scholarly journals Frequency of common factors leading to primary postpartum haemorrhage in patients presenting at Nishtar Hospital Multan.

2019 ◽  
Vol 26 (10) ◽  
pp. 1799-1804
Author(s):  
Hajira Masood ◽  
Sobia Mazhar ◽  
Syed Muhammad Ali ◽  
Muhammad Sajjad Masood ◽  
Saima Yasmin Qadir ◽  
...  
Keyword(s):  
Postpartum Haemorrhage ◽  
Mode Of Delivery ◽  
Significant Risk ◽  
Common Factors ◽  
Numerical Data ◽  
Cross Sectional Study ◽  
Uterine Atony ◽  
Delivery Mode ◽  
Cross Sectional ◽  
Maternal Deaths

Objectives: The objective was to determine the frequency of common factors leading to Primary postpartum hemorrhage. Study Design: Cross-sectional study. Setting: Study was conducted in obstetrics and Gynaecology ward of Nishtar Hospital Multan. Period: From 15-9-2017 to 14-03-2018. Material and Methods: Total 2119 deliveries were done in hospital during study period. Patients with loss of blood greater than 500 ml in vaginal delivery and 1000 ml in abdominal delivery were included. Main variables of study were age, paity, duration of delivery, mode of delivery. analysis was done by using SPSS for Window (version 10.0) Mean and stranded deviation was calculated for numerical data like ages of the patients and parity, while frequencies and percentages was calculated for qualitative data like mode of delivery. Results: 61.07% of the patients delivered vaginally and duration of labour was prolonged in 27.51% of cases. The single most frequent factor leading to primary postpartum haemorrhage was uterine atony i.e. in 48.99% of cases. Conclusion: Uterine atony was the most significant risk factors of primary postpartum haemorrhage. Our findings confirm the importance of previously recognized factors. Timely identification & management of these factors can help in reducing the incidence of maternal deaths.

scholarly journals Knowledge, Attitude and Practice on Postpartum Haemorrhage among Women in Kuantan, Pahang, Malaysia

2019 ◽  
Vol 10 (3) ◽  
pp. 2329-2333
Author(s):  
Sharifah Nadiah Syed Idrus ◽  
Nurjasmine Aida Jamani ◽  
Radiah Abdul Ghani
Keyword(s):  
Postpartum Haemorrhage ◽  
Cross Sectional Study ◽  
Excessive Bleeding ◽  
Cross Sectional ◽  
Maternal Deaths ◽  
Attitude And Practice ◽  
Level Of Knowledge ◽  
Socio Demographic Factors ◽  
Knowledge Attitude And Practice ◽  
Good Attitude

Postpartum haemorrhage (PPH) is defined as excessive bleeding of 500 ml or more within 24 hours after birth. It is known as one of the leading cause of maternal mortality worldwide. In Malaysia, from the year 2009 to 2014, PPH remained as one of the top contributors to maternal deaths; this suggests that the knowledge, attitude and practice on PPH among mothers in Malaysia still need to be improved. This cross-sectional study is aimed to determine the level of knowledge, attitude and practice on PPH, in addition to examining the association of socio-demographic factors with knowledge, attitude and practice of women in Kuantan, Pahang, Malaysia. This study involved 105 women who have experienced pregnancy and delivered at least once and is living in Kuantan. Self-administered questionnaires were distributed from February until March 2018. Data were analysed using the Statistical Package Software for Social Sciences (SPSS). From the findings, the level of knowledge on PPH among women in Kuantan was average (n=73, 69.5%), whereas the level of attitude and practice of most respondents was found in a good level, 101 (96.2%) and 98 (93.3%) respectively. The factors that have significant associations with knowledge on PPH in this study were age group (p=0.016) and background of education (p<0.001). In conclusion, this study showed that most of the participants in Kuantan have a moderate level of knowledge on PPH yet possess a good attitude and practice on the management of PPH.

scholarly journals A study on peripartum hysterectomy in a tertiary referral government hospital

2019 ◽  
Vol 8 (12) ◽  
pp. 4971
Author(s):  
Chaithra M. ◽  
Tejeswini K. K. ◽  
Savitha C.
Keyword(s):  
Caesarean Section ◽  
Postpartum Haemorrhage ◽  
Mode Of Delivery ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Peripartum Hysterectomy ◽  
Obstetrics And Gynaecology ◽  
Vaginal Deliveries ◽  
Life Threatening ◽  
Emergency Peripartum Hysterectomy

Background: Emergency peripartum hysterectomy (EPH) is a major surgical venture invariably performed in the setting of life-threatening haemorrhage during or immediately after abdominal and vaginal deliveries. Aim of the study was to study the frequency and indications for peripartum hysterectomy and to assess the maternal outcome of peripartum hysterectomy.Methods: Cross sectional study was done in the department of obstetrics and gynaecology, Vanivilas hospital, Bangalore from September 2018 to august 2019. This study consists of 24 cases of emergency peripartum hysterectomy within 24 hours of delivery, operated at Vanivilas hospital.Results: The frequency of peripartum hysterectomy was 1.102/1000 deliveries and following caesarean section and vaginal deliveries are 3.544/1000 deliveries and 0.248/1000 deliveries respectively. Among 24 cases who had peripartum hysterectomy, 16 cases were delivered by caesarean section and 4 cases delivered by vaginal route while another 4 cases delivered by laparotomy for rupture uterus. 22 cases (91.67%) survived with major number of cases having morbidities and there were 2 (8.33%) maternal death.Conclusions: The most common mode of delivery before peripartum hysterectomy was Caesarean section. The most common indication was atonic postpartum haemorrhage. Better protocols for induction and augmentation of labour will decrease the necessity of peripartum hysterectomies.

scholarly journals A study on status of neonatal transport to a level III neonatal intensive care unit

2018 ◽  
Vol 5 (3) ◽  
pp. 1040
Author(s):  
P. Sampathkumar Sampathkumar ◽  
S. Gobinathan
Keyword(s):  
Neonatal Intensive Care ◽  
Mode Of Delivery ◽  
Cross Sectional Study ◽  
Current Status ◽  
Delivery Mode ◽  
Low Oxygen ◽  
Cross Sectional ◽  
Neonatal Transport ◽  
Mode Of Transport ◽  
Interfacility Transport

Background: In the past decade, great advancements in Neonatal care contributed to a fall in IMR. A further fall in IMR can only be achieved by improving the neonatal transport facilities. Hence to assess the current status of neonatal transport we undertook this study.Methods: This is a cross-sectional study of 75 neonates transported to our NICU. For all the babies, data regarding the place of birth, mode of delivery, mode of transport, etc. were collected. On admission parameters like blood glucose, temperature, CRT, SPO2, the presence of cyanosis, shock was assessed.Results: In the present study 64% of neonates came to our NICU on their conveyance. 67% of referrals from PHCs did not utilize ambulance facility. 30% of neonates had hypothermia on arrival. 35%had hypoglycemia on arrival. 15% had a low oxygen saturation on arrival. 15% had prolonged CRT on arrival. Only 8% of neonates received prior treatment. 11% babies did not have any referral slip. Only a very few had complete and proper referral advice.Conclusions: To further reduce the neonatal mortality rate, the neonatal transport facilities should be upgraded. A standard protocol should be formulated for interfacility transport. A separate fleet of neonatal ambulances well equipped and manned by trained personnel is the need of the hour.

scholarly journals POSTPARTUM HAEMORRHAGE

2011 ◽  
Vol 18 (04) ◽  
pp. 604-610
Author(s):  
TEHNIYAT ISHAQ ◽  
SAID AMIN ◽  
ISHAQ KHATTAK
Keyword(s):  
Risk Factors ◽  
Maternal Mortality ◽  
Postpartum Hemorrhage ◽  
Past History ◽  
Mode Of Delivery ◽  
Cross Sectional Study ◽  
Uterine Atony ◽  
Cross Sectional ◽  
High Dependency ◽  
History Of

Objective: To determine the frequency, risk factors and existing practice for the management of massive primary postpartum hemorrhage (PPH). Study design: Retrospective cross-sectional study. Setting: Department of Obstetrics & Gynaecology at Kuwait Teaching Hospital, Peshawar. Materials and methods: this study was performed from June 2008 to June 2010. Women who developed massive primary PPH after admission or were admitted with it, were included in the study. Medical record files of these women were reviewed for maternal mortality and morbidities which included mode of delivery, possible cause of postpartum hemorrhage, supportive medical and surgical intervention. Data was entered in the pre-structured proforma. Estimates of blood loss were made on history, visual parameters and patient’s condition. All the data was analyzed by using statistical computer soft ware SPSS 6. Results: During the study period total number of obstetrical admissions were 2944. Forty nine out of 2769 (1.76%) deliveries, developed massive primary PPH. The highest frequency of massive primary PPH was observed in grand multiparous patients. Uterine atony was the most common cause of the complication. Birth attendants other than doctor and delivery outside the study unit were significantly associated with the adverse outcome in these patients. Seventy five percent patients,(36/49) who had massive PPH, delivered vaginally. High dependency unit (HDU) was required in 12% (6/49) of women. Only one caesarian hysterectomy was done. There was one maternal mortality. Blood transfusions were required in 82% (40/49) of the patients. Conclusions: Postpartum hemorrhage can be a preventable condition if early identification and timely management of this complication and its risk factors is observed. Uterine atony is the leading cause of immediate PPH. The main risk factors for PPH due to uterine atony are high parity, a large fetus, multiple fetuses, hydramnios, or past history of PPH. Determining the frequency, risk factors and management of primary postpartum hemorrhage will help design stepwise protocols for prevention and management of primary PPH in our setup. 

scholarly journals ATONIC UTERUS;

2014 ◽  
Vol 21 (06) ◽  
pp. 1122-1127
Author(s):  
Bilqees Ara ◽  
Zaib-un- Nisa ◽  
Firdos Ara ◽  
Palwasha Kakar ◽  
Abdul Salam ◽  
...  
Keyword(s):  
Mode Of Delivery ◽  
Previous History ◽  
Sampling Technique ◽  
Cross Sectional Study ◽  
Uterine Atony ◽  
Reproductive Age ◽  
Sectional Study ◽  
Inform Consent ◽  
Cross Sectional ◽  
Number Of Patients

Objective: This study was designed to determine the frequency of uterine atony in cases of primary postpartum hemorrhage (PPH) and to point out risk factors for it and observe different ways of management for control of atonic primary (PPH). Design: Prospective cross sectional study. Place and Duration of Study: This prospective cross sectional study was conducted in Obstetrics & Gynecology Department unit-I, Bolan Medical Complex Hospital Quetta from 1st January to 31st December 2002 (one year). The study was conducted on 80 patients. Subjects and Methods: The study included all the pregnant women either booked or non-booked, who gave the inform consent. The sampling technique was convenience non probability. The patients were admitted through out-patient department and emergency, irrespective of age, place and mode of delivery, developing atonic primary PPH within twenty four hours and diagnosed as a case of uterine atony. All the cases of primary PPH other than due to uterine atony were excluded. Complete history, general physical examination, abdominal examination and pelvic examination was done.All the data was analyzed by SPSS version 10. Results: Total number of deliveries during study period was 1438. Total number of patients with PPH were 155 out of which, the cases with primary PPH were 139, contributing about 89.7%. The incidence of primary PPH was 9.6 %. Out of 139 patients, the leading cause of primary PPH was uterine atony, contributing to 57.6%. The incidence of atonic uterus was 5.6 %. The highest incidence of uterine atony (37.5%) was found in women aged 26-30 years, followed by (27.5%) women aged 21-25 years.The highest incidence of primary PPH due to uterine atony was found in para 5-8 (56.3%), 6.3 % were primigravidas, 8.7% in para 1-4 and 28.7% in patients having more than eight children. Simple management included inj. Syntometrine, Oxytocin, uterine massage controlled bleeding in 53.7% cases. Prostaglandins (PGF2-alpha & PGE2) were administered in 32 cases & successful in 22 (68.7%) cases. Uterine packing was done in 8 cases, out of it, in 5 patients bleeding controlled (62.5%). Ligation of uterine arteries was performed in 5 cases, it proved successful in 4(80%) & hysterectomy was done in 7.5% cases. Conclusions: Uterine atony is a major cause of primary PPH and major threat to the life of women in reproductive age. Uterine atony is more common in grand multipara, young women and in home delivery. Major risk factor for atony are previous history of primary PPH, grand multiparity, baby weight > 3.5kg & prolonged labour.

scholarly journals Delivery Mode Preference and Associated Factors among Pregnant Mothers in Harar Regional State, Eastern Ethiopia: A Cross-Sectional Study

2021 ◽  
Vol 2021 ◽  
pp. 1-7
Author(s):  
Fissaha Tekulu Welay ◽  
Berhanu Gebresilassie ◽  
Guesh Gebreayezgi Asefa ◽  
Meresa Berwo Mengesha
Keyword(s):  
Caesarean Section ◽  
Antenatal Care ◽  
Associated Factors ◽  
Caesarean Delivery ◽  
Mode Of Delivery ◽  
Cross Sectional Study ◽  
Delivery Mode ◽  
Sectional Study ◽  
Cross Sectional ◽  
Pregnant Mothers

Background. The right to prefer mode of delivery is a crucial component of compassionate and respectful care that fosters both maternal and neonatal well-being as the failure to respect the mother’s interest increases to the risk of maternal depression and posttraumatic stress. Thus, the aim of the study was to assess delivery mode preference and associated factors among pregnant women. Methods and Materials. The study was conducted in two hospitals and two health centers. We used a cross-sectional study design incorporating 398 pregnant mothers attending an antenatal care follow-up from February to May 2018. The study excluded pregnant mothers with any previous uterine surgery including caesarean delivery from participation due to their restricted chance to prefer their mode of delivery. Data were collected by using a pretested questionnaire. Data were entered to EpiData Manager version 3.1 and exported to Statistical Package for the Social Sciences version 22 for analysis. Besides, the analysis included both the bivariate and multivariable analyses to check the association between dependent and independent variables. Finally, level of statistical significance was declared at P value < 0.05. Result. The participant’s level of response was 100% (398). The age of the mothers ranges from 15 to 45 years old. The delivery mode preference of the caesarean section (C/S) and spontaneous vertex delivery (SVD) was 115 (28.9%) and 283 (71.1%), respectively. The study revealed that planned 47 pregnancy [AOR, 1.76; CI: 0.89-3.47], young age [AOR, 12.9; CI: 0.23-7.1], and primigravida [AOR, 1.24; CI: 0.29-5.2] were among the variables associated with maternal preference of caesarean section. Conclusion and Recommendation. Nearly one-third of the mothers preferred caesarean delivery as their mode of delivery due to fear of labor pain and repeated vaginal examination by the care providers. This is particularly seen in women who had received higher education level, claim their pregnancy as planned, their choice of delivery at hospital, young aged, pregnant for the first time, and those who had visited antenatal care repeatedly. This implies that policy makers and stakeholders should exert due emphasis to ongoing desire of caesarean delivery as the procedure is not without risk, if it is done without indication. For researchers, we recommend to investigate the preference of mode of delivery in a much broader aspect.

scholarly journals Monitoring migrant groups as a post-validation surveillance approach to contain the potential reemergence of lymphatic filariasis in Togo

2021 ◽  
Vol 14 (1) ◽  
Author(s):  
Monique Ameyo Dorkenoo ◽  
Martin Kouame Tchankoni ◽  
Degninou Yehadji ◽  
Kossi Yakpa ◽  
Mawèké Tchalim ◽  
...  
Keyword(s):  
Lymphatic Filariasis ◽  
Significant Risk ◽  
Public Health Problem ◽  
Test Strip ◽  
Cross Sectional Study ◽  
Sub Saharan Africa ◽  
Positive Case ◽  
Cross Sectional ◽  
Case Investigation ◽  
Migrant Groups

Abstract Background In March 2017, Togo was declared the first country in sub-Saharan Africa to eliminate lymphatic filariasis as a public health problem, but post-validation surveillance has been lacking. In some areas of the country, migrant groups from neighboring countries that are still endemic for LF pose a risk of reintroduction of LF to Togo. The objective of this study was to identify the risk posed by migrant groups by measuring their prevalence of LF infection and investigating any positive case using Togo’s case investigation algorithm to prevent resurgence of LF and sustain Togo’s elimination success. Method A cross-sectional study was conducted in 2018 in the northernmost region of the country. Three migrant populations were identified: (i) nomadic Peuhls, (ii) Togolese members of local communities who migrate annually to neighboring countries for seasonal labor, and (iii) refugees from Ghana who came to Togo because of a communal conflict in Ghana. A questionnaire was designed to collect data on demographics and history of LF and MDA; all participants were tested for circulating filariasis antigen (CFA) using the filariasis test strip (FTS). Any CFA-positive case was confirmed with nocturnal microfilaremia. Results Refugees, seasonal economic migrants and nomadic Peuhls represented 42.1%, 31.4% and 26.5% of the study participants, respectively. The overall prevalence of CFA was 4.2% (58/1391) with the highest prevalence in the nomadic Peuhl group (11.9%), but only one of them (0.07%) was confirmed positive with nocturnal microfilaremia. Using the case investigation algorithm, no other positive case was identified in the positive case’s surroundings. Conclusion This study demonstrates that nomadic Peuhls, with a CFA prevalence of 11.9%, pose a potential risk for reintroduction of LF into Togo while Ghanaian refugees and seasonal economic migrants do not appear to pose a significant risk. Periodic monitoring of migrants, especially the nomadic Peuhl population, is a potential post-validation surveillance approach that could be used to promptly detect any LF cluster that may arise.

To Study the Clinical Profile and Management of Cellulitis of Lower Limb in Northern India

2021 ◽  
pp. 153473462098667
Author(s):  
Tripta S. Bhagat ◽  
Luv Kumar ◽  
Prakhar Garg ◽  
Apoorv Goel ◽  
Amit Aggarwal ◽  
...  
Keyword(s):  
Bacterial Infection ◽  
Lower Limb ◽  
Surgical Intervention ◽  
Significant Risk ◽  
Cross Sectional Study ◽  
Common Complication ◽  
Cross Sectional ◽  
Medical College ◽  
Northern India ◽  
Working Age

Cellulitis is a bacterial infection of the dermis and subcutaneous tissues occupying a large proportion of hospital beds. This study was conducted for analysis of patients with cellulitis according to their demographics and clinical presentation and to examine their comorbidities, complications, and its management. This observational cross-sectional study was conducted in the Department of Surgery at Santosh Medical College and Hospitals involving a total of 60 cases having cellulitis and other soft tissue infections of lower limb. Analysis of their demographic profile, management, and complications was done. Cellulitis is seen commonly in males, 46 (76.6%). The mean age of patients affected by cellulitis in the study was 36.4 ± 1.23 years. The most common site affected is leg involving more people in field jobs. The most common risk factor was trauma in 46.6%, and other factors were diabetes mellitus and smoking, while abscess formation was the most common complication observed in 36.6% of cases. A total of 56.6% cases were managed conservatively, while 43.3% cases required surgical intervention. Mean hospital stay in this study was 5.02 ± 0.23 days. It was concluded that cellulitis is subcutaneous, spreading bacterial infection is more common in males, and its incidence is highest in working age group population. Lower limb is commonly involved. Trauma, smoking, and diabetes are significant risk factors for development of cellulitis. Abscess is the most common complication. About 50% patients with cellulitis can be managed conservatively and the rest require surgical intervention.

scholarly journals Dogs as Sentinels for Flavivirus Exposure in Urban, Peri-Urban and Rural Hanoi, Vietnam

Viruses ◽  
2021 ◽  
Vol 13 (3) ◽  
pp. 507
Author(s):  
Long Pham-Thanh ◽  
Thang Nguyen-Tien ◽  
Ulf Magnusson ◽  
Vuong Bui-Nghia ◽  
Anh Bui-Ngoc ◽  
...  
Keyword(s):  
Mosquito Control ◽  
Risk Mitigation ◽  
Significant Risk ◽  
Cross Sectional Study ◽  
Cross Reactivity ◽  
Enzyme Linked Immunosorbent Assay ◽  
Serum Samples ◽  
Cross Sectional ◽  
Major Health ◽  
Household Level

Diseases caused by flaviviruses, including dengue fever and Japanese encephalitis, are major health problems in Vietnam. This cross-sectional study explored the feasibility of domestic dogs as sentinels to better understand risks of mosquito-borne diseases in Hanoi city. A total of 475 dogs serum samples from 221 households in six districts of Hanoi were analyzed by a competitive enzyme-linked immunosorbent assay (cELISA) for antibodies to the pr-E protein of West Nile virus and other flaviviruses due to cross-reactivity. The overall flavivirus seroprevalence in the dog population was 70.7% (95% CI = 66.4–74.8%). At the animal level, significant associations between seropositive dogs and district location, age, breed and keeping practice were determined. At the household level, the major risk factors were rural and peri-urban locations, presence of pigs, coil burning and households without mosquito-borne disease experience (p < 0.05). Mosquito control by using larvicides or electric traps could lower seropositivity, but other measures did not contribute to significant risk mitigation of flavivirus exposure in dogs. These results will support better control of mosquito-borne diseases in Hanoi, and they indicate that dogs can be used as sentinels for flavivirus exposure.

Sociodemographic factors associated with postnatal maternal complications in public hospitals in Nairobi City County, Kenya

2021 ◽  
Vol 15 (1) ◽  
pp. 1-7
Author(s):  
Raheli Misiko Mukhwana ◽  
Margaret N Keraka ◽  
Meshack Onyambu
Keyword(s):  
Antenatal Care ◽  
Mode Of Delivery ◽  
Cost Effective ◽  
Sociodemographic Factors ◽  
Cross Sectional Study ◽  
Public Hospitals ◽  
Maternal Complications ◽  
Cross Sectional ◽  
Factors Associated ◽  
Focused Antenatal Care

Introduction/Aims Focused antenatal care provides individualised counselling, targeted assessment and safe, cost effective, evidence-based intervention. It has been implemented in developing countries as a strategy to improve maternal health. This study aimed to investigate sociodemographic factors associated with maternal complications in selected public county hospitals in Nairobi City County, Kenya. Methods This was a cross-sectional study using a sample of 397 postnatal women who were given a questionnaire, with sections on their sociodemographic and health characteristics. Data analysis was done using the Chi Square test to determine the association between study variables, with P<0.05 considered statistically significant. Results The study found that 30% of respondents reported a maternal complication during their current delivery outcome. Sociodemographic factors significantly associated with maternal complications were age (P=0.002), occupation (P=0.001) and income (P=0.011). The health factors associated with occurrence of maternal complications were number of deliveries (P=0.001) and mode of delivery (P=0.001). Conclusions A number of factors were found to be significantly associated with maternal outcomes, including age and occupation. Further studies to determine why young women do not use focused antenatal care are necessary, as this would help reduce the incidence of birth-associated complications.

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