Obstetric Ward Research Articles

Gynecological Surgeries in COVID-19 Pandemic Era

ABSTRACT Introduction During the coronavirus disease-2019 (COVID-19) pandemic era, different types of emergency gynecological surgeries were performed in the Department of Obstetrics and Gynecology of our tertiary care teaching hospital as per the standard guidelines issued from time to time by the Indian Council of Medical Research (ICMR) and the Federation of Obstetric and Gynecological Societies of India Good Clinical Practice Recommendations (FOGSI GCPR) guidelines for the safety of the patients and healthcare providers. Materials and methods A different variety of gynecological surgeries were performed on cases which were admitted in the Obstetrics and Gynecology ward of Sri Guru Ram Das Institute of Health Sciences and Research, Vallah, Amritsar, with effect from the first lockdown, i.e., March 22, 2020, to the end of lockdown, i.e., May 31, 2020 following standard guidelines for the safety of patients and healthcare providers in the COVID pandemic. The details of these cases are being presented in this article. Results A very few gynecological surgeries were taken up as they could not have been postponed to the post-COVID times. The use of medical and conservative approach to each possible situation has been tremendous. All cases of abnormal uterine bleeding (AUB), endometriosis, and fibroid uterus were continued to be on medical management. All minor diagnostic procedures were done under short general anesthesia with premedication. Conclusion The resumption of regular gynecological work is being regularized in phases. It is a long way before we come back to the original gynecology practice. How to cite this article Bala R, Kumar SS, Khullar U, et al. Gynecological Surgeries in COVID-19 Pandemic Era. AMEI's Curr Trends Diagn Treat 2020;4(2):61–64.

Screening for Cervical Polyp among Women Attending SalahAldin General Hospital

Background: Cervical polyps are the commonest cervicallesions, affecting up to 10% of women, witha reported recurrence rate of 6.2%, they arise from the endocervical canal or, less frequently, from theectocervix, and vary in size from 5 mm to 50 mm. Symptomatic polyps are significantly more frequent inthe premenopausal women, while asymptomatic polyps are significantly more common in post-menopausalwomen.Aim of the Study: Screening for cervical polyps among women attending Salah-Aldin general hospital.Patients and Method: A cross sectional study conducted in outpatients clinic and obstetrical ward in SalahEl-Din general hospital at the period from the 1st of March 2018 to the end of August 2018. Simple randomsample of (200) women in different ages were included.Results: 200 women were enrolled in this study with the mean age of them were (27.30±6.8 years),the BMImean of the patients with polyp was (30.2±2.1),4(40%) in age group between 26-35years. Patients withpolyps have ? 1 parity 9(9%) and 1(10%) in nulliparous.Conclusion: The frequency of cervical polyp was 5% with no relation to the age, and 60% of the patientswere healed.

Exploring Maternal Self-Efficacy of First-Time Mothers among Rural-to-Urban Floating Women: A Quantitative Longitudinal Study in China.

(1) Background: China has the highest number of rural-to-urban floating women in the world, and the majority of them are of childbearing age. However, few studies have focused on maternal self-efficacy (MSE) for these women. This research aims to explore MSE and its influencing factors for primiparous women among the rural-to-urban floating population in China. (2) Methods: A quantitative longitudinal study was conducted, and primiparous women from the floating population were recruited in China. Face-to-face demographic questionnaires were collected from obstetric wards by the researchers, three days postpartum. The 6-week and 12-week questionnaires, including the Self-efficacy in Infant Care Scale (SICS), the Edinburgh Postnatal Depression Scale (EPDS), and the Postpartum Social Support Scale (PSSS), were sent to participants by wechat or email to measure MSE, postnatal depression, and social support, respectively. The completed 6-week and completed 12-week questionnaires were returned to the researchers. (3) Results: The mean MSE scores at 6 and 12 weeks postpartum were 67.16 (SD = 14.35) and 68.71 (SD = 15.00). The variables of social support, postnatal depression, whether women attended parenting training, baby fussiness, baby health, maternal educational level, occupation, and family income affected MSE at the two time points. (4) Conclusions: Primiparous women among the rural-to-urban floating population had a low MSE level. As a vulnerable and special group, more attention should be paid to the negative parenting status of floating women by health workers and family members. Effective measures must be taken to improve the floating women’s accessibility to parenting training from health services to strengthen their social support and alleviate postpartum depression. Health professionals should be more concerned with floating women with relatively low MSE levels, such as new mothers with lower education, poor working and living conditions, unhealthy babies, and babies with fussy temperaments.

Neonatal eye screening for 203 healthy term new-borns using a wide-field digital retinal imaging system

BackgroundThe current practice for new-born eye examination by an Ophthalmologist in Malaysian hospitals is limited to only preterm new-borns, syndromic or ill infants. Healthy term new-borns are usually discharged without a thorough eye examination. This study is aimed at determining the proportion and types of ocular abnormalities detected in purportedly healthy term new-borns.MethodThis cross-sectional study is comprised of 203 participants, all purportedly healthy term new-born infants from the Obstetrics and Gynaecology ward at Hospital Kuala Lumpur over a 6 months period. The examination list includes external eye examination, red reflex test, and fundus imaging using a wide-field digital retinal imaging system (Phoenix Clinical ICON Paediatric Retinal Camera) by a trained Investigator. The pathologies detected were documented. The results were compared and correlated with similar studies published in the literature previously.ResultsTotal ocular abnormalities were detected in 34% of the infants. The most common finding was retinal haemorrhage in 29.6% of the infants, of which 53.3% occurred bilaterally. Spontaneous vaginal delivery (SVD) remained the greatest risk factor which has nearly 3.5 times higher risk of new-borns developing retinal haemorrhage compared to Lower Segment Caesarean Section (LSCS). There was a 6% increased likelihood of developing retinal haemorrhage for every 1-min increment in the duration of 2nd stage of labour.ConclusionUniversal eye screening for all new-borns using a wide-field digital imaging system is realistically possible, safe, and useful in detecting posterior segment disorders. The most common abnormality detected is retinal haemorrhage.

Does Lung Ultrasound Have a Role in the Clinical Management of Pregnant Women with SARS COV2 Infection?

Severe Acute Respiratory Syndrome coronavirus 2 (SARS-CoV-2) infection is a major health threat. Pregnancy can lead to an increased susceptibility to viral infections. Although chest computed tomography (CT) represents the gold standard for the diagnosis of SARS-CoV-2 pneumonia, lung ultrasound (LUS) could be a valid alternative in pregnancy. The objectives of this prospective study were to assess the role of LUS in the diagnosis of lung involvement and in helping the physicians in the management of affected patients. Thirty pregnant women with SARS-CoV-2 infection were admitted at the obstetrical ward of our Hospital. Mean age was 31.2 years, mean gestational age 33.8 weeks. Several LUS were performed during hospitalization. The management of the patients was decided according to the LUS score and the clinical conditions. Mean gestational age at delivery was at 37.7 weeks, preterm birth was induced in 20% of cases for a worsening of the clinical conditions. No neonatal complications occurred. In 9 cases with a high LUS score, a chest CT was performed after delivery. CT confirmed the results of LUS, showing a significant positive correlation between the two techniques. LUS seems a safe alternative to CT in pregnancy and may help in the management of these patients.

SURGICAL SITE INFECTIONS AFTER OPERATIVE DELIVERY AT THE TERTIARY CARE HOSPITAL IN RAJASTHAN, THEIR MICROBIOLOGICAL PROFILE, ANTIBIOTIC SENSITIVITY AND CLINICAL RISK FACTORS

Introduction: Surgical site infections (SSI) are common problem in developing country like India. There are so many factors are responsible for SSI like low immunity, prolonged labour, production of hematoma presence of gestational diabetes Anaemia, multiparaty, heavy blood loss during delivery. Methods: It is a case-control study undertaken for a period of one year in a tertiary care hospital of Rajasthan state, India. The study population included patients suffering from SSIs in the various unit of obstetrics ward of our hospital. Result: in our study we found a lot of factor affecting prevalence of SSIs like anaemia, premature rupture of membrane, prolonged labour, multiparity and obesity. Common organism are Escherichia coli, staphylococcus and pseudomonas. Most of the organism are susceptible with carbapenems vancomycin and amikacin. Conclusion: Even though the total number of Cesarean delivery has increasing consistently, wound infection should be has remained less constant. This may be achieved by high compliance among the infection control practices by health care workers in the hospital

Incidence of neural tube defects and other external congenital anomalies among newborn

Background: Congenital malformations are becoming an important cause of neonatal death due to reduction of mortality by other common causes of death owing to the improvement of neonatal care. Routine physical examination of every newborn is important for multiple purposes including exploration of external congenital anomalies. Objective: To determine the incidence of Neural Tube Defects (NTDs) and other external congenital anomalies that can be detected by routine physical examination only. Methods: It was an observational cross sectional study. This study was conducted in the department of Pediatrics and Obstetrics of Khulna Medical College Hospital from June 2016 to May 2017. All the delivered newborn in Obstetrics ward and the neonates in the pediatrics ward were included in the study. The babies were examined immediately after delivery or admission. A detailed history including potential risk factors was taken and a thorough physical examination was performed. All the relevant information was noted in a predesigned questionnaire. Results: A total of 4,462 neonates were studied in pediatrics and obstetrics ward. Thirty four (0.76%) cases of congenital anomalies were found during one year. Neural tube defects were observed in 4 (0.04%) cases only. No other risk factor except folic acid intake was related with them. Congenital anomalies most frequently involved the musculoskeletal system (29.4%). Conclusion: Routine physical examination of newborn can identify a significant number of congenital anomalies. Non-intake of folic acid during preconceptional and antenatal period is the single-most risk factor for NTDs.

Circulating Micro particles: a Risk Factorfor Recurrent Abortion in Women at theUniversity Teaching Hospital, Lusaka,Zambia

Background: Circulating micro particles are minute particles associated with prothrombotic nature found to be increased in the uteroplacental circulation in pregnancy, as such micro particles may be directly or indirectly associated with pregnancy loss. With abortion cases accounting for approximately 80% of cases at the Obstetrics and Gynaecology emergency ward at The University Teaching Hospital, this study aimed to determine if circulating micro particles are associated with the risk of recurrent abortion. Methods: A case-control study enrolled 18 women with two or more recurrent abortions and 55 parous women as controls. After counselling performed by a trained mid-wife, a blood sample was collected in a citrated container and platelet poor plasma isolated. Micro particles were measured by flow cytometry using fluorescent annexin V-fluorescence isothiocyanate conjugate. Results: Increased micro particle levels was defined as more than 2 standard deviation above the mean of controls. The mean found was 202/μl in 4 of the 18 women with recurrent abortions (22%), as opposed to 2 of the 55 parous women (4%), t(20)=2.49, P=0.022, 95% CI 182.20-16.09. Conclusions: The increased micro particles levels in women with recurrent abortions supports emerging evidence that micro particles have a role to play in abortion.

Assessment of verbal Communication Skills of Healthcare Providers in Obstetric and Gynecological Wards

Assessment of verbal Communication Skills of Healthcare Providers in Obstetric and Gynecological Wards

Pregnant women’s opinions on universal screening for COVID-19 during hospital admission: a cross-sectional survey

Introduction: The present study aimed to evaluate pregnant women’s opinions on universal screening for COVID-19 during hospital admission. Methods: Between 1 September 2020 and 24 November 2020 in the antenatal ward and labour ward of United Christian Hospital, a self-administrated questionnaire (in Chinese and English) on universal screening was distributed to all obstetric patients upon admission (or after delivery). Results: Of 600 questionnaires distributed, 520 (86.7%) were returned. Of these, 11 were excluded owing to missing answers and 509 were included in analysis. All respondents had negative results of COVID-19. 98.4% of the women agreed with universal screening for all obstetric patients on admission. 69.0%, 73.9%, and 72.1% of women considered that a negative COVID-19 result would have a positive effect on their own care, their baby’s care, and their family, respectively, with 82.1% feeling more ready to breastfeed and 84.9% feeling more at ease to look after their babies after delivery. 97.2% thought that all staff in the obstetric ward should have COVID-19 screening. A logistic regression model showed that women with tertiary education or above (odds ratio [OR]=2.361, p<0.001) and with emergency admission (rather than elective admission) [OR=1.686, p=0.018] were more likely to believe that a negative screening result would have positive effects on her care, whereas women with tertiary education or above (OR=3.615, p<0.001) were more likely to believe that a negative result would have a positive impact on their baby’s care. Conclusion: Universal screening for COVID-19 on admission is well supported by obstetric patients.

Use of music during vaginal birth and caesarean section: an interprofessional survey

PurposeEvidence abounds about the beneficial effects of music on patients and healthcare professionals for many medical indications. This study aimed to evaluate the dissemination and use of music in the obstetrical setting.MethodsInvitations to an online survey were sent to physicians and midwives of all obstetrics departments in Germany. The survey gathered descriptive data as well as information about the personal relation to music and the use of it during vaginal birth (VB) and caesarean section (CS) and whether data about positive or negative effects of music were known to the participant.ResultsIn total, there were 293 respondents. The 47% that had the means to play music during CS stated that music was played in 15% of the cases. Most respondents have the means to play music during VB (97%). Music is played in 38% of VB. Regardless of the mode of delivery, music was estimated to be positive for team communication and patient communication. It was also deemed calming and mood lifting on the respondents. Regarding the patient, music during CS and VB was rated as being positive on all scales. Listening to music was recommended more often during VB (66%) than CS (38%).ConclusionsAlthough healthcare professionals are mostly aware of the beneficial effects of music in obstetrics, our study shows that music plays a more important role during VB than during CS in Germanys obstetrical wards. There is a lack of equipment to play music in operation theatres where CS take place.

Morbidities among Eclamptic Women of Lower Socioeconomic Community in a Selected Area of Bangladesh

Eclampsia is a serious obstetric emergency with new onset of grand mal seizure during pregnancy or postpartum women having signs symptoms of pre-eclampsia. The sequel of severe pre-eclampsia and eclampsia includes organ failure, loss of consciousness and finally loss of lives of both mother and fetus. This study aimed to evaluate morbidity of eclamptic women at lower socioeconomic community in a selected area of Bangladesh. This descriptive cross sectional study was conducted at Sheikh Hasina Medical College Hospital (SHMC.T) of Tangail district during the period of January to December 2019. During this period 7918 admitted patients from different sub-districts (Upazilas) of this district in obstetrics ward of SHMC.T were observed and 205 diagnosed eclamptic patients were selected as respondents for this study to detect morbidities. The prevalence rate of eclampsia among the obstetrics patients was 2.6%, where 81% of them were found during antepartum/ intrapartum and rest of them during postpartum period. The mean age of the eclamptic cases was 23.78±4.94 years and more than half of them were in age group 21-30 years. Most of the cases (84%) were from primary level or able to sign or illiterate and rest was secondary level of education. Mean age of marriage and first pregnancy were 17.81±SD2.19 and 19.39±SD2.5 years respectively, where majority of patients were primigravida. Among the multi gravida about one fourth had 2-4 children, 16.09% had 5-6 children, where 1.46% had ≥7 children and more than three-fourth of cases had 34-37 weeks of gestational period. Among cases 95.1% had hypertension, 94.6% edema, 83.9% convulsion, 39.5% headache with blurring of vision, 22.4% severe abdominal pain, 79.0% proteinuria and 9.76% unconsciousness. Incidence of maternal morbidity during study period was 14.36%, among them 9.4% pulmonary edema, 1.5% renal failure, 0.98% HELLP (Hemolysis, Elevated liver enzyme level and Low Platelet level) syndrome, 0.98% coma and 1.5% placental abruption. Caesarean delivery was 79.2% and 11.70% was detected as postpartum haemorrhage. Among fetal morbidity 19.5% intrauterine growth restriction, 48.8% low birth weight, 39.6% birth asphyxia, and 58.5% preterm baby. During follow up only persistent hypertension was found as morbidity of eclampsia, 19.5%, 9.8% and 7.32% at 2nd week, at 6th week and at 6th months respectively. Regarding health care services 93.7% had available facility and 41.5%, 47.8% and 10.7% lived in &gt;10 kilometers (kms), 5-10 kms and less than 5 km distance respectively. Regarding MCH services; only 5.9% patient received antenatal care (ANC) ≥4 times; more than half of them incompletely received ANC &lt;4 times and 42.0% never visited for ANC. This study reveals various matters of maternal and fetal morbidities commencing from eclamptic condition in lower socioeconomic community. Here important factors for morbidities in eclamptic women like lack of ANC/ PNC, availabilities of MCHC services and others. Pulmonary edema, renal failure, HELLP syndrome, coma and placental abruption are important maternal morbidities. Prematurity, low birth weight, intrauterine growth restriction and birth asphyxia are foremost fetal morbidities. Availabilities of MCH services, complete visit for ANC/ PNC and early diagnosis and management of eclamptic women positively reduce morbidity and will prevent eclampsia.&#x0D; Bangladesh Med J. 2020 Jan; 49 (1): 7-13

Comparison between Insulin-like Growth Factor Binding Protein-1 Level and Bishop Score as Predictor of Successful Labor Induction in Full Term Pregnancy with Preeclampsia

Introduction: preeclampsia/eclampsia contributed to 30% of maternal mortality in RSUP Dr. Kariadi. Pre-induction bishop score assessment is a standard for cervical maturity estimation. Other predictors currently being developed, including insulin-like growth factor binding protein-1 (IGFBP-1). However, there is no cut-off point for IGFBP-1 examination in full term pregnancy, especially with preeclampsia and its complications. Objective: to find IGFBP-1 levels and Bishop Score differences in preeclampsia women with induction labor.Methods: this prospective observational cohort study was conducted in preeclampsia women with gestational age ≥37 weeks planned labor induction at Obstetrics and Gynecology Ward RSUP Dr. Kariadi Semarang and networking hospital during study period (n=66). History taking, physical examination, proteinuria, cervical mucus IGFBP-1, and bishop score calculation was performed. Statistical analysis was performed with paired-t test, followed by ROC for cut-off value of successful induction prediction, and logistic regression to determine confounding variables effect on IGFBP-1 levels.Results: The average Bishop score of 66 subjects was 2.5±1.81 and 2.6±1.8 for women who deliver ≤24 labor and in labor for ≤12 hours, respectively. Although the bishop score was higher in the successful labor group, there was no significant difference between groups. Mean IGFBP-1 value was 8.29±5.033 mcg/L with median value of 10.8 mcg/L. Successful induction had significant higher IGFBP-1 levels with area-under-curve (AUC) 0.76 and 8.145 cutoff value (p=0.002, RR=5.1).Conclusion: IGFBP-1 level with cutoff point 8.145 can be used as predictor of successful labor induction in term pregnancy with preeclampsia.

Risk Factors for Birth Asphyxia in Togo: A Case-Control Study

Background: Birth Asphyxia (BA) is one of the leading causes of neonatal death in developing countries. In Togo, 30.55% of neonatal deaths were related to BA and caused by several risk factors. The purpose of this piece of work is to analyse the antepartum, intrapartum, and foetal risk factors of BA. Methods: This is a case control study, conducted from 1st December 2019 to 28th February 2020 in obstetrics wards and at neonatal intensive care of paediatric ward at the Sylvanus Olympio university teaching hospital (CHU-SO) in Lomé, Togo. Neonates diagnosed with BA (Apgar score th minute) were considered as “cases” (N = 200) while neonates born either with normal vaginal delivery or by cesarean section having no abnormality were considered as “control” (N = 200). Results: The prevalence rate of BA was 9.13%. Age (p = 0.0391), gravidity (p = 0.0040), type of facility for prenatal follow-up (p 0.0001), use of Long-lasting impregnated mosquito nets (LLIN) (p 0.0001), notion of maternal fever (p 0.0001) and chronic pathology (p 0.0001) were related to occurrence of BA. Significant antepartum risk factors observed were age private one (OR = 1.62; CI95% [1.03 - 12.55], p 0.0001), non-use of LLIN (OR = 2.50; CI 95% [1.61 - 3.88], p 0.0001), maternal fever (OR = 3.73; CI 95% [2.33 - 5.97], p 0.0001). Significant intrapartum risk factors were PRM (OR = 7.89; CI 95% [2.62 - 14.02], p 0.0001), abnormal AF (OR = 5.40; CI 95% [2.57 - 11.38],], p 0.0001), long labour (OR = 2.11; CI 95% [1.34 - 3.34],], p = 0.0004), use of oxytocin (OR = 2.14; CI 95% [1.38 - 3.32], p = 0.0003), and spontaneous vaginal (OR = 1.76; CI 95% [1.14 - 2.72,], p = 0.0008]). Significant Foetal risk factors were male gender (OR = 1.55; CI 95% [1.03 - 2.33], p = 0.0423), preterm babies (OR = 8.83; CI 95% [3.79 - 20.60], p 0.0001) and baby birth weight 0.0001). The Sarnat score had shown anoxo-ischemic encephalopathy stage III (19.00%), corresponding to 87.80% of case fatality rate (p Conclusion: Various risk factors lead to BA in Lomé. Early identification of high-risk cases with improved antenatal and perinatal care can decrease the high mortality of BA in Togo.

Postpartum depression and its risk factors: A cross-sectional exploratory study

Background: Postpartum depression (PPD) is a serious mental health condition affecting the psychological/physical health of a mother and the infant significantly. Aims: This study aims at assessing the prevalence, the pattern of symptoms, and the risk factors associated with PPD. The study also aims at finding the correlation between PPD and stressful life events. Subjects and Methods: A cross-sectional study was conducted in a tertiary care hospital on sixty participants after ethics committee approval. Consecutively selected patients in a postpartum state fulfilling the study criteria were selected from obstetric ward and interviewed using semi-structured pro forma, Diagnostic and Statistical Manual of Mental Disorders version 5 (DSM 5), Edinburgh Postnatal Depression Scale, Hamilton Depression Rating Scale (HAM-D), and Presumptive Stressful Life Events Scale (PSLES). Data collected were statistically analyzed with SPSS software using mean, standard deviation, and Chi-square test. Results: Mean age of the participants was 25.53 (standard deviation - 3.2). Prevalence of PPD was 6.7% which was a major depressive disorder as per the DSM 5 criteria. Sadness of mood (Depressed mood), impaired concentration, change in weight, and insomnia were the commonly reported symptoms. Seventy five percent of the participants had PSLES score of >100, indicating higher stress. Furthermore, 75% of the participants with a history of abortion showed a PSLES score above 100. Significant positive correlation was found between PSLES score and HAM-D score, with 63% of the participants with PSLES score >200 had a HAM-D score of >8 (suggestive of depression). Younger (<20 years) or older (>30 years) age at pregnancy, history of abortion, and higher level of stress were found to be the risk factors for developing PPD. Conclusion: Although the prevalence is less, PPD is an important mental health issue. It is worth screening all the patients in postpartum state so as to intervene early if needed. This may help in better care of physical and psychological health of a mother and the newborn.

The appropriateness of ceftriaxone utilization in government hospitals of Eastern Ethiopia: A retrospective evaluation of clinical practice.

Introduction:Drug use evaluation is a method of obtaining information to identify problems related to drug use and if properly developed, a means of correcting the problems. Ceftriaxone is among the most commonly utilized cephalosporins. Owing to a broad spectrum of activity and being used empirically, ceftriaxone has been used inappropriately posing a risk for development of antimicrobial resistance. This study is, therefore, designed to evaluate the appropriateness of ceftriaxone utilization in government hospitals in Harar town.Methods:A retrospective cross-sectional study was conducted in four government hospitals of Harar town by reviewing the medical records of 271 patients who received ceftriaxone from 1 January to 31 December 2016. Systematic random sampling was utilized to capture the medical records. Data were entered and analyzed using SPSS version 22.Results:From the 271 medical records reviewed majority of patients were from surgical ward (n = 85, 31.4%) followed by gynecology and obstetrics ward (n = 67, 24.7%). Demographically, the majority of the patients were female (n = 142, 52.4%). Patients in the age group of 20–29 years were dominant (n = 98, 36.2%). A total of 71 drugs were co-administered with ceftriaxone, the most common being metronidazole followed by tramadol. Among the co-administered drugs, unfractionated heparin (n = 6), warfarin (n = 5), and enoxaparin (n = 1) were found to have a moderate drug interaction with ceftriaxone. Ceftriaxone was commonly used for post-operative prophylaxis (n = 80, 27.5%) followed by for the management of pneumonia (n = 62, 21.3%). The result of ceftriaxone use evaluation showed that majority (n = 190, 70.1%) were found to be inappropriate. The inappropriate utilization was primarily due to wrong indication (indications for which ceftriaxone was not the primary option) (n = 114, 60.0%) followed by wrong duration (n = 54, 28.4%).Conclusion:Ceftriaxone was used inappropriately in more than two-thirds of the patients, with wrong indication and wrong duration contributing the majority. Inappropriate use of antibiotics may potentially lead to the emergence and spread of drug-resistant microorganisms and also ultimately exposes the patient to treatment failure, prolonged hospital stay, and higher cost of therapy.

Impact of multimodal intervention strategies on compliance to hand hygiene practices among staff nurses in Obstetric and gynaecological wards

Impact of multimodal intervention strategies on compliance to hand hygiene practices among staff nurses in Obstetric and gynaecological wards

Evaluation of Care Providers' Attitude toward Perinatal Palliative Care and its Challenges in the Selected Teaching Hospitals of Tehran in 2019.

Objectives:The present study aims to determine the attitudes of care providers including obstetricians, paediatricians and midwives working in perinatal, obstetric and neonatal intensive care unit (NICU) wards of the selected teaching hospitals in Tehran in 2019. In addition, the challenges of providing palliative care from the perspective of these individuals have been examined.Materials and Methods:In this descriptive study, the research population was selected through convenience sampling based on the inclusion criteria. To assess care providers’ attitude toward the perinatal palliative care and the challenges of its implementation, in addition to the questionnaire of demographic characteristics, a researcher-made questionnaire was also used.Results:Most of the care providers (90.5%) believed that parents should be involved in decision-making to select the treatment type. Most of the care providers (90%) believed that the lack of prepared infrastructures is one of the major challenges in providing these types of care.Conclusion:Care providers have almost positive attitudes toward the various dimensions of providing perinatal palliative care, but it has not been properly implemented yet due to the insufficient knowledge of this type of care, the lack of required infrastructures (appropriate conditions in NICUs to provide this type of care, the sufficient number of staff and experts in this field), as well as the health authorities’ neglecting this type of care.

High Class and Special Thorax Nourishing Carry Out Between Mothers: A Clinic Centred Research and Evaluation

Background: Majority of the women do not give exclusive breast feed to their children and waste colostrum. The objective of this study was to assess practices of exclusive breast feeding among mothers less than 5 year children attending a tertiary care hospital outpatient. There is a decline in proper breast feeding practices in Pakistan Methodology: A cross sectional study was carried out on 258 mothers, who presented to Gynaecological and Obstetrical OPD or ward and had at least one child between the age of 1 to 5. Questions regarding their demographic profile and breast feeding practices were asked. Results: Among them 110/250 (44%) practiced exclusive breast feeding and the rest either used formula milk or cow’s milk along with breast milk. Only 41/250 (16%) women had given colostrum to their children, 153/250 (61%) had given Ghurti (a traditional pre-lacteal feed, mainly honey). Women who were uniparous, housewives, lived in joint families, belonged to middle class families and had vaginal mode of delivery had better breast feeding practices than others. When grading and categorization of breast feeding practices were done 41/250 (18.5%) had excellent practice, 69/250 (31%) had good and 111/250 (50%) had poor practice.221/250 (88.4%) women had breast fed their children and 29/250 (11.6%) had not. Conclusion: The study emphasizes that there is a need to improve exclusive breast feeding and colostrum giving practices.

MATERNAL FACTORS ASSOCIATED WITH LOW BIRTH WEIGHT AMONG THE DELIVERIES IN A SIR SUNDER LAL HOSPITAL, BHU, VARANASI

Abstract: Birth weight is very important indicator of the health and viability of a newborn infant. It is a significant factor of newborn growth and survival. Globally, it is estimated that there are 20 million of infants who are born with low birth weight, it depends on many maternal factors such as maternal age, gestations, antenatal care, education level, weight gain, parity, sex of child, and body mass index. Logistic regression is a statistical model for analyzing a dataset in which one or more independent variables that determine an outcome. The main objective of this paper is to identify the predictors of low birth weight through binary logistic regression model. Methods: A hospital based cross sectional study was conducted in Obstetrics and Gynecology postnatal ward of Sir Sunder Lal hospital, BHU, Varanasi from 14th June 2015 to 15 January 2017. Altogether 500 respondents were taken and respondents were Mother who had delivered the newborns in SSL hospital. A spring type weighing machine scale was used to measure the birth weight of babies and birth weight was taken after the birth within the 24 hours. Result: A total of 517 births occurred during the study period among which 39.07% were low birth weight and 60.93% were normal birth weight. Low birth weight neonates mean birth weight was found to be 1.93 kg and overall the mean in birth weight was 2.97 kg. Chi square test to find out the risk factor associated with the low birth weight which shows that maternal education, initial weight of mother, weight gain of mother, gestation, sex of child, pregnancy complication, body mass index, antenatal care are statistically significant with low birth weight. The fitted binary Logistic regression model shows that use of iron and calcium supplements has the highest odd ratio compared to the other factors. Conclusion: This study suggest that there were several factors finding to affect the birth weight which are education level, maternal weight, weight gain, body mass index, antenatal care, sex of neonates, pregnancy complication, gestation age and use of iron calcium supplements.