Detection Of High-risk Pregnancies Research Articles

Factors Influencing Midwife Practices in Antenatal Services in The Early Detection of High Risk Pregnancy in Serang District

In Serang regency for 2 last years occured increasing of mother dead. This case more take place at antenatal period than having birth and porturition period. Mother dead can be prevented if high risk pregnant mother detected early, on of the method by doing pregnancy checkup appropriate with 7T standart to the pregnant mother. This research has purpose to identify and analize factors that affect midwife practice in antenatal care of high risk pregnancy early detection at Serang Regency. This research is analitik description research with cross sectional approach. The research subjects were midwife that practice BPM by use sample 73 midwifes. Result of the research showed that 52.1% respondent didn’t do antenatal care on the high risk pregnancy early detection. Factors that related to midwife practice in antenatal care were age, education, long time of work and knowledge where result of statistic experiment was gotten p value < 0,05. Suggestion for IBI is increase monitoring and educating to its members, Health Department should be more distinct give a reward and punishment to BPM practice so that rescuing mother and baby more success, and for BPM should increase knowledges.

Pemberdayaan Kader Posyandu dalam Program Gerakan Amankan Kehamilan dan Persalinan (GEBRAK) dengan Mobile Application Family Center Maternity Care (FCMC)

Efforts to accelerate the success of reducing the Maternal Mortality Rate (MMR) and Infant Mortality Rate (IMR), especially those related to maternal health efforts, are increasing cross-sectoral partnerships as outlined in a high-risk pregnant women's mentoring activity by cadres carried out in Malang City known as the GEBRAK (Movement to Secure Pregnancy and Childbirth) program. "Posyandu Melati" cadre activities such as training or mentoring cannot be carried out regularly scheduled and have not been carried out by all posyandu posts because of several constraints. The purpose of this community service is to increase the participation of the Cadre of Pregnant Women with High Risk Pregnancies and provide training and community empowerment on early detection of High Risk Pregnancies using the FCMC Mobile Application media method in Tasikmadu Village totaling 7 people. Results: three activities, namely Training Activities and mentoring Posyandu Cadres with the topic of high-risk pregnancy, KSPR, and FCMC mobile application, the second activity is socialization and application of the FCMC Mobile Application to pregnant women and their families and communities. The last activity is the Recording and Early Detection of High Risk Pregnancies by Cadres as a support for the success of the GEBRAK program. Increasing the skills of Posyandu cadres about monitoring high-risk pregnancies so that prevention, healing and recovery efforts can be given with clear indications as early as possible during pregnancy. Posyandu cadres are expected to be able to carry out their duties according to agreed commitments and be able to maintain infrastructure as a good support for activities.

Prevalence and factors associated with preterm births among postnatal mothers at Soroti Regional Referral Hospital, Eastern Uganda

BackgroundGlobally, prematurity is the leading cause of death in neonates and therefore a major contributor to the under 5-year mortality. The study assesses the prevalence and risk factors associated with preterm birth at a Regional Referral Hospital in Eastern Uganda. MethodsThis was a descriptive cross-sectional study conducted at a Regional Referral Hospital in Eastern Uganda. A questionnaire was used to capture data on maternal socio-demographic features, and obstetrical causes of preterm birth. Additional information was got from maternal medical records. In total, 350 mother-baby pairs were studied. Bivariate and multivariate logistic regression models were fitted so as to establish the factors associated with preterm birth. A p-value < 0.05 was considered statistically significant. ResultsPrevalence of preterm birth at Soroti Regional Referral Hospital was 24.6% (86/350). Factors associated with preterm birth included: Fewer than 3 antenatal attendances (aOR = 3.115, 95% CI [1.659–5.849], P = 0.038), twin gestation (aOR = 6.973, 95% CI [1.128–43.097], P = 0.016), antepartum hemorrhage (aOR = 4.743, 95% CI[806–12.458], P < 0.001) and PPROM (aOR = 18.902, 95% CI[7.267–49.167], P < 0.001). Maternal mid upper arm circumference (MUAC) measurement ≥24 cm was a protective factor against preterm birth (aOR = 0.155, 95% CI[0.0686–0.352], P < 0.001). ConclusionPreterm births in Soroti-RH in Eastern Uganda were associated with poor maternal nutrition status, low antenatal attendance, twin gestation, antepartum hemorrhage, and preterm premature rupture of membranes. Health education on proper nutrition and routine monthly antenatal visits by healthcare workers is important for early screening and detection of high risk pregnancies.

Need of High Dependency Unit in Obstetric Patients in Tertiary Care Centre

Aim: To analyze the requirement of HDU in Obstetric patients having Medical disorders &amp; Intraoperative/ Intrapartum complications &amp; Postoperative/Postpartum complications. Study Design: It is a retrospective study conducted at DY Patil hospital, Kolhapurfrom June 2020 to June 2021, in the department of Obstetrics &amp; gynecology. Methods: All the patients having associated Medical disorders, Intraoperative complications, Postoperative complications were admitted in HDU. Interventions required in HDU, duration of stay and outcome of the patient were collected &amp; results were analyzed. Results: Out of 1967 deliveries, 144 patients required admission in HDU. Among Obstetric causes requiring HDU, Hypertensive disorders in pregnancy is the leading cause for HDU admissions. Among Non-Obstetric causes requiring HDU, Anemia in Pregnancy is the leading cause for HDU admissions. Conclusion: Regular ANC checkups, detection of high-risk pregnancies, proper antenatal care, early referral of high-risk pregnancies, correction of modifiable causes of high-risk pregnancies (Anemia) can reduce maternal morbidity and mortality. Introduction of High dependency unit &amp; multidisciplinary approach in managing patients has brought down the maternal mortality in the Tertiary care referral centre.

ASSESSMENT OF NEONATAL OUTCOME IN BOOKED AND UNBOOKED PREGNANCY CASES IN A TERTIARY CARE CENTRE

Majority of neonatal deaths occurs in low and middle income countries indicating poor quality of health services provided by the government of the respective countries.In a developing country like India , a high morbidity and mortality serves as an sensitive indicator reecting the poor maternal and child health care services of the country.Most of the neonatal deaths can be attributed to avoidable factors which can be minimized by the effective utilization of antenatal services , early detection of high risk pregnancy and timely referral of these cases.The current study was conducted to determine the neonatal outcomes in booked and unbooked pregnancy cases in the tertiary care centre ,Assam Medical College and Hospital, Dibrugarh. METHODS: Close ended structured questionnaires were used to collect information from the parents (150 booked and 150 unbooked).Neonatal outcomes were categorised under groups of term and preterm ,live birth and stillbirts, birthweight, Gestational age, iugr, large for gestational age APGAR score ,NICU admissions and clinical course during hospital stay,course during rst 28 days of life along with complications,if any are all taken into consideration. RESULTS: During the study period 28.67% had low birth weight in booked cases and 41.33% had low birth weight in unbooked cases.The incidence of stillbirth and early neonatal deaths were 2%,4% respectively in booked cases and 4.67% , 6% respectively in unbooked cases.Higher incidence of MSL,prematurity ,birth asphyxia ,respiratory problems ,birth injuries,congenital malformations,infections and hyperbilirubinemia were seen in unbooked cases. CONCLUSIONS: The inference derived from the study ,showed that availability of antenatal care is directly proportional to the neonatal outcome .Thus unavailbility or lack of proper medical attention during the pregnancy results in unfavourable neonatal outcomes which can be prevented by increasing the range of availability , utilization and effectiveness of maternal and child health services alongwith ensuring booking of all the pregnancy cases in our country.

“Early Screening Test for High Risk Pregnancies by Second Trimester Color Doppler Imaging Of the Feto-Placental Circulation”

Objective: To examine the diagnostic value of umbilical artery velocity waveforms for the early detection of pregnancy induced hypertension and fetal growth restriction. To determine the utility of color Doppler Sonography of the fetoplacetal circulation for early detection of high risk pregnancies. Methods: This prospective study was conducted in the Department of Obstetrics &amp; Gynecology, Sir Sallimullah Medical Collage &amp; Mitford Hospital Dhaka in collaboration with radiology and imaging department of Dhaka hospital in 1st July, 2006 to 30 June, 2008. 126 randomly selected patients from 17-35 years of ages whose umbilical artery Doppler sonography was done between 16-22 weeks of gestation. All the patient were taken umbilical artery Doppler ultrasonography. Informed consent was taken from all patients. Results: A total 126 subjects of 16 to 22 weeks of gestation were included in this series. On application of the student‘t’ test for S/D ratio between normal and abnormal waveforms of the umbilical artery was found significant difference (P&lt;.0001). Distribution of patient according to umbilical artery systolic / diastolic ratio (n=126). Normal UA waveform 76 (60%), abnormal UA waveform 50(40%), Age (Mean ±SD) in year, normal UA waveform 25.63 ± 4.47 and abnormal UA waveform 25.86±3.75. Para: Primiparous normal UA waveform 36 (60%) &amp; abnormal UA waveform 24 (40%), multiparous normal UA waveform 40 (60.6%) &amp; abnormal UA waveform 26 (39.4%). Gestation age at scan in weeks (Mean± SD), normal UA waveform 19.5 ±2.5, abnormal UA waveform 19±2.0. Gestation age at delivery in weeks (Mean± SD), normal UA waveform 39.03±1.61, abnormal UA waveform 35.78 ±1.53, P value 0.0001. Birth wt. in Kg. (Mean ±SD), normal UA waveform 3.10 ±0.38, abnormal UA waveform 2.42 ±0.53, P value 0.0001. S/D ratio (Mean ±SD), normal UA waveform 2.40 ±0.31, abnormal UA waveform 5.46±1.62, P value 0.0001. Cases with an abnormal outcome in relation to whether the umbilical artery waveform was classified as normal or abnormal (n=126). Abnormal outcome in PIH normal UA waveform (n=76) 4%, PIH abnormal UA waveform (n=50) 14%, P value 0.001. In PIH/FGR, normal UA waveform (n=76) 1% &amp; abnormal UA waveform (n=50) 5%, P value 0.024. FGR normal UA waveform (n=76) 5% &amp; abnormal UA waveform (n=50) 13%, P value 0.002. Asphyxia normal UA waveform (n=76) 0% &amp; abnormal UA waveform (n=50) 3%, P value 0.017. PIH /IUD normal UA waveform (n=76) 0% &amp; abnormal UA waveform (n=50) 1%. A significant association was found when the Chi Square (X 2) test was used to examine the relationship between umbilical artery blood flow and the outcome of patient (i.e FGR, PIH, fetal asphyxia). The screening test had a sensitivity of 78.26% &amp; specificity of 82.5% and accuracy 80.95%. The predictive value of a positive test was 72% and of a negative test 86.84%. Conclusion : A close linear relationship between diagnosis of high risk pregnancy &amp; umbilical artery Doppler velocity waveforms was observed .As umbilical artery Doppler is easy to perform and it is done in between 16 to 22 weeks of gestation can be done along with anomaly scan which is also done at 20-22 week of gestation. So, UA Doppler does not cause additional USG scan. Along with anomaly scan UA Doppler will help to screen out high risk pregnancy.

ANALYSIS OF DETERMINANT FACTORS OF AFFECTING FAMILY ABILITY IN HIGH-RISK PREGNANCY

Background: The ability of pregnant women to deal with early response to high risks is still below the average, which is one of the causes of complications that can indicate the welfare of the mother and her fetus.&#x0D; Objectives: The aim of this study was to look at the determinants that influence early detection of high-risk pregnancies.&#x0D; Methods: This study used an analytic design with a cross sectional design. The sample size of 112 from a population of 155 was obtained by simple random sampling. The independent variables are individual factors, interpersonal influence, filial value and commitment, while the dependent variable is the family's ability to detect high risk of pregnancy for 3 months, namely August-October 2020 at PMB Ika Mardiyanti. This study uses a questionnaire. Data collection in the form of a questionnaire. Data analysis using SEM-PLS.&#x0D; Results: The results of the significance test concluded that all the path coefficients and the T statistical value of personal factors on interpersonal (0.453; 6.612), interpersonal on filial values ​​(0.753; 7.267), filial value for commitment (0.851; 17.048), filial value for ability (0.667 ; 4,679), commitment to ability (0.358; 2.356) is significant. Because all have a T-statistic value that is more than the T-table 1.96.&#x0D; Conclusion: The determinant factors that contribute to the ability of families to detect high risk of pregnancy need to be considered so that families are independent and have efforts to maintain the health of pregnant women in their families. In further research, it is necessary to involve other factors to improve family capacity, especially in the ability of families to detect high-risk pregnancies early.&#x0D; &#x0D; Keywords: Ability, family, high-risk.

Effect of Fillial Value and Commitment To Family Ability in Early Detection of High Risk Pregnancy

Pregnancy and childbirth are physiological processes that women experience, but sometimes have risky conditions. This study aims to determine the effect of filial value and commitment to family ability in early detection of high risk pregnancy. This study used a cross sectional design. The sample size of 112 from a population of 155 by simple random sampling. Data analysis using SEM PLS. The results (52.7%) were in early adulthood , (62.5%) secondary education, (75%) worked in private (57.1%) had good self-esteem, (52, 7%) self -motivated enough, (50%) good previous behavior. SEM-PLS statistical analysis CFA, fillial value were 10.23 and commitment was 13.78, on family abilities. The value of the fillial value (0.201), the value of commitment (0.102). R2 value (0.63) and Q2 value of 0.65. In further research, it is necessary to involve other factors to increase family capacity, especially in the ability of families to detect high-risk pregnancies early.

Analisis Faktor-Faktor yang berhubungan dengan kinerja bidan dalam pengisian buku KIA pada deteksi dini kehamilan risiko tinggi di puskesmas Kota Bukittinggi

The management of KIA program aims to strengthen and increase the reach and quality of KIA services effectively and efficiently. Today's strengthening of KIA services is prioritized on main activities, one of which is increasing early detection of risk factors and complications of obstetrics and neonates by health personnel. This study aims to analyze the factors associated with the performance of midwives in filling out the KIA handbook on early detection of high risk pregnancies. The research used is analytical and the independent variable is the level of knowledge, attitude, motivation and workload, and the dependent variable is the midwife performance. The population in the study was 37 respondents and the sampling technique was carried out by total sampling, the research data collection was carried out by using a questionnaire and observation sheet. The results of the study prove that the performance of midwives in filling out the KIA book has poor performance (62.2%), high level of knowledge (51.4%), poor attitude (51.4%), good motivation (67.6%) and light workload (83.8%). The results of multivariate analysis, it was found that the factor most related to the performance of midwives in filling out the KIA handbook was the attitude variable. Based on the research, it was concluded that the midwife would have a good performance in filling out the KIA book if it was based on a high level of knowledge, a positive attitude, high motivation, and supported by complete facilities.

An Effort to Increase the Independence of Pregnant Women in Detecting High Risk and Complications of Pregnancy

Health problems for pregnant women, both physically and psychologically, have an impact on the quality of life of the mother and the baby she is carrying. Women with high-risk pregnancies need to prepare themselves with more attention to their health conditions in facing pregnancy. Several factors that influence the independence of pregnant women in early detection of high risk pregnancies include age, developmental conditions, health conditions, cultural orientation, health care systems, family system factors or family support, lifestyle, environmental factors and available resources. The output target to be achieved in the implementation of this community service activity is to increase the understanding and skills of pregnant women about high-risk pregnancies and to be published in national journals. Efforts to increase the independence of pregnant women in detecting high risks and complications of pregnancy through the use of the health of both mother and childbook, Skor Pudji Rochyati and birth planning and complication prevention program stickers are a form of self-awareness for pregnant women and supported by social support by their families, it is hoped that pregnant women will be fully aware of the signs and dangers that occur. on himself and checked himself into a health facility and wanted to be referred to a higher level of service precisely and quickly.

EVALUATE THE DIRECT AND INDIRECT ETIOLOGIES OF MATERNAL MORTALITY: A RETROSPECTIVE ANALYSIS.

Aim: prevalence and the various direct and indirect etiologies of maternal mortality.&#x0D; Materials and Methods: The present 1 years retrospective hospital based study was conducted in the Department of Obstetrics and Gynecology, Jawaharlal Nehru Medical College and Hospital, Bhagalpur,Bihar,India&#x0D; Results: A total of 56 deaths were analyzed. The mortality rate in study period was 333 per 1,00,000 live births. Maximum maternal deaths (60.7%) were reported in the age group 21-25 years. More deaths were reported in multiparous women (67.9%) as compared to primiparous women (32.1%). Most of them were unbooked cases (60%). Hemorrhage (30.4%), eclampsia (16.1%), sepsis (12.5%) and embolism (7.1%) were the major direct causes of maternal death. Anemia (16.1%) was the major indirect cause of death.&#x0D; Conclusions: Hemorrhage is the leading cause of maternal death followed by hypertensive disorders and sepsis. Anemia continues to be the most common indirect cause. Majority of maternal deaths were preventable by proper antenatal care, early detection of high risk pregnancies and their timely referral to tertiary care centre.&#x0D; Keywords: MMR, Hemorrhage, Sepsis, Anemia

EVALUATE THE EXISTING MMR AND THE ETIOLOGY OF MATERNAL MORTALITY IN A TERTIARY CARE HOSPITAL IN BIHAR: A RETROSPECTIVE ANALYSIS.

Aim: to assess the existing MMR and the causes of maternal mortality.&#x0D; Materials and Methods: The present retrospective hospital based study was conducted in the Department of Obstetrics and Gynecology, Patna Medical College and Hospital, Patna, Bihar from Jan 2017 to march 2018.&#x0D; Results: A total of 56 deaths were analyzed. The mortality rate in study period was 333 per 1,00,000 live births. Maximum maternal deaths (60.7%) were reported in the age group 21-25 years. More deaths were reported in multiparous women (67.9%) as compared to primiparous women (32.1%). Most of them were unbooked cases (60%). Hemorrhage (30.4%), eclampsia (16.1%), sepsis (12.5%) and embolism (7.1%) were the major direct causes of maternal death. Anemia (16.1%) was the major indirect cause of death.&#x0D; Conclusions: Hemorrhage is the leading cause of maternal death followed by hypertensive disorders and sepsis. Anemia continues to be the most common indirect cause. Majority of maternal deaths were preventable by proper antenatal care, early detection of high risk pregnancies and their timely referral to tertiary care centre.&#x0D; Keywords: MMR, Hemorrhage, Sepsis, Anemia

A study of clinical profile of intractable epilepsy in children

Background: This study was undertaken to find out the prevalence and clinical features of intractable epilepsy (IE) in a tertiary referral center.Methods: Study was conducted in a tertiary care hospital on 60 children with intractable epilepsy. Cases includes intractable epilepsy is when seizures continue to occur despite maximally tolerated doses of more than two antiepileptics, occurrence of an average of one seizure per month for 18 months with no more than a 3 month seizure free period during these 18 months. Controls: epileptic children who had good control of seizures for the previous 18 months.Results: The prevalence of intractable seizures was 10% with maximum number of children 25 (41.6%) belonged to the 5-12 years. 15 (50%) children had daily seizures. Myoclonic seizures proved to be an important predictor of intractability. 4 children among the cases had history of family seizures, 6 children in cases had history febrile seizure, whereas, 6 children among the controls had history of family seizures, 8 children in controls had history febrile seizure. 23.3% of children presented with Status epilepticus in the cases and 16.6% of the children in the controls. Remote symptomatic etiology 12(40%) is the commonest cause of seizure. 13 (43.3%) children in cases and 3 (10%) children among the controls had a history suggestive of birth asphyxia. EEG was abnormal in 17 (56.6%) cases when compared to 11 (36.6%) children in the controls. CT scan was abnormal in 14 (46.6%) cases and 10 (33.3%) controls. MRI was abnormal in 16 (53.3%) children of the cases and 8 (26.6%) children of the controls.Conclusions: The commonest cause of intractable epilepsy was perinatal asphyxia. Perinatal asphyxia can be prevented by good nutrition during pregnancy, regular antenatal check ups with detection of high risk pregnancy, promoting hospital deliveries and prompt resuscitation of newborn when required.

Analysis of factors affecting families ability in early detection of high risk pregnancies

The purpose of this study is to analyze the factors that influence the ability of families to detect early high risk of pregnancy. The study design used observational analytic cross-sectional study approaches. The sample size consisted of 120 families of pregnant women working in the Primary Health Care working area in the city of Surabaya, East Java, Indonesia. The independent variables are personal factors, resources, the influence of cognition, interpersonal influence, basic values, and commitment. The dependent variable is family ability. Data were collected using a questionnaire that was tested for validity and reliability. Logistic regression is used to analyze the results. Complementary education (p = 0.001), level of knowledge (0.002), self-esteem (p = 0.047), self-motivation (p = 0.022), and previous behavior (p = 0.010) affect personal factors. Family connection (p = 0,001), community resources (p = 0,003), and competing role demand (0,008) influence the resources factor. Benefits (p = 0,000), obstacles (p = 0.026), and self-efficacy (p = 0,000) affect the influence of cognition. Family support (p = 0,000) and midwife support (p = 0.024) influence interpersonal factors. Responsibility (p = 0.047), attention (p = 0,000) and care (p = 0.046) affect the basic values. Affective (p = 0.011), Continuance (p = 0.001), and Normative (p = 0.012) affect the commitment factor. Introduction (p = 0.000), decision (p = 0.008), care (p = 0.001) and utilization (p = 0.001). The connection of family connection and interpersonal factors, including family support and midwife support, is very important to improve the ability of families in early detection of high risk pregnancies.

A cross sectional study to assess the utilization of Mother andChild Protection Card in High-Risk Pregnancy screening

Background The Mother and Child Protection MCPThayi card a service tool was introduced on 1st April 2010. The MCP card helps in timely identification referral and management of complications during pregnancy child birth and post natal period.Objectives To assess the usefulness of Thayi card in early diagnosis and treatmentreferral of High Risk Pregnancies and to assess the completeness of Thayi card entries.Methodology A hospital based cross-sectional study was conducted at Tertiary care hospital in Bengaluru on postnatal mothers admitted at PNC and High Risk Pregnancy HRP wards during the months of May to July 2019. Simple random sampling technique was used. In pilot study it was found that 70 of HRP mothers and 90 non-HRP mothers had undergone screening for all three high risk conditions. The sample size calculated was 130 6565. A structured checklist was used to assess whether screening was done for the high-risk conditions.Results 60.8 73 of the mothers were referred to this center for delivery. 90.7 of non-HRP and 89.2 of HRP cases had at least 4 antenatal care visits. Among non-HRP oral glucose tolerance test was done in only 64 and recording of BP at all 4 visits was done in 90.7. Among HRP 17.2 of Gestational diabetes 38.9 of pregnancy induced hypertension and 30 of severe anemia cases were diagnosed at the time of delivery. Majority 97 of the Thayi card entries showed completeness in Family information category and present pregnancy details.Conclusion MCP card is not being utilized to its complete and intended purpose of early detection of high risk pregnancy

Upaya Deteksi Dini Risiko Tinggi Kehamilan Ditentukan Oleh Pengetahuan Dan Pemeriksaan Kehamilan Di Pulau Osi

The most common cause of maternal death is bleeding (30.3%), followed by hypertension in pregnancy (27.1%), infection (7%). Other causes, 45%, are quite large, including non-obstetric causes. High maternal mortality is also caused by the high number of unexpected pregnancies. Approximately 65% of pregnancies still occur because "4 too" associated with pregnancies "too young (less than 20 years)," too old: (more than 35 years), "too often (pregnancy interval less than 2 years," too many”(more than 3 children). Most maternal deaths can be prevented if adequate treatment is provided in health care facilities. Time and transportation factors are very decisive in referring to high-risk cases. Therefore, detection of risk factors in mothers is good by personnel. Health and society is one of the important efforts in preventing death and morbidity. To avoid the risk of complications in pregnancy and childbirth, every pregnant woman needs at least 4 antenatal care, namely once in the first trimester (0-12 weeks gestation), one times in the second trimester (12-24 weeks of gestation), and twice in the second trimester third steer (24 weeks gestation until delivery). Keywords: Early Detection Of High Risk Pregnancy, Pregnancy Test.

A prospective study of causes and outcome of high risk pregnancies inreferred patients in a tertiary health care centre of southern Rajasthan

Objective: The present study was conducted in a tertiary care health centre of southern Rajasthan to assess the prevalence of referred high risk pregnancy in the region and its outcome. Material &amp; Methods: 200 high risk pregnancies referred to our tertiary healthcare centre during the study period, which were not registered in our antenatal record; with gestation of ≥ 28 weeks were included in the study. Obstetric outcomes were assessed in terms of maternal mortality and mode of delivery while neonatal outcomes were assessed in terms of incidences of intrauterine deaths, still births and live births. Results: Age of the patients’ ranges from 18 to 45 years with the mean age of 24.7 years. 73.5% of the cases in present study were belonged to rural society while 26.5% cases belonged to urban society. The most common cause for referral of the patients in present study was history of previous LSCS (31%) followed by anaemia (16%), hypertensive disorder of the pregnancy (9%) and bad obstetric history (9%).44.5% of the study participants had normal delivery while 54% had caesarean sections and the rest 1.5% had instrumental delivery (vacuum or forceps delivery). 200 study participants gave birth to 203 neonates (included 3 twin births). 97% were the live birth while 3% had intrauterine death and the rest 1.5% were stillborn. Conclusion: Early detection of high risk pregnancies at primary health care level with proper antenatal services and referral system is advisable to improve fetomaternal outcome.

Detection of high-risk pregnancies in low-resource settings: a case study in Guatemala

BackgroundMaternal and neonatal mortality is still very high at a global level, even though its reduction is a goal established among the Sustainable Development Goals by the United Nations. In order to improve prenatal care to address this challenge, this article proposes a strategy to detect and refer high risk pregnancies in rural setting through a portable ultrasound system combined with blood and urine strip tests.MethodsThe Healthy Pregnancy project was conceived as a single, explanatory and positivist case study, with a sample of ten thousand pregnant women attended by itinerant nurses of the Departments of Alta Verapaz and San Marcos. These nurses were trained and equipped with 31 portable ultrasound, and blood and urine tests to detect common obstetric pathology. Moreover, two obstetricians were responsible for remotely supervising the quality of prenatal care. Target communities were selected by the Health Directorates of the public health system from those that had the highest maternal mortality in previous years.ResultsThe project attended to 10,108 women in 2 years and 3 months. 55 twin gestations (0.54%) were diagnosed. Non-cephalic presentation was found in 14.87% of the pregnant women attended from week 32 onwards. 20 patients were referred for non-evolutive gestation. An 11.08% prevalence of anemia was detected. Urine infections were diagnosed in 16.43% of the cases. Proteinuria was detected in 2.6% of patients, but only 17 of them presented high blood pressure and were therefore referred with a suspected pre-eclampsia.DiscussionThe results obtained indicate that an intervention of these characteristics makes it possible to improve the quality of care of rural pregnant women in low and middle-income countries.ConclusionThe results show that with suitable equipment, training, and supervision, the nursing staff in charge of care in rural areas can identify and refer most of the obstetric risks in time, which may contribute to the reduction of maternal mortality.Trial registrationThis research was not registered because it is a case study in which the assignment of the medical intervention was not at the discretion of the investigators.

Analisis Jalur Faktor Angka Kematian Ibu di Provinsi Jawa Timur Tahun 2014

Path analysis was a statistical analysis technique which was developed from multiple regression analysis. This method was used to analyze the causal relationship that involve many variables such as maternal mortality rate (MMR). Many variables influenced the MMR but it was not easy to find the dominant variable because it will create problems multicolinearity. Therefore it used path analysis to analyze the direct and indirect effects in the incidence of MMR based on the model of causal relationship.The purpose of this study to apply path analysis on factors that affect maternal mortality rate in East Java province. This study was a non-reactive using data SUSENAS and East Java Provincial Health Profile 2014 on maternal mortality rate in all districts in East Java using path analysis. The results of path analysis showed that there was influence between the variables of women who married at age &lt;17 years (p = 0.045; β = 0.376), birth attendance by non-medical (p = 0.013; β = 0.475) and obstetric complications (p = 0.036; β = 0.323) on the incidence of MMR. Analyzed furthermore of variables woman who married at age &lt;17 years (β = 0.528) and birth attendance by non-medical (β = 0.632) influenced directly and indirectly to MMR. It was expected by using this path analysis health practitioners could improve their services and assistances to all pregnant women for early detection of high risk pregnancy.

Epidemiological predictor variables in relation to the outcome of pregnancy in an urban setting

Background: Fetal weight at birth is the singular parameter resonant of maternal health and is measured with reasonable precision, while measuring preterm birth or IUGR requires a valid estimate of gestational age. Notwithstanding the relevance of mortality and morbidity as measures of adverse pregnancy outcome, proxy markers like low birth weight (LBW), preterm birth, intrauterine growth restriction (IUGR) and congenital anomalies have been used in the past. This exercise aims to study the epidemiological predictor variables in pregnant women attending ante-natal clinic and its association with birth outcome.Methods: This prospective study was carried out over a one-year period at a tertiary care teaching hospital. Data was collected using structured questionnaire, investigation reports and ante-natal cards. The outcome of delivery in all registered women was recorded by following them up till delivery.Results: The variables having a statistically significant association with an adverse pregnancy outcome were maternal and paternal education, family income, socioeconomic status (SES), gravidity, maternal complications, level of physical activity, rest during pregnancy, trimester of initiation of ANC visits, diet, iron supplementation, maternal weight gain, exposure to tobacco/environmental tobacco smoke and gestational age.Conclusions: Parental education, good antenatal care, early detection of high risk pregnancy, light physical activity and adequate rest, adequate nutrition with supplementation and exposure to ETS markedly influence the pregnancy outcome and intervention in these areas would result in an improved birth outcome. Factors having marginal scope of intervention include age of the pregnant women, adequate inter-pregnancy interval, maternal weight gain and socioeconomic status.