scholarly journals Factors associated with failed spinal anaesthesia for Caesarean sections in Mthatha general hospital, Eastern Cape, South Africa

2017 ◽  
Vol 59 (4) ◽  
pp. 39
Author(s):  
Adeyinka Abiodun Alabi ◽  
Oladele Vincent Adeniyi ◽  
Olukayode Ademola Adeleke ◽  
Pamela Pilla ◽  
Mohamed Rashid Haffajee

Background: The use of spinal anaesthesia has increased in the last three decades, given that it is the recommended anaesthetic of choice for better foetal and maternal outcomes in Caesarean section. Failed spinal anaesthesia (FSA) exposes patients to unfavourable experience of pain and the potential complications of general anaesthesia that are being avoided in the first instance. This study determines the incidence and the predictors of failed spinal anaesthesia in pregnant women presenting for Caesarean section at Mthatha General Hospital, Eastern Cape. Methods: This descriptive cross-sectional study included 197 pregnant women scheduled for Caesarean section under spinal anaesthesia at Mthatha General Hospital from May 1 to August 30, 2013. A standard proforma was utilised for data collection on items of demographic, surgical and anaesthetic records of each parturient. The main outcome measure was the incidence of failed spinal anaesthesia (defined as partial or incomplete spinal block requiring conversion to general anaesthesia). Results: The incidence of failed spinal anaesthesia was 11.7%, which was slightly higher in emergency Caesarean sections. In univariate analysis, previous anaesthesia, obesity, dry tap of cerebrospinal fluid (CSF), bloody CSF and duration of work experience less than one year were significantly associated with FSA in the cohort. Conclusion: The study found a high incidence of failed spinal anaesthesia during Caesarean section in this setting. Upskilling of doctors in spinal anaesthesia is urgently needed in the study setting. (Full text of the research articles are available online at www.medpharm.tandfonline.com/ojfp) S Afr Fam Pract 2017; DOI: 10.1080/20786190.2017.1292696

2017 ◽  
Vol 2 (3) ◽  
Author(s):  
Febriyeni Febriyeni

<pre>Chronic Energy Deficiency is a situation where the nutritional status someone is on the Less Good Condition. Among the 22 health centers in the district of Lima Puluh Kota, CED highest coverage at the health center are Banja Laweh Namely Case 17 (16.50%) of 103 pregnant mothers. Preliminary Survey of 10 pregnant women at health centers Banja Laweh, note 4 people (40%) of them suffered CED. Based on the findings of interviews stating Not pregnant women know the importance of the size upper arm circumference on Against her pregnancy, in addition to pregnant women consume no food Diversified, because lust Eating Less and Economics not sufficient. Objectives for review determine factors related to the occurrence of Chronic energy deficiency on pregnant women. Methods descriptive analytic with cross sectional approach. Data collection is done on Date in January-February 2017. CASE is a whole population of pregnant women in the region are working Health Center Banja Laweh Year 2017, amounted to 55 people, with sampling total sampling. Operating data analysis using univariate and bivariate statistical test Chi Square. Results of univariate analysis 87,3% of respondents experienced Genesis not CED, (60,0%) High Knowledge, (56,4%) Economy High, and 61,8% of Eating Well. Bivariate analysis known Relationship of Knowledge (p = 0.013 and OR = 12,000, Economics (p = 0.035 and OR = 10,000), and Diet (p = 0.019 and OR = 13,200) with the Genesis CED pregnant women. Can be concluded that the factors related to the occurrence of CED pregnant women is Science, Economics and the Diet. Expected to conduct monitoring of the health center and Supervision of pregnant women at risk Against The Genesis CED, so the negative impact of the CED can be addressed early on.</pre>


Author(s):  
Leny Leny

ABSTRACT Prenatal care is health care by health personnel to care the pregnant according to standards. Worlrd Health Organization (WHO) estimates more than 500.000 women die during pregnancy or childbirth. Maternal mortality in Indonesia is 307 per 100,000 live births. The quantity of pregnant women’s visit in Kabupaten Banyuasin in 2009 of 89.1%. The purpose of this study to determine the relationship between education and occupation with prenatal care at Puskesmas Mariana  Kecamatan Banyuasin I Kabupaten Banyuasin in 2011. This study uses analytic approach survey by Cross Sectional methods, the population are 1.946 pregnant women and the samples as many as 332 people. The results of univariate analysis study of pregnant women who are higher education as much as 45.2%, and  low maternal education as much as 54.8%. In pregnant women who work of 43.4%, and pregnant women who do not work for 56.6%. From the results of bivariate analysis and Chi-Square statistical tests found a significant association between education of pregnant women with prenatal care with P Value = 0.000, and there was a significant association between occupation of pregnant women with prenatal care with P Value = 0.000. Can be concluded that there is a relationship between education and occupation of pregnant women with prenatal care. Expected to health workers to provide counseling on the importance of prenatal care in pregnant women and expected future studies may explore again the factors associated with prenatal care with the different variables.   ABSTRAK Pemeriksaan kehamilan adalah pelayanan kesehatan oleh tenaga kesehatan untuk memeriksakan ibu hamil sesuai standar. World Health Organization (WHO) memperkirakan lebih dari 500.000 ibu pertahunnya meninggal saat hamil atau bersalin. AKI di Indonesia 307 per 100.000 kelahiran hidup. Jumlah kunjungan ibu hamil di Kabupaten Banyuasin tahun 2009 sebesar 89,1%. Tujuan penelitian ini untuk mengetahui hubungan antara pendidikan dan pekerjaan dengan pemeriksaan kehamilan di Puskesmas Mariana Kecamatan Banyuasin I Kabupaten Banyuasin tahun  2011. Penelitian ini menggunakan metode survey analitik dengan pendekatan Cross Sectional, populasi ibu hamil dengan jumlah 1.946 orang dan jumlah sampel sebanyak 332 orang. Hasil penelitian Analisa Univariat adalah ibu hamil yang pendidikan tinggi sebanyak 45,2%, dan pendidikan rendah ibu hamil sebanyak 54,8%. Pada variabel pekerjaan ibu hamil yang bekerja sebesar 43,4%, dan ibu hamil yang tidak bekerja sebesar 56,6%. Dari hasil analisa bivariat dan uji statistik Chi-Square  didapatkan hubungan yang bermakna antara pendidikan ibu hamil dengan pemeriksaan kehamilan dengan  P Value = 0,000, dan ada hubungan yang bermakna antara pekerjaan ibu hamil dengan pemeriksaan kehamilan dengan P Value = 0,000. Dapat disimpulkan bahwa ada hubungan antara pendidikan dan pekerjaan ibu hamil dengan pemeriksaan kehamilan. Diharapkan kepada petugas kesehatan agar dapat memberikan penyuluhan tentang pentingnya pemeriksaan pada ibu hamil dan diharapkan penelitian yang akan datang dapat menggali lagi faktor-faktor yang berhubungan dengan pemeriksaan kehamilan dengan variabel yang berbeda.


2019 ◽  
Vol 3 (3) ◽  
Author(s):  
David Franli ◽  
Makmur Sitepu ◽  
Hotma Partogi Pasaribu ◽  
Sake Juli Martina

Introduction. Chronic energy deficieny (CED) is a condition of a body characterized by low body weight and low energy stores, possibly limited physical capacity due to deprivation of food over a long period time. Ministry of Health ( Kemenkes) showed that in 2015, 305 out of 100.000 death of pregnant women is realated to malnutriotion and CED. Objective. The aim of this study is to determine the overview of pregnant women nutritional status based on mid-upper arm circumference (MUAC) in Sundari Medan General Hospital. Method. The study was an observational descriptive study with a cross sectional design. The samples of this study consists of pregnant women from Sundari Medan Genaral Hospital, who had fulilled the inclusion and esclusion criteria by total sampling. Results.. Among 60 samples, the prevalance of Non-CED woman (85%) was found higher than the mild malnutrition (15%). Conclusion. Prevalance of CED pregnant women was found higher in risky age, middle educated and high income family.  


2009 ◽  
Vol 2009 ◽  
pp. 1-3 ◽  
Author(s):  
Roy Somers ◽  
Yves Jacquemyn ◽  
Luc Sermeus ◽  
Marcel Vercauteren

We describe a patient with severe scoliosis for which corrective surgery was performed at the age of 12. During a previous caesarean section under general anaesthesia pseudocholinesterase deficiency was discovered. Ultrasound guided spinal anaesthesia was performed enabling a second caesarean section under loco-regional anaesthesia.


2020 ◽  
Vol 5 (2) ◽  
pp. 101-106
Author(s):  
Dwi Saputri Mayang Sari

Asphyxia Neonatorum is a failure to start and continue breathing spontaneously and regularly when a new baby is born or some time after birth. Babies may be born in asphyxia or may be able to breathe but then experience asphyxia some time after birth. The purpose of this study was to determine the relationship between parity and old parturition with the incidence of asphyxia neonatorum in the pre-Sumatran city general hospital in 2019. This study uses an Analytical Survey using a Cross Sectional approach. The population of this research is the babies born in the prehumulih city general hospital in 2019 amounted to 1763 people. The number of samples in this study were 326 respondents. In the univariate analysis it was found that from 326 respondents it was found that parity of high risk mothers was 168 respondents (51.5%) while parity of low risk mothers was 158 respondents (48.5%) and mothers who were diagnosed with prolonged labor were 149 respondents (45.7 %) while mothers who were not diagnosed with prolonged labor were 177 respondents (54.3%). Bivariate analysis shows parity has a significant relationship with the incidence of asphyxia neonatorum (p value 0,000) and old parturition has a significant relationship with the incidence of asphyxia neonatorum (p value 0,000). The conclusion of this study is that there is a relationship between parity and old parturition with the incidence of asphyxia neonatorum.


2019 ◽  
Vol 6 (1) ◽  
pp. 69
Author(s):  
Made Riastuti Sumandari ◽  
Rina Listyowati

ABSTRAK Rumah Sakit Umum Daerah Kabupaten Klungkung sebagai rumah sakit yang sudah menerapkan Pengelolaan Keuangan Badan Layanan Umum terus meningkatkan dan mengembangkan mutu pelayanan, terutama mutu pelayanan kegawatdaruratan. Tujuan penelitian ini untuk mengetahui gambaran tingkat pengetahuan petugas di Instalasi Gawat Darurat dan Penunjang Pelayanan Kegawatdaruratan Rumah Sakit Umum Daerah Kabupaten Klungkung tentang Standar Pelayanan Minimal. Penelitian ini merupakan penelitian deskriptif kuantitatif, dengan rancangan cross-sectional. Populasi dalam penelitian ini adalah seluruh petugas yang bekerja di Instalasi Gawat Darurat dan penunjang pelayanan kegawatdaruratan. Jumlah sampel pada penelitian ini 94 petugas dengan teknik pengumpulan sampel yaitu total sampling. Teknik pengumpulan data pada penelitian ini yaitu dengan menyebarkan kuesioner dan analisis data yang digunakan yaitu analisis univariat.  Hasil penelitian ini adalah mayoritas petugas memiliki pengetahuan baik mengenai SPM yaitu sebesar 86,17% sedangkan 13,83% memiliki pengetahuan kurang baik. Dilihat dari tingkat pengetahuan berdasarkan karakteristik, pengetahuan baik sebagian besar pada umur umur ?30 (88,14%), jenis kelamin perempuan (96,23%), pendidikan DIII (87,93%) dan masa kerja >10 tahun (88,46%). Saran yang bisa diberikan kepada Rumah Sakit Umum Daerah Kabupaten Klungkung, sebaiknya rumah sakit memberikan sosialisasi kepada seluruh petugas mengenai SPM dengan rutin dan terjadwal sehingga petugas mendapatkan informasi mengenai SPM merata. Kata Kunci: Tingkat Pengetahuan, Standar Pelayanan Minimal ABSTRACT Klungkung Regency Regional General Hospital as a hospital that has implemented Financial Management Public Service Agency continues to improve and develop the quality of services, especially the quality of emergency services. The purpose of this study was to determine the level of knowledge of officers in the Emergency Installation and Supporting Emergency Services of the Klungkung Regency General Hospital on Minimum Service Standards. This research is a quantitative descriptive study, with a cross-sectional design. The population in this study were all officers who worked in the Emergency Installation and supporting emergency services. The number of samples in this study were 94 officers with total sample collection techniques. Data collection techniques in this study are by distributing questionnaires and data analysis used is univariate analysis. The results of this study were that the majority of officers had good knowledge of MSS, amounting to 86.17% while 13.83% had poor knowledge. Judging from the level of knowledge based on characteristics, good knowledge is mostly at the age of ?30 (88.14%), female gender (96.23%), DIII education (87.93%) and years of service> 10 years (88, 46%). Suggestions that can be given to the Klungkung Regency Regional General Hospital, the hospital should provide information to all officers on MSS routinely and on a regular basis so that officials get information about SPM evenly. Keywords: Knowledge Level, Minimum Service Standards.


2021 ◽  
pp. 228-228
Author(s):  
Vishal Vashist ◽  
Roohani Mahajan ◽  
Bhanu Gupta

Subarachnoid block is commonly employed for caesarean deliveries, by virtue of its simplicity in terms of performance, safety for the parturients as compared to general anesthesia. The case history of a 27-yearold female parturiant patient is presented. She was posted for emergency lower segment caesarean section in view of primigravida with breech presentation in labour . She was obese with bodyweight of 102 kg. She had a thick scaly plaque over the back in midline from L1 to L5 area, which is contraindication for administration of spinal anaesthesia via standard median and paramedian approach . Taylor’s approach for administration of the same was tried and proved successful, thus saving the patient from receiving general anaesthesia .


2018 ◽  
Vol 12 (2) ◽  
pp. 58-60
Author(s):  
Ritu Pradhan ◽  
Sangeeta Shrestha ◽  
Tara Gurung ◽  
Amirbabu Shrestha

Aims: This study aims to review the haemodynamic effects of the repeat spinal anaesthesia and to identify the different doses of Bupivacaine heavy used for the repeat spinal anaesthesia for the failed spinal in caesarean section.Methods: This study was conducted by reviewing medical anaesthesia records of the cases of the repeat spinal anesthesia regarding any adverse haemodynamic effects. The second dose of bupivacaine heavy, maximum sensory blockade and intraoperative events like bradycardia, hypotension, high spinal, nausea vomiting, conversion to general anaesthesia and inadequate block were also reviewed.Results: Out of 8040 caesarean section under subarachnoid block, 51(0.63%) cases were conducted under repeat spinal anaesthesia from April 2014 to December2016. All the cases had complete spinal failure with no sensory and motor effects even after 10 minutes of the intrathecal injection. The second dose of bupivacaine heavy used was variable but reduced than the first dose. The most common adverse effect was hypotension (27.5%). 50% of cases were uneventful. One case was converted to general anaesthesia even after repeat spinal anaesthesia and 9.8% cases had high spinal above T4.Conclusions: Repeat administration of Bupivacaine heavy in reduced dose and volume can be used in complete failure of administration of first spinal anaesthesia. However, it always requires careful assessment and the judicious monitoring.


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