Labor Complications Research Articles

Основные показатели родовспоможения региона Центральной России.

The article presents an analysis of the main indicators of obstetric care in the region of the Central Federal District – Kostroma Region. Despite the identified positive trends in the reproductive and demographic process in the Kostroma region, a number of significant problems remain (exceeding the Russian average for the number of complications in labor, termination of pregnancy, infant mortality, etc.) that require management decisions in improving the obstetric care system and ensuring the proper level of medical care mother and child. This direction of improving the activities of the healthcare system of the Kostroma region is of paramount importance in conditions of reduced population reproduction

#276 : Impact of Previous Cesarean Delivery on Pregnancy and Neonatal Outcomes of Subsequent In Vitro Fertilization/Intracytoplasmic Sperm Microinjection and Single Frozen-Thawed Embryo Transfer

Background and Aims: Cesarean delivery (CD) rates continue to rise worldwide. Prior studies have indicated that CD is associated with not only various gynaecological symptoms and obstetric complications but also lower probability of subsequent fertility. However, the recognition about impact of CD on clinical outcomes in subsequent IVF/ICSI-FET is very limited. The purpose was to investigate the effects of previous CD on pregnancy and neonatal outcomes in single frozen-thawed embryo transfer (FET) cycles so that women with a previous cesarean delivery can be given detailed fertility counseling during the ART process. Methods: This is a large retrospective cohort study including a total of 5,750 patients who desired to transfer single vitrified-thawed blastocyst from the same oocyte retrieval cycle as their last live birth between January 2011 and January 2021 in a center for reproductive medicine in Shandong, China, comprising FET cycles of 3,853 previous single CD and 1,897 previous single vaginal delivery (VD). Results: Women with a previous CD had significantly lower rates of biochemical pregnancy (64.52% vs. 71.48% before propensity score matching (PSM), P<0.001; and 65.58% vs. 71.49% after PSM, P<0.001), clinical pregnancy (58.16% vs. 65.79% before PSM, P<0.001; and 59.22% vs. 66.17% after PSM, P<0.001) and live birth (48.17% vs. 55.82% before PSM, P<0.001; and 49.29% vs. 56.10% after PSM, P<0.001) than those with a previous VD. Meanwhile, the CD rate was significantly higher in the CD group (97.85% vs. 18.53% before PSM, P<0.001; and 98.02% vs. 20.51% after PSM, P<0.001). The rates of multiple pregnancy, miscarriage, ectopic pregnancy, multiple live birth, labor complications and preterm and neonatal outcomes were comparable between the two groups. Conclusion: Compared to VD, a previous CD is associated with a significant reduction in the rates of biochemical pregnancy, clinical pregnancy and live birth in patients undergoing subsequent single frozen-thawed blastocyst transfer.

Determinants of Labour Complication in Indonesia (2017 IDHS Data Analysis)

An inconclusive fetal condition, or what is known as fetal distress, is one of the birth complications that needs attention, such as irregular heartbeat, low amniotic fluid and asphyxia. The aim of this study was to determine factors associated with pregnancy complications. This study is an analysis of secondary data from the 2017 IDHS (Indonesian Health Demographic Survey 2017). The design of this research is a cross-sectional studyThe sample in this study had 49,627 inclusion and exclusion criteria. The data was analyzed using logistic regression. the results of this research a relationship between maternal age in the high risk category, maternal education in the low category, parity in the high category, utilization of antenatal care is in the bad category, the use of family planning in the non MKJP category and having pregnancy complications with delivery complications.

Trends and Outcomes of Twin Births in Southwest Nigeria: A 14-Year Retrospective Cohort Study.

The study aimed to analyze the prevalence, trends, and outcomes of twin pregnancies in Ile-Ife, Nigeria, over two distinct periods. This research, based on a 14-year retrospective cohort study, scrutinized twin births occurring in two-time frames: recent years (2012-2018; Period II) and the recent past (2005-2011; Period I) at a University Teaching Hospital in Ile-Ife, Nigeria. The inclusion criteria were limited to twin births, excluding singleton and higher-order gestations. Outcomes were evaluated based on several parameters, including mode of delivery, birth weights, fetal gender combinations, APGAR scores, perinatal mortality, and maternal complications. Data analysis was conducted using the 26th version of Statistical Package for the Social Science, with a significance threshold of p < 0.05. The study documented a stable prevalence of twin gestations, registering at 20.7 per 1,000 births without a significant discrepancy between the two time periods (21.7‰ versus 19.7‰; p = 0.699). Individuals from the Yoruba tribe predominantly featured in both cohorts, showing no considerable variation between the two time periods [83 (95.4) vs. 120 (99.2); p-value = 0.116]). The data exhibited recurrent instances of caesarean delivery (65.6% vs. 50.2%, p = 0.119), vertex-vertex presentation (38.0% vs. 44.7%, p = 0.352), and differing sex combinations (33.3% vs. 38.0%, p = 0.722) across both time frames. Twin II neonates born through Caesarean section were more frequently admitted to neonatal intensive care units than Twin I (5.1% versus 4.6%; p = 0.001). The recent years witnessed a surge in preterm labor complications, notably higher than the earlier period (17.1% versus 7.8%; p = 0.008). The prevalence of twin births in Ile-Ife, Nigeria, demonstrates a fluctuating decline. To comprehensively understand the dynamics of twin births in the region, there is a pressing need for expansive, community-centric research in southwest Nigeria.

Neuraxial Anesthesia in Obstetric Patients with Thrombocytopenia: Practice Patterns and Clinical Correlates

Introduction: Thrombocytopenia, (platelets under 150x10 9/L) is observed in 10% of pregnancies with counts below 100x10 9/L seen in 1-2% (Reese et. al, 2018, Gernsheimer, 2012). Neuraxial anesthesia is an effective pain management strategy for vaginal delivery and a safe alternative to general anesthesia for c-section. Although the precise risk of spinal hematoma has not been established in this patient population, it remains a common barrier to neuraxial procedures (Bernstein et. al, 2016). The hematology/maternal fetal medicine clinic (MFM) was created in our academic institution in February 2018 in response to the need to provide multidisciplinary care to patients with hematologic disorders in the context of pregnancy, including those with thrombocytopenia. Objectives: To establish the rate of neuraxial anesthesia in patients with thrombocytopenia seen in the multidisciplinary hematology/MFM clinic in our academic institution between 2018 and 2023 and identify clinical characteristics and practice patterns that affect the ability of this patient cohort to receive neuraxial procedures. Methods: Medical charts from all patients with thrombocytopenia affecting pregnancy evaluated in the hematology/MFM clinic (n=40 patients) were retrospectively reviewed. Baseline demographics, laboratory values, medical interventions (platelets directed treatment, neuraxial anesthesia, delivery route) and delivery outcomes were captured and analyzed using descriptive statistics (Table 1). Results: 40 patients underwent 44 deliveries. 33 (75%) were able to receive neuraxial anesthesia for delivery (15 vaginal and 18 c-section) ( Table 1) The median platelet count at the time of delivery was 105x10 9/L with 30 of 33 of the neuraxial deliveries occurring with platelet counts greater than 70x10 9/L (threshold recommended by the SOAP consensus (Bauer et. al, 2021)). The median platelet count at time of delivery for those who received neuraxial anesthesia was higher than for those who did not receive neuraxial (110x10 9/L vs 77x10 9/L). Rates of platelet directed treatment were similar in all patients independent of whether they received neuraxial anesthesia. Overall patients that did not receive neuraxial anesthesia delivered earlier and many delivered prior to their scheduled date. Despite the hematology/MFM clinic facilitating OB anesthesia consultations, a large proportion of patients were not evaluated prior to admission for delivery. Of the 11 patients that did not receive neuraxial anesthesia, 4 did not desire it, but would have been eligible based on their platelet counts at delivery ( Figure 1). Conclusions: These preliminary results indicate that a multidisciplinary approach can effectively treat thrombocytopenia in pregnant people and enable them to receive desired neuraxial anesthesia. Pre-term labor, precipitous delivery, and medical complications of pregnancy remain challenges to pregnant patients receiving neuraxial anesthesia. Future directions include examining which clinical interventions facilitate neuraxial anesthesia for pregnant patients in a larger population.

Knowledge, attitude and practice of physical exercises among pregnant women attending prenatal care clinics of public health institutions in Hawassa city, Sidama, Ethiopia, in 2021: descriptive cross-sectional study

BackgroundParticipating in physical exercise enhances the physical and mental health of pregnant women. Preventing excessive weight gain, decreasing gestational hypertension, reducing back pain and labor complications are some of the main benefits of physical exercise during pregnancy and childbirth. Scrutinizing factors associated with sedentary life style among women during pregnancy could aid to design effective strategies to tackle the problem. Despite its benefit, little is explored about knowledge, attitude and practice of physical exercise among pregnant women in the study setting.ObjectiveTo assess prevalence of knowledge, attitude and practice of physical exercise among pregnant women who visit antenatal care at public health facilities of Hawassa town, Ethiopia, in 2023.MethodsFacility based survey was conducted from November-December, in 2021. Data were collected using interview administered and structured questionnaire. Data were cleaned, coded and entered using Epi-data 4.6 and exported into SPSS 25 for analysis. Descriptive statistics was done using frequency count, percentage and mean values of variables. Finally, findings are presented using text, tables and charts.ResultsAll of the study subjects completed interview making a response rate of 100% in this study. The mean adequate knowledge score was 42.2%. Positive attitude towards physical exercise during pregnancy was accounted as 63.7% and proportion of good practice of physical exercise was as 35.8%. Regarding practice of exercise, most (95.9%) of the subjects walk, however; only 11(8.9%) women perform pelvic floor exercise were the highest and least practiced physical exercise. Concerning knowledge of exercise, prevent excess weight 72.1% and increasing energy 53.2% were the commonly known benefits of physical exercise. Breathing difficulty (41.3%), chest pain (39.8%) and premature labor (34.0%) were the predominant perceptions of contra-indication of physical exercise during pregnancy.ConclusionsIn conclusion, the proportion of knowledge, attitude and practice of antenatal exercise is found to be sub-optimum in the study area. Therefore, health education should be enhanced about the benefit of physical exercise during pregnancy.

Визначення особливостей перебігу вагітності та пологів, стану плода і новонародженого у вагітних після застосування допоміжних репродуктивних технологій (дані ретроспективного аналізу)

The rapid growth in the number of infertile couples leads to the development of assisted reproductive technologies (ART). Among the most common forms of infertility are tubo-peritoneal, endocrine, and caused by the male factor, and prevention of pregnancy complications caused by ART treatment cycles becomes one of the main tasks of practicing clinicians. Purpose - to determine the features of the course of pregnancy and childbirth; to assess the condition of the fetus and newborn in pregnant women after the application of ART to improve the perinatal outcomes of pregnancy and childbirth. Materials and methods. A retrospective clinical and statistical analysis of 334 histories of pregnancy and childbirth of women, as well as medical records of newborns from women, was conducted over the past five years, which formed the ART group - 221 history of pregnancy and childbirth, and the group of spontaneous pregnancy - 113 history of pregnancy and childbirth. Results. The structure of the subjects was statistically significant dominated by pregnant women over the age of 35 years and pregnant women in late reproductive age. The main characteristics of women after the ART application were a statistically significant predominance of somatic and gynecological pathology. The structure of pregnancy complications in women after ART application was dominated by threatening late spontaneous miscarriages, isthmic-cervical insufficiency and vaginitis, and in the structure of labor complications - anomalies of labor activity and premature rupture of fetal membranes. Among newborns from women in the ART group, perinatal mortality was 18.0%. Conclusions. The revealed features of somatic and gynecological anamnesis, as well as aspects of the course of pregnancy and childbirth and the condition of newborns in women after ART application are the basis for an in-depth examination of this category of pregnant women in order to improve approaches to predicting, diagnosing and optimizing preventive measures, as well as to improve the perinatal consequences of pregnancy and childbirth. The research was carried out in accordance with the principles of the Helsinki Declaration. The study protocol was approved by the Local Ethics Committee of the participating institution. No conflict of interests was declared by the authors.

Maternal and perinatal outcomes of women with vaginal birth after cesarean section compared to repeat cesarean birth in select South Asian and Latin American settings of the global network for women’s and children’s health research

ObjectiveOur objective was to analyze a prospective population-based registry including five sites in four low- and middle-income countries to observe characteristics associated with vaginal birth after cesarean versus repeat cesarean birth, as well as maternal and newborn outcomes associated with the mode of birth among women with a history of prior cesarean.HypothesisMaternal and perinatal outcomes among vaginal birth after cesarean section will be similar to those among recurrent cesarean birth.MethodsA prospective population-based study, including home and facility births among women enrolled from 2017 to 2020, was performed in communities in Guatemala, India (Belagavi and Nagpur), Pakistan, and Bangladesh. Women were enrolled during pregnancy, and delivery outcome data were collected within 42 days after birth.ResultsWe analyzed 8267 women with a history of prior cesarean birth; 1389 (16.8%) experienced vaginal birth after cesarean, and 6878 (83.2%) delivered by a repeat cesarean birth. Having a repeat cesarean birth was negatively associated with a need for curettage (ARR 0.12 [0.06, 0.25]) but was positively associated with having a blood transfusion (ARR 3.74 [2.48, 5.63]). Having a repeat cesarean birth was negatively associated with stillbirth (ARR 0.24 [0.15, 0.49]) and, breast-feeding within an hour of birth (ARR 0.39 [0.30, 0.50]), but positively associated with use of antibiotics (ARR 1.51 [1.20, 1.91]).ConclusionsIn select South Asian and Latin American low- and middle-income sites, women with a history of prior cesarean birth were 5 times more likely to deliver by cesarean birth in the hospital setting. Those who delivered vaginally had less complicated pregnancy and labor courses compared to those who delivered by repeat cesarean birth, but they had an increased risk of stillbirth. More large scale studies are needed in Low Income Country settings to give stronger recommendations.Trial registrationNCT01073475, Registered February 21, 2010, https://clinicaltrials.gov/ct2/show/record/NCT01073475.

The Role of Midwives in the Education of Labor and Childbirth Readiness

Background: Efforts to reduce maternal mortality ratio can be done promotively, preventively, curatively, and rehabilitatively. One of the promotive efforts is to provide education during pregnancy, especially in the third trimester or before the estimated delivery. Childbirth preparation education is essential for pregnant women, husbands and families to improve knowledge and skills, one of which is the prevention and early detection of complications. The World Health Organization strongly recommends strengthening preparedness programs for childbirth and complications to increase utilization of quality care at delivery and to increase the use of health services for obstetric and newborn complications. Purpose: This study aims to identify the implementation of childbirth readiness education to prevent complications of childbirth in independent midwife practices in the DKI Jakarta area. Methods: Qualitative research design was used in this study with an explanatory descriptive design. Informants for this research were 15 midwives in the DKI Jakarta area. Selection of informants using purposive sampling technique. Analysis was done by means of data reduction, data presentation, and conclusion verification. Results: The implementation of labor and childbirth readiness education to prevent labor complications was quite good. Education on physical, psychological, and financial preparation has been carried out adequately, but there were several aspects of education related to cultural preparation related to pregnancy and childbirth that was still not optimal. Conclusion: It is expected that midwives can maintain the education that has been given to pregnant women. Midwives actively participate in monitoring and educating pregnant women so that they can carry out early detection of complications and appropriate treatment if emergencies occur.

Risk Factors Associated with Adverse Pregnancy Outcomes Among Women Who Were Attending Postnatal Services at Thika Level Five Hospital Kiambu County, Kenya

Stillbirths, preterm deliveries and neonatal deaths are examples of adverse pregnancy and infant outcomes that continue to be a global public health problem. The World Health Organization (WHO), States, and non-governmental organizations (NGO) have invested a lot of time, money, and resources into promoting the benefits of safe pregnancy and delivery. Despite efforts to promote healthy pregnancy, delivery, and maternal mortality, these numbers continue to be high. Pregnant mothers and their fetus are put in danger due to several risk issues. Despite the limited data from Thika level five hospitals, concern about poor pregnancy outcomes have been growing. The study’s goal is to pinpoint the risk factors connected to pregnancy outcomes at Thika level five hospitals. An analytical cross-sectional study was carried out on women between the age of 15 and 49 who were attending postnatal services at Thika level 5. The study used qualitative and quantitative data collection techniques. 80 samples were chosen out of 100 population. A Convenience sampling and purposive sampling were used. structured questionnaires were used at the health care facility. The mean age was 15 to 19. Most of them were married almost both living in urban and rural areas. According to education, most have reached college education but unfortunately, 55% of them are unemployed and 51% of them are living in temporally house, most generating income below 5000. Most of them live 5km away from the nearest health facility. 55% of them attended antenatal and its essential services in public facilities, motivated by self-motives. 47% of the respondents delivered via spontaneous vertex delivery followed by 37% of caesarean sections. Most complications were obstructed labor and most adverse outcomes were preterm labor. The most common pre-existing medical conditions were anemia and HIV/AIDS. The most common adverse pregnancy outcome found in this study included PPH, Obstructed labor, APH, neonatal mortality, preterm babies, and stillbirth and low birth weight babies. Inferential statistics including correlation and bivariate analysis were used. The regression coefficients results portrays that socio-demographics characteristics score 0.983 with standard error of 0.361. Pre-existing medical conditions scored 0.897 with a standard error of 0.323. Intrapartum care scored 0.920 with a standard error of 0.240. Chi-square analysis for all the variables was calculated at 47.633 and the p value less than 0.05 (p&lt; 0.05). Correlation study indicates a positive significance between pregnancy risk and socio-demographics, pre-existing medical conditions with a value of 0.934. The researcher concludes that numerous pregnancy problems arise from lack of medical knowledge and financial structure coming from the women who are pregnant. Concluding to the fact that when it comes to risk in pregnancy there are a number of factors that come into play. This ranges from ages of the women to pre-existing medical conditions when it comes to childbirth. Overall it is highly important for women who are prone to have complications in child labor to have medical checkups constantly so that any complications cane be dealt within a reasonable timeframe and with little consequences to the women or their unborn babies.

The prevalence and management of obstetric fistula among women of reproductive age in a low-resource setting

Obstetric fistula is one of the most significant obstetrical concerns and apparent indications of maternal morbidity in low-resource nations. Therefore, the study assessed the prevalence and management of fistula among women of reproductive age (15-49) in low-resource settings. This population-based cross-sectional study was conducted in three local government areas (Jere, Konduga and Maiduguri Municipal City) in Borno State. A structured questionnaire was used to collect data from 484 respondents, and the data were analysed using SPSS version 25.0. The overall prevalence of obstetric fistula was 10.7%. Over 13% of women with seven or more vagina deliveries had a fistula. Likewise, 19% of respondents knew about fistula prevention and treatment services available, and 13.7% of those did not participate in antenatal care services. Furthermore, 48.1% of respondents with a fistula during labour were treated successfully. Almost half (47.9%) who were aware of health facilities around them were successfully treated, same with 46.2% of those living within 1 to 2 km of a health facility, and almost half (49.0%) of those who got married within age 20. The study emphasizes the importance of effective community-level interventions to address obstetric fistula. To achieve this, a comprehensive action plan should be developed, ensuring pregnant women have access to necessary obstetric care services at all healthcare levels. The plan should include preventive measures, timely management of labour complications, and increased awareness of fistula prevention and treatment services. Prioritizing maternal healthcare and empowering women with knowledge and access to services are essential in preventing and managing obstetric fistula.

Intravenous fluid rate of 250 mL/h versus 125 mL/h in nulliparous women: A systematic review and meta-analysis of randomized controlled trials.

Evidence regarding the type and rate of intravenous (IV) fluid administration during labor is still inconclusive and the studies assessing the impact of IV fluids had mixed results. To evaluate the effects of IV fluids at an infusion rate of 250 mL/h as compared with 125 mL/h on labor outcomes in nulliparous women. We searched six databases for relevant studies through a search strategy containing the relevant keywords "IV hydration", "IV fluids", and "labor" from the inception of these databases to May 1, 2023, without any applied restrictions. Search results were imported to Covidence for screening of eligible articles for this review. Randomized controlled trials (RCTs) assessing the impact of IV fluids at 250 mL/h on the outcomes of labor in nulliparous women at term (>37 weeks) as compared with 125 mL/h were included only. Data regarding the characteristics of included studies, participant's baseline characteristics, and concerned outcomes were collected in an Excel spreadsheet and all the concerned outcomes were pooled as risk ratios (RR) or mean difference (MD) with 95% confidence interval (CI) in the meta-analysis models using RevMan 5.4. Pooled data from 11 RCTs with 1815 patients showed that 250 mL/h infusion rate had a significant reduction in cesarean section rate (RR 0.70, 95% CI 0.56-0.88, P = 0.002), the first stage of labor duration (MD -46.97, 95% CI -81.79 to -12.14, P = 0.008), the second stage of labor duration (MD -2.69, 95% CI -4.34 to -1.05, P = 0.001), prolonged labor incidence (RR 0.72, 95% CI 0.58-0.89, P = 0.003), as compared with 125 mL/h. Also, the vaginal delivery rate (RR 1.07, 95% CI 1.02-1.12, P = 0.009) was higher with a 250 mL/h infusion rate. IV fluids at an infusion rate of 250 mL/h during labor in nulliparous women decreased the cesarean delivery rate, increased the vaginal delivery rate, shortened the first and second-stage labor duration, decreased the incidence of prolonged labor as compared with 125 mL/h. These findings suggest enhanced labor progression and a lower risk of labor complications with higher infusion rates. However, future research involving a more diverse population and exploring the potential benefits of combining IV infusion rates with other interventions, such as adding dextrose or less restrictive oral intake during labor, is needed.

Perinatal events and development of juvenile idiopathic arthritis-associated uveitis

Uveitis is one of the most common manifestations of juvenile idiopathic arthritis (JIA). Currently, JIA is associated with decreased gut microbiota diversity. Studies confirm that perinatal events can cause aberrant microbial colonization. The objective of this study is to determine if JIA is associated with perinatal events with a secondary focus on these variables to the development of JIA-uveitis. 369 patients with strabismus (n = 200) or JIA (n = 196) were included in the study. Completed surveys (JIA 37; strabismus 18) collected data about birth route, pregnancy and labor complications, JIA medications, and the presence of eye disorders. Analysis indicates that there is no relationship between JIA development and the perinatal events investigated. Similarly, no significance was found between JIA-uveitis and birth route or labor complications. Pregnancy complications, namely gestational diabetes (GD), were statistically higher in the JIA group with uveitis compared to JIA without uveitis. The data from this survey study showed that JIA-uveitis was highly associated with pregnancy complications, particularly with GD. However, no statistically significant association was found between JIA and route of delivery, labor complications, or pregnancy complications. Further studies are needed to understand the ways that GD interrelates with the development of uveitis in JIA patients.

Maternal Characteristics and Outcomes Affected by COVID-19 Pandemic in Indonesia.

Compare the impact of the intervention on the outcome of pregnancy of patients receiving obstetric care with and non-COVID-19 diagnosis at a tertiary referral hospital located in the region of East Java, Indonesia. This was a cross-sectional analysis of 694 pregnant women. These patients' information was acquired based on the medical data obtained from the hospital. The Mann-Whitney test was used to analyze the disparities among the factors examined in this research investigation. There was a statistically significant difference in length of stay (LOS). It has been shown that individuals diagnosed with COVID-19 often exhibit a longer length of stay (LOS) in healthcare facilities compared to those who do not have the infection. More than fifty percent of patients gave birth by cesarean section, 83 in COVID-19 group and 283 in non-COVID-19 group. The most prevalent complications among COVID-19 patients were maternal infectious and parasitic diseases (1.3 vs 0%), prolonged labor (12.3 vs 9.6%) and puerperal complications (0.6 vs 0%). In 40.9% of COVID-19 patients, acute respiratory distress syndrome (ARDS) was encountered. Infection due to COVID-19 had no discernible impact on the outcomes of pregnancy. Numerous interventions, including cesarean delivery in COVID-19 and non-COVID-19 patients, require reevaluation. It is imperative to undertake a comprehensive reassessment of the health care delivery system, with particular emphasis on enhancing the efficacy of the referral system.

Birth asphyxia and its associated factors among newborns at a tertiary hospital: evidence from Southern Ethiopia.

Globally, 45% of under-five children death occurs during the neonatal period and about 25% of all neonatal deaths are caused by birth asphyxia. In Ethiopia, in 2015, it was the first cause of neonatal deaths followed by prematurity and sepsis. The study aims to assess prevalence of Birth asphyxia and associated factors. Institution-based cross-sectional study was conducted among neonates admitted to Neonatal intensive care unit of Hawassa University Specialized comprehensive hospital from December 1 to December 30, 2020. Systematic random sampling technique was employed to select samples. Logistic regression analysis using Statistical Package for Social sciences version 24was employed. The prevalence of neonatal asphyxia in this study was17.9%. Prolonged labor [AOR (Adjusted odds ration) = 2.909; (95% CI (Confidence Interval): 1.184 - 7.151)], presence of meconium [AOR= 2.137; 95% CI 1.028 - 4.683)], premature rapture of membrane [AOR = 2.459; 95% CI: 1.021 - 6.076)] and complication during labor [AOR= 3.351; 95% CI: 2.142-5.871))], were factors associated with neonatal asphyxia. Nearly two in every ten newborns faced perinatal asphyxia in the study area. Early identification of high-risk women, intervening on delay in referral, and early and vigorous management of abnormal labor and complicated labor is essential to halt the problem.

Student nurse-midwives' knowledge and practice conducting normal labour in Windhoek, Namibia

Background/Aims It is crucial that maternity health workers understand how to prevent complications during labour. A lack of knowledge and the skills required to manage uncomplicated physiological labour (‘normal’ labour) may result in unanticipated complications, such as vaginal lacerations and perineal tears. This study's aim was to assess the knowledge and practices of undergraduate nurse-midwife students at the University of Namibia in conducting normal labour. Methods This quantitative study used a descriptive, non-experimental design to gather data from a total of 64 student nurse-midwives. A questionnaire was used to gather participants' sociodemographics and assess their knowledge and practice of normal labour. Descriptive statistics were used to analyse the data. Results The majority of the participants (87.3%) knew the correct supporting technique to prevent perineal tears. Most (84.1%) correctly indicated that a partograph is used to monitor labour progress. However, the majority (87.3%) did not practice episiotomy to prevent perineal tears. Conclusions Most students were knowledgeable on the use of a partograph, practices to prevent perineal tears and care of a newborn after birth. Students should receive continual education during clinical allocations, and be supervised and guided to improve practice and competency. Provision of sufficient preceptors is needed to cater for the high number of students. Future research should be conducted on the experiences and perspectives of students on conducting births and prevention of labour complications.

A Narrative Review of Autism Spectrum Disorder in the Indian Context

Autism is called “spectrum” disorder because there is a wide variation in the type and the severity of symptoms that people experience. India has a vast population, diverse cultures, and multiple languages, making it crucial to under- stand the unique challenges faced by individuals with autism spectrum disorder in the Indian context. This narrative review explores the current state of knowledge about autism spectrum disorder in the Indian context. Databases such as PubMed, Google Scholar, Sage journals, and other sources were searched with relevant terms for preparing this review. All published literature till January 2023 was studied and those which met the inclusion criteria were included. The resources included were original research articles, review articles, web pages, and book chapters addressing the purpose of the paper. Forty-eight such studies which met the inclusion criteria were included in the study. Results showed that the prevalence of autism varied across different studies in India. The study found advanced paternal age, fetal distress, gestational respiratory infections, labor complications, preterm birth, neonatal jaundice, delayed birth cry, birth asphyxia, late initiation of breastfeeding, neonatal seizures, use of maternal hormonal intervention, and consanguinity as some of the identified risk factors of autism spectrum disorder. Parents and families of children with autism have to go through a complex negative experience, both in the family and the community. This negative experience is further compounded by the lack of awareness and access to appropriate professional help and resources. It can be concluded that there is an urgent need for services that help parents cope with the stress of parenting a child with autism.

Predisposisi Inkontenensia Urin pada Postpartum; Studi Retrospektif

Background : Urinary incontinence as a condition of unconscious urine output and is a social problem or a hygiene problem. The incidence of urinary incontinence at RSUD dr. Abdul Rivai Berau, in 2020 there were 36 people (0.02%), in 2021 there were 52 people (0.04%) and January-November 2022 there were 21 people (0.03%). Objective: to retrospectively determine the causes of postpartum urinary incontinence. Methods: This type of research was a quantitative study with an retrospective design. The sample is postpartum patients who experience urinary incontinence in 2022 as many as 21 people. Data analysis was descriptive univariate. Results: Description of the causes of urinary incontinence in postpartum mostly types of vaginal delivery (66.7%), multiparous parity (85.7%), labor complications in the form of prolonged labor (76.2%) and there was perineal tear (57.1%).

Husband's Support for the Childbirth Process: Concept Analysis

It is hoped that the husband's support will make the mother feel calm so that the mother can face the delivery process smoothly. Lack of social support from the husband is a significant determinant of depression in childbirth. The purpose of conducting a conceptual analysis of a husband's help, in the beginning, is to find out how much the benefits or effects of a husband's support during childbirth are. The method used in this concept analysis refers to the technique developed by Walker &amp; Avant using the PubMed and Scopus databases both domestically and abroad. The process of conceptual analysis goes through the stages of choosing a concept, determining goals, identifying the use of the idea, determining attributes, creating a case model, making borderline and contrary cases, identifying antecedents and consequences and determining empirical references. Husband's physical and psychological support, as well as support in undergoing childbirth, has a positive impact in reducing anxiety and labour pain to complications of labour and postpart

Relationship between Attendance of ANC and labour Complications among Mothers who delivered at Fort Portal Regional referral Hospital

Appropriate antenatal care (ANC) is key for the health of the mother and child. Globally, approximately 515,000 women die from pregnancy-related complications each year. It has been estimated that 25 percent of maternal deaths occur during pregnancy, with variability between countries depending on the prevalence of unsafe abortion, violence, and disease in the area. This study focused on the relationship between attendance of ANC and gestational or labor complications among mothers who delivered at Fort Portal Regional Referral Hospital (FPRRH). A cross-sectional study was conducted whereby quantitative data was acquired using participant self-administered questionnaires, investigator administered questionnaires. A total of 323 mothers were randomly sampled from the population using the convenience sampling technique. Results are depicted in 95% Confidence Intervals, Odd Ratios (OR), and P-values; all calculated using Binary Logistic Regression with Pearson’s correlation in the Statistical Package for Social Sciences. Graphical representation was done by Microsoft Excel Software. A total of 323 mothers were studied with a response rate of 91.02%. Results based on 294 participants show that 70(23.7%) of the mothers studied were in the age range of 15-25 years, majorly 170(57.8%) were 26-35 years, 54(18.5%) were 36-45 years; of these 33(11.1%) were single, 171(58.2%) were married, 55(18.6%) were separated and 36(12 %) were widows; 39(13.2%) attained primary level of education, 117(39.8%) secondary, 88(29.8%) tertiary, and 51(17.2%) were university graduates; 40(13.5%) were casual laborers, majority 208(70.8%) self- employed, and 46(15.7%) were civil servants. The study showed that the overall attendance of ANC among mothers in Fort Portal FPRRRH was low. This trend was shown to be significantly associated with a number of factors. Intensive health education and awareness campaigns on the importance of ANC should be done to equip mothers with the knowledge so as to reduce the burden of pregnancy-related complications. More effort must be applied to spreading awareness about proper health service seeking by mothers. Keywords: Antenatal care, Pregnancy, Maternal mortality, Labour, Health facilities