  
Author(s):  
Agus Dwi Harso ◽  
Hadjar Siswantoro ◽  
Armaji Kamaludi Syarif

Abstract One of the government’s efforts to reduce MMR, which is still high, is the implementation of the Antenatal Care (ANC) program at the primary health center (PHC). Besides, the government also accredits PHC to improve the quality of health services starting in 2015, so it is hoped that ANC achievements will increase. This study aims to determine the relationship between accreditation status and ANC achievements in PHC. The study design was cross-sectional with a sample of 103 accredited PHC. The distribution of PHC samples is seen based on the 2013 Public Health Development Index (IPKM) categorized as low, medium, and high. Analysis of the relationship between accreditation status and the K4 achievement program used the chi-square test. The results of this study indicate that the majority of the PHC in the sample are distributed in areas with a high and medium IPKM areas. The relationship between accreditation status and K4 achievement showed a value of p = 0.034. The logistic regression results showed that when compared with primary - complete accredited PHC, basic PHC had OR = 0.224 (95% CI: 0.064 - 0.786) with p = 0.020 to the proportion of K4 achievements. Meanwhile, the middle PHC had OR = 0.517 (95% CI: 0.146 - 1.828) with a p-value = 0.306. This study concludes that the accreditation status of PHC is related to the proportion of K4 achievements. The proportion of K4 achievements increases with the increase in the level of PHC accreditation. A basic accredited PHC has a chance to achieve K4 by 0.224, lower than a primary – complete accredited PHC. There was no significant difference between middle accredited PHC with primary - complete PHC for the proportion of K4 achievement Abstrak Salah satu upaya pemerintah menurunkan AKI yang masih tinggi adalah dengan pelaksanaan program Antenatal Care (ANC) di puskesmas. Selain itu, pemerintah juga melakukan akreditasi puskesmas untuk meningkatkan mutu pelayanan kesehatan yang dimulai tahun 2015, sehingga diharapkan capaian ANC meningkat. Penelitian ini bertujuan untuk mengetahui hubungan status akreditasi terhadap capaian ANC di puskesmas. Desain penelitian ini adalah crosssectional dengan sampel penelitian sebanyak 103 puskesmas terakreditasi. Sebaran sampel puskesmas dilihat berdasarkan Indeks Pembangunan Kesehatan Masyarakat (IPKM) tahun 2013 dengan dikategorikan sebagai IPKM rendah, sedang, dan tinggi. Analisis hubungan status akreditasi dengan program capaian K4 digunakan uji chi-square. Hasil dari penelitian ini menunjukkan mayoritas puskesmas yang menjadi sampel terdistribusi pada wilayah dengan IPKM tinggi dan sedang. Hasil analisis chi-square hubungan antara status akreditasi dengan ketercapaian K4 menunjukkan nilai p=0,034. Hasil regresi logistik menunjukkan bahwa jika dibandingkan dengan puskesmas terakreditasi utama-paripurna, puskesmas terkareditasi dasar mempunyai OR = 0,224 (95%CI: 0,064 - 0,786) dengan nilai p = 0,020 terhadap proporsi capaian K4. Sedangkan puskesmas terkareditasi madya mempunyai OR = 0,517 (95% CI: 0,146 - 1,828) dengan nilai p = 0,306. Kesimpulan penelitian ini adalah status akreditasi puskesmas berhubungan dengan proporsi capaian K4. Proporsi capaian K4 meningkat seiring meningkatnya satus akreditasi puskesmas. Puskesmas terakreditasi dasar mempunyai peluang untuk tercapaianya K4 sebesar 0,224 lebih rendah dibandingkan puskesmas terakreditasi utama - paripurna. Tidak ada perbedaan yang signifikan antara puskesmas terakreditasi madya dengan puskesmas terakreditasi utama-paripurna terhadap proporsi capaian K4.


Author(s):  
Teungku Nih Farisni ◽  
Dian Fera

ABSTRAK Tingginya angka kematian ibu dan bayi di wilayah pesisir Kabupaten Nagan Raya menjadi perhatian khusus disektor kesehatan. Salah satu penyebabnya adalah pendidikan pada masa hamil (prenatal) yang minim, pendidikan prenatal sangat penting dalam rangka mempersiapkan pasangan untuk menjadi orang tua. Kurangnya pengetahuan ibu hamil tentang kehamilannya merupakan salah satu bentuk ketidakberdayaan yang dapat mendukung tingginya angka kematian ibu/perinatal. Kegiatan pengabdian ini dilakukan bertujuan untuk mengimplemantasikan program berbasis masyarakat yang memfasilitasi masyarakat untuk membentuk kelompok hamil pintar dan meningkatkan pengetahuan ibu hamil dan meningkatkan kepatuhan ibu hamil untuk melakukan Antenatal Care (ANC) di Wilayah Pesisir Kabupaten Nagan Raya. Metode Penelitian ini adalah one group pre post design dengan Training Of Trainer (TOT) kader berjumlah 10 kader yang diukur pengetahuan, sikap, dan self-efficasy sebelum dan sesudah TOT. Instrumen yang digunakan adalah instrumen baku yang terdapat pada pedoman kelas ibu hamil. Setelah kader mengikuti TOT, kemudian kader membentuk kelompok ibu hamil pintar berjumlah 2 kelompok (10 ibu hamil/kelompok).  Analisis data menggunakan distribusi frekuensi dan uji Wilcoxon. Hasil kegiatan pengabdian ini adalah terdapat perbedaan yang signifikan dari pengetahuan, sikap, dan self-efficacy kelompok ibu hamil pintar (P-Value < 0,05). Melalui pembentukan kelompok ibu hamil pintar ini dapat diaplikasikan secara mandiri dan kontinue melalui kader kesehatan dengan pengawasan petugas kesehatan, sehingga bisa menurunkan angka kematian ibu dan angka kematian bayi. Kata Kunci: Ibu-hamil, Pintar, Kader, ANC ABSTRACT The high maternal and infant mortality rates in the coastal areas of Nagan Raya Regency are of particular concern in the health sector. One reason is that education in the prenatal period is minimal, prenatal education is very important in order to prepare couples to become parents. Lack of knowledge of pregnant women about pregnancy is one form of helplessness that can support the high maternal / perinatal mortality rate. This service activity was carried out aimed at implementing community-based programs that facilitate the community to form smart pregnancy groups and increase the knowledge of pregnant women and increase the adherence of pregnant women to carry out Antenatal Care (ANC) in the Coastal Area of ​​Nagan Raya Regency. The method of this research is one group pre post design with training of trainers (TOT) cadres totaling 10 cadres who measured knowledge, attitudes, and self-efficacy before and after TOT. The instruments used were standard instruments contained in class guidelines for pregnant women. After the cadres joined TOT, then the cadres formed 2 groups of smart pregnant women (10 pregnant women / groups). Data analysis using frequency distribution and Wilcoxon test. The result of this service activity is that there is a significant difference from the knowledge, attitudes, and self-efficacy of the group of smart pregnant women (P-Value <0.05). Through the establishment of this group of smart pregnant women, it can be applied independently and continuously through health cadres with the supervision of health workers, so as to reduce maternal. Keywords: Mother-pregnant, Smart, Cadre, ANC


2016 ◽  
Vol 11 (1) ◽  
pp. 30-36
Author(s):  
Upendra Pandit

Aims: The purpose of this study was to find out the time interval from admission to delivery in eclamptic/ severe preeclamptic mothers and see the relationship to their obstetrics (maternal and fetal) outcomes.Methods: A retrospective case review was conducted at Nepalgunj Medical College, Teaching hospital, Nepalgunj. About 152 mothers with eclampsia/severe preeclampsia and postpartum eclampsia whom received either loading or both loading and maintenance doses of Magnesium Sulfate, while they were admitted to the hospital from 1stJanuary 2011 to 31st December 2015. Out of them, 132 were eclampsia/severe preeclampsia (antepartum / intrapartum) and 20 mothers were postpartum eclampsia were enrolled in the study. Descriptive analysis was used by reviewing medical records and Maternity registers. A 95% CI and P-value of <0.05 were considered as statistically significant.Results: Among 132 mothers, 53 (40.1%), 35 (26.5%) and 44 (33.3%) mothers delivered within 2 hours, 6 hours and ≥12 hours respectively. Ninety seven (73.4%) mothers underwent caesarean section, 27 (20.4%) had spontaneous vertex delivery 8(6%) underwent assisted vaginal deliveries. Out of 139 births there were 118 (84.8%) live births; 21 (15.1%) still births. The apgar score ≥7 at 5 minutes was seen in 81(58.2%) babies and low apgar <7 was seen in 37(26.6%) babies. and no evidence of live apgar "0" was seen in 23(16.5%).There were 2 neonatal deaths. Eleven still births in 2 hours, 4 in 6 hours and 6 in≥12 hours of admission were noted .Among 152 mothers including postpartum 20(13.1%) eclampsia, complications developed in 51 (33.5%) mothers. Maternal deaths were 2(1.3%).Conclusions: There is no significant difference in obstetrics outcomes in early (2 hour), later (6 hours) and late (≥12 hours) delivery of eclamptic/severe preeclamptic mothers. 


2019 ◽  
Vol 26 (06) ◽  
Author(s):  
Muslim Khahro ◽  
Qaimuddin Shaikh ◽  
Mehnaz Baloch ◽  
Surwaich Ali Channa ◽  
Arhama Shah

Objectives: To determine the frequency of dental caries in patients with type II diabetes mellitus. Study Design: Cross sectional study. Setting: Dental Department of Science of Dental Materials Department and Oral Pathology Department. Period: 6 months from October 2016 to February 2017. Material and Methods: All the diagnosed patients of type II diabetes mellitus either gender were selected for the study. Complete dental clinical examination and duration of diabetes were carried out. Dental caries were categorized as mild moderate and severe. Duration of diabetes was categorized as < years and > 5 years. All the data was recorded in the self-made proforma. Results: In this study total 58 patients were selected with history of type II diabetes mellitus; patient’s mean age was 46.36+5.34 years. Male gender was found in the majority 38(65.5%). Majority of the cases 37(63.8%) were found with low socioeconomic status. 26(44.8%) patients had history of type II diabetes mellitus less than 5 years, 32(55.2%) were with more than 5 years history of diabetes. 15.51% patients were without dental caries, 37.39% patients were with mild, 34.4% had moderate and 12.06% patients were with severe dental caries. No significant difference was found in severity of dental caries when compared with duration of diabetes p-value 0.93.  Conclusion: We concluded that there are a big prevalence dental caries among patients with type II diabetes mellitus, while severity of dental caries was insignificantly associated with duration of diabetes.


2019 ◽  
Vol 4 (1) ◽  
pp. 1
Author(s):  
Dini Kesuma

Synthesis of the 4-chlorobenzoylthiourea compound was carried out by acylating thiourea with 4-chlorobenzoyl chloride. The 4-chlorobenzoylthiourea compound  will increase the lipophilic and the electronic properties other than the lead compounds of benzoylthiourea in order to, by expectation, raise the central nervous system depressant as well. The lipophilic would affect the ability of the compounds in penetrating biological membranes, which is highly dependent on the solubility of the drug within lipid/water. Log P is the most common method used in determining the parameter value. This experiment was to mix two dissolvents (octanol and water) which are immissible. The both levels of the compounds were carefully observed by a spectrophotometer UV-Vis. From the test, the result of log P value of the 4-chlorobenzoylthiourea compound was 2.32, while the theoretical log P value of the compounds, by using the π Hansch-Fujita method is 1.62 and the f Rekker-Mannhold method is 2.225. Consequently, the result of the test shows that there is a significant difference between the progress experiment and both theoretical log P methods. Moreover, in the test of the central nervous system depressant through the potentiation test to thiopental using mice indicates that the 4-chlorobenzoylthiourea compound have potentiation effects to thiopental compared to the lead compounds of benzoylthiourea.


Author(s):  
Eliyas Sulaiman Mohandas ◽  
Nik Mastura Nik Ismail Azlan ◽  
Salwa Othman ◽  
Muhammad Aizat Azhari

This study aims to investigate whether the use of six selected short stories throughout the duration of a 14-week course could enhance students’ reading comprehension achievement at the end of the semester. Out of the six short stories read, three were chosen as in-class assignments known as ‘Personal Reading Logs’ (hereafter, PRLs). One group of semester two Diploma students taking a reading skills course was selected through a convenience sampling method. A pre-test was conducted by having the students answer a past semester reading quiz of which the results would then be compared to their post-test (final reading exam) results. A paired samples t-test revealed no significant difference in the reading scores of the pre-test and the post-test, t (17) = -.265, p > .05. Since the p-value was bigger than 0.05, this indicated that the mean reading score of the post-test (M = 50.556) was not significantly higher than the mean reading score of the pre-test (M = 49.722). Therefore, the null hypothesis which stated that there was no difference in the mean score of the pre-test and post-test was retained. Overall, the result refuted the findings of other studies promoting the effectiveness of using short stories to enhance L2 reading comprehension achievement.


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