Primi Mothers Research Articles

A study to Evaluate the Effectiveness of Structured Teaching Programme on Knowledge Regarding Importance of Antenatal Checkup and Diagnostic Measures among Primi Mothers at Selected Community Area at Bangalore

Background of the study : Antenatal checkup is the systematic medical supervision of women during pregnancy and it includes education, counseling, screening and treatment to monitor and to promote the well-being of the mother and fetus. Antenatal check up is the key entry point of a pregnant woman to receive broad range of health promotion and preventive services which promote the health of the mother and the baby. India being developing countries contribute 26% global burden MMR with annually 136000 women dying annually. Proper antenatal checkup and diagnostic is one of the important ways to reduce the maternal and child mortality and morbidity. Therefore present study is to evaluate the effectiveness of structured teaching programme on knowledge regarding importance of antenatal checkup and diagnostic measures among primi mothers. Material and methods : Evaluative research approach and quasi experimental one group pre test and post test design was adopted. Convenient sampling method was used to select the 60 primi antenatal mothers in selected community area at Bangalore. Demographic performa and structured questionnaire were used to collect the data from the sample and the data were analyzed by descriptive and inferential statistics. Results : The results showed that in pre test all primi mothers 60(100%) are inadequate knowledge. Over all pretest mean 8.84, SD 1.65 and mean percentage 22.1%. In post test, 40(66.7%) primi mothers had adequate knowledge, 20 (33.3%) had moderately adequate knowledge. In post test over all mean 31.89, SD 1.32 and mean percentage 79.7%. The paired't 'test value 36.4 of overall score of knowledge was significant at P<0.01 level. There was a significant association between the post test demographic variables such as education, monthly income, types of family and do you receive information among primi mothers. Conclusion : Therefore it is proved statistically and concluded that structured teaching was effective in the improvement of knowledge on primi mothers, regarding antenatal check up and diagnostic measures. Antenatal check-up and diagnostic is very important for every pregnant woman should take in to great consideration. The study recommended an emphasis on health education for mother's awareness of the importance of regular antenatal checkup and diagnostic measures to health centre and hospital during pregnancy. There is a need to motivate women to utilize maternal care services which are freely available in all government health setup.

Effect of Health Care Package on Birth Preparedness and Complication Readiness in Terms of Knowledge, Practice and Labour Outcome Among Primi Gravida Mothers

The study evaluated the effectiveness health care package on birth preparedness and complication readiness in terms of knowledge, practice and labour outcome among primi mothers at a selected hospital of Delhi. It was an experimental research study with pre-test post-test control group design. The study was conducted in antenatal outpatient department of Safdarjung Hospital with 60 primi gravida mothers, 30 in each experimental and control group. Purposive sampling technique was used to select the sample, and assigned to the group by randomly. The pre-test and post-test were conducted by using a structured interview schedule and check list to assess the knowledge and practices respectively regarding birth preparedness and complication readiness. The health care package includes individual teaching, demonstration, pictorial cards, pamphlets, self-activity checklist, and daily foetal movement cont. chart. A structured performa was used to assess the labour outcome. The analysis was done by using both descriptive statistics and inferential statistics, in terms of frequencies, percentage, mean, median, standard deviation, ‘t’ value and ‘chi square’ value. The study revealed a knowledge deficit among primigravida mothers regarding birth preparedness and complication readiness. The health care package was effective to increase the knowledge and enhanced practices. Even though some of the physiological factors of labour outcome were not affected, a remarkable difference was found was found to establish a good feeding practices and less time of hospital stay. The health care package on birth preparedness and complication readiness was effective to enhance the knowledge and practices of primigravida mothers regarding preparations for birth, to identify complications early so as to seek appropriate care without delay.

A study to assess the effectiveness of self instructional module on neonatal care among Primi mothers

A study to assess the effectiveness of self instructional module on neonatal care among Primi mothers

Point of care in nursery to diagnose pneumothorax in neonates by new use of LED torch

Baby, A preterm female infant, was born to a primi mother at 33 weeks of gestation with a birth weight of 1.5 kg. Tracheo-esophageal fistula was diagnosed on antenatal scan and was confirmed after birth. The infant underwent primary end-to-end anastomosis on day 2 of life and was sustained by mechanical ventilation postoperatively. On day 5 of life, when the baby was on setting of peak inspiratory pressure of 15 mm Hg/peak, end-expiratory pressure of 4 mm Hg, and FiO 2 of 30%, there was a progressive increase in pressure and oxygen requirement. Suspecting air leak transillumination test was executed with a new LED device (Vein Finder @MIHIR NICS, Hyderabad, India). Transillumination tests confirmed the pneumothorax. Chest tube was inserted and baby improved dramatically.

A study to evaluate the knowledge, attitude and practices of exclusive breast feeding among primi mothers of healthy term neonates in a tertiary care hospital and predictors of failure of establishment of exclusive breast feeding in first six months

A study to evaluate the knowledge, attitude and practices of exclusive breast feeding among primi mothers of healthy term neonates in a tertiary care hospital and predictors of failure of establishment of exclusive breast feeding in first six months

English

English

Correlation of three dimensional anorectal manometry and three dimensional endoanal ultrasound findings in primi gravida: a cross sectional study.

Background3-dimensional anorectal manometry (3DARM) and 3-dimensional endoanal ultrasound (3DEAUS) have not been used to assess the anal sphincter complex (ASC) in primi gravida. This study was conducted to identify any correlation that may exist between 3DARM and 3DEAUS.Methods We analyzed 3DARM and 3DEAUS data of 101 consecutive primi mothers assessed in the late second trimester or early 3rd trimester. 3DARM was performed using the Given Imaging® Manoscan system and 3DEAUS was performed with the Olympus® RU 12M-R1 probe and EU-ME1 ultrasound system.ResultsThe mean age was 24.7 (SD—5.1) years. All patients had a normal Cleveland Clinic Incontinence Score. The mean resting pressure (RP) was 87.02 (SD—18.43) mmHg and the maximum squeeze pressure (SP) was 179.21 (SD—52.96) mmHg. The mean length of the high pressure zone was 3.67 (SD—0.52) cm. On 3DEAUS, there were three characteristic segments of the ASC that were identified; upper, middle and lower. Mean thicknesses for both internal anal sphincter (IAS) and external anal sphincter (EAS) were identified for primi gravida. IAS was thicker anteriorly and at 9 o’ clock positions and EAS was thicker posteriorly. There was good correlation in the length of the ASC at each quadrant between 3DARM and 3DEAUS. There was no correlation between either RP or SP thickness of IAS or EAS at each level and quadrant.ConclusionCorrelation is seen only in the length of ASC at each quadrant. No correlation exist between RP or SP and thickness of IAS and EAS.

A STUDY ON KNOWLEDGE OF PRIMI MOTHERS ON SELF MANAGEMENT OF MINOR DISCOMFORTS OF PREGNANCY

Abstract'A study on knowledge of primi mothers on self-management of minor discomfort of pregnancy with a view to develop information' was carried out in Justice K.S Hegde Charitable hospital on 100 primi-gravida mothers by using purposive sampling technique. The findings of the study showed that 87% of the primi mothers were in the age group of 21-30 years, 37% of the women had high school education, 70% of the subjects were Hindus, 77% belonged to joint families and 53% were in the gestational age group of 29-40 weeks.Most 59% of the Primigravida mothers had poor knowledge, 29% had average knowledge, and 12% had good knowledge regarding minor discomforts of pregnancy and its self-management.Area wise knowledge of Primigravida mothers reveals deficiency in most of the areas, but the lowest mean percentage of score is 28.25% with a standard deviation of 1.74 in the area of knowledge related to Circulatory and Nervous system, which indicated that the maximum knowledge deficit is in this area.There was significant association between knowledge of Primigravida mothers and age, educational qualification. The calculated ?2 values were 3.953 and 12.603 respectively which are more than the table value 3.84 and 7.82 at 0.05% level of significance. Hence, the research hypothesis was accepted.The result of the study proved that Primigravida mothers had poor knowledge regarding minor discomforts of pregnancy and its selfmanagement. The findings of the study showed that there was a need to educate all women on preparation towards motherhood. Providing an information booklet on minor discomforts of pregnancy and its management, an uneventful antenatal period can be expected from the mother.

Effectiveness of Social Support during Labour on Behavioural Response among Primi Mothers

Effectiveness of Social Support during Labour on Behavioural Response among Primi Mothers

Knowledge of common problems of newborn among primi mothers admitted in a selected hospital for safe confinement.

Background:Among the almost 3.9 million newborn deaths that occur worldwide, about 30% occur in India. Children are our future and utmost precious resources. After birth the health of the child depends upon the health care practice adopted by the family, especially by the mothers. Information about neonatal problems and newborn care practices will help in reducing mortality and morbidity during the neonatal period. This study was conducted to identify the knowledge of primi mothers with regard to the common problems of normal neonates.Materials and Methods:This descriptive study was carried out among the mothers of neonates in the Maternity Unit of a Medical College Hospital in Mangalore. A pretested structured knowledge questionnaire was used to collect information from 60 primi mothers, who were admitted for safe confinement for a one-month period.Results:The findings of the study show that the majority, that is, 27 (45%) of the primi mothers had a good knowledge of all the areas such as vomiting, regurgitation, diaper rash, umbilical cord infection, fever, constipation, and diarrhea. About 20 (33.3%) had very good knowledge and about 13 (21.67%) had an average level of knowledge on the common problems of newborns. Knowledge about vomiting was average among 34 (56.67%), poor in 21 (35%), and good in five (8.33%). Knowledge about diaper rash was average among 36 (60%), good among 21 (35%), and poor among three (5%). Knowledge on umbilical cord infection was average in 29 (48.33%), good in 27 (45%), and poor in 4 (6.67%). Knowledge on fever was good in 38 (63.33%), average in 19 (31.66%), and poor in three (5%). Knowledge on constipation and diarrhea were average in 38 (63.34%), good in 11 (18.33%), and poor in 11 (18.33%). No association was found between the knowledge of primi mothers and selected baseline variables, such as, age, education, religion, occupation, type of family or area of dwelling.Conclusion:The study concludes that there is a need to provide adequate information to first-time mothers about common newborn problems and this will help mothers care for their newborns better.

Effect of Acupressure on Labour Pain during First Stage of Labour among Primi Mothers in a Selected Hospital of Delhi

The study aimed to assess the degree of pain during labour in experimental and control groups before and after intervention and to compare the pain score during labour between the experimental and control groups after intervention. This experimental pre-test and post-test control group study was conducted on 60 primi mothers (30 each in experimental and control group) in Swami Dayanand Hospital, Delhi. The mean post-test pain score of control group (8.23) was higher than mean pre-test pain score (7.13) with a mean difference of 1.1 and standard deviation of 2.22. The obtained t-value (3.98) was higher than the t-value of 2.04 at df (29) at 0.05 level of significance. The mean post-test pain score in experimental group was 6.17 and mean post-test pain score of control group was 8.23 with a mean difference of 2.06 and standard deviation of 1.10. The t-value computed at 2.41 was more than the t-value of 2.00 at df (58) at 0.05 level of significance. The results indicate that Acupressure at point Li4 was effective in reducing the pain in experimental group. The findings suggest that the non-pharmacological method of pain relief measure like acupressure at point Li4 was effective in reducing labour pain in experimental group and in the control group it was found that pain was increasing as no intervention was done.

ESTIMATION OF AVERAGE BIRTH WEIGHT IN TERM NEWBORNS: A HOSPITAL BASED STUDY IN COASTAL KARNATAKA

Introduction: Average birth weight (BW) of Indian babies is believed to be 2.8-3 kg. BW is a key predictor of newborn outcome and indicator of health trend of a child. This study gives an insight into BW in coastal Karnataka. The objective of the present study was to estimate the average BW in term newborns and to study its correlation with sex of the newborn and maternal conditions. Methods: The retrospective study of data from medical records of births during May 2012-April 2014 in the Medical College Hospital. Multiple pregnancy, preterm and post-term were excluded. Parameters such as BW, gender, maternal age, parity, history of gestational diabetes mellitus (GDM), pregnancy-induced hypertension (PIH) were noted. Data were analyzed using Chi-square test. Results: A data of 3882 babies was included. BW ranged from 1.92 kg to 4.45 kg. The mean BW was 3.07 ± 0.455 kg. Mean BW of male babies was 3.09 ± 0.41 and female babies was 3.03 ± 0.4 kg. Average BW in primi mothers was 3.02 kg, multipara was 3.08 kg and grand multipara was 3.18 kg. In babies of PIH and GDM mothers, BW was 2.87 and 3.48 kg respectively. BW was not related to age of the mother or gender of the baby. Anomalous babies were found more in small for gestational age and large for gestational age rather than appropriate for gestational age. Conclusions: Average BW of term newborns is estimated as 3.07 kg. BW increased with parity of the mother and not with age of the mother or sex of the baby.

Colloidion baby - A case report

A female newborn baby delivered by LSCS to a primi mother with second degree consanguinity with typical features of colloidion baby is being presented. If this condition being recognized early and with early institution of therapy morbidity and mortality can be significantly reduced.

Obstetric Profile of Primi Teenage and Non-teenage mothers: A comparative study from Maharashtra, India

Introduction: Early marriages and teenage pregnancies are important contributing factors for high maternal as well as neo-natal morbidity and mortality.Objectives: To assess the magnitude of obstetric profile of teenage and non-teenage primi mothers and to determine the association among them. Methodology: A cross-sectional study was conducted at OB/Gynac clinic Krishna hospital Karad over a period of first quarter of year 2012. 93 eligible teenage primi mothers and equal number of non-teenage primi mothers admitted to Krishna hospital for delivery were enrolled, interviewed and observed for socio-demographic, obstetric outcome and it’s complications by investigator according to pre- designed structured proforma. Frequency percentage distribution and association was determined by applying tests of significance. Observations: Magnitude of teenage primi pregnancy was 6% during study period and most of them 92.50%, 76.30% and 46.20% were Hindus, housewives and belonged to lower class by religion, occupation and economically with mean age at marriage and delivery was 17.8 yrs and 18.8 yrs respectively. Max. 81.7% teenage primi mothers were anaemic and the percentage of obstetric complications like PIH, Oligohydramnios, PROM, Foetal distress among teenage primi mothers was 24%,8.6%, 1%, and 6.4% which was higher than nonteenage mothers. IUGR, cord prolapse, breech presentation and abruption placenta also reported among teenage primi mothers, however absent among non-teenage mothers. Max 55.9% teenage mothers were delivered before expected date of delivery and proportion of low birth weight baby was also high (39.8%) in teenage mothers than non-teenage mothers. Chance of delivery of male baby also increases as age at marriage increases. Conclusion: Adolescent pregnancy is an issue that calls for more education &amp; support to encourage girls to delay motherhood until they are ready. DOI: http://dx.doi.org/10.3329/bjms.v13i1.17432 Bangladesh Journal of Medical Science Vol. 13 No. 01 January2014: 63-66

No Crying Episode after DwPT- A Case of Congenital Hypothyroidism

Most of the parenteral vaccines induce some degree of local reactions, which include pain, erythema and induration. The DwPT vaccine is the most common vaccine which is being used in India.The current schedule, as has been recommended by the National Immunization Schedule, calls for DwPT vaccine injections from 1 1/2 months to 18 months. The local reactions are more with the whole cell pertusis vaccines and the aluminium adjuvant vaccines like DwPT (Diphtheria whole cell Pertusis Tetanus). A 1½ month old male baby was brought with the complaint of not crying after getting the DwPT injection. The baby was delivered at term to nonconsanguinous parents at a Primary Health Centre (PHC). The baby had received a zero dose polio and BCG immediately after birth and DwPT and Hepatitis B at 1½ months of age at a local PHC. The mother had been told about the normal reactions like fever, irritability and redness at the injection site that the baby could develop after taking the DwPT vaccine. The mother brought the child on the next day to us with a history of not having had irritability and a crying episode in spite of having swelling and redness at the injection site, as was told to her by the health workers at the PHC. On further questioning, it was found that the baby had a history suggestive of constipation. This prompted us to think about the underlying disorder like congenital hypothyroidism. His serum TSH was high and his T3 and T4 levels were very low. The baby was started on thyroxin tablets. At the next follow up, the baby was administered a second dose of DwPT, after which he showed the normal post vaccine phenomena like crying and fever. Minor adverse effects like pain, swelling, redness at the local site, fever, fussiness, anorexia and vomiting are reported when almost half of the vaccines are administered after any of the 3 primary doses of DwPT [1].Up to half of the children may have pain, redness or swelling at the site of the injection [2]. The local and the systemic reaction rates which are associated with DwPT are local redness in 37.4% of the babies, pain in 51%, fever in 31.5% and fretfulness in 53.4% of the cases [3]. The thyroid hormones, T3 and T4 act as the modulators of the immune response. The immune reactions like chemotaxis, phagocytosis, cytokine synthesis and release are altered in hypothyroidism [4].This may result in a diminished usual response to the vaccination, as it happened in our case. In the community setting, a large number of children are vaccinated at PHCs. Only very few children are vaccinated by paediatricians. The occult symptoms like a decreased activity, constipation, fever and cold to touch are likely to be neglected by the uneducated mothers, especially who are primi mothers or in early infancy, even by multipara mothers. The disorders like congenital hypothyroidism can be suspected and referred early to specialists, if the doctors and the peripheral health workers at the PHCs and the rural places are sensitized to recognize the importance of the post vaccine phenomena (DwPT), like irritability and crying. Congenital hypothyroidism is a treatable cause of mental retardation. Since we do not have routine neonatal thyroid screening programmes in our country, it is important to suspect, diagnose and treat congenital hypothyroidism at an early stage.

Predictive Values of Risk Factors in Neonatal Sepsis

Neonatal sepsis is one of the most important causes of mortality and morbidity especially in developing countries. Management of such cases is difficult, costly and need expert centers in many cases. Therefore, identification of the risk factors and their predictive values may help optimizing its management. With the above idea this case-control study was done to see the effects of maternal and neonatal risk factors and to find their predictive values in the development of neonatal sepsis. Fifty cases and fifty suitably matched controls were enrolled in the study and different maternal, natal and newborn factors were compared. Many risk factors were found to have influence in the development of neonatal sepsis. Among them the maternal intrapartum fever, foul smelling liquor, young mother (&lt; 20 yrs), poor income group, prolonged labor, unclean vaginal examination (UVE) and primi mother were much associated with the occurrence of sepsis. Also the neonatal factors, like prematurity, resuscitation at birth and low APGAR score carried the significant risk of developing sepsis. But when relative influence of these risk factors were analyzed over neonatal sepsis in detecting their predictive values, it was found that irregular antenatal check up, prematurity, resuscitation at birth, and maternal intrapartum fever had influenced most in the development of neonatal sepsis in chronological order. DOI: http://dx.doi.org/10.3329/jbcps.v29i4.11324 J Bangladesh Coll Phys Surg 2011; 29: 187-195

A Prospective Study for the Prediction of Preeclampsia with Urinary Calcium Level

To assess the efficacy of calciuria as a diagnostic test for the prediction of preeclampsia, and also to determine the changes in urinary excretion of calcium in preeclampsia and normotensive women. A prospective study was conducted on 60 primi mothers in the age group of 20-30years, and all were enrolled at 16weeks of gestation with clinical follow up by 4weeks and 24h urinary calcium and creatinine estimation. Ten mothers developed preeclampsia (study groups) and fifty remained normotensive (control groups). By means of Receiver-operator curve, a cut-off level of urinary calcium in 24h was chosen for predicting preeclampsia. Preeclamptic women excreted significantly less total urine calcium (87.0±3.59mg/24h) than normotensive women (303.68±17.699mg/24h) (p<0.0001) at 40weeks of gestation. Urinary calcium and calcium/creatinine (Ca:Cr) ratio decreases progressively from 28weeks to 40weeks in the study group when compared to normotensive group. Preeclamptic women excrete less calcium than normotensive women. This parameter would predict preeclampsia earlier in pregnancy.

Effective Nursing Interventions on Pain during Labour among Primi Mothers

Effective Nursing Interventions on Pain during Labour among Primi Mothers

Deviated nasal septum in the newborn-A 1-year study.

A prospective study of 200 newborn babies was done at Silchar Medical College Hospital from September 2002 to August 2003. The babies aged from 0 to 4 days were taken in the study. They were examined for any signs of nasal obstruction, birth trauma, prolonged labour, mode of delivery (forceps/vaginal/caeserian section), intrauterine malposition, postmaturity, birthweight, cephalopelvic disproportion, parity of the mother and gestational period. The diagnosis was done by clinical examination, rhinometry, struts and applying cotton wool. In the study, the incidence was found to be 14.5% (29 cases). It was found that high-birth weight babies, delivered by vaginal route (55%), to a primi mother are more likely to have DNS after birth. Moreover, intrauterine malposition particularly breech (45%) and prolonged labour seemed to play a role in newborn DNS. More importantly, the present study seems to indicate that since a good percentage of such deformity originate at the gestational period, early detection at the neonatal age is vital to manage and also to prevent complications and sequelae in adult life. Therefore, a policy of routine screening in view of early correction is advocated to decrease the morbidity associated with nasal septal deviation in newborns.