Prolonged Labor
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PLoS ONE ◽  
2021 ◽  
Vol 16 (12) ◽  
pp. e0261951
Hulubante Bizuayew ◽  
Haimanot Abebe ◽  
Getachew Mullu ◽  
Likinaw Bewuket ◽  
Daniel Tsega ◽  

Purpose Maternal surgical site infection after cesarean delivery is a clinical problem which contributes to significant morbidity and mortality. In Ethiopia admissions following cesarean section due to surgical site infection have been routine activities of health care institutions but there is limited scientific evidence on both the magnitude of the problem and factors associated with it making prevention mechanisms less effective. Therefore, this study aimed to assess magnitude and risk factors of post-cesarean section surgical site infection at primary hospitals of East Gojjam Zone, Northwest Ethiopia. Methods Institution-based cross sectional study with retrospective chart review was conducted from September 10–30 /2020 at 3 randomly selected primary hospitals of east Gojjam zone. The data were entered in Epi data version 3.1 and exported to Statistical Package for Social Science Software version 26. Post-cesarean section surgical site infection was measured based on disease classification and definition of the term by Center for Disease Control and Prevention. After checking for presence of multicollinarity, presence and degree of association of factors with outcome variable were computed through logistic regression analysis. Factors with P value ≤ 0.2 in bi-variable logistic regression analysis were included in the multivariable logistic regression analysis and those variables with P-value of <0.05 in multivariable analysis were considered statistically significant. Result From 622 medical records of women who underwent cesarean section, 77 (12.4%) of them developed surgical site infection. Rural residence [(AOR = 2.30, 95%CI: (1.29, 4.09)], duration of labor greater than 24hrs [(AOR = 3.48, 95%CI: (1.49, 8.09)], rupture of membrane>12hrs[(AOR = 4.61,95%CI:(2.34,9.09)], hypertension[(AOR = 3.14,95%CI:(1.29,7.59)] and preoperative Hematocrit ≤30%[(AOR = 3.22,95%CI:(1.25,8.31)] were factors significantly associated with post-cesarean section surgical site infections. Conclusion Magnitude of post-cesarean section surgical site infection was a significant problem in primary hospitals. Minimizing prolonged labor; minimize early rupture of membrane, properly managing patients with comorbidities like hypertension, strengthen prophylaxis and treatment for anemia during antenatal care and raising awareness for rural residents can reduce the problem. Zonal police makers should give emphasis to reduce its burden.

Lea Ingne Reffita ◽  
Senditya Indah Mayasari ◽  
Ummi Halfida ◽  
Wili Sinarti ◽  
Yaumil Fitriyah ◽  

Indonesia's Health Profile in 2019 in general, there was a decrease in maternal mortality during the period 1991-2015 from 390 to 305 per 100,000 live births, if it is associated with the 2015 Millennium Development Goals (MDGs), namely reducing the maternal mortality rate (MMR) to 102/100,000 live births. the maternal mortality rate did not reach the MDGs target. Physiological efforts are made to prevent prolonged labor, such as pelvic rocking exercise using the birthing ball technique. This is also a method that really helps respond to pain in an active way and reduces the length of the first stage of labor in the active phase. This study aims to determine the effectiveness of the implementation of pelvic rocking with a birthing ball on the progress of labor in primiparous women in 2020. This study uses Systematic Literature Reviews (SLR), which is a synthesis of systematic, clear, comprehensive literature studies, by identifying, analyzing , evaluating through the collection of existing data with an explicit search method and involving a critical review process in the selection of studies. In 6 journals, all journals perform pelvic rocking exercise techniques using the birthing ball technique when the mother enters the first stage of the active phase. The conclusion in this study is that all journals reviewed by researchers can be ascertained that all of these journals get the same results, namely stating that using the Pelvic Rocking Exercise technique with the help of a birthing ball can make delivery times for mothers go faster

2021 ◽  
Vol 7 (2) ◽  
pp. 141
Mita Puspitasari ◽  
Mitra Mitra ◽  
Tin Gustina ◽  
Novita Rany ◽  
Zulfayeni Zulfayeni

Chronic Energy Deficiency in pregnant women is a condition of pregnant women due to an imbalance in the intake of energy and protein nutrients, so that the substances the body needs are not fulfilled. Incident chronic energy deficiency in pregnant women have a risk of abortion, bleeding, prolonged labor, infection, low birth weight baby, birth defects, and causes of death indirectly. An attemt to resolve the incidence of malnutrition in pregnant women in chronic energy deficiency with supplementary food. Type of qualitative research. Research informants were pregnant women chronic energy deficiency, nutrition staff, midwives, health promotion officers, and cadres. Research results are the knowledge of pregnant women in chronic energy deficiency about supplementary feeding is stil lacking, the attitudes of pregnant women in chronic energy deficiency and their husband’s support about supplementary feeding are already good, compliance of pregnant women in chronic energy deficiency is still lacking, acceptance of pregnant women in chronic energy deficiency about supplementary feeding is stil lacking, delivery of information when counseling needs to be improved by using the contemporary method, distribution of supplementary feeding for Puskesmas officers in collaboration with cadres. Advice doing technical guidance to health workers about supplementary feeding, health workers increase again in providing information related to supplementary feeding, provide information using digital media such as video, made a special trick of setting an alarm as a reminder to consume supplementary feeding, make derivate technical guidelines from the ministry of helath according to conditions in the field.

2021 ◽  
Sara Carlhäll ◽  
Marie Nelson ◽  
Maria Svenvik ◽  
Daniel Axelsson ◽  
Marie Blomberg

Abstract A negative childbirth experience may have long term negative effects on maternal health. New international guidelines allow a slower progress of labor in the early active phase, however a longer time in labor may influence the childbirth experience. In this population-based cohort study including 26,429 women, who gave birth between Jan 2016 to March 2020, the association between duration of the different phases of active labor and childbirth experience was studied. The women assessed their childbirth experience by visual analogue scale (VAS) score. Data including VAS score and labor time estimates were obtained from electronic medical records and adjusted odds ratios (aOR) were calculated.The prevalence of negative childbirth experience (VAS 1-3) was 4,9%. A significant association between longer duration of all phases of active labor and a negative childbirth experience (VAS 1-3) was found for primi- and multipara. The aOR for negative childbirth experience and longer time in active labor in primipara was 1.88, 95% CI (1.59-2.22) and for multipara aOR 1.90, 95% CI (1.59-2.28).It is of great importance to identify and optimize the clinical care of women with prolonged labor to reduce the risk of negative childbirth experience and associated adverse long-term effects.

2021 ◽  
Vol 3 (2) ◽  
pp. 77
Widya Maya Ningrum ◽  
Erni Puspitasari

Ibu hamil yang mengalami KEK akan mengalami kekurangan gizi, tubuh mudah lelah, pucat, lemas, dan mengalami kesulitan salah satunya dalam proses persalinan. Pengaruh KEK terhadap proses persalinan dapat mengakibatkan persalinan sulit dan lama, persalinan sebelum waktunya (prematur), pendarahan setelah persalinan, serta persalinan dengan operasi. Puskesmas Sadananya data ibu hamil yang mengalami KEK sebanyak 70 orang (9,49%) dan berlanjut ke penyulit lainnya yaitu mengalami Abortus 5 0rang (3,5%), BBLR 9 bayi (6,3%). Jenis Penelitian ini merupakan penelitian deskriptif. Populasi dalam penelitian ini adalah seluruh ibu bersalin dengan riwayat KEK pada masa kehamilan di Wilayah Kerja Puskesmas Sadananya Kabupaten Ciamis Tahun 2019 sebanyak 70, Teknik pengambilan sempel mengunakan Simple Random Sampling. Analisa dalam penelitian ini adalah Univariat. Hasil penelitian menunjukan sebanyak 3 oang mengalami persalinan sebelum waktunya (4,3%), 1 orang mengalami perdarahan paska salin disebebkan atonia uteri (1,4%), dan 8 orang proses persalinan dengan Operasi (SC) (11,4%). Kesimpulan dari penelitian ini adalah Ibu hamil dengan riwayat KEK mengalami penyulit persalinan, meskipun secara jumlah tidak terlalu signifikan, namun hal ini tentunya tetap harus menjadi perhatian khususnya bagaimana bisa mencegah ibu hamil untuk tidak mengalami anemia, dan apabila sudah terjadi sebagai seorang bidan tentunya harus dapat mendeteksi penyulit yang akan terjadi denganmelakukan penapisan awal persalinanPregnant women who experience KEK will experience malnutrition, body easily tired, pale, weak, and experience difficulties, one of which is in the delivery process. The effect of KEK on the labor process can result in difficult and prolonged labor, preterm labor, bleeding after delivery, and delivery by surgery. Puskesmas Sadananya data on pregnant women who experience KEK as many as 70 people (9.49%) and continue to other complications, namely experiencing 5 0rang abortion (3.5%), LBW 9 babies (6.3%). This type of research is a descriptive study. The population in this study were all 70 women who gave birth with a history of KEK during pregnancy in the Work Area of the Sadananya Health Center, Ciamis Regency in 2019, the sampling technique used was Simple Random Sampling. The analysis in this research is Univariate.. The results showed as many as 3 people experienced premature labor (4.3%), 1 person experienced post-saline bleeding due to uterine atony (1.4%), and 8 people went into labor by surgery (11.4%). The conclusion of this study is that pregnant women with a history of KEK experience difficulty in childbirth, although the numbers are not too significant, this of course still has to be a concern, especially how to prevent pregnant women from experiencing anemia, and if it has occurred as a midwife, of course they must be able to detecting impending complications by performing an early screening of labor.

2021 ◽  
Vol 25 (3) ◽  
pp. 675-685
Parween Nawkhas ◽  
Shahla Alalaf

Background and objective: Venous thromboembolism is a leading cause of maternal morbidity and mortality. Few published articles have evaluated obstetricians' compliance with thromboprophylaxis guidelines, especially after vaginal delivery. This study aimed to assess obstetricians’ adherence to postpartum thromboprophylaxis guidelines and correlate adherence with the risk factors for venous thromboembolism after vaginal and cesarean delivery. Methods: A cross-sectional study involving 981 women delivered at the Maternity Teaching Hospital, Erbil city, Kurdistan Region, Iraq, was conducted. Obstetricians' compliance with the thromboprophylaxis guideline regarding dose, duration, and indications were recorded. We assessed the risk factors for thromboembolism using the 2015 Royal College of Obstetricians and Gynecologists guideline. Results: Medical thromboprophylaxis was required but not given to 93.2% of the women who delivered vaginally compared with 6.7% of the women who delivered by cesarean section. Women who delivered vaginally had a higher rate of age ˃ 36 years, parity of 3 and more, varicose vein, and current infection (P <0.001). The rates of preeclampsia, preterm labor, and prolonged labor were highest in the emergency cesarean section group (P <0.001). Factors associated with making a wrong decision were having no preeclampsia (odds ratio=15.4; 95% confidence interval=3.4–68.6), post-partum hemorrhage (odds ratio=15.3; 95% confidence interval=2.0–114.2), and vaginal delivery (odds ratio=250.2; 95% confidence interval=110.6–566.0). Conclusion: Obstetricians' compliance with postpartum thromboprophylaxis in the hospital was low, especially after vaginal delivery. Keywords: Thromboprophylaxis; Postpartum; Compliance; Venous thromboembolism; Guideline.

Rita S. Sitorus ◽  
Indra Maharddhika Pambudy ◽  
Rinawati Rohsiswatmo ◽  
Julie Dewi Barliana ◽  
Dian Estu Yulia ◽  

Abstract Aim To screen for ocular abnormalities in healthy full-term newborn infants using wide-field digital imaging and to analyze factors associated with the findings. Methods A total of 1208 full-term newborn infants at a tertiary eye hospital (Cipto Mangunkusumo National Referral Hospital) and a district hospital in Jakarta (Koja Hospital) were enrolled to the study. All eligible newborns underwent fundus examination within 48 h after birth using the RetCam shuttle (Natus Medical Incorporated, USA). Retinal findings were documented and analyzed according to obstetric and neonatal risk factors. Results Of the 1208 newborn infants enrolled, ocular abnormalities were found in 150 infants (12.4%). Retinal hemorrhage (RH) was the most common finding (88%) in which 2.67% involved the macula, followed by chorioretinitis (4.67%). Univariate analysis showed caesarean section (C-section) (OR 0.27, 95% CI 0.18–0.41, p < 0.001) was a protective factor against RH, while prolonged labor increased the risk of developing RH (OR 1.84, 95% CI 1.24–2.72, p = 0.002). Further multivariate analysis showed similar protective association between C-section and risk of RH (OR 0.29, 95% CI 0.19–0.44, p < 0.001), while other risk factors were not. Conclusions Our study showed that universal eye screening in healthy neonates is beneficial in the early diagnosis, monitoring and treatment of ocular abnormalities such as retinal hemorrhage, chorioretinitis and retinoblastoma. Retinal hemorrhage is the most common ocular abnormality and is associated with the delivery method and the duration of labor. Universal eye screening is visual-saving and life-saving for neonates with chorioretinitis, retinoblastoma as well as other abnormalities and should be mandatory in newborn screening.

2021 ◽  
Jemberu Nigussie ◽  
Bekahegn Girma ◽  
Alemayehu Molla ◽  
Takila Tamir ◽  
Rute Tilahun

Abstract Background: Postpartum hemorrhage or postpartum bleeding (PPH) is often defined as loss of > 500 ml of blood after vaginal delivery or > 1,000 ml after cesarean delivery within 24 hrs. Postpartum hemorrhage is a leading direct cause of maternal morbidity and mortality in Ethiopia. Therefore, the main objective of this systematic review and meta-analysis was to estimate the pooled magnitude of postpartum hemorrhage and the pooled effect size of the associated factors in Ethiopia.Methods: Primary studies were searched in PubMed / MEDLINE online, Science Direct and Hinari Cochrane Library, CINAHL, African Journals Online databases, Google and Google Scholars. The search for studies was not limited by time and all articles up to October 10/2021 were included. The data extraction format was prepared in Microsoft Excel. The data extracted from the Microsoft Excel format was exported to Stata Version 16.0 statistical software for analysis. A random effect meta-analysis model was used. Statistical heterogeneity was evaluated by the I2 test and Egger's weighted regression test was used to assess publication bias.Result: A total of 165 records from the electronic databases were excluded, but 145 records were excluded for different reasons, and finally 20 studies were included in this final analysis. The pooled magnitude of postpartum hemorrhage in Ethiopia was 8.18% [(95% CI; 6.996 - 9.363]. Older age [OR= 5.038 (95% CI; 2.774 - 9.151)], prolonged labor [OR = 4.054 (95% CI; 1.484 - 11.074)], absence of ANC visit [OR = 13.84 (95% CI; 5.57 - 34.346)] grand-multiparty, [OR = 6.584 (95% CI; 1.902 - 22.795)], and history of postpartum hemorrhage [OR = 4.355 (95% CI; 2.347 - 8.079)] were identified as factors for the occurrence of postpartum hemorrhage.Conclusions: This study concludes that the magnitude of postpartum hemorrhage in Ethiopia was moderately high. The finding was strongly help different stakeholder working in maternal and child health to focus on the main contributors factors to reduce PPH. Health professionals attending delivery should emphasize high-risk groups of mothers. Encouraging ANC visit and prevent prolonged labor should be recommended to reduce the occurrence of postpartum hemorrhage.

2021 ◽  
Vol 7 (4) ◽  
pp. 738-743
Sri Ayu Arianti ◽  
Sri Lestari ◽  
Supriyatni Kartadarma

Background : Anemia in pregnancy is currently a global problem in Indonesia because it can cause maternal death. The role of iron is very important for pregnant women and fetuses. The risk of anemia in pregnant women can cause postpartum bleeding, prolonged labor and infection during the puerperium. Disorders of fetal development can also be caused by iron deficiency. The importance of efforts to reduce the problem of anemia in pregnant women can be pharmacologically and non pharmacologically. Non-pharmacological treatment can be know as complementary or alternative therapy by  giving seaweed and honey  drinks. Consumption of foods containing Fe such as seaweed and consumption of food containing Fe absorption aids (Fe enhancers) containing vitamin C can increase hemoglobin levels in pregnant women.  Purpose: to determine the effectiveness of seaweed (Eucheuma Spinosum) and honey drinks on increasing haemoglobin levels in pregnant women.Methods : The research using a quasi-experimental research method with one group pre test-post test design. The sampling technique used was the non-probability sampling technique of "purposive sampling" with a sample of 30 pregnant women who were given 100 grams of seaweed drink and 25 grams of honey a day for 10 days.Results :  The results showed that there was a change in the mean before being given treatment (Pre test) of 10.4 gr/dl after being given an intervention (post test) of 11.4 gr/dl. Hemoglobin levels after treatment increased on average by 1 g/dl with p-value (0.001) (P <0.05).Conclusion : consuming seaweed and honey drinks has an effect on increasing hemoglobin levels in pregnant women. Keywords:  Haemoglobin, Seaweed , Honey ABSTRAK Latar Belakang : Anemia pada kehamilan saat ini menjadi masalah global di Indonesia karena dapat mengakibatkan kematian pada ibu. Peranan zat besi sangatlah penting bagi ibu hamil dan janin. Resiko anemia pada ibu hamil dapat menyebabkan terjadinya perdarahan pasca salin, persalinan lama dan  infeksi pada masa nifas. Gangguan pada perkembangan janin dapat disebabkan juga karena kekurangan zat besi. Pentingnya dilakukan upaya mengurangi masalah anemia pada ibu hamil dapat secara farmakologi dan non farmakologi. Penanganan secara non farmakologi dapat kita kenal dengan therapi komplementer atau alternatif dengan pemberian minuman rumput laut dan madu. Konsumsi makanan yang mengandung Fe seperti rumput laut dan konsumsi  makanan  yang mengandung  zat pembantu penyerapan Fe (enhancer Fe)  yang mengandung vitamin C dapat meningkatkan kadar haemoglobin pada ibu hamil.Tujuan: penelitian ini bertujuan untuk mengetahui efektifitas minuman rumput laut (Eucheuma Spinosum) dan madu terhadap peningkatan kadar haemoglobin pada ibu hamil.Metode : penelitian ini menggunakan quasy experiment dengan one group pretest-post test design. Teknik pengambilan sampel dengan teknik Nonprobability sampling jenis “Purposive sampling” dengan jumlah sampel 30 orang ibu hamil yang diberikan minuman rumput laut 100 gr dan 25 gr sehari madu selama 10 hari.Hasil : Hasil penelitian menunjukkan bahwa terdapat perubahan mean sebelum diberikan perlakuan (Pre test) 10,4 gr/dl setelah di berikan intervensi (post test) 11,4 gr/dl. kadar haemoglobin setelah perlakuan  rata-rata meningkat sebesar 1 gr/dl dengan p-value (0,001) (P <0,05).  Kesimpulan : mengkonsumsi minuman  rumput laut dan madu memiliki pengaruh terhadap peningkatan kadar haemoglobin pada ibu hamil. Kata kunci: Haemoglobin, rumput laut, madu 

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