scholarly journals POST PARTUM HEMORRHAGE;

2017 ◽  
Vol 24 (09) ◽  
pp. 1347-1353
Author(s):  
Sardar Alfareed Zafar ◽  
Asim Shaukat ◽  
Ayesha Khalid ◽  
Ammara Niaz ◽  
Shagufta Noor
Keyword(s):  
Medical Therapy ◽  
Post Partum ◽  
Young Patients ◽  
Reproductive Capacity ◽  
Cross Sectional ◽  
Vaginal Deliveries ◽  
Future Fertility ◽  
Third Stage ◽  
Conventional Medical Therapy ◽  
Time Required

Primary postpartum hemorrhagic, rightly called as obstetrician’s nightmare,refers to excessive blood loss of more than 500ml during the third stage of labour or in the first24 hours after delivery. It continues to be one of the leading causes of maternal mortality andmorbidity all over the world including Pakistan where it is responsible for 21-31% of maternalmortality and morbidity. Objectives: Objective of study was to determine the efficacy of balloontamponade in the management of primary PPH, so that a low cast, easy to use technology isavailable for conserving future fertility by treating postpartum hemorrhage. Settings: Departmentof Gynae & Obs, Allied Hospital, Faisalabad. Study Design: Descriptive cross sectional study.Study Period: 6 months from 1st Oct, 2015 to 31st March, 2016. Material & Methods: All patientsdelivered vaginally at term (after 37 completed weeks of gestation) who developed PPH due touterine atony after failure of conventional medical therapy were included in this study. Patientselection was based on inclusion and exclusion criteria. Their demographic profile and efficacyof balloon tamponade was checked in terms of time required to control hemorrahage andneed of laparotomy. Results: During study period total no. Of vaginal deliveries were 3000.Out of these 298 developed PPH, 220 had PPH due to uterine atony and did not respond toconventional medical therapy. The age of patients ranged between 22 and 40 years with meanage of 30 year (±4.88SD). The parity of the patients ranged between 1 and 14 with the meanparity of 4 (±2.26SD). The condom catheter was introduced in all the selected 80 patients andwas successful in 73 patients. Conclusions: In developing countries such as Pakistan wherethe maternal death rate from PPH is very high, this safe, in expensive and easy procedure (itdoes not require any expertise) can be applied in any situation to save a life and to save theuterus in young patients to conserve reproductive capacity and prevent them from surgery andits morbidity. This will protect the patients from irreversible shock and even death with a successrate of 85-95%.

scholarly journals A prospective randomized controlled trial for comparison of oral misoprostol with methyl ergometrine in the third stage of labour for prevention of post-partum haemorrhage

2017 ◽  
Vol 6 (7) ◽  
pp. 2825 ◽  
Author(s):  
Sushma Gore ◽  
Atul Padmawar ◽  
Sabir Khan Pathan
Keyword(s):  
Post Partum ◽  
Tertiary Care ◽  
Active Management ◽  
Oral Misoprostol ◽  
Vaginal Deliveries ◽  
Third Stage ◽  
Group A ◽  
Post Partum Haemorrhage ◽  
Group B ◽  
Study Participants

Background: Near about 11% of women having live births have severe PPH (Globally 14 million women per year). About 3.9% of vaginal deliveries and 6.4% of cesarean section get PPH. Near about 1.4 million women die of PPH every year. Frequency of PPH is related to management of third stage of labour. Objective of the study was to compare the efficacy of misoprostol with conventional oxytocics for active management of third stage of labour.Methods: The present study was carried out in tertiary care teaching hospital for a period of three years from June 2007-May 2010. A total of 364 study participants who reported to labour ward with labour pains in latent phase and subsequently went in spontaneous labour were enrolled and randomly distributed to two groups and given oral misoprostol and i.v. ergometrine.Results: The mean age in Group A was 23.17±2.55 and 24.31±3.28 respectively. It was observed that most the study participants in both the groups had the duration of third stage of labour in between 10-14 minutes i.e. 29% in Group A and 36.3% in Group B respectively. The duration of third stage of labour was significantly more in Group B compared to Group A.Conclusions: Misoprostol is a promising drug in the management of third stage of labour for the prevention of post- partum haemorrhage.

scholarly journals Immediate postpartum intrauterine contraceptive device insertions in caesarean and vaginal deliveries: a comparative study

2020 ◽  
Vol 9 (10) ◽  
pp. 4140
Author(s):  
Ritu . ◽  
Mini .
Keyword(s):  
Vaginal Delivery ◽  
Retention Rate ◽  
Post Partum ◽  
Cross Sectional Study ◽  
Normal Vaginal Delivery ◽  
Contraceptive Device ◽  
Good Continuation ◽  
Cross Sectional ◽  
Vaginal Deliveries

Background: Post-partum family planning is prevention of unintended and closely spaced pregnancies during first 12 months following childbirth. Postpartum IUCD is the best method of all as it is the safest, most effective, has no effect on breast feeding, reliable and with minimum complications.Methods: The cross-sectional study was conducted in AIMSR Bathinda on 400 postpartum patients. It was a prospective, observational study of women who received PPIUCD in our region.Results: Out of total 400, 58% had normal vaginal delivery and 42% had cesarean section. PPIUCD was done in all cases after applying exclusion criteria and the females were called for follow up.  53% cases who had cesarean and 47% of normal vaginal delivery turned up for follow up. Acceptance is more in multipara (20.7%) than in primi patients (13.7%). Almost 90% patients had good continuation rate. There were few problems faced by patients like irregular bleeding for first few months, pain lower abdomen, leucorrhea etc. which were removed by good counseling and some treatment like NSAIDs for bleeding.Conclusions: The acceptance of PPIUCD was high in present study in both types of females delivered by normal vaginal delivery or post LSCS but with good counseling efforts. It was safe and effective and had high retention rate when done at good timing by trained service provider that is within 10 minutes of placental delivery. So the need of time is creating awareness of public towards it and removing fear from minds, breaking taboos and myths. 

scholarly journals HUBUNGAN MANAJEMEN AKTIF KALA III DENGAN KEJADIAN PERDARAHAN POST PARTUM PRIMER DI PBM UMI SURABAYA

2020 ◽  
Vol 3 (1) ◽  
pp. 35
Author(s):  
Sulenti Widiastutik
Keyword(s):  
Health Services ◽  
Health Workers ◽  
Post Partum ◽  
Sampling Technique ◽  
Active Management ◽  
Chi Square ◽  
Cross Sectional ◽  
Post Partum Hemorrhage ◽  
The Third ◽  
Third Stage

ABSTRAK ABSTRAK         Manajemen akif kala III merupakan suatu intervesi yang sangat penting dilakukan pada setiapasuhan persalinan normal dengan tujuan menurunkan angka kemati ibu. Sebagian besar kasus perdarahan terjadi selama persalinan kala III salah satunya seperti atonia uteri.         Dalam penelitian ini menggunakan metode analitik observasional, dengan desain penelitian ini bersifat “ cross sectional “ populasi penelitian ini sebanyak  60 ibu bersalin di PBMUmi Surabaya.Hasil penelitian menunjukkan bahwa manajemen aktif kala III dilakukan dengan sempuirna sebanyak 36 ibu  bersalin.(60%) dan ibu bersalin yang tidak mengalami perdarahan post partum primer sebanyak 33 ibu (55%) Populasi dalam penelitian ini adalah semua ibu  yang bersalin di PBM Umi Surabayadengan besar sampel sebanyak 60 ibu bersalin dengan tehnik total sampling.Dari hasil analisis data menggunakan chi square menunjukkan hasil   hitung (21,237) >  tabel (3,84) = Ho ditolak H1 diterima. Sehingga ada hubungan manajemen aktif kala III dengan kejadian perdarahan post partum primer di PBM Umi Surabaya        Upaya percepatan penurunan  AKI dapat dilakukan dengan menjamin agar setiap ibu mampu mengakses pelayanan kesehatan ibu yang berkwalitras, seperti pelayanan kesehatan ibu hamil, pertolongan persalinan oleh tenaga kesehatan terlatih, dan perawatan pasca persalinan ibu dan bayi, perawatan khusus dan rujukan jika terjadi komplikasi Kata kunci Manajemen aktif kala III, Perdarahan Post Paetum PrimerABSTRACTThe third stage of active management is a very important intervention performed in every normal childbirth care with the aim of reducing maternal mortality. Most cases of bleeding occur during the third stage of labor such as uterine atony.         In this study using observational analytic methods, the design of this study is "cross sectional" in this study population of 60 women giving birth in PBM Umi Surabaya.The results showed that the active management of the third stage was carried out with up to 36 mothers (60%) and women who did not experience primary post partum hemorrhage as many as 33 mothers (55%). a large sample of 60 mothers with total sampling technique. From the results of data analysis using chi square showed the results of X2 count (21,237)> X2 table (3.84) = Ho rejected H1 accepted. So there is an active management relationship between the third stage and the incidence of primary post partum hemorrhage at PBM Umi Surabaya        Efforts to accelerate the reduction of MMR can be done by ensuring that every mother is able to access quality maternal health services, such as health services for pregnant women, delivery assistance by trained health workers, and postpartum care for mothers and babies, special care and referrals if complications occur. Keywords Active management stage III, Primary Post Partum Bleeding

scholarly journals Study of incidence and outcome of acute inversion of uterus

2018 ◽  
Vol 7 (12) ◽  
pp. 5145
Author(s):  
Vidyadhar B. Bangal ◽  
Swati D. Gagare ◽  
Samita Bhardwaj ◽  
Sonal Raut
Keyword(s):  
Early Recognition ◽  
Hypovolemic Shock ◽  
Emergency Obstetric Care ◽  
Obstetric Care ◽  
Severe Anaemia ◽  
Rural Hospital ◽  
Active Management ◽  
Cross Sectional ◽  
Vaginal Deliveries ◽  
Third Stage

Background: Acute inversion of uterus also called as puerperal inversion of uterus is a rare, but life-threatening complication of third stage of labour. Severe uterine atony, mismanagement of third stage of labour, adherent placenta are some of the common factors associated with the occurrence of acute inversion of uterus. Early recognition and prompt treatment are important to save life of the woman.Methods: A retrospective cross-sectional record-based study was carried out to find out the incidence, presentation and outcome of cases of acute inversion of uterus admitted to Pravara Rural Hospital Loni for a period of three years (October 2015 to September 2018).Results: During the study period, there were 27,134 deliveries including 8,834 caesarean sections. There were six cases of acute inversion of uterus in the hospital during study period. The incidence of acute inversion of uterus was 0.22 per one thousand deliveries (0.27 per thousand vaginal deliveries and 0.11per one thousand caesarean sections). Three cases were referred from outside hospital and three cases had delivered at Pravara Rural Hospital. Five cases had delivered vaginally, where as one case had undergone caesarean section. There were two maternal deaths and four survivals among six cases of inversion of uterus. Severe anaemia, irreversible hypovolemic shock and multi-organ failure were causes of maternal deaths.Conclusions: Prompt recognition of uterine inversion and its immediate reposition under anaesthesia was a key for successful management. Delay in recognition and transfer of cases resulted in haemorrhagic and neurogenic shock, leading to death of a women. Institutional deliveries with practice of principles of active management of third stage of labour (AMTSL) and improvement in emergency obstetric care services at peripheral hospitals, avoiding delays at all levels will help to reduce the incidence, morbidity and mortality associated with acute inversion of uterus.

scholarly journals Outcome of Instrumental Vaginal Delivery at Patan Hospital

2018 ◽  
Vol 13 (3) ◽  
pp. 10-12
Author(s):  
Basant Lamichhane
Keyword(s):  
Vaginal Delivery ◽  
Apgar Score ◽  
Post Partum ◽  
Forceps Delivery ◽  
Maternal Complications ◽  
Cross Sectional ◽  
Vaginal Deliveries ◽  
Vacuum Delivery ◽  
The Mean ◽  
Minute Apgar Score

Aim: To estimate the severity of neonatal and maternal morbidity associated with instrumental vaginal delivery (IVD). Methods: Record based cross-sectional retrospective study of 80 instrumental vaginal deliveries during two years from 2013 to 2015 were performed. Variables studied were neonatal and maternal complications. Results: Out of 80 IVD, 19(23.8%) were forceps deliveries and 61(76.2%) were vacuum deliveries. The mean one minute Apgar score was 6 and 7 for forceps and vacuum delivery respectively. The five minute Apgar score for the both IVD was 8. Regarding maternal complications 7(8.75%) cases had extended episiotomy with deep vaginal tears. In forceps delivery 5 had deep vaginal tear and one each for primary post-partum hemorrhage and urinary retention but among the vacuum deliveries two had deep vaginal tear only. Regarding neonatal complications, one had subgaleal bleed in forceps delivery and one had cephalhematoma with Erbs palsy in vacuum delivery. Conclusions: The neonatal and maternal complications between both types of IVD were comparable. Forceps and repeated vacuum application resulted in low one minute Apgar score; and extended episiotomy and deep vaginal tear were associated with use of forceps.

1035325 Analisis Faktor Penyebab Terjadinya Post Partum Blues dengan Skrining Edinburgh Postnatal Depression Scale (EPDS)

2019 ◽  
Vol 9 (2) ◽  
pp. 126-136
Author(s):  
Adriani
Keyword(s):  
Postnatal Depression ◽  
Edinburgh Postnatal Depression Scale ◽  
Post Partum ◽  
Depression Scale ◽  
Cross Sectional ◽  
Postpartum Blues

Abstrak Perubahan peran seorang wanita menjadi seorang ibu tidaklah selalu berupa hal yang menyenangkan saja bagi pasangan suami istri, kadang kala terjadi terjadi konflik baik didalam diri wanita tersebut maupun konflik dengan suami. Jika perhatian terhadap keadaan psikologis ibu post partum kurang maka dapat menyebabkan ibu akan cenderung untuk mencoba mengatasi permasalahannya atau ketidaknyamanannya tersebut sendiri, keadaan ini jika dibiarkan saja dapat menyebabkan ibu post partum mengalami postpartum blues. Di Indonesia, diperkirakan terdapat 50-70% ibu pasca melahirkan mengalami postpartum blues pada hari 4-10. Penelitian ini menggunakan survey analitik dengan desain penelitian cross sectional, dengan jumlah sampel sebanyak 160 orang. Data diambil menggunakan kuesioner yang ditampilkan dalam analisa univariat dan bivariat menggunakan sistem komputerisasi SPSS. Hasil penelitian yaitu ada hubungan antara pendidikan ibu (p 0,013), pekerjaan ibu (p 0,013), dukungan suami (p 0,021), pendapatan keluarga dengan kejadian post partum blues (p 0,000) dan tidak ada hubungan antara paritas ibu (p 0,199), umur ibu (p 0,391), dan riwayat PMS (p 0,087) dengan kejadian post partum blues. Diharapkan bagi peneliti untuk dapat melanjutkan penelitian dengan variabel yang lebih bergam dan diharapkan bagi para tenaga kesehatan agar dapat meningkatkan pelayanan terutama dalam pemberian dukungan pada ibu masa post partum, sehingga mengurangi resiko ibu mengalami postpartum blues. Kata kunci : Postpartum blues, pendidikan, pekerjaan, dukungan suami, riwayat PMS

HUBUNGAN ANTARA UMUR IBU DAN JARAK KEHAMILAN DENGAN KEJADIAN PERDARAHAN POSTPARTUM DI RUANG KEBIDANAN RSUD KOTA PRABUMULIH TAHUN 2016

2019 ◽  
Vol 7 (2) ◽  
Author(s):  
Desti Widya Astuti Desti Widya Astuti
Keyword(s):  
General Hospital ◽  
Post Partum ◽  
District General Hospital ◽  
Study Data ◽  
P Value ◽  
Chi Square ◽  
Cross Sectional ◽  
Significance Level ◽  
Chi Square Test ◽  
Post Partum Bleeding

ABSTRAK   Berdasarkan data di RSUD Kota Prabumulih bahwa terdapat peningkatan jumlah kejadian perdarahan post partum, tahun 2014 sebanyak 178 orang, tahun 2015 sebanyak 246 orang dan tahun 2016 sebanyak 151 orang. Penelitian ini bertujuan untuk mengetahui hubungan umur ibu dan jarak kehamilan terhadap kejadian perdarahan post partum di RSUD Kota Prabumulih Tahun 2016. Penelitian ini merupakan penelitian analitik dengan rancangan cross sectional. Populasi yang digunakan adalah semua ibu bersalin di RSUD Kota Prabumulih, sebanyak 1.296 ibu bersalin dan 306 sampel. Pengambilan sampel dengan mengunakan random sampling, analisa data menggunakan analisa univariat dan bivariat dengan menggunakan uji statistik chi-square dengan derajat kemaknaan 0,05. Hasil penelitian ini menunjukan bahwa dari 288 ibu bersalin terdapat 151 yang mengalami perdarahan post partum sebagian besar adalah ibu dengan umur resiko tinggi sebanyak 43 orang  (40,9%) dan ibu dengan jarak kehamilan resiko tinggi sebanyak 21 orang (17,3%). Hasil uju chi-square umur didapatkan p.value 0,000 < α 0,05 dan uji chi-square untuk jarak kehamilan didapatkan p.value 0,000 < α 0,05. Maka ada hubungan umur ibu dan jarak kehamilan terhadap kejadian perdarahan post partum di RSUD Kota Prabumulih Tahun 2016. ABSTRACK   Based on the data at District General Hospital (RSUD) Prabumulih, there was increasing of post-partum bleeding, in 2014, there were 178 people. In 2015, there were 246 people. And in 2016, there were 151 people. The purpose of the study was to know relationship between maternal mother and the distance and old post-partum bleedingat District General Hospital (RSUD) Prabumulih in 2013. The study was analytic researchwith cross sectional design. Population thas was used in the study was all maternal mother ar District General Hospital (RSUD) Prabumulih. It was about 1.296 maternal mother and from 306. Random sampilng was done in the study, data analyses used univariate and bivariate analyses by using chi-square statistic test with significance level 0,05. The study result showed that from 306 maternal mother, there were 151 mother who experienced old post-partum bleeding, the large of that was high maternal mother 43 people  (40,9%) and mother age high distance 21 people (17,3%). The result of chi-square test was p value 0,000 < α 0,05 and chi-square test for age was p value 0,000 < α 0,05. It meant that there was relationship between maternal mother and the distance and of post-partum bleeding at District General Hospital (RSUD) Prabumulih in 2016.

Desigualdade social em doentes renais crônicos/ Social inequality in chronic renal patients

1970 ◽  
Vol 1 (1) ◽  
pp. 44-49
Author(s):  
Beatriz Bertolaccini Martínez ◽  
Fernanda Marcelino Da Silva ◽  
Vinícius Tavares Veiga ◽  
Rodrigo Pereira Custódio ◽  
José Vítor Da Silva
Keyword(s):  
Social Inequality ◽  
Access To Health Care ◽  
Young Patients ◽  
Cross Sectional Study ◽  
Access To Health Services ◽  
Access To Treatment ◽  
Cross Sectional ◽  
Economic Class ◽  
Access To Health ◽  
Clinical Background

Introdução: A pobreza influencia na evolução dos pacientes com doenças crônicas, porque contribui para o seu agravamento e dificulta o acesso à assistência médica. O objetivo deste trabalho foi avaliar os aspectos relacionados à desigualdade social de pacientes em hemodiálise. Métodos: Estudo transversal com 123 pacientes em hemodiálise no Hospital Samuel Libânio – Pouso Alegre, MG, divididos, de acordo com a classe econômica, em 3 grupos: AB (n=23), C (n=60) e DE (n=40),. Foram coletados dados sociodemográficos e econômicos, antecedentes clínicos e informações sobre o acesso a serviços de saúde. Para a análise dos resultados, foi utilizada estatística analítica e descritiva. Adotou-se p £ 0,05. Resultados: O grupo AB apresentou um menor número de pacientes jovens (4,3% em AB vs 40% em C e 25% em DE, p < 0,05), um maior número de indivíduos com mais anos de escolaridade (65,3% em AB vs 18,3% em C e 2,5% em DE; p < 0,05), predomínio de pacientes com menos de um ano em tratamento de hemodiálise (65,2% em AB vs 10% em C e 5% em DE, p < 0,05), menor número de usuários do SUS (40% em C e 25% em DE vs 4,3% em AB; p < 0,05) e maior acesso ao tratamento com nefrologista (73,9% em AB vs 46,7% em C e 52,5 em DE; p < 0,05). Conclusão: Classes economicamente desfavorecidas agregam indivíduos mais jovens, com menor escolaridade, usuários do SUS, com maior tempo em hemodiálise e pior acesso ao tratamento com nefrologista.Introduction: The poverty influence on the evolution of patients with chronic diseases because it contributes to your aggravation and hinders access to health care. Our goal was to evaluate the aspects related to social inequality on hemodialysis patients. Methods: cross-sectional study with 123 patients on hemodialysis in Samuel Libânio Hospital – Pouso Alegre, MG, divided according to the economic class, into 3 groups: AB (n = 23), C (n = 60) and DE (n = 40). Were collected socio-demographic and economic data, clinical background and information about access to health services. For analysis of the results has been used statistical analytical and descriptive. We take p £ 0,05.  Results: The AB group has fewer young patients (4,3% in AB vs 40% in C and 25% in DE, p< 0,05), a greater number of individuals with more years of schooling (65,3% in AB vs 18,3% in C and 2,5% in DE; p< 0,05), predominance of patients with less than a year on haemodialysis treatment (65,2% in AB vs 10% in C and 5% in DE, p< 0,05), smaller number of users of SUS (40% in C and 25% in DE vs 4,3% in AB; p< 0,05), greater access to treatment with nephrologist (73,9% in AB vs 46,7% in C and 52,5% in DE; p< 0,05). Conclusion: Economically disadvantaged classes bring younger patients, with less schooling, users of SUS, patients with greater time on hemodialysis and worse access to treatment with nephrologist. 

scholarly journals A Numerical Study of Sub-Millisecond Integrated Mix-and-Inject Microfluidic Devices for Sample Delivery at Synchrotron and XFELs

2021 ◽  
Vol 11 (8) ◽  
pp. 3404
Author(s):  
Majid Hejazian ◽  
Eugeniu Balaur ◽  
Brian Abbey
Keyword(s):  
Molecular Dynamics ◽  
Flow Rate ◽  
Numerical Study ◽  
Three Dimensional ◽  
Microfluidic Devices ◽  
Liquid Jets ◽  
Mixing Efficiency ◽  
X Ray Diffraction ◽  
Cross Sectional ◽  
Time Required

Microfluidic devices which integrate both rapid mixing and liquid jetting for sample delivery are an emerging solution for studying molecular dynamics via X-ray diffraction. Here we use finite element modelling to investigate the efficiency and time-resolution achievable using microfluidic mixers within the parameter range required for producing stable liquid jets. Three-dimensional simulations, validated by experimental data, are used to determine the velocity and concentration distribution within these devices. The results show that by adopting a serpentine geometry, it is possible to induce chaotic mixing, which effectively reduces the time required to achieve a homogeneous mixture for sample delivery. Further, we investigate the effect of flow rate and the mixer microchannel size on the mixing efficiency and minimum time required for complete mixing of the two solutions whilst maintaining a stable jet. In general, we find that the smaller the cross-sectional area of the mixer microchannel, the shorter the time needed to achieve homogeneous mixing for a given flow rate. The results of these simulations will form the basis for optimised designs enabling the study of molecular dynamics occurring on millisecond timescales using integrated mix-and-inject microfluidic devices.

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