摘要
Background:Sub-Saharan African countries have some of the worst maternal mortality ratios in the world sub-regions. Uncoordinated antenatal care practices and delivery outside health institutions are some of the determinants of thesedeaths experienced in the region. The objective of the study is todetermine some of these erring behavioral antenatal practices that are inimical to good obstetric outcomes and how health care planners can use the results to close thesegaps of maternal mortality and save lives.Method:This study was a cross sectional retrospective study of the women who delivered at The Niger Delta University Teaching Hospital, Okolobiri, between 1 st June,2021 to 1st June, 2022. The study compared the maternal and fetal outcomes between the booked andunbooked patients who delivered during this period. Relevant data to the study were extracted from patients' medicalrecords using a proforma and data collected entered SPSS Version 25 foranalysis.Results:Three hundred and forty-six patients participated in the stud, 72.3 % were booked and 27.7%were unbooked. Place of delivery N = 253, 75.5 % delivered in health facilities and 24.5 in non-Health facilities. Unbooked patients have prolonged labor lasting more than 24 hours, suffered more blood loss during delivery, their babies have more unfavorable one minute Apgar, all compared to outcomes of the booked patientsConclusion:Booked patients have more favorable pregnancy outcomes compared to the unbooked patients. Health care planners and care providers should devote more time and resources to unbooked patients to have favorable pregnancy outcomes
Subject(s)
Prenatal Care , Delivery of Health Care , Pregnancy Outcome , Case-Control Studies摘要
Acute puerperal inversion is rare but potentially fatal obstetric emergency and prompt recognition will enable immediate repositioning of uterus before it becomes edematous and incarcerated. Manual repositioning along with use of uterine balloon tamponade is simple and effective way for repositioning of inverted uterus as well as prevention of recurrence.
摘要
Background: As the frontier of knowledge expands, surgicalskills improve;and with the advent of increasingly potent antibiotics, it is expected that puerperal sepsisand itscomplications as captured in the literature of studieswill be on the down turn. With this in mind,we decided to find out what is current as par risk factors and complications of puerperal sepsis in these obstetric referral centres in Port Harcourt.Objective:To determine the risk factors and complications of puerperal sepsis at the University of Port Harcourt Teaching Hospital(UPTH), Port Harcourt and the River State University Teaching Hospital (RSUTH), Port Harcourt, Nigeria.Methods: The case notes of these patients were retrieved from the medical records departments and relevant data extracted using a well-structured proforma. Data collected included the demographic characteristics, booking status, background immune suppression (HIV/AIDSor DM) abour characteristics, place and mode of delivery, fetal outcome, length of hospital stay. Morbidities like septicaemia, pelvic abscess, disseminated intravascular coagulopathy among others; and the presence of mortality was also noted.The data was analyzed using SPSS version 23.0. Statistical analysis of data was done by Chi-square test. A p-value less than 0.05 was considered significant. The result is presented in tables of frequencies and percentages.Results: The prevalence of puerperal sepsis was 1.7%. Risk factors were low parity,unbooked status (84.35%) and wound infection (29.9%),among otherintrauterine foetal death (22.8%), obstructed labour (14.2%)and perineal tear (11.0%). The main complications of puerperal sepsis noticed were prolonged hospital stay (58.3%) and septicaemia (13.4%); pelvic abscess (10.2%) and intestinal obstruction (4.7%) while (1)3.1% ended in mortality.Conclusion:Complications of puerperal sepsis were still high in these centres. Worrisomely, a huge number of these patients wereunbooked.
摘要
Background: The high maternal and perinatal mortality rates in Nigeria continue to be issues of concern. That antenatal care improves both perinatal and maternal outcomes is now well established. The study seeks to identify the predictors of poor maternal and perinatal outcome among singleton maternal delivery cases referred to Rivers State University Teaching Hospital (RSUTH).Methods: A longitudinal study was employed; the patients referred to RSUTH were followed up to ascertain maternal and neonatal outcomes. A sample size of 460 was used. Selection of cases was done by systematic sampling. Data obtained in the study were demographic, obstetric and perinatal findings. Maternal and perinatal outcome were dichotomized into poor and good outcomes. Bivariate and multivariate analyses were performed using SPSS version 20.0.Results: A total of 460 cases were recruited. The mean age±SD was 28.7±4.6 years. There was poor maternal outcome in 65 (14.1%) and poor perinatal outcome in 291 (63.3%). There was one maternal death (rate 0.2%), perinatal mortality rate was 26.5%, low birth-weight rate was 6.3% and asphyxia rate was 23.3%. There is an association of multiparity and unbooked status with poor maternal outcome, while poor perinatal outcome was influenced by unbooked status.Conclusions: Perinatal and maternal mortality were high amongst all referral cases. There is a positive correlation of multiparity with poor maternal outcome and between unbooked status and an increased risk of both maternal and perinatal adverse outcomes.
摘要
Background: Formal education, antenatal care, and improved health services still remain the key to a large-scale reduction in maternal mortality in developing countries. Pregnancy and labourcomplications are most prevalent among unbooked patients compared to booked patients. Prompt and effective treatment will go a long way to reduce these complications.Objective:To determine the pattern of Obstetric referral cases to the Rivers State University Teaching Hospital (RSUTH) and assess time to response by the hospital.Methodology:A retrospective review of hospital records of all pregnant women referred to RSUTH for maternal delivery and care in a six months period, 1stApril to 30thSeptember2015, was carried out. Data on patients’ age, educational level, marital status, gestational age, parity, booking status, time interval between admission and intervention, obstetric diagnoses and outcome were retrieved using structured pro-forma. Data were analyzed using United States CDC Epi Info Version 7.Results:There were 460 cases referred to the hospital, which represents 42.6% of all maternal deliveries, with a mean age of 28.7±4.6 years and median age of 27.0 years. A majority, 73.7% had secondary education, 55.4% were Primigravidae, 55.4% had term pregnancies and 77.8% were booked elsewhere. Over 60% of diagnoses comprised of difficult labour, Pre-eclampsia/Eclampsia and prolonged pregnancy. About 75% of the cases had intervention carried out within 12 hours of arrival to hospital.Conclusion: The pattern of referral cases to our hospital are mainly young educated primigravidae at term, who have had some form of antenatal care and presenting with common complications associated with this group. The intervention response time is good, but we recommend that high risk pregnancies should ab initio be registered at centers properly equipped to handle such cases to avoid calamity
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Background: Antenatal Care (ANC) utilization facility is available but poorly utilized because of many factors which play indirect role in inadequate utilization of antenatal care facility: low social status of women in the society, less opportunity for basic education, less ability to make decisions. Therefore, the present study is an attempt to study the effect of maternal education on antenatal care utilization, maternal and perinatal outcome in a tertiary care hospital.Methods: A prospective study was carried out on 525 cases delivered during period of one year at Dayanand Medical College and Hospital, Ludhiana, Punjab, India; a tertiary care hospital catering both urban and rural population. All cases were categorized into two groups: booked and unbooked. The age, parity and education of each patient in booked and unbooked cases was noted. Further, its impact on antenatal care utilization, maternal and perinatal outcome was studied.Results: On studying education pattern, among illiterate subjects 50% were booked and 50% were unbooked; For graduate and above were 80.6% and 19.4%respectively. Among mothers who were illiterate 90.9% had low birth weight babies and 13.6% had stillborn. Among those graduates and above 38.7% had low birth weight babies,1.5 % stillborn and 1.2% neonatal deaths.Conclusions: The educational status of the women came out as a significantly important variable and predictor of perinatal outcome. Hence, whole hearted efforts should be directed in educating women population and also improving health care facilities in rural areas to provide early referral to higher centers.
摘要
Aims: This study assessed and compared compliance with preferred infant feeding options among HIV positive booked and un-booked women in Osun State in South western Nigeria. Study Design: Descriptive cross sectional study. Place and Duration of Study: This study was carried out in Osun state in Southwestern Nigeria between January 2007 and June 2009. Methodology: Descriptive cross sectional comparative study among 210 booked and 105 un-booked HIV positive women, to assess their compliance with pre-delivery infant feeding options preferred up to four months after delivery. Research instruments employed were semi structured, interviewer administered and pre tested questionnaires. Responses were analyzed using the SPSS software version 13.0. Results: More booked women 153 (72.9%) preferred or selected exclusive replacement feeding as compared with un-booked women 29 (27.6%). Among un-booked women, 43 (40.9%) currently breastfeeds exclusively, while 22 (21.0%) give cow milk. Among booked women, 44 (21.0%) currently breastfeeds exclusively while 152 (72.4%) give cow milk. Compliance rate with preferred breastfeeding option was higher among booked than un-booked women (77.2% vs. 58.1%, p=0.010). Compliance rate with preferred replacement feeding option was also higher among booked than un-booked women, (93.2% vs. 75.9%, p=0.001). Mixed feeding rate was higher among un-booked than booked respondents (27.6% vs. 6.7%, p=0.001). Respondents who preferred breastfeeding and replacement feeding among un-booked women were a half ((O.R of 0.57, 95%C.I of 0.41-0.95, and p=0.013) and one-third ((OR of 0.32, 95%C.I of 0.1-0.8 and p=0.044) fold more likely to practice preferred method respectively when compared with booked women. Conclusion: Un-booked HIV positive women were less likely to practice selected infant feeding method compared to booked women.