Maternity Ward Of Hospital Research Articles

The COVID-19 Pandemic and Levels of Physical Activity in the Last Trimester, Life Satisfaction and Perceived Stress in Late Pregnancy and in the Early Puerperium.

Background: The aim of this study was to determine the impact of the COVID-19 pandemic on the levels of physical activity during the third trimester of pregnancy, life satisfaction and stress in women in late pregnancy and early postpartum. Methods: The study was conducted among 740 patients of maternity wards in Cracow hospitals on days 1–8 postpartum. Patients who were surveyed before the pandemic (December 2019–March 2020) were included in the prepandemic group (PPan: n = 252). The second group of women (COVID 1 group, Cov1: n = 262) was examined in the early stages of the pandemic (May–September 2020). In turn, participants who were surveyed during the population vaccination campaign (June–September 2021) were qualified to the COVID 2 group (Cov2: n = 226). The research tools used were the original questionnaire in addition to standardized questionnaires assessing physical activity in the last trimester of pregnancy (the Pregnancy Physical Activity Questionnaire); previous life satisfaction (the Satisfaction with Life Scale); and stress levels during the last month (the Perceived Stress Scale). Results: During the pandemic, women reduced the level of energy spent on total physical activity; nevertheless, statistically significant differences were found only between the PPan and Cov2 groups (p = 0.001). At the early stages of the pandemic, patients significantly reduced mobility activities (Cov1 vs. PPan: p < 0.001; Cov1 vs. Cov2: p = 0.007), while late in the pandemic they spent less energy on household activities (Cov2 vs. PPan: p = 0.002, Cov2 vs. Cov1: p = 0.002). There were no differences in the levels of stress and life satisfaction. Conclusions: The COVID-19 pandemic impacted the level of physical activity; however, it did not change levels of perceived stress and life satisfaction in women in late-stage pregnancy and in the early puerperium.

Maternal Childhood Maltreatment History and Child Behavior Problems: Developmental Patterns and Mediation via Maternal Depressive Symptoms and Parenting Behavior.

Maternal exposure to childhood maltreatment (CM) is associated with offspring behavioral problems; however, little work has examined these associations longitudinally across child development. This study examined the effects of maternal history of CM on trajectories of child internalizing and externalizing behavior measured from toddlerhood to preschool, and the role of maternal depressive symptoms and parenting behavior as potential mediators. Participants included 115 mother-child dyads recruited from a hospital maternity ward. Maternal CM was measured at 3-months postpartum. At 18, 36, and 60months, maternal depressive symptoms and child behavior were assessed via maternal report and parenting behavior was assessed through direct observation. Findings indicated that children of mothers exposed to CM demonstrated poorer trajectories of problem behavior across early childhood. Maternal depressive symptoms mediated the relation between CM and children's internalizing problems. Findings highlight the importance of screening for maternal depressive symptoms and early intervention for maternal and child mental health.

Prevalence and Determinants of Pregnancy Outcomes among Mothers with Hypertensive Disorders at Woliso Saint Luke Hospital, Southwest Ethiopia

Objective: The study aimed to determine the prevalence of hypertensive disorders of pregnancy and determinants of its maternal and neonatal outcomes among pregnant mothers admitted to maternity wards of Woliso Saint Luke hospital, Ethiopia. Materials and Methods: Retrospective, institution-based cross-sectional study was conducted by reviewing records of pregnant mothers admitted to the maternity ward of the hospital between January 01, 2018, and December 31, 2020. The data were extracted using a structured checklist and analyzed using SPSS v. 24. Descriptive statistics of findings, univariate and multivariate logistic regression analysis were performed to identify the independent effect of predictor variables on the maternal and perinatal clinical outcomes. Results: During a three-year period, 15,097 pregnant mothers were admitted to the hospital's maternity ward. The prevalence of hypertensive disorders of pregnancy was 197(1.3%); more than half 121(61%) attributed to preeclampsia. From the total cases 37(18.8%) of mothers encountered adverse pregnancy outcomes of which 5(2.5%) of them died of its complications. Over half (51.8%) of neonates encountered adverse pregnancy outcomes; 17(20%) were born extremely LBW and 32(16.2%) died. Mothers who had blood pressure level of ˂ 160/110 mmHg during admission were 63% less likely to have adverse maternal outcomes compared to higher levels (AOR = 0.37, 95% CI = 0.14-0.94). The earlier gestational age at admission for hypertensive disorder associated to higher odd of adverse pregnancy outcome of neonates (AOR = 18.272, 95% CI = 6.330-52.742). Conclusion: The magnitude of hypertensive disorders of pregnancy showed significant rate. Besides, the complications or adverse pregnancy outcomes were higher compared to other previous studies. Earlier diagnosis during gestation, prompt management of complications and effective antenatal care are crucial in minimizing adverse outcomes for both mothers and newborns. Provision of focused and better quality care for high-risk mothers from pregnancy to post-partum period is highly recommended.

Secondary traumatic stress in iranian midwives: stimuli factors, outcomes and risk management

BackgroundThe present qualitative study was conducted to explain the experiences of secondary traumatic stress (STS) and its related factors in midwives working in maternity wards.MethodsData were collected using semi-structured interviews with 11 midwives working in the maternity wards of hospitals in Urmia, Iran, through in-depth interviews with open-ended questions. Data were analyzed using the conventional content analysis approach.ResultsThe results of data analysis led to the extraction of three themes, seven main categories, and 18 subcategories. The first theme was “STS stimuli,” with the two categories of “Discriminatory approach to midwifery” and “The nature of the midwifery profession”. The second theme was “Traumatic outcomes”, which included the subcategories of “Psychological-emotional trauma”, “Physical trauma” and “Social trauma”. The third theme was “Risk management”, which had the two subcategories of “Reactive approach” and “Proactive approach”.Conclusions The results showed that, in addition to the traumatic nature of events that midwives experience during work as the secondhand victims, factors such as governance-organizational structure, unbalanced distribution of power, and poor supportive laws undermine their professional role and provide conditions conducive to STS. Therefore, avoiding traumatic situations and scientific and skill self-empowerment were the most important strategies adopted by the midwives in this study to prevent risky situations and cope with the consequences of STS. The participation of midwifery stakeholders in policy-making and adopting supportive legislation in redefining the position and role of midwives can play a major role in reducing STS and sustaining their role and position in maternal care.

Cuidado respeitoso às parturientes em maternidades hospitalares: um protocolo de revisão de escopo

The aim is to map the evidence on respectful care for parturients in hospital maternity wards. The scope review will be conducted according to the methodology proposed by the Joanna Briggs Institute. As inclusion criteria: articles involving women who gave birth in hospital maternity wards; discuss respectful care for pregnant women or use terms equivalent to respectful, such as humanized, appropriate, welcoming or sensitive; care performed in an obstetric center, normal intrahospital delivery center or delivery rooms. The search strategy, elaborated in a preliminary search, will use the following databases: PubMed, CINAHL, LILACS, APA PsyArticles, Web of Science Core Collection, Scopus, BASE, EMBASE, BDENF, Cochrane Library and other specific gray literature. Reference lists of retrieved articles will be screened to include them in the study sample. Qualitative, quantitative studies, reviews, opinion articles, editorials will be included in the review. The selection of studies will be carried out by two independent reviewers using Zotero and Rayyan software, while a third will resolve differences between them. For extraction, analysis of evidence and synthesis of knowledge MaxQda software will be used. In the final scope review there will be a description of the research results and the process of including articles in the study.

THE MATERNITY WARD AT THE REBRO HOSPITAL FROM 1942 TO 1946

The maternity ward at the Rebro Hospital in Zagreb was established in the newly opened new hospital on 12 May 1942. It operated discontinuously at the gynaecology and obstetrics department during three periods between 1942 and 1946, when it was closed. It was located on the second floor of the eastern part of the hospital with 24 beds. During the activity of the maternity ward from 13 May 1942 to 16 December 1942, 24 May 1944 to 28 August 1945, and from 6 February 1946 to 28 July 1946, there were 1,337 births. They were registered as live births, stillbirths and aborted children weighing 450 grams or more, so perinatal mortality was therefore significantly higher (38.89 ‰) because, in addition to physiological, a significant number of pathological births were performed in the hospital. The head of the newly established ward was Assoc. prim. Dr Filip Dražančić, who worked alongsideward doctors and midwives. Most of the women who gave birth were from Zagreb, with a smaller number of women from other parts of Croatia, primary housewives aged 20-30. In the mentioned period, three mothers died. All obstetric procedures, episiotomies, caesarean section, assistance during breech delivery, rotating of a baby, forceps, and treatment of perineallacerations were performed under local infiltration, spinal (lumbar) or general inhalation anaesthesia using ether. Along with a significant number of home midwifery deliveries and the already established hospital maternity wards in the Petrova and Merkur sanatoriums, the maternity ward at the Rebro hospital, until now only sporadically mentioned as an institution, had an important place in the development of hospital obstetrics in Zagreb and Croatia.

Effect of the Covid-19 Pandemic on Prenatal Consultations for Pathological Pregnancies at the Maternity Unit of Abass Ndao Hospital, Dakar, Senegal

Introduction: The COVID-19 pandemic has led to changes in health systems. The objective was to assess the effect of Covid-19 on the frequency of prenatal consultations (PNCs) for pathological pregnancies at the Abass NDAO Hospital Centre. Materials and Methods: This was primarily a retrospective study conducted at the Abass NDAO Hospital maternity ward. The target was the medical records of women followed for a pathological pregnancy at maternity from July 2019 to November 2020. Second, the department’s qualified staffs were asked about their experiences with the Covid-19 pandemic. Data collection was carried out between October 2021 and February 2022. Results: A total of 690 prenatal charts for pathological pregnancy were collected: 375 (54%) before the pandemic compared to 315 during Covid-19 (46%). The average age of women was 28.15 years. The age group 25 and 35 was the most represented (36.81%). Reasons for consultation were dominated by threats of premature delivery (51%), followed by severe pre-eclampsia (14%) and premature membrane rupture (11%), respectively. The frequency of prenatal consultations (PNCs) was inversely related to pandemic dynamics and significant monthly variations were observed. Qualified health personnel were midwives (71.40%) and gynecologists (28.60%). During the pandemic, more than the majority of staff (67%) worked 3 days a week, and 24% of health workers 5 days. The majority of staff (60%) reported experiencing overwork during the pandemic. Non-compliance with consultation days was noted in 38% of health providers. Protective equipment was not provided to 14% of the staff. Staff difficulties during prenatal consultations were fear of occupational exposure (12%) and patient reluctance (88%). Conclusion: The Covid-19 pandemic is having a major impact on prenatal consultations for pathological pregnancies at Abass NDAO Hospital. Effective measures must be taken to avoid the consequences of maternal mortality and the functioning of the structure.

Pilot study of home phototherapy for neonatal jaundice monitored in maternity ward during the enforced Italy-wide COVID-19 national lockdown.

In Italy, where neonatal jaundice treatment is required, it is largely carried out in hospitals. However, it is possible to safely administer home phototherapy (HPT). We report our pilot center’s experience of HPT and its potential benefits during the COVID-19-enforced national lockdown. This is an observational study performed at the Policlinic Abano Terme, a suburban hospital that covers a large catchment area near the Euganean Hills in Northeast Italy with around 1000 deliveries per year. HPT was started after regular nursery discharge, and the mothers brought the neonates back to the hospital maternity ward each day to check infants’ bilirubin levels, weight, and general state of health, until it was deemed safe to stop. The efficacy of HPT in bilirubin reduction, hospital readmission rates, and parental satisfaction were evaluated. Thirty infants received HPT. In 4 of these infants, HPT was associated with total serum bilirubin (TSB) between 75 and 95th percentile (high-intermediate-risk zone) and in 26 infants HPT was associated with TSB > 95th percentile (high-risk zone) of the Bhutani nomogram. Among these 30 infants, 27 (90%) completed the HPT with a progressive decrease of TSB levels with 4 neonates requiring a second course and 3 infants requiring a third course of 24-h HPT. Three (10%) neonates failed HPT and were readmitted after one 24-h phototherapy course. No abnormalities of breastfeeding, body weight (defined as > 10% decrease), temperature, nor COVID infections were detected following HPT consultation in the neonatal ward. Home treatment efficacy with varying degrees of parental satisfaction occurred in all but 3 cases that involved difficulties with the equipment and inconsistent lamp manipulation practices.Conclusion: Our pilot study suggests that HPT for neonatal jaundice can be carried out effectively and with parental satisfaction as supported by daily back bilirubin monitoring in the maternity ward during the enforced COVID-19 national lockdown in Italy. What is Known:• No high-quality evidence is currently available to support or refute the practice of phototherapy in patients’ own homes.What is New:• Phototherapy can be delivered at home in a select group of infants and could be an ideal option if parents are able to return with their infants to the hospital maternity ward for daily follow-up.• It can be as effective as inpatient phototherapy and potentially helps in delivering family-centered care.

Rubella Immunity among Pregnant Women in Bangui, Central African Republic

Sero-positivity rates of the rubella virus among pregnant women vary from country to country widely throughout the world. In the Central African Republic, rubella vaccination is not included in the national immunization schedule. Thus, we propose to evaluate the immune status of pregnant women. This was an analytical retrospective study that consulted the records of pregnant women received in prenatal consultations at the Bangui Community Hospital maternity ward from January to December 2020. Socio-demographic and laboratory data (IgM, IgG) were collected from January to June 2021. Chi2 test was used. A total of 289 pregnant women were analyzed. Women with an IgM+ response accounted for 4.15%. Those with an IgG+ were 14.87%. The distribution by age group shows that patients aged 20 - 24 and those aged 25 - 29 had a rubella profile suggesting persistent infection (p = 0.010). The average age of women included was 28 (±6) years. The average parity for the entire sample was 2.18 (1.93). At any age pregnant women were not significantly exposed to rubella infection (p = 0.96), (ORbrut = 1.03; CI95% = [0.32 - 3.34]). Both immunized and non-immunized individuals are similarly exposed [OR = 0.86; 95% IC95% = 0.44 - 1.68] with no difference (p = 0.96). Rubella infection remains particularly severe when it occurs during pregnancy. It would be wise to seek immunity in all girls of childbearing age in order to rule out any risk of rubella embryopathy.

Study of the association of the nutritional profile of pregnant women with the birth weight of newborns in Morocco.

Low birth weight (LBW) is an important predictor of neonatal morbidity and mortality. It reflects the nutritional status of the mother and the quality of health care services during pregnancy. The objective of this study is to determine the factors associated with low birth weight of children born to Moroccan pregnant women in the province of El Jadida. This cross-sectional case-control study was carried out in the maternity ward of El Jadida provincial hospital on 344 parturient women, half of whom had given birth to children with an LBW and the other half of children with normal weight (NW) at birth. Information on maternal gestational and socioeconomic characteristics as well as eating habits was collected using a questionnaire and anthropometric measurements were taken on the newborns. The study identified 172 parturient who gave birth to newborns with LBW and 172 parturient who gave birth to newborns of NW. The proportions of LBW are greater in first-time mothers (50.6%) and professionally inactive (86.6%). The mean weight of LBW newborns is 2013.95 ± 372.95g compared to 3380 ± 217.59g for NW newborns. The determined factors associated with LBW are the low socio-economic level (OR = 3.18; 95% CI: 1.09-9.23), insufficient monitoring of prenatal consultation (OR = 2.91; 95% CI: 1, 71-4.95), origin from rural areas (OR = 0.52; 95% CI: 0.30-0.91) and lack of nutritional education (OR = 0.17; 95% CI: 0, 09-0.34). The daily calcium intake in mothers of newborns with LBW is 33.82% of the recommended daily allowance (RDA), the daily iron requirement coverage was 50%, folates 66, 16% and zinc 87.72% of the RDA. Well-targeted and coordinated education and awareness-raising actions on early pregnancy and feeding pregnant women could have a positive impact on improving the birth rate of children with a weight deficit.

Optimal outcome factors in maternity and newborn care for inpatient (hospital maternity ward-HMW) and outpatient deliveries (outhospital maternity clinics -OMC)

Background and objectivesThe aim of the study was to use the United States Optimality Index (OI-US) to assess the feasibility of its application in making decisions for more optimal methods of delivery and for more optimal postpartum and neonatal outcomes. Numerous worldwide associations support the option of women giving birth at maternity outpatient clinics and also at home. What ought to be met is the assessments of requirements and what could be characterized as the birth potential constitute the basis for making the right decision regarding childbirth.Materials and methodsThe study is based on a prospective follow-up of pregnant women and new mothers (100 participants) who were monitored and gave birth at the hospital maternity ward (HMW) and pregnant women and new mothers (100 participants) who were monitored and gave birth at the outhospital maternity clinics (OMC). Selected patients were classified according to the criteria of low and medium-risk and each of the parameters of the OI and the total OI were compared.ResultsThe results of this study confirm the benefits of intrapartum and neonatal outcome, when delivery was carried out in an outpatient setting. The median OI of intrapartum components was significantly higher in the outpatient setting compared to the hospital maternity ward (97 range from 24 to 100 vs 91 range from 3 to 100). The median OI of neonatal components was significantly higher in the outpatient compared to the inpatient delivery. (99 range from 97 to 100 vs 96 range from 74 to 100). Certain components from the intrapartum and neonatal period highly contribute to the significantly better total OI in the outpatient conditions in relation to hospital conditions.ConclusionOutpatient care and delivery provide multiple benefits for both the mother and the newborn.

Mechanisms for racial separation and inequitable maternal care in hospital maternity wards

Few studies have examined mechanisms of racial maternal separation (RMS) of birthing mothers in hospital maternity wards (MWs), and how separation might reinforce institutional healthcare racism and discrimination, leading to inequitable maternal care (MC). In Israel, while birth mothers report mostly pleasant experiences, RMS has become a matter of public debate. Although the Ministry of Health (MoH) condemns the practice, birthing Palestinian-Arab women have sued hospitals for discrimination after being assigned to separate MW rooms from other women. We drew on critical race theory (CRT) and intersectionality to uncover mechanisms for RMS and inequitable MC in hospital MWs at three levels—policy, practice, and women's experiences. In 2019–2020 we conducted 10 in-depth interviews with hospital directors (HDs) and 8 focus groups (FGs) with 40 midwives and nurses; then, in 2020–2021, we held 26 in-depth Zoom interviews with birthing women. Our findings reveal intersecting mechanisms for RMS through which structural racism and institutional discrimination outside hospitals in the form of ethno-racial residential segregation penetrate hospitals via women's requests to maintain separation in MWs. While all HDs opposed RMS and prized quality care, they instituted insufficient mechanisms to prohibit racial separation, which helped to institutionalize the practice. Commodification of Healthcare services (HCS) accelerates RMS as hospitals compete for funds derived from birthing mothers' care. Under the guise of cultural sensitivity and indirect pressure of hospital management, nursing staff comply with requests for RMS. Nurses assigned rooms based on stereotypical categorizations of women's group membership (ethno-national, religiosity level, class). RMS targeted mostly visibly religious Muslim Palestinian-Arab women. These mothers felt MC discrimination; others normalized RMS as preference. While the MoH cannot eliminate outside-hospital structural discrimination, more efforts should be made to eradicate inside-hospital RMS, as the practice violates the principle of universality enshrined in the National Health Insurance Law.

Contribution Factors on Congenital Malformations in Neonates in Iran

Background: Congenital malformations are one of the most important and common types of anomalies in infants, and they are considered as the leading causes of disability and mortality in children. These malformations impose enormous costs on families and organizations involved in the treatment, maintenance, and education of patients. Objectives: This study aimed to investigate the risk factors affecting the incidence of congenital anomalies in infants born in Iran. Methods: In this retrospective descriptive-analytical study, we registered various information of all newborns examined and their mothers, including gender, family relationship of parents, type of delivery, types of congenital malformations, anomalies of the hands and feet, and anomalies of the nervous and reproductive systems in the maternity wards of hospitals in Iran. Data were gathered using a checklist. The relationships between different factors were assessed by chi-square test, and the factors influencing congenital malformations were investigated by logistic regression using SPSS-26 software. The significance level of all tests was 0.05. Results: According to the results, 7.5% of newborns had congenital malformations. Eclampsia and diabetes mellitus increased the risk of congenital malformations by 15 and 11%, respectively. The risk of congenital malformations in rural areas was 12% higher than in urban areas. Factors such as consanguineous marriages, history of abortion, and gender also affected the risk of congenital malformations. Conclusions: Necessary measures and plans in the field of premarital counseling, regular pre-pregnancy and post-pregnancy tests and controls, especially in rural and deprived areas, are essential and effective in reducing the incidence of congenital malformations.

Screening of the Risk Factors for Congenital Anomalies in Pregnant Women Attending Maternity and Obstetric Hospitals at Mosul City

To determine the possible risk factor leading to common congenital anomalies among fetuses and neonatal and assess possibly causes the lead to congenital anomalies A descriptive study (it was cross-sectional) was adopted to achieve the objectives of the current study for the period from October 16 to May 31, 2020. Data were collected from Nineveh Governorate. An objective sample of (120) women who gave birth to children with congenital anomalies in maternity wards was selected in this study. Data were prepared, organized, and entered a computer file; Statistical Package for the Social Science (SPSS, version 26). In a questionnaire for women in maternity wards in maternity hospitals in the city of Mosul, 120 women who gave birth to deformed children were monitored. Most of the risk factors were important in an association between congenital malformations and parental kinship, fever, and maternal nutrition. Malnutrition during pregnancy also shows an association between parental consanguinity and NTD. It was concluded from the available data that there is a significant association between congenital anomalies, parental consanguinity, maternal nutritional status, and high temperature during pregnancy. Support parents who have a deformed baby or are at risk of having a baby with a congenital problem, by doing basic checkups before and during pregnancy to make sure the pregnancy is healthy. Keywords: Risk Factor, Pregnant Woman, Congenital Anomalies.

Perceptual Access Reasoning (PAR) in Developing a Representational Theory of Mind.

An important part of children's social and cognitive development is their understanding that people are psychological beings with internal, mental states including desire, intention, perception, and belief. A full understanding of people as psychological beings requires a representational theory of mind (ToM), which is an understanding that mental states can faithfully represent reality, or misrepresent reality. For the last 35 years, researchers have relied on false‐belief tasks as the gold standard to test children's understanding that beliefs can misrepresent reality. In false‐belief tasks, children are asked to reason about the behavior of agents who have false beliefs about situations. Although a large body of evidence indicates that most children pass false‐belief tasks by the end of the preschool years, the evidence we present in this monograph suggests that most children do not understand false beliefs or, surprisingly, even true beliefs until middle childhood. We argue that young children pass false‐belief tasks without understanding false beliefs by using perceptual access reasoning (PAR). With PAR, children understand that seeing leads to knowing in the moment, but not that knowing also arises from thinking or persists as memory and belief after the situation changes. By the same token, PAR leads children to fail true‐belief tasks. PAR theory can account for performance on other traditional tests of representational ToM and related tasks, and can account for the factors that have been found to correlate with or affect both true‐ and false‐belief performance. The theory provides a new laboratory measure which we label the belief understanding scale (BUS). This scale can distinguish between a child who is operating with PAR versus a child who is understanding beliefs. This scale provides a method needed to allow the study of the development of representational ToM.In this monograph, we report the outcome of the tests that we have conducted of predictions generated by PAR theory. The findings demonstrated signature PAR limitations in reasoning about the mind during the ages when children are hypothesized to be using PAR. In Chapter II, secondary analyses of the published true‐belief literature revealed that children failed several types of true‐belief tasks.Chapters III through IX describe new empirical data collected across multiple studies between 2003 and 2014 from 580 children aged 4–7 years, as well as from a small sample of 14 adults. Participants were recruited from the Phoenix, Arizona metropolitan area. All participants were native English‐speakers. Children were recruited from university‐sponsored and community preschools and daycare centers, and from hospital maternity wards. Adults were university students who participated to partially fulfill course requirements for research participation. Sociometric data were collected only in Chapter IX, and are fully reported there.In Chapter III, minor alterations in task procedures produced wide variations in children's performance in 3‐option false‐belief tasks. In Chapter IV, we report findings which show that the developmental lag between children's understanding ignorance and understanding false belief is longer than the lag reported in previous studies. In Chapter V, children did not distinguish between agents who have false beliefs versus agents who have no beliefs. In Chapter VI, findings showed that children found it no easier to reason about true beliefs than to reason about false beliefs. In Chapter VII, when children were asked to justify their correct answers in false‐belief tasks, they did not reference agents’ false beliefs. Similarly, in Chapter VIII, when children were asked to explain agents’ actions in false‐belief tasks, they did not reference agents’ false beliefs. In Chapter IX, children who were identified as using PAR differed from children who understood beliefs along three dimensions—in levels of social development, inhibitory control, and kindergarten adjustment.Although the findings need replication and additional studies of alternative interpretations, the collection of results reported in this monograph challenges the prevailing view that representational ToM is in place by the end of the preschool years. Furthermore, the pattern of findings is consistent with the proposal that PAR is the developmental precursor of representational ToM. The current findings also raise questions about claims that infants and toddlers demonstrate ToM‐related abilities, and that representational ToM is innate.

Impact of an educational intervention on WHO surgical safety checklist and pre-operative antibiotic use at a referral hospital in southwestern Uganda.

The World Health Organization (WHO) recommends adherence to its surgical safety checklist (SSC) to optimize patient safety and reduce cesarean surgical site infection (SSI). Educational interventions combined with audit and feedback mechanisms on the checklist use by clinicians have the potential to improve adherence and clinical outcomes. Despite the increase in cesarean delivery rates, there is a paucity of data on how such interventions can improve adherence in resource-limited settings. We performed a quality improvement project to measure the impact of an educational intervention with daily audit and feedback procedures on rates of WHO SSC adherence, including pre-operative antibiotic administration and SSI at Mbarara Regional Referral Hospital maternity ward in Uganda. The study involved chart abstraction of WHO SSC and pre-operative antibiotic use during cesarean deliveries and signs of subsequent SSI in three phases. First, we conducted a retrospective review of all charts from May to June 2018 (pre-intervention phase). Second, we instituted an educational intervention on the WHO SSC and pre-operative antibiotics use, followed by a daily audit of charts and feedback to clinicians from July to August 2018 (the intervention phase). Third, we reviewed charts from September to October 2018 (the post-intervention phase). The WHO SSC adherence, pre-operative antibiotic administration and SSI rates were measured as the proportion of the total cesarean deliveries per study phase and then compared across the three phases. We reviewed 678 patients' charts (200 in the pre-intervention phase, 230 in the intervention phase and 248 in the post-intervention phase). The mean patient age was 25 years. The use of the WHO SSC was 7% in the pre-intervention phase compared to 92% in the intervention phase (P < 0.001), and 77% in the post-intervention phase (P < 0.001). Pre-intervention antibiotic receipt was 18% compared to 90% in the intervention phase (P < 0.001) and 84% in the post-intervention phase (P < 0.001). The documented SSI rate in the pre-intervention phase was 15% compared to 7% in the intervention phase (P = 0.02) and 11% in the post-intervention phase (P = 0.20). An educational intervention, daily audit and feedback to clinicians increased the use of the WHO SSC and prophylactic antibiotics for cesarean delivery-although the rates waned with time. Research to understand factors influencing the checklist use and antibiotic prophylaxis including prescriber knowledge, motivation and clinical process is required. Implementation interventions to sustain usage and impact on clinical outcomes need to be explored.

Evaluation of Post-operative Nursing Care of Psychological Support and Discharge Plan for Women Undergone Hysterectomy at Maternity Wards in Baghdad City's Teaching Hospitals

Objective: The study aims at evaluating the psychological support and discharge plan from the hospital provided by nurses for woman undergone hysterectomy. Methodology: The study uses descriptive design and non-probability (convenient) sample which is consisted of (40) nurses from (8) teaching hospitals in the City of Baghdad within the maternity wards. The study is carried out from 11 November 2020 to 27 June 2021. A observational tool is developed to evaluate the psychological support and the discharge plan after surgery. Content validity and internal consistency reliability are determined through pilot study. Data are collected through the use of the questionnaire and data are analyzed through the use of descriptive and inferential statistical data analysis approaches.Results: Findings of the study show that all of the nurses have delivered inadequate postoperative nursing care.Recommendations: The study recommends that there is necessity of implementing training programs for nursing care after hysterectomy. And increase the number of nurses in this area to treat weakness in the wards. In addition, hospital management needs to play a strong role in monitoring patient care.

Factors associated with nosocomial urinary tract infections in maternity wards of public hospitals in Lubumbashi in DR Congo

Introduction: Nosocomial urinary tract infection represents between 30 and 50% of all these nosocomial infections. It occupies the first place and constitutes the third entry point for bacteremia. The objective of our study was to identify the risk factors associated with nosocomial urinary tract infections in maternity wards of public hospitals in Lubumbashi. Method: We carried out an analytical cross-sectional study in which the population consisted of parturients who did not have a urinary tract infection on admission. The urine samples were taken and analyzed in the laboratory of the university clinics of Lubumbashi. A case of nosocomial urinary tract infection was defined according to the WHO definition. To collect this urine, the parturients did it themselves after a health education session. Two samples were taken, one at the entry and the other at the exit of the parturient from the maternity hospital. The univariate analysis used the prevalence ratio as an indicator of risk with a 95% confidence interval and the bivariate analysis included all risk factors that had a significance level p ˂ 0.05 by a regression model binary logistics. Results: Out of the total of 1240 parturients selected and who were distributed in seven maternities of public hospitals in the city of Lubumbashi. It was noted that women who gave birth at HGR Kampemba were up to ten times more likely to develop nosocomial urinary tract infection than those who did at HGR Kisanga. An association was observed between delivery with complications (p = 0.032), long length of stay (p &lt;0.001), delivery with surgical intervention (p &lt;0.001) and antibiotic therapy (p = 0.020). Conclusion: Nosocomial urinary tract infections were varied depending on the characteristics of health structures, characteristics of parturients and health care. It is necessary to improve the hospital hygiene of the personnel, the hospital environment and the materials as well as a good policy of use of the antibacterials.

The practice of hand hygiene in the maternities of the public hospitals of Lubumbashi

Introduction: The objective of this study was to evaluate the practice of hand hygiene in the maternities of the public hospitals of Lubumbashi. Method and techniques: We carried out a cross-sectional descriptive study in which the population consisted on the one hand of the technical rooms of the maternity hospitals and the operating rooms for cesarean sections and on the other hand the nurses responsible for these maternities. The observation technique using an observation guide of the WHO model allowed us to collect the data. Results: Hand hygiene was not properly carried out in the maternity wards of Lubumbashi's public hospitals. Most of the prerequisites before hand washing and hydro-alcoholic hand rubbing were not respected, the prerequisites for surgical hand washing were observed only at 21.4%:e wearing of short-sleeved clothing (43.0%),absence of jewelry (78.6%), short nails without varnish and false nails (50.0%). In the absence of hydroalcoholic solution (SHA) (71.4%) for the friction, they used denatured alcohol (28.6%). The duration of soaping and friction was in an interval between 11 to 20 seconds or 42.9% and that of hygienic hand washing was observed at 28.6%. The duration of surgical and antiseptic hand washing was 21 to 40 seconds to 35.7%. Only 21.4% of the departments surveyed had used the broad-spectrum antiseptic foaming solution, no structure had a sterile disposable brush for hygienic and surgical hand washing, 2/14 departments surveyed had sterile disposable towels, the water used had not undergone bacteriological control and only one service, ie 7.1%, which had non-manually operated bins. Conclusion: Hand hygiene is not properly carried out in maternity hospitals in Lubumbashi's public hospitals, due to a lack of equipment and knowledge on this practice, equipment must be provided and staff trained in hand hygiene.

Modern Notions of Health of Newborns from Mothers with Gestational Diabetes Mellitus

The aimed of the study was to research of health of newborns from mothers with gestational diabetes mellitus. Methods: The study included 210 pregnant women with gestational diabetes mellitus (GDM) and 200 without disorders of carbohydrate metabolism, who gave birth during the period: II quarter of 2017 III quarter of 2018 in the maternity ward of the city clinical hospital No. 29 named after N.E. Bauman in Moscow. This was a prospective case-control study. Results: One of the leading problems of the early neonatal period was morpho-functional immaturity: more than half of the children from mothers with GDM were born with signs of immaturity - 115 (54.8%). In the “on insulin therapy” group, children were 5 times more likely to have cardiomyopathy than those from mothers who were on a diet. With the same frequency in the control group, and for newborns from mothers with GDM, heart defects occurred: 20 (9.5%) and 24 (12.1%), respectively (p> 0.05). The main part of them were small (valvular) heart defects: defects of the interventricular and interatrial septums (18 (8,6%) in GDM group). Conclusion: The level of health in the early neonatal period of newborns from mothers with GDM in modern conditions is determined mainly by morpho-functional impairments. The incidence of newborns from mothers who were on insulin therapy was higher than from mothers who only had a diet.