The Expectations of Low and High Risk Pregnant Women Who Seeking Obstetrical Care in a Highly Specialized Hospital

Background: In the context of a highly specialized hospital, birth care might be is expected to be more medicalized and technocratic for both low and high risk pregnant women.Objective: This study aimed to explore the expectation of low and high risk pregnant women who seeking an obstetrical care in a highly specialized hospital.Methods: A single case study design was chosen for this study. The case under study was a tertiary and university affiliated hospital in Montreal, Canada. The data were collected through semi-structured interviews, field notes, participant observations and self-administered questionnaire. An inductive qualitative content analysis was used.Results: As a whole 157 women were participated in the study. The analysis of data showed that both high and low risk women felt more satisfied with the care they received if they were provided with informed choices, had the right to participate in the decision-making process and were surrounded by competent care providers and obstetric technology. The presence of an attentive care provider during labour who humanly cared for women and her family considered as essential component of birth care by women participant.Conclusion: A birth care provider in a tertiary hospital setting should aim to meet both physiological and psychological aspects of birth care, including respect of the fears, beliefs, values, and needs of women and their families. Integration of competent and caring professionals, as well as the use of obstetric technology, could enhance the level of certainty and assurance in both high-risk and low risk women in a tertiary hospital.

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Obstetric care providers are able to assess psychosocial risks, identify and refer high-risk pregnant women: validation of a short assessment tool – the KINDEX Greek version

BMC Pregnancy and Childbirth ◽

10.1186/s12884-015-0462-y ◽

2015 ◽

Vol 15 (1) ◽

Cited By ~ 7

Author(s):

Andria Spyridou ◽

Maggie Schauer ◽

Martina Ruf-Leuschner

Keyword(s):

High Risk ◽

Pregnant Women ◽

Assessment Tool ◽

Obstetric Care ◽

Care Providers ◽

Greek Version ◽

Psychosocial Risks ◽

Obstetric Care Providers

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Antenatal Care Utilisation and Content between Low-Risk and High-Risk Pregnant Women

PLoS ONE ◽

10.1371/journal.pone.0152167 ◽

2016 ◽

Vol 11 (3) ◽

pp. e0152167 ◽

Cited By ~ 13

Author(s):

Ping Ling Yeoh ◽

Klaus Hornetz ◽

Maznah Dahlui

Keyword(s):

High Risk ◽

Antenatal Care ◽

Pregnant Women ◽

Low Risk ◽

Care Utilisation

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Comparação da Aplicação da EER Hema-Obs a 250 Gestações da Consulta de Hematologia-Obstetrícia do Centro Hospitalar São João, Portugal Versus EER Galit Sarig a 90 Gestações no Rambam Health Care Campus, Israel

Acta Médica Portuguesa ◽

10.20344/amp.5200 ◽

2015 ◽

Vol 28 (2) ◽

pp. 189

Author(s):

Ana Salselas ◽

Inês Pestana ◽

Francisco Bischoff ◽

Mariana Guimarães ◽

Joaquim Aguiar Andrade

Keyword(s):

High Risk ◽

Risk Stratification ◽

Pregnant Women ◽

Receiver Operating Characteristic ◽

Operating Characteristic ◽

Characteristic Curve ◽

Risk Groups ◽

Low Risk ◽

Very High ◽

Receiver Operating

Introduction: Pregnant women with thromboembolic diseases, previous thrombotic episodes or thrombophilia family history were supervised in a multidisciplinary Obstetrics/ Hematology consultation in Centro Hospitalar São João EPE, Porto, Portugal. For the evaluation and medication of these women, a risk stratification scale was used. Purposes: The aim of this study was to validate a Risk Stratification Scale and thromboprophylaxis protocol by means of comparing it with a similar scale, developed and published by Sarig. Material and Methods: We have compared: The distribution, by risk groups, obtained through the application of the two scales on pregnant women followed at Centro Hospitalar São João, Porto, Portugal, consultation; the sensibility and specificity for each one of the scales (DeLong scale, applied to Receiver Operating Characteristic) curves; the outcomes in pregnancies followed in Hospital São João, Porto, Portugal Results: According to our Hema-Obs risk stratification scale, 29% were allocated to low-risk, 47% to high-risk and 24% to very-high-risk groups. According to Galit Sarig risk stratification scale, 24% were considered low-risk, 53% moderate, 16% high-risk and 7% as very high-risk group. In our study we observed 9% of spontaneous abortions, in comparison with 18% in the Galit Sarig cohort. From the application of Receiver Operating Characteristic curve to both risk stratification scales, the results of the calculated areas were 58,8% to our Hema-Obs risk stratification scale and 38,7% to Galit Sarig risk stratification scale, with a Delong test significancie of p = 0.0006. Conclusions: We concluded that Hema-Obs risk stratification scale is an effective support for clinical monitoring of therapeutic strategies.

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Associations Among Depression, Leisure-time and Occupational Physical Activity of Health Care Providers in a Nigerian Tertiary Hospital Setting

African Journal of Physiotherapy and Rehabilitation Sciences ◽

10.4314/ajprs.v9i1-2.3 ◽

1970 ◽

Vol 9 (1-2) ◽

pp. 16-21

Author(s):

E.S. Aliyu ◽

A.F. Adeniyi

Keyword(s):

Physical Activity ◽

Health Care ◽

Health Care Providers ◽

Health Care Workers ◽

Leisure Time ◽

Health Benefits ◽

Hospital Setting ◽

Tertiary Hospital ◽

Care Providers ◽

Care Workers

Physical activity (PA) has been consistently associated with enhanced quality of life. The tight schedule of duty of health care workers may predispose them to physical inactivity and psychosocial morbidities which most of them tend to ignore while rendering services to others. The prevalence of depression among Nigerian health care workers and its association with PA is not known. This study investigated the levels of leisure-time and occupational PA and their association with depression among health care providers in a Nigerian tertiary hospital setting. The research was a cross-sectional survey of 734 health care providers. The Godin-Shephard Leisure Time Physical Activity Questionnaire, Occupational Physical Activity Questionnaire and the Depression Anxiety and Stress Scale were used to assess leisure-time PA, occupational PA and depression respectively. Data obtained were analysed using descriptive and inferential statistics at α= 0.05. The mean age of participants was 39.6 ± 9.4 years (range 22-57 years). Nearly half of the health care providers (46.2%) reported low participation or insufficient leisure-time PA that could provide substantial health benefits, while 20.2% participated in leisure-time PA that could give some health benefits and 33.7% participated in leisure-time PA that could give substantial health benefits. Sitting/standing were the main occupational PAs of the majority (96.2%) of the health workers. The overall prevalence for depression was 11.4%. There was a significant association between leisure-time PA and depression (χ2 =18.9, p= 0.016). There was no significant association between occupational PA and depression. There is low participation in leisure-time PA among health care workers and this is linked with depression. Efforts to improve participation in leisure-time PA among workers may help to relieve their depression symptoms. KEY WORDS: leisure time, occupation, physical activity, depression

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Implementing a Cardiovascular Screening Tool for High-Risk Pregnant Women in a Hospital Setting

Nursing for Women s Health ◽

10.1016/j.nwh.2021.11.001 ◽

2022 ◽

Author(s):

Aimee Black ◽

Jodi Gute ◽

Alice Kindschuh

Keyword(s):

High Risk ◽

Pregnant Women ◽

Screening Tool ◽

Hospital Setting ◽

Cardiovascular Screening

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The effect of periconceptional supplementation on blood vitamin concentrations in women at recurrence risk for neural tube defect

British Journal Of Nutrition ◽

10.1079/bjn19830026 ◽

1983 ◽

Vol 49 (2) ◽

pp. 203-211 ◽

Cited By ~ 42

Author(s):

C. J. Schorah ◽

J. Wild ◽

R. Hartley ◽

S. Sheppard ◽

R. W. Smithells

Keyword(s):

Folic Acid ◽

High Risk ◽

Vitamin C ◽

Neural Tube Defect ◽

Low Risk ◽

Vitamin Supplementation ◽

Mean Values ◽

High Risk Women ◽

The Mean ◽

Low Risk Women

1. We measured erythrocyte folic acid and riboflavin, serum folic acid and leucocyte vitamin C in women at high risk for neural tube defect (NTD) recurrence who were receiving periconceptional vitamin supplementation, before they received extra vitamins, after 28 d of supplementation and at the 8th week of pregnancy. Blood vitamin concentrations in unsupplemented high-risk women were also compared with the values found in unsupplemented low-risk women.2. Vitamin supplementation with Pregnavite Forte F (Bencard®) raised the mean values for all vitamins measured by the 8th week of pregnancy. Mean erythrocyte folic acid rose from 250 to 478 ng/ml; plasma folic acid from 8·4 to 26·1 ng/ml; leucocyte vitamin C from 1·82 to 3·21 μg/ml blood; erythrocyte riboflavin (glutathione reductase (EC 1.6.4.2) activation ratio) from 1·08 to 1·04. All women receiving supplements had increased their serum and erythrocyte folic acid levels above the highest values found in women in an earlier study, who subsequently gave birth to children with NTD. Not all women, however, increased their leucocyte ascorbic acid or erythrocyte ribflavin levels above the highest values.3. When vitamin concentrations in unsupplemented high-risk women were compared with levels in unsupplemented women at low risk for NTD, no significant differences were found in the mean values. However, a significantly higher proportion of high-risk compared with low-risk women had erythrocyte folic acid and leucocyte vitamin C values on or below the 5th percentile of the adult normal range.4. The effectiveness of Pregnavite Forte F (Bencard®) for increasing maternal vitamin reserves is discussed with a view to preventing NTD and the possibility of identifying groups at risk for NTD because of low blood vitamin levels is considered.

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Hemorrhage Risk Assessment on Admission: Utility for Prediction of Maternal Morbidity

American Journal of Perinatology ◽

10.1055/s-0040-1710501 ◽

2020 ◽

Author(s):

Homa K. Ahmadzia ◽

Jaclyn M. Phillips ◽

Rose Kleiman ◽

Alexis C. Gimovsky ◽

Susan Bathgate ◽

...

Keyword(s):

Risk Assessment ◽

High Risk ◽

Blood Transfusion ◽

Maternal Morbidity ◽

Assessment Tool ◽

Low Risk ◽

Risk Assessment Tool ◽

Maternal Outcomes ◽

Hemorrhage Risk ◽

Low Risk Women

Objective Hemorrhage is a major cause of maternal morbidity and mortality prompting creation of innovative risk assessment tools to identify patients at highest risk. We aimed to investigate the association of hemorrhage risk assessment with maternal morbidity and to evaluate maternal outcomes after implementation of the risk assessment across hospital sites. Study Design We conducted a retrospective cohort analysis of a multicenter database including women admitted to labor and delivery from January 2015 to June 2018. The Association of Women's Health, Obstetric and Neonatal Nurses risk assessment tool was used to categorize patients as low, medium, or high risk for hemorrhage. Multivariate logistic regression was used to describe the association between hemorrhage risk score and markers of maternal morbidity and evaluate maternal outcomes before and after standardized implementations of the risk assessment tool. Results In this study, 14,861 women were categorized as low risk (26%), 26,080 (46%) moderate risk, and 15,730 (28%) high risk (N = 56,671 births). For women with high-risk scores, the relative risk (RR) ratio compared with low-risk women was 4.9 (RR: 95% confidence interval [CI]: 3.2–7.4) for blood transfusion and 5.2 (RR: 95% CI: 4.6–5.9) for estimated blood loss (EBL) ≥ 1,000 mL. For the second objective, 110,633 women were available for pre- and postimplementation analyses (39,027 and 71,606, respectively). A 20% reduction in rates of blood transfusion (0.5–0.4%, p = 0.02) and EBL ≥ 1,000 mL (6.3–5.9%, p = 0.014) was observed between pre- and postimplementations of the admission hemorrhage risk assessment tool. Conclusion Women who were deemed high risk for hemorrhage using a hemorrhage risk assessment tool had five times higher risk for blood transfusion and EBL ≥ 1,000 mL compared with low-risk women. Given the low incidence of the outcomes explored, the hemorrhage risk assessment works moderately well to identify patients at risk for peripartum morbidity. Key Points

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Analisis Angka Seksio Caesarea di RSUP Dr. Sardjito Yogyakarta Tahun 2009-2013

Jurnal Kesehatan Reproduksi ◽

10.22146/jkr.36192 ◽

2016 ◽

Vol 3 (1) ◽

pp. 14

Author(s):

Netty Katrina Dameria ◽

Djaswadi Dasuki ◽

Rukmono Siswishanto

Keyword(s):

High Risk ◽

Caesarean Section ◽

Perinatal Outcome ◽

Risk Group ◽

Caesarean Section Rate ◽

National Level ◽

High Risk Group ◽

Low Risk ◽

Mortality And Morbidity ◽

Low Risk Women

Background: Caesarean section is a procedure to reduce maternal and perinatal mortality and morbidity. The caesarean section rate is continuously uprising in the last 3 decades. However, the increasing rate, especially in low risk women, may compromise maternal and perinatal outcome. In 1985, WHO recommended that optimal national caesarean rates should be in the range of 5% to 10% and the rate above 15% might be less benefits. Previous study conducted in DR Sardjito hospital reported caesarean section rate in 1996 was 13.38%, while in 2001 was 18.39%. In national level, based on Indonesia Basic Health Survey 2010, caesarean section rate was 10.8%. Therefore, in this study we analyzed the rate of Caesarean section performed in DR Sardjito hospital, and studied whether the operations occurred in high-risk group or low-risk group.Objective: To compare the rate of caesarean section between high-risk group and low-risk group in DR Sardjito hospitalMethod: Retrospective cohortResult and Discussion: Participants of this study were 7821 patients undergoing labor at RSUP DR Sardjito in 2009-2013. Among them, 3152 patients underwent caesarean section and 4669 patients underwent vaginal delivery. There was an increasing in the overall caesarean section rate of 38,7% in 2009 to 43% in 2013. T-test found the presence of significant differences between the caesarean section rate of high-risk group and low-risk group in 2009-2013 (p<0.05) with a mean difference was 28.5 (20.2-36.8). Caesarean section rate of high-risk group was significantly higher than the low-risk group (p<0.05).Conclusion: There was a difference in caesarean section rate of high-risk group compared to low-risk group. Caesarean section rate in high-risk group was significantly higher than in the low-risk group.Keywords: caesarean section rate, caesarean section, low-risk group, high- risk group

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KARAKTERISTIK IBU HAMIL YANG MENGALAMI HIPEREMESIS GRAVIDARUM

Jurnal Kebidanan : Jurnal Medical Science Ilmu Kesehatan Akademi Kebidanan Budi Mulia Palembang ◽

10.35325/kebidanan.v8i2.128 ◽

2019 ◽

Vol 8 (2) ◽

Author(s):

Yuni Kurniati Yuni Kurniati

Keyword(s):

High Risk ◽

Pregnant Women ◽

World Health Organization ◽

Gestational Age ◽

Health Workers ◽

Low Risk ◽

World Health ◽

Pregnancy History ◽

Risk Parity ◽

Health Organization

Kematian maternal menurut World Health Organization (WHO) mencapai 585.000 jiwa setiap tahun. Faktor predisposisi yang menyebabkan hiperemesis gravidarum antara lain paritas, usia kehamilan, riwayat kehamilan, umur ibu, pekerjaan, pendidikan, riwayat penyakit ibu, psikologis, pengetahuan, dan sosial budaya. Tujuan penelitian ini untuk mengetahui karakteristik ibu hamil yang mengalami hiperemesis gravidarum di Rumah Sakit Bhayangkara Palembang tahun 2017. Dengan menggunakan metode deskriptif yaitu untuk mendeskripsikan variabel paritas, usia kehamilan, riwayat kehamilan, umur ibu, pekerjaan, dan pendidikan ibu hamil yang mengalami hiperemesis gravidarum di Rumah Sakit Bhayangkara Palembang tahun 2017. Populasi dalam penelitian ini adalah semua ibu hamil yang mengalami hiperemesis gravidarum yang pernah dirawat di Rumah Sakit Bhayangkara Palembang tahun 2017 yang berjumlah 17 orang. Sampel penelitian diambil dengan menggunakan metode Porpusive Sampling. Hasil penelitian menunjukkan paritas resiko tinggi lebih sedikit (11,8%) dibandingkan paritas resiko rendah (88,2%). Usia kehamilan Trimester I lebih banyak (82,4%) dibandingkan Trimester II (17,6%). Ibu dengan molahidatidosa dan gemeli lebih sedikit (23,5%) dibandingkan dengan ibu yang tidak pernah mengalami molahidatidosa dan gemeli (76,5%). Umur resiko tinggi lebih sedikit (29,4%) dibandingkan dengan resiko rendah (70,6%). Ibu yang bekerja lebih sedikit (41,2%) dibandingkan dengan yang tidak bekerja (58,8%). Ibu yang berpendidikan tinggi lebih banyak (64,7%) dibandingkan dengan yang berpendidikan rendah (35,3%). Diharapkan kepada petugas kesehatan dapat memberikan informasi dan penyuluhan tentang hiperemesis gravidarum dan bagi peneliti selanjutnya agar meneliti dengan metode yang berbeda serta sampel yang lebih banyak. ABSTRACT Maternal mortality according to the World Health Organization (WHO) reach 585,000 inhabitants every year. Predisposing factors that cause hiperemesis gravidarum, among others, gestational age, parity, maternal age, pregnancy history, employment history, education, maternal diseases, psychological, social, and cultural knowledge. The purpose of this research is to know the characteristics of pregnant women who experience hiperemesis gravidarum Bhayangkara Hospital in Palembang year 2017. By using descriptive method to describe the variable parity, gestational age, pregnancy history, age, occupation, and education of pregnant women who experience hiperemesis gravidarum Bhayangkara Hospital in Palembang year 2017. The population in this research is all the pregnant women who experience hiperemesis gravidarum ever hospitalized Bhayangkara Palembang 2017 year totalling 17 people. Research samples taken using Porpusive method of Sampling. The results showed fewer high risk parity (11.8%) than low risk parity (88.2%). Pregnancy Trimester I more (82.4%) than a Trimester II (17.6%). Mom with molahidatidosa and fewer gemeli (23.5%) compared with mothers who've never experienced molahidatidosa and gemeli (76.5%). High risk age less (29.4%) compared to the low risk (70.6%). Mothers work less (41.2%) compared to not working (58.8%). Mothers who are highly educated more (64.7%) compared to the low educated (35.3%). Expected to health workers can provide information and guidance about the hiperemesis gravidarum and for subsequent researchers in order to examine different methods and samples more.

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