Hospital Labor Research Articles

Impact of hospital architecture on the birthing experience: a phenomenological study with mothers-to-be who are design experts

The birthplace has a crucial role in shaping the childbirth experience and mothers' satisfaction levels. This study aimed to identify the experiences and perceptions that may have an impact in the long-term on mothers' birthing experience, considering hospital design features in the birthing environment until discharge. Inductive thematic analysis of twenty-five hospital labor testimonies employing a phenomenological research approach and utilizing a biographical method. Participants were women with a professional background in architecture, landscape architecture, engineering, or interior design. The results are organized into four themes and seven subthemes. The first theme is "First sight and long term impression" which is subdivided into the subthemes "Depersonalized itinerary in entrances and corridors" and "Instinctive search for connection with nature". The second theme deals with "Accompaniment and tucking in during the birthing process", subdivided into "Hotel-like: space for movement and personalized adaptation" and "Helplessness, cold and uncertainty: spaces to be against one's will". The third theme is "Damage in collateral rooms", which includes "The integration of toilets in the birthing process", "Operating rooms unchangeable in the face of cesarean delivery" and "Neonatal units that do not integrate families". Finally, the fourth theme includes "Improvement proposals for new designs". This study contributes to the existing literature by deepening the understanding of the design features identified in hospitals in recent studies. Further research incorporating the experiences of women in the birthing process is needed to facilitate evidence-based design policies.

Stone Hotel and the fight over minimum wages

This case study examines at how Ahmad, a hotel worker, changed over the course of his life while the hospitality business and labour laws in Malaysia changed. At first, Ahmad's family lived a simple life, like many others in their coastal town. They made a living by fishing and working in other nearby industries. But commercial and tourism growth pushed by the government drove them to move, which put Ahmad into the growing hotel business. Ahmad's job at Stone Hotel is very different from what he used to do for a living, which shows that he can adapt to new situations. Ahmad worked hard, but his pay stayed the same. He joined a trade union to try to get better working conditions and pay. This action started a big argument about how to read the Minimum Wages (Amendment) Order 2012, mainly about whether or not service charges should be counted towards the minimum wage. The fights between the union and the hotel, as well as the later court cases, show how complicated labour laws and collective bargaining can be. The court's decisions against the hotel's pay practises made it clear how important fair pay is and set a standard for how labour law should be applied. Ahmad's story shows how group action and legal actions can change fair labour practises and is a microcosm of the larger fight for worker rights in Malaysia.
 
 Keywords: Minimum Wages; Collective Agreements; Industrial Relations; Conciliation

The relationship between women's empowerment and staff turnover in the Egyptian hospitality labor market

PurposeAlthough the hospitality sector is considered the most active and profitable sector in the Egyptian economy, it suffers from the non-stop immigration of skilled manpower and the high rates of labor turnover. One of the apparent solutions for this problem that could be implemented is empowering Egyptian females to play an active role in the success of this sector. Females faced many obstacles while working in hospitality, including prevailing social perception, the culture of shame, the traditional negative view of feminine hoteliers, long working hours and the shift system, which led to weak females' desire to enroll in the hospitality field. The study aims to determine how empowering Egyptian women in the hospitality industry affects staff turnover.Design/methodology/approachTo achieve the aim of the study, a sample of four- and five-star resorts in Red Sea, Egypt, was under study. A self-administrated questionnaire was addressed to female hotel employees, and 140 forms were statistically analyzed in addition to 14 semi-structured interviews with hospitality experts.FindingsThe study recommends that hotels should start re-tailoring policies to activate Egyptian females' role in reducing the high rate of hospitality labor turnover through increasing their work engagement (WENG) (as a mediator) by adopting a decent work environment and motivating them to get promoted to hold senior positions.Research limitations/implicationsIn spite of some noteworthy contributions, the authors would like to point out certain shortcomings. The sample was homogeneous, consisting of female hotels employees in Egypt, but the findings are generalizable to other Arabian communities. Nonetheless, the authors feel that they have supplied some suggestive evidence, even for the most careful reader who wants to further study these elements of working attitudes in the hotel business.Originality/valueAccording to the authors' knowledge, this study is among the few studies covering females' reluctance to continue working in the hospitality field.

Comparison of effectiveness of Foley catheter versus vaginal misoprostol for cervical ripening in induction of labour in Gedeo zone public hospitals, Ethiopia, 2022. Quasi-experimental design

BackgroundThis study aims to evaluate the effectiveness of two methods commonly used to induce labor in women with an unfavorable cervix, which is Misoprostol and trans-cervical Foley catheterization. MethodA total of 120 pregnant women who met the inclusion criteria and were scheduled for induction were recruited for this study. Group 1 comprised 60 women who received the Foley catheter, and Group 2 comprised 60 women who received Misoprostol. The data analysis was done using SPSS version 25, and the student’s independent t-test and chi-square analysis were used to compare the means and proportions of continuous and categorical variables, respectively. The level of statistical significance was set at P < 0.05. ResultsThe results showed that 41 (68.3 %) participants in the Foley catheter group and 49 (81.7 %) participants in the Misoprostol group had a favorable cervix within 24 h. The mean time interval from the start of ripening to a favorable cervix was shorter in the Misoprostol group (10.27 + 2.506) than in the Foley catheter group (11.78 + 2.151). The successful outcome of the induction was 33 (80.5 %) in the Foley catheter group and 35 (71.4 %) in the Misoprostol group.Conclusion and recommendation: misoprostol was a more effective method of cervical ripening than the Foley catheter, resulting in a higher rate of favorable cervix in a shorter time frame. Further research is recommended with different study designs and larger sample sizes.

Knowledge, attitude and practice of healthcare providers on mistreatment of women during labour and childbirth: A cross-sectional study in Tehran, Iran, 2021.

Mistreatment of women during childbirth is a global health challenge. Maternity healthcare providers play a key role in influencing women's birth experience. This study aimed to assess the knowledge, attitudes, and practices of healthcare providers regarding mistreatment of women during labour and childbirth in public hospitals in Tehran, Iran. This cross-sectional study was part of an implementation research project that was conducted from October to December 2021 at five public teaching hospitals in Tehran. All eligible maternity healthcare providers (obstetricians and midwives) and students were invited to participate in this study. Data were collected using a questionnaire consisting of four sections: socio-demographic characteristics (11 items), knowledge (11 items), attitudes (13 items), and practices (14 items) about mistreatment. Knowledge, attitude, and practice scores were determined using Bloom's cut-off points. Logistic regression analyses were used to identify the socio-demographic characteristics associated with knowledge and attitudes. A p-value of <0.05 was considered statistically significant. Of the 270 participants, 255 (94.5%) participated in the study. Majority of the participants (82.7%) had poor knowledge regarding mistreatment of women during labour and childbirth. Poor knowledge was more apparent in the categories of physical abuse, verbal abuse, poor rapport between women and providers, and failure to meet professional standards of care. Most participants (69.4%) had poor attitudes towards mistreatment; they were alright with physical abuse, verbal abuse, and discrimination. Only 3.1% of the participants reported moderate mistreatment practices towards birthing women. Verbal and physical abuse were the most prevalent categories used by the participants. The number of night shifts was associated with attitudes regarding mistreatment (AOR = 0.45, 95% CI = 0.22-0.89, p = 0.02). The knowledge and attitude of our participants regarding maternity mistreatment were poor. A small percentage of the participants reported mistreatment practices. The findings of our study have important implications for program planners and decision-makers in developing effective interventions to reduce mistreatment of women during labour and childbirth in Iran.

'Bringing forth' skills and knowledge of newly qualified midwives in free-standing birth centres: A hermeneutic phenomenological study.

To understand and interpret the lived experience of newly qualified midwives (NQMs) as they acquire skills to work in free-standing birth centres (FSBCs), as well as the lived experience of experienced midwives in FSBCs in Germany who work with NQMs. In many high-, middle- and low-income countries, the scope of practice of midwives includes autonomous care of labouring women in all settings, including hospitals, home and FSBCs. There has been to date no research detailing the skills acquired when midwives who have trained in hospitals offer care in out-of-hospital settings. This study was underpinned by hermeneutic phenomenology. Fifteen NQMs in their orientation period in a FSBC were interviewed three times in their first year. In addition to this, focus groups were conducted in 13 FSBCs. Data were collected between 2021 and 2023. Using Heidegger's theory of technology as the philosophical underpinning, the results illustrate that the NQMs were facilitated to bring forth competencies to interpret women's unique variations of physiological labour, comprehending when they could enact intervention-free care, when the women necessitated a gentle intervention, and when acceleration of labour or transfer to hospital was necessary. NQMs learned to effectively integrate medical knowledge with midwifery skills and knowledge, creating a bridge between the medical and midwifery approaches to care. This paper showed the positive effects that an orientation and familiarization period with an experienced team of midwives have on the skill development of novice practitioners in FSBCs. The findings of this study will have an impact on training and orientation for nurse-midwives and direct-entry midwives when they begin to practice in out-of-hospital settings after training and working in hospital labour wards. This research study has four cooperating partners: MotherHood, Network of Birth Centres, the Association for Quality at Out-of-Hospital Birth and the German Association of Midwifery Science. The cooperating partners met six times in a period of 2 ½ years to hear reports on the preliminary research findings and discuss these from the point of view of each organization. In addition, at each meeting, three midwives from various FSBCs were present to discuss the results and implications. The cooperating partners also helped disseminate study information that facilitated recruitment.

The difference that the institutional environment makes: Leveraging coordination to balance platform dominance, mutuality and autonomy in geographically fragmented hospitality labour markets

It has been argued that digital platform firms leverage their position at spatial bottlenecks in such a fashion so as to allow operations in local labour markets while at the same time insulating themselves from the regulatory provisions that govern those local markets. This is not necessarily a stable condition, but as long as platform firms exert power, they may shift the social relationships that platforms embody in their favour: domination trumps mutuality and autonomy. However, this does not have to be so. Depending on the context, opportunities for breaking out of this mould exist. Specifically, we focus on the institutional context provided by coordinated market economies to argue that, depending on pre-existing forms of cooperation, platforms can be designed and applied in a manner that enables the building and maintenance of trust through an emphasis on mutuality and autonomy rather than inevitably drifting towards the pole of domination. Using the example of the hospitality industry and focusing on training and certification in geographically fragmented labour markets, we set out to explore the possible role of the institutional setting in shaping platform use as recruitment needs are to be resolved.

A Study on the Behavior Intentional for Healthcare Consumers in Mobile Registration System

In seeking medical care, registration is a necessary procedure, and many hospitals provide a mobile app service for appointment scheduling. Encouraging the patients or people to utilize this app can reduce patient waiting times for appointments, enhance hospital service quality, and decrease hospital labor costs. This study primarily aims to explore the influencing factors of user acceptance of hospital mobile registration system. Objective: The aim of this study is to investigate the relationships among the behavior intention to use, perceived usefulness, perceived ease of use, information quality, system quality, and service quality of mobile registration system within a population who have previously utilized such apps in healthcare settings. Methods: This study employs meta-analysis combined with structural equation modeling using Python software to explore the relationships and model validation between the behavior intention to use, perceived usefulness, perceived ease of use, information quality, system quality, and service quality of mobile registration system among healthcare-seeking individuals. The study focuses on a total of 4 dissertations obtained from the Taiwan Electronic Theses and Dissertations System. Results: The study findings suggest that the primary reasons patients seek appointments through the hospital’s mobile registration system include perceived usefulness (Path Coefficients=1.154, p-value&lt;0.001) and perceived ease of use (Path Coefficients=0.217, p-value=0.037). Perceived usefulness is influenced by perceived ease of use (Path Coefficients=0.792, p-value&lt;0.001) and information quality (Path Coefficients=0.161, p-value=0.035), whereas perceived ease of use is influenced by system quality (Path Coefficients=0.602, p-value&lt;0.001).

The future of tourism and hospitality labour: challenges, requirements, trends, skills and the impact of technology

ABSTRACT This study was designed to fill two main research gaps: the need for a multidimensional perspective on the future of tourism and hospitality (T&H) labour and the lack of studies from the perspectives of key stakeholders who are representatives of tourism organisations and involved in policymaking. Therefore, it unveils the perceptions of policymakers responsible for tourism organisations in Portugal towards the future of T&H labour. Following an exploratory qualitative case study approach based on semi-structured interviews with eleven policymakers, the results illustrate that the most prominent challenges that the COVID-19 pandemic created are the damage to practical ability, finding a skilled and experienced workforce, and attracting tourism labour back to the sector. However, there are some requirements to overcome such challenges in the future. Moreover, future trends and skills for T&H employment were revealed as new working models, digitisation and robotisation, and the expected skills such as management, analytical, digital marketing, and customer behaviour analysis. Finally, technology was found to have positive and negative impacts on T&H employment. The results and implications will benefit Portugal and different destinations in understanding the dimensions of T&H labour for the future and developing future actions, strategies and policies.

Novel multidisciplinary cooperation model for obstetric medical quality control: A quasi-experimental study.

To explore the impact of a novel multidisciplinary cooperation model in obstetric medical quality control. This quasi-experimental study analyzed the quality indicators of full-term pregnant women who underwent vaginal trial labor in Zibo Maternal and Child Health Hospital between July 2021 and June 2022. The pregnant women were divided into two groups based on implementation of novel multidisciplinary cooperation: multidisciplinary and non-multidisciplinary. We compared the rate of labor analgesia, postpartum hemorrhage in vaginal delivery, transfer to cesarean section, and the 5-min Apgar score ≤7 in full-term neonates. A total of 3751 pregnant women were enrolled into the study, of whom 2004 were included in the non-multidisciplinary group and 1747 in the multidisciplinary group. The analgesic rate of delivery of the multidisciplinary group was higher than that of the non-multidisciplinary group (P = 0.000). We established that the rate of postpartum bleeding (P = 0.040), transfer cesarean section (P = 0.003) and the incidence of Apgar score ≤7 in 5 min of full-term neonates (P = 0.038) of the multidisciplinary group was lower than that of the non-multidisciplinary group. There was no significant difference in the mean ages (29.40 ± 3.99 vs. 29.90 ± 4.27 years; P = 0.126), mean delivery gestational ages (39.65 ± 0.87 vs. 39.64 ± 1.06; P = 0.221), mean gravidity values (1.93 ± 1.09 vs. 2.00 ± 1.18; P = 0.586) and mean parity (1.40 ± 0.56 vs. 1.42 ± 0.59; P = 0.635) of the women in the two groups. Multidisciplinary cooperation in delivery management can significantly improve some quality indicators. We established the analgesic rate of delivery can be increased and the rate of postpartum bleeding, transfer cesarean section and the incidence of Apgar score ≤7 in 5 min of full-term neonates can be decreased with the implementation of novel multidisciplinary cooperation.

Prevalence of Neglect and Abuse During Labor and Delivery in a Tertiary Hospital

BACKGROUND:Childbirth is a significant event with a great impact on maternal physical and psychological health. Childbirth abuse has been reported in different countries with variable rates. This study aims to determine the prevalence of childbirth abuse during labor in a governmental hospital in Egypt.METHODS:This cross-sectional study was conducted from March 2020 to December 2021. We recruited 190 women. Patients were asked to fill in the Arabic-validated childbirth verbal abuse and neglect questionnaire immediately after delivery. The questionnaire consisted of four parts enquiring about personal data and childbirth history, the occurrence of physical violence, and other elements of satisfaction.RESULTS:Fifty (26.3%) patients were neglected during childbirth. Verbal abuse was reported by 25.8%. Two women (1.1%) were slapped (physical abuse) during childbirth. Women reported being satisfied and strongly satisfied at 57.9% and 37.9%, respectively. Multiparity (p-value .02), patient ignorance about the childbirth process (p-value .004), their rights (p-value .0001), and lack of participation in decision-making (p-value .0001) were associated with exposure to neglect. Verbal abuse was associated with the delivery time in addition (p-value .004).CONCLUSION:Neglect and abuse occurred significantly at the current facility.

The Effect of Natural Disasters on Hotel Demand, Supply and Labour Markets: Evidence from the La Palma Volcano Eruption

Natural disasters are an important deterrent factor for tourism activities from both supply and demand perspectives. This paper studies the short-term effect of a volcano eruption on hotel demand, supply and hospitality labour in La Palma (Spain), an island economy that is highly dependent on the tourism sector. Based on a monthly panel dataset, we employ seemingly unrelated difference-in-differences (SUR-DiD) to identify the distinct responses of these three outcomes both during and post eruption. We are particularly interested in examining the asymmetry in their elasticities to the shock, which serve as indicators of disaster resilience. Potential spillover effects on nearby islands are also examined. We find that the eruption resulted in significant yet asymmetrical drops in international demand, number of hotels opened, and hospitality workers hired. Our findings inform about the resilience of the tourism industry to natural disasters, offering relevant insights about heterogeneous effects depending on exposure to the event.

Gossypiboma – “string of pearls” sign may be diagnostic: A case report

Gossypiboma is a retained non-absorbable material composed of the common cotton matrix. It is an unexpected surgeon’s “never event” with serious medicolegal implications. We present a case of a young woman who came to our facility 6 days after an emergency cesarean section for prolonged labor in a private hospital with features in keeping with post-operative peritonitis. Pre-operative abdominal radiographs revealed bowel loops that were majorly gasless, except for a row of small round pockets of gas running horizontally across the right hemi-abdomen, giving the “string-of-pearls” sign. She was optimized for an emergency laparotomy. The intraoperative finding was a retained sponge walled off by loops of the dilated small bowel. Within this cavity was found 400 mL of pus. The sponge was removed with ease and the pus was drained with a good post-operative outcome. The finding of a gasless abdomen on a plain radiograph is a thing of concern as small bowel obstruction with or without bowel ischemia is the most feared cause of a gasless abdomen which can be life threatening. Therefore, a gossypiboma should always be considered in a post-surgical patient with abdominal radiographic findings of a gasless abdomen; in particular, with the “string-of-pearls” appearance present. This case highlights that retention of foreign bodies after surgery is a persisting “never event” and as such there is the need to comply with current recommendations on the prevention of retained foreign bodies. The most important approach to reducing the incidence of gossypiboma is prevention. Thus, awareness of this problem is mandatory to avoid unnecessary morbidities.

Clinical benefit of MKANDA SALAMA KIT in a real-world population with Postpartum Hemorrhage. A prospective observational study

Based on Tanzania administrative data and policy Implication report of 2018, revealed that Postpartum hemorrhage contributed to about 29% of all maternal deaths in Tanzania. MKANDA SALAMA KIT (MSK) is the new innovated technological device designed to stop Postpartum hemorrhage (PPH). To determine the effects of MSK on the clinical symptoms improvement, hemodynamic restoration, and bleeding stoppage in post- delivery mothers with PPH. The primary outcome was the composite of Postpartum hemorrhage maternal death and PPH rehospitalization within 42 days follow-up time; secondary outcomes were all causes of maternal death and the occurrence of rehospitalization for worsening PPH -data from 120 women with PPH aged from 13 to 39 years from December 2020 to May 2021 (6 months) at St. Francis referral hospital labor ward were included. Patients were grouped into mild PPH, moderate PPH, and severe PPH. A multinomial regression model was used to determine the associations between risk and outcomes using Statistical Package for Social Sciences software version 21.0". 23% had a previous history of PPH, 36% had maternal hypertension, 45% had anemia, and 12% had maternal diabetes. Mild PPH was 20%, moderate PPH was 37%, and severe PPH was 43%. MSK significantly improved clinical symptoms and signs of all PPH categories by 84%. A significant restoration to normal all hemodynamic parameters was observed to all patients by 79% MSK significantly stopped mild PPH by 100% within 10-20 minutes, while stopped moderate PPH by 70.3% within 10-20 minutes and stopped severe PPH by 63.5% within 10-20 minutes. There was no rehospitalization during follow-up time and no death was reported. MSK significantly improved clinical symptoms, hemodynamic parameters and stopped bleeding in PPH patients, timely application of MSK can significantly prevent PPH maternal death and PPH rehospitalization.

Use of Induction of Labor and Emergency Cesarean Section and Perinatal Outcomes in English Maternity Services: A National Hospital-level Study

(BJOG. 2022;129:1899–906) Maternity services vary widely worldwide. A recent independent review of the National Health Service (NHS) in England looked at what may have been avoidable harm during births between 2000 and 2019. The review found that cesarean delivery (CD) rates were discouraged and intentionally kept low. In response, this study aimed to determine if there was an association between induction of labor and emergency CD in English hospitals and an increased risk of stillbirth, use of neonatal mechanical ventilation in babies born at term, and admission to a neonatal intensive care unit (ICU).

Efficacy of Intravaginal Administration of Isosorbide Dinitrate Together with Misoprostol versus Misoprostol Alone in Induction of Labor

Background Cervical ripening is a complex process involving extensive remodeling and dynamic anatomic and physiologic alternations governed by hormonal changes, inflammatory responses, vasodilatory changes, and other biological processes. Prostaglandins, produced both locally in the cervix and uterus as well as originating from the fetal membranes, play a critical role in cervical ripening and uterine contractility by increasing inflammatory mediators in the cervix and inducing cervical remodeling. Objective To assess the adjunctive Role of intravaginal administration of Isosorbide dinitrate in induction of labor. Patients and Methods This randomized controlled clinical trial was conducted at tertiary care hospital at Ain Shams University Maternity hospital (labor ward) and was randomly selected from full term patients attending the labor ward and scheduled for induction of labor. Results Our results revealed that the need to cesarean section was statistically significantly less frequent among Isosorbide dinitrate group. Our results revealed that the duration of induction to active phase interval and the duration of active stage of labor were significantly shorter among Isosorbide dinitrate group than among Control group. Conclusion As evident from the current study, both intravaginal misoprostol and combination of vaginal Isosorbide dinitrate and misoprostol are safe and effective modes of labor induction. Vaginal isosorbide dinitrate and misoprostol is more effective than misoprostol alone in terms of post induction Bishop Score, shorter induction to active phase interval and induction to delivery interval. Thus, the combined use of vaginal isosorbide dinitrate with misoprostol for preinduction cervical ripening at term may prove to be a major therapeutic advance.

RESPECTFUL MATERNITY CARE AND THEIR POSTPARTUM EFFECTS IN WOMEN

Aim:To recognise the benefits of Respectful Maternity Care during labor and encouraging the practice of the same. Design: Cross Sectional Study Methodology : Sample Size : 100 patients Inclusion Criteria :Antenatal patients in Active Phase of Labor proceeding for Normal Vaginal Delivery Procedure : The study is a questionnaire based study. The study population will be antenatal patients admitted in a Tertiary Care Hospital. After getting informed consent , the procedure will be explained thoroughly to the participants and only the participants who are willing to take part in the study will be selected. The participants were observed in the labor ward and the post natal ward during their stay in the hospital .They were asked to answer a questionnaire postnatally . The questionnaire contains questions related to the WHO recommendations of the Respectful Maternity Care which includes topics like dignity, privacy and confidentiality, ensuring freedom from harm and mistreatment, and enabling informed choice and continuous support during labour and childbirth. This study is complelety a non invasive study. Study Duration: 4 Months Results: The study population included 100 participants admitted for labor in a tertiary care hospital where they received proper Respectful Maternity Care both antenatally and Postnatally. It was observed that women who were treated with proper RMC had more bonding with their babies and were able to breastfeed more effectively. The participants did not have common complaints of post partum depression, hesitancy to breastfeed, insomnia, lack hesitancy to Breast feed and reduced incidence of Traumatic Deliveries. Conclusion: Providing Respectful Maternity Care to antenatal patients has more positive outcomes in both antenatal and postnatal periods of a patient. It reduces common post partum ailments and promotes maternal and neonatal well being by reducing maternal and neonatal morbidity and mortality rate.

Factors Associated with Postpartum Care during the Fourth Stage of Labor in Nepal: A Hospital-based Cross-sectional Study

Postnatal care is an important part of maternal and neonatal care, and life-threatening complications can occur during the postpartum period. Empirical information on the level of postpartum care services is generally scarce in Nepal. Key elements of postpartum care during the fourth stage of labor include providing proper nutrition, promoting breastfeeding, and helping the mother manage any physical discomforts or challenges that may arise. This study investigated the level of postpartum care services delivered during the fourth stage of labor in a tertiary-level hospital in the Chitwan district of Nepal. A descriptive cross-sectional hospital-based study was conducted among 148 women admitted for vaginal delivery. A set of structured observation checklists was developed and finalized based on the WHO Recommended Interventions for Improving Maternal and Newborn Health: Integrated Management of Pregnancy and Childbirth. The structured observation checklist had twenty-two items, including twelve critical steps. A good level of care was valid with a score of ≥ 90% based on total items, including all twelve critical steps of care, and a poor level of care was valid with a score &lt;90%. The purpose of the study was explained to and written informed consent was obtained from all respondents. Ethical approval was received from the Institutional Review Committee of Chitwan Medical College. One third (33.8%) of the women received a good level of postpartum care services. Women’s residence (&lt;em&gt;p&lt;/em&gt; = .021), number of pregnancies (&lt;em&gt;p&lt;/em&gt; =.002), and number of antenatal visits (&lt;em&gt;p&lt;/em&gt; =.029) were significantly associated with the level of postpartum care during the fourth stage of labor. Going forward, it will be important for Nepal to enhance the capacity of clinicians or nurses to provide postpartum care as per WHO guidelines.

The prevalence and associated factors of success of labor induction in Hargeisa maternity hospitals, Hargeisa Somaliland 2022: a hospital-based cross-sectional study

BackgroundThe induction of labor is an artificial initiation of labor and has become one of the most common interventions in modern obstetrics to improve maternal and neonatal health. Understanding the prevalence and pregnancy outcomes following labor inductions is crucial in regions with high rates of maternal mortality and morbidity because of insufficient access to comprehensive emergency obstetric care. Therefore, this study aimed to assess the prevalence and associated factors of the success of induction of labor in Hargeisa maternity hospital Somaliland.MethodsA hospital-based cross-sectional study was employed among 453 women in Hargeisa maternity hospitals, Somaliland from January 1st to March 30th, 2022. Data were entered using Epi data version 4.6 and analyzed by using SPSS version 25. Bivariable and multivariable logistic regression were used to identify the associated factors with the success of labor induction and an odds ratio with a 95% confidence interval was used to measure the strength of the association. A P-value of ≤ 0.05 was considered statistically significant in multivariate analysis.ResultsOf a total of 453 study participants who had undergone induction of labor, 349 (77%) of them had successful induction of labor with a 95% CI: 73%, 81%. Favorable Bishop score (AOR = 3.45, 95% CI: 1.98, 5.99), time from the start of induction to delivery < 12 h (AOR = 4.01, 95% CI: 2.16, 7.450), non-reassuring fetal heart rate pattern (AOR = 0.42, 95% CI: 0.22, 0.78) and amniotic fluid change to meconium (AOR = 0.43, 95% CI: 0.23, 0.79) were significantly associated with the success of labor induction.ConclusionThis study implies that three out of four women who underwent induction had successful induction of labor. Favorable bishop score, time from the start of induction to delivery < 12 h, non-reassuring fetal heart rate pattern, and amniotic fluid change to meconium were significantly associated with the success of labor induction. The hospital should establish a clear bishop scoring system and there should be a strict follow-up on the condition of the fetal heartbeat and take corrective actions as needed. The factors related to healthcare facilities and providers need to be addressed by additional prospective studies.

Platelet counts affect the association between hyperhomocysteinemia and pregnancy complications

BackgroundThe joint effect of platelet and other modifiers on the risk of pregnancy complications is unknown. This study investigated whether platelet count (PC) and total homocysteine (tHcy) level have a synergistic effect on the incidence of pregnancy complications in a Chinese population.MethodsTotal 11,553 consecutive pregnant women who received whole blood cell and biochemical tests at the time of admission for labor in Changzhou Maternal and Child Health Care Hospital were analyzed. The primary outcome was the prevalence of pregnancy complications: gestational diabetes mellitus (GDM), intrahepatic cholestasis of pregnancy (ICP), pre-eclampsia (PE), and pregnancy induced hypertension (PIH).ResultsThe prevalence of GDM, ICP, PE, and PIH was 8.4%, 6.2%, 3.4%, and 2.1%, respectively. The highest rate of ICP (28.6%) was observed in women with high tHcy (> 15 μmol/L) and low PC (quartile 1); and the lowest rate of GDM (0.6%) was found in women with high tHcy and high PC (quartiles 2 to 4). In low PC group, the prevalence of ICP in women with high tHcy was significantly higher than that in women with low tHcy (≤ 15 μmol/L) (28.6% vs. 8.4%), representing an absolute risk increment of 20.2% and a relative risk increment of 3.3-fold (OR: 3.34; 95% CI: 1.55, 7.17; P = 0.002), whereas no joint effect was observed among high PC group.ConclusionsAmong Chinese pregnant women, one subgroup (high tHcy and low PC) has the highest risk of ICP and another (high tHcy and high PC) has the lowest risk of GDM; tHcy and platelet could be used as indicators to identify the women with high risk of ICP or low risk of GDM.