Pregnant Women In Hospital Research Articles

The Prevalence of Extended Spectrum Beta-Lactamase (ESBL) Producing gut flora among Pregnant Women peripartum in Community and Hospital, Indonesia

The data of the carrier rate of ESBL producing bacteria in pregnant women in Indonesia is limited. ESBLproducing bacteria colonization among women during labor is one of the risks for spreading and infection to the neonate. This study aimed to compare the carrier rate of ESBL-producing bacteria in pregnant women in the community and hospitals. This study was an observational analytic study with cross-sectional approach. Samples were collected from rectal swab of pregnant women who visited during antenatal care at the Primary Health Center (PHC), and inpatient pregnant women that referred to Dr. Soetomo referral hospital, Surabaya. The samples were cultured on MacConkey Agar media supplemented with cefotaxime 1 mg/L, incubation 37oC overnight. The growth colonies that were suspected ESBL producer were further identified by biochemically and confirmed the ESBL using the DDST (Double Disk Synergy Test) method. Among 200 samples (101 from PHC and 99 from hospital), 79 ESBL producers were identified, 28 (40%) from PHC and 51 (68.9%) from hospital. The carrier rate of ESBL producing bacteria was significantly different between PHC and hospital (p=0.001; 95%CI= 1.54–4.98). The antibiotic consumed by pregnant women was higher in hospital rather than PHC (p=0.001). Conclusion: The carrier rate of ESBL producing bacteria among pregnant women in hospital was higher than PHC. Antibiotic used was identified as risk factor.

Indoor Thermal Comfort of Pregnant Women in Hospital: A Case Study Evidence

Despite studies on thermal comfort being consolidated in the scientific literature, people’s well-being in some specific conditions and places, such as hospitals, requires to be further explored. The paper describes the methodological approach adopted to evaluate thermal comfort level and perception of pregnant women hosted in the obstetric ward of a test-bed case (Sant’Orsola hospital in Bologna, Italy). The methodology adopts a mixed approach that compares the results of on-site monitoring by probe (as quantitative data) with the ones of a survey (questionnaire form) delivered to the involved subjects (as qualitative data) to understand if metabolic alteration may influence the pregnant women’s perception of comfort conditions. The first follows ISO 7730, the second, ISO 10551. The comparison between the instrumental collected data and the outcomes of the survey revealed a wide gap between TSV (Thermal Sensation Vote) and PMVm (Predicted Mean Vote, measured on-site). The reason can be identified in the use of a standardized metabolic unit from ISO that does not correctly reflect the physiologic condition of pregnant women. Following a trial and error methodology, a met value for pregnant women is accordingly proposed. Moreover, an adaptive thermal comfort approach is adopted. This research is a first step towards the definition of specific thermal comfort in a hospital ward hosting pregnant women and more generally offers a reflection about the need to define specific met in the standards for some particular categories (children, elderly, pregnant women, etc.) when investigating thermal comfort.

FEATURES OF THE COURSE OF THE PERINATAL PERIOD AND DELIVERIESDURING PREGNANCY WITH A SINGLE UMBILICAL ARTERY OF THE FETUS

Among the anomalies in the number of vessels of the umbilical cord,thesingle umbilical artery (SUA) is most often found. A significant impact of SUA on the course of such pregnancy and deliveries is expected. The article presents some peculiarities of the deliveries and condition of newborns after pregnancies with SUA compared with pregnant women with three umbilical cord vessels and physiological deliveries. The objective of the workwasto analyze the peculiarities of the perinatal period and deliveries after pregnancy with SUA, to conduct a comparative analysis of the revealed features with the corresponding indicators among pregnant women with two umbilical arteries and physiological births. Thestudygroupconsistedof 31 pregnant women with a SUA (study group)and control group – 62 pregnant women with 2 arteries of the umbilical cord. According to our data, pregnant womenwith SUA were hospitalized earlier and spent more time in the maternity hospital, although the terms of delivery did not differ between the two study groups, although there was a tendency to an earlier term of delivery in pregnant women with SUA. Among pregnant women with SUA, deliveries were premature in 4 women (12.9 %). No differences were found between pregnant women with SUA and control group in such indicators as early discharge of amniotic fluid, anthropometric indicators of pregnant women, entanglement of umbilical cord, pelvic presentation, rupture of the perineum or episiotomy during deliveries. The duration ofI, II and III periods of deliveries also did not differ significantly between the two study groups. Weakness of patrimonial activity was more often in women with SUA, accounting for 12.9 % of all deliveries, compared to 3.2 % in the control group. Fetal hypoxia in deliveries was observed in 25.8 % of cases among pregnant women with SUA, and in 4.8 % among pregnant women in the control group. Fetal distress in deliveries was estimated at 4 (12.9 %) and 4 caesarean sections were performed. Physiological childbirth occurred in all cases in the control group. In the SUA group, the infant weight was significantly lower than the control group children, but the Apgar score at 1 and 5 minutes did not differ between the two study groups. Cardio-respiratory depression, risk of neurological disorders, and congenital malformations (esophageal atresia, Gothic palate, and syndactylium) were more frequently reported in the SUA group. Long-term hospitalization of pregnant women, weakness in delivery, premature birth, fetal hypoxia in delivery, fetal distress and incidence of cesarean delivery are much more common in SUA group. The weight of newborns from pregnancies with SUA is significantly lower, however, the infants' status on the Agar scale after pregnancies with SUA did not differ from those of children in the control group. Cardiovascular depression, the risk of neurological disorders, and congenital malformations (esophageal atresia, Gothic palate, and syndactyly) were more common in the SUA group.

Magnesium and health outcomes: an umbrella review of systematic reviews and meta-analyses of observational and intervention studies.

To map and grade all health outcomes associated with magnesium (Mg) intakeand supplementation using an umbrella review. Umbrella review of systematic reviews with meta-analyses of observational studies and randomized controlled trials (RCTs) using placebo/no intervention as control group. We assessed meta-analyses of observational studies based on random-effect summary effect sizes and their p values, 95% prediction intervals, heterogeneity, small-study effects and excess significance. For meta-analyses of RCTs, outcomes with a random-effect p value < 0.005 and a high-GRADE assessment were classified as strong evidence. From 2048 abstracts, 16 meta-analyses and 55 independent outcomes were included (36 in RCTs and 19 in observational studies). In RCTs of Mg versus placebo/no active treatment, 12 over 36 outcomes reported significant results (p < 0.05). A strong evidence for decreased need for hospitalization in pregnancy and for decreased risk of frequency and intensity of migraine relapses in people with migraine was observed using the GRADE assessment. In observational studies, 9/19 outcomes were significant (p < 0.05). However, only one outcome presented highly suggestive evidence (lower incidence of type 2 diabetes in people with higher Mg intake at baseline) and one suggestive (lower incidence of stroke associated with higher Mg intake at baseline). Strong evidence according to the GRADE suggests that Mg supplementation can decrease the risk of hospitalization in pregnant women and reduce the intensity/frequency of migraine. Higher Mg intake is associated with a decreased risk of type 2 diabetes and stroke with highly suggestive and suggestive evidence, respectively, in observational studies.

Nephrolithiasis in Pregnancy

Nephrolithiasis is a common condition that practicing urologists will encounter and manage. The pregnant patient presents unique challenges when it comes to the diagnosis and treatment of stones. Altered anatomy and physiology, considerations of the fetus, and various imaging and procedural contraindications make navigating the care of pregnant patients with nephrolithiasis more complex than that of the general population. This review presents an algorithmic approach to the diagnosis and management of nephrolithiasis in the pregnant patient. Certain areas that are highlighted include diagnostic imaging modalities and the pros and cons of each with regard to the pregnant patient. Also discussed in detail are various treatment options, including medical management and available surgical interventions. As renal colic is the most common reason for nonobstetric hospitalization in pregnant women, it is important that they are managed with a multidisciplinary approach. This review contains 2 highly rendered figures, 4 tables, and 26 references Key words: low-dose CT, medical expulsive therapy, nephrolithiasis, obstructive hydronephrosis, percutaneous nephrostomy, physiologic hydronephrosis, pregnancy, renal colic, resistive index, ureteral stent, ureteroscopy

Nephrolithiasis in Pregnancy

Nephrolithiasis is a common condition that practicing urologists will encounter and manage. The pregnant patient presents unique challenges when it comes to the diagnosis and treatment of stones. Altered anatomy and physiology, considerations of the fetus, and various imaging and procedural contraindications make navigating the care of pregnant patients with nephrolithiasis more complex than that of the general population. This review presents an algorithmic approach to the diagnosis and management of nephrolithiasis in the pregnant patient. Certain areas that are highlighted include diagnostic imaging modalities and the pros and cons of each with regard to the pregnant patient. Also discussed in detail are various treatment options, including medical management and available surgical interventions. As renal colic is the most common reason for nonobstetric hospitalization in pregnant women, it is important that they are managed with a multidisciplinary approach. This review contains 2 highly rendered figures, 4 tables, and 26 references Key words: low-dose CT, medical expulsive therapy, nephrolithiasis, obstructive hydronephrosis, percutaneous nephrostomy, physiologic hydronephrosis, pregnancy, renal colic, resistive index, ureteral stent, ureteroscopy

Obstetric and neonatal outcome following minor trauma in pregnancy. Is hospitalization warranted?

ObjectiveTo evaluate if hospitalization of pregnant women, involved in minor trauma, for 24h of surveillance, is warranted. Study DesignThe medical files of pregnant women involved in minor trauma, during 2009–2014, at 22–42 gestational weeks, were reviewed. Minor trauma was defined as an injury severity score <3, no immediate complains, normal ultrasound evaluation, reactive non-stress test, and no regular contractions. Patients were divided into those who, according to our departmental protocol, were hospitalized for 24h observation (hospitalized group), and those who refused to be hospitalized, (non-hospitalized group). Pregnancy, delivery and neonatal outcomes were compared between the groups. ResultsIncluded in the study were 946 minor trauma patients that met the inclusion criteria. Gestational age (GA) at the trauma event was lower in the non-hospitalized group (n=331) compared to the hospitalized group (n=615), 29.1 vs. 30.8 weeks, p<0.001, respectively. There were no between-groups differences in the rate of preterm birth, vaginal bleeding, GA at delivery, or cesarean delivery. There were no cases of placental abruption or intrauterine fetal death in both groups. Neonatal outcome did not differ between the groups. ConclusionMinor trauma during pregnancy, with normal initial assessment, is not associated with adverse pregnancy outcomes. Therefore, routine hospitalization is probably not warranted.

Predictors of anxiety among pregnant New Zealand women hospitalised for complications and a community comparison group

Objectiveto investigate predictors of anxiety for women experiencing hospitalisation during pregnancy and a comparison group of pregnant women (with or without medical complications) in the community. Designcorrelational, cross-sectional observational questionnaire study. Settingregional antenatal inpatient unit and community-based settings in New Zealand in 2009 and 2010. Participants118 pregnant women in hospital and 114 pregnant women in community. Measurements and findingswomen in hospital and community groups completed a battery of questionnaires on pregnancy and health history, life events, anxiety, optimism, coping, and relationship factors. Midwives caring for the women provided ratings of health status and psychological distress. Both groups of women had scores on state anxiety significantly above local norms; women in the hospital were significantly higher than those in the community on state anxiety and worry about their pregnancy. The groups did not differ on factors such as life events, optimism, and coping self-efficacy. Ratings of health and distress made by women and their midwives showed poor agreement. Predictors of acute anxiety differed across the groups: for hospitalised women, anxiety was predicted by their rating of their health and their dispositional optimism; for women in the community, anxiety was predicted by stressful life events, dispositional optimism, and coping self-efficacy. Key conclusionsmany women hospitalised during pregnancy are extremely anxious, and those most vulnerable are those who are less optimistic and see their health as poor. Health care professionals may not be aware of how anxious women are, and women and their hospital caregivers had poor agreement on ratings of the woman׳s health status. Implications for research and practicewomen hospitalised during pregnancy are at risk for high levels of anxiety. Midwives are well placed to help women by recognising their distress, supporting informed optimism, and guiding women toward realistic coping strategies and using existing social support networks. Research is needed on strategies for implementation and effectiveness of brief interventions to support women to manage anxiety and stress during pregnancy both in hospital and in the community.

Study results on the use of different therapies for the treatment of vaginitis in hospitalised pregnant women

During pregnancy, many women experience vaginal infections due to a weakened immune system and changes in hormonal status. Treating these infections is of crucial importance, because women are at high risk for serious complications such as preterm birth and late miscarriage. For this reason, the present study was conducted to investigate the effectiveness of octenidine dihydrochloride/phenoxyethanol (OHP) in comparison to antimicrobial therapies in pregnant women in hospital suffering from different types of vaginitis. A total of 1,000 patients were divided into 4 different groups according to their type of vaginal infection after smear analyses. Each group was again divided into two subgroups receiving treatment with OHP or antimicrobial therapies with neomycin/polymyxin B/nystatin, metronidazole or miconazole vaginal tablets. The most frequent causes of vaginitis were unspecific bacterial infections (42.4 %) and vaginal candidiasis (44.8 %). The average time needed to obtain negative results from smear analyses was significantly shorter when treated with OHP, both in patients with bacterial vaginosis (BV) or vaginal candidiasis (VC) compared to antimicrobial therapy (1.7 ± 0.8 vs. 2.3 ± 1.1 days; 2.3 ± 1.4 vs. 3.4 ± 1.6 days; both p < 0.001). Equally, the maximum number of days until negative results were detected was significantly lower with OHP compared to antimicrobial therapy (BV: 3 vs. 5 days; VC: 5 vs. 7 days). OHP has a great effect in the treatment of vaginitis during pregnancy and thus should be an integral part of standard therapy regimens.

Risk of First Venous Thromboembolism in Pregnant Women in Hospital

Log in or Register Subscribe to journalSubscribe Get new issue alertsGet alerts Enter your Email address: Wolters Kluwer Health may email you for journal alerts and information, but is committed to maintaining your privacy and will not share your personal information without your express consent. For more information, please refer to our Privacy Policy. Subscribe to eTOC Secondary Logo Journal Logo All Articles Images Videos Podcasts Blogs Advanced Search Toggle navigation Subscribe Register Login Articles & Issues Current IssuePrevious Issues Collections Obstetric Airway ManagementMaternal EmbolismRegional Anesthesia for Cesarean SectionGeneral Anesthesia for Cesarean SectionAnalgesia for LaborObstetric HemorrhagePre-Eclampsia/EclampsiaPharmacologyTraumaInfection and SepsisMaternal ObesityMaternl Morbidity and MortalityNeonatal Morbidity and MortalityObstetric ComplicationsAnesthetic ComplicationsNon-Obstetric Maternal DiseaseCritical CareDrug Abuse in PregnancyEthicsSystems Based Practice For Authors Information for AuthorsLanguage Editing Services Journal Info About the JournalEditorial BoardAdvertisingOpen AccessSubscription ServicesReprintsRights and Permissions All Articles Images Videos Podcasts Blogs Advanced Search

Influenza vaccination during pregnancy: a systematic review of effectiveness and safety

Background Influenza vaccination during pregnancy is the primary intervention to protect pregnant women, their fetus and infant from influenza infection. The World Health Organization recommends that countries expanding or initiating influenza immunization programs should consider pregnant women as the highest priority group. However, it is considered to be an expensive public health measure and data on the effectiveness and safety of the vaccine has been lacking and inconsistent. Evidence of the vaccine's effectiveness and safety is critical to the decision making process of governments and policy-makers, as well as clinicians and pregnant women. Objectives To synthesize the best available evidence on the effectiveness and safety of influenza vaccination during pregnancy for pregnant women, their fetus and infant up to six months of age. Inclusion criteria Types of participants Pregnant women with or without risk factors for complications from influenza infection, their fetus and infants up to the age of 6 months. Types of intervention Inactivated influenza vaccination, irrespective of antigenic configuration or adjuvant, administered via any route and any dose, to pregnant women of any trimester. Types of studies Studies using quantitative research methods were considered for this systematic review. Types of outcomes This systematic review considered studies that reported on the effectiveness of maternal influenza vaccination at reducing the rate and severity of influenza and influenza-like illness for pregnant women and infants up to six months of age. The review also investigated the safety outcomes for pregnant women and fetus following influenza vaccination during pregnancy. Outcomes for pregnant women included both adverse events and serious adverse events. For the fetus, outcomes included spontaneous abortion, fetal death, premature birth, low birth weight, small for gestational age and congenital malformation. Search strategy An extensive search of the literature was undertaken to find both published and unpublished English language studies between the inception of each database to March 2014. Methodological quality Papers selected for retrieval were assessed by two independent reviewers for methodological validity prior to inclusion in the review. Data collection Data were extracted from included papers using data extraction tools developed by the Joanna Briggs Institute. Data synthesis Data were, where possible, pooled in statistical meta-analysis. Where statistical pooling was not possible the findings were presented in narrative and table form. Results A total of 46 relevant studies were included in the review following critical appraisal. Birthing and fetal outcomes were included from 23 studies and adverse event outcomes for pregnant women from 28 studies. The effectiveness of maternal influenza vaccination in reducing illness in pregnant women and infants up to six months included outcomes from another 10 studies. Conclusions Influenza vaccine administered during pregnancy is effective and provides a similar reduction in influenza-like illness as it does for a healthy adult population. Despite this, there is no evidence on the effectiveness of the influenza vaccine at reducing severe illness or hospitalization in pregnant women. Infants of pregnant women vaccinated during their second or third trimester can expect to have reduced rates of influenza and influenza-related hospitalization, for their first six months of life. Influenza vaccination during pregnancy had no association with adverse outcomes for the fetus including premature birth, small for gestational age, congenital malformation, spontaneous abortion and fetal death.

Journal Watch November 2013 – February 2014

Risk of first venous thromboembolism in pregnant women in hospital: population based cohort study from England.

Interfamilial transmission of HTLV-1 in the South of Bahia, Brazil

The objective of this study was to investigate the prevalence of HTLV in the south of Bahia and to verify the interfamilial transmission of this virus. Initially, blood was collected from pregnant women in hospitals in southern Bahia.The HTLV-1 status was analyzed by ELISA and confirmed by Western Blot and PCR. The HTLV positive women were contacted and visited. In this opportunity, it was explained the results and collected samples from family members. They signed a consent informed and it was applied questionnaire. A total of 2766 pregnant women were analyzed. The prevalence was 1.05% (n=29) (CI95%:0,70-1,50). Besides, it was possible to follow 18 mothers (16 positives and 2 indeterminates) for 2 years. During the following, it was collected samples from 34 family members, including: partners (n=8), mothers (n=7), father (n=1), sisters (n=2), brothers (n=4), sons (n=5), daughters (n=4), others (n=3). Specific reactivity was observed in 11/34 (32,35%) individuals, of which two samples were from children (1 son and 1 daughter - 2,3 and 8 years old, respectively). The others members were: 3 mothers, 1 father, 3 partners, 2 sisters. In one case, we had three generation HTLV-1 positive: grandmother, mother and daughter. These results are very relevant because: (1) so far no studies of HTLV-1 seroprevalence in pregnant/puerperal women from the South region of Bahia had been described, (2) previous studies in areas endemic for the HTLV in Brazil found: 0.84% - Salvador, Bahia and 1.1% in Belo Horizonte, Minas Gerais, (3) evidence of important interfamilial transmission in this area.

Risk of first venous thromboembolism in pregnant women in hospital: population based cohort study from England

Objective To examine the potential for preventing venous thromboembolism during and after antepartum hospital admissions in pregnant women.Design Cohort study using linked primary (Clinical Practice Research Datalink) and secondary (Hospital...

Outcomes of Hospitalization in Pregnant Women with Brain Tumors: A Population-Based Study (P07.112)

Objective: To determine whether pregnant women with brain tumors have an elevated risk of adverse pregnancy outcomes. Background Diagnosis of a brain tumor during pregnancy presents complex management challenges, and relevant population-based studies are lacking. Design/Methods: We designed a retrospective cohort study using the Nationwide Inpatient Sample (NIS), a stratified sample of US hospitalizations, to investigate pregnancy outcomes in women with brain tumors. We constructed a logistic regression model for the outcomes of maternal mortality, preterm labor, Caesarean delivery, miscarriage, and elective abortion, controlling for age, medical comorbidities, and demographic and hospital characteristics. Results: We identified 379 malignant and 437 benign brain tumors among 19 million pregnancy-related admissions between 1988 and 2009. Malignant brain tumors were associated with maternal mortality (OR 143), miscarriage (OR 1.8), and elective abortion (OR 11.6). Caesarean delivery was more frequent for malignant (OR 5.3) and benign (OR 2.2) brain tumors. Admissions not resulting in a delivery were more common for malignant (OR 8.6) and benign (OR 4.3) brain tumors. As with non-pregnant adult brain tumor patients, seizures (16%) and hydrocephalus (6%) were the most common associated diagnoses. Hyperemesis gravidarum was more common for malignant (OR 2.2) and benign (OR 2.8) brain tumors, raising the suspicion that elevated intracranial pressure was responsible for symptoms thought to be pregnancy-related. 27% of all hospitalizations involved a neurosurgical procedure, but the likelihood of pregnancy complications was not significantly increased in these patients. All reported associations were statistically significant to a level of p Conclusions: Brain tumors are strongly associated with adverse pregnancy outcomes, but neurosurgery during pregnancy does not appear to enhance these risks. Brain tumors were associated with higher rates of Caesarean delivery, implying a conservative management strategy. Further research is needed to improve understanding of obstetric risk in this patient population and to assist with treatment, prenatal counseling, and monitoring during delivery. Supported by: Harvard Center for Neurofibromatosis and Allied Disorders. Disclosure: Dr. Terry has nothing to disclose. Dr. Barker has nothing to disclose. Dr. Leffert has nothing to disclose. Dr. Bateman has nothing to disclose. Dr. Souter has nothing to disclose. Dr. Plotkin has received research support from Pfizer.

Outcomes of hospitalization in pregnant women with CNS neoplasms: a population-based study

Managing a CNS neoplasm during pregnancy presents complex challenges, and population-based studies are lacking. We designed a retrospective cohort study using the Nationwide Inpatient Sample (NIS) to investigate pregnancy outcomes in women with CNS neoplasms. We constructed a logistic regression model for maternal mortality, preterm labor, intrauterine growth restriction (IUGR), and Caesarean delivery, controlling for age, comorbidities, and demographic characteristics. We identified 379 malignant brain tumors, 437 benign brain tumors, and 44 spine tumors among 19 million pregnancy-related admissions from 1988 through 2009. Malignant brain tumors were associated with maternal mortality (odds ratio [OR], 143), preterm labor (OR, 3.4), and IUGR (OR, 2.9). Benign brain tumors were associated with preterm labor (OR, 2.3). A diagnosis of hyperemesis gravidarum was more common in malignant (OR, 2.2) and benign (OR, 2.8) brain tumors. Compared with the general population, Caesarean delivery was more frequent for malignant (OR, 6.4) and benign (OR, 2.8) brain tumors and spine tumors (OR, 3.9). Admission without delivery was more common for malignant (OR, 8.6) and benign (OR, 4.3) brain tumors and spine tumors (OR, 3.8; P < .05 for all outcomes). Thirty-three percent of all hospitalizations involved neurosurgical procedures, but pregnancy complications were not significantly more likely to occur in surgical patients. In conclusion, malignant brain tumors were associated with adverse pregnancy outcomes, and CNS neoplasms were associated with higher rates of Caesarean delivery. Additional research is needed to improve understanding of obstetric risk in these patients and to assist with treatment, counseling, and monitoring during delivery.

Effect of excellent nursing on happiness index of pregnant women

Objective To explore effect of excellent nursing and responsibility system holistic nursing on happiness index of pregnant women in hospital.Methods 200 pregnant women in hospital were divided into observation group ( 100 cases ) and control group ( 100 cases) using a lottery.Both groups received similar treatment,nursing care and health education.Besides,the observation group was given responsibility system holistic nursing which provided whole course seamless excellent nursing service.Self-made questionnaire was used to compare the happiness index of the two groups.Results There were significant differences in terms of maternal and infant safety [( 9.50 ± 1.00) points vs.( 6.80 ± 1.30) points],delivery mode [ ( 9.40 ± 1.08 )points vs.(6.80 ± 1.36 ) points ],nursing skills of neonates [ ( 9.34 ± 1.10) points vs.( 6.32 ± 1.33 )points ],custom and culture [ ( 9.22 ± 1.27 ) points vs.( 6.92 ± 1.59 ) points ],basic nursing [ (9.48 ±1.05 ) points vs.(6.14 ± 1.46 ) points ],professional nursing [ (9.50 ± 1.08 ) points vs.( 6.46 ± 1.65 )points ],technical operation [ (9.08 ± 1.19 ) points vs.( 6.32 ± 1.47 ) points ],service standard [ ( 9.18 ±1.14) points vs.(6.40 ± 1.16) points] and communication [(9.38 ± 1.13) points vs.(8.46 ± 1.33)points] (F =270.303,223.08,306.907,127.572,346.208,237.124,213.565,190.915,27.894,respectively ; P ＜ 0.05 ).No significant differences were found regarding maternal and infant health care,breast feeding and hospital environment (F=1.600,1.348,2.467,respectively; P＞0.05).Conclusions Application of excellent nursing and responsibility system holistic nursing could effectively enhance happiness index of pregnant women in hospital and improve quality of nursing service. Key words: Pregnant woman; Puerpera; Happiness Index; Excellent nursing

Hospitalization of pregnant women with pandemic A(H1N1) 2009 influenza in Canada

This article describes the epidemiology of pandemic A(H1N1) 2009 influenza in all Canadian pregnant women admitted to hospital, and compares it with historical inter-pandemic influenza activity. We used weekly hospitalization and death counts of laboratory-confirmed pandemic A(H1N1) influenza cases reported to the Public Health Agency of Canada's (PHAC) 2009-2010 national pandemic influenza surveillance programme. Pregnant women infected and admitted with the pandemic strain were described and compared with: (1) confirmed admissions of all women of reproductive age; (2) all admitted cases reported to PHAC; and (3) to a historical average of inter-pandemic seasonal influenza admissions, and pneumonia and influenza (P&I) admissions for pregnant women. During the pandemic, 263 pregnant women with confirmed infections were admitted; four died in their third trimester. The median age for admitted pregnant cases was 27.5 years, which is consistent with the median age of the 3-year historical inter-pandemic pregnant comparison group. Aboriginal women appeared to be overrepresented but ethnicity was unavailable for 15.2% of all pregnant cases. Overall admission volumes were higher than those for seasonal influenza in the historical comparison group but were lower than those for P&I admissions. Despite increased admission volumes, severe outcomes in pregnant women were proportionally fewer than in all cases admitted for influenza A(H1N1) infection during the pandemic.

Hospitalizaciones de mujeres embarazadas en España entre 1997 y 2007

Objective To study the non-delivery pregnancy associated hospitalizations in Spain during the period 1997-2007. Methods A descriptive epidemiological study was performed using data from the National Epidemiological Surveillance System for hospital data (Minimum Basic Data Set [MBDS]). Records of all pregnant women admitted to hospital with a pregnancy associated complication (excluding delivery) as a principal admitting diagnosis were studied. Results There were a total of 4,506,449 deliveries reported in Spain during the study period (1997-2007), with a hospitalization rate of 11.86% deliveries (95% CI, 11.83%-11.89%). The principal admitting diagnoses were abortions (10%), abnormal products of conception and non-viable pregnancies (1.5%). The mortality rate was 2.35 per 100,000 deliveries (95% CI, 1.9%-2.8%) and the case-fatality rate was 0.02% (95% CI, 0.016%-0.024%). Adolescents and women over 45 years had higher hospitalization and mortality rates. Conclusions The main causes for hospitalization in pregnant women in Spain were abortions, abnormal products of conception and non-viable pregnancies. Hospitalization and mortality rates were higher in adolescents and women over 45 years, and did not vary during the study period.

Incremental Charges, Costs, and Length of Stay Associated With Obesity as a Secondary Diagnosis Among Pregnant Women

Elevation in prepregnancy body mass index (BMI) has been linked to a host of perinatal complications, but increases in charges or costs associated with obesity during pregnancy have not been quantified. To evaluate the economic impact of obesity as a diagnosis on hospitalizations of pregnant women, we performed descriptive, univariate, and multivariable analysis of the 1999 to 2005 Nationwide Inpatient Sample, a nationally representative sample of admissions to US community hospitals. Hospitalizations with a diagnosis of obesity were rare (0.7%), but when obesity was a diagnosis, it was associated with significant increases in length of stay (LOS), charges, and costs. Cesarean section was more frequent among women hospitalized with a diagnosis of obesity, with increases in this procedure across nearly every pregnancy-related diagnostic category. Controlled for cesarean section, diagnosed obesity was associated with significant increases in LOS (0.55 day), charges ($2015), and costs ($1805). Increases in LOS were sustained across nearly every diagnostic category when cesarean section was incorporated into the modeling, whereas increased cesarean section explained increases in costs for hemorrhage during pregnancy and abnormal glucose tolerance during pregnancy. Although these hospitalizations represent a relatively small sample of all obese pregnant women, diagnosed obesity seems to contribute heavily to increased costs among pregnant women. Further studies are needed to identify reasons increased health care costs of caring for women with obesity during pregnancy besides increased cesarean section. These data may encourage insurers to provide fiscal incentives to prevent complications of obesity during pregnancy.