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Emergency Obstetric Care

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https://www.readbyqxmd.com/read/28820340/effect-of-support-supervision-on-maternal-and-newborn-health-services-and-practices-in-rural-eastern-uganda
#1
Angela N Kisakye, Rornald Muhumuza Kananura, Elizabeth Ekirapa-Kiracho, John Bua, Martha Akulume, Gertrude Namazzi, Suzanne Namusoke Kiwanuka
BACKGROUND: Support supervision is one of the strategies used to check the quality of services provided at health facilities. From 2013 to 2015, Makerere University School of Public Health strengthened support supervision in the district of Kibuku, Kamuli and Pallisa in Eastern Uganda to improve the quality of maternal and newborn services. OBJECTIVE: This article assesses quality improvements in maternal and newborn care services and practices during this period...
August 2017: Global Health Action
https://www.readbyqxmd.com/read/28816629/a-cascade-model-of-mentorship-for-frontline-health-workers-in-rural-health-facilities-in-eastern-uganda-processes-achievements-and-lessons
#2
Judith Ajeani, Richard Mangwi Ayiasi, Moses Tetui, Elizabeth Ekirapa-Kiracho, Gertrude Namazzi, Ronald Muhumuza Kananura, Suzanne Namusoke Kiwanuka, Jolly Beyeza-Kashesya
BACKGROUND: There is increasing demand for trainers to shift from traditional didactic training to innovative approaches that are more results-oriented. Mentorship is one such approach that could bridge the clinical knowledge gap among health workers. OBJECTIVES: This paper describes the experiences of an attempt to improve health-worker performance in maternal and newborn health in three rural districts through a mentoring process using the cascade model. The paper further highlights achievements and lessons learnt during implementation of the cascade model...
August 2017: Global Health Action
https://www.readbyqxmd.com/read/28814285/quality-of-midwife-provided-intrapartum-care-in-amhara-regional-state-ethiopia
#3
Tegbar Yigzaw, Fantu Abebe, Lalem Belay, Yewulsew Assaye, Equlinet Misganaw, Ashebir Kidane, Desalegn Ademie, Jos van Roosmalen, Jelle Stekelenburg, Young-Mi Kim
BACKGROUND: Despite much progress recently, Ethiopia remains one of the largest contributors to the global burden of maternal and newborn deaths and stillbirths. Ethiopia's plan to meet the sustainable development goals for maternal and child health includes unprecedented emphasis on improving quality of care. The purpose of this study was to assess the quality of midwifery care during labor, delivery and immediate postpartum period. METHODS: A cross-sectional study using multiple data collection methods and a 2-stage cluster sampling technique was conducted from January 25 to February 14, 2015 in government health facilities of the Amhara National Regional State of Ethiopia...
August 16, 2017: BMC Pregnancy and Childbirth
https://www.readbyqxmd.com/read/28806579/access-to-emergency-care-services-a-transversal-ecological-study-about-brazilian-emergency-health-care-network
#4
T A H Rocha, N C da Silva, P V Amaral, A C Q Barbosa, J V M Rocha, V Alvares, D G de Almeida, E Thumé, E B A F Thomaz, R C de Sousa Queiroz, M R de Souza, A Lein, N Toomey, C A Staton, J R N Vissoci, L A Facchini
OBJECTIVES: Studies of health geography are important in the planning and allocation of emergency health services. The geographical distribution of health facilities is an important factor in timely and quality access to emergency services; therefore, the present study analyzed the emergency health care network in Brazil, focusing the analysis at the roles of small hospitals (SHs). STUDY DESIGN: Cross-sectional ecological study. METHODS: Data were collected from 9429 hospitals of which 3524 were SHs and 5905 were high-complexity centers (HCCs)...
August 11, 2017: Public Health
https://www.readbyqxmd.com/read/28800668/-epidemiology-risk-factors-and-risk-stratification-of-venous-thromboembolism-in-pregnancy-and-the-puerperium
#5
Panagiotis Tsikouras, Georg-Friedrich von Tempelhoff, Werner Rath
Venous thromboembolism (VTE) remains a leading cause of direct maternal deaths in the developed countries. The incidence of VTE has increased significantly during the past two decades. The absolute risk of VTE is estimated 0.6-2.2 per 1000 deliveries. Compared with age-matched non-pregnant women, the daily risk of VTE is increased 7- to 10-fold for antepartum VTE, but it is 15- to 35-fold for postpartum VTE. The incidence of pulmonary embolism (PE) during the first 6 weeks postpartum is nearly 15-fold higher compared to the incidence in pregnancy, and remains significantly increased up to 12 weeks postpartum...
August 2017: Zeitschrift Für Geburtshilfe und Neonatologie
https://www.readbyqxmd.com/read/28793840/inadequate-visits-to-the-emergency-department-by-pregnant-women
#6
Elena Ferriols Pérez, Nadwa Kanjou Augé, Jordi Genovés González, Andrea Burón Prust, Antonio Payà Panadés, Ramón Carreras Collado
Inadequate emergency visits, which could be resolved in primary care, are an unnecessary expense for the healthcare service. We did a review of all gynaecology and obstetrics emergency visits by pregnant or postpartum women during 2010 and 2011 in order to describe the adequacy of the visits by pregnant women to the emergency service. We defined three levels of adequacy: adequate, moderately adequate, and inadequate. One thousand seven hundred and forty-three visits to the emergency room of gynaecology and obstetrics were studied...
August 9, 2017: Journal of Obstetrics and Gynaecology: the Journal of the Institute of Obstetrics and Gynaecology
https://www.readbyqxmd.com/read/28793315/home-is-best-why-women-in-rural-zimbabwe-deliver-in-the-community
#7
Munyaradzi Kenneth Dodzo, Marvellous Mhloyi
Maternal mortality in Zimbabwe has unprecedentedly risen over the last two and half decades although a decline has been noted recently. Many reasons have been advanced for the rising trend, including deliveries without skilled care, in places without appropriate or adequate facilities to handle complications. The recent decline has been attributed to health systems strengthening through a multi-donor pooled funding mechanism. On the other hand, the proportion of community deliveries has also been growing steadily over the years and in this study we investigate why...
2017: PloS One
https://www.readbyqxmd.com/read/28767491/medical-student-perceptions-of-global-surgery-at-an-academic-institution-identifying-gaps-in-global-health-education
#8
Ambar Mehta, Tim Xu, Matthew Murray, Kathleen M Casey
PURPOSE: Robust global health demands access to safe, affordable, timely surgical care for all. The long-term success of global surgery requires medical students to understand and engage with this emerging field. The authors characterized medical students' perceptions of surgical care relative to other fields within global health. METHOD: An optional, anonymous survey was given to all Johns Hopkins medical students from February to March 2016 to assess perceptions of surgical care and its role in global health...
August 1, 2017: Academic Medicine: Journal of the Association of American Medical Colleges
https://www.readbyqxmd.com/read/28764269/analysis-of-clinical-indicators-of-quality-in-patients-with-endotracheal-intubation
#9
Sulochana Dash, Sreelatha Balasubramanian
INTRODUCTION: Quality and safety in anaesthesia is usually monitored by analysis of perioperative mortality-morbidity and are influenced by anaesthetic and non-anaesthetic factors. AIM: This study was conducted to analyse the incidence of clinical indicators of quality in endotracheally intubated patients undergoing general abdominal surgeries and obstetric and gynaecological procedures under general anaesthesia and to determine contributing factors for the same...
June 2017: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/28763454/the-introduction-of-new-policies-and-strategies-to-reduce-inequities-and-improve-child-health-in-kenya-a-country-case-study-on-progress-in-child-survival-2000-2013
#10
Marie A Brault, Kenneth Ngure, Connie A Haley, Stewart Kabaka, Kibet Sergon, Teshome Desta, Kasonde Mwinga, Sten H Vermund, Aaron M Kipp
As of 2015, only 12 countries in the World Health Organization's AFRO region had met Millennium Development Goal #4 (MDG#4) to reduce under-five mortality by two-thirds by 2015. Given the variability across the African region, a four-country study was undertaken to examine barriers and facilitators of child survival prior to 2015. Kenya was one of the countries selected for an in-depth case study due to its insufficient progress in reducing under-five mortality, with only a 28% reduction between 1990 and 2013...
2017: PloS One
https://www.readbyqxmd.com/read/28760430/is-maternal-body-mass-index-associated-with-neonatal-mortality-a-pooled-analysis-of-nationally-representative-data-from-nine-asian-countries
#11
Rajesh Kumar Rai, Lucky Singh, Prashant Kumar Singh
OBJECTIVE: Children born to mothers with abnormal body mass index (BMI) have increased risk for mortality. The aim of this study was to investigate whether maternal BMI is a risk factor for neonatal death in select Asian countries, including the nature of association between maternal BMI and the discrete timing of neonatal death. METHODS: Nationally representative, the standard Demographic and Health Survey data from nine Asian countries were used. In all, 55 629 mothers reported their index birth; 840 reported neonatal mortality...
September 2017: Nutrition
https://www.readbyqxmd.com/read/28750370/social-birth-rites-of-passage-for-the-newborn
#12
Michael Obladen
Rites of passage mark important changes during human life and, for the neonate, its transition from intrauterine life into society. Their original intent was to purify the body from blood and meconium. But the cleansing rites had a spiritual dimension from the very start. When the rites of Mesopotamian, Egyptian, Jewish, Greek, Roman, Hindu, Nordic, Muslim, Maya, and Christian cultures are briefly compared, they reveal a remarkable similarity. What most rites had in common was the cleansing of the body, or sprinkling it with water; special clothing; the exorcism of evil spirits; blessings and prayers for good spirits; and a name-giving ceremony and a feast for family, relatives, and friends...
July 28, 2017: Neonatology
https://www.readbyqxmd.com/read/28749055/a-failure-to-be-candid
#13
Jennifer McGuirl
I was a second-year neonatal-perinatal fellow in a meeting between other members of the neonatal intensive care team and parents who had just received devastating news about their planned-for and highly desired baby, born after what had been an uncomplicated pregnancy. At home, a little sister was waiting to meet her new brother. These conversations are never easy, but this one I found particularly disturbing. John had been born at term via emergency cesarean section after his mother, Muriel, had come for a routine obstetrical visit and reported decreased fetal movement...
July 2017: Hastings Center Report
https://www.readbyqxmd.com/read/28742162/trajectories-of-anxiety-and-health-related-quality-of-life-during-pregnancy
#14
K Oliver Schubert, Tracy Air, Scott R Clark, Luke E Grzeskowiak, Edward Miller, Gustaaf A Dekker, Bernhard T Baune, Vicki L Clifton
Anxiety and health related Quality of Life (HRQoL) have emerged as important mental health measures in obstetric care. Few studies have systematically examined the longitudinal trajectories of anxiety and HRQoL in pregnancy. Using a linear growth modeling strategy, we analyzed the course of State-Trait Anxiety Inventory (STAI)- and Short Form (36) Health Survey (SF-36) scores between the 12th and the 36th week of gestation, in a sample of 355 women. We additionally analyzed the impact of depressive symptoms and a chronic medical condition (asthma), on STAI and SF-36 trajectory curves...
2017: PloS One
https://www.readbyqxmd.com/read/28733056/uninsured-maternity-patients-in-calgary-local-trends-and-survey-of-health-care-workers
#15
Fiona M Mattatall
OBJECTIVE: Uninsured maternity patients comprise a small but complex group of patients and include marginalized Canadians, undocumented immigrants, visitors, and non-Canadians seeking health care and/or citizenship for their newborn. This is the first Canadian study to quantify these patients and to review health care providers' perspectives and practices of care. METHODS: Data for all deliveries in Calgary, Alberta over a 4-year period (2013-2016) were analyzed...
July 18, 2017: Journal of Obstetrics and Gynaecology Canada: JOGC, Journal D'obstétrique et Gynécologie du Canada: JOGC
https://www.readbyqxmd.com/read/28729097/post-caesarean-section-surgical-site-infection-surveillance-using-an-online-database-and-mobile-phone-technology
#16
Eliana Castillo, Corrine McIsaac, Bhreagh MacDougall, Douglas Wilson, Rosemary Kohr
BACKGROUND: Obstetric surgical site infections (SSIs) are common and expensive to the health care system but remain under reported given shorter postoperative hospital stays and suboptimal post-discharge surveillance systems. SSIs, for the purpose of this paper, are defined according to the Center for Disease Control and Prevention (1999) as infection incurring within 30 days of the operative procedure (in this case, Caesarean section [CS]). PRIMARY OBJECTIVE: Demonstrate the feasibility of real-life use of a patient driven SSIs post-discharge surveillance system consisting of an online database and mobile phone technology (surgical mobile app - how2trak) among women undergoing CS in a Canadian urban centre...
August 2017: Journal of Obstetrics and Gynaecology Canada: JOGC, Journal D'obstétrique et Gynécologie du Canada: JOGC
https://www.readbyqxmd.com/read/28728520/in-and-out-hospital-mortality-rate-in-surgical-patients
#17
Philippe Dony, Magali Pirson, Jean G Boogaerts
BACKGROUND: Death rates after surgery are increasingly analysed for clinical audit and quality assessment. Many studies commonly provide information only on deaths that occur during hospital stay, known as in-hospital death rates. By using hospital data set linked to death certificate registry, we recorded in- and out-hospital deaths within 30 and 60 post-operative days. METHODS: The study included all consecutive surgical procedures (denominator) under general or locoregional anaesthesia in adult patients admitted for elective or non-elective inpatient surgery...
July 20, 2017: Acta Chirurgica Belgica
https://www.readbyqxmd.com/read/28728102/uterine-necrosis-following-a-combination-of-uterine-compression-sutures-and-vascular-ligation-during-a-postpartum-hemorrhage-a-case-report
#18
Saad Benkirane, Hanane Saadi, Badr Serji, Ahmed Mimouni
INTRODUCTION: The Postpartum bleeding is the first cause of maternal mortality in Morocco. It is an obstetrical emergency that requires a fast multimodal management including medical care, interventional procedure and in few cases a salvatory surgery. CLINICAL CASE: We report a rare case of uterine necrosis following postpartum hemorrhage, refractory to medical therapy, and which was controlled by a combination of uterine hemostatic techniques and vascular ligation three days after surgery, the patient developed a fever (39°C)...
2017: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/28722621/health-care-access-during-the-ebola-virus-epidemic-in-liberia
#19
Patricia A McQuilkin, Kanagasabai Udhayashankar, Michelle Niescierenko, Louise Maranda
The Ebola virus disease (EVD) epidemic, which began in West Africa in December 2013, claimed more than 11,000 lives, with more than 4,800 of these deaths occurring in Liberia. The epidemic had an additional effect of paralyzing the health-care systems in affected countries, which led to even greater mortality and morbidity. Little is known about the impact that the epidemic had on the provision of basic health care. During the period from March to May 2015, we undertook a nationwide, community-based survey to learn more about health-care access during the EVD epidemic in Liberia...
July 10, 2017: American Journal of Tropical Medicine and Hygiene
https://www.readbyqxmd.com/read/28722561/the-quality-of-free-antenatal-and-delivery-services-in-northern-sierra-leone
#20
Manso M Koroma, Samuel S Kamara, Evelyn A Bangura, Mohamed A Kamara, Virgil Lokossou, Namoudou Keita
BACKGROUND: The number of maternal deaths in sub-Saharan Africa continues to be overwhelmingly high. In West Africa, Sierra Leone leads the list, with the highest maternal mortality ratio. In 2010, financial barriers were removed as an incentive for more women to use available antenatal, delivery and postnatal services. Few published studies have examined the quality of free antenatal services and access to emergency obstetric care in Sierra Leone. METHODS: A cross-sectional survey was conducted in 2014 in all 97 peripheral health facilities and three hospitals in Bombali District, Northern Region...
July 12, 2017: Health Research Policy and Systems
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