Does antenatal care facilitate utilization of emergency obstetric care? A case-referent study of near-miss morbidity in Bolivia

2010 ◽  
Vol 89 (3) ◽  
pp. 335-342 ◽  
Author(s):  
Mattias Rööst ◽  
Víctor Conde Altamirano ◽  
Jerker Liljestrand ◽  
Birgitta Essén
Keyword(s):  
Antenatal Care ◽  
Emergency Obstetric Care ◽  
Obstetric Care ◽  
Near Miss

scholarly journals Factors affecting stillbirth: prospective study

2021 ◽  
Vol 10 (3) ◽  
pp. 939
Author(s):  
Balaji Jadhav ◽  
Shweta Avinash Khade ◽  
Ganesh Shinde ◽  
Shilpa Chandan
Keyword(s):  
Antenatal Care ◽  
Gestational Age ◽  
Prospective Observational Study ◽  
Emergency Obstetric Care ◽  
Obstetric Care ◽  
Tertiary Hospital ◽  
Fetal Weight ◽  
Factors Affecting ◽  
Medical Disorders ◽  
Number Of Births

Background: Stillbirth is defined by WHO as the birth of a baby with a birth weight of 500 gm or more, 22 or more completed weeks of gestation or a body length of 25 cm or more, who died before or during labour and birth.Methods: This was prospective observational study of factors affecting stillbirth was conducted in tertiary hospital for a period of 1 year from 1st June 2014 to 31st May 2015. During the study period, 200 parturient of gestational age 28 weeks or more and fetal weight 1000 gm or more with or without medical disorders were included.Results: The total number of births during study period was 11,951. Stillbirth rate in the present study was 16.73 per 1000 births. Most of stillbirths were seen in the antepartum period (76%) when compared to intrapartum period (24%). Maximum stillbirths occurred in gestational age of 36 weeks and above (52%) and fetal weight between 2001-2500 gm (27.50%). Patients with inadequate antenatal care, less than three visits had 86% stillbirths.Conclusions: Proper antenatal care, prompt referral services and availability of emergency obstetric care will provide a pivotal role for reduction of stillbirths.

scholarly journals Review of obstetric fistulas in a rural hospital in South-South Nigeria

2011 ◽  
Vol 25 (1) ◽  
pp. 7
Author(s):  
Aniefiok J. Umoiyoho ◽  
Aniekan M. Abasiattai ◽  
Okon E. Akaiso
Keyword(s):  
Antenatal Care ◽  
Rural Areas ◽  
Formal Education ◽  
Health Workers ◽  
Medical Condition ◽  
Obstetric Fistula ◽  
Emergency Obstetric Care ◽  
Obstetric Care ◽  
Medical Personnel ◽  
Health Facilities

<em>Background</em>. Obstetric fistula is a devastating medical condition associated with adverse social, psychological and reproductive health consequences. This study was carried out to review the pattern of presentation and outcome of patients with obstetric fistulas in a rural health facility in South-South Nigeria. <em>Design and Method</em>. A retrospective review of case notes of 51 patients with obstetric fistula that were managed at the Family Life Center, Mbribit Itam, in Itu, Local Government Area of Akwa Ibom State. <em>Results</em>. During the study period, 51 obstetric fistulas were repaired in the hospital. The ages of the patients ranged from 15 to 50 years with median age of 25.8 years and modal age group of 21-30 years (45.1%). The majority of the patients were of low parity (72.5%), 56.9% had no formal education and 27.5% were traders. Thirty four patients (66.7%) had their fistulas for between 1 and 6 years, 19.6% of the patients had juxta-cervical fistulas, while eight (15.7%) had circumferential loss of the urethra. Thirty-seven (72.5%) of them where unbooked and thus had no antenatal care, while 4 (7.8%) booked and had antenatal care in conventional health facilities. Thirty-four patients (66.7%) remained dry twenty-one days after surgery, thirteen (23.5%) were still wet, while 4 patients (7.8%) had stress incontinence despite repair. <em>Conclusion</em>. Obstetric fistulas are found most commonly among young, poorly educated women of low parity who do not avail themselves of orthodox ANC in our environment. Government, community and religious leaders must make concerted efforts to ensure women obtain formal education and when pregnant, have access to emergency obstetric care even if resident in the rural areas. Government, relevant non-Governmental organisations, community leaders and health workers should through relevant health messages enlighten women in the community about obstetric fistulas and the dangers of delivering in unorthodox health facilities. More medical personnel should be trained as the first attempt at repair is the one that is most likely to succeed.

scholarly journals Comparison of antenatal care factors and pregnancy outcome in rural and urban context

2019 ◽  
Vol 68 ◽  
pp. 02007
Author(s):  
Irisa Zile ◽  
Dace Rezeberga ◽  
Gunta Lazdane ◽  
Iveta Gavare
Keyword(s):  
Antenatal Care ◽  
Pregnancy Outcome ◽  
Rural Area ◽  
Emergency Obstetric Care ◽  
Obstetric Care ◽  
Perinatal Period ◽  
Antenatal Visit ◽  
Urban Context ◽  
Maternal Characteristics ◽  
Increased Risk

Antenatal care plays a basic role in the management of woman's health during pregnancy, and women who have not been registered to antenatal care are at increased risk of poor pregnancy outcome, including stillbirth. The aim of this study was to identify differences in maternal characteristics, antenatal care factors and perinatal mortality between urban and rural area in Latvia. The Medical Birth Register of Latvia (MBR) was used as a data source, all births in 2017 (n = 20,406) were included in the analysis. Mother's place of residence was categorized in 3 groups: Riga, other cities and rural area. Higher risk of smoking (OR = 1.4; p < 0.001), late first antenatal visit (after 12th gestation week) (OR = 1.2; p < 0.05) and incomplete antenatal care (including cases without care) (OR = 1.3; p < 0.05) were detected more in other regions (other cities and rural area) than in Riga. After adjustment by maternal age and education, just late first antenatal visit was significantly higher in other regions (ORadj = 1.2; p < 0.05) vs. Riga. New-born mortality in perinatal period is substantially higher in other regions vs. Riga. The results indicate health education gap and potential inequalities in receiving antenatal care and emergency obstetric care by regions.

scholarly journals Analysing maternal determinants and characteristics of obstetric referrals at a tertiary care centre in Kerala, India

2019 ◽  
Vol 6 (12) ◽  
pp. 5321
Author(s):  
Heera Shenoy T. ◽  
Sheela Shenoy T. ◽  
Remash Krishnan
Keyword(s):  
Tertiary Care ◽  
Emergency Obstetric Care ◽  
Obstetric Care ◽  
Near Miss ◽  
Tertiary Care Centre ◽  
Maternal Risk ◽  
Tertiary Centre ◽  
Adverse Pregnancy ◽  
Maternal Determinants ◽  
Mode Of Transport

Background: Timely and prompt referral of high risk pregnancies is an integral part of emergency obstetric care and is one of the effective strategies to avoid adverse pregnancy outcomes. This study aims to assess the maternal determinants and characteristics of obstetric referrals to Travancore Medical College and Hospital.Methods: This observational study reviewed 124 obstetric referrals over 3 years. Maternal risk factors and sources of referral were looked into. Distance travelled, referral-arrival interval, mode of transport, gestational age at referral, medical co-morbidities necessitating emergency/elective transfers to this tertiary centre have been analysed.Results: Referral rate was 7.03%. Mean age was 26. Primipara and multipara went hand in hand. 95% were graduates. Materno-fetal (58%) contributed the bulk of obstetric referrals. 83.1% were from private hospitals and 64 were in-labour referrals. 71.6% had referral arrival distance of <15 kms. Mode of transport used by the referred patients was by ambulances (73.9%). Around 48% of our population had GA of 33-36.6 weeks. 73% had emergency decision among which caesarean was 83%. Anaemia (34%), HDP (30.5%), GDM (14.2%) and hypothyroidism (17.7%) were medical co-morbidities necessitating referrals. There was 1 maternal death and 4 near miss mortality cases. Mean hospital stay in private sector referrals was 10.17 days and it was 7.62 days in government referrals.Conclusions: Timely referrals with detailed referral slips imparting information regarding treatment received at the referring hospital has helped in early and optimal intervention in the study. 

scholarly journals A Seven-Year Review of Emergency Obstetric Hysterectomy in a Nigerian Tertiary Institution

2019 ◽  
Vol 5 (1) ◽  
pp. 65-72
Author(s):  
Olusoji Edward Jagun ◽  
Gbenga Victor Nathaniel ◽  
Adeniyi Kazeem Akinseku
Keyword(s):  
Data Extraction ◽  
Emergency Obstetric Care ◽  
Obstetric Care ◽  
Near Miss ◽  
University Teaching ◽  
Tertiary Institution ◽  
Common Procedure ◽  
Skilled Personnel ◽  
The Mean ◽  
Ruptured Uterus

Background: Extirpative uterine surgeries for near-miss events are usually the last resort when other conservative measures fail. Emergency obstetric hysterectomy (EOH) may still have a significant role where there are limited options. Objectives: To determine the prevalence of EOH, the associated factors and the foeto-maternal outcome at the Olabisi Onabanjo University Teaching Hospital, Nigeria. Methods: This was a retrospective observational study covering seven years (January 2010 to December 2016). The case records of patients who had EOH during this period were retrieved for data extraction. Results: There were 5, 608 deliveries and 31 cases requiring EOH giving a prevalence rate of 31/5,608 (0.55%). The mean age of the patients was 30.3±4.2 years, while the mean gestational age at delivery was 36.3±5.1 weeks. Most of the patients 16/25 (64.0%) were of higher parity (>3), and 12/25 (48%) of the patients were within the age bracket of 25-34 years. Subtotal hysterectomy was the most common procedure (18; 72.0%), and ruptured uterus was the main indication for EOH (40.0%). The two most common interventions that were critical to survival included massive blood transfusion (24.0%) and Intensive Care Unit admission (20%). Two (8%) maternal deaths and 58.3% perinatal mortality were recorded. Conclusion: EOH is still relatively frequently performed at this centre due to the high incidence of a ruptured uterus. Efforts should be made to increase the proportion of deliveries attended by skilled personnel and improve the capacity of lower level hospitals for comprehensive emergency obstetric care.

scholarly journals Antenatal Care Counseling Pamphlet and Emergency Obstetric Care

2009 ◽  
Vol 1 (1) ◽  
pp. 56-60
Author(s):  
Ferdousi Begum ◽  
AB Bhuiyan
Keyword(s):  
Antenatal Care ◽  
Service Providers ◽  
Emergency Obstetric Care ◽  
Obstetric Care ◽  
Obstetric Complications ◽  
Care Providers ◽  
Prospective Longitudinal ◽  
Pregnant Mothers ◽  
Care Counselling

Abstract A prospective longitudinal study with experimental design was undertaken among the MCH providers and antenatal mothers in 2 zones of Dhaka city, between July 1997 to June 1998. One of the objective of the study was to find out the effect of using antenatal care counselling pamphlet by the MCH service providers on quality of their antenatal care delivery and change in awareness of pregnant mother's on emergency obstetric care (EOC). A colored pamphlet on antenatal care counselling was developed and finalized after focal group discussion, pretesting and general discussion among professionals. Different category of MCH care providers were trained on why and how to use such pamphlet. Service providers (n-307) who used ANC pamphlet discussed various obstetric emergencies more frequently (p < .05 to p < .001) with the pregnant mothers in comparison to those who did not use such card. Similarly, knowledge among the service providers on place and person of referral for different obstetric complications also increased significantly (p < .04 to p < .001) after orientation on use of ANC pamphlet. Pregnant mothers who received at least 2 ANC session were interviewed during antenatal care, before (n-172) and after (n-300) the use of ANC pamphlet. Scoring on recognizing the pictures as obstetric emergency and being able to mention places and person of contact if such emergency arise (self referral) increased significantly (p <. 001). Use of ANC pamphlet increased quality of ANC counselling and the knowledge of pregnant mothers on obstetric complications and self referral.

Risk perception on the labour ward: A mixed methods study

2021 ◽  
Vol 26 (2) ◽  
pp. 56-63
Author(s):  
Claire McCarthy ◽  
Sarah Meaney ◽  
Marie Rochford ◽  
Keelin O’Donoghue
Keyword(s):  
Mixed Methods ◽  
Lived Experience ◽  
Healthcare Providers ◽  
Emergency Obstetric Care ◽  
Obstetric Care ◽  
Daily Basis ◽  
Mixed Methods Study ◽  
Structured Interviews ◽  
Staff Support ◽  
Staff Wellbeing

Healthcare providers commonly experience risky situations in the provision of maternity care, and there has been increased focus on the lived experience in recent years. We aimed to assess opinions on, understanding of and behaviours of risk on the LW by conducting a mixed methods study. Staff working in a LW setting completed a descriptive questionnaire-based study, followed by qualitative structured interviews. Statistical analysis was performed with SPSS on quantitative data and thematic analysis performed on qualitative data. Nearly two thirds of staff (64%; 73/114) completed the questionnaire, with 56.2% (n = 47) experiencing risk on a daily basis. Experiencing risk evoked feelings of apprehension (68.4%; n = 50) and worry (60.2%; n = 44) which was echoed in the qualitative work. Structured clinical assessment was utilised in risky situations, and staff described “ going on autopilot” to manage these situations. A large number of respondents reflected on their provision of care following an adverse event (87.7%; n = 64). Debriefing was mentioned as an important practice following such events by all respondents. This study describes the negative terminology prevailing in emergency obstetric care. These experiences can have a profound impact on staff. Risk reduction strategies and the provision of increased staff support and training are crucial to improve staff wellbeing in stressful scenarios.

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