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Emergency Obstetric Care

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https://www.readbyqxmd.com/read/29219937/relationship-between-maternal-characteristics-and-postpartum-hemorrhage-a-meta-analysis-study
#1
Aysegul Durmaz, Nuran Komurcu
BACKGROUND: Postpartum hemorrhage (PPH) is a leading cause of maternal death in low-income countries and the primary cause of approximately one of every four maternal deaths worldwide. PURPOSE: The aim of this study was to determine the antenatal risk factors of PPH and its effects. METHODS: The literature from nine databases was reviewed, and studies published between 2000 and 2012 were analyzed using terms such as "postpartum hemorrhage," "prevention of postpartum hemorrhage," and "management of postpartum hemorrhage...
December 6, 2017: Journal of Nursing Research: JNR
https://www.readbyqxmd.com/read/29219140/-near-miss-obstetric-events-and-maternal-mortality-in-a-tertiary-care-hospital
#2
Shravya Tallapureddy, Revathi Velagaleti, Himabindu Palutla, Chaitanya Venkata Satti
Obstetric near-miss or severe acute maternal morbidity is gaining interest internationally as a new indicator of the quality of obstetric care. This is a retrospective study conducted using "The WHO Near-Miss Approach" to provide insight into obstetric emergencies, near-miss cases, and maternal deaths in our hospital. The maternal near-miss ratio was 8.4/1000 live births, maternal near-miss to mortality ratio was 5.3:1. Hemorrhage was the leading cause (43.7%) of morbidity in near-miss cases while hypertensive disorders were the leading cause in maternal deaths (66...
October 2017: Indian Journal of Public Health
https://www.readbyqxmd.com/read/29212509/incremental-cost-and-cost-effectiveness-of-low-dose-high-frequency-training-in-basic-emergency-obstetric-and-newborn-care-as-compared-to-status-quo-part-of-a-cluster-randomized-training-intervention-evaluation-in-ghana
#3
Michelle Willcox, Heather Harrison, Amos Asiedu, Allyson Nelson, Patricia Gomez, Amnesty LeFevre
BACKGROUND: Low-dose, high-frequency (LDHF) training is a new approach best practices to improve clinical knowledge, build and retain competency, and transfer skills into practice after training. LDHF training in Ghana is an opportunity to build health workforce capacity in critical areas of maternal and newborn health and translate improved capacity into better health outcomes. METHODS: This study examined the costs of an LDHF training approach for basic emergency obstetric and newborn care and calculates the incremental cost-effectiveness of the LDHF training program for health outcomes of newborn survival, compared to the status quo alternative of no training...
December 6, 2017: Globalization and Health
https://www.readbyqxmd.com/read/29212457/the-decision-delivery-interval-in-emergency-caesarean-section-and-its-associated-maternal-and-fetal-outcomes-at-a-referral-hospital-in-northern-tanzania-a-cross-sectional-study
#4
Birjna A Hirani, Bariki L Mchome, Nicholaus S Mazuguni, Michael J Mahande
BACKGROUND: Decision delivery interval (DDI) is the time line between a decision to conduct an emergency caesarean section and actual delivery of the baby. Prolong DDI constitute a third phase delay in provision of emergency obstetric care. Intervention designed to minimize DDI are vital, in attempt to prevent maternal morbidity and neonatal morbidity and mortality. The feasibility and practicability of the recommended DDI in recent studies have been questioned especially in limited resource setting and therefore the objective of our study was to determine the DDI and its associated fetalmaternal outcomes at a tertiary referral hospital in Tanzania...
December 7, 2017: BMC Pregnancy and Childbirth
https://www.readbyqxmd.com/read/29207784/emergency-peripartum-hysterectomy-a-14-year-experience-at-a-tertiary-care-centre-in-india
#5
S Tahmina, Mary Daniel, Preetha Gunasegaran
Introduction: Emergency Peripartum Hysterectomy (EPH), although relatively infrequent in present day obstetrics, is a life-saving procedure in the event of a massive postpartum haemorrhage. Aim: To assess incidence, risk factors, indications and complications of peripartum hysterectomies at a tertiary care teaching hospital in India. Materials and Methods: A retrospective study was conducted at 650-bedded tertiary care medical teaching hospital in Southern India...
September 2017: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/29202731/economic-evaluation-of-emergency-obstetric-care-training-a-systematic-review
#6
Aduragbemi Banke-Thomas, Megan Wilson-Jones, Barbara Madaj, Nynke van den Broek
BACKGROUND: Training healthcare providers in Emergency Obstetric Care (EmOC) has been shown to be effective in improving their capacity to provide this critical care package for mothers and babies. However, little is known about the costs and cost-effectiveness of such training. Understanding costs and cost-effectiveness is essential in guaranteeing value-for-money in healthcare spending. This study systematically reviewed the available literature on cost and cost-effectiveness of EmOC trainings...
December 4, 2017: BMC Pregnancy and Childbirth
https://www.readbyqxmd.com/read/29202307/the-impact-of-free-healthcare-on-women-s-capability-a-qualitative-study-in-rural-burkina-faso
#7
Oumar Mallé Samb, Valery Ridde
In March 2006, the government of Burkina Faso implemented an 80% subsidy for emergency obstetric and neonatal care (EmONC). To complement this subsidy, an NGO decided to cover the remaining 20% in two districts of the country, making EmONC completely free for women there. In addition, the NGO instituted fee exemptions for children under five years of age in those two districts. We conducted a qualitative study in 2011 to examine the impact of these free healthcare interventions on women's capability. We conducted semi-structured interviews with 40 women, 16 members of health centre management committees, and eight healthcare workers in three health districts, as well as a documentary analysis...
November 28, 2017: Social Science & Medicine
https://www.readbyqxmd.com/read/29195637/professional-confidence-among-swedish-final-year-midwifery-students-a-cross-sectional-study
#8
Lena Bäck, Bharati Sharma, Annika Karlström, Katarina Tunon, Ingegerd Hildingsson
OBJECTIVE: Previous international studies have shown that midwifery students do not feel confident in many areas where they are supposed to practice independently. The knowledge about Swedish midwifery students' confidence is fairly under investigated. The purpose of the present study was to explore final years' midwifery students' professional confidence in basic midwifery skills according to ICM competencies and associated factors. METHODS: A cross-sectional survey where all midwifery programs in Sweden were invited to participate...
December 2017: Sexual & Reproductive Healthcare: Official Journal of the Swedish Association of Midwives
https://www.readbyqxmd.com/read/29191200/emergency-general-surgery-in-rwandan-district-hospitals-a-cross-sectional-study-of-spectrum-management-and-patient-outcomes
#9
Christophe Mpirimbanyi, Alexandre Nyirimodoka, Yihan Lin, Bethany L Hedt-Gauthier, Jackline Odhiambo, Theoneste Nkurunziza, Joaquim M Havens, Jack Omondi, Emile Rwamasirabo, Faustin Ntirenganya, Gabriel Toma, Joel Mubiligi, Scheilla Bayitondere, Robert Riviello
BACKGROUND: Management of emergency general surgical conditions remains a challenge in rural sub-Saharan Africa due to issues such as insufficient human capacity and infrastructure. This study describes the burden of emergency general surgical conditions and the ability to provide care for these conditions at three rural district hospitals in Rwanda. METHODS: This retrospective cross-sectional study included all patients presenting to Butaro, Kirehe and Rwinkwavu District Hospitals between January 1st 2015 and December 31st 2015 with emergency general surgical conditions, defined as non-traumatic, non-obstetric acute care surgical conditions...
December 1, 2017: BMC Surgery
https://www.readbyqxmd.com/read/29189694/committee-opinion-no-726-hospital-disaster-preparedness-for-obstetricians-and-facilities-providing-maternity-care
#10
(no author information available yet)
Large-scale catastrophic events and infectious disease outbreaks highlight the need for disaster planning at all community levels. Features unique to the obstetric population (including antepartum, intrapartum, postpartum and neonatal care) warrant special consideration in the event of a disaster. Pregnancy increases the risks of untoward outcomes from various infectious diseases. Trauma during pregnancy presents anatomic and physiologic considerations that often can require increased use of resources such as higher rates of cesarean delivery...
December 2017: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/29189692/committee-opinion-no-726-summary-hospital-disaster-preparedness-for-obstetricians-and-facilities-providing-maternity-care
#11
(no author information available yet)
Large-scale catastrophic events and infectious disease outbreaks highlight the need for disaster planning at all community levels. Features unique to the obstetric population (including antepartum, intrapartum, postpartum and neonatal care) warrant special consideration in the event of a disaster. Pregnancy increases the risks of untoward outcomes from various infectious diseases. Trauma during pregnancy presents anatomic and physiologic considerations that often can require increased use of resources such as higher rates of cesarean delivery...
December 2017: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/29181210/bilateral-tubal-pregnancy-without-known-risk-factor
#12
Hyacinthe Zamané, Barnabé Yameogo, Paul Dantola Kain, François Gueswendé Xavier Kaboré, Yobi Alexis Sawadogo, Sibraogo Kiemtoré, Sidbewenné Yacinthe Kaboré, Blandine Bonané Thiéba
Spontaneous bilateral ectopic gestation is very rare. The authors report a case diagnosed and taken care of at Yalgado Ouedraogo Teaching Hospital, Ouagadougou. It was a 30-year-old patient with no known pathological history. She had presented at the obstetric emergencies with a state of hypovolemic shock by haemoperitoneum with digestive disorders, pelvic pain, vaginal bleeding, and a mention of delayed menstruation. The ultrasound coupled with the urinary immunological pregnancy test confirmed the diagnosis of ruptured ectopic pregnancy and a bilateral form was suspected...
2017: Case Reports in Obstetrics and Gynecology
https://www.readbyqxmd.com/read/29178885/severe-maternal-outcomes-and-quality-of-care-at-district-hospitals-in-rwanda-a-multicentre-prospective-case-control-study
#13
Felix Sayinzoga, Leon Bijlmakers, Koos van der Velden, Jeroen van Dillen
BACKGROUND: Despite a significant decrease in maternal mortality in the last decade, Rwanda needs further progress in order to achieve Sustainable Development Goals (SDG)3 which addresses among others maternal mortality. Analysis of severe maternal outcomes (SMO) was performed to identify their characteristics, causes and contributory factors, using standard indicators for quality of care. METHODS: A prospective case-control study was conducted for which data were collected between November 2015 and April 2016 in four rural district hospitals...
November 25, 2017: BMC Pregnancy and Childbirth
https://www.readbyqxmd.com/read/29149877/key-bottlenecks-to-the-provision-of-safe-obstetric-anaesthesia-in-low-income-countries-a-cross-sectional-survey-of-64-hospitals-in-uganda
#14
Isabella Epiu, Agnes Wabule, Andrew Kambugu, Harriet Mayanja-Kizza, Jossy Verel Bahe Tindimwebwa, Gerald Dubowitz
BACKGROUND: Despite recent advances in surgery and anaesthesia which significantly improve safety, many health facilities in low-and middle-income countries (LMICs) remain chronically under-resourced with inability to cope effectively with serious obstetric complications (Knight et al., PLoS One 8:e63846, 2013). As a result many of these countries still have unacceptably high maternal and neonatal mortality rates. Recent data at the national referral hospitals in East Africa reported that none of the national referral hospitals met the World Federation of Societies of Anesthesiologists (WFSA) international standards required to provide safe obstetric anaesthesia (Epiu I: Challenges of Anesthesia in Low-and Middle-Income Countries...
November 17, 2017: BMC Pregnancy and Childbirth
https://www.readbyqxmd.com/read/29145815/illness-recognition-and-care-seeking-for-maternal-complications-of-pregnancy-and-birth-in-rural-amhara-and-oromia-regional-states-of-ethiopia
#15
Lynn Sibley, Yared Amare
BACKGROUND: Ethiopia has made steady progress in improving maternal health over the decade, yet mortality remains high. The Maternal and Newborn Health in Ethiopia Partnership (MaNHEP) was a 3.5-year project aimed at developing a community-oriented model to improve maternal and newborn survival in rural Ethiopia. Two years after the project ended, we carried out a case study to explore illness recognition and care seeking for complications of pregnancy and childbirth in the project area...
November 16, 2017: BMC Pregnancy and Childbirth
https://www.readbyqxmd.com/read/29143614/composite-measures-of-women-s-empowerment-and-their-association-with-maternal-mortality-in-low-income-countries
#16
Chiao-Wen Lan, Paula Tavrow
BACKGROUND: Maternal mortality has declined significantly since 1990. While better access to emergency obstetrical care is partially responsible, women's empowerment might also be a contributing factor. Gender equality composite measures generally include various dimensions of women's advancement, including educational parity, formal employment, and political participation. In this paper, we compare several composite measures to assess which, if any, are associated with maternal mortality ratios (MMRs) in low-income countries, after controlling for other macro-level and direct determinants...
November 8, 2017: BMC Pregnancy and Childbirth
https://www.readbyqxmd.com/read/29137506/measuring-the-impact-of-cash-transfers-and-behavioral-nudges-on-maternity-care-in-nairobi-kenya
#17
Jessica Cohen, Claire Rothschild, Ginger Golub, George N Omondi, Margaret E Kruk, Margaret McConnell
Many patients in low-income countries express preferences for high-quality health care but often end up with low-quality providers. We conducted a randomized controlled trial with pregnant women in Nairobi, Kenya, to analyze whether cash transfers, enhanced with behavioral "nudges," can help women deliver in facilities that are consistent with their preferences and are of higher quality. We tested two interventions. The first was a labeled cash transfer (LCT), which explained that the cash was to help women deliver where they wanted...
November 2017: Health Affairs
https://www.readbyqxmd.com/read/29122802/emergency-obstetric-care-provision-in-southern-ethiopia-a-facility-based-survey
#18
Mitchell Windsma, Tienke Vermeiden, Floris Braat, Andualem Mengistu Tsegaye, Asheber Gaym, Thomas van den Akker, Jelle Stekelenburg
OBJECTIVES: To assess the provision of basic emergency obstetric and newborn care (BEmONC), knowledge of high-risk pregnancies and referral capacity at health centres in Southern Ethiopia. DESIGN: A facility-based survey, using an abbreviated version of the Averting Maternal Death and Disability needs assessment tool for emergency obstetric and newborn care. Modules included infrastructure, staffing, number of deliveries, maternal and perinatal mortality, BEmONC signal functions, referral capacity and knowledge of risk factors in pregnancy...
November 8, 2017: BMJ Open
https://www.readbyqxmd.com/read/29122786/a-nationwide-population-based-cohort-study-of-peripartum-hysterectomy-and-arterial-embolisation-in-belgium-results-from-the-belgian-obstetric-surveillance-system
#19
Griet Vandenberghe, Marine Guisset, Iris Janssens, Virginie Van Leeuw, Kristien Roelens, Myriam Hanssens, Erika Russo, Joachim Van Keirsbilck, Yvon Englert, Hans Verstraelen
OBJECTIVES: To assess the prevalence of major obstetric haemorrhage managed with peripartum hysterectomy and/or interventional radiology (IR) in Belgium. To describe women characteristics, the circumstances in which the interventions took place, the management of the obstetric haemorrhage, the outcome and additional morbidity of these women. DESIGN: Nationwide population-based prospective cohort study. SETTING: Emergency obstetric care. Participation of 97% of maternities covering 98...
November 8, 2017: BMJ Open
https://www.readbyqxmd.com/read/29096592/-safe-yet-violent-women-s-experiences-with-obstetric-violence-during-hospital-births-in-rural-northeast-india
#20
Sreeparna Chattopadhyay, Arima Mishra, Suraj Jacob
The majority of maternal health interventions in India focus on increasing institutional deliveries to reduce maternal mortality, typically by incentivising village health workers to register births and making conditional cash transfers to mothers for hospital births. Based on over 15 months of ethnographically informed fieldwork conducted between 2015 and 2017 in rural Assam, the Indian state with the highest recorded rate of maternal deaths, we find that while there has been an expansion in institutional deliveries, the experience of childbirth in government facilities is characterised by obstetric violence...
November 3, 2017: Culture, Health & Sexuality
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