Top PDF Factors associated with postpartum hemorrhage maternal death in referral hospitals in Senegal and Mali: a cross sectional epidemiological survey

Factors associated with postpartum hemorrhage maternal death in referral hospitals in Senegal and Mali: a cross sectional epidemiological survey

Factors associated with postpartum hemorrhage maternal death in referral hospitals in Senegal and Mali: a cross sectional epidemiological survey

Our findings may have direct implications for clinicians in resource poor settings. We demonstrated that women ’ s characteristics, aspects of pregnancy and delivery; PPH management; and organizational characteristics of hospi- tals are risk factors for PPH maternal mortality in SSA. We suggest that severe antepartum anemia should be di- agnosed more accurately and treated before delivery, while effort should be put on improving the capacity of the blood banks and making blood quickly accessible when needed. Early detection of PPH and timely decision- making for transfusion are critical. It is also important to improve the identification of women who need to be transferred to another facility and transportation system. Finally, our findings suggest that training in emergency obstetric care of GPs is probably insufficient. If that train- ing may respond to the shortage of obstetricians, whose training is time and money consuming; on the other hand it prevents the same quality care. A better supervision and extensive training are essential keys to reduce gaps in knowledge and to prevent PPH maternal death.
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Individual and institutional determinants of caesarean section in referral hospitals in Senegal and Mali: a cross sectional epidemiological survey

Individual and institutional determinants of caesarean section in referral hospitals in Senegal and Mali: a cross sectional epidemiological survey

For each type of CS, analysis was performed using a two-step procedure. As the first step, we assessed only individual factors, as they were expected to have the highest impact on CS likelihood. Potential individual risk factors were selected according to results obtained from previous studies in low- and middle-income countries [11,16-19]: age, parity, previous CS, multiple pregnancy (vs. single pregnancy), hypertensive disorders, vaginal bleeding near full term, suspected cephalopelvic-dispro- portion, suspected intrauterine death, premature rupture of the membranes, referral from another hospital, pre- mature labour and oxytocin use. We considered that women did not have a condition if it had not been reported by a midwife. Obstetric complications that oc- curred during labour (i.e. obstructed labour or foetal dis- tress) were not included in the analyses because they closely affected the decision regarding CS. Referral from another hospital was considered as a potential marker for more severe conditions because of delays due to large travel distances or lack of transportation. Both tri- variate (i.e., adjusted for the country and the period) and multi-variable analyses were performed. All variables, regardless of their association with CS in tri-variate analyses, were included in the multivariable model. They were all kept in the final model as they were in- dependent and highly significant determinants of outcome (P<0.01). We used a conservative significance level to account for multiple analyses, and a very large sample size implied that any clinically relevant association was very significant.
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Predictors of uterine rupture in a large sample of women in Senegal and Mali: cross sectional analysis of QUARITE trial data

Predictors of uterine rupture in a large sample of women in Senegal and Mali: cross sectional analysis of QUARITE trial data

Methods: Cross-sectional data analysis from the pre-intervention period (Oct. 1, 2007- Oct. 1, 2008) of the QUARITE trial, a large-scale maternal mortality study. This research examines uterine rupture among 84,924 women who delivered in one of 46 referral hospitals in Mali and Senegal. A mixed-effects logistic regression model identified individual and geographical risk factors associated with uterine rupture, accounting for clustering by hospital. Results: Five hundred sixty-nine incidences of uterine rupture (0.67% of sample) were recorded. Predictors of uterine rupture: grand multiparity defined as > 5 live births (aOR = 7.57, 95%CI; 5.19 – 11.03), prior cesarean (aOR = 2.02, 95%CI; 1. 61 – 2.54), resides outside hospital region (aOR = 1.90, 95%CI: 1.28 – 2.81), no prenatal care visits (aOR = 1.80, 95%CI; 1.44 – 2. 25), and birth weight of > 3600 g (aOR = 1.61, 95%CI; 1.30 – 1.98). Women who were referred and who had an obstructed labor had much higher odds of uterine rupture compared to those who experienced neither (aOR: 46.25, 95%CI; 32.90 – 65.02).
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ASSESSMENT OF RISK FACTORS FOR PRIMARY POSTPARTUM HEMORRHAGE AT ZAGAZIG UNIVERSITY HOSPITALS

ASSESSMENT OF RISK FACTORS FOR PRIMARY POSTPARTUM HEMORRHAGE AT ZAGAZIG UNIVERSITY HOSPITALS

In order to reduce the maternal morbidity and mortality, we recommend properly organized antenatal visits helping early detection of risk factors of PPH and providing an opportunity to educate the women about the risk factors of PPH and training on active management of the third stage of labour for the prevention and treatment of PPH. Clinicians should identify risk factors before and during labour as early as possible to optimize care for high risk women. Finally, Every health facility should have adequate supplies of uterotonic drugs, equipment and protocols for the prevention and treatment of PPH as well as blood transfusion facilities.
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Are hypertensive disorders in pregnancy associated with congenital malformations in offspring? Evidence from the WHO Multicountry cross sectional survey on maternal and newborn health

Are hypertensive disorders in pregnancy associated with congenital malformations in offspring? Evidence from the WHO Multicountry cross sectional survey on maternal and newborn health

Only a few studies have explored the associations be- tween pre-eclampsia and malformations providing in- conclusive results: one reported an increased risk of renal dysgenesis (OR 4.7, 95 % CI 1.7–12.8), esophageal atresia/stenosis (OR 4.6, 95 % CI 1.8–12.2) and rectal/ anal stenosis (OR 3.7, 95 % CI 1.6–8.5) in the offspring of pregnant women who developed preeclampsia with superimposed chronic hypertension [11] whilst another found that esophageal atresia/stenosis was a greater risk in pregnant women with chronic hypertension (OR 3.1, 95 % CI 1.4–6.8) [12]. Some studies have suggested a correlation between maternal hypertension and severe hypospadias (OR 2.1, 95 % CI 1.6–2.9) [13, 14]. Altered perfusion of placenta and embryo/fetus is being consid- ered as plausible biological pathway [15]; however, there is a dearth of knowledge on the likely common events leading to hypertensive disorders and congenital abnor- malities [16] mainly because of the different gestational timing of these two separate events, namely first trimes- ter of gestation for congenital malformation and second/ third trimester for hypertensive disorders [17]. Using data collected in 29 countries worldwide as part of the World Health Organization Multicountry Survey (WHOMCS), in this analysis we aimed to examine the association be- tween hypertensive disorders of pregnancy and the risk of congenital malformations in the newborn.
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<p>Moral Distress and Its Associated Factors Among Nurses in Northwest Amhara Regional State Referral Hospitals, Northwest Ethiopia</p>

<p>Moral Distress and Its Associated Factors Among Nurses in Northwest Amhara Regional State Referral Hospitals, Northwest Ethiopia</p>

common in clinical practice because caring for the patient is a natural moral activity. 6 Clinical care involves the interfacing of multiple moral actors. 6,7 MD is not isolated to one geographical location. 8 In the United States, one in three nurses experiences moral distress. 9 The source of moral distress may vary but it is associated with in dis- agreement in the patient care plan, not involved in decision making, restraint of healthcare resources, inadequate staff- ing, a continuation of futile patient care, poor communica- tion and restricting patient ’ s autonomy. 4 Moral distress has a deleterious effect on patients, nurses, and organizations which results in decreased job satisfaction, increased turn- over, withdrawal from a job, and developing physical and psychological symptoms. 10 Moral distress hurts nursing practice and the patient treatment outcome as well as their performance and wellbeing that can in fl uence the quality, quantity, and cost of nursing care. 11 Moral distress affects nurses ’ personality as well as their ability to work and continue working on the same unit. 12 Moral distress is facing the nursing profession because nurses are involved in all areas of healthcare. 13 Therefore, nurses can lose their capacity to care, fail to provide good care, devoid of patient contact, become emotionally aloof, deny their emo- tional pain, and become cynical and sarcastic. 11 Moral distress varies from individual to individual. When nurses cannot do what they think is right, they experience moral distress. 14 As a result, this study tries to investigate the proportion of moral distress among nurses in Northwest Amhara regional state referral hospitals.
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Joshi

Joshi

The growth rate of the slum population in India has been much higher than the growth rate of the non-slum population. 7 The research in the urban slums has primarily focused on child health, and reproductive and communicable diseases. 8 Only a few reports are available on the prevalence of lifestyle diseases, such as hypertension, in the slums. The study to assess knowledge, attitude and practices regarding hypertension in an urban slum was needed to help to understand the lesser known facts of this problem. Hence, we conducted a cross sectional epidemiological study to assess knowledge, attitude, practices, associated socio- demographic risk factors along with prevalence of hypertension in an urban slum.
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A cross sectional survey of policies guiding second stage labor in urban Japanese hospitals, clinics and midwifery birth centers

A cross sectional survey of policies guiding second stage labor in urban Japanese hospitals, clinics and midwifery birth centers

According to the Guidelines for Midwives [13] there was no evidence that applying warm compresses to the perineum was effective for preventing perineal trauma. However, there was evidence that the women receiving warm compress ex- perienced less perineal pain at post-delivery day one and two compared to the control group [13]. A more recent re- view suggests that warm compresses were associated with a significant decrease in 3 rd and 4 th degree tears [21]. More- over, it was shown that no harmful outcomes occurred; therefore, warm compress to the perineum could be applied if clinicians used an appropriate temperature [13]. In this re- search, with two-thirds of the midwifery birth centers and only a quarter of the hospitals and clinics responding ‘almost all cases or depending on the cases’ , it appears to be a wide- spread practice of midwives and may be more related to promoting comfort. Additional research regarding the lack of using warm compresses in clinics and hospitals should be explored.
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Maternal healthcare services use in Mwanza Region, Tanzania: a cross sectional baseline survey

Maternal healthcare services use in Mwanza Region, Tanzania: a cross sectional baseline survey

The present findings regarding the impact of wealth and income on MHS use were equivocal. In the bivariate analysis, wealth was significant but the relationship was U-shaped, indicating that those in the lowest and highest categories had an advantage in MHS use compared with those in the middle wealth categories. However, after adjusting for other factors (e.g., geographic district and maternal education), there was no significant association between wealth quintile and use of ANC4+ or health facility delivery services. The only significant finding was that women in the lowest wealth category were more likely to receive postpartum care compared with those in the middle wealth categories. These findings were consistent with a study on determinants of postnatal care in rural Tanzania [16], but contrasted with findings of other studies that reported significant associations be- tween wealth index and MHS use [27, 29, 31, 32]. This suggested that offering ANC services free of charge may not be sufficient to improve the use of these services, as other factors (e.g., cost of transportation to the health fa- cility and finding money for other treatment services) may be impediments to accessibility and use of these services among those in lower income categories. In addition, maternal education and geographic proximity appeared to be more important in predicting use of services for delivery, whereas initiating earlier ANC visits appeared to be more important for ANC4+ visits. In fact, timing of initiation of ANC services appeared to be the strongest predictor of ANC4+ and was also a
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Does knowledge on socio cultural factors associated with maternal mortality affect maternal health decisions? A cross sectional study of the Greater Accra region of Ghana

Does knowledge on socio cultural factors associated with maternal mortality affect maternal health decisions? A cross sectional study of the Greater Accra region of Ghana

had the goal of halving the 1990 maternal mortality figures by the year 2000, maternal mortality ratios are still high in some parts of the world. Ghana signing up on the Nairobi declaration put up various interventions which included free maternal care, establishment of maternal and child health clinics, safe motherhood protocol development, training of traditional birth attendants among others. The Nairobi con- ference was an eye opener that paved the way for the devel- opment of the major maternal health related policies and interventions in the country. With these policies and inter- ventions in place, Ghana ’ s maternal mortality ratio dropped from 760 per 100,000 live births in 1990 to 570 per 100,000 live births in 2000 [10], though Ghana was not able to halve her maternal deaths by the year 2000 [11]. With Ghana sign- ing up on the Millennium Development Goals (MDGs) in 2000 and therefore committed to achieving the MDG 5 by reducing her maternal mortality by 75 % by 2015, the coun- try made a recognizable gain by reducing the 1990 maternal mortality ratio figure to 319 deaths per 100,000 live births in 2015 representing an overall reduction of 44% in fifteen years. It is however, clear that safe motherhood interventions have not lived up to expectation since maternal mortality ra- tios in Ghana and other low and middle-income countries are still high. Some scholars attribute this to the failure on the part of policy makers to identify and tackle effectively the other category of determinants- socio-cultural [4].
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Incidence of postpartum infection, outcomes and associated risk factors at Mbarara regional referral hospital in Uganda

Incidence of postpartum infection, outcomes and associated risk factors at Mbarara regional referral hospital in Uganda

This present study is the primary analysis of data collected in this prospective cohort study. Summary statistics were used to characterize the cohort. Demographic characteris- tics and outcomes were compared between febrile/ hypothermic participants and normothermic participants using Chi-squared analysis for categorical variables and stu- dent’s t-test or Wilcoxon Ranksum for continuous vari- ables. P-values < 0.05 were considered statistically significant. Separate multivariable logistic regression models were used to identify factors associated with development of fever/hypothermia, postpartum endometritis and the composite postpartum infection outcome. Predictor vari- ables selected for potential inclusion in each model in- cluded published risk factors for postpartum fever and infection such as age, parity, employment, district of
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The maternal and perinatal outcome in antepartum hemorrhage: A cross-sectional study

The maternal and perinatal outcome in antepartum hemorrhage: A cross-sectional study

study reported only one placenta accrete in placenta previa group of his study (2.5%) and only one maternal death, but what differentiated it from our study is that the maternal death was due to shock and renal failure of a lady presented as severe abruption placentae. Blood transfusion ≥5 units required in 10 cases of placenta previa and 7 cases of abruptio placenta in present study whereas in Majumder et al. 12 study ≥5 units of blood were given in 3 cases of placenta previa and 2 cases of abruption placenta. This may be due to their small sample size and the higher incidence of anemia in our study. The perinatal mortality in our study was 23.64% which was parallel to the study done by Wasnik et al. 13 which was 21% and Adekanle et al. 21 (22.2%). Meanwhile, we found high low birth weight rate in the current study, which was 50.7% for abruption placentae, and 34.3% for placenta previa, but these were 67.64% and 33.34% respectively in Kedar et al. 15
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RESEARCH ARTICLE Investigation of factors affecting postpartum maternal weight retention: A cross-sectional study

RESEARCH ARTICLE Investigation of factors affecting postpartum maternal weight retention: A cross-sectional study

prevalence is higher in women in Turkey. Some traditional approaches in Turkish culture support gaining weight in pregnancy and the postpartum period. In traditional Turkish culture, the mother is commonly seen as the one who carries "two human beings" and therefore eats more, with friends and family encouraging a pregnant woman to eat everything. The puerperant woman eats more in order to have more milk and an excessive intake of carbohydrate-rich foods is encouraged. These incorrect practices make it more difficult to manage weight in

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A Cross-Sectional Survey to Assess Knowledge, Attitude, and Practices in Patients with Hypothyroidism in Riyadh, Saudi Arabia

A Cross-Sectional Survey to Assess Knowledge, Attitude, and Practices in Patients with Hypothyroidism in Riyadh, Saudi Arabia

Previous studies indicate that the symptoms of hypothyroidism are nonspecific and often overlap with other disease conditions. Fatigue is one of the most common symptoms of the condition, but could be misleading [1]. In our study, 60% of the participants showed a consistent knowledge on fatigue, weight gain, and muscle aches, but 40% had inconsistent information various other symptoms associated with hypothyroidism. Knowledge of disease symptoms is critical for patients to identify treatment effects, progression, and narrate clinical evidence of the disease to the treating physician during follow up.
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Community Pharmacists’ Knowledge, Practices and Perceptions on Antibiotic Use and Resistance: A Cross Sectional, Self Administered Questionnaire Survey, in Guediawaye and Pikine, Senegal

Community Pharmacists’ Knowledge, Practices and Perceptions on Antibiotic Use and Resistance: A Cross Sectional, Self Administered Questionnaire Survey, in Guediawaye and Pikine, Senegal

Background: Antibiotic resistance is a threat to global health. Community pharmacists are among the most accessible health professionals. Therefore, their role in improving antibiotic use and subsequently in fighting resistance is crucial. The objective of this study was to evaluate community pharmacists’ knowledge, practices and perceptions on antibiotic use and resistance. Me- thods: We conducted a cross-sectional study in community pharmacies lo- cated in the departments of Guediawaye and Pikine, Senegal. The study took place between November 2017 and February 2018. A total of 121 community pharmacies were located. In each of them, we planned to include one phar- macist. A self-administered questionnaire was used. The data were analyzed using Epi Info 7. The analysis was descriptive. Variables were expressed as number (n) and percentage (%). Results: The response rate was 75.2%. The majority mistakenly thought that antibiotics are always effective against sore throat (64.8%), bronchitis (51.6%), paronychia (72.5%) and dental caries (65.9%). Most respondents knew that self-medication (96.7%), poor treat- ment compliance (94.5%), inappropriate antibiotic dispensing (79.1%), inap- propriate antibiotic prescribing (85.7%) were causes of resistance. Further, How to cite this paper: Bassoum, O.,
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Epidemiological Profile and Risk Factors of Preterm Births in two Referral Hospitals of Butembo, Eastern Democratic Republic of the Congo

Epidemiological Profile and Risk Factors of Preterm Births in two Referral Hospitals of Butembo, Eastern Democratic Republic of the Congo

married. In fact, men support financially and psychologically their spouses during pregnancy. In the same table, it appears that the primiparity and the grand multiparity, multiplies successively 2.29 and 1.36 times the risks of a preterm births. These risks are significant for the CI at 95% does not contain 1. Shah found that only primiparity was associated with preterm births. But grand as well as great grand multiparities were not associated with preterm births. [13]. In fact, as noticed by Nagalo et al. [7] the first pregnancy was closely associated with young maternal age and influenced preterm birth.
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Patient satisfaction with peri operative anesthesia care and associated factors at two National Referral Hospitals: a cross sectional study in Eritrea

Patient satisfaction with peri operative anesthesia care and associated factors at two National Referral Hospitals: a cross sectional study in Eritrea

and they would also recommend it to their families, friends and other service rendering customers [13]. Strengthening the communication skills with the pa- tients is also among the important determinant factors of patient satisfaction [12]. It determines the adequacy of information provided during the preoperative period and having and empathic attitude towards the patient during this period can possibly decrease patient’s anx- iety while increasing patient satisfaction and there by improves the quality of service [14]. Poor quality of an- aesthesia services may discourage patient from using available services and as people are becoming more and more aware of their rights and what they can expect, the demands of best possible care is increasing even also in developing countries. Therefore, it remains the duty of every staff to deliver the best possible care. Consequently, many health care organizations have considered the measurement of patient satisfaction to be a critical component of quality assessment. Thus, nowadays assessment of patient satisfaction with anaes- thesia services is a reality of practice [1, 9]. Having suf- ficient data related to patient satisfaction is assumed to improve and understand its strengths and to target areas in which performance is insufficient and it pro- vides an opportunity for the improvement or change of the identified gaps [3, 9, 15–19]. Furthermore, the assess- ment of patient satisfaction with the care they experi- ence is a key performance measure that is increasingly used in various payment models and payment for per- formance plans. In the future, it is likely that payment for anaesthesia services will depend in part on the de- gree of patient satisfaction [9].
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Improvement in the active management of the third stage of labor for the prevention of postpartum hemorrhage in Tanzania: a cross sectional study

Improvement in the active management of the third stage of labor for the prevention of postpartum hemorrhage in Tanzania: a cross sectional study

Under the MAISHA program, facilities formed quality improvement teams (QITs), which received training and ongoing supportive supervision and mentorship. QITs in- cluded representatives from different departments within the facility and used the Standards-Based Management and Recognition approach, which utilizes a “ Plan-Do-Stu- dy-Act” cycle to improve the quality of maternal and new- born care [21]. Subsequently, the QITs facilitated quality circles, referred to as work improvement teams (WITs), which used a participatory management technique that enlists the help of health care providers in solving prob- lems related to the provision of care. WITs included staff providing care in labor and delivery wards, antenatal and postnatal wards and antenatal clinics. Both teams met regularly to assess actual performance against desired per- formance, identify performance gaps, select solutions to improve performance and prepare action plans to imple- ment the performance-improvement solutions (Fig. 1).
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Factors associated with severe maternal morbidity in Kelantan, Malaysia: A comparative cross sectional study

Factors associated with severe maternal morbidity in Kelantan, Malaysia: A comparative cross sectional study

Information on women’s previous obstetric history is valuable. Although the studies were conducted with dif- ferent case definitions, cases of severe maternal morbid- ity are consistently reported to be more likely to have past obstetric complications [4, 33]. Our results ob- served that the occurrence of past obstetric complica- tions was doubled in severe maternal morbidity cases than in non-severe maternal morbidity cases. Most of the complications that occurred were related to hyper- tensive and haemorrhagic disorders and gestational dia- betes. Our results also suggest that the odds of severe maternal morbidity were two-fold higher in women with a past history of obstetric complications than those with- out any past history. However, a more concerning issue is that the past events do not affect family planning deci- sion making of the women leading to the recurrence of severe morbid conditions [34]. A recent study showed that after excluding cases with tubal ligation and hyster- ectomy among women with severe morbid conditions in the past pregnancies, there was no difference in the proportion of becoming pregnant again within five years between severe morbid women and controls (7.5 % vs 9.3 %) [35].
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The magnitude and associated factors of postpartum hemorrhage among mothers who delivered at Debre Tabor general hospital 2018

The magnitude and associated factors of postpartum hemorrhage among mothers who delivered at Debre Tabor general hospital 2018

Results: In this study, one hundred forty-four mothers’ charts were reviewed which made the response rate 100%. This study revealed that the magnitude of postpartum hemorrhage was 7.6% (CI 6.2, 9.8). Chi-square test revealed that there was an association between postpartum hemorrhage and gravidity, parity, having antenatal care visit, and the previous history postpartum hemorrhage. This finding confirmed that uterine atony, retained placenta, and geni- tal tract trauma were the most common leading cause of postpartum hemorrhage.

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