Therapeutic Abortion Methods in Women in Educational and Medical Centers in Shiraz

2021 ◽  
Vol 17 ◽  
Author(s):  
Sedighe Alipanahpour ◽  
Naeimeh Tayebi ◽  
Mahnaz Zarshenas ◽  
Marzieh Akbarzadeh

Background: Pregnancy often results in abortion, and it has shown a steady or even a growing trend over the past few decades despite extensive efforts in prenatal care. Objective: This study aimed to investigate medical interventions for abortions in pregnant women referring to educational and medical centers in Shiraz, Iran, in 2018. Methods: In this cross-sectional study, 437 pregnant women who were referred to Shiraz Educational and Forensic Medicine Centers were selected. Then a questionnaire including demographic characteristics, midwifery information, and types of medical interventions was completed for each. Data were analyzed by SPSS software using statistical tests. Results: According to the results of the present study, most subjects were aged 31-40 years (202 (46%)), had a high school diploma (183 (41%)), and were housewives (331 (57%)). Most of their gestational age was in the range of 16-20 weeks (184 (41%)). There was also a significant positive relationship between maternal age and gestational age (p = 0.01). Misoprostol and cervical Foley were the most used methods in induced abortions with a forensic permit (44.3%), vaginal misoprostol was the most used method in induced abortions with other indications (43.9%), and most spontaneous abortions had no intervention (41.9%). Conclusion: Considering the importance of the medical abortion method, it is suggested for patients with different conditions in interventional studies. Also, the correct use of different family planning methods and identification of factors affecting the use of contraceptives are recommended after an abortion. Women’s education and men’s participation should be considered in the prevention of high-risk and unwanted pregnancies.

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
L Kundisova ◽  
N Nante ◽  
S Bardelli ◽  
C Lorenzini ◽  
L Alaimo

Abstract Background The timing of hospitalization of pregnant females could influence the outcomes of both mother and the baby. The aim of this study was to analyze impact of coming to hospital too early on outcomes of childbirth. Methods A cross-sectional study was conducted in the birth center of Siena University hospital (Italy), all women that gave birth between 2017 and 2019 were included. Examined variables were: age, parity, gestational age: GA(weeks), Bishop score at admission: BS (0-13; >9 high possibility of spontaneous delivery), time to delivery:TTD (min), labor duration:LD (min), n°of interventions (induction, amniorhexis, augmentation):NI, type of birth (vaginal/caesarean section: CS/operational birth: OB), laceration, episiotomy, hematic loss: HL (ml), skin to skin:StS and initiation of breastfeeding: BR (yes/no). The females that came too early were identified if TTD >75° percentile. Analysis was performed with Stata 12. Results A total of 758 females were analyzed (32.0±5.2years), 55.5% multiparous, average GA was 39.6±1weeks, average BS was 7.2±2.5; 63% had BS <9. Average TTD was 376.7±318.5min; 23% came too early (TTD 865.6±244), more likely primiparous (OR 3.9) and those with higher GA (OR 1.2). A negative correlation between BS and TTD was observed (Rho=-0.6), females with BS <9 had higher probability to have prolonged TTD (OR10.8). Ninety-three% had vaginal birth, 6%CS, 1%OB Average LD was 169.1±145 min, average NI was 0.64±0.93, 78% had lacerations, 7.2% episiotomy. Average HL was 299.3±282.7ml. Females with prolonged TTD had higher NI (1.2 ±1 vs 0.4±0.6), higher probability of CS (OR 3), OB (OR4.5) and episiotomy (OR3.6), lower probability of StS and BR (OR 0.9), prolonged LD (299±184 vs. 120±102) and major HL (347.2±301.8 vs 284.9±275.4). Conclusions Our study showed an association between too early arrival to hospital and adverse maternal and fetal outcomes in terms of higher use of medical interventions that can interfere with physiological processes. Key messages The risk of arriving too early in hospital for labor was higher in primiparous and in those with higher gestational age. The too early arrival in hospital for labor was associated within increased use of medical interventions, interfering with physiological processes.


Author(s):  
Margit Steinholt ◽  
Shanshan Xu ◽  
Sam Ol Ha ◽  
Duong Trong Phi ◽  
Maria Lisa Odland ◽  
...  

We conducted a cross-sectional study among 194 pregnant women from two low-income settings in Cambodia. The inclusion period lasted from October 2015 through December 2017. Maternal serum samples were analyzed for persistent organic pollutants (POPs). The aim was to study potential effects on birth outcomes. We found low levels of polychlorinated biphenyls (PCBs) and organochlorine pesticides (OCP), except for heptachlors, β-hexachlorocyclohexane (HCH), heptachlor epoxide, and p,p’-DDE. There were few differences between the two study locations. However, the women from the poorest areas had significantly higher concentrations of p,p’-DDE (p < 0.001) and hexachlorobenzene (HCB) (p = 0.002). The maternal factors associated with exposure were parity, age, residential area, and educational level. Despite low maternal levels of polychlorinated biphenyls, we found significant negative associations between the PCB congeners 99 (95% CI: −2.51 to −0.07), 138 (95% CI: −1.28 to −0.32), and 153 (95% CI: −1.06 to −0.05) and gestational age. Further, there were significant negative associations between gestational age, birth length, and maternal levels of o,p’-DDE. Moreover, o,p’-DDD had positive associations with birth weight, and both p,p’-DDD and o,p’-DDE were positively associated with the baby’s ponderal index. The poorest population had higher exposure and less favorable outcomes.


2019 ◽  
Vol 10 (2) ◽  
pp. 1110-1117
Author(s):  
Aseel Ghazi Rifat

This study was designed to evaluate maternal and obstetrical factors associated with a successful trial of labour after one caesarean section (TOLAC) as well as evaluating the associated fetal and maternal outcomes and to determine the rate of vaginal delivery and repeated C/S. A prospective cross-sectional study was done on 237 women with previous one C/S then patients were selected for the trial of labour based on the department protocol. Those who were chosen for TOL were strictly monitored & observed for the progress of labour and the outcomes were recorded in terms of mode of delivery, maternal & fetal complications and were analysed and compared with those who had repeated C/S. Seventy-three (30.8%) patient was delivered by elective C/S without trial, 109 (46%) of the patients who were admitted to labour room delivered vaginally while 55 (23.2%) delivered by emergency C/S. It has been found that maternal BMI of (<25), history of vaginal birth after C/S (VBAC) and smaller gestational age were significantly associated with the success of TOL and can predict the outcome. Higher maternal & fetal complications rates were reported in cases delivered by emergency C/S compared to those who delivered vaginally or through elective C/S. The trial of labour after one caesarean section is a safe alternative to repeated C/S and decreases the associated morbidities with repeated C/S. The success rate of TOLAC reported in this study was (66.5%). A successful TOLAC is associated with normal maternal BMI, smaller gestational age and history of the previous VBAC.


2021 ◽  
Vol 9 ◽  
Author(s):  
Latileta Odrovakavula ◽  
Masoud Mohammadnezhad ◽  
Sabiha Khan

Background: Adolescent population face a number of health concerns which calls for objective and comprehensive assessment of their wellness during their critical development phase. This study aimed to determine adolescent wellness and its predictors amongst adolescents in secondary schools in Fiji.Methods: This quantitative cross sectional study was conducted in four purposively selected schools in Suva and the greater Suva area, Fiji, between August and September, 2019. Students of Fijian nationality, enrolled into years 11-13 in the selected schools were purposively selected. A structured self-administered questionnaire was used to collect data on four dimensions of wellness including physical, emotional, social, and spiritual. Spearman's Rho correlation was conducted to test for associations. Descriptive and inferential statistical tests were applied to analyze the data by the SPSS software version 25. A p-value &lt; 0.05 was considered significant.Results: A total of 350 students participated in the study. Mean raw scores for wellness dimensions were as follows: physical = 51 (out of 60), psychological = 63 (out of 80), social = 42 (out of 50), and spiritual = 34 (out of 40). For overall wellness, two significant differences were observed: students of Fijian Itaukei descent (193.68 ± 14.2) and participants with a family income of $40,000-50,000 (199.08 ± 12.60) (p = 0.04) had a higher overall wellness score. There were three significant differences observed for psychological wellness dimension; Fijians of Indian descent (64.68 ± 9.30), participants enrolled into year 13 (64.68 ± 9.30) and those with a family income of $40,000-50,000 had higher psychological score. For social wellness, a significant difference was observed: Itaukei participants had higher scores (43.34 ± 4.42) when compared to other ethnic groups (p &lt; 0.05). In terms of spiritual wellness, a significant difference was observed for ethnicity: Itaukei participants had a higher mean score (35.59 ± 4.26) when compared to other ethnic groups (p &lt; 0.05). Strong correlations were observed for all dimensions of wellness.Conclusions: Findings of this study highlighted different factors affecting adolescents' wellness in Fiji. It is recommended that health education and awareness program be carried out for developing adolescent wellness by considering these factors. It is also recommended that parental and family support are provided to adolescents.


2020 ◽  
Author(s):  
Yeliz Mercan ◽  
Kevser TARI SELCUK ◽  
Figen DIGIN ◽  
Hasan SAYGIN

Abstract Background: The aim of the present study was to determine the level and predictors of prenatal distress in pregnant women according to gestational age.Methods: This a cross-sectional study was conducted in eight Family Health Centers (FHCs) in Kirklareli, in Turkey. The study included 179 pregnant women who presented to the FHCs, who were at ≥12th week of gestation. Results:The frequency of prenatal distress in the participants was 21.2% (between 12th-27th weeks:16.5%, between 28th-41st weeks: 26.8%). It was found that level of education, age of the spouse, current pregnancy being unplanned, and social support levels were associated with the level of prenatal distress in ≥12th week or between 12th-27th weeks or between 28th-41st weeks (p<0.05). And also, perceived income level, abortion, and the number of pregnancies were associated with the level of prenatal distress in ≥12th weeks; the age of women, perceived income levels, previous abortion experience, and the number of pregnancies were associated with the level of prenatal distress in between 12th-27th weeks; the age of women, education level of spouse', and previous birth experience prenatal distress levels were associated in between 28th-41st weeks (p<0.05).Conclusion: The level of prenatal distress according to the gestational age, the education level of the woman, the age of her spouse’, the unplanned pregnancy, and social support levels were predictors. In both periods, the age of women were determinants in prenatal stress levels in pregnant women. Pregnant women should be screened and evaluated for prenatal distress in their application to FHCs.


2020 ◽  
Author(s):  
Atefeh Ghanbari ◽  
Somaye Pouy ◽  
Latif Panahi ◽  
Abolfazl Etebarian Khorasgani ◽  
Fateme Hasandoost

Abstract BackgroundViolence in the workplace is one of the most important risk factors worldwide. Nurses are always exposed to all kinds of violence due to their presence and activity in medical centers and direct contact with patients and their companions, as well as exposure to various stressors. The aim of this study was to determine the violence against nurses working in Razi educational and medical center in Rasht, Guilan.MethodsThe present study was an analytical cross-sectional study that was performed on 112 nurses working in Razi educational and medical centers in Rasht by convenience sampling method. The instrument used includes a questionnaire to assess workplace violence in medical settings, which has been used in several Iranian studies and has been psychometric assessed by Najafi et al, In Iran. After collecting the data and entering into the SPSS software version 22, they will be evaluated through descriptive and inferential statistical tests (Chi-square, independent t-test and Fisher's exact test). The level of significance was considered as P<0.05.ResultsThe findings of this study showed that 11.1% of nurses experienced physical violence and 55.7% of them experienced verbal violence. Verbal violence is often caused by the patient's companions and physical violence is often caused by the patient, and in the majority of cases, those who did not report the violence attributed it to the uselessness of the report. In addition, the findings showed that there is a statistically significant relationship between education level and verbal violence (p = 0.02) and between work status (p = 0.02) and marital status (p = 0.02) with physical violence.ConclusionThe results of the study show that during the pandemic of COVID-19, verbal and physical violence for nurses occurred in several occasions, which requires the authorities to take effective measures to reduce the incidence of violence in hospitals.


2018 ◽  
Vol 2018 ◽  
pp. 1-6 ◽  
Author(s):  
Dwiana Ocviyanti ◽  
William Timotius Wahono

Background. Premature rupture of the membrane (PROM) is associated with high maternal as well as perinatal morbidity and mortality risks. It occurs in 5 to 10% of all pregnancy while incidence of amniotic membrane infection varies from 6 to 10%. This study aimed to determine the incidence of neonatal sepsis in Cipto Mangunkusumo Hospital and the risk factors. Methods. A cross-sectional study was done in Cipto Mangunkusumo Hospital, Jakarta, from December 2016 to June 2017. The study used total sampling method including all pregnant women with gestational age of 20 weeks or more experiencing PROM, who came to the hospital at that time. Samples with existing comorbidities such as diabetes mellitus or other serious systemic illnesses such as heart disease or autoimmune condition were excluded from the analysis. Results. A total of 405 pregnant women with PROM were included in this study. There were 21 cases (5.2%) of neonatal sepsis. The analysis showed that risk of neonatal sepsis was higher in pregnant women with prolonged rupture of membrane for ≥ 18 hours before hospital admission (OR 3.08), prolonged rupture of membrane for ≥ 15 hours during hospitalization (OR 7.32), and prolonged rupture of membrane for ≥ 48 hours until birth (OR 5.77). The risk of neonatal sepsis was higher in preterm pregnancy with gestational age of <37 weeks (OR 18.59). Conclusion. Risk of neonatal sepsis is higher in longer duration of prolonged rupture of membrane as well as preterm pregnancy.


2021 ◽  
Vol 15 (10) ◽  
pp. 3520-3523
Author(s):  
Muneeba Sadaf ◽  
Afshan Zaman ◽  
Fatima Bibi ◽  
Maria Tariq ◽  
Uzma Nayyer ◽  
...  

Objectives: To determine the frequency of asymptomatic bacteriuria in pregnantwomen. Study design: Descriptive, Cross sectional study Place and Duration: Department of Obstetrics & Gynaecology, Benazir Bhutto Hospital, Rawalpindi. 26th December 2017 to 25th June 2018 Materials & Methods: A total of 151 pregnant women of gestational age ≥28 weeks, 18 to 40 years of age were included. Patients with genital tract trauma, history of UTI in the past one year and urinary tract stones were excluded. Then clean-catch midstream urine was collected from each woman into a sterile universal container and sample was sent to the institutional laboratory for presenceor absence of asymptomatic bacteriuria. Results: Age range in this study was from 18 to 40 years with mean age of 28.78 ± 3.90 years. Majority of the patients 84 (55.63%) were between 18 to 30 years of age. Mean gestational age was 31.06 ± 1.67 weeks. Mean parity was 3.17 ± 0.99. Mean BMI was 27.44 ± 3.02 kg/m2. In our study, frequency of asymptomatic bacteriuria in pregnant women was found in 25 (16.56%) patients. Conclusion: This study concluded that frequency of asymptomatic bacteriuria in pregnant women is quite high. Keywords: Asymptomatic Bacteriuria, Pregnancy, Urinary Tract Infection.


Author(s):  
Sirlei Morais ◽  
Simony Nascimento ◽  
Ana Godoy-Miranda ◽  
Karina Kasawara ◽  
Fernanda Surita

Objective To evaluate the relation between changes the body mass index (BMI) percentile, reflected in the Atalah curve, and perinatal outcomes. Methods A cross-sectional study with 1,279 women was performed. Data regarding gestational weight, sociodemographic characteristics and perinatal outcomes were collected through medical charts, prenatal card and interviews in the postpartum period. Women could be classified according to the Atalah curve in the following categories: low weight, adequate weight, overweight, and obese. The BMI was calculated at the first and at the last prenatal care visits, and these values were compared. Results An increase in the BMI category according to the Atalah classification occurred in 19.9% of pregnant women, and an increase of 3.4, 5.8 and 6.4 points of BMI were found for women respectively classified in the adequate weight, overweight and obese categories at the first prenatal visit. Women with high school education presented a lower chance of increasing their BMI (odds ratio [OR] 0:47 [0.24- 0.95]). Women who evolved with an increase in the the Atalah classification were associated with cesarean section (OR 1.97–2.28), fetal macrosomia (OR 4.13–12.54) and large for gestational age newborn (OR 2.88–9.83). Conclusion Pregnant women who gained enough weight to move up in their BMI classification according to the Atalah curve had a higher chance of cesarean section and macrosomia. Women classified as obese, according to the Atalah curve, at the first prenatal visit had a high chance of cesarean section and delivering a large for gestational age newborn.


2021 ◽  
Vol In Press (In Press) ◽  
Author(s):  
Sedigh Alipanahpour ◽  
Naeimeh Tayebi ◽  
Mahnaz Zarshenas ◽  
Marzieh Akbarzadeh

Background: Abortion is an important pregnancy complication with short-term and long-term adverse physical and psychological effects on women. Objectives: The present study aimed to investigate the short-term physical and psychological effects of various types of medical abortion in pregnant women referring to educational and medical centers in Shiraz, Iran. Methods: In this cross-sectional study, among 5176 deliveries by the women referring to Shiraz Educational and Forensic Medicine Centers during a 4-month period, 437 pregnancies ended in abortion and thus were included in this study. A questionnaire was completed for each of the abortions, recording demographic characteristics and midwifery information. As well, the Mississippi Post Traumatic Stress Disorder Scale (M‑PTSD) was filled. Data were analyzed by SPSS software using appropriate statistical tests. Results: The most common physical complications of induced and spontaneous abortion were fever (10.3%) and the need for transfusion of blood products (4.6%). Among the patients who received abortion therapy, 73.1% had moderate stress due to psychological complications. Conclusions: Since the most common complications after abortion are fever, the need for blood transfusion, and bleeding, it is recommended to prepare a protocol to standardize post-abortion care. Most women in both induced and spontaneous abortion groups had moderate levels of stress. Due to the lack of attention to the mental health of the women experiencing abortion, it is necessary for these women to receive adequate supportive counseling, in addition to other medical services, after abortion.


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