Maternity Ward Of Hospital Research Articles

Post-earthquake spiritual well-being and depression levels of postpartum women in Turkey

ABSTRACT This study was carried out to examine the spiritual well-being and depression levels of postpartum women following the two major earthquakes that occurred in 2023 with the epicenter Kahramanmaraş in Turkey. This cross-sectional analytical study was conducted with the participation of 345 postpartum women admitted to the maternity ward of a medical faculty hospital in the provincial center of Kahramanmaraş in Turkey between June and September 2023. Data were collected using the Spiritual Well-Being Scale (SWBS) and the Edinburgh Postnatal Depression Scale (EPDS). Independent-samples t-tests, Pearson’s correlation tests, and simple linear regression analysis were used in the analyses. It was determined that 48.7% of the participants were at risk of postpartum depression. The participants whose relatives were lost/injured in the earthquakes and those who experienced financial losses had significantly lower total SWBS scores and significantly higher total EPDS scores (p < 0.05). A negative and statistically significant relationship was found between the total SWBS and total EPDS scores of the participants (p < 0.001). In this study, it was determined that after the Kahramanmaraş earthquakes in 2023, almost one in every two postpartum women was at risk of depression, and their earthquake experience affected their mental health and spiritual well-being negatively. Moreover, as the spiritual well-being of the postpartum women increased, their risk of postpartum depression decreased.

Perineal massage and warm compresses–Implementation study of a complex intervention in health

ObjectivesTo determine the effect of using tailored and multifaceted strategies on the acceptability, appropriateness, feasibility and adoption of a perineal massage and warm compress intervention by midwives in a maternity ward of a tertiary hospital in Portugal. MethodsThe complex intervention in health was developed based on the Medical Research Council framework and guided by the Theory of Change. Tailored and multifaceted strategies, including dissemination, integration and implementing process strategies, were applied. A mixed-methods approach was adopted, with a combination of qualitative (semi-open interviews) and quantitative (surveys, audits and electronic health records) methods. Surveys were applied to assess the acceptability, appropriateness and feasibility of the intervention. In order to evaluate adoption of the intervention, data from interviews were introduced into NVivo Version 10 to perform thematic analysis, and each audit checklist criterion was analysed using McNemar's exact test to determine differences in paired proportion. ResultsThis study found high acceptability (mean±standard deviation 4.28±0.45), high appropriateness (4.32±0.47) and high feasibility (4.26±0.43) of the intervention by midwives. Differences were reported for most topics between interviews conducted before and after implementation of the intervention. Pre-intervention, the midwives reported that the main factor affecting the application of perineal protection techniques was the lack of continuous presence of the midwife. The birth position was the alternative birth position (hands and knees, side-lying, squatting and semi-sitting), avoiding the lithotomy position. Techniques used for perineal protection were warm compresses, hands-on techniques, hands-off techniques and spontaneous pushing; and the reasons given for performing an episiotomy were large (high-birthweight) baby, Kristeller manoeuvre, tense perineum and previous obstetric sphincter injury. Post-intervention, the midwives reported that the presence of a second person increases the safety of professionals and women and improves working relations. The technique used for perineal protection was autonomy to adapt the intervention with perineal massage and warm compresses. A comfortable birth position for woman was used, and the rate of episiotomy reduced (only performed in the case of fetal distress). Regarding audits, significant differences (p < 0.05) were found for all audit criteria (pre- and post-intervention), which means that midwives adopted the intervention into their clinical practice. ConclusionAcceptability, appropriateness, feasibility and adoption of the intervention by midwives were high. Thus, tailored and multifaceted strategies were effective to achieve the implementation outcomes.

Roles of different organizations in implementing patient-reported measures in routine maternity care in Finland

BackgroundThe integration of patient-centered care (PCC) and value-based healthcare (VBHC) principles, emphasizing personalized, responsive care and cost efficiency, is crucial in modern healthcare. Despite advocation from the International Consortium for Health Outcomes Measurement (ICHOM) for the global adoption of these principles through patient-reported measures (PRMs), their implementation, especially the pregnancy and childbirth (PCB) set, remains limited in maternity care. This study focuses on understanding the optimal organizational entity for integrating standard ICHOM-PCB-PRMs into routine maternity care in Finland. It aims to clarify the distribution of tasks among stakeholders and gather Finnish maternity healthcare professionals’ perspectives on organizational responsibility in PRM collection. The emphasis was on identifying the optimal organizational framework for managing PRMs in maternity care.ResultsA total of 66 maternity healthcare professionals participated in the study, reaching a consensus that public maternity care centers in Finland should be the primary entity responsible for managing PRMs in the maternity sector. Key aspects such as confidence with the role as a mother, maternal confidence with breastfeeding, and satisfaction with the result of care were identified as crucial and should be inquired about in both public maternity care centers and hospital maternity wards. The findings highlight the importance of comprehensive and consistent attention to these PRMs across public maternity care centers and hospital maternity settings to ensure holistic and effective maternal care.ConclusionsThe study highlights the central role of public maternity care centers in the collection and management of PRMs within Finnish maternity care, as agreed upon by the professional consensus. It underscores the importance of a consistent and holistic approach to PRM inquiry across different care settings to enhance the quality and effectiveness of maternity care. This finding is crucial for policymakers and healthcare practitioners, suggesting that reinforcing the collaborative efforts between public maternity care centers and hospital maternity wards is vital for a patient-centric, efficient healthcare system. Aligning with PCC and VBHC principles, this approach aims to improve healthcare outcomes for pregnant and postpartum women in Finland, emphasizing the need for a unified strategy in managing maternity care.

Missed nursing care and associated factors among nurses and midwives in maternity wards of Sidama region public hospitals, Ethiopia

BackgroundMissed nursing care refers to any aspect of care performed by nursing staff that is omitted or significantly delayed. Even though the potential impact of missing nursing care on maternal and fetal outcomes is significant, there is currently limited evidence regarding the extent of this issue specifically within the maternity wards. Therefore, this study aimed to assess missed nursing care and associated factors in the maternity wards of public hospitals in the Sidama region, Ethiopia 2022.MethodsA hospital-based cross-sectional study was conducted among 361 nurses and midwives in maternity wards of Sidama region public hospitals from March 28 to April 26, 2022. Simple random sampling was used to select participants. The data was collected using the MISSCARE survey tool and analyzed with SPSS version 26. Simple linear and multiple linear regression analyses were used to identify the factors associated with missed nursing care.ResultsThe overall mean missed nursing care score was 67 out of 130 (95% CI: 65.92, 68.02) and the average score for each nursing intervention was 2.58 out of 5 (95% CI: 2.54, 2.62). The intention to leave the institution (β = 3.812, 95% CI: 2.285, 5.340) and increasing weekly work hours (β = 0.203, 95% CI: 0.134, 0.272) were factors positively associated with missed nursing care. However, increased work experience (β= -0.963, 95%CI: -1.475, -0.452) and job satisfaction (β= -4.976, 95%CI: -6.431, -3.522) were negatively associated with missed nursing care.ConclusionThis study found that the level of missed nursing care was significant. Factors positively associated with missed nursing care included an intention to leave the institution and an increase in weekly work hours. In contrast, an increase in work experience and higher job satisfaction were negatively associated with missed nursing care.

Home birth in Croatia - a medico-legal perspective today.

In Croatia, the model of obstetrics-midwifery management of childbirth in maternity hospitals is still in effect, and this is how > 99% of Croatian women give birth. However, in my view, midwives are still not sufficiently educated for completely independent work notwithstanding their university education. The Law on Midwifery defined the role of the midwife in home birth without, however, setting out other organisational-communication and professional provisions. Then it began with sporadic midwifery home births of a few per year, which grew quite rapidly, especially with the impact of the Covid-19 virus pandemic, to about 100 out of a total of about 38,000 births that are performed annually in the Republic of Croatia in maternity hospitals. Since the start of planned home births many bad perinatal outcomes have been recorded in hospital maternity wards who have admitted women after such deliveries. These include puerperal sepsis, protracted labour of several days, neglected protracted labour with perinatal asphyxia and aspiration of meconium amniotic fluid and resuscitation of the newborn (who later developed cerebral palsy), severe postpartum haemorrhage with obstetric shock and postpartum hysterectomy, episiotomy infection, and stillbirth at term pregnancy. Therefore, planned home birth in Croatia should now be regarded as an unsafe birth in extraordinary circumstances and the person who takes charge of it must be professionally prepared, educated and have numerous social skills. Most Croatian gynaecologists and obstetricians give support to midwives in their efforts to be professional and independent when at work, including the controlled and legal implementation of the planned home birth. We unreservedly support self-aware midwives to maintain their profession as highly ethical and professional as possible above the wishes of non-professionals who call for autonomy, so that we do not have to discuss such problems of malpractice of Croatian midwifery in the 21st century.

Determinants of maternal near-miss among women admitted to public hospitals in the Hadiya zone, central Ethiopia: a case-control study

One of the Sustainable Development Goals of the United Nations is to bring the global maternal mortality ratio down to less than 70 per 100,000 live births by 2030. Therefore, pinpointing the factors that influence maternal near-misses would help expedite the accomplishment of this goal. Studies on these topics are, nevertheless, scarce in the Hadiya zone and throughout Ethiopia as a whole. Therefore, the purpose of this study was to determine the factors that contribute to maternal near-misses among women who are admitted to public hospital maternity wards in the Hadiya zone in central Ethiopia. A facility-based, unmatched case-control study was conducted from February 17 to August 16, 2019. The study covered all secondary and tertiary public healthcare facilities in the Hadiya zone, which includes three district hospitals and one referral hospital offering comprehensive emergency obstetric care services. The study included 279 women in total (70 cases and 209 controls). Mothers who had had a near-miss were the cases, and mothers who had not had one were the controls. The Statistical Package for Social Sciences version 24 was used to analyze the data, and the multivariable binary logistic regression model was used to control confounders. The odds ratios (OR) and 95% confidence intervals (CI) were used to determine statistical significance at a p-value of less than 0.05. Living in a rural area [adjusted OR (AOR)=3.16; 95% CI: 1.62, 6.16], no birth preparedness (AOR=3.50; 95% CI: 1.66, 7.41), ever gave birth by cesarean section (AOR=3.68; 95% CI: 1.63, 8.31), previous history of hypertension (AOR=3.69; 95% CI:1.52, 8.96), and poor knowledge of pregnancy danger signs (AOR=3.15; 95% CI: 1.32, 7.52) were all determinants of maternal near-miss. Thus, strengthened public health and clinical interventions in these arenas need to prioritize rural women and women with a previous history of hypertension.

Energy Savings, Environmental Impacts and Monitoring Results of a Pumped Solar Water Heating System at Katutura Hospital Maternity Ward, Namibia

The SADC region is endowed with solar radiation between 1800-2400 kWh/m2 [1]. Nevertheless only 0.3 % of the worldwide solar thermal capacity is installed in the Sab-Saharan African Countries. Therefore, the main goal of the Southern African Solar Renewable Heating and Cooling Initiative (SOLTRAIN+) project funded by the Austrian Development Agency is to contribute to the transformation of the energy system to a sustainable, affordable and carbon-free system. This will be done by the implementation of Renewable, Heating and Cooling (RHC) systems in the targeted sectors: buildings, industry &amp; commerce, tourism and hospitals, and enable this by a holistic capacity building. RHC technologies are solar thermal, heat pump and energy efficiency. This study therefore intends to evaluate and produce energy balance, based on real data recorded from January 2023 to December 2023 on a 120 m2 collector area with 8000 litres storage tanks, and a 22 kW heat pump, installed at Katutura State Hospital maternity ward.

Impact of early postnatal support by lactation consultant on breastfeeding outcomes in urban population: A prospective observational study

Abstract Background: Early breastfeeding support helps in achieving exclusive breastfeeding by reducing the incidence of painful breast problems. A comparison of the impact of lactation counselling by lactation consultants and nursing staff would help to optimise care. Methods: In this prospective study conducted in the maternity ward of a private sector tertiary care hospital in an urban area, breastfeeding outcomes such as achievement of exclusive breastfeeding and incidence of painful breast problems such as sore nipples and breast engorgement as well as breastfeeding technique were compared between two groups of mother–newborn dyads receiving support from lactation consultants (study group) and maternity ward nursing staff (control group), respectively. Results: A total of 477 mother–newborn pairs were enrolled. Sixty-three out of 225 mothers (28%) in the study group complained of sore nipples as against 122 out of 252 mothers (48.4%) in the control group (odd ratio [OR] 0.414, 95% confidence intervals [CI] 0.282–0.607, P &lt; 0.001). Breast engorgement was reported in 45 mothers (20%) in the study group and 117 mothers (46.4%) in the control group (OR 0.288, 95% CI 0.191–0.434, P &lt; 0.001). Two hundred and three newborns (90.2%) from the study group were discharged on exclusive breastfeeding as compared to 149 newborns (59.1%) in the control group (OR 0.156, 95% CI 0.094–0.260, P &lt; 0.001). Conclusions: Lactation consultants are significantly better than nursing staff at improving breastfeeding outcomes by providing trained support to optimise breastfeeding position and attachment, thereby preventing painful breast problems.

Prevalence and Factors Associated with Puerperal Sepsis among Women Attending the Postnatal Ward at Fort Portal Regional Referral Hospital

Puerperal sepsis is a global problem. It causes maternal morbidity in every hospital in the world. Some people acquire the sepsis after they have been admitted to the hospital maternity ward. Usually about 4-6 percent of patients who come into the hospital and maternity ward acquire some kind of clinical infection. The study aimed to determine the factors contributing to puerperal sepsis in postnatal mothers in maternity ward at Fort Portal Regional Referral Hospital. A cross sectional study was conducted whereby questionnaires were availed to mothers in maternity ward to fill. All mothers who delivered from Fort Portal Regional Referral Hospital and develop puerperal sepsis were included in the study. Quantitative data was analyzed using Microsoft excel manually and interpreted into average and percentages and presented on tables, graphs and pie charts. The study found out that the prevalence of puerperal sepsis at fort portal regional referral hospital is 22.4% and most respondents were multiparous (80.6%0, 49.4% delivered from the hospital, 41.7% from home while 8,8% delivered from the traditional birth attendant. 64.7% had spontaneous vaginal delivery, while 35.3% had caesarean section, and 58.8% were assisted by doctors while 41.2% were assisted by midwives/nurses, 57.6% took the normal period of labor and 42.4% had prolonged labor and 12.9% experienced antepartum hemorrhage. The prevalence of puerperal sepsis was found to be 22.4% and it as associated to factors such as parity, mode of delivery, place of delivery, duration of labor and other medical conditions like diabetes, hypertension and HIV infection. Government through the Ministry of Health should partner with hospitals creating affordable costs to mothers whenever serious conditions a rise. Aseptic technique should be practiced when assisting mothers during delivery. Keywords: Puerperal sepsis, Clinical infection, Patients, Postnatal mothers, Caesarean section, Vaginal delivery.

Factors Associated With Hospital Outcomes for Cases of Anemia in Pregnancy at a Regional Level in Burkina Faso

BACKGROUND: Complications related to anemia in pregnancy are common in referral hospitals in Burkina Faso. This study aimed to identify the factors associated with hospital outcomes for anemia in pregnancy at a regional level in Burkina Faso. METHODS: A retrospective study was conducted on anemia cases identified from hospital records of pregnant women admitted between 2009 and 2011 in the maternity wards of public referral hospitals of the Cascades region in Burkina Faso. The hospital outcome was favorable if it was satisfactory for both the mother and the fetus, and unfavorable in the other cases. The factors associated with unfavorable hospital outcomes were identified through multivariable logistic regression. RESULTS: A total of 1,815 cases of anemia in pregnancy were identified from hospital records and considered in the study. The outcome of hospitalization for the mother and fetus entity was unfavorable in 42.6% of cases. The factors associated with unfavorable hospital outcomes were rural residence (OR = 1.32; 95% CI: 1.00-1.74), evacuation cases (OR = 1.96; 95% CI: 1.48-2.60), 1st or 2nd trimester of pregnancy (OR = 2.74; 95% CI: 2.03-3.68), severe anemia (OR = 2.46; 95% CI: 1.75-3.46), moderate anemia (OR = 1.39; 95% CI: 1.05-1.85) and poor quality of anemia prevention (OR = 2.81; 95% CI: 1.62-4.88). The unfavorable hospital outcomes were less frequent in women in a union (OR = 0.46; 95% CI: 0.26-0.84), in nulliparous and primiparous (OR = 0.69; 95% CI: 0.54-0.88). CONCLUSION: Unfavorable maternal-fetal hospital outcomes were common among cases of anemia in pregnancy in the Cascades region of Burkina Faso. They were more common in rural women, those admitted from an evacuation, those in early pregnancy, those with severe anemia, and those with poor quality anemia prevention.

The effect of Camellia sinensis ointment on perineal pain and episiotomy wound healing in primiparous women: A triple-blind randomized clinical trial.

Episiotomy is one of the most commonly performed procedures in obstetrics. complications of episiotomy are pain, bleeding, infection, pain in the sitting position, and difficulty in taking care of the baby. This study aimed to investigate the effect of Camellia sinensis ointment on perineal pain and episiotomy wound healing in primiparous women. This triple-blinded randomized clinical trial was conducted on 60 primiparous women who were referred to the maternity ward of Al-Hadi hospital in Shoushtar and Ganjovian hospital in Dezful, Iran, from 2020 to 2021. Participants were randomly assigned into two groups of intervention (Camellia sinensis extract ointment) and control (placebo) with a follow-up of 14 days. REEDA scale (redness, edema, ecchymosis, discharge, and approximation) was used to measure wound healing and the Visual Analog Scale (VAS) was used to measure the pain intensity. There was no significant difference between two groups before intervention in terms of sociodemographic characteristics, pain intensity, and episiotomy wound status. Scores of pain intensity and wound healing reduced on days 7, 10, and 14 post-intervention in the intervention group compared to placebo. There was a significant decrease between the groups of intervention and control in terms of the mean score of pain intensity (VAS scale) on day 10 (1.33 ± 0.71, 1.77 ± 0.93) and day 14 (0.73 ± 0.74, 1.13 ± 0.81) post-intervention (P < 0.05). Also, on day 14 post-intervention, there was a significant decrease between the groups of intervention and control in terms of the mean score of episiotomy wound healing (REEDA index) (0.53 ± 0.77, 1.77 ± 1.46) (P < 0.05). The GLM test was applied for repeated measures. REEDA index and VAS scale changed during different times (time-variable) (p < .001). But, the studied groups (group variable) and the studied groups (interaction effect of group * time) did not affect the changes in the REEDA index (p = .292, p = .306) and VAS scale (p = .47) during different times. Our study showed that Camellia sinensis extract ointment has a small effect on the healing process and pain reduction of episiotomy wounds. to confirm its effect, a study with a larger sample size should be conducted. This trial was registered in the Iranian Registry of Clinical Trials on 04/10/2019 with the IRCT ID: IRCT20190804044428N1. Participants were enrolled between 11 April 2020 and 20 January 2021. URL of registry: https://en.irct.ir/trial/41326.

Obstetric Emergencies at the Kara University Hospital Maternity Ward: Sociodemographic, Etiological and Prognostic Aspects

Obstetric Emergencies at the Kara University Hospital Maternity Ward: Sociodemographic, Etiological and Prognostic Aspects

Prevalence and Factors Associated with Puerperal Sepsis among Women Attending the Postnatal Ward at Fort Portal Regional Referral Hospital

Puerperal sepsis is a widespread issue globally, causing maternal health complications across hospital maternity wards. Typically, around 4-6% of hospital-admitted patients within maternity wards contract clinical infections, including sepsis. The overarching aim of this study was to identify the contributing factors to puerperal sepsis among postnatal mothers in the maternity ward at Fort Portal Regional Referral Hospital. Conducted as a cross-sectional investigation, questionnaires were distributed to mothers in the maternity ward for selfcompletion. All postnatal mothers who delivered at Fort Portal Regional Referral Hospital and developed puerperal sepsis were included in the study. Quantitative data was manually analyzed using Microsoft Excel, summarized through averages and percentages, and presented via tables, graphs, and pie charts. The study uncovered that the prevalence of puerperal sepsis at Fort Portal Regional Referral Hospital stands at 22.4%. Key findings include that the majority of respondents were multiparous (80.6%), with 49.4% delivering at the hospital, 41.7% at home, and 8.8% with the assistance of a traditional birth attendant. Furthermore, 64.7% had spontaneous vaginal deliveries, while 35.3% underwent cesarean sections. Additionally, 58.8% were assisted by doctors, and 41.2% were assisted by midwives/nurses. Of note, 57.6% experienced normal labor duration, while 42.4% endured prolonged labor, and 12.9% encountered antepartum hemorrhage. The prevalence of puerperal sepsis was strongly associated with factors such as parity, mode of delivery, place of delivery, duration of labor, and concurrent medical conditions like diabetes, hypertension, and HIV infection. Recommendations stemming from these findings emphasize collaborative efforts between the government (particularly the Ministry of Health) and hospitals to alleviate costs for mothers during critical health situations. Moreover, aseptic techniques during delivery assistance should be rigorously practiced to mitigate the incidence of puerperal sepsis. Keywords: Puerperal sepsis, Clinical infection, Patients, Postnatal mothers, Caesarean section, Vaginal delivery.

Intelligent classification of cardiotocography based on a support vector machine and convolutional neural network: Multiscene research.

To propose a computerized system utilizing multiscene analysis based on a support vector machine (SVM) and convolutional neural network (CNN) to assess cardiotocography (CTG) intelligently. We retrospectively collected 2542 CTG records of singleton pregnancies delivered at the maternity ward of the First Affiliated Hospital of Xi'an Jiaotong University from October 10, 2020, to August 7, 2021. CTG records were divided into five categories (baseline, variability, acceleration, deceleration, and normality). Apart from the category of normality, the other four different categories of abnormal data correspond to four scenes. Each scene was divided into training and testing sets at 9:1 or 7:3. We used three computer algorithms (dynamic threshold, SVM, and CNN) to learn and optimize the system. Accuracy, sensitivity, and specificity were performed to evaluate performance. The global accuracy, sensitivity, and specificity of the system were 93.88%, 93.06%, and 94.33%, respectively. In acceleration and deceleration scenes, when the convolution kernel was 3, the test data set reached the highest performance. The multiscene research model using SVM and CNN is a potential effective tool to assist obstetricians in classifying CTG intelligently.

The German version of the Bristol breastfeeding assessment tool: A validation study

ObjectivesThis study aimed, first, to validate the Bristol Still [Breastfeeding] Assessment Tool (BSAT) through determining inter-rater reliability, construct and criterion and second, to assess if healthcare professionals viewed the tool as appropriate for use on a maternity ward. Design and settingA validation study was performed at the maternity ward of a university hospital in the German-speaking region of Switzerland. ParticipantsWe included 44 mother–newborns dyads in the validation study, and 15 healthcare professionals assessed its appropriateness for use on a maternity ward. Measurements and findingsInter-rater reliability was determined by observing 82 breastfeeding sessions, which were independently assessed by two assessors based on the criteria of the BSAT. Convergent validity was determined using the Breastfeeding Self-Efficacy Scale Short Form. Predictive validity was determined by breastfeeding status at hospital discharge. A self-developed 5-item questionnaire assessed the appropriateness of the tool for use on a maternity ward.Inter-rater reliability was good at the item level (six out of eight intraclass-correlation coefficient values were greater than 0.75 and p < 0.00). The convergent validity demonstrated a moderate positive correlation with breastfeeding self-efficacy, with a Pearson's correlation coefficient of 0.69 (Confidence Interval = 0.46–0.83, p < 0.00). The predictive validity with breastfeeding status at hospital discharge was not statistically significant with χ2(22, n = 44) = 26.98, p = 0.21). Healthcare professionals confirmed that the tool was appropriate for using in daily practice on the maternity ward. Key conclusionThe BSAT had an overall good inter-rater reliability and a moderate construct validity with the mother's breastfeeding self-efficacy level and has comparable psychometrics properties as the original. Implications for practiceWe recommend assessing breastfeeding with the BSAT and scoring it at the item level and not with a total score. Using the BSAT on maternity wards could help monitor and objectify breastfeeding practices.

Factors Influencing Pueperal Sepsis among Postpartum Women at Hoima Regional Referral Hospital, in Hoima District Western Uganda.

The main objective of the study was to identify factors influencing puerperal sepsis among post-partum women at Hoima regional referral hospital, in Hoima district, Western Uganda. The specific objectives were; To determine the prevalence of puerperal sepsis at Hoima regional referral hospital, to assess the social demographic factors affecting puerperal sepsis at Hoima regional referral hospital, to determine Patients factors affecting puerperal sepsis at Hoima regional referral hospital and to determine the healthcare factors affecting the prevalence of puerperal sepsis at Hoima regional referral hospital. The study adopted the descriptive cross-sectional method. The study population was all mothers in the maternity ward of Hoima regional referral hospital who developed puerperal sepsis and consented to the study. The two sets of data; qualitative and quantitative data were analyzed separately using Microsoft Excel manually and interpreted into averages and percentages and presented on tables, graphs, and pie charts. It was found that the prevalence of puerperal sepsis was 37.5%, with most participants (51.7%) delivered by cesarean section, and 35.5% by spontaneous vaginal delivery. The study concluded that the majority of puerperal sepsis occurs due to poverty, low income, and low maternal age and that the caesarian section is a very high-risk factor. The study further recommended that the government through the Ministry of Health should partner with hospitals creating affordable costs for mothers whenever serious conditions arise. Also, the promotion of education of girl children to higher levels would reduce low maternal age and also directly reduce puerperal sepsis. Furthermore, healthcare workers should work in a skilled way to prevent sepsis in postpartum mothers. Keywords: Puerperal sepsis, Mothers, Health care workers, Spontaneous vaginal delivery, Caesarian section.

The Effect of Hospital Maternity Ward Closures on Maternal and Infant Health

The Effect of Hospital Maternity Ward Closures on Maternal and Infant Health

Early breastfeeding initiation: Exploring rates and determinants among postpartum women in Eastern Morocco

IntroductionBreast milk is the only complete food source for infants under the age of six months, as it provides the bioactive nutrients needed to strengthen the infant's immune system, promote growth, and facilitate tissue repair. Despite the many benefits of colostrum, the National Demographic and Family Health Survey of 2018 revealed that only 42% of women in Morocco were breastfeeding within an hour of giving birth. Therefore, the aim of this study was to determine the factors influencing breastfeeding initiation after discharge within the maternity ward of the Provincial Hospital of Taza, in the Eastern Region of Morocco. Materials and methodsA cross-sectional study was conducted over a four-month period among 400 women who had given birth and were breastfeeding in the maternity ward of Ibn Baja Hospital, in the city of Taza. Questionnaires were filled out on site to collect socio-demographic, obstetric, and timely breastfeeding initiation data, as well as its determinants, before the mothers' discharge from the maternity ward. Statistical analysis was performed using SPSS software. ResultsThe participants in this study were all breastfeeding mothers who had given birth at full term. Their average age was 28.43±6.18 years, and 94.5% of them were housewives. Of these, 74% lived in rural areas, 49% lived in large families, and 48% had been married for over 5 years. The study found that only 37% of mothers initiated breastfeeding within the first hour, 78% had a vaginal delivery, and 71.5% of mothers had at least a primary education compared to 75% of fathers. Among the newborns, the majority (99.5%) had a birth weight exceeding 2.5 kgs, of which 52% were female. 66% of mothers reported having already experienced breastfeeding, and 48.5% had information about early breastfeeding. 64.5% of the respondents had made the decision to breastfeed their newborns during pregnancy. Binary logistic regression analysis revealed the involvement of six factors in the determination of early breastfeeding, namely mother's age, parents' education, sex of the newborn, prior knowledge about early breastfeeding, as well as whether or not the mother had already been breastfed by her mother. ConclusionThe study found that just 37% of mothers initiated breastfeeding within one hour of delivery. This highlights the strong association between early breastfeeding initiation and factors such as parental education, newborn sex, prior knowledge about early breastfeeding, and the mother's breastfeeding history. To promote early breastfeeding initiation, it is recommended that women of childbearing age receive education on the topic, particularly those who are less educated.

Obstetric referrals, complications and health outcomes in maternity wards of large hospitals during the COVID-19 pandemic: a mixed methods study of six hospitals in Guinea, Nigeria, Uganda and Tanzania

ObjectivesThe COVID-19 pandemic affected provision and use of maternal health services. This study describes changes in obstetric complications, referrals, stillbirths and maternal deaths during the first year of the pandemic...

Risk and Protective Factors Associated with Hypertensive Disorders in Ghana: The Case of the Bolgatanga Regional Hospital of the Upper East Region

Aim: The goal of this study was to identify some risk and protective factors associated with hypertensive disorders among pregnant women in the Bolgatanga Regional Hospital of Ghana's Upper East Region.&#x0D; Study Design: This study is a one case-control study design.&#x0D; Place of Study: The study was conducted in the Antenatal clinic and Maternity ward of the Upper East Regional hospital in Bolgatanga.&#x0D; Methodology: The study population consisted of pregnant women who were attending their antenatal care at the Bolgatanga regional hospital whose gestational ages were more than 20 weeks.&#x0D; Hundred (100) study participants were selected using the purposive sampling technique (a non-probability sampling technique). Data for the study was gathered from the history of the 100 pregnant women who were visiting the Bolgatanga Regional Hospital for antenatal care. The analysis was conducted using the logistic regression model of STATA 14.&#x0D; Results: The study disclosed that white blood cells (WBC), low-density lipoprotein cholesterol (LDL), placenta weight (PW), gestational weight (GW), body mass index (BMI) were statistically significant. BMI was discovered to have a positive association with hypertensive disorders (OR= 2.208, P= .025), whereas PW (OR=0.994, P= .085), GW (OR=0.815, P=.079), WBC (OR=0.719, P=.01), and LDL (OR=0.645, P= .027) were discovered to have negative associations with hypertensive disorders (odds ratios less than one). &#x0D; Conclusion: The study identified BMI as a risk factor and PW, GW, WBC, and LDL as protective factors. On the basis of the analysis it was recommended that health professionals should raise the awareness of women on the risks of hypertensive disorders even before they become pregnant, especially maintaining healthy weight.