scholarly journals Pregnancy Outcome between Booked and Unbooked Cases in A Tertiary Level Hospital

2018 ◽  
Vol 9 (2) ◽  
pp. 43-48
Author(s):  
Alpana Adhikary ◽  
Anwara Begum ◽  
Fahmida Sharmin Joty ◽  
Nihar Ranjan Sarker ◽  
Tahmina Akhter

To achieve the Sustainable Development Goals (SDG’2030) with regards to maternal health, there is need for research on the local causes and factors influencing adverse maternal & foetal outcomes in health institutions. Antenatal care throughout the pregnancy can ensure better feto-maternal outcome. It also contributed to reduction of maternal and infant mortality. This study was an attempt to enable health care providers to know where to focus to overcome adverse maternal outcome.Objectives: To find out the difference in maternal and perinatal outcome and socio-demographic characteristics in booked and unbooked cases. Design: A Cross-sectional observational study.Place of study :Department of Obststrics and Gynaeology , Shaheed Suhrawardy Medical College Hospital.Study period: April’2015 to july’2015. Study population- All patients admitted for delivery and puerperium during study period.Results: Unbooked mothers constituted 39.1% of the 218 deliveries in the studied period. There was no mean age difference between booked mothers and unbooked mothers (26.05±5.5 and 25.44±5.4; P=0.667) .But unbooked cases had a lower educational status (P<0.0036). Majority of the unbooked cases were from low family income group. Unbooked mothers were about less likely to deliver by spontaneous vaginal delivery compared to booked mothers (28% to 39%; P<0.339) and more likely to be delivered by emergency caesarean section than booked mothers. Unbooked mothers were having low birth weight babies than booked mother (2.65±0.595 and 3.02±0.477, p<0.010). Referral to neonatal unit more common in unbooked cases (69.6% to 25.6%). Post partum complications in unbooked and booked cases were (44%and 20.5%).Conclusion: The study showed a positive correlation between socio –demographic factor and lack of proper antenatal care and adverse pregnancy outcome. Improving the availability and accessibility of quality antenatal and delivery care services in all our institutes will improve pregnancy outcome.J Shaheed Suhrawardy Med Coll, December 2017, Vol.9(2); 43-48

2020 ◽  
Vol 16 ◽  
pp. 174550652097601
Author(s):  
Daniel Adane ◽  
Biresaw Wassihun

Background: The majority of maternal and neonatal adverse events take place during the postnatal period. However, it is the most neglected period for the provision of quality care. Objective: The aim of this study among mothers in the Awi Zone, Amhara region, Ethiopia, was to assess client satisfaction with existing postnatal care and associated factors. Methods: An institution-based cross-sectional study was conducted in Awi Zone hospitals from 1 to 30 April 2018. A total of 422 post-partum mothers were selected by systematic sampling. The data were collected using a pre-tested structured questionnaire via a face-to-face interview. Data entry and analysis were completed using EpiData version 3.1 and SPSS version 22, respectively. The data were summarized with frequency and cross-tabulation. Both binary and multiple logistic regressions were used to identify predictor variables using odds ratios and 95% confidence intervals. Result: The prevalence of postnatal care satisfaction was 63%. Being from urban area (AOR = 2.1, 95% CI = (1.11–3.99)), having a history of antenatal care follow up (AOR = 1.62, 95% CI = (1.23–1.64)), spontaneous vaginal birth (AOR = 3.14, 95% CI = (1.77–3.28)), and those who did not face any complications during birth (AOR = 2.90, 95% CI = (1.47–1.69)) were some of the factors associated with client satisfaction. Conclusion: According to the results of this study, the majority of mothers were satisfied with post-partum care services. The study findings indicate that maternal satisfaction on post-partum care is mainly affected by residency, antenatal care follow up, mode of delivery, and complications during birth. Therefore, health care providers and other concerned bodies should give special attention to those mothers who are from rural areas, who face complications during birth or who have instrumental-assisted or cesarean section birth. Also, every pregnant mother should be supported to have at least four regular antenatal care visits.


2017 ◽  
Vol 13 (1) ◽  
pp. 8-12
Author(s):  
SM Humayun Kabir ◽  
Md Ziaul Islam ◽  
Masuda Begum ◽  
Masud Ahmed ◽  
Mohammad Mohsin ◽  
...  

Introduction: Health problems of elderly are an emerging health burden throughout the world. Bangladesh is currently undergoing a demographic transition and the proportion of the population of 60 years and older is increasing rapidly. Health care providers and policymakers are highly concerned with this burning issue. Objective: To know the disease pattern among the elderly patients in Combined Military Hospital, Dhaka. Materials and Methods: This cross-sectional study was carried out from July 2015 to June 2016 among 152 elderly patients above 60 years of age admitted in Combined Military Hospital (CMH), Dhaka Cantonment. Data were collected by face-to-face interview with semi-structured questionnaire and checklist following purposive sampling technique. Analysis of data was done by Statistical Package for Social Science (SPSS, version 20.0). Results: Mean age of the elderly was 72.06±4.56 years with the range of 60-80 years and majority (90.8%) of the elderly was male. Out of total 152 elderly patients, by occupation majority (31.6%) were in the business group followed by 30.3% in the retired group and 9.2 % in the housewife group. Average monthly family income was BDT 17927.63±7360.75 with the range of BDT 6000-35000. With initial complaints elderly patients reported to doctors in private chamber (38.2%), private hospital (25.6%) and Govt hospital (5.9%). Among all of the elderly patients, majority (21.1%) had Diabetes Mellitus followed by Rheumatoid Arthritis (17.6%), Asthma (12.5%), Cataract (11.2%), ENT problem (6.6%), Malignancy (5.9%) and Benign Enlargement of Prostate 8(5.3%). Conclusion: The number of elderly people is expanding rapidly; it also presents multifaceted health problems and thus creates unique challenges for the national healthcareservices. Early identification of problem and ensuring the availability of health with economic and social support can have a control over the elderly health problems. Journal of Armed Forces Medical College Bangladesh Vol.13(1) 2017: 8-12


2021 ◽  
Vol 71 (3) ◽  
pp. 831-35
Author(s):  
Ambreen Amna ◽  
Farkhunda Nadeem ◽  
Amin Fahim ◽  
Altaf Hussian Jatoi ◽  
Kanwal Abbas ◽  
...  

Objective: To find out the prevalence of antibodies against cytomegalovirus and their association with adverse pregnancy outcome in women, at Isra University Hospital Hyderabad. Study Design: Cross-sectional study. Place and Duration of Study: Department of Gynaecology & Obstetrics, Isra University Hospital (IUH) Hyderabad, from Jan to Jun 2018. Methodology: Cytomegalovirus IgM and IgG antibodies in 305 women of reproductive age group were measured using the Enzyme Linked Fluorescent Assaysystem kit. Results: The combined positivity of anti cytomegalovirus IgG and IgM antibodies was 93 (30.40%). About 37 (37.37%) and 28 (34.14%) women were found to be seropositive for cytomegalovirus antibodies who had history of spontaneous miscarriage and recurrent miscarriages respectively. Conclusion: Higher association of seropositivity for cytomegalovirus IgM and IgG with bad obstetrical history and low economy was found.


2020 ◽  
Vol 26 (1) ◽  
pp. e25-e34
Author(s):  
Jacoline Sommer Albert ◽  
Ahtisham Younas ◽  
Gideon Victor

The global adult lifetime risk of maternal mortality is 1 in 180; in Pakistan, it is 1 in 170; in developed regions, 1 in 4,900 (Alkema et al., 2016; Filippi, Chou, Ronsmans, Graham, & Say, 2016; World Health Organization [WHO], 2015). The differences in maternal mortality between developed and developing countries are mainly due to the quality of antenatal care (ANC) available in the two groups of countries. The purpose of this study was to assess the structural and procedural quality of ANC services provided and to assess satisfaction levels of women receiving ANC services in two large hospitals in Islamabad, Pakistan. A cross-sectional survey was conducted at the hospitals' outpatient maternal and child health clinics, with a random sample of 138 women. The overall quality of ANC was rated as good (61%), average (17.5%), or poor (17.5%). The findings suggest a need to cultivate quality of care at public health facilities, train health workers in communication skills, and build technical capacity by continuing education and supportive supervision to train health-care providers to follow standard protocols for provision of quality ANC services.


2019 ◽  
Vol 8 (2) ◽  
pp. 59-65
Author(s):  
S. Subedi ◽  
K. Paudel ◽  
M. Koirala ◽  
P. Chhetri

Introduction: Anxiety is a vague, uneasy feeling, the source of which is often non-specific but known to cause abnormal hemodynamic changes as a consequence of sympathetic, parasympathetic and endocrine stimulation. Most patients awaiting elective surgery experience anxiety. The degree, to which patient develops anxiety depends on many factors like age, gender, type and extent of the proposed surgery, previous surgical experience, and personal susceptibility to stressful situations. This study was conducted to find out the prevalence of preoperative anxiety and factors contributing to it. Material and Method: This is a cross-sectional study done among 74 pre-operative patients admitted the day before elective surgery in Department Of Surgery Universal College Of Medical Sciences Teaching Hospital, Bhairahawa. Socio-demographic as well contributing factor questionnaire, semi structured pro forma by interview method and Beck Anxiety Inventory Scale (BAI) Nepali Version were used to collect the data. Results: The findings of the study revealed that 90.54%, had very low level of anxiety and 2.70% of patients had severe pre-operative anxiety. The bivariate logistic regression analysis showed statistically significant association between family income (p= 0.004, AOR=2.03, CI= 0.009-2.567), family support (p< 0.001, AOR= 2.34, CI= 0.003-3.368), expected duration of hospital stay (p= 0.049, AOR=8.889, CI= 78.051-78.051), clarity on given information by health care providers (p< 0.001, AOR= 53.33, CI=7.165-396.99), staffs friendliness (p< 0.001, AOR= 21.01, CI= 3.450-127.82), fear of nil per oral (p= 0.015, AOR= 2.32, CI= 0.26-3.67) and level of pre-operative anxiety. Conclusion: It is concluded that varying degree of pre-operative anxiety were found in patients undergoing surgery. Providing adequate information about Peri-Operative procedure can help in reducing these anxiety.


2018 ◽  
Vol 12 (2) ◽  
pp. 32-35
Author(s):  
Nira Singh Shrestha ◽  
Sajipta Panta

Aims: To study the maternal and perinatal outcome of pregnancies complicated with obstetric cholestasis with active management.Methods: This is a cross- sectional, descriptive study done at the department of obstetrics and gynecological of KMCTH for 24 months. All the cases of obstetric cholestasis that were managed by active management were enrolled as cases. Their demographic details, maternal and perinatal outcome were noted. Data was analyzed and presented as mean, percentage and frequency and presented as tables and figures. Results: Total 84 cases of obstetric cholestasis were managed by active management during the study period. The mean age of the women were 26.59 years (21-34 years), the mean gestational age at diagnosis was 32.53 weeks (18 - 38 weeks).  Diabetes mellitus was present in 17.85% and15.47% % had hypertensive disorder of pregnancy.All the cases had complaint of pruritus and 89.25% of the case had itching over abdomen, 73.78% of the women had itching over palms and soles. The itching was severe enough to cause sleep disturbance in over 65% of the cases. Meconium staining of liquor was present in 17.85% of the cases; cesarean section rate was 60.69%. There were 3 cases (3.57%) of postpartum hemorrhage but none required blood transfusion. There were no cases of still birth or neonatal death. Over 10% of the neonate had Apgar score less than 7 at 5 minute and approximately one fourth of the newborn required NICU care.Conclusions: Adverse pregnancy outcome associated with obstetric cholestasis can be minimized with active management of the cases.


Author(s):  
Kirui N. Jelagat ◽  
Keraka M. Nyanchoka ◽  
Musili F.

Background: Male participation in utilization of reproductive health is likely to promote timely and proper antenatal care, encourage women to deliver under the care of a skilled attendant, and also help identify and seek heath care in cases of post-partum complications. However, in most African societies, pregnancy, delivery and postnatal services has been erroneously classified as purely feminine issue by the society.Methods: A cross-sectional descriptive study design was adopted for the study. The target population of the study comprised of males above 18 years working in selected manufacturing industries in the area of Babadogo located in Nairobi County, Kenya. The sample size for the study was 266 respondents. Structured questionnaires were used for data collection. Data collected was quantitatively analysed using Statistical Package for Social Sciences (SPSS).Results: 56.0% (145) of the respondents had accompanied their partner to antenatal care facilities; 34.0% (88) of the respondents had ever participated in ANC services. Chi-square test statistics showed that distance to the nearest health facility (χ2=7.472 df=3, p=0.024), cost of accessing ANC services (χ2=26.253 df=4, p=0.001), attitude of healthcare providers (χ2=31.705 df=3, p=0.001) and friendliness of the waiting bay (χ2=9.718 df=2, p=0.008) significantly influenced male participation in antenatal care services’ utilization among spouses.Conclusions: Despite majority of men accompanying their wives to antenatal care facilities, most of them did not participate in the antenatal care services. Another conclusion is that facility factors such as distance, cost, health care providers’ attitude, and waiting bay friendliness influence male participation in utilization of antenatal care services.


Author(s):  
Paramita Sengupta ◽  
Anoop I. Benjamin ◽  
Bontha V. Babu

Background: It is essential to monitor the coverage of health interventions in subgroups of populations, especially the marginalized and those at higher risk, because national averages can hide important inequalities. This study was carried out to find out the utilization and coverage of MCH services among migrants in the slums of Ludhiana, Punjab.Methods: Cross-sectional sample study.  370 women, who had childbirth within two years prior to the survey, were randomly selected from the 3947 newer migrant households in 30 slum settlements in Ludhiana surveyed for provision of health care, and information obtained from them with regard to MCH services availed by them for their last pregnancy and childbirth. Their children 12-23 months old, 195 in number, were studied for child health services.Results: Antenatal care (ANC) was availed by 44.0% of the women, with 24.6% of them going for minimum 4 antenatal visits and 29.1% having an institutional delivery but only 35.9% by trained health personnel. Place of delivery was found to be a significant predictor of antenatal care. Women staying in Ludhiana availed the least ANC. Complete immunization coverage in the 12-23 month olds was 37.4%. Government health worker visited 7.8% of the homes.Conclusions: Despite the relative proximity and concentration of health centers in urban compared to rural areas, migrant slum-dwellers are still not able to access quality MCH care. The problem of non-availability of essential healthcare and uneven distribution of skilled health care providers is the central challenge in meeting our health goals. 


2021 ◽  
Vol 39 (1) ◽  
pp. 50-59
Author(s):  
Mumtahana Nabi ◽  
Abul Masud Md Nurul Karim ◽  
SM Mamun Ur Rashid

Background: Oral health care in pregnancy is often neglected by women and is also not appropriately addressed by prenatal and other health care providers and justify appropriate attention. The purpose of this cross sectional study was to describe percentage of oral disease occurrence and underlying causes in this sample of pregnant women. Methods: The study included 147 women aged between 15 to 49 years receiving prenatal care at the outdoor department of Azimpur Maternal and Child Health Training Institute in Dhaka, Bangladesh were invited to participate in this study from January 2013 to April 2013. Semi-structured interviews were conducted for data collection. Clinical exam data were recorded using validated scales in a special form. Results: Majority (72%) of the women were  between  20 to 24 years.  57%  had secondary  school  education.  88% of the women were unemployed and 52% women had very low family income of BOT s;10000. More than 90% of the women had good oral hygiene practices. However, 68% liked to  have  sugary  snacks  or  drinks  in  between  main meals, 7% visited their dentists during pregnancy , only 3% received advice  for  routine  oral  health  screening  from their prenatal care providers and only 4% women started their antenatal check-up during first trimester.  All  these negative influences might expose expecting mothers to high level of dental caries (54%), dental  erosion  (52%),  gingivitis (100%) and periodontitis (27%). This study also showed that majority of the women acquired oral health information through watching television (61%) or reading  newspaper  (12%)  while  only  4%  received  information from doctors/dent ists throughout their lifetime. Conclusion: The undertaken research highlighted the importance of using media in modifying Bangladeshi pregnant woman's behaviours toward oral health. It also emphasizes the need for inclusion of oral health preventive programme as part of pre and postnatal care. Further study in this area on a large scale will facilitate formulation of appropriate oral health policy to achieve satisfactory oral and general health outcomes during pregnancy and ensure optimum oral health conditions of their offspring. JOPSOM 2020; 39(1): 50-59


2021 ◽  
Vol 9 (E) ◽  
pp. 328-335
Author(s):  
Ghada Wahby Elhady ◽  
Tarek Amin Tawfik ◽  
Eman Aly Hussein ◽  
Sherry Magdy ◽  
Marwa Rashad Salem

Objectives: Postnatal care (PNC) is an essential component of maternal care program. However, gap exists between high coverage with antenatal and natal care and low coverage with PNC in Egypt. Consequently, the current study was conducted to explore pattern of early PNC (after first day following delivery) among rural mothers. Methods: An exploratory cross-sectional study was done in four Primary Health Care (PHC) centers related to one district in rural Egypt. Mothers who had delivered in the previous year were invited to a structured exit interview. Focus group discussions and in-depth interviews were done with mothers and health care providers (HCPs). Results: Out of the total mothers (n=600), 34.2% received PNC. Multivariate analysis showed that low family income was a significant negative predictor for receiving PNC (P=0.000), while utilization of ANC (P=0.00), delivery at public (P=0.004) or private health facility (P=0.00) were significant positive predictors for receiving PNC. Qualitative data identified barriers for seeking PNC as shortage in HCPs, especially nurses, poor communication by HCPs, mothers perceived HCPs as incompetent in PNC service delivery. Lack of knowledge among women about the importance of PNC and unavailability of female physicians formed social barriers. Conclusion: Inadequate knowledge about the importance and components of PNC among service providers and served community reduces the demand for PNC.


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