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Sample records for royal maternity hospital

  1. Maternal 'near miss' at Royal Darwin Hospital: An analysis of severe maternal morbidity at an Australian regional tertiary maternity unit.

    Science.gov (United States)

    Jayaratnam, Skandarupan; Burton, Alice; Connan, Kirsten Fiona; de Costa, Caroline

    2016-08-01

    Assessment of severe maternal morbidity using World Health Organization (WHO) 'near-miss' criteria is gaining in importance as a valuable tool in the assessment of maternity care of women. Identification of cases allows an understanding of aetiology of severe morbidity and factors contributing to poor maternal outcomes. The aim of this study is to determine the rate of maternal 'near miss' at Royal Darwin Hospital (RDH) and the utility of the WHO near-miss criteria as a tool for data collection in a regional Australian context. Cases of maternal 'near miss' and deaths were prospectively identified over a period of 12 months using the WHO criteria. During the audit period, there were 2080 live births at Royal Darwin Hospital (RDH): 10 women presented with a 'near miss' and there was one maternal death. The maternal mortality ratio for the hospital was 48/100 000 live births, the maternal 'near-miss' index ratio was 4.8/1000 live births, and the combination of maternal deaths and near misses gave a severe maternal outcome (SMO) ratio of 5.3/1000 live births. The main cause of obstetric 'near miss' was obstetric haemorrhage. Indigenous women and women from remote areas comprised a significant portion of 'near-miss' cases. The rates of maternal 'near miss' at RDH are consistent with other studies in the developed world. The WHO maternal 'near-miss' audit tool helps health professionals understand and anticipate severe maternal morbidities, with the aim of improving maternal and perinatal outcomes. © 2016 The Royal Australian and New Zealand College of Obstetricians and Gynaecologists.

  2. [Medical care at the Royal Hospital of Natives].

    Science.gov (United States)

    Romero-Huesca, Andrés; Ramírez-Bollas, Julio

    2003-01-01

    After the Conquest, the indigenous populations of New Spain were left unprotected by the new government. Thus the Royal Hospital of Naturals (RHN) was created, offering care to the indigenous population for health and with hospitality, as well as religious aid. However, later solely care was provided. The RHN had great support from the Spanish Crown and became a suitable place for clinical investigation that on the peninsula and in all of Europe was forbidden: the autopsies, that in indigenous population are carried out without sanction, only needing authorization of local authorities for their accomplishment, considering the indigenous as inferior to Spaniards. In addition, the RHN was the best place for foundation of the Royal Surgery School of Mexico in the XVIII century. The contribution of the RHN was the fusion of indigenous medicine with European medicine, increasing the therapeutic resource array, as well as the opportunity of carrying clinic investigation through autopsy's for better clinic correlation, and matchless learning for the era in the art of out surgery, this being an important point in the development of the medicine and surgery of Mexico.

  3. Anaemia in elective orthopaedic surgery - Royal Adelaide Hospital, Australia.

    Science.gov (United States)

    Kearney, B; To, J; Southam, K; Howie, D; To, B

    2016-01-01

    An anaemia clinic was established to improve the preoperative management of elective orthopaedic patients scheduled for arthroplasty. This paper is a report on the first 100 patients assessed. To assess the incidence and causes of anaemia in patients on a waiting list for elective arthroplasty in a public hospital and to assess the impact of anaemia detection in this patient population. Patients attending an Anaemia Clinic for elective orthopaedic surgical patients, during March 2010 to June 2013 were studied. Outcome measures included change in haemoglobin preoperative results and perioperative transfusion rates by preoperative haemoglobin. Seventeen per cent of patients scheduled for elective surgery were found to be anaemic. Of the 100 patients who attended, approximately half were found to be iron deficient and the remainder had anaemia of chronic disease. Serum ferritin anaemia were able to be treated, in all cases, to achieve a significant increase in preoperative haemoglobin. The general unavailability of erythropoietin limited effective intervention for the non-iron-deficient anaemic patients. Seven patients had their surgery cancelled because of the screening programme. Half of the anaemic patients in a joint replacement screening clinic were iron deficient, and treatment was effective in improving the pre-operative haemoglobin and reducing perioperative transfusion rates. This screening process should improve patient outcome. Another important finding in this group of patients is that ferritin levels cannot be reliably used as the sole indicator in the diagnosis of iron deficiency anaemia in this group of patients undergoing elective arthroplasty. © 2015 Royal Australasian College of Physicians.

  4. [Carl Gustav Carus, the first director of the newly established maternity institute of the Dresden Royal Surgical-Medical Academy 1814-1827].

    Science.gov (United States)

    Sarembe, B

    1989-01-01

    Carl Gustav Carus was born in 1789 in Leipzig. He studied at the University of Leipzig. His specialization in Gynecology and Obstetrics took place at the Triersches Maternity Hospital. In 1814 he was named Professor for Obstetrics in Dresden at the Royal-Surgical-Medical-Academy. He was the head of the Maternity Hospital till 1827. Under his direction many midwives, students and physicians were educated. He published numerous articles and books on medical and philosophical-psychological topics. He was a talented artist of the Romantic especially in painting landscapes. He was a friend of Caspar David Friedrich and Johann Wolfgang von Goethe. After 1827 he was the physician in ordinary to 3 saxonian kings. He died in 1869. The Medical Academy in Dresden bears his name "Carl Gustav Carus" since its foundation.

  5. [Proximity and breastfeeding at the maternity hospital].

    Science.gov (United States)

    Fradin-Charrier, Anne-Claire

    2015-01-01

    The establishment of breastfeeding, as well as its duration, are facilitated through the proximity of the mother with her new baby. However, in maternity hospitals, breastfeeding mothers very often leave their baby in the nursery at night time. A study carried out in 2014 in several maternity hospitals put forward suggestions and highlighted areas to improve in everyday practice. Copyright © 2015 Elsevier Masson SAS. All rights reserved.

  6. Use of Royal Darwin Hospital emergency department by immigration detainees in 2011.

    Science.gov (United States)

    Deans, Adrienne K; Boerma, Clare J; Fordyce, James; De Souza, Mark; Palmer, Didier J; Davis, Joshua S

    2013-12-16

    To describe the number and nature of emergency department (ED) attendances by immigration detainees in Darwin, in the Northern Territory, over a 12-month period. Retrospective observational study of immigration detainees attending the Royal Darwin Hospital ED during the 2011 calendar year. Number of ED attendances and primary diagnoses. In 2011, there were 770 ED attendances by 518 individual detainees at Royal Darwin Hospital. Those who attended the ED had a mean (SD) age of 27.6 (12.2) years, and 112 of them (21.6%) were children. Most (413, 79.7%) were male, and Iran and Afghanistan were the two most common countries of birth. We estimate that 50.1% (95% CI, 47.0%-53.2%) of immigration detainees in Darwin (mean, 776 per month; total, 1034), attended the Royal Darwin Hospital ED at least once in 2011. The most common primary diagnosis was psychiatric problems (187 attendances, 24.3%), including self-harm (138 attendances, 17.9%). In 2011, asylum seekers in immigration detention in Darwin had a high prevalence of unmet health needs and substantial levels of psychiatric morbidity. The primary health care provided to them was inadequate.

  7. Intraocular lens confusions: a preventable "never event" - The Royal Victorian Eye and Ear Hospital protocol.

    Science.gov (United States)

    Zamir, Ehud; Beresova-Creese, Katarina; Miln, Linda

    2012-09-01

    Intraocular lens (IOL) confusions and errors are among the most common postoperative adverse events. Errors may occur at any stage from the decision to operate to the insertion of the IOL. The most common errors occur during IOL selection pre-operative preparation (anaesthesia given before recognition that the intended IOL is not available), or intraoperatively (wrong IOL implanted because of confusion in the operating room). We review the mechanisms of errors reported in the literature and describe the experience at The Royal Victorian Eye and Ear Hospital. We also describe the implementation of an error-detection protocol and provide qualitative data on its performance.

  8. Maternal mortality in a Transitional Hospital in Enugu, South East ...

    African Journals Online (AJOL)

    Maternal mortality in a Transitional Hospital in Enugu, South East Nigeria. ... deaths at Enugu State University Teaching Hospital Parklane, over its 5 year transition period ... There were 7146 live births and 60 maternal deaths giving an overall ...

  9. Using 'reverse triage' to create hospital surge capacity: Royal Darwin Hospital's response to the Ashmore Reef disaster.

    Science.gov (United States)

    Satterthwaite, Peter S; Atkinson, Carol J

    2012-02-01

    This report analyses the impact of reverse triage, as described by Kelen, to rapidly assess the need for continuing inpatient care and to expedite patient discharge to create surge capacity for disaster victims. The Royal Darwin Hospital was asked to take up to 30 casualties suffering from blast injuries from a boat carrying asylum seekers that had exploded 840 km west of Darwin. The hospital was full, with a backlog of cases awaiting admission in the emergency department. The Disaster Response Team convened at 10:00 to develop the surge capacity to admit up to 30 casualties. By 14:00, 56 beds (16% of capacity) were predicted to be available by 18:00. The special circumstances of a disaster enabled staff to suspend their usual activities and place a priority on triaging inpatients' suitability for discharge. The External Disaster Plan was activated and response protocols were followed. Normal elective activity was suspended. Multidisciplinary teams immediately assessed patients and completed the necessary clinical and administrative requirements to discharge them quickly. As per the Plan there was increased use of community care options: respite nursing home beds and community nursing services. Through a combination of cancellation of all planned admissions, discharging 19 patients at least 1 day earlier than planned and discharging all patients earlier in the day surge capacity was made available in Royal Darwin Hospital to accommodate blast victims. Notably, reverse triage resulted in no increase in clinical risk with only one patient who was discharged early returning for further treatment.

  10. First trimester maternal urinary metabolomic profile to predict macrosomia

    LENUS (Irish Health Repository)

    Walshe, J

    2011-02-01

    Institute of Obstetricians & Gynaecologists, RCPI Four Provinces Meeting, Junior Obstetrics & Gynaecology Society Annual Scientific Meeting, Royal Academy of Medicine in Ireland Dublin Maternity Hospitals Reports Meeting, Nov 2010

  11. Lessons From a 17-Year Radiosurgery Experience at the Royal Adelaide Hospital

    Energy Technology Data Exchange (ETDEWEB)

    Roos, Daniel E., E-mail: daniel.roos@health.sa.gov.au [Department of Radiation Oncology, School of Medicine, University of Adelaide, Royal Adelaide Hospital, Adelaide, South Australia (Australia); Brophy, Brian P. [Department of Neurosurgery, School of Surgery, University of Adelaide, Royal Adelaide Hospital, Adelaide, South Australia (Australia); Taylor, James [Department of Radiology, Royal Adelaide Hospital, Adelaide, South Australia (Australia)

    2012-01-01

    Purpose: To illustrate some of the potential pitfalls of cranial stereotactic radiosurgery (SRS) and its planning based on prospectively gathered data from a 17-year experience at the Royal Adelaide Hospital. Methods and Materials: More than 250 treatments have been planned since 1993 using previously described standard SRS techniques for intracranial benign and malignant lesions. Results: Five case studies are presented (1 meningioma, 1 acoustic neuroma, 2 solitary brain metastasis, 1 arteriovenous malformation), each of which demonstrates at least one salutary lesson. Conclusions: Because SRS delivers a highly conformal dose distribution, it is unforgiving of any geographic miss due to inaccurate outlining and thus dependent on neuroradiological expertise and collaboration. There are also potentially significant implications of misdiagnosis in SRS cases without histological proof-in particular, presumed brain metastases.

  12. Implementation of an Open Source Library Management System: Experiences with Koha 3.0 at the Royal London Homoeopathic Hospital

    Science.gov (United States)

    Bissels, Gerhard

    2008-01-01

    Purpose: The purpose of this paper is to describe the selection process and criteria that led to the implementation of the Koha 3.0 library management system (LMS) at the Complementary and Alternative Medicine Library and Information Service (CAMLIS), Royal London Homoeopathic Hospital. Design/methodology/approach: The paper is a report based on…

  13. Influence of the support offered to breastfeeding by maternity hospitals

    OpenAIRE

    Adriana Passanha; Maria Helena D'Aquino Benício; Sônia Isoyama Venâncio; Márcia Cristina Guerreiro dos Reis

    2015-01-01

    ABSTRACT OBJECTIVE To evaluate whether the support offered by maternity hospitals is associated with higher prevalences of exclusive and predominant breastfeeding. METHODS This is a cross-sectional study including a representative sample of 916 infants less than six months who were born in maternity hospitals, in Ribeirao Preto, Sao Paulo, Southeastern Brazil, 2011. The maternity hospitals were evaluated in relation to their fulfillment of the Ten Steps to Successful Breastfeeding. Data were ...

  14. A retrospective analysis of deep neck infections at Royal perth hospital.

    Science.gov (United States)

    Matzelle, S J; Heard, A M B; Khong, G L S; Riley, R H; Eakins, P D

    2009-07-01

    Serious deep neck infections may result in life-threatening airway complications. The aim of this study was to review the management of patients requiring surgical drainage with deep neck infections and to identify possible factors that may predict a greater risk of airway complications. In this study the authors reviewed the notes of patients requiring surgical drainage of deep neck infections who were admitted to Royal Perth Hospital over a seven-year period (2000 to 2007). One hundred and twenty-nine suitable patients were identified, of whom 15.5% encountered airway complications including one death due to airway obstruction. Airway complications were more common if there was no consultant anaesthetist present (odds ratio 4.01 [confidence interval 1.20 to 13.46], P = 0.02). Deep neck infections are still relatively common and are associated with significant morbidity and mortality. Patients with deep neck infections represent an anaesthetic challenge which should be managed by those with an appropriate level of experience.

  15. Delta F508 testing of the DNA bank of the Royal Manchester Children's Hospital.

    Science.gov (United States)

    Schwarz, M J; Super, M; Wallis, C; Beighton, P; Newton, C; Heptinstall, L E; Summers, C; Markham, A; Hambleton, G; Webb, K W

    1990-09-01

    Details of haplotype and delta F508 status from various populations represented in the cystic fibrosis (CF) DNA bank of the Royal Manchester Children's Hospital are provided, together with information on the association of genotype and clinical status. Clinical details and DNA analyses from native English in the North-West and South-West of England (Bath), from Lancashire Pakistani families and from Afrikaans Namibian families are compared. A 78.5% incidence of delta F508 has been found in English families. Compound heterozygotes with CF and only one delta F508 gene have an increased likelihood of having milder disease, with less Pseudomonas isolated from sputum and relatively more showing either no regular respiratory pathogens or colonisation with Staphylococcus. There is also a relative increase in meconium ileus in these compound heterozygotes. The diagnosis of CF may be in doubt in some subjects negative for delta F508. Some of the Bath families have unusual haplotypes for an English population and a compound heterozygote delta F508/delta I507 has been found. There is evidence from metD analysis of the founder effect in the Afrikaans Namibian families, who have a high delta F508 incidence.

  16. Clinical correlation of maternal and fetal placental growth hormone in Type 1 diabetic pregnancy

    LENUS (Irish Health Repository)

    Higgins, M

    2011-02-01

    Institute of Obstetricians & Gynaecologists, RCPI Four Provinces Meeting, Junior Obstetrics & Gynaecology Society Annual Scientific Meeting, Royal Academy of Medicine in Ireland Dublin Maternity Hospitals Reports Meeting, Nov 2011

  17. The last Viking King: a royal maternity case solved by ancient DNA analysis

    DEFF Research Database (Denmark)

    Dissing, Jørgen; Binladen, Jonas; Hansen, Anders

    2006-01-01

    Estridsen to haplogroup H; Estrid's sequence differed from that of Sven at two positions in HVR-1, 16093T-->C and 16304T-->C, indicating that she belongs to subgroup H5a. Given the maternal inheritance of mtDNA, offspring will have the same mtDNA sequence as their mother with the exception of rare cases...... (approximately 35 years) at the time of death than the 70 years history records tell. Although the entombed woman cannot be the Estrid, she may well be one of Sven's two daughters-in-law who were also called Estrid and who both became queens....

  18. Hormonal treatments in metastatic endometrial stromal sarcomas: the 10-year experience of the sarcoma unit of Royal Marsden Hospital

    OpenAIRE

    2015-01-01

    Background Hormonal manipulation is sometimes recommended in the treatment of metastatic endometrial stromal sarcoma, but there are few data assessing the efficacy of endocrine therapies in this subtype of uterine sarcomas. Methods We performed a retrospective electronic medical record review of patients with metastatic ESS treated with a hormonal agent at Royal Marsden Hospital between 1999 and 2011. We assessed progression-free survival (PFS), objective response and toxicity profile among p...

  19. A portrait of prefrontal lobotomy performed at the Royal Prince Alfred Hospital in Sydney by Dr Rex Money.

    Science.gov (United States)

    White, Richard T; McGee-Collett, Martin

    2016-10-01

    The objective of this article is to provide a portrait of prefrontal lobotomy performed at the Royal Prince Alfred Hospital, Sydney by the Head of Neurosurgery Dr Rex Money and to describe Dr Money's role in the promotion of psychosurgery in Sydney. We draw attention to an oral presentation by Dr Rex Money in 1951, a journal article written by Money, archival information held at the Royal Prince Alfred Hospital, including Dr Money's accounts of his travels and his reports regarding neurosurgery - both internationally and in Australia. Dr Rex Money performed a series of 13 prefrontal lobotomies between 1945 and 1951, and presented the theoretical basis for his series, his operative procedures and the outcomes at the annual meeting of its medical officers' association. Notwithstanding various deficiencies in his clinical research, Money's descriptions give a relatively comprehensive account of one of the first series of prefrontal lobotomies performed in Australia. The current article also describes Dr Money's contributions to the promotion of psychosurgery in Sydney, and illustrates the participation of a senior neurosurgeon and of a major Sydney teaching hospital during the psychosurgery saga. © The Royal Australian and New Zealand College of Psychiatrists 2016.

  20. Ghrelin concentrations in maternal and cord blood of type 1 diabetic and non-diabetic pregnancies at term

    LENUS (Irish Health Repository)

    Heir, MP

    2011-02-01

    Institute of Obstetricians & Gynaecologists RCPI Four Provinces Meeting, Junior Obstetrics & Gynaecology Society Annual Scientific Meeting, Royal Academy of Medicine in Ireland Dublin Maternity Hospitals Reports Meeting Nov 2010

  1. Influence of the support offered to breastfeeding by maternity hospitals.

    Science.gov (United States)

    Passanha, Adriana; Benício, Maria Helena D'Aquino; Venâncio, Sônia Isoyama; Reis, Márcia Cristina Guerreiro dos

    2015-01-01

    To evaluate whether the support offered by maternity hospitals is associated with higher prevalences of exclusive and predominant breastfeeding. This is a cross-sectional study including a representative sample of 916 infants less than six months who were born in maternity hospitals, in Ribeirao Preto, Sao Paulo, Southeastern Brazil, 2011. The maternity hospitals were evaluated in relation to their fulfillment of the Ten Steps to Successful Breastfeeding. Data were collected regarding breastfeeding patterns, the birth hospital and other characteristics. The individualized effect of the study factor on exclusive and predominant breastfeeding was analyzed using Poisson multiple regression with robust variance. Predominant breastfeeding tended to be more prevalent when the number of fulfilled steps was higher (p of linear trend = 0.057). The step related to not offering artificial teats or pacifiers to breastfed infants and that related to encouraging the establishment of breastfeeding support groups were associated, respectively, to a higher prevalence of exclusive (PR = 1.26; 95%CI 1.04;1.54) and predominant breastfeeding (PR = 1.55; 95%CI 1.01;2.39), after an adjustment was performed for confounding variables. We observed a positive association between support offered by maternity hospitals and prevalences of exclusive and predominant breastfeeding. These results can be useful to other locations with similar characteristics (cities with hospitals that fulfill the Ten Steps to Successful Breastfeeding) to provide incentive to breastfeeding, by means of promoting, protecting and supporting breastfeeding in maternity hospitals.

  2. Influence of the support offered to breastfeeding by maternity hospitals

    Directory of Open Access Journals (Sweden)

    Adriana Passanha

    2015-01-01

    Full Text Available ABSTRACT OBJECTIVE To evaluate whether the support offered by maternity hospitals is associated with higher prevalences of exclusive and predominant breastfeeding. METHODS This is a cross-sectional study including a representative sample of 916 infants less than six months who were born in maternity hospitals, in Ribeirao Preto, Sao Paulo, Southeastern Brazil, 2011. The maternity hospitals were evaluated in relation to their fulfillment of the Ten Steps to Successful Breastfeeding. Data were collected regarding breastfeeding patterns, the birth hospital and other characteristics. The individualized effect of the study factor on exclusive and predominant breastfeeding was analyzed using Poisson multiple regression with robust variance. RESULTS Predominant breastfeeding tended to be more prevalent when the number of fulfilled steps was higher (p of linear trend = 0.057. The step related to not offering artificial teats or pacifiers to breastfed infants and that related to encouraging the establishment of breastfeeding support groups were associated, respectively, to a higher prevalence of exclusive (PR = 1.26; 95%CI 1.04;1.54 and predominant breastfeeding (PR = 1.55; 95%CI 1.01;2.39, after an adjustment was performed for confounding variables. CONCLUSIONS We observed a positive association between support offered by maternity hospitals and prevalences of exclusive and predominant breastfeeding. These results can be useful to other locations with similar characteristics (cities with hospitals that fulfill the Ten Steps to Successful Breastfeeding to provide incentive to breastfeeding, by means of promoting, protecting and supporting breastfeeding in maternity hospitals.

  3. Melioidosis Causing Critical Illness: A Review of 24 Years of Experience From the Royal Darwin Hospital ICU.

    Science.gov (United States)

    Stephens, Dianne P; Thomas, Jane H; Ward, Linda M; Currie, Bart J

    2016-08-01

    Melioidosis is increasing in incidence with newly recognized foci of melioidosis in the Americas, Africa, and elsewhere. This review describes the demographics, management, and outcomes of a large cohort of critically ill patients with melioidosis. Data were extracted from two prospective databases-the Menzies School of Health Research Melioidosis Database (1989-2013) and the Royal Darwin Hospital ICU Melioidosis Database (2001-2013). The Royal Darwin Hospital ICU is the only ICU in the tropical Top End of Northern Territory of Australia, an endemic area for melioidosis. The study included all patients with melioidosis admitted to Royal Darwin Hospital ICU from 1989 to 2013. From 1989 to 2013, 207 patients with melioidosis required admission to ICU. Mortality reduced from 92% (1989-1997) to 26% (1998-2013) (p < 0.001). The reduced mortality coincided with the introduction of an intensivist-led service, meropenem, and adjuvant granulocyte colony-stimulating factor for confirmed melioidosis sepsis in 1998. Pneumonia was the presenting illness in 155 of 207 (75%). ICU melioidosis patients (2001-2013) had an Acute Physiology and Chronic Health Evaluation II score of 23, median length of stay in the ICU of 7 days, and median ventilation hours of 130 and one third required renal replacement therapy. The mortality for critically ill patients with melioidosis in the Top End of the Northern Territory of Australia has substantially reduced over the past 24 years. The reduction in mortality coincided with the introduction of an intensivist-led model of care, the empiric use of meropenem, and adjunctive treatment with granulocyte colony-stimulating factor in 1998.

  4. Cocaine and amphetamine-regulated transcript (CART) concentration in maternal and cord blood in type 1 diabetic and non diabetic pregnancies at term

    LENUS (Irish Health Repository)

    Hehir, MP

    2011-02-01

    Institute of Obstetricians & Gynaecologists, RCPI Four Provinces Meeting, Junior Obstetrics & Gynaecology Society Annual Scientific Meeting, Royal Academy of Medicine in Ireland Dublin Maternity Hospitals Reports Meeting Nov 2010

  5. Informal patient payments in maternity hospitals in Kiev, Ukraine.

    Science.gov (United States)

    Stepurko, Tetiana; Pavlova, Milena; Levenets, Olena; Gryga, Irena; Groot, Wim

    2013-01-01

    Maternity care in Ukraine is a government priority. However, it has not undergone substantial changes since the collapse of the Soviet Union. Similar to the entire health care sector in Ukraine, maternity care suffers from inefficient funding, which results in low quality and poor access to services. The objective of this paper is to explore the practice of informal payments for maternity care in Ukraine, specifically in cases of childbirth in Kiev maternity hospitals. The paper provides an ethnographic study on the consumers' and providers' experiences with informal payments. The results suggest that informal payments for childbirth are an established practice in Kiev maternity hospitals. The bargaining process between the pregnant woman (incl. her partner) and the obstetrician is an important part of the predelivery arrangement, including the informal payment. To deal with informal payments in Kiev maternity hospitals, there is a need for the following: (i) regulation of the "quasi-official" patient payments at the health care facility level; and (ii) improvement of professional ethics through staff training. These strategies should be coupled with improved governance of the health care sector in general, and maternity care in particular in order to attain international quality standards and adequate access to facilities.

  6. Birthing Centers and Hospital Maternity Services

    Science.gov (United States)

    ... What are the hospital's statistics for cesarean sections, episiotomies, and mortality? (Keep in mind, though, that these ... What are the center's statistics for hospital transfers, episiotomies, and mortality? What procedures are followed after your ...

  7. Severe maternal morbidity for 2004-2005 in the three Dublin maternity hospitals.

    LENUS (Irish Health Repository)

    Murphy, Cliona M

    2012-02-01

    OBJECTIVE: To assess the prevalence and causes of severe maternal morbidity in Dublin over a two year period from 2004 to 2005. STUDY DESIGN: A prospective cohort study from January 2004 to December 2005 was undertaken in the three large maternity hospitals in Dublin, which serve a population of 1.5 million people. All are tertiary referral centres for obstetrics and neonatology and have an annual combined delivery rate of circa 23,000 births. Cases of severe maternal morbidity were identified. A systems based classification was used. The primary cause of maternal morbidity and the number of events experienced per patient was recorded. RESULTS: We identified 158 women who fulfilled the definition for severe maternal morbidity, giving a rate of 3.2 per 1000 maternities. There were two maternal deaths during the time period giving mortality to morbidity ratio of 1:79. The commonest cause of severe morbidity was vascular dysfunction related to obstetric haemorrhage. Eclampsia comprised 15.4% of cases. Intensive care or coronary care admission occurred in 12% of cases. CONCLUSION: The prevalence of severe maternal morbidity in this population is 3.2\\/1000 maternities. Obstetric haemorrhage was the main cause of severe maternal morbidity.

  8. Royal Victoria Eye and Ear Hospital annual report and accounts,1996: celebrating 100 years.

    LENUS (Irish Health Repository)

    1997-01-01

    The Dublin Eye and Ear Hospital Act, 1897 came in to force on 15th July 1897. The Act provided for the amalgamation of the National Eye and Ear Hospital in Molesworth Street (founded in 1814) and St Mark\\'s Ophthalmic Hospital in Lincoln Place founded in 1844 by Sir William R. Wilde) and established this Hospital. We are therefore celebrating this year the completion of one hundred year of service by the Hospital to the citizens of Dublin and indeed to people from all parts of Ireland.

  9. Preparedness planning for pandemic influenza among large US maternity hospitals

    Directory of Open Access Journals (Sweden)

    A Akers

    2009-01-01

    Full Text Available The objective of this investigation was to determine the state of pandemic influenza preparedness and to delineate commonly reported challenges among a sample of larger US national maternity hospitals. This was done given the recent emphasis on hospital disaster planning and the disproportionate morbidity and mortality that pregnant women have suffered in previous influenza pandemics. An internet-based survey was sent to all 12 members of the Council of Women's and Infants' Specialty Hospitals. Questions addressed hospital demographics and overall pandemic preparedness planning, including presence of a pandemic planning committee and the existence of written plans addressing communications, surge capacity, degradation of services, and advance supply planning. Nine of 12 (75% hospitals responded. All had active pandemic planning committees with identified leadership. The majority (78% had written formal plans regarding back-up communications, surge/overflow capacity, and degradation of services. However, fewer (44% reported having written plans in place regarding supply-line/stockpiling of resources. The most common challenges noted were staff and supply coordination, ethical distribution of limited medical resources, and coordination with government agencies. In conclusion, the majority of the Council of Women's and Infants' Specialty Hospitals maternity hospitals have preliminary infrastructure for pandemic influenza planning, but many challenges exist to optimize maternal and fetal outcomes during the next influenza pandemic.

  10. Secondary postpartum haemorrhage - a underappreciated danger. A retrospective review of the incidence of hysterectomy for the 37 years at Holles St Hospital

    LENUS (Irish Health Repository)

    2011-02-01

    Institute of Obstetricians & Gynaecologists, RCPI Four Provinces Meeting, Junior Obstetrics & Gynaecology Society Annual Scientific Meeting, Royal Academy of Medicine in Ireland Dublin Maternity Hospitals Reports Meeting, Nov 2010

  11. Maternal near-miss in a rural hospital in Sudan

    Directory of Open Access Journals (Sweden)

    Adam Gamal K

    2011-06-01

    Full Text Available Abstract Background Investigation of maternal near-miss is a useful complement to the investigation of maternal mortality with the aim of meeting the United Nations' fifth Millennium Development Goal. The present study was conducted to investigate the frequency of near-miss events, to calculate the mortality index for each event and to compare the socio-demographic and obstetrical data (age, parity, gestational age, education and antenatal care of the near-miss cases with maternal deaths. Methods Near-miss cases and events (hemorrhage, infection, hypertensive disorders, anemia and dystocia, maternal deaths and their causes were retrospectively reviewed and the mortality index for each event was calculated in Kassala Hospital, eastern Sudan over a 2-year period, from January 2008 to December 2010. Disease-specific criteria were applied for these events. Results There were 9578 deliveries, 205 near-miss cases, 228 near-miss events and 40 maternal deaths. Maternal near-miss and maternal mortality ratio were 22.1/1000 live births and 432/100 000 live births, respectively. Hemorrhage accounted for the most common event (40.8%, followed by infection (21.5%, hypertensive disorders (18.0%, anemia (11.8% and dystocia (7.9%. The mortality index were 22.2%, 10.0%, 10.0%, 8.8% and 2.4% for infection, dystocia, anemia, hemorrhage and hypertensive disorders, respectively. Conclusion There is a high frequency of maternal morbidity and mortality at the level of this facility. Therefore maternal health policy needs to be concerned not only with averting the loss of life, but also with preventing or ameliorating maternal-near miss events (hemorrhage, infections, hypertension and anemia at all care levels including primary level.

  12. Predicting in-hospital maternal mortality in Senegal and Mali.

    Directory of Open Access Journals (Sweden)

    Cheikh Ndour

    Full Text Available OBJECTIVE: We sought to identify predictors of in-hospital maternal mortality among women attending referral hospitals in Mali and Senegal. METHODS: We conducted a cross-sectional epidemiological survey using data from a cluster randomized controlled trial (QUARITE trial in 46 referral hospitals in Mali and Senegal, during the pre-intervention period of the trial (from October 1st 2007 to October 1st 2008. We included 89,518 women who delivered in the 46 hospitals during this period. Data were collected on women's characteristics, obstetric complications, and vital status until the hospital discharge. We developed a tree-like classification rule (classification rule to identify patient subgroups at high risk of maternal in-hospital mortality. RESULTS: Our analyses confirm that patients with uterine rupture, hemorrhage or prolonged/obstructed labor, and those who have an emergency ante-partum cesarean delivery have an increased risk of in-hospital mortality, especially if they are referred from another health facility. Twenty relevant patterns, based on fourteen predictors variables, are used to predict in-hospital maternal mortality with 81.41% sensitivity (95% CI = [77.12%-87.70%] and 81.6% specificity (95% CI = [81.16%-82.02%]. CONCLUSION: The proposed class association rule method will help health care professionals in referral hospitals in Mali and Senegal to identify mothers at high risk of in-hospital death, and can provide scientific evidence on which to base their decisions to manage patients delivering in their health facilities.

  13. Obstetric near-miss and maternal mortality in maternity university hospital, Damascus, Syria: a retrospective study

    Directory of Open Access Journals (Sweden)

    Al Chamat Ahmad

    2010-10-01

    Full Text Available Abstract Background Investigating severe maternal morbidity (near-miss is a newly recognised tool that identifies women at highest risk of maternal death and helps allocate resources especially in low income countries. This study aims to i. document the frequency and nature of maternal near-miss at hospital level in Damascus, Capital of Syria, ii. evaluate the level of care at maternal life-saving emergency services by comparatively analysing near-misses and maternal mortalities. Methods Retrospective facility-based review of cases of near-miss and maternal mortality that took place in the years 2006-2007 at Damascus Maternity University Hospital, Syria. Near-miss cases were defined based on disease-specific criteria (Filippi 2005 including: haemorrhage, hypertensive disorders in pregnancy, dystocia, infection and anaemia. Main outcomes included maternal mortality ratio (MMR, maternal near miss ratio (MNMR, mortality indices and proportion of near-miss cases and mortality cases to hospital admissions. Results There were 28 025 deliveries, 15 maternal deaths and 901 near-miss cases. The study showed a MNMR of 32.9/1000 live births, a MMR of 54.8/100 000 live births and a relatively low mortality index of 1.7%. Hypertensive disorders (52% and haemorrhage (34% were the top causes of near-misses. Late pregnancy haemorrhage was the leading cause of maternal mortality (60% while sepsis had the highest mortality index (7.4%. Most cases (93% were referred in critical conditions from other facilities; namely traditional birth attendants homes (67%, primary (5% and secondary (10% healthcare unites and private practices (11%. 26% of near-miss cases were admitted to Intensive Care Unit (ICU. Conclusion Near-miss analyses provide valuable information on obstetric care. The study highlights the need to improve antenatal care which would help early identification of high risk pregnancies. It also emphasises the importance of both: developing protocols to

  14. Early hospital discharge in maternal and newborn care.

    Science.gov (United States)

    Fink, Anne M

    2011-01-01

    This article highlights the historic precedence of early discharge practices and the debate regarding length of stay for new mothers and newborns in the United States. Although the documented effects of early discharge on maternal and newborn health are inconsistent, research findings universally support follow-up care for mothers and infants within 1 week of hospital discharge. Research is needed to identify the components and timing of follow-up care to optimize maternal and newborn outcomes. © 2011 AWHONN, the Association of Women's Health, Obstetric and Neonatal Nurses.

  15. Audit of maternal mortality ratio and causes of maternal deaths in the largest maternity hospital in Cairo, Egypt (Kasr Al Aini) in 2008 and 2009: lessons learned.

    Science.gov (United States)

    Saleh, Wael F; Ragab, Wael S; Aboulgheit, Samah S

    2013-09-01

    This study examined maternal deaths at Cairo University Maternity Hospital between January 2008 and December 2009. The aim was to calculate Maternal Mortality Ratio (MMR) as well as identify the causes and predisposing factors to maternal deaths. Data were collected from the files of the hospitalized pregnant women in the hospital. There were 38 maternal deaths and MMR was 79 per 100,000 live births for the two years examined. The main causes of death were obstetric hemorrhage, hypertensive disorders of pregnancy and cardiac arrest. Substandard medical care and the delay in seeking of medical advice were two contributing factors to maternal deaths recorded. The need for audit and publication of all obstetric hospitals MMR to compare and identify areas of improvements is recommended.

  16. “Near Miss” Obstetric Events and Maternal Deaths in a Tertiary Care Hospital: An Audit

    OpenAIRE

    PS, Roopa; Shailja Verma; Lavanya Rai; Pratap Kumar; Murlidhar V. Pai; Jyothi Shetty

    2013-01-01

    Objectives. (1) To determine the frequency of maternal near miss, maternal near miss incidence ratio (MNMR), maternal near miss to mortality ratio and mortality index. (2) To compare the nature of near miss events with that of maternal mortality. (3) To see the trend of near miss events. Design. Audit. Setting. Kasturba Hospital, Manipal University, Manipal, India. Population. Near miss cases & maternal deaths. Methods. Cases were defined based on WHO criteria 2009. Main Outcome Measures. Sev...

  17. Melioidosis at Royal Darwin Hospital in the big 2009-2010 wet season: comparison with the preceding 20 years.

    Science.gov (United States)

    Parameswaran, Uma; Baird, Robert W; Ward, Linda M; Currie, Bart J

    2012-03-19

    To compare the unprecedented 91 cases of melioidosis in the Top End of the Northern Territory of Australia from 1 October 2009 to 30 September 2010 with the 540 cases in the preceding 20 years and postulate reasons for this year of very high melioidosis incidence. Review of prospectively collected data on all patients with culture-confirmed melioidosis at Royal Darwin Hospital, the Top End's tertiary referral centre, since 1 October 1989. Population-based annual incidence of melioidosis; differences in epidemiology, clinical presentations and outcomes for 2009-2010 compared with the preceding 20 years. In 2009-2010, the estimated population-based incidence of melioidosis was 50.2 cases per 100 000 in the Top End population overall, and 102.4 cases per 100 000 in the Top End Indigenous population. The proportion of patients acquiring melioidosis in the Darwin urban area increased from 49% in 1989-2009 to 65% in 2009-2010 (OR, 1.96; 95% CI, 1.20-3.19). Among the 49 Indigenous Australian patients with melioidosis in 2009-2010, 63% acquired the infection in Darwin, compared with 35% of Indigenous patients in the previous 20 years (OR, 3.17; 95% CI, 1.62-6.24). In 2009-2010, the Top End had the highest annual incidence of melioidosis documented from anywhere to date. The prominent increase in cases in Darwin was associated with above average rainfall in Darwin during December 2009 to February 2010. The increase in the proportion of Indigenous Australians who acquired melioidosis in Darwin may reflect movement of some Indigenous people into Darwin from remote communities.

  18. Survey of patient satisfaction with the Breastfeeding Education and Support Services of The Royal Women's Hospital, Melbourne

    Directory of Open Access Journals (Sweden)

    Amir Lisa H

    2008-04-01

    Full Text Available Abstract Background The Breastfeeding Education and Support Services (BESS is a unit of The Royal Women's Hospital in Melbourne, Australia, staffed by International Board Certified Lactation Consultants (IBCLCs, providing day/short-stay and an outpatient clinic for mothers and infants with breastfeeding problems. It is important to measure women's experience of visiting the service as part of quality assurance. The aim of this project was to conduct an anonymous postal survey of clients' satisfaction with BESS. Methods An anonymous survey was posted on 16 November 2005 and again on 31 January 2006, to all women who had attended BESS in September 2005. Results The response rate was 60.5% (78/129. Eighty percent (62/78 of respondents attended day-stay, 33% (26/78 attended short-stay and 15% (12/78 attended the outpatient clinic. The percentage of women who responded "strongly agree" to the statement "Overall, I am satisfied with the services" was 49% (35/72 and 50% (6/12 for those who went to day/short-stay and the outpatient clinic respectively. Overall, 56% of all respondents responded that the quality of BESS was "better than expected". The most common breastfeeding problem reported was difficulty attaching the baby to the breast, followed by nipple damage, low milk supply and painful feeding. Conclusion BESS seems to have provided a satisfactory service to most clients. Most respondents were clearly satisfied with the support given by the IBCLCs and have also responded that the staff were professional and knowledgeable in their field of work.

  19. The first lady almoner: the appointment, position, and findings of Miss Mary Stewart at the Royal Free Hospital, 1895-99.

    Science.gov (United States)

    Cullen, Lynsey T

    2013-10-01

    This article examines the professional roots of the hospital almoner, a position which has been widely neglected in medical history. The first almoner was Miss Mary Stewart, a former Charity Organization Society employee, appointed at the Royal Free Hospital of central London in 1895. The Royal Free was a charitable hospital which offered free medical treatment to patients considered morally deserving but unable to afford medical care elsewhere. The role expected of Stewart was to means test patients in order to ensure that only those deemed "appropriate" received free medical treatment, and to establish the extent to which the hospital was being abused by those who could afford to contribute toward their medical care. While in office, Stewart continually reshaped the role of almoner. She fashioned the position into that of a medical social worker and undertook such duties as referring patients to other means of medical and charitable assistance, visiting patients' homes, and training almoners for positions at other voluntary hospitals. Through the examination of Mary Stewart's Almoners Report Book, this article considers the circumstances of her appointment, the role she performed, and the findings of her investigations.

  20. Severe maternal morbidity and near misses in tertiary hospitals, Kelantan, Malaysia: a cross-sectional study.

    Science.gov (United States)

    Norhayati, Mohd Noor; Nik Hazlina, Nik Hussain; Sulaiman, Zaharah; Azman, Mohd Yacob

    2016-03-05

    Severe maternal conditions have increasingly been used as alternative measurements of the quality of maternal care and as alternative strategies to reduce maternal mortality. We aimed to study severe maternal morbidity and maternal near miss among women in two tertiary hospitals in Kota Bharu, Kelantan, Malaysia. A cross-sectional study with record review was conducted in 2014. Severe maternal morbidity and maternal near miss were classified using the new World Health Organization criteria. Health indicators for obstetric care were calculated and descriptive analyses were performed using SPSS version 22.0. In total, 21,579 live births, 395 women with severe maternal morbidity, 47 women with maternal near miss and two maternal deaths were analysed. The severe maternal morbidity incidence ratio was 18.3 per 1000 live births and the maternal near miss incidence ratio was 2.2 per 1000 live births. The maternal near miss mortality ratio was 23.5 and the mortality index was 4.1 %. The process indicators for essential interventions were almost 100.0 %. Haemorrhagic disorders were the most common event for severe maternal morbidity (68.6 %) and maternal near miss (80.9 %) and management-based criteria accounted for 85.1 %. Comprehensive emergency care and intensive care as well as overall improvements in the quality of maternal health care need to be achieved to substantial reduce maternal death.

  1. Chromogranin A as a Biochemical Marker for Neuroendocrine Tumors: A Single Center Experience at Royal Hospital, Oman

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    Elham S. Al-Risi

    2017-09-01

    Full Text Available Objectives: To evaluate the significance of serum chromogranin A (CgA status in patients with and without different neuroendocrine tumors (NETs by conducting a retrospective assessment of the diagnostic utility and limitations of CgA as a biomarker for NETs in a tertiary care hospital in Oman. Methods: We conducted a retrospective analysis of CgA requests referred to the Clinical Biochemistry Laboratory, Royal Hospital, Oman over a 24-month period (April 2012 to March 2014. During this time, 302 CgA tests for 270 patients (119 males and 151 females; age range 11–86 years and mean±standard deviation (SD 44.0±18.0 years, were requested. Of these CgA tests, 245 tests were performed for 245 patients investigated for the diagnosis of NETs, and 57 CgA tests were performed for 25 patients with diagnosed NETs who were undergoing follow-up. Serum CgA levels were analyzed using the enzyme-linked immunosorbent assay based on a cut-off value of 22 IU/L. Results: Of the 302 CgA tests reviewed, 197 (65.2% were within the quoted normal range; however, 105 (34.8% had CgA > 22 IU/L. Of the 245 patients with first-line CgA, 38 patients (15.5% had NET that included carcinoid, pheochromocytoma, pancreatic NET, adrenal adenoma, prostatic adenocarcinoma, gastrointestinal NET, medullary thyroid carcinoma, Schwannoma, lung small cell carcinoma, parathyroid adenoma, and pituitary macroadenoma. The mean±SD of CgA in these patients with NETs was 205.0±172.0 IU/L. Meanwhile, there were 45 (18.3% patients with CgA > 22 IU/L (83.0±116.0 IU/L who did not have NETs. The conditions/diseases included: essential hypertension, chronic kidney disease, heart failure, peptic ulcer, chronic diarrhea, use of proton pump inhibitors, and other chronic diseases (hypothyroidism, asthma, diabetes mellitus. Of the 25 patients with known NET who were followed-up, there were 57 CgA results (29 with CgA ≤ 22 IU/L and 28 with CgA > 22 IU/L. The overall clinical sensitivity of CgA in the

  2. Factors influencing vaccination uptake. Workshop report. Current Australian research on the behavioural, social and demographic factors influencing immunisation, Royal Alexandra Hospital for Children, Sydney, March 1998.

    Science.gov (United States)

    Forrest, J M; Burgess, M A; McIntyre, P B

    2000-03-16

    Current Australian research on factors influencing vaccination was discussed at a workshop held at the Royal Alexandra Hospital for Children, Sydney, in March 1998, sponsored by the National Centre for Immunisation Research and Surveillance of Vaccine Preventable Diseases (NCIRS). The application of decision making theory to vaccination behaviour, the expectations and experiences of mothers, and reasons why parents fail to vaccinate their children were considered. Mothers' perceptions of the risks of vaccines, preferences of parents and providers for the mode of vaccine delivery, and community and social factors were all found to be part of the framework within which vaccination is accepted in Australia. Consumer considerations, media influences and overseas comparisons were discussed.

  3. Maternal mortality in the government hospitals, West Malaysia 1967-1969.

    Science.gov (United States)

    Ariffin Bin Marzuki; Thambu, J A

    1973-03-01

    The attempt was made to determine the factors responsible for the maternal deaths in the government hospitals of West Malaysia over the 1967-1969 period. The study covered all maternal deaths in the government hospitals during this 2-year period. Despite an increase in the number of deliveries in government hospitals from 83,654 in 1964 to 92,583 in 1969, the maternal mortality had declined from 27/10,000 to 22/10,000. The maternal mortality rate in government hospitals was higher than the national maternal mortality rate because of the practice of referring all abnormal obstetric cases to hospitals for management. Hemorrhage continued as the primary cause of maternal deaths with toxemia as the 2nd important cause and infection as the 3rd. In the rural areas midwives found postpartum hemorrhage a major problem because of the coexistence of anemia in pregnancy. Other complications of pregnancy, childbirth and puerperium included obstructed and neglected labors due to cephalo-pelvic disproportion, abnormal lie, and presentation and ruptured uterus referred from the rural areas to the hospitals. Hypertension was the most important cause in the associated maternal diseases. The following are included among the steps taken by the government to reduce maternal mortality: 1) development of an excellent infrastructure of health units; 2) a training program for midwives; and 3) a plan to integrate the family planning services with the health services.

  4. “Near Miss” Obstetric Events and Maternal Deaths in a Tertiary Care Hospital: An Audit

    Directory of Open Access Journals (Sweden)

    Roopa PS

    2013-01-01

    Full Text Available Objectives. (1 To determine the frequency of maternal near miss, maternal near miss incidence ratio (MNMR, maternal near miss to mortality ratio and mortality index. (2 To compare the nature of near miss events with that of maternal mortality. (3 To see the trend of near miss events. Design. Audit. Setting. Kasturba Hospital, Manipal University, Manipal, India. Population. Near miss cases & maternal deaths. Methods. Cases were defined based on WHO criteria 2009. Main Outcome Measures. Severe acute maternal morbidity and maternal deaths. Results. There were 7390 deliveries and 131 “near miss” cases during the study period. The Maternal near miss incidence ratio was 17.8/1000 live births, maternal near miss to mortality ratio was 5.6 : 1, and mortality index was 14.9%. A total of 126 cases were referred, while 5 cases were booked at our hospital. Hemorrhage was the leading cause (44.2%, followed by hypertensive disorders (23.6% and sepsis (16.3%. Maternal mortality ratio (MMR was 313/100000 live births. Conclusion. Hemorrhage and hypertensive disorders are the leading causes of near miss events. New-onset viral infections have emerged as the leading cause of maternal mortality. As near miss analysis indicates the quality of health care, it is worth presenting in national indices.

  5. Substandard emergency obstetric care - a confidential enquiry into maternal deaths at a regional hospital in Tanzania

    DEFF Research Database (Denmark)

    Sorensen, Bjarke Lund; Elsass, Peter; Nielsen, Brigitte Bruun

    2010-01-01

    OBJECTIVE: (i) To identify clinical causes of maternal deaths at a regional hospital in Tanzania and through confidential enquiry (CE) assess major substandard care and make a comparison to the findings of the internal maternal deaths audits (MDAs); (ii) to describe hospital staff reflections...... on causes of substandard care. METHODS: A CE into maternal deaths was conducted based on information available from written sources supplemented with participatory observations and interviews with staff. The compiled information was summarized and presented anonymously for external expert review to assess...... for major substandard care. Hospital based maternal deaths between 2006 and 2008 (35 months) were included. Of 68 registered maternal deaths sufficient information for reviewing was retrieved for 62 cases (91%). As a supplement, in-depth interviews with staff about the underlying causes of substandard care...

  6. MATERNAL NEAR MISS IN A TERTIARY CARE HOSPITAL: A CROSS SECTIONAL STUDY

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    Namrata

    2016-06-01

    Full Text Available BACKGROUND Maternal mortality is one of the important indicators of maternal health. To overcome the challenge of reduction of maternal mortality, nationwide notion of SAMM (Severe Acute Maternal Morbidity and near miss event was introduced to access maternal health care. Maternal near miss case is defined as “A woman who nearly died, but survived a complication that occurred during pregnancy, childbirth or within 42 days of termination of pregnancy.” SAMM refers to a life-threatening disorder that can end up in near miss with or without residual morbidity or mortality. Women who develop SAMM during pregnancy share many pathological and circumstantial factors related to their condition. Although some of these women die, a proportion of them narrowly escape death. Near miss cases and maternal deaths together are referred to as Severe Maternal Outcome (SMO. AIMS AND OBJECTIVES 1. To determine the prevalence of maternal near miss due to severe obstetric complications or maternal disease in a tertiary hospital. 2. To determine Severe Maternal Outcome Ratio (SMOR, Maternal Near Miss Ratio (MNM Ratio and Maternal Mortality Ratio. MATERIALS AND METHODS Cross sectional observational study carried out from 01st October 2014 to 30th September 2015. The study was conducted in Obstetric Department of Krishna Hospital, Krishna Institute of Medical Sciences Deemed University, Karad. Near-miss case definition was based on validated specific criteria comprising of five diagnostic features and WHO Criteria: Haemorrhage, hypertensive disorders in pregnancy, dystocia, infection and anaemia. The main outcome measures were frequency and characteristics of nearmiss cases, total hospital stay, high dependency unit/ICU stay and development of multiple organ dysfunction. The maternal death to near-miss ratio was calculated. RESULT There were 4800 deliveries from October 2014 to September 2015, 220 near miss cases and 17 maternal deaths. Maternal death to near miss

  7. Maternal mortality in Cameroon: a university teaching hospital report.

    Science.gov (United States)

    Tebeu, Pierre-Marie; Pierre-Marie, Tebeu; Halle-Ekane, Gregory; Gregory, Halle-Ekane; Da Itambi, Maxwell; Maxwell, Da Itambi; Enow Mbu, Robinson; Robinson, Enow Mbu; Mawamba, Yvette; Yvette, Mawamba; Fomulu, Joseph Nelson; Nelson, Fomulu Joseph

    2015-01-01

    More than 550,000 women die yearly from pregnancy-related causes. Fifty percent (50%) of the world estimate of maternal deaths occur in sub-Saharan Africa alone. There is insufficient information on the risk factors of maternal mortality in Cameroon. This study aimed at establishing causes and risk factors of maternal mortality. This was a case-control study from 1st January, 2006 to 31st December, 2010 after National Ethical Committee Approval. Cases were maternal deaths; controls were women who delivered normally. Maternal deaths were obtained from the delivery room registers and in-patient registers. Controls for each case were two normal deliveries following identified maternal deaths on the same day. Variables considered were socio-demographic and reproductive health characteristics. Epi Info 3.5.1 was used for analysis. The mean MMR was 287.5/100,000 live births. Causes of deaths were: postpartum hemorrhage (229.2%), unsafe abortion (25%), ectopic pregnancy (12.5%), hypertension in pregnancy (8.3%), malaria (8.3%), anemia (8.3%), heart disease (4.2%), and pneumonia (4.2%), and placenta praevia (4.2%). Ages ranged from 18 to 41 years, with a mean of 27.7 ± 5.14 years. Lack of antenatal care was a risk factor for maternal death (OR=78.33; CI: (8.66- 1802.51)). The mean MMR from 2006 to 2010 was 287.5/100,000 live births. Most of the causes of maternal deaths were preventable. Lack of antenatal care was a risk factor for maternal mortality. Key words: Maternal mortality, causes, risk factors, Cameroon.

  8. Trends in maternal mortality in a tertiary care hospital

    Directory of Open Access Journals (Sweden)

    K. P. Mohana Sundari

    2016-11-01

    Conclusions: Majority of maternal deaths can be prevented by adopting improved standards in early identification of preeclampsia, anemia and its management and early referral. Routine iron and folic acid supplementation to be done in an effective way. Proper antenatal care, emergency obstetrics care and routine audits are very much essential to decrease the maternal mortality as well as to know the trends of maternal deaths to develop subsequent management protocols. [Int J Reprod Contracept Obstet Gynecol 2016; 5(11.000: 3659-3662

  9. Factors Affecting The Adoption Of Mhealth In Maternal Health Care In Nakuru Provincial General Hospital

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    Simon Munyua

    2015-08-01

    Full Text Available Abstract Access to timely and quality maternal health care remains to be a major development challenge in many developing economies particularly in Kenya. The countrys system of providing maternal health care also continue to be anchored on conventional methods of physical presence of the patient and the doctor in a hospital setup. The countrys ICT and health policies also place very little emphasis on the use of these platforms. This study therefore sought to establish the factors affecting the adoption of mHealth by focusing on maternal health in Nakuru Provincial General Hospital. Objectives of the study were to determine the extent to knowledge and awareness affects the adoption of mHealth in maternal health care at Nakuru PGH to identify the government policies affecting the adoption of mHealth in maternal health care at Nakuru PGH to assess how access to technology affects the adoption of mHealth in maternal healthcare to establish the effects of ICT infrastructure on the adoption of mHealth in maternal health care and to identify the cost aspects affecting the adoption of mHealth in maternal health care at Nakuru Provincial General Hospital. It is envisaged that the study could provide useful information on the adoption of mHealth in managing maternal health care in Nakuru Provincial General Hospital. Descriptive survey research design will be used where all the medical staff and patients of Nakuru Provincial General Hospital was surveyed. The study population therefore was made up of 24 medical staff and 3460 mothers visiting the antenatal clinic selected using clustered random sampling technique. The main instrument for primary data collection was the questionnaire. Data analysis was then done using both descriptive and inferential statistics. Descriptive statistics to be used include frequency counts percentages and measures of central tendency. Inferential statistics on the other hand include t-test analysis and spearman correlation

  10. MATERNAL NEAR MISS AND MATERNAL MORTALITY AS HEALTH INDICATORS IN A TERTIARY CARE HOSPITAL

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    Simarpreet

    2014-09-01

    Full Text Available : OBJECTIVES: To assess the various causes and incidence of maternal near miss (MNM and maternal deaths (MD and to define the limitations and to search the level of delay. METHODS: A prospective and observational study, including women who were admitted in emergency from April 2012 to March 2013 with severe maternal complications and who fulfilled any of the WHO criteria of MNM. Results: A total of 6008 live births (LB and 156 severe maternal outcomes (25.9/1000 LB were observed, consisting of 140 MNM (23.3/1000 LB and 16 MD(266/100, 000 LB. The maternal near miss/mortality ratio was 8.75. Hypertensive disorders accounted for the most common event of MNM (50.6%, followed by haemorrhagic disorders (38.6%. Majority of maternal deaths were due to hypertensive disorders (31.2% and sepsis (25%. CONCLUSION: Reduction of present MNM and MD may be achieved by strictly following management protocols for hypertension and haemorrhage.

  11. Trend and causes of maternal mortality among women delivering in S. N. Medical College Hospital, Agra.

    Science.gov (United States)

    Jain, A; Gupta, S C; Misra, S K; Singh, Richa; Bhagoliwal, A K; Kaushal, S K

    2009-01-01

    A retrospective data analysis from records of patients from medical record section of department of gynecology and obstetric, S. N. Medical College and Hospital, Agra was done to find out the trend and causes of maternal mortality occurred during 1999-2007. The maternal deaths in the context of different causes were analyzed. A total of 192 maternal deaths occurred on 6386 live-births during last 9 years which gives anoverall hospitalized Maternal Mortality Ratio (MMR) as 30.07 per 1000 live births during the period. Out of these total deaths more than half (51.04%) were due to indirect causes. Anaemia (47, 24.48%), hemorrhage (35,18.23%), toxemia (35,18.23%), septicemia (18, 19.23%) were the main causes.

  12. Maternal Infection Requiring Hospitalization during Pregnancy and Autism Spectrum Disorders

    Science.gov (United States)

    Atladottir, Hjordis O.; Thorsen, Poul; Ostergaard, Lars; Schendel, Diana E.; Lemcke, Sanne; Abdallah, Morsi; Parner, Erik T.

    2010-01-01

    Exposure to prenatal infection has been suggested to cause deficiencies in fetal neurodevelopment. In this study we included all children born in Denmark from 1980, through 2005. Diagnoses of autism spectrum disorders (ASDs) and maternal infection were obtained through nationwide registers. Data was analyzed using Cox proportional hazards…

  13. Maternal mortality ratio in Lebanon in 2008: a hospital-based reproductive age mortality study (RAMOS).

    Science.gov (United States)

    Hobeika, Elie; Abi Chaker, Samer; Harb, Hilda; Rahbany Saad, Rita; Ammar, Walid; Adib, Salim

    2014-01-01

    International agencies have recently assigned Lebanon to the group H of countries with "no national data on maternal mortality," and estimated a corresponding maternal mortality ratio (MMR) of 150 per 100,000 live births. The Ministry of Public Health addressed the discrepancy perceived between the reality of the maternal mortality ratio experience in Lebanon and the international report by facilitating a hospital-based reproductive age mortality study, sponsored by the World Health Organization Representative Office in Lebanon, aiming at providing an accurate estimate of a maternal mortality ratio for 2008. The survey allowed a detailed analysis of maternal causes of deaths. Reproductive age deaths (15-49 years) were initially identified through hospital records. A trained MD traveled to each hospital to ascertain whether recorded deaths were in fact maternal deaths or not. ICD10 codes were provided by the medical controller for each confirmed maternal deaths. There were 384 RA death cases, of which 13 were confirmed maternal deaths (339%) (numerator). In 2008, there were 84823 live births in Lebanon (denominator). The MMR in Lebanon in 2008 was thus officially estimated at 23/100,000 live births, with an "uncertainty range" from 153 to 30.6. Hemorrhage was the leading cause of death, with double the frequency of all other causes (pregnancy-induced hypertension, eclampsia, infection, and embolism). This specific enquiry responded to a punctual need to correct a clearly inadequate report, and it should be relayed by an on-going valid surveillance system. Results indicate that special attention has to be devoted to the management of peri-partum hemorrhage cases. Arab, postpartum hemorrhage, development, pregnancy management, verbal autopsy

  14. Major Placenta Previa: Rate, Maternal and Neonatal Outcomes Experience at a Tertiary Maternity Hospital, Sohag, Egypt: A Prospective Study

    Science.gov (United States)

    Ahmed, Salah Roshdy; Aitallah, Abdusaeed; Abdelghafar, Hazem M.

    2015-01-01

    Introduction Major degree placenta is a serious health issue and is associated with high fetal-maternal morbidity and mortality. Literature from developing countries is scant. Aim To determine the prevalence and maternal and neonatal outcomes among women with major placenta previa (PP). Materials and Methods A prospective descriptive study of 52 singleton pregnancies with PP was evaluated in this study. The study was conducted at Sohag University Hospital, Egypt from January through June 2014. Outcome measures, including the prevalence of PP, maternal and neonatal outcomes, and case-fatality rate. Results The total number of deliveries performed during the study period was 3841, of them, 52 cases were placenta previa. Thus, the prevalence of PP was 1.3%. The mean of previous cesarean scars was 2.2±1.4. Of women with PP, 26.4% (n=14) had placenta accreta. In total, 15.1% (n=8) of women underwent an obstetric hysterectomy. From the total no. of babies, 13.2% (n=7) were delivered fresh stillborn babies. Of the surviving babies (n=45), 20% (n=9) required admission to NICU. The frequencies of bowel and bladder injuries were 3.8% (n=2) and 13.2% (n=7) respectively. There was no maternal death in this study. Conclusion The rate of PP is comparable to previous studies, however, the rate of placenta accreta is high. Also, there are high rates of neonatal mortality and intraoperative complications which can be explained by accreta. The study highlights the need to revise maternity and child health services. PMID:26674539

  15. Maternal mortality: a tertiary care hospital experience in Upper Egypt

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    Ahmed M. Abbas

    2016-05-01

    Conclusions: Preeclampsia and PPH, as well as their complications are the leading causes of death in one of the biggest tertiary care university hospitals in Egypt. However, there are other important avoidable predisposing factors that should be dealt with including lack of patient education, delayed transfer from other hospitals, and substandard practice. [Int J Reprod Contracept Obstet Gynecol 2016; 5(5.000: 1466-1471

  16. Hospital- and patient-related characteristics determining maternity length of stay: a hierarchical linear model approach.

    Science.gov (United States)

    Leung, K M; Elashoff, R M; Rees, K S; Hasan, M M; Legorreta, A P

    1998-03-01

    The purpose of this study was to identify factors related to pregnancy and childbirth that might be predictive of a patient's length of stay after delivery and to model variations in length of stay. California hospital discharge data on maternity patients (n = 499,912) were analyzed. Hierarchical linear modeling was used to adjust for patient case mix and hospital characteristics and to account for the dependence of outcome variables within hospitals. Substantial variation in length of stay among patients was observed. The variation was mainly attributed to delivery type (vaginal or cesarean section), the patient's clinical risk factors, and severity of complications (if any). Furthermore, hospitals differed significantly in maternity lengths of stay even after adjustment for patient case mix. Developing risk-adjusted models for length of stay is a complex process but is essential for understanding variation. The hierarchical linear model approach described here represents a more efficient and appropriate way of studying interhospital variations than the traditional regression approach.

  17. Maternal Tetanus at the University College Hospital in Ibadan Nigeria: A 15-Year Retrospective Analysis

    Institute of Scientific and Technical Information of China (English)

    OA Roberts; IO Morhason-Bello; BO Adedokun; AO Adekunle

    2008-01-01

    Objective To determine the characteristics of women with maternal tetanus, pattern of presentation and outcome of management.Methods A total of 19 women were managed with maternal tetanus between 1990 and 2005 from the University College Hospital in Ibadan Nigeria. A retrospective study was performed. The medical records of all women managed as a case of maternal tetanus were retrieved from the central record department of the hospital The pattern of presentation, characteristics of women, the duration of hospital admission, tetanus toxoid immunization, and outcome of care were measured.Results The records of 18 women managed were analyzed. The mean age at presentation was 25.2±5.3 years. The patients were mostly single, nulliparous and had primary school education. The maternal tetanus cases seen mainly complicated induced abortion while 5 and 2 other cases were due to childbirth complication and leg wound respectively. The portal of entry of the remaining 3 cases could not be ascertained.None of the patient managed had complete immunization schedule. The average duration of admission was 11.2±6. 7 d. Five women had intensive care with 3 of them requiring ventilatory support. The case fatality rate was 66. 7%. The only factor that significantly improved survival was presence of generalized spasm at presentation (P=0. 006) Conclusion The occurrence of maternal tetanus is a reflection of low quality of health care delivery and lack or inefficient routine immunization coverage in any community.

  18. Severe acute maternal morbidity (SAMM) in postpartum period requiring tertiary Hospital care

    OpenAIRE

    Seema Bibi; Saima Ghaffar; Shazia Memon; Shaneela Memon

    2012-01-01

    Background: Postpartum period is the critically important part of obstetric care but most neglected period for majority of Pakistani women. Only life threatening complications compel them to seek for tertiary hospital care. We describe the nature of these obstetric morbidities in order to help policymakers in improving prevailing situation. Objective: To find out the frequency and causes of severe post-partum maternal morbidity requiring tertiary hospital care and to identify the demographic ...

  19. Severe acute maternal morbidity (SAMM in postpartum period requiring tertiary Hospital care

    Directory of Open Access Journals (Sweden)

    Seema Bibi

    2012-01-01

    Full Text Available Background: Postpartum period is the critically important part of obstetric care but most neglected period for majority of Pakistani women. Only life threatening complications compel them to seek for tertiary hospital care. We describe the nature of these obstetric morbidities in order to help policymakers in improving prevailing situation. Objective: To find out the frequency and causes of severe post-partum maternal morbidity requiring tertiary hospital care and to identify the demographic and obstetrical risk factors and adverse fetal outcome in women suffering from obstetric morbidities. Materials and Methods: This prospective cross-sectional study was carried out in the Department of Gynecology and Obstetrics, Liaquat University Hospital Hyderabad, between April 2008-July 2009. The subjects comprised of all those women who required admission and treatment for various obstetrical reasons during their postpartum period. Women admitted for non-obstetrical reasons were excluded. A structured proforma was used to collect data including demographics, clinical diagnosis, obstetrical history and feto-maternal outcome of index pregnancy, which was then entered and analyzed with SPSS version 11. Results: The frequency of severe postpartum maternal morbidity requiring tertiary hospital care was 4% (125/3292 obstetrical admissions. The majority of them were young, illiterate, multiparous and half of them were referred from rural areas. Nearly two third of the study population had antenatal visits from health care providers and delivered vaginally at hospital facility by skilled birth attendants. The most common conditions responsible for life threatening complications were postpartum hemorrhage (PPH (50%, preeclampsia and eclampsia (30% and puerperal pyrexia 14%. Anemia was associated problem in 100% of cases. Perinatal death rate was 27.2% (34 and maternal mortality rate was 4.8%. Conclusion: PPH, Preeclampsia, sepsis and anemia were important causes

  20. Free does not mean affordable: maternity patient expenditures in a public hospital in Bangladesh

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    Khan Suhaila H

    2005-01-01

    Full Text Available Abstract Objective This study investigated a the amount and types of out-of-pocket expenditures by patients for nominally free services in a large public hospital in Bangladesh, b the factors influencing these expenses, and c the impact of these expenses on household income. Methods Eighty-one maternity patients were interviewed during their hospitalization in the Dhaka Medical College Hospital. Patients were selected by quota sample to match the distribution of maternity patient categories in the hospital. Patients were interviewed with a semi-structured, in-depth questionnaire. Results All interviewees incurred substantial out-of-pocket expenditures for travel, hospital admission fees, medicine, tests, food, and tips. Only two of the expenditures, travel expenses and admission fees, were not supposed to be provided free of charge by the hospital. The median total per-patient expenditure was $65 (range $2–$350, equivalent to 7% (range 0.04%–225% of annual household income. Half of all patients reported that their families had to borrow to pay for care at interest rates of 5%–30% per month. A third of these families reported selling jewelry, land or household items to moneylenders. The rural patients reported more difficulty in paying for care than the urban patients. Factors increasing the expenditures were duration of hospitalization, rural residence, and necessary (e.g. C-section, hysterectomy and unnecessary (e.g. episiotomy medical procedures. Conclusion Free maternity services in Bangladesh impose large out-of-pocket expenditures on patients. Authorities could reduce the burden by reducing the duration of hospital stays, limiting use of medical procedures, eliminating tips, and moving routine services closer to potential users. Fee for service could reduce unofficial expenditures if the fee were lower than and replaced typical unofficial expenditures, otherwise adding service fees without reform of current hospital practices would

  1. [Epidemiological profile of maternal complications related to cesarean section at the Al Farabi Hospital in Oujda].

    Science.gov (United States)

    Benkirane, Saad; Saadi, Hanane; Mimouni, Ahmed

    2017-01-01

    In Morocco cesarean section rate has increased from 2% in 1992 to 16% in 2011. This was associated with increased per- and postoperative mortality and morbidity, which was 19% in our case series. This study is the first of its kind to be conducted in the eastern region of Morocco and aims to analyze the comprehensive epidemiologic profile of maternal complications related to cesarean section on the basis of 2417 cases observed in the Maternity Department at the El Farabi Hospital, Oujda. We conducted an observational, descriptive, retrospective study of a series of 2416 patients undergoing cesarean section in the Maternity Department at the El Farabi Hospital, Oujda, over the period 1 January 2011-31 December 2013. Out of 24464 deliveries, 2416 were cesarean sections, reflecting a rate of 9.87%. The frequency of complications related to cesarean section was 19.45%. Postoperative complications accounted for 63.6% of the complications dominated by infection. Haemorrhagic complications accounted for 25.53% of all complications. 4 cases of maternal deaths were recorded. If the increased rate of cesarean sections has contributed to improve maternal-fetal prognosis, the surgical act itself is not complication-free, which leads us to review its indications for improved patient management.

  2. [The role of the psychologist in hospitals and maternity wards in the state of Sergipe].

    Science.gov (United States)

    Santos, Lyvia de Jesus; Vieira, Maria Jésia

    2012-05-01

    This article seeks to reflect on the professional activity of the psychologist in the hospital context by examining the role of psychologists working in hospitals and maternity wards in the State of Sergipe. It seeks to identify the specific role of these professionals in hospitals and maternity wards, as well as their motivating forces and the difficulties encountered. This work is part of a broader project that sought to study not only the activity per se, but also training aspects of these professionals. The sample was analyzed using a qualitative and quantitative approach for thematic analysis. Results revealed that the characterization of the role of psychologists has a focus on psychotherapeutic work with patients before and after surgery, as well as the caregivers and family members of critically ill patients in the following units: ICU, ICC, oncology, dialysis and surgical wards, offering support, especially at the pre- and post-surgery phase.

  3. A review of governance of maternity services at South Tipperary general hospital

    LENUS (Irish Health Repository)

    Flory, David

    2015-09-01

    This review of the governance of maternity services at South Tipperary General Hospital has focussed on the systems and processes for assurance of service quality, risk management and patient safety primarily inside the hospital but also in the Hospital Group structure within which it operates. The effectiveness of the governance arrangements is largely determined by the quality of the leadership and management – both clinical and general – which designs, implements, and oversees those systems and processes and is ultimately responsible and accountable.\\r\

  4. Prepare and prevent rather than repair and repent: Study of maternal mortality in tertiary care hospital

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    Anjali Mundkur

    2013-07-01

    Full Text Available Context: Maternal death signifies the quality of healthcare provided in the population. It is the young, relatively healthy women who die of various reasons. Audit of such mortality would prevent the recurrence by taking appropriate measures. Aims: To find the causes of maternal mortality. Settings and Design: Retrospective observational study. Materials and Methods : All maternal deaths in a tertiary care referral center from January 2007 to September 2012 were studied for their demographic profile and causes of death. Results: All 62 women were referred from other healthcare units. Twenty-nine patients died within 24 h of admission and 33 women died after 24 h of admission. Death of 34 patients was due to direct obstetric causes and of 26 patients due to indirect obstetric causes. There were 2 maternal deaths due to accidental causes. Conclusions: The corrective action to prevent the recurrence of such deaths should be taken. Sepsis was found to be the commonest cause for maternal mortality followed by hemorrhage. It important to note that, in the present study, all mothers received antenatal care, had hospital delivery (none had home delivery, no teenage pregnancy or grand multigravidas, and no obstructed labor or rupture uterus, and yet they died. There is a change in the trend of causes of maternal mortality. Strengthening of the first referral units with equipment, blood bank, and adequately competent staff should be of prime importance. Continued medical education of the medial personnel at the periphery is required. Maternal deaths occur in inspite of atenatal care and hospital delivery which is alarming. Contributing factors may be delay in referral or the travel which should be looked in to inorder to minimize such death of young women.

  5. Maternal mortality in obstetrics and gynaecology in a tertiary care hospital.

    Science.gov (United States)

    Khatun, K; Ara, R; Aleem, N T; Khan, S; Husein, S; Alam, S; Roy, A S

    2015-01-01

    Maternal mortality is the leading causes of death and disability of reproductive age in the developing countries. Bangladesh is one of the developing countries where maternal mortality is very high. The purpose of the present study was to see the causes of maternal deaths at Obstetrics and Gynaecology ward. This retrospective study was carried out in the Department of Obstetrics and Gynaecology at Dhaka Medical College Hospital (DMCH). All maternal deaths were included in this study from July 2003 to June 2004 for a period of one year. The incidence of maternal death was 18.5/1000 live birth. Hypertensive disorder of pregnancy (41.84%) was the most common cause of maternal death followed by unsafe abortions (21.4%), PPH (10.2%), obstructed labour (8.2%). Among 98 patients 36(36.7%) cases are died due to eclampsia. Death due to pre-eclampsia (5.1%), unsafe Abortion (21.4%), Obstetric haemorrhage (18.4%) and obstructed labour (8.3%) were commonly found in this study. The study permits to conclude that Hypertensive disorder of pregnancy is the leading cause of pregnancy related deaths followed by unsafe abortions and obstetric haemorrhage. Other causes include obstructed labour, anaesthetic complications and others.

  6. Maternal clinical diagnoses and hospital variation in the risk of cesarean delivery: analyses of a National US Hospital Discharge Database.

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    Katy B Kozhimannil

    2014-10-01

    Full Text Available BACKGROUND: Cesarean delivery is the most common inpatient surgery in the United States, where 1.3 million cesarean sections occur annually, and rates vary widely by hospital. Identifying sources of variation in cesarean use is crucial to improving the consistency and quality of obstetric care. We used hospital discharge records to examine the extent to which variability in the likelihood of cesarean section across US hospitals was attributable to individual women's clinical diagnoses. METHODS AND FINDINGS: Using data from the 2009 and 2010 Nationwide Inpatient Sample from the Healthcare Cost and Utilization Project--a 20% sample of US hospitals--we analyzed data for 1,475,457 births in 1,373 hospitals. We fitted multilevel logistic regression models (patients nested in hospitals. The outcome was cesarean (versus vaginal delivery. Covariates included diagnosis of diabetes in pregnancy, hypertension in pregnancy, hemorrhage during pregnancy or placental complications, fetal distress, and fetal disproportion or obstructed labor; maternal age, race/ethnicity, and insurance status; and hospital size and location/teaching status. The cesarean section prevalence was 22.0% (95% confidence interval 22.0% to 22.1% among women with no prior cesareans. In unadjusted models, the between-hospital variation in the individual risk of primary cesarean section was 0.14 (95% credible interval 0.12 to 0.15. The difference in the probability of having a cesarean delivery between hospitals was 25 percentage points. Hospital variability did not decrease after adjusting for patient diagnoses, socio-demographics, and hospital characteristics (0.16 [95% credible interval 0.14 to 0.18]. A limitation is that these data, while nationally representative, did not contain information on parity or gestational age. CONCLUSIONS: Variability across hospitals in the individual risk of cesarean section is not decreased by accounting for differences in maternal diagnoses. These

  7. Severe Maternal Morbidity and Near Misses in Two Tertiary Referral Hospitals in Iran

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    Zargar

    2015-04-01

    Full Text Available Background Investigating severe maternal morbidity/near miss is a newly recognized tool which identifies women at the highest risk of maternal death and helps allocate resources, especially in developing countries. Objectives This study aimed to document the prevalence and causes of severe maternal morbidity (SMM at two educational hospitals in Ahvaz, Khuzestan, Iran. Patients and Methods In this prospective study, we found and selected SMM patients based on organ failure criteria from patients admitted in two educational hospitals of Ahvaz Jundishapur University of Medical Sciences during 2009 - 2010. Until recovery discharge or death, the diagnosis and management of these patients were under observation of obstetricians. The main outcome was maternal mortality ratio, SMM rate (SMMR. Results Totally, there were 12,149 deliveries, eight maternal deaths and 226 SMM cases. This study showed the SMMR of 18.6/1000 live births, an MMR of 65.8/100000 live births, and case fatality ratio of 1/28 or 3.5%. Severe preeclampsia and hemolysis elevated liver enzymes low platelet count syndrome (HELLP (38%, hemorrhage (23% and ectopic pregnancy (14% were the top causes of SMM. Similar to HELLP syndrome (25% hemorrhage (25%, sepsis (25% was the commonest cause of mortality; 39% of patients were referred from primary or secondary health care units; 85% of the cases needed intensive care unit admissions. Conclusions SMM analysis provides valuable information on obstetric care. This study highlighted the need to improve antenatal care, which would help early identification of high-risk pregnancies. Every SMM could progress to maternal mortality if is not suspected, diagnosed and managed on its golden time.

  8. [Analysis of abortions at a community maternity hospital in Bangui].

    Science.gov (United States)

    Sepou, A; Ngbale, R; Yanza, M C; Domande-Modanga, Z; Nguembi, E

    2004-01-01

    Abortion, i.e., early termination of pregnancy, has few complications when it occurs spontaneously. However self-inflicted abortion (SIA) often leads to more or less serious complications. In view of the increasing number of abortion cases in our department, we undertook this yearlong transversal study to evaluate the incidence of SIA in the department, determine the demographic characteristics of the women that practiced SIA, and identify the complications of SIA. Only ongoing or incomplete abortions were studied. Amenorrhea not related to pregnancy or associated with ectopic pregnancy was excluded from study. Clinical and demographic data were noted on forms specially designed by the research team. Data analysis yielded the following findings. Abortion accounted for 719 of the 5292 hospitalizations (13.6%) in gynecology unit, including 43.4% of SIA. Mean patient age was 24.7 years (range, 13 to 39). Spontaneous abortion was more likely to be observed in married women than in students who usually presented SIA. Wanted pregnancy was more likely to be reported by married women than by single woman who posed the problem of unwanted pregnancy. Students had more SIA. The main reasons for practicing SIA were financial (61.5%). The most common methods used for SIA were drug combinations (39.1%) and mechanical tools (26.0%). All severe complications such as infection and death were observed in women who practiced SIA. The high incidence of SIA in the department was especially disturbing due to the young age of the women involved and the severity of the complications. More action is needed to spread information on contraceptive methods in schools and universities to avoid unintended pregnancies that drive young people to practice SIA.

  9. RETROSPECTIVE EVALUATION OF CAUSES AND SOCIAL CORRELATES OF MATERNAL DEATHS AT ASSAM MEDICAL COLLEGE AND HOSPITAL, DIBRUGARH, ASSAM, INDIA

    Directory of Open Access Journals (Sweden)

    Milan Kumar

    2016-01-01

    Full Text Available Reduction of maternal death to achieve MDG – 5 Target - 6 is a challenge for most of the developing countries of the world in spite of steady decline in maternal death. There is a great difference in MMR of developing and developed countries as well as within the countries, states, districts depending upon the socioeconomic and educational status. This study was conducted to estimate the MMR, evaluate the causes of maternal death and to formulate strategies for reduction of maternal death at Assam Medical College and Hospital, Dibrugarh, Assam. MATERIAL AND METHODS A retrospective study of causes of maternal deaths from 1st January 2012 to 31st August 2015 at Obstetrics and Gynaecology Department of Assam Medical College and Hospital, Dibrugarh, Assam, India. The records were collected from Maternal Death Register and analysis were made to find out the MMR, causes of maternal deaths and its contributing factors. OBSERVATIONS There were 279 maternal deaths out of 33833 live births giving MMR of 824.64. Hypertensive disorder of pregnancy (37.63% was the leading direct cause followed by infections (14.69% and hemorrhage (12.90% and the anaemia (24.73% was the commonest indirect cause of maternal death. Contributory factors like age, locality, booking visit play a major rule in maternal death in our study.

  10. Warfarin and royal jelly interaction.

    Science.gov (United States)

    Lee, Nancy J; Fermo, Joli D

    2006-04-01

    An 87-year-old African-American man came to the internal medicine clinic for a routine anticoagulation management visit. He had no complaints. His medical history was significant for stage IV-A follicular non-Hodgkin's lymphoma, atrial fibrillation, and hypertension. His long-term drug therapy consisted of warfarin, felodopine, lisinopril-hydrochlorothiazide, controlled-release diltiazem, potassium chloride, and oxycodone. He reported adherence with his prescribed drugs and denied taking any over-the-counter or herbal products. Overall, the patient's drug therapy had been consistent during the preceding 3 months, no significant changes had occurred in his clinical status, and no significant changes had been noted in his diet; his international normalized ratio (INR) had ranged from 1.9-2.4 (therapeutic range 2-3). He denied tobacco use, alcohol consumption, and recent travel. Four weeks later, the patient came to the emergency department with hematuria. He denied dysuria, taking more than the prescribed amount of warfarin, any changes in his diet, taking any over-the-counter or herbal products, and any other bleeding. On admission to the hospital, his INR was 6.88, which increased to 7.29 during his hospital stay. On further investigation, the patient admitted that he had started taking an herbal supplement, royal jelly, 1 week earlier. When asked specifically about the ingredients in the supplement, he stated that royal jelly was the only component. Relative to the patient's denial of any other changes in his condition or drug regimen, the most probable explanation for his elevated INR and subsequent bleeding is a possible interaction between royal jelly and warfarin. To our knowledge, no case reports concerning royal jelly and warfarin taken concomitantly have been reported. Clinicians should be proactive and repeatedly provide education regarding the potential dangers of dietary supplements taken with conventional drugs.

  11. Geographic Distribution of Maternal Group B Streptococcus Colonization and Infant Death During Birth Hospitalization: Eastern Wisconsin

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    Jessica J. F. Kram

    2016-04-01

    Full Text Available Purpose: Maternal group B Streptococcus (GBS can be transmitted from a colonized mother to newborn during vaginal delivery and may or may not contribute to infant death. This study aimed to explore the geographic distribution and risk factors of maternal GBS colonization and infant death during birth hospitalization. Methods: We retrospectively studied mothers with live birth(s in a large eastern Wisconsin hospital system from 2007 through 2013. Associations between maternal and neonatal variables, GBS colonization and infant death were examined using chi-squared, Mann-Whitney U and t-tests. Multivariable logistic regression models also were developed. Results: Study population (N = 99,305 had a mean age of 28.1 years and prepregnancy body mass index (BMI of 26.7 kg/m2; 64.0% were white, 59.2% married, 39.3% nulliparous and 25.7% cesarean delivery. Mean gestational age was 39.0 weeks. Rate of maternal GBS colonization (22.3% overall was greater in blacks (34.1% vs. 20.1% in whites, P < 0.0001, unmarried women (25.5% vs. 20.0% married, P < 0.0001, women with sexually transmitted or other genital infections (P < 0.0001 and residents of ZIP code group 532XX (P < 0.0001, and was associated with increasing BMI (P < 0.0001. All predictors of colonization were significant on multivariable analysis. Rate of infant death was 5.7 deaths/1,000 live births (n = 558 excluding lethal anomalies and stillbirths and was negatively associated with maternal GBS colonization (P < 0.0001. On multivariable analysis, 532XX ZIP code group, lower gestational age, preterm labor, hyaline membrane disease, normal spontaneous vaginal delivery, hydramnios, oligohydramnios and absence of maternal GBS were associated with infant death. Conclusions: Geographic characteristics were associated with infant death and maternal GBS colonization. Further research is needed to determine if increased surveillance or treatment of mothers colonized with GBS decreases the risk of infant

  12. Born in Haiti: A Maternity Hospital in the Context of a Humanitarian Crisis

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    Christina Sutter

    2016-11-01

    Full Text Available This is a report on the experience of implementing a mental health program in a maternity hospital and three mobile clinics in the city of Port-au-Prince. We started by listening to the difficulties faced by the national teams in their daily routines at the hospital and what they expected of a mental health program. The program was planned in a way to contemplate the perceived needs of the hospital teams as well as those of the target population, pre and post-natal women, within a systemic perspective. Thus the program covered the following aspects: training with the hospital team on communication and helping relationships, a series of speeches on mental health at the hospital, psychological treatment of the patients through counseling sessions, involvement of partners and families being assisted, support groups for peri-natal mourning, men's groups with the future fathers, psychoeducation in the mobile clinics, a survey of the social network in the city, psycho-social assistance and the introduction of relaxation strategies at the hospital. We concluded that in the context of a humanitarian crisis, as in the case of Haiti, a mental health program should contemplate different levels of need and take into consideration that health care professionals are also subject to the context of social stress. At the same time, the involvement of hospital teams in the process is fundamental to the success of the program.

  13. Scheduled cesarean delivery: maternal and neonatal risks in primiparous women in a community hospital setting.

    Science.gov (United States)

    Quiroz, Lieschen H; Chang, Howard; Blomquist, Joan L; Okoh, Yvonne K; Handa, Victoria L

    2009-04-01

    We compared the short-term maternal and neonatal outcomes of women who deliver by cesarean without labor compared with women who deliver by cesarean after labor or by vaginal birth. This was a retrospective cohort study of women delivering a first baby from 1998 to 2002. Hospital discharge diagnostic coding identified unlabored cesarean deliveries (UCDs), labored cesarean deliveries (LCDs), and vaginal births (VBs). Medical records were abstracted and mode of delivery confirmed. The three outcomes of interest were maternal bleeding complications, maternal febrile morbidity, and neonatal respiratory complications. Using logistic regression for each outcome, we investigated whether mode of delivery was associated with the outcome, independent of other factors. The study groups included 513 UCDs, 261 LCDs, and 251 VBs. Compared with the UCD group, the adjusted odds of bleeding complications was higher in the LCD comparison group (odds ratio [OR] 2.3; 95% confidence interval [CI] 1.21, 4.53) and the VB comparison group (OR 1.96; 95% CI 0.95, 4.02). The incidence of febrile morbidity was similar for both cesarean groups but lower in the VB group. Both comparison groups had lower odds of neonatal complications than the UCD group (OR for LCD comparison group 0.52; 95% CI 0.27, 0.95 and OR for VB comparison group 0.26; 95% CI 0.098, 0.59). Scheduled cesarean is associated with increased odds of neonatal respiratory complications but decreased odds of maternal bleeding complications.

  14. Maternal and Fetal Outcomes of Triplet Gestation in a Tertiary Hospital in Oman

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    Maryam Al-Shukri

    2014-05-01

    Full Text Available Objectives: The aim of this study was to describe the fetal and maternal outcomes of triplet gestation and to report on the maternal characteristics of those pregnancies in a tertiary care centre in Oman. Methods: A retrospective study was undertaken of all triplet pregnancies delivered at Sultan Qaboos University Hospital, Muscat, Oman, between January 2009 and December 2011. Results: Over the three-year study period, there were 9,140 deliveries. Of these, there were 18 triplet pregnancies, giving a frequency of 0.2%. The mean gestational age at delivery was 31.0 ± 3.0 weeks, and the mean birth weight was 1,594 ± 460 g. The most common maternal complications were preterm labour in 13 pregnancies (72.2%, gestational diabetes in 7 (39% and gestational hypertension in 5 (28%. Of the total deliveries, there were 54 neonates. Neonatal complications among these included hyaline membrane disease in 25 neonates (46%, hyperbilirubinaemia in 24 (43%, sepsis in 18 (33% and anaemia in 8 (15%. The perinatal mortality rate was 55 per 1,000 births. Conclusion: The maternal and neonatal outcomes of triplet pregnancies were similar to those reported in other studies.

  15. Assessment of Midwives’ Communication Skills at the Maternity Wards of Teaching Hospitals in Mashhad in 2014

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    Talate Khadivzadeh

    2015-06-01

    Full Text Available Background & aim:The quality of communication between midwives and parturient women is a determinant of maternal satisfaction with midwifery care. Therefore, this study was conducted to determine the communication skills of midwives at maternity wards of Mashhad teaching hospitals in 2014.   Methods:In this descriptive study, 49 midwives, working at Mashhad teaching hospitals, were randomly selected. All midwives worked rotating shifts at the wards. The midwives’ communication skills were assessed by the researcher, using the self-structured  observation checklist of communicative performance.   Results: The mean age of midwives was 39.11±9.66 years and their mean work experience was 15.9±8.77 years. In total, 68.3% of the participants experienced childbirth themselves. 66.7% of midwives were moderately  keen on midwifery as a profession. The mean score of the checklist obtained by midwives was 67.9±10.7. There was no relationship between midwives’ communication skills and work experience, childbirth experience, age or interest in midwifery. Conclusion:Considering the inadequacy of midwives’ communication skills, which could be the major cause of maternal dissatisfaction with delivery care, it is recommended that in-service training courses be held by applying new teaching methods. Moreover, the educational needs of midwives, including communication skills, should be considered in these training programs .

  16. Maternal and fetal outcome of mothers with gestational diabetes mellitus attending BIRDEM Hospital.

    Science.gov (United States)

    Sajani, T T; Rahman, M T; Karim, M R

    2014-04-01

    Gestational diabetes mellitus, most of which progress to type-2 diabetes mellitus is increasing worldwide. Identification of gestational diabetes and control of glucose can reduce such complications and improve maternal and neonatal health. A hospital based cross sectional study was conducted to find out maternal and fetal outcome of gestational diabetes from January to July 2011. Data were collected from 109 gestational diabetes mothers attending Bangladesh Institute of Research and Rehabilitation in Diabetes, Endocrine and Metabolic Disorders (BIRDEM) hospital for delivery. Study revealed that gestational diabetes was more common among mothers aged >25 years old and multiparaous women. Mean gestational age of diagnosis was 16.82±9.54 weeks. Sixty eight (68%) mothers were diagnosed before 20 weeks of gestation and more than 90% mothers with gestational diabetes delivered by caesarean section. Mean pregnancy weight gain was 6.8±1.18kg. Adverse maternal outcome observed in 24% cases and adverse fetal outcome was present in 34% cases. In univariate analysis weeks of delivery and fasting blood sugar were statistically significantly associated with adverse pregnancy outcome. Babies born to mothers with only diet restriction had less birth weight than mothers with insulin therapy. Pregnancy thought to be the most vulnerable stage of women's life and protecting her health along with her fetus during this period yields a positive impact on the health of future generation. Particular attention should be given during antenatal period to initiate screening programme and treatment protocol for gestational diabetic mothers.

  17. Maternal mortality and its relationship to emergency obstetric care (EmOC) in a tertiary care hospital in South India.

    Science.gov (United States)

    Dasari, Papa

    2015-06-01

    To determine the trends in maternal mortality ratio over 5 years at JIPMER Hospital and to find out the proportion of maternal deaths in relation to emergency admissions. A retrospective analysis of maternal deaths from 2008 to 2012 with respect to type of admission, referral and ICU care and cause of death according to WHO classification of maternal deaths. Of the 104 maternal deaths 90% were emergency admissions and 59% of them were referrals. Thirty two percent of them died within 24 hours of admission. Forty four percent could be admitted to ICU and few patients could not get ICU bed. The trend in cause of death was increasing proportion of indirect causes from 2008 to 2012. The trend in MMR was increasing proportion of indirect deaths. Ninety percent of maternal deaths were emergency admissions with complications requiring ICU care. Hence comprehensive EmOC facilities should incorporate Obstetric ICU care.

  18. Maternal and neonatal outcomes after implementation of a hospital policy to limit low-risk planned caesarean deliveries before 39 weeks of gestation: an interrupted time-series analysis.

    Science.gov (United States)

    Hutcheon, J A; Strumpf, E C; Harper, S; Giesbrecht, E

    2015-08-01

    To evaluate the extent to which implementing a hospital policy to limit planned caesarean deliveries before 39 weeks of gestation improved neonatal health, maternal health, and healthcare costs. Retrospective cohort study. British Columbia Women's Hospital, Vancouver, Canada, in the period 2005-2012. Women with a low-risk planned repeat caesarean delivery. An interrupted time series design was used to evaluate the policy to limit planned caesarean deliveries before 39 weeks of gestation, introduced on 1 April 2008. Composite adverse neonatal health outcome (respiratory morbidity, 5-minute Apgar score of policy, the proportion of planned caesareans dropped by 20 percentage points (adjusted risk difference of 20 fewer cases per 100 deliveries; 95% CI -25.8, -14.3) to 41% (1033/2518). The policy had no detectable impact on adverse neonatal outcomes (2.2 excess cases per 100; 95% CI -0.4, 4.8), maternal complications, or healthcare costs, but increased the risk of out-of-hours delivery from 16.2 to 21.1% (adjusted risk difference 6.3 per 100; 95% CI 1.6, 10.9). We found little evidence that a hospital policy to limit planned caesareans before 39 weeks of gestation reduced adverse neonatal outcomes. Hospital administrators intending to introduce such policies should anticipate, and plan for, modest increases in out-of-hours and emergency-timing. © 2015 Royal College of Obstetricians and Gynaecologists.

  19. Major clonal lineages in impetigo Staphylococcus aureus strains isolated in Czech and Slovak maternity hospitals.

    Science.gov (United States)

    Růžičková, Vladislava; Pantůček, Roman; Petráš, Petr; Machová, Ivana; Kostýlková, Karla; Doškař, Jiří

    2012-11-01

    One hundred and twenty-seven exfoliative toxin-producing (ET-positive) strains of Staphylococcus aureus collected in 23 Czech and one Slovak maternity hospitals from 1998 to 2011 were genotypically characterized by multilocus sequence typing (MLST), pulsed-field gel electrophoresis (PFGE) profiling, spa gene polymorphism analysis, and ETA-converting prophage carriage, which resulted in the identification of 21 genotypes grouped into 4 clonal complexes (CC). Ninety-one isolates carried the eta gene alone whilst 12 isolates harboured only the etb gene. Two new, to date not defined, spa types (t6644 and t6645) and 2 novel sequence types (ST2194 and ST2195) were identified in the set of strains under study. The predominant CC121 occurred in 13 Czech hospitals. CC15, CC9, and ST88 (CC88) exclusively included eta gene-positive strains while the strains belonging to ST121 harboured the eta and/or etb genes. This study highlights not only significant genomic diversity among impetigo strains and the distribution of major genotypes disseminated in the Czech and Slovak maternity hospitals, but also reveals their impact in epidermolytic infections.

  20. Situation analysis of quality of abortion care in the main maternity hospital in Hai Phòng, Viet Nam

    DEFF Research Database (Denmark)

    Nguyen, My H Ng; Gammeltoft, Tine; Rasch, Vibeke

    2007-01-01

    Six months after a Comprehensive Abortion Care project was implemented in Phu-San Hospital, the main maternity hospital in Hai Phòng, northern Viet Nam, a study of quality of abortion services was carried out. The study explored the interaction between providers and women seeking abortion and how...

  1. A study of maternal mortality at the teaching hospital, Hubli, Karnataka

    Directory of Open Access Journals (Sweden)

    Sahaja Kittur

    2013-02-01

    (2.5% due to hepatic failure. Conclusions: Reviewing the maternal deaths that occurred in our hospital, there is an urgent need to address the issue of obstetric haemorrhages and early intervention in PIH. Much needs to be done for maternal health care in rural areas as most of the deaths reported from urban institutions are referrals from peripheral centres. Rapid transport facilities should be made available to all remote rural areas with easy accessibility. It is necessary even in urban areas to channel the working of emergency obstetric care. This prevents early intervention and adequate emergency obstetric care. The essential obstetric care for all and early detection of complications and management of emergency obstetric care services need to be seriously looked into. Most maternal deaths are preventable by health education of masses, adequate health care in the community and transport facilities. [Int J Reprod Contracept Obstet Gynecol 2013; 2(1.000: 74-79

  2. Is baby-friendly breastfeeding support in maternity hospitals associated with breastfeeding satisfaction among Japanese mothers?

    Science.gov (United States)

    Hongo, Hiroko; Nanishi, Keiko; Shibanuma, Akira; Jimba, Masamine

    2015-06-01

    While the World Health Organization's Baby-Friendly Hospital Initiative has increased breastfeeding duration and exclusivity, a survey found that only 8.5 % of maternity hospitals in 31 developed countries could be designated baby-friendly. Baby-friendly breastfeeding support is sometimes criticized as mother unfriendly. This study examined whether baby-friendly breastfeeding support was associated with breastfeeding satisfaction, duration, and exclusivity among Japanese mothers. In this cross-sectional study, 601 breastfeeding Japanese mothers completed questionnaires at their infants' 4-month health checkups at two wards in Yokohama, Japan; 363 were included in the analysis. Baby-friendly breastfeeding support was measured based on the WHO's "Ten Steps to Successful Breastfeeding." We measured satisfaction using two subscales of the Japanese version of the Maternal Breastfeeding Evaluation Scale. The association of baby-friendly support with maternal satisfaction was assessed using multiple linear regression, while the prevalence ratios (PRs) for breastfeeding were estimated using Poisson regression. Mothers were stratified by prepartum exclusive breastfeeding intention (yes, n = 256; no, n = 107). Mothers who experienced early skin-to-skin contact with their infants were more likely to report breastfeeding satisfaction than those who did not. Among mothers without exclusive breastfeeding intention, those who were encouraged to feed on demand were more likely to be breastfeeding without formula at 1 month (PR 2.66 [95 % CI 1.32, 5.36]) and to perceive breastfeeding as beneficial for their baby (regression coefficient = 3.14 [95 % CI 0.11, 6.17]) than those who were not so encouraged. Breastfeeding satisfaction was a useful measure of breastfeeding outcome. Early skin-to-skin contact and encouragement to feed on demand in the hospital facilitate breastfeeding satisfaction.

  3. A safety culture assessment by mixed methods at a public maternity and infant hospital in China

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    Listyowardojo TA

    2017-07-01

    Full Text Available Tita Alissa Listyowardojo,1 Xiaoling Yan,2,3 Stephen Leyshon,1 Bobbie Ray-Sannerud,1 Xin Yan Yu,4 Kai Zheng,4 Tao Duan2,3 1Life Sciences Program, Group Technology and Research, DNV GL, Hovik, Norway; 2Quality and Safety Department, Shanghai First Maternity and Infant Hospital, 3Tongji University School of Medicine, Shanghai, 4Healthcare Department, Business Assurance, DNV GL, Beijing, China Objective: To assess safety culture at a public maternity hospital in Shanghai, China, using a sequential mixed methods approach. The study was part of a bigger study looking at the application of the mixed methods approach to assess safety culture in health care in different organizations and countries.Methodology: A mixed methods approach was utilized by first distributing the Safety Attitudes Questionnaire measuring six safety culture dimensions and five independent items to all hospital staff (n=1482 working in 18 departments at a single hospital. Afterward, semistructured interviews were conducted using convenience sampling, where 48 hospital staff from nine departments at the same hospital were individually interviewed.Results: The survey received a response rate of 96%. The survey findings show significant differences between the hospital departments in almost all safety culture dimensions and independent items. Similarly, the interview findings revealed that there were different, competing priorities between departments perceived to result in a reduced quality of collaboration and bottlenecks in care delivery. Another major finding was that staff who worked more hours per week would perceive working conditions significantly more negatively. Issues related to working conditions were also the most common concerns discussed in the interviews, especially the issue on high workload. High workload was also reflected in the fact that 91.45% of survey respondents reported that they worked 40 hours or longer per week. Finally, interview findings complemented

  4. Incidence of maternal near miss in hospital childbirth and postpartum: data from the Birth in Brazil study.

    Science.gov (United States)

    Dias, Marcos Augusto Bastos; Domingues, Rosa Maria Soares Madeira; Schilithz, Arthur Orlando Corrêa; Nakamura-Pereira, Marcos; Diniz, Carmen Simone Grilo; Brum, Ione Rodrigues; Martins, Alaerte Leandro; Theme Filha, Mariza Miranda; Gama, Silvana Granado Nogueira da; Carmo Leal, Maria do

    2014-08-01

    This study evaluated data on the incidence of maternal near miss identified on World Health Organization (WHO) criteria from the Birth in Brazil survey. The study was conducted between February 2011 and October 2012. The results presented are estimates for the study population (2,337,476 births), based on a sample of 23,894 women interviewed. The results showed an incidence of maternal near miss of 10.21 per 1,000 live births and a near-miss-to-mortality ratio of 30.8 maternal near miss to every maternal death. Maternal near miss was identified most prevalently by clinical criteria, at incidence of 5.2 per 1,000 live births. Maternal near miss was associated with maternal age 35 or more years (RR=1.6; 95%CI: 1.1-2.5), a history of previous cesarean delivery (RR=1.9; 95%CI: 1.1-3.4) and high-risk pregnancy (RR=4.5; 95%CI: 2.8-7.0). incidence of maternal near miss was also higher at hospitals in capital cities (RR=2.2; 95%CI: 1.3-3.8) and those belonging to Brazil's national health service, the Brazilian Unified National Health System (SUS) (RR=3.2; 95%CI: 1.6-6.6). Improved quality of childbirth care services can help reduce maternal mortality in Brazil.

  5. MATERNAL OUTCOME IN PREGNANCY INDUCED HYPERTENSION IN A TEACHING HOSPITAL IN A RURAL AREA IN TELANGANA

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    Kavitha Reddy Kothapally

    2016-09-01

    Full Text Available AIM To analyse the maternal outcome in pregnancy induced hypertension and improve the management strategies. INTRODUCTION Pregnancy induced hypertension is a medical disease peculiar to pregnancy, making pregnancy a high risk condition. Among medical disorders complicating pregnancy, it stands next to anaemia in prevalence. It is responsible for majority of the maternal morbidity and mortality. It also has an adverse perinatal outcome. Hence, early detection and timely intervention of women with pregnancy induced hypertension is important for good maternal and perinatal outcome. MATERIAL & METHODS The present Prospective Observational study was done from April 2015 to February 2016 in the department of obstetrics & gynaecology at Bhaskar medical college and general hospital, Yenkepally, Moinabad, Telangana. A total of 102 pregnant women with pregnancy induced hypertension were enrolled into the study. Demographic details like age, parity, previous obstetric history of pregnancy induced hypertension and diabetes, past history of polycystic ovarian disease, treatment for infertility, gestational age at which hypertension developed in the present pregnancy were noted. Relevant investigations were performed. Gestational age of delivery, mode of delivery and maternal complications were noted. RESULTS The incidence of pregnancy induced hypertension was 4% in the study population. About 59.8% developed pregnancy induced hypertension in the third trimester. Out of this, 64.7% cases were gestational hypertension and 35.3% cases were preeclampsia. Nearly half (41.7% of preeclampsia cases were severe preeclampsia. Postpartum haemorrhage is the commonest complication (13.7%, next being imminent eclampsia (7.8%, abruption (4.9%, eclampsia (3.9% and HELLP syndrome (0.98%. 80% of cases could be delivered beyond 37 weeks of gestational age. 71.57% of cases had lower segment caesarean section for indicated conditions. More than half of pregnancy induced

  6. Maternal post natal hospital readmission-trends and association with mode of delivery.

    LENUS (Irish Health Repository)

    Ade-Conde, J A

    2012-02-01

    The aim of this study is to examine the trend in maternal postnatal readmission within six weeks of discharge from childbirth hospitalisation. It is a retrospective review of the maternity computer records system, patient\\'s clinical notes and HIPE data base. All women who delivered babies weighing > 500 g and\\/ > or = 24 weeks gestational age at Our Lady of Lourdes Hospital, Drogheda, Ireland from 1st January 2005 to 31st December 2008 who were re-hospitalised within six weeks of discharge from hospital following child birth were included in the study. A total of 15782 women were delivered over the four year study period. Of these, 236 were readmitted. A series of chi-square analysis were conducted to assess the difference in readmission rates between the year 2008 86 (2.03%) and the years 2005-51(1.46%), 2006-39 (1.01%) and 2007-60 (1.42%). The readmission rate was found to be significantly higher in 2008 compared with the three preceding years. Complications of Caesarean section and secondary postpartum haemorrhage following spontaneous vaginal delivery constitute the major indications for readmission.

  7. Neonatal hearing screening in a low-risk maternity hospital in São Paulo state

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    Adriana Aparecida Tahara Kemp

    2015-10-01

    Full Text Available ABSTRACT INTRODUCTION: The literature indicates that neonatal hearing screening should be universal, so a description of programs that adopt this recommendation is relevant. OBJECTIVE: To describe the results of newborn hearing screening and the profile of mothers and newborns attended to in a low-risk maternity setting, and to correlate the characteristics of this population with the results of transient evoked otoacoustic emissions. METHODS: A contemporary cross-sectional cohort study. The sample consisted of 670 infants and the procedures performed were audiological history, transient-evoked otoacoustic emissions (TEOAE, distortion product-evoked otoacoustic emissions (DPEOAE, and automated-brainstem auditory evoked potential (ABSAEP. RESULTS: The rate of success in this program was 98.5%, the failure rate was 0.62%, and that of non-attendance to finalize the diagnostic process, 0.93%. When correlating the variables studied with the results of transient evoked otoacoustic emissions, there was a significant negative correlation only for age of infant. CONCLUSION: The program of this maternity hospital was effective and complies with national and international recommendations. The population consisted of young mothers with few pregnancy complications and healthy infants. The only variable that influenced transient evoked otoacoustic emission results, after hospital discharge, was the age at which infants were evaluated.

  8. Evaluation of the determinants of maternal mortality in H. Adam Malik General Hospital, Medan during 2010-2012

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    Morel Sembiring

    2017-07-01

    Full Text Available Background: Maternal mortality rate is one indicator used to assess overall women health status. According to the WHO, 99% of maternal deaths are delivery related and dominantly occur in developing countries. Objective: To determine the causes of maternal deaths at H. Adam Malik General Hospital Medan based on the following factors: remote determinants, the intermediate determinants, and outcome determinants as a risk factor of maternal deaths. Methods: This retrospective analytical study reviewed medical records of women who underwent delivery at H. Adam Malik General Hospital, Medan from January 1st 2010 until December 31th 2012. Data were statiscally analysed using a descriptive and inferential approach. Univariate, bivariate, and multivariate logistic regression analysis were used. Results: This study obtained as much as 681 complete medical records for 3 years, with 37 maternal deaths. Pre-eclampsia / eclampsia is the most common cause of death by 20 cases (54.1%. Maternal education degree, referral systems, facilities for delivery, history of systemic diseases, pregnancy and postpartum related complications were significantly correlated to the outcome of labor with OR of 1.97; 10.11; 41.36; 5.818; 3.49; and 685.7, respectively and p<0.05. Based on the multiple logistic regression test, maternal history of systemic diseases, pregnancy and postpartum related complications were the three factors that most significantly correlated to maternal mortality with p <0.05. Conclusion: Delivery outcomes were significantly associated with the followingfacrors: formal education, referral status, facilities for delivery, history of systemic diseases, mode of delivery, pregnancy and postpartum related complications. Maternal history of systemic diseases, pregnancy and postpartum related complicationswere the three factors that most significantly correlated to maternal mortality.

  9. Contribution of genome-environment interaction to pre-eclampsia in a Havana Maternity Hospital.

    Science.gov (United States)

    Lardoeyt, Roberto; Vargas, Gerardo; Lumpuy, Jairo; García, Ramón; Torres, Yuselis

    2013-07-01

    Pre-eclampsia is a major cause of morbidity and mortality during pregnancy worldwide and is among the leading causes of maternal mortality in Cuba. It is a complex, multifactoral disease, in which interaction of genetic and environmental factors should not be overlooked if the goal is proper risk assessment to support personalized preventive genetic counseling and more effective prenatal care to prevent pregnancy complications. Determine the contribution to pre-eclampsia of interaction between a predisposing genome and adverse environmental factors in pregnant women in a Havana maternity hospital. This was the exploratory phase of a hospital-based case-control study, using January 2007-December 2009 patient records from the Eusebio Hernández University Hospital, a provincial maternity hospital in Havana. Eighty pregnant women diagnosed with pre-eclampsia and 160 controls were studied. The main variables were age, parity, nutritional status (measured by BMI), alcohol use, tobacco use, and history of pre-eclampsia in relatives of the pregnant woman (proband) or of her partner. Pearson chi square and Fisher exact test were used to assess statistical significance of associations between variables and odds ratio as a measure of association strength. Familial aggregation was studied and a case-control design used to assess gene-environment interaction, using multiplicative and additive models. Among the environmental risk factors studied, alcohol showed the strongest effect on pre-eclampsia risk (OR 3.87, 95% CI 1.64-9.13). Familial pre-eclampsia clustering was observed; risk was increased for both first-degree (OR 2.43, 95% CI 1.62-3.73) and second-degree (OR 1.89, 95% CI 1.34-2.68) relatives as well as for husband's relatives (OR 2.32, 95% CI 1.40-3.86). There was evidence of interaction between alcohol consumption and family history. Familial aggregation of the disorder was demonstrated, the first Cuban epidemiological evidence of genetic and enviromental

  10. Severe maternal morbidity in the intensive care unit of a havana teaching hospital,1998 to 2004.

    Science.gov (United States)

    Pérez, Albadio; Bacallao, Jorge; Alcina, Serafín; Gómez, Yamilka

    2008-07-01

    Introduction In recent years, several reports have appeared in the international literature concerning evolution and prognosis for obstetric patients whose illnesses have led to admission to intensive care units (ICUs). The term severe maternal morbidity has been proposed to refer to life-threatening complications that occur during pregnancy, delivery or postpartum. Objective Characterize severe maternal morbidity in obstetric patients admitted to the ICU of the Enrique Cabrera General Teaching Hospital in Havana from 1998 to 2004. Methods From 1998 to 2004, we conducted a prospective, descriptive, and observational study of 312 patients admitted to the ICU of the Enrique Cabrera General Teaching Hospital in Havana, Cuba. Patients were included whose length of stay was >24 hours, and whose family members provided written informed consent. A data collection form was developed to record general characteristics, personal and family medical history, cause of ICU admission, diagnosis, obstetric condition at the onset of illness and at admission, pregnancy outcome, surgeries performed and patient's ICU discharge status (survivor or non-survivor), the latter a dependent variable. An Excel database was compiled and processed using SPSS 13.0. Percentages were used to summarize qualitative variables. A Chi-square test was used for univariate analysis between these qualitative variables and patient discharge status; t-test was used for quantitative analyses. Results Overall mortality in the cohort was 7.4% (23 patients), greater among women aged <20 years, those with a history of previous illnesses, and those subjected to several surgical interventions. Obstetric hemorrhage, pre-eclampsia/eclampsia, and postpartum sepsis were the most commonly diagnosed obstetric disorders. Non-obstetric disorders diagnosed included severe asthma, pneumonia and peritonitis. Amniotic fluid embolism, postpartum sepsis, early postpartum hemorrhage and pre-eclampsia/eclampsia were associated with

  11. [Assessment of undiagnosed critical congenital heart disease before discharge from the maternity hospital].

    Science.gov (United States)

    Zhao, Q M; Liu, F; Wu, L; Ye, M; Jia, B; Ma, X J; Huang, G Y

    2017-04-02

    Objective: Undiagnosed critical congenital heart disease (CCHD) was assessed before discharge from maternity hospital.Basic information was provided for screening CCHD in the early neonatal stage.Chi-squared test was used for comparison of categorical variables(detection rate of different types of CCHD). Method: A retrospective cohort study was conducted in neonates with CCHD who were admitted to Children's Hospital of Fudan University between 1 January 2012 and 31 December 2015. For comparing with the previously reported undiagnosed rate of CCHD at discharge, CCHD was defined as all duct dependent congenital heart disease (DDCHD) and any cyanotic CHD that required early surgery. Result: A total of 1 036 infants with CCHD were included. The prenatal detection rate of CCHD was 14.04%(122/869). As a whole, 52.51% (544/1 036) of CCHD cases were undiagnosed at discharge, and 14.09%(146/1 036)were still missed after 6-week examination. The diagnoses most likely to be unrecognized at discharge included critical coarctation of the aorta (COA) (75.00%), total anomalous pulmonary venous connection (61.54%), pulmonary atresia (PA) with ventricle septal defect (VSD) (61.45%), single ventricle (SV) (60.10%) and critical aortic stenosis (52.94%). Among newborns diagnosed prior to discharge, 54.88% (270/492) due to symptom or prenatal ultrasonographic diagnosis, 45.12% (222/492) due to abnormal findings in routine examination. Among asymptomatic CCHD cases without prenatal diagnosis, 71.02% (544/766) were undiagnosed and the most common delayed diagnosis was SV (82.78%), interrupted aortic arch (81.82%), transposition of the great arteries with intact ventricular septum (79.63%), PA/VSD (79.07%), and critical COA (78.57%). Newborns with DDC were more likely to develop symptoms within the first few days after birth, in comparison with non-DDC cases. However, their detection rates were close to each other. Conclusion: The rate of misdiagnosis of CCHD before discharge from

  12. Complications of childbirth and maternal deaths in Kinshasa hospitals: testimonies from women and their families

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    Gourbin Catherine

    2011-04-01

    Full Text Available Abstract Background Maternal mortality in Kinshasa is high despite near universal availability of antenatal care and hospital delivery. Possible explanations are poor-quality care and by delays in the uptake of care. There is, however, little information on the circumstances surrounding maternal deaths. This study describes and compares the circumstances of survivors and non survivors of severe obstetric complications. Method Semi structured interviews with 208 women who survived their obstetric complication and with the families of 110 women who died were conducted at home by three experienced nurses under the supervision of EK. All the cases were identified from twelve referral hospitals in Kinshasa after admission for a serious acute obstetric complication. Transcriptions of interviews were analysed with N-Vivo 2.0 and some categories were exported to SPSS 14.0 for further quantitative analysis. Results Testimonies showed that despite attendance at antenatal care, some women were not aware of or minimized danger signs and did not seek appropriate care. Cost was a problem; 5 deceased and 4 surviving women tried to avoid an expensive caesarean section by delivering in a health centre, although they knew the risk. The majority of surviving mothers (for whom the length of stay was known had the caesarean section on the day of admission while only about a third of those who died did so. Ten women died before the required caesarean section or blood transfusion could take place because they did not bring the money in time. Negligence and lack of staff competence contributed to the poor quality of care. Interviews revealed that patients and their families were aware of the problem, but often powerless to do anything about it. Conclusion Our findings suggest that women with serious obstetric complications have a greater chance of survival in Kinshasa if they have cash, go directly to a functioning referral hospital and have some leverage when dealing

  13. Human immunodeficiency virus and AIDS and other important predictors of maternal mortality in Mulago Hospital Complex Kampala Uganda

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    Khainza Betty

    2011-07-01

    Full Text Available Abstract Background Women with severe maternal morbidity are at high risk of dying. Quality and prompt management and sometimes luck have been suggested to reduce on the risk of dying. The objective of the study was to identify the direct and indirect causes of severe maternal morbidity, predictors of progression from severe maternal morbidity to maternal mortality in Mulago hospital, Kampala, Uganda. Methods This was a longitudinal follow up study at the Mulago hospital's Department of Obstetrics and Gynaecology. Participants were 499 with severe maternal morbidity admitted in Mulago hospital between 15th November 2001 and 30th November 2002 were identified, recruited and followed up until discharge or death. Potential prognostic factors were HIV status and CD4 cell counts, socio demographic characteristics, medical and gynaecological history, past and present obstetric history and intra- partum and postnatal care. Results Severe pre eclampsia/eclampsia, obstructed labour and ruptured uterus, severe post partum haemorrhage, severe abruptio and placenta praevia, puerperal sepsis, post abortal sepsis and severe anaemia were the causes for the hospitalization of 499 mothers. The mortality incidence rate was 8% (n = 39, maternal mortality ratio of 7815/100,000 live births and the ratio of severe maternal morbidity to mortality was 12.8:1. The independent predictors of maternal mortality were HIV/AIDS (OR 5.1 95% CI 2-12.8, non attendance of antenatal care (OR 4.0, 95% CI 1.3-9.2, non use of oxytocics (OR 4.0, 95% CI 1.7-9.7, lack of essential drugs (OR 3.6, 95% CI 1.1-11.3 and non availability of blood for transfusion (OR 53.7, 95% CI (15.7-183.9 and delivery of amale baby (OR 4.0, 95% CI 1.6-10.1. Conclusion The predictors of progression from severe maternal morbidity to mortalitywere: residing far from hospital, low socio economic status, non attendance of antenatal care, poor intrapartum care, and HIV/AIDS. There is need to improve on the

  14. HIV self-care practices during pregnancy and maternal health outcomes among HIV-positive postnatal mothers aged 18-35 years at Mbuya Nehanda maternity hospital.

    Science.gov (United States)

    Dodzo, Lilian Gertrude; Mahaka, Hilda Tandazani; Mukona, Doreen; Zvinavashe, Mathilda; Haruzivishe, Clara

    2017-06-01

    HIV-related conditions are one of the indirect causes of maternal deaths in Zimbabwe and the prevalence rate was estimated to be 13.63% in 2009. The study utilised a descriptive correlational design on 80 pregnant women who were HIV positive at Mbuya Nehanda maternity hospital in Harare, Zimbabwe. Participants comprised a random sample of 80 postnatal mothers. Permission to carry out the study was obtained from the respective review boards. Participants signed an informed consent. Data were collected using a structured questionnaire and record review from 1 to 20 March 2012. Interviews were done in a private room and code numbers were used to identify the participants. Completed questionnaires were kept in a lockable cupboard and the researcher had sole access to them. Data were analysed using the Statistical Package for Social Sciences (SPSS) version 12. Descriptive statistics were used to analyse data on demographics, maternal health outcomes and self-care practices. Inferential statistics (Pearson's correlation and regression analysis) were used to analyse the relationship between self-care practices and maternal health outcomes. Self-care practices were good with a mean score of 8 out of 16. Majority (71.3%) fell within the good category. Maternal outcomes were poor with a mean score of 28 out of 62 and 67.5% falling in the poor category. Pearson's correlation indicated a weak significant positive relationship (r = .317, p = <.01). Regression analysis (R(2)) was .10 implying that self-care practices explained 10% of the variance observed in maternal health outcomes. More research needs to be carried out to identify other variables affecting maternal outcomes in HIV-positive pregnant women.

  15. A 10-year review of maternal mortality in Chon Buri Hospital, Thailand.

    Science.gov (United States)

    Pinchun, P; Chullapram, T

    1993-06-01

    1. The overall maternal mortality rate (MMR) in Chon Buri Hospital in the 10-yr period from 1982-1991 was 51.1/100,000 livebirths. 2. The top causes of death were abortion related complications, pregnancy induced hypertension, puerperal infection and postpartum hemorrhage. 3. What we have done is to improve the quantity and quality of obstetric and medical care, solve the problem of vital statistics reports in our hospital, contact doctor in nearby hospitals in referral and interhospital OB-GYN conferences to meet and discuss both knowledge and management problems. 4. What we still faced in the last 4-yr were deaths from abortion related complications, puerperal sepsis and postpartum hemorrhage. Most of the deaths were preventable. 5. So what we have to target to lessen the MMR is to improve the obstetric and medical care, improve the quality of medical personnel in our area in KAP aspect (knowledge, attitude, practice) especially in the field of family planning to prevent unwanted pregnancies, proper prevention and management of postpartum hemorrhage, and prevention and treatment of puerperal and postabortal infection.

  16. Maternal and fetal outcome in pre-eclampsia in a secondary care hospital in South India

    Directory of Open Access Journals (Sweden)

    Parveen M Aabidha

    2015-01-01

    Full Text Available Background: Hypertensive disorders in pregnancy are one of the common causes for perinatal and maternal morbidity and mortality in developing countries. Pre-eclampsia is a condition which typically occurs after 20 weeks of gestation and has high blood pressure as the main contributing factor. The aim was to study the effects of pre-eclampsia on the mother and the fetus in rural South Indian population. Materials and Methods: This was a descriptive study conducted in a secondary level hospital in rural South India. A total of 1900 antenatal women were screened for pre-eclampsia during the period August 2010 to July 2011 to study the effects on the mother and fetus. Results: Of the 1900 women screened 93 were detected with pre-eclampsia in the study. Among these, 46.23% were primigravida, 30.1% belonged to socio-economic class 4 and 48.8% were among those with BMI 26-30. The incidence of severe pre-eclampsia was higher in the unregistered women. The most common maternal complication was antepartum hemorrhage (13.9% and the most common neonatal complication was prematurity (23.65%. Conclusions: Treating anemia and improving socioeconomic status will improve maternal and neonatal outcome in pre-eclampsia. Antenatal care and educating women on significance of symptoms will markedly improve perinatal morbidity and mortality. Prematurity, growth restriction and low birth weight are neonatal complications to be anticipated and dealt with when the mother has pre-eclampsia. A good neonatal intensive care unit will help improve neonatal outcomes.

  17. Maternal assessment of recommendations on the newborn infant care upon hospital discharge.

    Science.gov (United States)

    Herrero-Morín, José David; Huidobro Fernández, Belén; Amigo Bello, María Cristina; Quiroga González, Rocío; Fernández González, Nuria

    2015-01-01

    It is common for pediatricians to provide parents with information on how to look after their newborn baby at the time of discharge from the hospital. The objectives of this study are to determine the level of satisfaction regarding such information, to be aware of what additional information parents would have liked to receive, and to establish which factors may impact any additional information request. Descriptive study evaluating the opinion of women at 5-15 days post- partum regarding such information. A hundred and seventy-six surveys were collected. Of these, 68.8% respondents had attended childbirth classes. Sixty-one point four percent referred to have looked for advice on the newborn infant care, mostly on the Internet and in books. Seventy-four point four percent considered that the information provided sufficed. Most commonly, information was requested on breastfeeding (33.3%), bottle feeding (20.0%), and umbilical cord care (11.1%). Mothers who requested more information attended childbirth classes more frequently (significant) and searched for information during pregnancy (not significant). In addition, this group significantly assigned a lower score to the opportunity to ask questions and the level of trust on the pediatrician. Maternal satisfaction regarding the information provided is adequate; and most mothers do not request additional information. The topic on which they most frequently request additional information is breastfeeding. The decision to request information does not depend on maternal age, maternal education, employment condition, or having other children. Likewise, mothers have questions that are not satisfactorily answered during childbirth classes.

  18. Does Maternal HIV Status Affect Infant Growth?: A Hospital Based Follow Up Study

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    Sangeeta Trivedi

    2012-08-01

    Full Text Available Introduction: HIV infection is difficult to diagnose in infants, as most infected babies appear healthy and exhibit no signs and symptoms at birth. The present study was conducted to study the clinical profile & morbidity pattern of infants born to HIV positive mothers, their nutritional status and growth pattern and compare them with HIV non exposed infants. Methodology: This observational longitudinal study was conducted in Dec 2009 – Dec 2010 where all HIV exposed baby born in the hospital (n=44 were compared with suitable sample of HIV non exposed babies (n=140 in context of clinical profile & morbidity pattern. Results: In maternal weight <50 Kg category, mean weight, length and head circumference of HIV exposed infants is significantly lower than HIV non exposed infants. However, pattern of weight gain remain similar in both group. Grade 1 and grade 2 malnutrition was more in HIV exposed group at 3 month & 6 month. HIV exposed baby reported higher episodes of diarrhea (28.57% as compared to non exposed group (15.33% with statistically significant difference (p value<0.05. Conclusion: HIV exposure does not adversely affect growth potential of infants but because of their lower baseline values they seem to lag behind. Moreover maternal HIV status does not lead to severe degree of malnutrition if these babies were not themselves affected with HIV. [Natl J of Med Res 2012; 2(4.000: 512-517

  19. [Institutional violence, medical authority, and power relations in maternity hospitals from the perspective of health workers].

    Science.gov (United States)

    Aguiar, Janaina Marques de; d'Oliveira, Ana Flávia Pires Lucas; Schraiber, Lilia Blima

    2013-11-01

    The current article discusses institutional violence in maternity hospitals from the health workers' perspective, based on data from a study in the city of São Paulo, Brazil. Eighteen health workers from the public and private sectors were interviewed, including obstetricians, nurses, and nurse technicians. A semi-structured interview was used with questions on professional experience and the definition of violence. The analysis revealed that these health workers acknowledged the existence of discriminatory and disrespectful practices against women during prenatal care, childbirth, and the postpartum. Examples of such practices cited by interviewees included the use of pejorative slang as a form of "humor", threats, reprimands, and negligence in the management of pain. Such practices are not generally viewed by health workers as violent, but rather as the exercise of professional authority in what is considered a "difficult" context. The institutional violence is thus trivialized, disguised as purportedly good practice (i.e., "for the patient's own good"), and rendered invisible in the daily routine of care provided by maternity services.

  20. [Normative prenatal evaluation at a philanthropic maternity hospital in São Paulo].

    Science.gov (United States)

    Corrêa, Claudia Regina Hostim; Bonadio, Isabel Cristina; Tsunechiro, Maria Alice

    2011-12-01

    This cross-sectional study counted with the participation of 301 pregnant women seen in 2009 at a philanthropic maternity hospital in the city of São Paulo (a prenatal support program named Pré-Natal do Amparo Maternal - PN-AM). The objectives of this study were to evaluate the prenatal care according to the initial gestational age, the number of appointments that were held, the continuity of the assistance, and relate the appropriateness with the socio-demographic, obstetric and local variables of the initial prenatal care. The analysis criteria used was initiating prenatal care before 120 days of gestation and attending at least six appointments. The relationship between the variables was analyzed using the Chi-Square Test. Results showed that 41.5% of the pregnant women initiated prenatal care at another health care service and transferred spontaneously to the PN-AM; 74.1% initiated the prenatal care early and 80.4% attended at least six appointments; 63.1% met both criteria simultaneously. Appropriate prenatal care showed a statistically significant difference for mother's age, steady partner, employment, place of residence, having a companion during the appointment and place where prenatal care was initiated.

  1. Fetal outcome in emergency versus elective cesarean sections at Souissi Maternity Hospital, Rabat, Morocco

    Science.gov (United States)

    Benzouina, Soukayna; Boubkraoui, Mohamed El-mahdi; Mrabet, Mustapha; Chahid, Naima; Kharbach, Aicha; El-hassani, Amine; Barkat, Amina

    2016-01-01

    Introduction Perinatal mortality rates have come down in cesarean sections, but fetal morbidity is still high in comparison to vaginal delivery and the complications are more commonly seen in emergency than in elective cesarean sections. The objective of the study was to compare the fetal outcome and the indications in elective versus emergency cesarean section performed in a tertiary maternity hospital. Methods This comparative cross-sectional prospective study of all the cases undergoing elective and emergency cesarean section for any indication at Souissi maternity hospital of Rabat, Morocco, was carried from January 1, to February 28, 2014. Data were analyzed with emphasis on fetal outcome and cesarean sections indications. Mothers who had definite antenatal complications that would adversely affect fetal outcome were excluded from the study. Results There was 588 (17.83%) cesarean sections among 3297 births of which emergency cesarean section accounted for 446 (75.85%) and elective cesarean section for 142 cases (24.15%). Of the various factors analyzed in relation to the two types of cesarean sections, statistically significant associations were found between emergency cesarean section and younger mothers (P cesarean section performed under general anesthesia (P cesarean section was fetal distress (30.49%), while the most frequent indication in elective cesarean section was previous cesarean delivery (47.18%). Conclusion The overall fetal complications rate was higher in emergency cesarean section than in elective cesarean section. Early recognition and referral of mothers who are likely to undergo cesarean section may reduce the incidence of emergency cesarean sections and thus decrease fetal complications. PMID:27347286

  2. Seasonal variation of maternally derived respiratory syncytial virus antibodies and association with infant hospitalizations for respiratory syncytial virus

    DEFF Research Database (Denmark)

    Stensballe, Lone Graff; Ravn, Henrik; Kristensen, Kim;

    2009-01-01

    This study used 459 prospectively sampled cord blood samples to examine the association between maternally derived respiratory syncytial virus (RSV)-neutralizing antibodies and the RSV hospitalization season in Denmark. We found a clear temporal association and suggest that RSV-neutralizing antib...

  3. Royal Observatory, Greenwich

    Science.gov (United States)

    Murdin, P.

    2000-11-01

    The Royal Observatory at Greenwich, London, founded in 1675, is the location of the Airy Transit Telescope that defines the prime meridian of the world and is the home of the Harrison Chronometers. The Observatory was founded by Charles II with the ultimate purpose of providing an accurate star catalog and model of the Moon's motion, that enabled mariners to find their longitude. During the twen...

  4. High rates of burnout among maternal health staff at a referral hospital in Malawi: A cross-sectional study

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    Meguid Tarek

    2011-05-01

    Full Text Available Abstract Background Burnout among maternal healthcare workers in sub-Saharan Africa may have a negative effect on services provided and efforts to mitigate high maternal mortality rates. In Malawi, research on burnout is limited and no empirical research has been conducted specifically among maternal health staff. Therefore, the aims of the study were to examine the prevalence and degree of burnout reported by healthcare workers who provide antenatal, intrapartum, and postnatal services in a district referral hospital in Malawi; and, to explore factors that may influence the level of burnout healthcare workers experience. Methods In the current cross-sectional study, levels of burnout among staff working in obstetrics and gynaecology at a referral hospital in Malawi were examined, in addition to individual and job characteristics that may be associated with burnout. Results In terms of the three dimensions of burnout, of the 101 participants, nearly three quarters (72% reported emotional exhaustion, over one third (43% reported depersonalization while almost three quarters (74% experienced reduced personal accomplishment. Conclusions Based on these findings, burnout appears to be common among participating maternal health staff and they experienced more burnout than their colleagues working in other medical settings and countries. Further research is needed to identify factors specific to Malawi that contribute to burnout in order to inform the development of prevention and treatment within the maternal health setting.

  5. Placenta previa and pre-eclampsia: analyses of 1645 cases at Medani Maternity Hospital, Sudan

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    Ishag eAdam

    2013-02-01

    Full Text Available A retrospective case- control study was conducted to investigate the risk factors for pre-eclampsia -including the protective effect of placenta previa -at Medani Maternity Hospital, Sudan. Medical files of the patients during the period 2003 to 2010 were reviewed for age, parity, education level, prenatal care, placenta previa and hemoglobin level. Women with pre-eclampsia were the cases, and women with normal pregnancy were the controls. There were 54339 singleton deliveries and 1765 women with pre-eclampsia in the hospital, giving the incidence of pre-eclampsia of 3.2%. The risk factors for pre-eclampsia were; women with age > 35 year (OR= 1.4, 95% CI: 1.1-1.8, primiparity (OR = 3.3, 95% CI: 2.7–4.0, para > 5 (OR= 3.1, 95% CI: 2.4–4.0 and anemia (OR= 3.3, 95% CI: 2.8–3.9. The risk of pre-eclampsia was inversely increased with education level and prenatal care attendance. The prevalence of placenta previa was 0(0% and 55 (3.3%, P< 0.001 in pre-eclamptic and control women, respectively. Placenta previa was a significant protective factor of pre-eclampsia (OR= 0.3, 95% CI: 0.1–0.7. Although, the socio-demographic risk factors for pre-eclampsia observed among women at Medani hospital were similar to those found in other settings; placenta previa was associated with decreased incidence of pre-eclampsia.

  6. Placenta Previa and Pre-Eclampsia: Analyses of 1645 Cases at Medani Maternity Hospital, Sudan

    Science.gov (United States)

    Adam, Ishag; Haggaz, AbdElrahium D.; Mirghani, Omer A.; Elhassan, Elhassan M.

    2013-01-01

    A retrospective case-control study was conducted to investigate the risk factors for pre-eclampsia – including the protective effect of placenta previa – at Medani Maternity Hospital, Sudan. Medical files of the patients during the period 2003–2010 were reviewed for age, parity, education level, prenatal care, placenta previa, and hemoglobin level. Women with pre-eclampsia were the cases, and women with normal pregnancy were the controls. There were 54,339 singleton deliveries and 1765 women with pre-eclampsia in the hospital, giving the incidence of pre-eclampsia of 3.2%. The risk factors for pre-eclampsia were; women with age >35 years (OR = 1.4, 95% CI: 1.1–1.8), primiparity (OR = 3.3, 95% CI: 2.7–4.0), para >5 (OR = 3.1, 95% CI: 2.4–4.0), and anemia (OR = 3.3, 95% CI: 2.8–3.9). The risk of pre-eclampsia was inversely increased with education level and prenatal care attendance. The prevalence of placenta previa was 0 (0%) and 55 (3.3%), P Placenta previa was a significant protective factor of pre-eclampsia (OR = 0.3, 95% CI: 0.1–0.7). Although, the socio-demographic risk factors for pre-eclampsia observed among women at Medani hospital were similar to those found in other settings; placenta previa was associated with decreased incidence of pre-eclampsia. PMID:23450096

  7. Factors associated with postpartum hemorrhage maternal death in referral hospitals in Senegal and Mali: a cross-sectional epidemiological survey.

    Science.gov (United States)

    Tort, Julie; Rozenberg, Patrick; Traoré, Mamadou; Fournier, Pierre; Dumont, Alexandre

    2015-09-30

    Postpartum hemorrhage (PPH) is the leading cause of maternal mortality in Sub-Saharan-Africa (SSA). Although clinical guidelines treating PPH are available, their implementation remains a great challenge in resource poor settings. A better understanding of the factors associated with PPH maternal mortality is critical for preventing risk of hospital-based maternal death. The purpose of this study was thus to assess which factors contribute to maternal death occurring during PPH. The factors were as follows: women's characteristics, aspects of pregnancy and delivery; components of PPH management; and organizational characteristics of the referral hospitals in Senegal and Mali. A cross-sectional survey nested in a cluster randomized trial (QUARITE trial) was carried out in 46 referral hospitals during the pre-intervention period from October 2007 to September 2008 in Senegal and Mali. Individual and hospital characteristics data were collected through standardized questionnaires. A multivariable logistic mixed model was used to identify the factors that were significantly associated with PPH maternal death. Among the 3,278 women who experienced PPH, 178 (5.4%) of them died before hospital discharge. The factors that were significantly associated with PPH maternal mortality were: age over 35 years (adjusted OR = 2.16 [1.26-3.72]), living in Mali (adjusted OR = 1.84 [1.13-3.00]), residing outside the region location of the hospital (adjusted OR = 2.43 [1.29-4.56]), pre-existing chronic disease before pregnancy (adjusted OR = 7.54 [2.54-22.44]), prepartum severe anemia (adjusted OR = 6.65 [3.77-11.74]), forceps or vacuum delivery (adjusted OR = 2.63 [1.19-5.81]), birth weight greater than 4000 grs (adjusted OR = 2.54 [1.26-5.10]), transfusion (adjusted OR = 2.17 [1.53-3.09]), transfer to another hospital (adjusted OR = 13.35 [6.20-28.76]). There was a smaller risk of PPH maternal death in hospitals with gynecologist

  8. Hawaiian Royal Incest

    Directory of Open Access Journals (Sweden)

    Joanne Carando

    2006-03-01

    Full Text Available When early navigators reported on Hawaii, its practices and customs, one of the most often mentioned features of the archipelago was the practice of incest among members of the royal families. Though it was restricted to a limited number of people, it was such an openly practiced tradition that it could not go unnoticed, all the more so as it concerned the rulers of the islands. What struck these first observers was also the fact that it was not considered as a sin nor as a peculiar custom by...

  9. A royal visit

    CERN Multimedia

    2006-01-01

    King Harald V and Queen Sonja of Norway made a trip to CERN on Tuesday 4 April, taking a tour of part of the LHC and greeting the Norwegian students and scientists at the Laboratory. Norway's King Harald V and Queen Sonja take a tour of the ATLAS detector with CERN Director-General Robert Aymar.King Harald V and Queen Sonja are greeted warmly by members of the Norwegian community at the CERN Globe. CERN Director-General Robert Aymar welcomed the royal party, which included the Norwegian Minister of Foreign Affairs, Jonas Gahr Støre, and provided an overview of CERN's history and current and future research. ATLAS deputy spokesperson Steinar Stapnes then quickly explained the concept and inner workings of the LHC, some LHC physics goals and ATLAS, which is one of the main experiments receiving Norwegian contributions. 'I don't think I've ever had so many distinguished students before,' Stapnes said jokingly to the crowd.The royal delegation was then escorted underground for a look at the LHC tunnel and the...

  10. Cytomegalovirus and herpes simplex infections in mothers and newborns in a Havana maternity hospital.

    Science.gov (United States)

    Festary, Aimée; Kourí, Vivian; Correa, Consuelo B; Verdasquera, Denis; Roig, Tania; Couret, Martha P

    2015-01-01

    Cytomegalovirus and herpes simplex virus are associated with congenital or perinatal infection, causing potential damage to the newborn. Determine the prevalence of active or latent infection by cytomegalovirus and herpes simplex virus in a population of mothers, congenital infection by these agents in their infants, and association between prevalence of virus infection in mothers and in their newborns. A cross-sectional study was conducted from June to September 2012 in a population of 95 pregnant women admitted to the Dr Ramón González Coro University Maternity Hospital during the third trimester of pregnancy, and their infants (98). Patients were tested for antibodies specific to these viruses; vaginal swabs and urine from the women and serum and urine from the newborns were tested for viral genome. The Fisher exact test with 95% confidence interval was used for comparisons. Of the women studied, 89.5% tested positive for cytomegalovirus and 83.2% for herpes simplex. Active infection from cytomegalovirus was detected in 16.7%, and from herpes simplex in 3.2%. Congenital cytomegalovirus infection was detected in 4.1% of newborns; no herpes simplex virus infection was found in this group. Two newborns of women with active cytomegalovirus infection were congenitally infected. Serology demonstrated that most of the women were immune to both viruses. Active cytomegalovirus infections are common in this population, and newborns of women with active cytomegalovirus infection during pregnancy are at increased risk of congenital infection.

  11. Prevalence of vaginitis among pregnant women attending Paropakar Maternity and Women's Hospital, Thapathali, Kathmandu, Nepal.

    Science.gov (United States)

    Shrestha, S; Tuladhar, N R; Basnyat, S; Acharya, G P; Shrestha, P; Kumar, P

    2011-12-01

    Vaginitis is the most prevalent disorder among the pregnant women. The objective of this study was to find out the prevalence of common types of vaginitis among the pregnant women visiting Paropakar Maternity and Women's Hospital in Kathmandu. Among 200 pregnant women included in the study, 78 (39.0%) had vaginitis. Of total 78 positive cases of vaginitis, 29.5% had candidiasis, 52.6% bacterial vaginosis and 1.3% trichomoniasis. Approximately 83% had monomicrobial infection and 16.7% had polymicrobial infection. Vaginitis was common in the age group of 20 to 29 years (41.8%) and 30-39 years (40.0%). Ethnically, Indo-Aryans (40.2%) were mostly infected. The infection rate was the highest among illiterate women (47.6%) and least among the women having education above secondary (23.0%). The positive infection rate was higher in women from rural area (45.2%) than those from urban area (37.3%). Nearly half of the women with agriculture occupation (48.4%) had vaginitis. Vaginitis was common in women with third pregnancy (52.6%). Among 78 vaginitis cases, 53 (67.9%) were asymptomatic cases.

  12. Mortalidade materna: 75 anos de observações em uma Maternidade Escola Maternal mortality: 75 years of observations in a teaching maternity hospital

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    Amaury Teixeira Leite Andrade

    2006-07-01

    Full Text Available OBJETIVO: avaliar as causas de todas as mortes maternas ocorridas no período de 1927 a 2001 entre 164.161 pacientes, internadas no Serviço de Obstetrícia da Universidade Federal de Juiz de Fora. MG. MÉTODOS: estudo retrospectivo das 144 mortes maternas que ocorreram na maternidade em 75 anos, com um total de 131.048 nascidos vivos, utilizando todos os prontuários de pacientes, avaliados pela história clínica e dados da certidão de óbito (não foram realizadas necropsias. Foram registrados a idade, paridade, tempo de gestação, complicações, momento e causas de morte, estabelecendo-se o índice de mortalidade materna (IMM hospitalar por cem mil nascidos vivos. Análise estatística pelo teste do chi2 e pela técnica de amortecimento exponencial (alfa =0,05. RESULTADOS: de 1927 a 1941 o IMM foi de 1544, entre 1942 e 1956 houve redução para 314 (pPURPOSE: to evaluate all maternal deaths that occurred between 1927 and 2001, among 164,161 patients admitted to the Maternidade Therezinha de Jesus, the obstetrical service of the "Universidade Federal de Juiz de Fora", Brazil. METHODS: a retrospective study of 144 maternal deaths that occurred in the maternity hospital in 75 years, with 131,048 live births in the same period of time, analyzing all patients's records regarding their clinical history and data from death certificates. Autopsies were not performed. Data obtained were age, parity, gestation length, complications, moment, and causes of death. The index of maternal mortality (IMM period 100 thousand live births was utilized. For statistical analysis the chi2 test and the exponential smoothing technique were used (alpha=0.05. RESULTS: IMM decreased from 1544 in the period 1927-1941 to 314 (p<0.001 between 1942 and 1956 and from 1957 to 1971 it was reduced to 76.4 per 100 thousand live births (p<0.001. Nevertheless, since 1972 there was no further significant improvement (IMM=46 in the last 15 years, p=0.139. Maternal mortality was

  13. Profile of maternal and foetal complications during labour and delivery among women giving birth in hospitals in Matlab and Chandpur, Bangladesh.

    Science.gov (United States)

    Huda, Fauzia Akhter; Ahmed, Anisuddin; Dasgupta, Sushil Kanta; Jahan, Musharrat; Ferdous, Jannatul; Koblinsky, Marge; Ronsmans, Carine; Chowdhury, Mahbub Elahi

    2012-06-01

    Worldwide, for an estimated 358,000 women, pregnancy and childbirth end in death and mourning, and beyond these maternal deaths, 9-10% of pregnant women or about 14 million women per year suffer from acute maternal complications. This paper documents the types and severity of maternal and foetal complications among women who gave birth in hospitals in Matlab and Chandpur, Bangladesh, during 2007-2008. The Community Health Research Workers (CHRWs) of the icddr,b service area in Matlab prospectively collected data for the study from 4,817 women on their places of delivery and pregnancy outcomes. Of them, 3,010 (62.5%) gave birth in different hospitals in Matlab and/or Chandpur and beyond. Review of hospital-records was attempted for 2,102 women who gave birth only in the Matlab Hospital of icddr,b and in other public and private hospitals in the Matlab and Chandpur area. Among those, 1,927 (91.7%) records were found and reviewed by a physician. By reviewing the hospital-records, 7.3% of the women (n=1,927) who gave birth in the local hospitals were diagnosed with a severe maternal complication, and 16.1% with a less-severe maternal complication. Abortion cases--either spontaneous or induced--were excluded from the analysis. Over 12% of all births were delivered by caesarean section (CS). For a substantial proportion (12.5%) of CS, no clear medical indication was recorded in the hospital-register. Twelve maternal deaths occurred during the study period; most (83%) of them had been in contact with a hospital before death. Recommendations include standardization of the hospital record-keeping system, proper monitoring of indications of CS, and introduction of maternal death audit for further improvement of the quality of care in public and private hospitals in rural Bangladesh.

  14. Socioeconomic and physical distance to the maternity hospital as predictors for place of delivery: an observation study from Nepal

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    Nielsen Birgitte

    2004-05-01

    Full Text Available Abstract Background Although the debate on the safety and women's right of choice to a home delivery vs. hospital delivery continues in the developed countries, an undesirable outcome of home delivery, such as high maternal and perinatal mortality, is documented in developing countries. The objective was to study whether socio-economic factors, distance to maternity hospital, ethnicity, type and size of family, obstetric history and antenatal care received in present pregnancy affected the choice between home and hospital delivery in a developing country. Methods This cross-sectional study was done during June, 2001 to January 2002 in an administratively and geographically well-defined territory with a population of 88,547, stretching from urban to adjacent rural part of Kathmandu and Dhading Districts of Nepal with maximum of 5 hrs of distance from Maternity hospital. There were no intermediate level of private or government hospital or maternity homes in the study area. Interviews were carried out on 308 women who delivered within 45 days of the date of the interview with a pre-tested structured questionnaire. Results A distance of more than one hour to the maternity hospital (OR = 7.9, low amenity score status (OR = 4.4, low education (OR = 2.9, multi-parity (OR = 2.4, and not seeking antenatal care in the present pregnancy (OR = 4.6 were statistically significantly associated with an increased risk of home delivery. Ethnicity, obstetric history, age of mother, ritual observance of menarche, type and size of family and who is head of household were not statistically significantly associated with the place of delivery. Conclusions The socio-economic standing of the household was a stronger predictor of place of delivery compared to ethnicity, the internal family structure such as type and size of family, head of household, or observation of ritual days by the mother of an important event like menarche. The results suggested that mothers, who

  15. Prenatal lead exposure and relationship with maternal exposure determinants in a public maternity hospital of La Plata, Argentina.

    Science.gov (United States)

    Martins, Enrique; Varea, Ana; Apezteguía, María; González, Horacio F; Girardelli, Ana; Caro, Laura Sanchez; Lobisuto, Mario; Delgado, Griselda; Disalvo, Liliana

    2014-03-01

    Prenatal lead exposure is a health hazard that may cause cognitive development impairments and other adverse effects in children. We conducted a cross sectional study analyzing cord blood lead levels (CBLL) of newborns and their relationship with maternal determinants of lead exposure. Mothers answered a questionnaire about socio-demographic, lifestyle habits and environmental characteristics. We used Mann-Whitney's test to compare CBLL geometrical means (GM) corresponding to the presence or absence of each lead exposure determinant, and Chi square test to study the relationship between CBLL and maternal lead exposure determinants. A total of 159 newborns participated in the study. CBLL GM was 2.1 μg/dL; and 25% of the participants had a measurable CBLL (LOQ=3.3 μg/dl). Although the participants had several determinants of lead exposure, we only found a significant relationship with inside household determinants, such as presence of lead piping (p=0.026), unplastered walls (p=0.046) and peeling paint (p=0.048). Our results show that CBLL GM was similar to that reported in several studies conducted around the world. However, 25% of the participants might have some degree of risk for lead poisoning.

  16. Trends in maternal mortality at University of Maiduguri teaching hospital, Maiduguri, Nigeria - A five year review

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    B M Audu

    2010-01-01

    Full Text Available Background: Maternal mortality is on the rise in Nigeria with the North- East having the highest ratio, and Borno state records one of the highest maternal mortality ratios in the country. Objective: To determine the trends in maternal mortality in UMTH, identify the background socio- cultural factors, establish the major causes of deaths and determine avoidable factors. Study design: Retrospective study of maternal deaths. Methods: The case records of all recorded cases of maternal deaths between January 2001 and December 2005 inclusive were retrieved and relevant data obtained and analysed. Results: The maternal mortality ratio (MMR for the period under review was 430 per 100,000 live births. There were annual fluctuations in MMR. However, there was a consistently rising trend in MMR from 2002-2004 with the highest ratio of 545 per 100,000 live births recorded in the year 2004, with a decline in 2005. Thirty (78.9% of these deaths occurred among the unbooked patients and more than 90% of this were referred as obstetric emergencies. Age range was 14-39 years with a mean of 26.5years. The highest maternal death occurred at the two extremes of reproductive age group (14-19 years and 35 years and above. Grandmultiparas suffered the highest maternal mortality of 36.8%, followed by teenage mothers. P1-4 contributed the least to maternal mortality. The direct causes of maternal death accounted for 92.1% of the deaths. The major causes of death were eclampsia 34.2%, sepsis 26.3% and prolonged obstructed labour/ruptured uterus 13.2%. Amongst the indirect causes of maternal death, HIV/Tuberculosis was the leading cause accounting for 5.3%. Basic but professional antenatal care, skilled attendance at birth, community mobilization and health education messages for a healthy pregnancy and safe birth will help to reduce the unacceptably high maternal mortality ratio in Borno state and the country at large.

  17. Insight into maternal mortality of tertiary referral hospital of Madhya Pradesh: destination far ahead

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    Bharti Sahu

    2015-10-01

    Conclusions: The burden of maternal mortality was found to be unacceptably high. Most women died of direct causes and experienced delays in care. Improvement in the quality of skilled maternity care, utmost need to avail good, proper and effective antenatal care, timely referral, prompt transportation, provision of family planning services, among other factors, can drastically curtail the maternal deaths. [Int J Reprod Contracept Obstet Gynecol 2015; 4(5.000: 1339-1343

  18. Evaluation of factors influencing maternal and fetal outcome in eclampsia in a tertiary care hospital

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    Paresh Shyam

    2016-02-01

    Conclusions: Eclampsia is still a major cause of maternal death. Occurrence of eclampsia can be reduced by optimizing antenatal care of pregnant woman of low socioeconomic class. Improvement in capacity of intensive care unit and blood bank are essential prerequisite to reduce maternal death due to eclamptic mother. [Int J Reprod Contracept Obstet Gynecol 2016; 5(2.000: 280-284

  19. Teamwork among midwives during neonatal resuscitation at a maternity hospital in Nepal.

    Science.gov (United States)

    Wrammert, Johan; Sapkota, Sabitri; Baral, Kedar; Kc, Ashish; Målqvist, Mats; Larsson, Margareta

    2017-06-01

    The ability of health care providers to work together is essential for favourable outcomes in neonatal resuscitation, but perceptions of such teamwork have rarely been studied in low-income settings. Neonatal resuscitation is a proven intervention for reducing neonatal mortality globally, but the long-term effects of clinical training for this skill need further attention. Having an understanding of barriers to teamwork among nurse midwives can contribute to the sustainability of improved clinical practice. To explore nurse midwives' perceptions of teamwork when caring for newborns in need of resuscitation. Nurse midwives from a tertiary-level government hospital in Nepal participated in five focus groups of between 4 and 11 participants each. Qualitative Content Analysis was used for analysis. One overarching theme emerged: looking for comprehensive guidelines and shared responsibilities in neonatal resuscitation to avoid personal blame and learn from mistakes. Participants discussed the need for protocols relating to neonatal resuscitation and the importance of shared medical responsibility, and the importance of the presence of a strong and transparent leadership. The call for clear and comprehensive protocols relating to neonatal resuscitation corresponded with previous research from different contexts. Nurse midwives working at a maternity health care facility in Nepal discussed the benefits and challenges of teamwork in neonatal resuscitation. The findings suggest potential benefits can be made from clarifying guidelines and responsibilities in neonatal resuscitation. Furthermore, a structured process to deal with clinical incidents must be considered. Management must be involved in all processes. Copyright © 2017 Australian College of Midwives. Published by Elsevier Ltd. All rights reserved.

  20. Molecular Testing for Toxoplasma Diagnosis in Aborted Fetuses- Taleghani Maternity Hospital- Arak- Iran

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    Zahra Eslamirad

    2014-08-01

    Full Text Available Background: The diagnosis of toxoplasmosis is most critical in pregnant women who acquire infection during gestation and also in fetuses and newborns who are congenitally infected. This study described the performance of molecular and confirmatory serologic testing for toxoplasma infection in the tissues of human spontaneous aborted fetuses and their mothers' blood. Materials and Methods: 87 random samples from the tissues of body of spontaneous aborted fetuses (less than 14 weeks in a separate container of preservative solution were collected from the delivery room of the university maternity hospital, Arak- Iran , during autumn 2012 to 2013. In the ward, 3 ml of blood sample of their mothers were collected and the sera were separated and analyzed by ELISA method for the detection of specific IgG. DNA extraction from the tissues of fetuses was performed and stored until use. The PCR reaction was performed by a pair of primers. PCR products were analyzed by electrophoresis and stained with safe stain. It is necessary to mention first that the written consent was obtained from their mothers and after recovery, a demographic questionnaire was completed. Results: Most of the mothers were 20-29 years of age and the correlation between the location of residence, contact with cats and eating undercooked food with abortion, not significant. Serological tests on the sera of 87 mothers for anti-Toxoplasma IgG showed 39.08% positive results. The results of PCR amplification showed that none of the 87 samples from aborted fetuses were infected with Toxoplasma gondii. Conclusion: In aborted fetuses, we did not observe any evidence of Toxoplasmosis and it appears that Toxoplasma gondii was not the cause of spontaneous abortion in this area of Iran but considering the importance of the infection during pregnancy, the control measurements during pregnancy is required.

  1. [Reminiscence on the municipal out-of-hospital maternity unit and the motherhood home in Novi Sad].

    Science.gov (United States)

    Dobanovacki, Dusanka; Breberina, Milan; Vujosević, Bozica; Pećanac, Marija; Zakula, Nenad; Trajković, Velicko

    2013-01-01

    In the mid-twentieth century, the health care of women and children was inadequate in the post-war Yugoslavia, including the city of Novi Sad, due to the severe post-war reality: poverty in the devastated country, shortage of all commodities and services and especially of medical supplies, equipment and educated staff. OUT-OF-HOSPITAL MATERNITY UNIT: One of the serious problems was parturition at home and morbidity and mortality of the newborns and women. Soon after the World War II the action programme of improving the women's health was realized on the state level by establishing out-of-hospital maternity units but under the expert supervision. The Maternity unit at 30 Ljudevita Gaja Street in Novi Sad played a great role in providing skilled birth attendance at mainly normal deliveries. With a minimal number of medical staff and modest medical equipment, about 2000 healthy babies were born in this house. After 5 years of functioning in that way, this unit was transformed into the Motherhood Home and became a social and medical institution for pregnant women and new mothers. Regardless of the redefined organization concept the curative and preventive health care as well as women and children social protection programmes were provided successfully for the next 12 years. Although the Motherhood Home was moved into the Women Health Centre of Novi Sad and later into the former Maternity Hospital in Sremski Karlovci, its great importance for women and children's health care remained unchanged. In 1979 the overall social situation and mostly economic issues led to its closing. The house in Gajeva Street is now used as the municipality office. However, this house with its story recommends itself to become a house for a special social function, such as a museum of medical history of Novi Sad. A small investment could make it possible to collect, preserve and display the valuable records of our past, which is something we do owe to the generations to come.

  2. Care during the third stage of labour: obstetricians views and practice in an Albanian maternity hospital

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    Dokle Anika

    2010-01-01

    Full Text Available Abstract Background Relatively little is known about current practice during the third stage of labour in low and middle income countries. We conducted a survey of attitudes and an audit of practice in a large maternity hospital in Albania. Methods Survey of 35 obstetricians and audit of practice during the third stage was conducted in July 2008 at a tertiary referral hospital in Tirana. The survey questionnaire was self completed. Responses were anonymous. For the audit, information collected included time of administration of the uterotonic drug, gestation at birth, position of the baby before cord clamping, cord traction, and need for resuscitation. Results 77% (27/35 of obstetricians completed the questionnaire, of whom 78% (21/27 reported always or usually using active management, and 22% (6/27 always or usually using physiological care. When using active management: 56% (15/27 gave the uterotonic after cord clamping; intravenous oxytocin was almost always the drug used; and 71% (19/27 clamped the cord within one minute. For physiological care: 42% (8/19 clamped the cord within 20 seconds, and 96% (18/19 within one minute. 93% would randomise women to a trial of early versus late cord clamping. Practice was observed for 156 consecutive births, of which 26% (42/156 were by caesarean section. A prophylactic uterotonic was used for 87% (137/156: this was given after cord clamping for 55% (75/137, although timing of administration was not recorded for 21% (29/137. For 85% of births (132/156 cord clamping was within 20 seconds, and for all babies it was within 50 seconds. Controlled cord traction was used for 49% (76/156 of births. Conclusions Most obstetricians reported always or usually using active management for the third stage of labour. For timing and choice of the uterotonic drug, reported practice was similar to actual practice. Although some obstetricians reported they waited longer than one minute before clamping the cord, this was not

  3. Public and private maternal health service capacity and patient flows in Southern Tanzania: using a geographic information system to link hospital and national census data.

    Science.gov (United States)

    Tabatabai, Patrik; Henke, Stefanie; Sušac, Katharina; Kisanga, Oberlin M E; Baumgarten, Inge; Kynast-Wolf, Gisela; Ramroth, Heribert; Marx, Michael

    2014-01-01

    Strategies to improve maternal health in low-income countries are increasingly embracing partnership approaches between public and private stakeholders in health. In Tanzania, such partnerships are a declared policy goal. However, implementation remains challenging as unfamiliarity between partners and insufficient recognition of private health providers prevail. This hinders cooperation and reflects the need to improve the evidence base of private sector contribution. To map and analyse the capacities of public and private hospitals to provide maternal health care in southern Tanzania and the population reached with these services. A hospital questionnaire was applied in all 16 hospitals (public n=10; private faith-based n=6) in 12 districts of southern Tanzania. Areas of inquiry included selected maternal health service indicators (human resources, maternity/delivery beds), provider-fees for obstetric services and patient turnover (antenatal care, births). Spatial information was linked to the 2002 Population Census dataset and a geographic information system to map patient flows and socio-geographic characteristics of service recipients. The contribution of faith-based organizations (FBOs) to hospital maternal health services is substantial. FBO hospitals are primarily located in rural areas and their patient composition places a higher emphasis on rural populations. Also, maternal health service capacity was more favourable in FBO hospitals. We approximated that 19.9% of deliveries in the study area were performed in hospitals and that the proportion of c-sections was 2.7%. Mapping of patient flows demonstrated that women often travelled far to seek hospital care and where catchment areas of public and FBO hospitals overlap. We conclude that the important contribution of FBOs to maternal health services and capacity as well as their emphasis on serving rural populations makes them promising partners in health programming. Inclusive partnerships could increase

  4. Public and private maternal health service capacity and patient flows in southern Tanzania: using a geographic information system to link hospital and national census data

    Directory of Open Access Journals (Sweden)

    Patrik Tabatabai

    2014-01-01

    Full Text Available Background: Strategies to improve maternal health in low-income countries are increasingly embracing partnership approaches between public and private stakeholders in health. In Tanzania, such partnerships are a declared policy goal. However, implementation remains challenging as unfamiliarity between partners and insufficient recognition of private health providers prevail. This hinders cooperation and reflects the need to improve the evidence base of private sector contribution. Objective: To map and analyse the capacities of public and private hospitals to provide maternal health care in southern Tanzania and the population reached with these services. Design: A hospital questionnaire was applied in all 16 hospitals (public n=10; private faith-based n=6 in 12 districts of southern Tanzania. Areas of inquiry included selected maternal health service indicators (human resources, maternity/delivery beds, provider-fees for obstetric services and patient turnover (antenatal care, births. Spatial information was linked to the 2002 Population Census dataset and a geographic information system to map patient flows and socio-geographic characteristics of service recipients. Results: The contribution of faith-based organizations (FBOs to hospital maternal health services is substantial. FBO hospitals are primarily located in rural areas and their patient composition places a higher emphasis on rural populations. Also, maternal health service capacity was more favourable in FBO hospitals. We approximated that 19.9% of deliveries in the study area were performed in hospitals and that the proportion of c-sections was 2.7%. Mapping of patient flows demonstrated that women often travelled far to seek hospital care and where catchment areas of public and FBO hospitals overlap. Conclusions: We conclude that the important contribution of FBOs to maternal health services and capacity as well as their emphasis on serving rural populations makes them promising

  5. Public and private maternal health service capacity and patient flows in southern Tanzania: using a geographic information system to link hospital and national census data

    Science.gov (United States)

    Tabatabai, Patrik; Henke, Stefanie; Sušac, Katharina; Kisanga, Oberlin M. E.; Baumgarten, Inge; Kynast-Wolf, Gisela; Ramroth, Heribert; Marx, Michael

    2014-01-01

    Background Strategies to improve maternal health in low-income countries are increasingly embracing partnership approaches between public and private stakeholders in health. In Tanzania, such partnerships are a declared policy goal. However, implementation remains challenging as unfamiliarity between partners and insufficient recognition of private health providers prevail. This hinders cooperation and reflects the need to improve the evidence base of private sector contribution. Objective To map and analyse the capacities of public and private hospitals to provide maternal health care in southern Tanzania and the population reached with these services. Design A hospital questionnaire was applied in all 16 hospitals (public n=10; private faith-based n=6) in 12 districts of southern Tanzania. Areas of inquiry included selected maternal health service indicators (human resources, maternity/delivery beds), provider-fees for obstetric services and patient turnover (antenatal care, births). Spatial information was linked to the 2002 Population Census dataset and a geographic information system to map patient flows and socio-geographic characteristics of service recipients. Results The contribution of faith-based organizations (FBOs) to hospital maternal health services is substantial. FBO hospitals are primarily located in rural areas and their patient composition places a higher emphasis on rural populations. Also, maternal health service capacity was more favourable in FBO hospitals. We approximated that 19.9% of deliveries in the study area were performed in hospitals and that the proportion of c-sections was 2.7%. Mapping of patient flows demonstrated that women often travelled far to seek hospital care and where catchment areas of public and FBO hospitals overlap. Conclusions We conclude that the important contribution of FBOs to maternal health services and capacity as well as their emphasis on serving rural populations makes them promising partners in health

  6. An IBCLC in the Maternity Ward of a Mother and Child Hospital: A Pre- and Post-Intervention Study

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    Antonella Chiurco

    2015-08-01

    Full Text Available Published evidence on the impact of the integration of International Board Certified Lactation Consultants (IBCLCs for breastfeeding promotion is growing, but still relatively limited. Our study aims at evaluating the effects of adding an IBCLC for breastfeeding support in a mother and child hospital environment. We conducted a prospective study in the maternity ward of our maternal and child health Institute, recruiting 402 mothers of healthy term newborns soon after birth. The 18-month intervention of the IBCLC (Phase II was preceded (Phase I by data collection on breastfeeding rates and factors related to breastfeeding, both at hospital discharge and two weeks later. Data collection was replicated just before the end of the intervention (Phase III. In Phase III, a significantly higher percentage of mothers: (a received help to breastfeed, and also received correct information on breastfeeding and community support, (b started breastfeeding within two hours from delivery, (c reported a good experience with the hospital staff. Moreover, the frequency of sore and/or cracked nipples was significantly lower in Phase III. However, no difference was found in exclusive breastfeeding rates at hospital discharge or at two weeks after birth.

  7. [Analysis of maternal mortality during three periods at Hospital de Ginecología y Obstetricia del Centro Médico Nacional de Occidente].

    Science.gov (United States)

    Angulo Vázquez, José; Cortés Sanabria, Laura; Torres Gómez, Luís Guillermo; Aguayo Alcaraz, Guadalupe; Hernández Higareda, Salvador; Avalos Nuño, Joel

    2007-07-01

    Most of deceases due to pregnancy, delivery, puerperium and them attention are avoidable with current medicine resources. To analyze some basic elements of epidemiologic behavior of a hospital environment maternal mortality in a third level hospital during a period of 21 years. Analytical cross-sectional study, 222 maternal deaths registered at Hospital de Ginecologia y Obstetricia, Centro Medico Nacional de Occidente del Instituto Mexicano del Seguro Social, were included, during the period 1985-2005. Deaths were analyzed in three periods of 7 years each one. The analysis of results was made based on descriptive statistic. chi2 was used for comparison between periods. Maternal death ratio was 73 per 100,000 live births during the 21 years. Maternal mortality was lower in the group of women under 20 years and increase agreed maternal age. Frequency of direct obstetric deaths decreased when comparing the 3 periods. The main causes of maternal death were preeclampsia/eclampsia and obstetric hemorrhage, which were responsible for almost 50% of maternal deaths. There was no significant difference to anticipation by comparing periods, between 28 and 37% of deaths were foreseen. 98% of deaths occurred at Intensive Care Units. Direct and indirect maternal deaths show very similar values in the third period, which translates in an improvement in anticipation. It must be reinforce the simple and opportune information to the patient with regard to warning signs and the permanent medical training must be a priority at the 3 medical levels.

  8. Retrospective Comparative Study of Obstetric complications and Maternal Mortality in Registered and Unregistered women at Tertiary Care Hospital.

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    Kruti Deliwala

    2013-01-01

    Full Text Available Background: At tertiary care hospital, many women with obstetric complications are referred not only from private clinics/hospitals, but also from nearby primary health centers and urban health centers. There are women who come for delivery, who have not taken any ante natal care (ANC. Complication can arise at any time during pregnancy, childbirth and postnatal period and in absence of intervention, there is a high feto-maternal morbidity and mortality. With every maternal death there are many life threatening complications known as ‘maternal near miss’.Objectives: 1.To analyze causes of referrals of unregistered patients coming to our institute.2.To analyze pregnancy outcomes, Obstetric complications and maternal mortality in registered and unregistered women coming to our institute. 3.To analyze near miss cases and to analyze causes of maternal mortality and reasons of delay. Methods:This retrospective comparative study was conducted after due permission from the Scientific Advisory Committee and Institutional Ethics Committee of Sheth V S Medical Research Foundation Trust and data was collected as per pre-tested structured proforma from December 2009 to February 2010. Analysis of 1171 patients was done. Results: Out of total 1171 women included in the study, 952 (81.2 % were registered and 219 (18.7% were unregistered women. Proportion of unregistered women who had less than 3 ante natal visits 109 (49.7% was significantly higher compared to registered women 95 (9.9% (x2 = 195.97; P<0.0001. Severe anaemia was found to be significantly higher in unregistered women 18 (8.2% as compared to registered women 1 (0.1% (x2 = 68.442; P<0.0001. Transfusion of blood or other blood product was significantly higher in unregistered women 44 (20% compared to registered women 31 (3.2% (x2 = 84.177; P<0.0001 . Because of multi-disciplinary team approach at our institute, many women with complications in unregistered group could be saved (maternal near

  9. [Hospital maternal mortality: causes and consistency between clinical and autopsy diagnosis at the Northeastern Medical Center of the IMSS, Mexico].

    Science.gov (United States)

    Calderón-Garcidueñas, Ana Laura; Martínez-Salazar, Griselda; Fernández-Díaz, Héctor; Cerda-Flores, Ricardo M

    2002-02-01

    The aim was to study the causes of maternal mortality (MM) and the percent of concordance between the clinical diagnosis and the autopsy findings. The autopsies of maternal death (1980-1999) from the Hospital de Especialidades, Centro Médico del Noreste, IMSS in Monterrey, México, were analyzed. The cases were classified in directly obstetric maternal mortality (DOM) and indirectly obstetric maternal mortality (IOM), the causes were studied and the percent of concordance between pre- and post-mortem diagnosis was determined. There were 124 deaths. Autopsy was performed in 61 (49.1%) women. In 55 cases the clinical file and the autopsy protocol were available. This was our sample for study. Sixty percent of the cases were DO. Causes of DOM were: specific hypertensive pregnancy disease (SHPD) (51.6%), sepsis (35.5%), hypovolemic shock (9.7%), anesthetic accidents (3%); causes of IOM were: sepsis (41.7%), malignancies (16.7%), hematological diseases (12.5%), cardiopathy and systemic arterial hypertension (12.5%), hepatic disorders (12.5%), and Superior Longitudinal Sinus thrombosis (4%). A 100% clinical-pathological concordance was observed in DOM cases, while only a 41.6% was found in IOM cases. In those cases of sepsis (IOM), the etiologic agents were identified only in 20% before death. The early detection and treatment of SHPD and the prevention of sepsis should decrease the MM. This study showed some weakness in the Health Services that should be improved.

  10. The dilemma of a practice: experiences of abortion in a public maternity hospital in the city of Salvador, Bahia.

    Science.gov (United States)

    McCallum, Cecilia; Menezes, Greice; Reis, Ana Paula Dos

    2016-01-01

    The article discusses abortion and miscarriage from the perspective of women admitted to a public maternity hospital in Salvador (BA), Brazil. Based on qualitative and quantitative research, it draws on participant observation of everyday hospital life. Taking an ethnographic approach, it addresses the hospital experiences of women who had miscarriages or induced abortions, also presenting the views of health professionals. It argues that the way the institution structures care for abortion and miscarriage involves symbolic processes that profoundly affect women's experiences. The discrimination against women who have had abortions/miscarriages is an integral part of the structure, organization and culture of these institutions, and does not derive solely from the individual actions of healthcare personnel.

  11. A Study On Maternal Factors And Pregnancy Outcome In Medical College Hospital Of Jhansi City

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    Sandip kumar

    2005-12-01

    Full Text Available Research Question : What are the maternal factors which affect the pregnancy outcome.Objectives : To study the effects of maternal factors on the outcome of pregnancy in terms of pregnancy wastage as abortions or stillbirths and to assess the magnitude of low birth babies.Study Design: Cross-sectional studyStudy Area: maternity wards of department of obstetrics & Gynecology of M.L.B. Medical college.Jhansi (U.P. Participants : 1350 pregnant women, who were admitted in the maternity wards & their new born babies Study variables : Age, parity, education, per capita income, inter pregnancy interval Statistical analysis:Chi-square testResults : Live born babies were 81.48% while pregnancy wastage was 18.52% Among the live born babies 44.36% had normal weight at birth & 55.64% were low birth weight. Out of total pregnancy wastage, 58.80% were terminated as abortions and 41.20% as still births.

  12. Maternal Chlamydia trachomatis Infections and Preterm Births in a University Hospital in Vitoria, Brazil

    Science.gov (United States)

    Schmidt, Renylena; Muniz, Renan Rosetti; Cola, Elizandra; Stauffert, Dulce; Silveira, Mariangela Freitas; Miranda, Angelica E.

    2015-01-01

    Background Preterm birth (PTB) is a major determinant of neonatal morbimortality with adverse consequences for health. The causes are multifactorial, with intrauterine infection probably explaining most of these outcomes. It is believed that infection with Chlamydia trachomatis (CT) is also involved in PTB and premature rupture of membranes. Objetives To evaluate the prevalence of and associated factors for CT among cases of PTB attended at a University Hospital in Vitoria, Brazil. Methods A cross-sectional study performed among parturient who had preterm birth from June 2012 to August 2013 in Vitoria, Brazil. Participants answered a questionnaire including demographic, behavioral, and clinical data. A sample of urine was collected and screened for CT using polymerase chain reaction. Chi-square tests were used for proportion differences and Student’s-t tests and variance analysis were used for testing differences between mean values. Odds ratio was used as a measure of association with a 95% confidence interval. Results The prevalence of PTB during the period of the study was 26% and the prevalence of CT among them was 13.9%. A total of 31.6% pregnant women were younger than 25 years old and women infected by CT were even younger than women not infected by CT (p = 0.022). Most of them (76.2%) were married or had a living partner, and CT infection was more frequent among the single ones (p = 0.018); 16.7% of women reported their first sexual intercourse under 14 years old. The causes of prematurity were maternal-fetal in 40.9%; rupture of the membranes in 29.7% and premature labor in 29.4%. In multivariate analysis, being married was a protective factor for infection [OR = 0.48 (95%CI:0.24–0.97)]. None of the other characteristics were associated with CT infection. Conclusions This study shows a high prevalence of CT infection among parturient who have preterm birth. This high prevalence highlight the need for defining screening strategies focused on young

  13. Risk factors for preterm birth in five Maternal and Child Health hospitals in Beijing.

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    Yun-Ping Zhang

    Full Text Available BACKGROUND: Preterm birth, the birth of an infant prior to 37 completed weeks of gestation, is the leading cause of perinatal morbidity and mortality. Preterm infants are at greater risk of respiratory, gastrointestinal and neurological diseases. Despite significant research in developed countries, little is known about the causes of preterm birth in many developing countries, especially China. This study investigates the association between sciodemographic data, obstetric risk factor, and preterm birth in five Maternal and Child Health hospitals in Beijing, China. METHODS AND FINDINGS: A case-control study was conducted on 1391 women with preterm birth (case group and 1391 women with term delivery (control group, who were interviewed within 48 hours of delivery. Sixteen potential factors were investigated and statistical analysis was performed by univariate analysis and logistic regression analysis. Univariate analysis showed that 14 of the 16 factors were associated with preterm birth. Inter-pregnancy interval and inherited diseases were not risk factors. Logistic regression analysis showed that obesity (odds ratio (OR = 3.030, 95% confidence interval (CI 1.166-7.869, stressful life events (OR = 5.535, 95%CI 2.315-13.231, sexual activity (OR = 1.674, 95%CI 1.279-2.191, placenta previa (OR 13.577, 95%CI 2.563-71.912, gestational diabetes mellitus (OR = 3.441, 95%CI1.694-6.991, hypertensive disorder complicating pregnancy (OR = 6.034, 95%CI = 3.401-10.704, history of preterm birth (OR = 20.888, 95%CI 2.519-173.218 and reproductive abnormalities (OR = 3.049, 95%CI 1.010-9.206 were independent risk factors. Women who lived in towns and cities (OR = 0.603, 95%CI 0.430-0.846, had a balanced diet (OR = 0.533, 95%CI 0.421-0.675 and had a record of prenatal care (OR = 0.261, 95%CI 0.134-0.510 were less likely to have preterm birth. CONCLUSIONS: Obesity, stressful life events, sexual activity, placenta previa

  14. [The Hospital Information System of the Brazilian Unified National Health System: a performance evaluation for auditing maternal near miss].

    Science.gov (United States)

    Nakamura-Pereira, Marcos; Mendes-Silva, Wallace; Dias, Marcos Augusto Bastos; Reichenheim, Michael E; Lobato, Gustavo

    2013-07-01

    This study aimed to investigate the performance of the Hospital Information System of the Brazilian Unified National Health System (SIH-SUS) in identifying cases of maternal near miss in a hospital in Rio de Janeiro, Brazil, in 2008. Cases were identified by reviewing medical records of pregnant and postpartum women admitted to the hospital. The search for potential near miss events in the SIH-SUS database relied on a list of procedures and codes from the International Classification of Diseases, 10th revision (ICD-10) that were consistent with this diagnosis. The patient chart review identified 27 cases, while 70 potential occurrences of near miss were detected in the SIH-SUS database. However, only 5 of 70 were "true cases" of near miss according to the chart review, which corresponds to a sensitivity of 18.5% (95%CI: 6.3-38.1), specificity of 94.3% (95%CI: 92.8-95.6), area under the ROC of 0.56 (95%CI: 0.48-0.63), and positive predictive value of 10.1% (IC95%: 4.7-20.3). These findings suggest that SIH-SUS does not appear appropriate for monitoring maternal near miss.

  15. UK Royal Navy WWII Logbooks

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    National Oceanic and Atmospheric Administration, Department of Commerce — In 2006, the UK and NOAA's Climate Database Modernization Program (CDMP) funded the imaging of approximately 8,000 Royal Navy logbooks in the UK National Archives...

  16. Home or hospital? Midwife or physician? Preferences for maternity care provider and place of birth among Western Australian students.

    Science.gov (United States)

    Stoll, Kathrin H; Hauck, Yvonne L; Hall, Wendy A

    2016-02-01

    Australian caesarean birth rates have exceeded 30% in most states and are approaching 45%, on average, in private hospitals. Australian midwifery practice occurs almost exclusively in hospitals; less than 3% of women deliver at home or in birthing centres. It is unclear whether the trend towards hospital-based, high interventionist birth reflects preferences of the next generation of maternity care consumers. We conducted a descriptive cross-sectional online survey of 760 Western Australian (WA) university students in 2014, to examine their preferences for place of birth, type of maternity care, mode of birth and attitudes towards birth. More students who preferred midwives (35.8%) had vaginal birth intentions, contested statements that birth is unpredictable and risky, and valued patient-provider relationships. More students who preferred obstetricians (21.8%) expressed concerns about childbirth safety, feared birth, held favourable views towards obstetric technology, and expressed concerns about the impact of pregnancy and birth on the female body. One in 8 students preferred out-of-hospital birth settings, supporting consumer demand for midwife-attended births at home and in birthing centres. Stories and experiences of friends and family shaped students' care provider preferences, rather than the media or information learned at school. Students who express preferences for midwives have significantly different views about birth compared to students who prefer obstetricians. Increasing access to midwifery care in all settings (hospital, birthing centre and home) is a cost effective strategy to decrease obstetric interventions for low risk women and a desirable option for the next generation. Copyright © 2015 Australian College of Midwives. Published by Elsevier Ltd. All rights reserved.

  17. [Anaphylaxis caused by royal jelly].

    Science.gov (United States)

    Roger, A; Rubira, N; Nogueiras, C; Guspi, R; Baltasar, M; Cadahia, A

    1995-01-01

    Royal jelly is the food on which are fed and which causes them to develop into queen bees. It is claimed to have rejuvenating virtues for human beings. This report describes a 15-year-old atopic woman who presented, 15 minutes after the intake of royal jelly, local angioedema, generalised urticaria, dysphonia and bronchospasm. She was given antihistaminics and corticoesteroids and responded well. The ingested product contains royal jelly, lactose and potassium sorbate. No anaphylactic reactions to lactose and sorbates have been described previously. Prick test to common food allergens hymenoptera venoms and pollens were negative. RAST to meletin was also negative. Blood eosinophils were 600 and total IgE 465. Non-commercial prepared specific IgE to royal jelly was positive (0.8 KU/l). Prick by prick was positive to 1/10 dilution, being negative in controls (undiluted). No oral provocation test was performed due to the risk of anaphylaxis. No reported cases of royal jelly allergy were founded in a review of the medical literature. Concluding, it is the first described case of IgE anaphylactic reaction due to royal jelly.

  18. Live maternal speech and singing have beneficial effects on hospitalized preterm infants.

    Science.gov (United States)

    Filippa, Manuela; Devouche, Emmanuel; Arioni, Cesare; Imberty, Michel; Gratier, Maya

    2013-10-01

    To study the effects of live maternal speaking and singing on physiological parameters of preterm infants in the NICU and to test the hypothesis that vocal stimulation can have differential effects on preterm infants at a behavioural level. Eighteen mothers spoke and sang to their medically stable preterm infants in their incubators over 6 days, between 1 and 2 pm. Heart rate (HR), oxygen saturation (OxSat), number of critical events (hypoxemia, bradycardia and apnoea) and change in behavioural state were measured. Comparisons of periods with and without maternal vocal stimulation revealed significantly greater oxygen saturation level and heart rate and significantly fewer negative critical events (p singing. Unexpected findings were the comparable effects of maternal talk and singing on infant physiological parameters and the differential ones on infant behavioural state. A renewed connection to the mother's voice can be an important and significant experience for preterm infants. Exposure to maternal speech and singing shows significant early beneficial effects on physiological state, such as oxygen saturation levels, number of critical events and prevalence of calm alert state. These findings have implications for NICU interventions, encouraging maternal interaction with their medically stable preterm infants. ©2013 Foundation Acta Paediatrica. Published by John Wiley & Sons Ltd.

  19. Maternal outcome in HELLP syndrome requiring intensive care management in a Turkish hospital

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    Mehmet Armagan Osmanagaoglu

    Full Text Available CONTEXT AND OBJECTIVE: Despite the development of tertiary care facilities, intensive care and advanced blood banking techniques, pregnancy-related hypertensive disorders are the main cause of maternal mortality in most countries. Our purpose was to determine maternal outcome in pregnancies complicated by HELLP syndrome (hemolysis, elevated liver enzymes and low platelet count that required intensive care management. DESIGN AND SETTING: Retrospective study at Department of Obstetrics and Gynecology, and Department of Anesthesiology and Reanimation, Karadeniz Technical University, Trabzon, Turkey. METHODS: 37 patients with HELLP syndrome admitted to the obstetric intensive care unit were analyzed retrospectively from 1992 to 2004. RESULTS: All patients were hypertensive, with mean Glasgow coma score (GCS of 11 ± 3.96. Mean gestational age at delivery was 32 ± 4.09 weeks. Delivery was vaginally in nine and by cesarean section in 27 patients. General anesthesia was used in 12 and spinal anesthesia in 25 patients. Maternal morbidity included acute renal failure (11%, disseminated intravascular coagulation (5%, acute lung edema (3%, severe ascites (11%, pleural effusion (3%, adult respiratory distress syndrome (11%, abruptio placenta (11%, cerebral edema (8% and cerebral hemorrhage (40%. All patients required transfusions using blood products. There were 11 maternal deaths (30%. CONCLUSION: Because of high maternal mortality and morbidity found among patients with HELLP syndrome, standard antenatal follow-up protocols should be applied, so as to obtain early diagnosis and improve the speed of transfer to obstetric departments with expertise in this field.

  20. Emergency obstetrical complications in a rural African setting (Kayes, Mali): the link between travel time and in-hospital maternal mortality.

    Science.gov (United States)

    Pirkle, Catherine McLean; Fournier, Pierre; Tourigny, Caroline; Sangaré, Karim; Haddad, Slim

    2011-10-01

    The West African country of Mali implemented referral systems to increase spatial access to emergency obstetrical care and lower maternal mortality. We test the hypothesis that spatial access- proxied by travel time during the rainy and dry seasons- is associated with in-hospital maternal mortality. Effect modification by caesarean section is explored. All women treated for emergency obstetrical complications at the referral hospital in Kayes, Mali were considered eligible for study. First, we conducted descriptive analyses of all emergency obstetrical complications treated at the referral hospital between 2005 and 2007. We calculated case fatality rates by obstetric diagnosis and travel time. Key informant interviews provided travel times. Medical registers provided clinical and demographic data. Second, a matched case-control study assessed the independent effect of travel time on maternal mortality. Stratification was used to explore effect modification by caesarean section. Case fatality rates increased with increasing travel time to the hospital. After controlling for age, diagnosis, and date of arrival, a travel time of four or more hours was significantly associated with in-hospital maternal mortality (OR: 3.83; CI: 1.31-11.27). Travel times between 2 and 4 h were associated with increased odds of maternal mortality (OR 1.88), but the relationship was not significant. The effect of travel time on maternal mortality appears to be modified by caesarean section. Poor spatial access contributes to maternal mortality even in women who reach a health facility. Improving spatial access will help women arrive at the hospital in time to be treated effectively.

  1. Causes of maternal deaths at Tezpur medical college AND hospital, Tezpur, Assam, India: a retrospective study

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    Rumen Chandra Boro

    2016-04-01

    Conclusions: In our study it is observed that anaemia, haemorrhage and toxaemia are the three major causes of maternal deaths in TMCH, Tezpur. Obstructed labour, sepsis, unsafe abortions, etc. are the causes of the rest of the maternal deaths. It is seen from the study that illiteracy, ignorance, unawareness, poor socioeconomic conditions, lack of antenatal checkups, non-availability of quality care set ups, and drawbacks in referral systems were the major causative factors. [Int J Reprod Contracept Obstet Gynecol 2016; 5(4.000: 1006-1009

  2. An analysis of variations of indications and maternal-fetal prognosis for caesarean section in a tertiary hospital of Beijing

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    Liu, Yajun; Wang, Xin; Zou, Liying; Ruan, Yan; Zhang, Weiyuan

    2017-01-01

    Abstract In recent decades, we have observed a remarkable increase in the rate of caesarean section (CS) in both developed and developing countries, especially in China. According to the World Health Organization (WHO) systematic review, if the increase in CS rate was between 10% and 15%, the maternal and neonatal mortality was decreased. However, above this level, increasing the rate of CS is no longer associated with reduced mortality. To date, no consensus has been reached on the main factors driving the cesarean epidemic. To reduce the progressively increasing rate of CS, we should find indications for the increasing CS rate. The aim of our study was to estimate the change of CS rate of Beijing Obstetrics and Gynecology Hospital and to find the variation of the indications. From January 1995 to December 2014, the CS rate of Beijing Obstetrics and Gynecology Hospital was analyzed. For our analysis, we selected 14,642 and 16,335 deliveries respectively that occurred during the year 2011 and 2014, to analyze the difference of indications, excluding incomplete data and miscarriages or termination of pregnancy before 28 weeks of gestation because of fatal malformations, intrauterine death, or other reasons. The average CS rate during the past 20 years was 51.15%. The highest caesarean delivery rate was 60.69% in 2002; however, the caesarean delivery rate declined to 34.53% in 2014. The obviously different indications were caesarean delivery on maternal request and previous CS delivery. The rate of CS due to maternal request in 2014 was decreased by 8.16% compared with the year 2011. However, the percentage of pregnancy women with a previous CS delivery increased from 9.61% to 20.42% in 3 years. Along with the decline of CS rate, the perinatal mortality and the rate of neonatal asphyxia decreased in 2014 compared with that in 2011. After a series of measures, the CS rate declined indeed. Compared with 2011, the perinatal mortality and the rate of neonatal asphyxia

  3. Availability and quality of emergency obstetric care, an alternative strategy to reduce maternal mortality: experience of Tongji Hospital, Wuhan, China.

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    Bangoura, Ismael Fatou; Hu, Jian; Gong, Xun; Wang, Xuanxuan; Wei, Jingjing; Zhang, Wenbin; Zhang, Xiang; Fang, Pengqian

    2012-04-01

    The burden of maternal mortality (MM) and morbidity is especially high in Asia. However, China has made significant progress in reducing MM over the past two decades, and hence maternal death rate has declined considerably in last decade. To analyze availability and quality of emergency obstetric care (EmOC) received by women at Tongji Hospital, Wuhan, China, this study retrospectively analyzed various pregnancy-related complications at the hospital from 2000 to 2009. Two baseline periods of equal length were used for the comparison of variables. A total of 11 223 obstetric complications leading to MM were identified on a total of 15 730 hospitalizations, either 71.35% of all activities. No maternal death was recorded. Mean age of women was 29.31 years with a wide range of 14-52 years. About 96.26% of women had higher levels of schooling, university degrees and above and received the education of secondary school or college. About 3.74% received primary education at period two (P2) from 2005 to 2009, which was significantly higher than that of period one (P1) from 2000 to 2004 (P<0.05) (OR: 0.586; 95% CI: 0.442 to 0.776). About 65.69% were employed as skilled or professional workers at P2, which was significantly higher than that of P1 (P<0.05). About 34.31% were unskilled workers at P2, which was significantly higher than that of P1 (P<0.05). Caesarean section was performed for 9,930 women (88.48%) and the percentage of the procedure increased significantly from 19.25% at P1 to 69.23% at P2 (P<0.05). We were led to conclude that, despite the progress, significant gaps in the performance of maternal health services between rural and urban areas remain. However, MM reduction can be achieved in China. Priorities must include, but not limited to the following: secondary healthcare development, health policy and management, strengthening primary healthcare services.

  4. A survey of the incidence of neonatal sepsis by group B Streptococcus during a decade in a Brazilian maternity hospital

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    Edinéia Vaciloto

    Full Text Available Group B Streptococcus (GBS is the main etiological agent of neonatal sepsis in developed countries, however there is no detailed information on its incidence in Brazil. We registered the incidence and lethality of GBS infection in a Brazilian private maternity hospital from April 1991 to March 2000. Maternal risk factors contributing to neonatal infections were also scored. The rate of infection was determined by checking for GBS in the blood and liquor of symptomatic neonates within 72 hours of birth. Sepsis and/or early onset meningitis were diagnosed in 43 neonates (32 cases in blood, 1in liquor and 10 in blood and liquor. The overall incidence was 0.39 per thousand neonates and remained quite constant throughout the period, ranging from 0.25-0.63. Septic shock occurred in 33 neonates within 1 to 36 hours of birth (mean 15 hours. Among those patients, 26 (60% died between the 5th and the 85th hour after birth. Maternal risk factors, according to CDC criteria, included: gestational age below 37 weeks in 26 cases (60%, amniorrhexis equal or superior to 18 hours in 7 cases (16%, and maternal temperature equal or superior to 38ºC in 4 cases (9%. None of the mothers had received prophylactic antibiotics during labor nor were urine, rectal or vaginal swabs screened for GBS. Although the incidence of GBS infection in the population in this study was lower than that found in developed countries, its rate of mortality was higher. The death rate could be reduced through recognition of the risk factors and prophylactic antibiotics during labor.

  5. A study on maternal and perinatal out comes in cases of eclampsia admitting to government medical college and general hospital, Anantapuramu, Andhra Pradesh, India

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    Shamshad Begum Shaikh

    2016-07-01

    Conclusions: Eclampsia continues to be an important etiological factor for maternal/perinatal morbidity and mortality. The contributory factors for this being lack of proper antenatal care, low socio economic status and lack of education. There is an urgent need for proper antenatal care, proper medication (magnesium sulfate, intensive monitoring of women with eclampsia and timely hospitalization to improve both the maternal and perinatal outcome. Early presentation and timely decision to terminate pregnancy will improve the maternal and perinatal outcome. [Int J Reprod Contracept Obstet Gynecol 2016; 5(7.000: 2146-2150

  6. [Hospital readmission after postpartum discharge of term newborns in two maternity wards in Stockholm and Marseille].

    Science.gov (United States)

    Boubred, F; Herlenius, E; Andres, V; des Robert, C; Marchini, G

    2016-03-01

    The consequences of early postpartum discharge (EPPD, within 2 days after birth) on newborn health remain debated. Early discharge has been associated with increased neonatal morbidity. However, neonatal re-hospitalization can be prevented by careful follow-up during the 1st week after birth. We compared the early neonatal hospitalization of term newborns over 2 years in two hospitals: Karolinska University Hospital in Stockholm (n=7300 births), which allowed early discharge from 6h after birth with specific neonatal follow-up, and Marseille University Hospital (AP-HM) (n=4385) where postpartum discharge was more conventional after 72 h. During the study period, the EPPD rate was 41% vs. 2% in Stockholm and Marseille, respectively (PHospital readmission was comparable (5.6‰ vs. 7‰, P=0.2). The leading cause associated with hospitalization was icterus in Stockholm (76% vs. 26%, Phospitalization. Copyright © 2016 Elsevier Masson SAS. All rights reserved.

  7. A study to assess burnout among nurses of maternity department in Gauhati Medical College Hospital, Assam

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    Marami Baishya

    2016-01-01

    Full Text Available Background: Burnout in healthcare workers, especially among nurses, can have an impact on overall healthcare delivery system. For health in general and maternal health in particular, wellbeing of healthcare workers, including nurses, is of paramount importance. Material and methods: This study aimed to assess burnout among nurses working in the maternity department. One hundred nurses of a tertiary care centre, selected by non-purposive convenient sampling, were examined by a standardised questionnaire. Data were analysed by descriptive statistics. Results: Burnout in depersonalisation was moderate while that in emotional exhaustion and personal achievement were of low-levels. Conclusion: Understanding the nature of the problem of burnout can guide in better management.

  8. Evaluation of Maternal Complications in Severe Preeclampsia in a University Hospital in Tirana

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    Eriseida Ndoni

    2016-02-01

    Full Text Available BACKGROUND: Preeclampsia is a hypertensive multisystem disorder of pregnancy that complicates up to 10% of pregnancies worldwide and is one of the leading causes of maternal and perinatal morbidity and mortality. AIM: To evaluate maternal complications associated with severe preeclampsia. METHODS: This is a retrospective cross-sectional study conducted in the UHOG “Koço Gliozheni”, in Tirana. Primary outcomes evaluated: maternal death, eclampsia, stroke, HELLP syndrome, and pulmonary edema. Secondary outcomes: renal failure, admission in ICU, caesarean section, placental abruption, and postpartum hemorrhage. Fisher’s exact test and Chi-squared test were used as statistical methods. RESULTS: In women with severe preeclampsia we found higher rates of complications comparing to the group with preeclampsia. Eclampsia (1.5% vs. 7.1%, P < 0.001, HELLP syndrome (2.4% vs. 11.0%; P < 0.001, stroke (0.5% vs 1.9%, P = 0.105 pulmonary edema (0.25% vs. 1.3%, P = 0.0035, renal failure (0.9% vs. 2.6%, P = 0.107, admission in ICU (19.5% vs. 71.4%, P = 0.007, caesarean section rates (55.5% vs. 77%, P = 0.508, placental abruption (4.3% vs. 7.8%, P = 0.103 and severe postpartum hemorrhage (3.2% vs. 3.9%, P = 0.628. CONCLUSION: Severe preeclampsia is associated with high rates of maternal severe morbidity and early diagnosis and timely intervention can prevent life treating complications.

  9. Maternal and Perinatal Outcomes Among Adolescents and Mature Women: A Hospital-Based Study in the North of Mexico.

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    Minjares-Granillo, Ramón O; Reza-López, Sandra A; Caballero-Valdez, Selene; Levario-Carrillo, Margarita; Chávez-Corral, Dora Virginia

    2016-06-01

    To compare maternal and newborn pregnancy outcomes from adolescents and mature women. A cross-sectional study was carried out in a public hospital, including women with singleton pregnancies, who were classified according to their age, as follows: group 1: younger than 16 years old (n = 37), group 2: 16-19 years old (n = 288), and group 3: 20-34 years old (n = 632). Information on clinical characteristics, gynecological and obstetric history, pregnancy complications, and perinatal outcomes was obtained through interviews and from clinical records. Thirty-four percent of deliveries were from adolescents. Mature women were more likely to have prepregnancy overweight or obesity than adolescents (odds ratio [OR] = 2.4, 95% confidence interval [CI], 1.7-3.4). The frequency of maternal complications during pregnancy or delivery was not different between groups. Birth asphyxia was more frequent in group 2 (P = .02). Women with inadequate prenatal care had an increased risk of preterm deliveries (OR = 1.64; 95% CI, 1.06-2.54) and of having newborns with low birth weight (OR = 2.02; 95% CI, 1.22-3.35). Weight of newborns from noncomplicated pregnancies was lower in group 1 (P = .02), after adjustment for prepregnancy body mass index, gestational weight gain, preterm delivery, and newborn sex. The frequency of maternal and perinatal complications was similar in adolescents and mature women. Birth weight was decreased in noncomplicated pregnancies of adolescents younger than 16 years of age. Adequate prenatal care might be helpful in prevention of some adverse perinatal outcomes. Copyright © 2015 North American Society for Pediatric and Adolescent Gynecology. Published by Elsevier Inc. All rights reserved.

  10. Feto-Maternal Outcome of Jaundice in Pregnancy in a Tertiary Care Hospital.

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    Parveen, T; Begum, F; Akhter, N

    2015-07-01

    Acute viral hepatitis is the most common cause of jaundice in pregnancy. Amongst hepatitis E bears a deadly combination with pregnancy, leading to loss of very young lives. There is almost no data available in this aspect documenting prevalence, profile and effect of jaundice on outcome of pregnancy in Bangladesh. This observational study was done to determine and analyze the frequency, cause and outcome of jaundice in pregnancy among the admitted patients in the feto-maternal medicine wing of Bangabandhu Sheikh Mujib Medical University, for a 2 years period from August 2009 to July 2011. Management was done in collaboration with the hepatologists, hematologists and intensive care unit specialist. Outcome was noted in terms of the mode of delivery, maternal complications, need of blood transfusion and fresh frozen plasma and maternal end result. Fetal outcome was assessed by birth weight, Apgar score, neonatal admission, and perinatal mortality. Prevalence of jaundice was found 2.5% among all high risk and 1.3% among all obstetric admissions. Hepatitis E was the commonest cause and responsible for 80.4% cases of jaundice and next was cholestatic jaundice. Almost half of the patients (43.4%) faced complications like post partum haemorrhage (15.3%), hepatic encephalopathy (10.8%), ante partum hemorrhage (6.5%). Preterm delivery was noted in 71.1% cases. Out of 46 patients with jaundice four (4) mothers died due to hepatic encephalopathy in hepatitis E group. Regarding perinatal outcome 55.8% were of low birth weight, 35.3% had low Apgar score and perinatal mortality was 6.4%.

  11. [Aspects related to choice of type of delivery: a comparative study of two maternity hospitals in São Luís, State of Maranhão, Brazil].

    Science.gov (United States)

    Mandarino, Natália Ribeiro; Chein, Maria Bethânia da Costa; Monteiro Júnior, Francisco das Chagas; Brito, Luciane Maria Oliveira; Lamy, Zeni Carvalho; Nina, Vinícius José da Silva; Mochel, Elba Gomide; de Figueiredo Neto, José Albuquerque

    2009-07-01

    This study aimed to analyze aspects related to choice of type of delivery in two maternity hospitals, one public and the other private, in São Luís, Maranhão State, Brazil. This cross-sectional study compared 163 primiparous women in a public maternity hospital and 89 in a private hospital, with mean ages of 21.63 +/- 5.24 and 28.8 +/- 5.41 years, respectively. In the public hospital, 79.1% of the women reported preferring vaginal deliveries, while in the private hospital 67.4% of the women preferred cesareans (p < 0.0001). Cesareans were performed in 46% of the women in the public maternity hospital and 97.8% of those in the private hospital (p < 0.0001). Patient satisfaction was high for both modes of delivery, but the desire to repeat the same mode was reported more frequently by women with vaginal deliveries (71.6% vs. 41.3% in the public maternity hospital and 100% vs. 65.5% in the private). In the public maternity hospital, the cesarean subgroup included more white and higher-income women. The cesarean rate was thus high in both maternity hospitals and was significantly higher in the private hospital; the study also showed a preference for vaginal delivery in the public hospital and cesareans in the private.

  12. Bacteriological profile and associated risk factors of neonatal sepsis in Paropakar Maternity and Women's Hospital Thapathali, Kathmandu.

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    Adhikari, N; Shah, P K; Acharya, G; Vaidya, K M

    2014-12-01

    Neonatal Sepsis is one of the most common reasons for admission to neonatal units in developing countries. It is also a major cause of mortality in both developed and developing countries. Identification of the common bacteria and risk factors causing such infections and their susceptibility patterns will provide necessary information for timely intervention. This study was carried out to determine the bacteriological profile and associated risk factors of neonatal sepsis in Paropakar Maternity and Women's hospital. A cross-sectional prospective study was conducted among neonates suspected of neonatal sepsis. Blood culture was performed and organisms were identified and antibiotic susceptibility was carried out with standard microbiological methods. Data were analysed by using SPSS. Ver. 16 software. The positive yield of blood culture was 21%. The most common isolates were Staphylococcus epidermidis, E. coli, Staphylococcus aureus, Klebsiella pneumoniae and Pseudomonas spp. In Antibiotic susceptibility pattern Gentamycin showed the highest sensitivity to all types of isolated organisms. Vancomycin sensitivity was highest for Gram positive organism and Ciprofloxacin was most effective for Gram negative organisms isolated. Ampicillin and Amoxycillin were the least effective drug. Multiple drug resistance was observed in 77.15% of isolates. Prematurity, low birth weight and maternal pyrexia before delivery were found to be strongly associated with neonatal sepsis. Gram positive organisms were more prevalent than gram negative organisms.

  13. Mortalidad materna en Guatemala: diferencias entre muerte hospitalaria y no hospitalaria Maternal mortality in Guatemala: differences between hospital and non-hospital deaths

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    Ana Marina Tzul

    2006-06-01

    Full Text Available OBJETIVO: Estimar la asociación entre características obstétricas, sociodemográficas y factores de riesgo relacionados con la mortalidad materna hospitalaria y no hospitalaria en Guatemala durante el año 2000 MATERIAL Y MÉTODOS: Se realizó un estudio epidemiológico transversal con 649 casos de muertes maternas (MM ocurridas en la República de Guatemala durante el año 2000, en el que se compararon las características de las muertes maternas hospitalarias y no hospitalarias RESULTADOS: De 649 MM registradas, 270 (41.6% se clasificaron como MM hospitalarias y 379 (58.4% como MM no hospitalarias. La mayor proporción de muertes ocurrió en mujeres mayores de 35 años de edad (29.28%, indígenas (65.49%, casadas o unidas (87.83%, con ocupación no remunerada (94.78%, sin educación (66.56%. El riesgo de MM no hospitalaria fue mayor en mujeres del grupo indígena (RM= 3.4; IC95% 2.8-5.3, con ocupación no remunerada (RM= 8.95; IC95% 1.7-46.4, bajo nivel escolar (RM= 1.96; IC95% 1.0-3.8, y hemorragia como causa básica de muerte (RM= 4.28; IC95% 2.3-7.9 CONCLUSIONES: De los 679 casos de MM ocurridas en Guatemala en el año 2000, 58% correspondió a MM no hospitalarias, lo que puede estar relacionado con el hecho de que una alta proporción de la población habita en áreas rurales o de alta marginalidad, además de aspectos culturales (mayoría indígena que dificultan la accesibilidad a los servicios de salud. Los resultados presentados pueden servir de orientación para determinar estrategias de intervención que prevengan la mortalidad materna en los ámbitos hospitalario y extrahospitalario, en Guatemala.OBJECTIVE:To estimate the association between obstetric and socio-demographic characteristics and risk factors related to intra- and extra-hospital maternal mortality in Guatemala during the year 2000 MATERIALS AND METHODS: A cross-sectional epidemiologic study was carried out in 649 maternal mortality (MM cases that occurred in

  14. HIV infection in pregnancy: maternal and perinatal outcomes in a tertiary care hospital in Calabar, Nigeria.

    Science.gov (United States)

    Ikpim, Ekott Mabel; Edet, Udo Atim; Bassey, Akpan Ubong; Asuquo, Otu Akaninyene; Inyang, Ekanem Etim

    2016-04-01

    Human immunodeficiency virus (HIV) infection is likely to have untoward effects on pregnancy and its outcome. This study assessed the impact of maternal HIV infection on pregnancy outcomes in a tertiary centre in Calabar, Nigeria. This retrospective study analysed delivery records of 258 HIV-positive and 257 HIV-negative women for pregnancy and delivery complications. Maternal and fetal outcomes of HIV-positive pregnancies were compared with those of HIV-negative controls. Adverse pregnancy outcomes significantly associated with HIV status were: anaemia: 33 (8.1%) vs. 8 (3.1%) in controls; puerperal sepsis: 18 (7%) vs. 2 (0.8%); and low birth weight: 56 (21.7%) vs. 37 (14.4%). Caesarean delivery was higher among HIV-positive women than controls: 96 (37.2%) vs. 58 (22.6%). Preterm births were higher in those HIV cohorts who did not receive antiretroviral therapy (ART): 13 (16.9%) vs. 7 (3.9%). HIV-positive status increased adverse birth outcome of pregnancy. ART appeared to reduce the risk of preterm births in HIV-positive cohorts. © The Author(s) 2015.

  15. Loneliness and pregnancy in an urban Latino community: associations with maternal age and unscheduled hospital utilization.

    Science.gov (United States)

    Geller, Jeffrey S

    2004-01-01

    The objective is to compare loneliness in a pregnant population to a non-pregnant control group, and to evaluate loneliness and unscheduled hospital visits during pregnancy. A prospective cohort study in a Latino urban community including 53 consecutive pregnant women in their first trimester, and 61 non-pregnant women as a control. The UCLA Loneliness Scale version 3, and demographic information was collected. A chart review after delivery determined total number of unscheduled pregnancy related hospital visits. Appropriate data analysis using t-test and regression analysis was used. Forty-eight women continued to delivery. There was no difference in mean loneliness scores between pregnant (41) and non-pregnant groups (43), or that of normal populations (41). There was a significant association between UCLA loneliness scores and total pregnancy related unscheduled hospital visits p = 0.042, beta = 0.06, r= 0.29. There was a significant association between increasing age and increasing loneliness during pregnancy p = 0.007, beta = 0.21, r= 0.36, not seen in the non-pregnant group p = 0.98. Loneliness, when controlling for age, yielded a stronger association with unscheduled hospital visits p = 0.018, beta = 0.076, and r = 0.40. The findings were that increased loneliness is associated with increased unscheduled pregnancy related hospital utilization during pregnancy. Older pregnant women had higher loneliness scores. Loneliness was more significant than age in predicting higher unscheduled hospital visits. The combination of increased loneliness and younger age predicted the highest number of unscheduled hospital visits.

  16. Maternal asthma, diabetes, and high blood pressure are associated with low birth weight and increased hospital birth and delivery charges; Hawai'i hospital discharge data 2003-2008.

    Science.gov (United States)

    Hayes, Donald K; Feigal, David W; Smith, Ruben A; Fuddy, Loretta J

    2014-02-01

    Asthma, diabetes, and high blood pressure are common maternal conditions that can impact birth outcomes. Data from hospital discharges in Hawai'i were analyzed for 107,034 singleton births from 2003-2008. Categories were determined using the International Statistical Classification of Diseases, ninth revision (ICD-9) from linked delivery records of mother and infant. Prevalence estimates of asthma (ICD-9: 493), diabetes (ICD-9: 250,648.0, 648.8), high blood pressure (ICD-9: 401-405,642) as coded on the delivery record, low birth weight (high birth weight (>4500 grams), Cesarean delivery, and median hospital charges were calculated. Median regression analysis assessed total hospital charges adjusting for maternal age, maternal race, insurance, and Cesarean delivery. Maternal asthma was present in 4.3% (95% confidence interval=4.1-4.4%), maternal diabetes was present in 7.7% (95% CI=7.6-7.9%), and maternal high blood pressure was present in 9.2% (95% CI=9.0-9.3%) of births. In the adjusted median regression analysis, mothers with asthma had $999 (95% CI: $886 to $1,112) higher hospital charges compared to those without; mothers with diabetes had $743 (95% CI: $636 to $850) higher charges compared to those without; and mothers with high blood pressure had $2,314 (95% CI: $2,194 to $2,434) higher charges compared to those without. Asthma, diabetes, and high blood pressure are associated with higher hospital delivery charges and low birth weight. Diabetes and high blood pressure were also associated with Cesarean delivery. An increased awareness of the impact of these conditions on both adverse birth outcomes and the development of chronic disease is needed.

  17. Maternal and Umbilical Cord Blood Levels of Zinc and Copper in Active Labor Versus Elective Caesarean Delivery at Khartoum Hospital, Sudan.

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    Elhadi, Alaeldin; Rayis, Duria A; Abdullahi, Hala; Elbashir, Leana M; Ali, Naji I; Adam, Ishag

    2016-01-01

    A case-control study was conducted in Khartoum Hospital Sudan to determine maternal and umbilical cord blood levels of zinc and copper in active labor versus elective cesarean delivery. Cases were women delivered vaginally and controls were women delivered by elective cesarean (before initiation of labor). Paired maternal and cord zinc and copper were measured using atomic absorption spectrophotometry. The two groups (52 paired maternal and cord in each arm) were well matched in their basic characteristics. In comparison with cesarean delivery, the median (interquartile range) of both maternal [87.0 (76.1-111.4) vs. 76.1 (65.2-88.3) μg/dL, P = 0.004] and cord zinc [97.8 (87.0-114.1) vs. 81.5(65.2-110.2) μg/dL P = 0.034] levels were significantly higher in the vaginal delivery. While there was no significant difference in the maternal copper [78.8 (48.1-106.1) vs. 92.4 (51.9-114.9) μg/dL, P = 0.759], the cord copper [43.5(29.9-76.1) vs. 32.2(21.7-49.6) μg/dL, P = 0.019] level was significantly higher in vaginal delivery. There was no significant correlation between zinc (both maternal and cord) and copper. While the cord zinc was significantly correlated with maternal zinc, there was no significant correlation between maternal and cord copper. The current study showed significantly higher levels of maternal and cord zinc and cord copper in women who delivered vaginally compared with caesarean delivery.

  18. Maternal and Hospital Factors Associated with First-Time Mothers' Breastfeeding Practice: A Prospective Study.

    Science.gov (United States)

    Tsai, Tzu-I; Huang, Shu-Her; Lee, Shoou-Yih D

    2015-01-01

    Continuity of breastfeeding is infrequent and indeterminate. Evidence is lacking regarding factors associated with breastfeeding at different postpartum time points. This prospective study investigated the change in, and correlates of, breastfeeding practices after delivery at a hospital and at 1, 3, and 6 months postpartum among first-time mothers. We followed a cohort of 300 primiparous mothers of Taiwan who gave birth at two hospitals during 2010-2011. Logistic and Cox regression analyses were performed to determine factors that were correlated with breastfeeding practices. In the study sample, the rate of exclusive breastfeeding during the hospital stay was 66%; it declined to 37.5% at 1 month and 30.2% at 3 months postpartum. Only 17.1% of women reported continuing breastfeeding at 6 months. Early initiation of breastfeeding, rooming-in practice, and self-efficacy were significantly related to exclusive breastfeeding during the hospital stay. After discharge, health literacy, knowledge, intention, and self-efficacy were positively and significantly associated with breastfeeding exclusivity. Later initiation (hazard ratio=1.53; 95% confidence interval, 1.05, 1.97), shorter intention (hazard ratio=1.42; 95% confidence interval, 1.13, 1.68), and self-efficacy (hazard ratio=0.98; 95% confidence interval, 0.96, 0.99) were important predictors of breastfeeding cessation within 6 months of delivery. Continuous breastfeeding practice for 6 months is challenging and difficult for new mothers. Results showed that factors related to breastfeeding varied over time after delivery. Interventions seeking to sustain breastfeeding should consider new mothers' needs and barriers at different times.

  19. Statistical analysis of the maternal death rate at the Ebonyi State University Teaching Hospital, Abakaliki, for the year ending 31 December 2007

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    Uchechukwu M. Okeh

    2009-04-01

    Full Text Available Background: The maternal mortality rate in developing countries, such as Nigeria, remains relatively high, with the causes being multidimensional. The unbooked primigravidae with severe pre-eclampsia/eclampsia constitute a high risk group.Method: The data from the case notes of all the maternal deaths that occurred at the Ebonyi State University Teaching Hospital, Abakaliki, between 1 January and 31 December 2007 form the basis of this study. The case notes relating to all such deaths were stored in the office of the Head of the Department of Obstetrics and Gynaecology when the deaths occurred. Information was extracted from the case files at the end of 2007. Data relating to the total number of deliveries were obtained from the registers kept in the labour and isolation wards.Results: Of the 45 maternal deaths recorded, 40 (88.9% were found to have occurred among the unbooked and 5 (11% among the booked mothers, constituting a maternal mortality ratio (MMR of 23 121.4 and 339.7 per 100 000 deliveries respectively. The combined mortality ratio was 2 735.6 per 100 000 deliveries. Fifteen (37.5% unbooked primigravidae were found to have died of severe pre-eclampsia/eclampsia. A total of 1 645 mothers were noted to have delivered babies, of whom 1 472(89.5% were booked, and 173 (10.5% unbooked, with the hospital.Conclusion: Severe pre-eclampsia/eclampsia, haemorrhaging and sepsis were the major causes of death. A high maternal mortality rate was found to be common among the unbooked primigravidae, who are known usually to present late with pre-eclampsia/eclampsia. More research into the causes and management of pre-eclampsia/eclampsia is needed to reduce the high maternal death rate associated with it. The lack of antenatal care is also a high risk factor for maternal death.

  20. [Career perspectives of hospital health workers after maternity and paternity leave: survey and observational study in Germany].

    Science.gov (United States)

    Engelmann, C; Grote, G; Miemietz, B; Vaske, B; Geyer, S

    2015-02-01

    A term of maternity and paternity (parental) leave becomes frequent on the career paths of medical personnel. Hospitals are highly competitive environments. The question employees universally face is how such a leave will alter their personal work situation and prospects upon return. We questioned 709 leave-takers and 88 department heads of a German university hospital (2009-12; full data sets: n = 406 and n = 63) about their experiences. This data was validated by epidemiology data extraction and expert interviews, also in a Swiss and in a Norwegian institution. Parental leave elicited high emotionality (score: 4.0 +/- 2 out of 5). Superiors' appraisal of employees' parental leave was more positive than negative (p leave takers doubled to 39 %; 51 % of leave-takers experienced significant task profile changes. 58 % of doctors thought about changing their employer and 17 % of leave-taking executives lost status after return. Employees' "power" and "influence" dropped significantly (p leave. The Swiss and Norwegian comparators appeared to have more liberal substitution and part-time schemes than the German institution. A competitive hospital environment can effectively demote leave-taking medical employees in their jobs. Despite sufficient financial arrangements high-commitment staff will only take parental leave of adequate length when an institutional framework protects their status. Data support four requirements: 1. Formal recognition of the leave taker's status pre-leave. 2. Establishment of a written ("claimable") return policy. 3. Substitution scheme for each individual, preferably by a locum. 4. Redirection of funds to facilitate part-time work schemes temporarily after return. © Georg Thieme Verlag KG Stuttgart · New York.

  1. Pattern of abortion care in a tertiary level maternity hospital in Nepal.

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    Paudel, Punya; Paudel, Luna; Bhochhibhoya, Manisha; Vaidhya, Sapana Amatya; Shah, Nabina; Khatiwada, Dipendra

    2013-01-01

    Complications from unsafe abortion are believed to account for the largest proportion of hospital admissions for gynaecological services in developing countries and not to mention the cost it imparts to the health system of a country. Therefore, it is equally important to find out the prevalence and the pattern of abortion among the women who utilize the safe abortion care services and provide a framework to target various health promotion programs including safe-motherhood and reproductive health; such that the future interventions to avoid the unintended pregnancy and unsafe abortion can be implemented accordingly. A cross-sectional study was conducted in a tertiary care hospital in Kathmandu, Nepal. Social and demographic information of all the women seeking induced abortions from January 2011 to December 2012 were included and the result was analyzed. Abortion contributed to about 1.68% of the total patient served in the hospital that provides both obstetrical and gynecological services. Of the total 4830 patients who underwent induced abortion in this period, the mean age was 27, 92.3% were from the Kathmandu valley and more than one-third women (35.2%) were illiterate who couldn't read and write. Majorities were more than two parity and belonged to higher caste. The socio-demographic profile of the abortion clients in Nepal has remained similar over the years. We need to address the accessibility and availability to the safe abortion care services along with other safe motherhood programs guaranteeing access to safe abortion and post-abortion care to all group of women and also, women education regarding contraception to avoid repeated abortions or unwanted pregnancy in the future.

  2. Neonatal near miss and mortality: factors associated with life-threatening conditions in newborns at six public maternity hospitals in Southeast Brazil

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    Pauline Lorena Kale

    Full Text Available Abstract: We aimed to evaluate factors associated with cases of neonatal near miss and neonatal deaths at six public maternity hospitals in São Paulo and Rio de Janeiro States, Brazil, in 2011. A prospective hospital-based birth cohort investigated these outcomes among live births with life-threatening conditions. Associations were tested using multinomial logistic regression models with hierarchical levels. High rates of near miss were observed for maternal syphilis (52.2‰ live births and lack of prenatal care (80.8‰ live births. Maternal black skin color (OR = 1.9; 95%CI: 1.2-3.2, hemorrhage (OR = 2.2; 95%CI: 1.3-3.9, hypertension (OR = 3.0; 95%CI: 2.0-4.4, syphilis (OR = 3.3; 95%CI: 1.5-7.2, lack of prenatal care (OR = 5.6; 95%CI: 2.6-11.7, cesarean section and hospital, were associated with near miss; while hemorrhage (OR = 4.6; 95%CI: 1,8-11.3, lack of prenatal care (OR = 17.4; 95%CI: 6.5-46.8 and hospital, with death. Improvements in access to qualified care for pregnant women and newborns are necessary to reduce neonatal life-threatening conditions.

  3. Study of cases of still births at tertiary maternity care hospital (ReCoDe

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    Ami Yagnik

    2016-06-01

    Full Text Available To study the characteristics of pregnancies which end in antepartum still births using the classification systemReCoDe (Relevant Condition at Death and to suggest measures to reduce incidence of still births in our study population. The study is a retrospective study of cases of stillbirths. In the present study 100 cases with still births admitted to Deptt. Of Obs & Gynecology Govt Medical College, Sir.T.Hospital, Bhavnagar fulfilling the inclusion criteria was included. All these cases were subjected to routine investigations and the placenta with cord was sent for HPE in all the cases and followed up to one week in the postpartum period. All the cases were classified according to relevant condition at death classification of still births (ReCoDe. On classifying the aetiology of stillbirths in all cases according to the ReCoDe classification we were able to classify 90% of cases and only 10% remain unclassified. In the present study 28% stillbirths were attributed IUGR as a cause, 22% cases mother had hypertensive disorder, 21% with antepartum haemorrhage as a cause and 15% with congenital fetal anomaly. Of 100 cases 53 had a positive correlation in placental and cord on histopathological examination. The present study helped to classify and study the aetiology of stillbirths in study population in simplified way on condition relevant at death. This study lets us know that most of the causes can be taken care of by instituting appropriate measures at right time. The importance of antenatal care, nutrition, counseling early detection and medical help, timely referral to tertiary care hospital,

  4. "Maternal and neonatal outcome in teenage pregnancy in Tehran Valiasr Hospital "

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    "Nili F

    2002-05-01

    Full Text Available Among 2357 prenant women at Tehran Valiasr hospital, 99 women under 18 years with their 102 neonates were evaluated retrospectively during Aprill 1999 to April 2000. frequency of adolescent pregnancy was detected in 41.5 per 1000 live birth 7 (7.1% of mothers had preeclampisa, 7 thyroidal diseases, 3 valvular heart diseases, 2 urinary tract infections and 20.3% of women had prolonged rupture of membrane (more than 24 hrs. the route of delivery in 21.2% of women was cesarean section. 32% of neonates were low birth weight and the gestational age in 38.2% of neonates was lower than 37 weeks. Intrauterine growth retardiation was detected in 11.8% of patients 38.2% of babies were admitted into neonatal care unit. Perinatal resuscitation and ventilator care were needed in 9.8% and 3.9% of neonates respectively. Nonatal mortality occurred in 6.9% of patients. Compared with total deliveries the frequency of variables was higher than could be expected except for cesarean section. Our adolescent pregnancy rate is lower than worldwide range but rates for prematurity and low birth weight are the same as other reports from developed and developing countries. Frequency of cesarean section was lower than expected range in this group as in developed countries.With respect to higher rates for rheumatic heart disease, premature labor, prolonged rupture o membrane and low birth weight, it seems that lower socioeconomic factors may result in these adverse outcomes.Higher neonatal ICU admissions, artificial ventilation and resuscitation in adolescent pregnancies suggest that confinement in hospitals with level III nurseries is advisable in these high risk group

  5. [Maternal mortality rate in the Aurelio Valdivieso General Hospital: a ten years follow up].

    Science.gov (United States)

    Noguera-Sánchez, Marcelo Fidias; Arenas-Gómez, Susana; Rabadán-Martínez, Cesar Esli; Antonio-Sánchez, Pedro

    2013-01-01

    Antecedentes: en México, la mortalidad materna ha disminuido en las últimas décadas. En Oaxaca esto no se ha manifestado porque se incrementó la tasa de mortalidad materna. Este estado se ubica entre las entidades con más muertes maternas. Objetivo: analizar 10 años de mortalidad materna en el Hospital General Dr. Aurelio Valdivieso de los Servicios de Salud de Oaxaca, para conocer el comportamiento epidemiológico y caracterización de los decesos. Material y métodos: estudio retrospectivo, transversal y descriptivo efectuado mediante la revisión de expedientes clínicos de mortalidad materna en la División de Gineco-Obstetricia. Se consideraron variables sociales, obstétricas y circunstanciales y las comprobaciones se efectuaron con estadística general y descriptiva. Resultados: entre el 1 de enero de 2000 y el 31 de diciembre de 2009 se registraron 109 muertes maternas, excluidas dos que no fueron obstétricas; es decir, que hubo 107 muertes maternas: 75 directas y 32 indirectas. La tasa de mortalidad materna fue de 172.14 × 100,000 nacidos vivos. De las muertes maternas revisadas 89 pudieron evitarse (83%) y 18 no (17%), esto con base en el dictamen del Comité ad hoc del Hospital General Dr. Aurelio Valdivieso. La enfermedad hipertensiva aguda del embarazo fue la de mayor mortalidad; la escolaridad y el puerperio ueron el mayor riesgo. Conclusiones: las variables atribuibles a bajo índice de desarrollo humano, como: baja escolaridad y paridad elevada incrementaron el riesgo de mortalidad materna, que fue intrahospitalaria y durante el puerperio. La tasa de mortalidad materna fue la mayor encontrada en publicaciones nacionales con respecto a este referente.

  6. Sero-prevalence of Toxoplasma gondii infection among pregnant women attending antenatal clinics in Khartoum and Omdurman Maternity Hospitals, Sudan

    Institute of Scientific and Technical Information of China (English)

    Musa Abdel-Raouff; Mohamed Mobarak Elbasheir

    2014-01-01

    Objective:To determine the sero-prevalence of Toxoplasma gondii (T. gondii) infection among pregnant Sudanese women. Methods:One hundred and sixty three pregnant women attending antenatal care in Omdurman Maternity Hospitals, Khartoum, Sudan during June to August in 2013 were enrolled and screened for immunoglobulin G (IgG) and IgM antitoxoplasma antibodies using enzyme linked immunosorbent assay technique. Results:Among 163 pregnant women, 33 (20.2%) were positive for (IgG) antitoxoplasma antibodies, while 130 (79.8%) were seronegative. None of the examined women had IgM antitoxoplasma antibodies. The highest rate of infection (26.7%) was detected among women aged 21-29 years. No statistically significant relation was observed between T. gondii sero-prevalence and the other variable of risk factors studied. Conclusions: Over 79% Sudanese women screened for antitoxoplasma IgG antibodies were seronegative and they were at risk of seroconversion during pregnancy. Moreover, the study showed that screening of T. gondii infections during antenatal care should be considered in Khartoum state as the main strategy to minimize congenital toxoplasmosis.

  7. Reasons for routine episiotomy: A mixed-methods study in a large maternity hospital in Phnom Penh, Cambodia.

    Science.gov (United States)

    Schantz, Clémence; Sim, Kruy Leang; Ly, Ek Meng; Barennes, Hubert; Sudaroth, So; Goyet, Sophie

    2015-05-01

    First documented in 1741, the practice of episiotomy substantially increased worldwide during the 20th century. However, research shows that episiotomy is not effective in reducing severe perineal trauma and may be harmful. Using a mixed-methods approach, we conducted a study in 2013-14 on why obstetricians and midwives in a large maternity hospital in Phnom Penh, Cambodia, still do routine episiotomies. The study included the extent of the practice, based on medical records; a retrospective analysis of the delivery notes of a random sample of 365 patients; and 22 in-depth interviews with obstetricians, midwives and recently delivered women. Of the 365 women, 345 (94.5%, 95% CI: 91.7-96.6) had had an episiotomy. Univariate analysis showed that nulliparous women underwent episiotomy more frequently than multiparous women (OR 7.1, 95% CI 2.0-24.7). The reasons given for this practice by midwives and obstetricians were: fear of perineal tears, the strong belief that Asian women have a shorter and harder perineum than others, lack of time in overcrowded delivery rooms, and the belief that Cambodian women would be able to have a tighter and prettier vagina through this practice. A restrictive episiotomy policy and information for pregnant women about birthing practices through antenatal classes should be implemented as soon as possible.

  8. Birthing support and breastfeeding initiation in Somaliland: experiences at the Edna Adan Maternity Hospital in Hargeisa, Somaliland.

    Science.gov (United States)

    Holder, Kelly

    2011-03-01

    Research has identified a relationship between birthing practices and breastfeeding initiation Continuous support during labor and delivery is a key component to increasing breastfeeding initiation. The purpose of this project was to assess the impact of labor support on breastfeeding initiation in a setting in which women receive traditional birthing support from female family members. Research was conducted at the Edna Adan Maternity Hospital in Hargeisa, Somaliland using the grounded theory method of qualitative research. Semi-structured interviews, direct observations and participant observations were conducted. A purposeful, non-statistical sample was chosen: ten women, five family members, six health care providers and five birth observations were included. The CDC EZ-Text, a software program developed by the Center for Disease Control and Prevention for use in qualitative research, was used in managing and analyzing the data. Data analysis and interpretation was conducted using micro-analysis, open, axial and selective coding procedures. The results indicated that due to cultural influences, contradictory beliefs and practices, lack of critical thinking and lack of long term planning, traditional birthing support was not always indicative of immediate breastfeeding initiation. The presence of a labor companion is a low-cost, preventative intervention that is consistent with the cultural practices of Somaliland. Breastfeeding education and support should, therefore, include a tertiary approach which includes pregnant and birthing women, labor support persons or family members and health care providers.

  9. Sero-prevalence of Toxoplasma gondii infection among pregnant women attending antenatal clinics in Khartoum and Omdurman Maternity Hospitals, Sudan

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    Musa Abdel-Raouff

    2014-06-01

    Full Text Available Objective: To determine the sero-prevalence of Toxoplasma gondii (T. gondii infection among pregnant Sudanese women. Methods: One hundred and sixty three pregnant women attending antenatal care in Omdurman Maternity Hospitals, Khartoum, Sudan during June to August in 2013 were enrolled and screened for immunoglobulin G (IgG and IgM antitoxoplasma antibodies using enzyme linked immunosorbent assay technique. Results: Among 163 pregnant women, 33 (20.2% were positive for (IgG antitoxoplasma antibodies, while 130 (79.8% were seronegative. None of the examined women had IgM antitoxoplasma antibodies. The highest rate of infection (26.7 % was detected among women aged 21-29 years. No statistically significant relation was observed between T. gondii sero-prevalence and the other variable of risk factors studied. Conclusions: Over 79% Sudanese women screened for antitoxoplasma IgG antibodies were seronegative and they were at risk of seroconversion during pregnancy. Moreover, the study showed that screening of T. gondii infections during antenatal care should be considered in Khartoum state as the main strategy to minimize congenital toxoplasmosis.

  10. Mobility and maternal position during childbirth in Tanzania: an exploratory study at four government hospitals

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    Smith Helen

    2004-02-01

    Full Text Available Abstract Background Emerging research evidence suggests a potential benefit in being upright in the first stage of labour and a systematic review of trials suggests both benefits and harmful effects associated with being upright in the second stage of labour. Implementing evidence-based obstetric care in African countries with scarce resources is particularly challenging, and requires an understanding of the cumulative nature of science and commitment to applying the most up to date evidence to clinical decisions. In this study, we documented current practice rates, explored the barriers and opportunities to implementing these procedures from the provider perspective, and documented women's preferences and satisfaction with care. Methods This was an exploratory study using quantitative and qualitative methods. Practice rates were determined by exit interviews with a consecutive sample of postnatal women. Provider views were explored using semi-structured interviews (with doctors and traditional birth attendants and focus group discussions (with midwives. The study was conducted at four government hospitals, two in Dar es Salaam and two in the neighbouring Coast region, Tanzania. Main outcome measures Practice rates for mobility during labour and delivery position; women's experiences, preferences and views about the care provided; and provider views of current practice and barriers and opportunities to evidence-based obstetric practice. Results Across all study sites more women were mobile at home (15.0% than in the labour ward (2.9%, but movement was quite restricted at home before women were admitted to labour ward (51.6% chose to rest with little movement. Supine position for delivery was used routinely at all four hospitals; this was consistent with women's preferred choice of position, although very few women are aware of other positions. Qualitative findings suggest obstetricians and midwives favoured confining to bed during the first

  11. High rates of burnout among maternal health staff at a referral hospital in Malawi: A cross-sectional study

    OpenAIRE

    2011-01-01

    Background Burnout among maternal healthcare workers in sub-Saharan Africa may have a negative effect on services provided and efforts to mitigate high maternal mortality rates. In Malawi, research on burnout is limited and no empirical research has been conducted specifically among maternal health staff. Therefore, the aims of the study were to examine the prevalence and degree of burnout reported by healthcare workers who provide antenatal, intrapartum, and postnatal serv...

  12. Frequency and risk factors for the birth of small-for-gestational-age newborns in a public maternity hospital.

    Science.gov (United States)

    Teixeira, Marina Parca Cavelagna; Queiroga, Tatiana Peloso Reis; Mesquita, Maria Dos Anjos

    2016-01-01

    To determine the frequency and risk factors of small-for-gestational-age newborns in a high-risk maternity. This is an observational, cross-sectional, and case-control study, conducted in a public tertiary care maternity hospital. Data from 998 newborns and their mothers were collected through interviews and review of medical records and prenatal care cards. Some placentas underwent histopathological analysis. The variables of small-for-gestational-age and non-small-for-gestational-age newborns and of their mothers were statistically compared by means of Student's t test, Fisher's exact test, and odds ratio. The significance level used was 0.050. There was a 17.9% frequency of small-for-gestational-age newborns. The statistically significant factors associated with the birth of these babies were female sex (p=0.012); positive history of another small-for-gestational-age child (p=0.006); inadequate prenatal care (p=0.019); smoking (p=0.003); hypertensive disorders of pregnancy (p=0.007); placental bleeding (p=0.009) and infarction (p=0.001). In the population studied, the frequency of small-for-gestational-age newborns was high and associated with sex, inappropriate prenatal care, presence of maternal diseases and addictions, and placental abnormalities. Determinar a frequência e os fatores de risco de recém-nascidos pequenos para idade gestacional em uma maternidade de alto risco. Trata-se de um estudo observacional, transversal e caso-controle, realizado em maternidade pública de nível terciário. Foram levantados dados de 998 recém-nascidos e de suas respectivas mães por meio de entrevista e análise de prontuários e de cartões do pré-natal. Algumas placentas foram submetidas à análise anatomopatológica. As variáveis dos recém-nascidos pequenos e não pequenos para idade gestacional e de suas respectivas mães foram comparadas estatisticamente pelo teste paramétrico t de Student, pelo teste exato de Fisher e por odds ratio. O nível de signific

  13. Royal Commissions into Policing: Australia

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    Alan Beckley

    2013-03-01

    Full Text Available Royal Commissions and Inquiries have investigated every police force in Australia in relation to their integrity, accountability and effectiveness—a factor of major importance to every citizen in maintaining their freedom, safety and security. The crucial question this paper poses is whether such tribunals are effective or otherwise in terms of the benefits and outcomes accrued from their findings. The paper is in the form of a critical discussion which investigates and analyses the Inquiries using the method of desk research of official documents over the last 50 years from which it identifies common findings and recommendations contained in the official discourse. The research concludes that lessons have not been learned in relation to policing operations, accountability and integrity in a number of cases and highlights a variety of adverse issues that persist into current policing practice.

  14. Improving obstetric care in low-resource settings: implementation of facility-based maternal death reviews in five pilot hospitals in Senegal

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    Fournier Pierre

    2009-07-01

    Full Text Available Abstract Background In sub-Saharan Africa, maternal and perinatal mortality and morbidity are major problems. Service availability and quality of care in health facilities are heterogeneous and most often inadequate. In resource-poor settings, the facility-based maternal death review or audit is one of the most promising strategies to improve health service performance. We aim to explore and describe health workers' perceptions of facility-based maternal death reviews and to identify barriers to and facilitators of the implementation of this approach in pilot health facilities of Senegal. Methods This study was conducted in five reference hospitals in Senegal with different characteristics. Data were collected from focus group discussions, participant observations of audit meetings, audit documents and interviews with the staff of the maternity unit. Data were analysed by means of both quantitative and qualitative approaches. Results Health professionals and service administrators were receptive and adhered relatively well to the process and the results of the audits, although some considered the situation destabilizing or even threatening. The main barriers to the implementation of maternal deaths reviews were: (1 bad quality of information in medical files; (2 non-participation of the head of department in the audit meetings; (3 lack of feedback to the staff who did not attend the audit meetings. The main facilitators were: (1 high level of professional qualifications or experience of the data collector; (2 involvement of the head of the maternity unit, acting as a moderator during the audit meetings; (3 participation of managers in the audit session to plan appropriate and realistic actions to prevent other maternal deaths. Conclusion The identification of the barriers to and the facilitators of the implementation of maternal death reviews is an essential step for the future adaptation of this method in countries with few resources. We

  15. Characteristics of pregnant Women admitted with 2009 H1N1 Influenza in a referral maternity hospital at Al-Madinah, Saudi Arabia

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    Inass Taha

    2013-07-01

    Full Text Available Background: To date there has been no study done in Saudi Arabia to identify the risk factors for poor outcome of H1N1 infection in pregnancy. Objectives: we aimed to evaluate the epidemiological data, clinical course, treatment modalities, and maternal and fetal outcomes of 33 pregnant women diagnosed with H1N1 Influenza A in a referral maternity and children hospital at Al- Madinah Saudi Arabia on the period from June 2009 till February 2010.Methods: This retrospective cohort study reported 33 pregnant women (9.1% primigravida aged 27.7±5.6 years who were laboratory-confirmed cases diagnosed with H1N1 Influenza A in a referral maternity and children hospital at Al- Madinah Saudi Arabia on the period from June 2009 till February 2010. Their mean gestation age was 23.5±10.9 weeks with history of bronchial asthma in 45.5%.Results: The mean duration between symptoms’ onset and hospital presentation was 5.0±2.2 days with late presentation in 10 cases (30,3%. Large number of cases presented with fever more than 39 (24 (72.7%, sore-throat (24 (72.7% and cough (29 (87.9% while 19 patients presented with dyspnea (57.6%. Pregnant patients with H1N1 received Tamiflu (oseltamivir from 2 to 7 days with a mean of 4.7±1.3 days. They stayed at hospital for variable periods from 2 to 28 days with a mean of 7.9±6.6 days (Table 4. Most patients (31(93.9% received antibiotics. Maternal poor outcome included hypoxia in 6 patients (18.2%, ICU admission for 2-3 days with mechanical ventilation in 4(12.1%. The main fetal poor outcome was intrauterine fetal death in 2 (6.1% babies .Conclusion:The main presentation of H1N1 among pregnant women was typical influenza-like illness. Considerable percentage of patients presented late (30.3%. The duration of hospital admission is variable up to 28 days. Bronchial asthma was prevalent (45.5% among pregnant women with H1N1 infection. The main poor outcomes were maternal respiratory failure (18.2% and intrauterine fetal

  16. Study of maternal mortality trends: 10 years retrospective and comparative analysis at a tertiary teaching hospital of Gwalior Chambal region

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    Jyoti Bindal

    2016-03-01

    Conclusions: Delay in seeking emergency obstetric care and not having regular antenatal checkups by pregnant females are the major contributors for maternal mortality. Dedicated obstetric intensive care units at referral centers for prompt and comprehensive care may help in reducing the maternal morbidity and mortality. [Int J Reprod Contracept Obstet Gynecol 2016; 5(3.000: 730-733

  17. Maternal vaginal microflora during pregnancy and the risk of asthma hospitalization and use of antiasthma medication in early childhood

    DEFF Research Database (Denmark)

    Benn, Christine Stabell; Thorsen, Poul; Jensen, Jørgen Skov;

    2002-01-01

    BACKGROUND: Infants with wheezing and allergic diseases have a microflora that differs from that of healthy infants. The fetus acquires microorganisms during birth when exposed to the maternal vaginal microflora. It is therefore conceivable that the maternal vaginal microflora might influence the...

  18. Causas de mortalidade materna segundo níveis de complexidade hospitalar Causes of maternal mortality according to levels of hospital complexity

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    Vânia Muniz Néquer Soares

    2012-12-01

    áveis.PURPOSES: To identify and to analyze maternal mortality causes, according to hospital complexity levels. METHODS: A descriptive-quantitative cross-sectional study of maternal deaths that occurred in hospitals in Paraná, Brazil, during the periods from 2005 to 2007 and from 2008 to 2010. Data from case studies of maternal mortality, obtained by the State Committee for Maternal Mortality Prevention, were utilized. The study focused on variables such as site and causes of death, hospital transfer, and avoidability. Maternal mortality rate, proportions, and hospital lethality ratio were calculated according to subgroups of low and high-risk pregnancy reference hospitals. RESULTS: Maternal mortality rate, including late maternal deaths, was 65.9 per 100.000 live-borns (from 2008 to 2010. Almost 90% of all maternal deaths occurred in the hospital environment, in both periods. The hospital lethality ratio at the high-risk pregnancy reference hospital was 158.4 deaths per 100,000 deliveries during the first period and 132.5/100,000 during the second, and the main causes were pre-eclampsia/eclampsia, puerperal infection, urinary tract infection, and indirect causes. At the low-risk pregnancy reference hospitals, the hospital lethality ratios were 76.2/100,000 and 80.0/100,000, and the main causes of death were hemorrhage, embolism, and anesthesia complications. In 64 (2005 - 2007 and in 71% (2008 - 2010 of the cases, the patients died in the same hospital of admission. During the second period, 90% of the casualties were avoidable. CONCLUSIONS: Hospitals of both levels of complexity are having difficulties in treating obstetric complications. Professional training for obstetric emergency assistance and the monitoring of protocols at all hospital levels should be considered by the managers as a priority strategy to reduce avoidable maternal deaths.

  19. Frequency of Congenital Anomalies in Newborns and Its Relation to Maternal Health in a Tertiary Care Hospital in Peshawar, Pakistan

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    Adnan Khan

    2015-03-01

    Full Text Available Background: Congenital anomalies are a major cause of perinatal and neonatal deaths, both in low- and high-income countries. They are relatively common worldwide, affecting 3% to 5% of live births. Methods: A cross-sectional study was conducted from January 2014 to June 2014 at the Khyber teaching hospital in Peshawar. Specific patient information was obtained from patient records at the beginning of the study. Those individuals found to have at least one birth defect were approached and their attendants (mothers were interviewed. Information regarding various risk factors was collected. Descriptive analyses were carried out. Results: Out of 1062 deliveries, 2.9% (31 of newborns had various congenital anomalies. Hydrocephalus (22.6%, anencephaly (12.9%, and spina bifida (9.7% were major anomalies. The maternal age ranged from 18 years to 46 years (mean: 30 ± 8. Most of the anomalies (35.5% were present in the 26-30 years age group. Out of 31 babies, 6.4% had multiple anomalies. The preponderance of various congenital anomalies was seen in parity 1 (35.4%; parities 2 to 4 had lower incidences (35.4%. The consanguinity rate was 67.7%; only 32.3% of patients were using folic acid. History of passive smoking was positive in 16.1% of cases. Conclusion: Anencephaly and hydrocephalus were the most prominent anomaly detected; early prenatal diagnosis may be helpful in decreasing mortality by offering early termination. Low intake of folic acid and a high consanguinity rate were the most common associated risk factors for congenital anomalies. These risk factors may be reduced by creating awareness regarding the avoidance of consanguineous marriage and promoting the use of folic acid during pregnancy.

  20. Maternal vaginal microflora during pregnancy and the risk of asthma hospitalization and use of antiasthma medication in early childhood

    DEFF Research Database (Denmark)

    Benn, Christine Stabell; Thorsen, Poul; Jensen, Jørgen Skov;

    2002-01-01

    BACKGROUND: Infants with wheezing and allergic diseases have a microflora that differs from that of healthy infants. The fetus acquires microorganisms during birth when exposed to the maternal vaginal microflora. It is therefore conceivable that the maternal vaginal microflora might influence...... the establishment of the infant flora and, as a consequence, the development of wheezing and allergic diseases. OBJECTIVE: We sought to study the associations between the composition of the maternal vaginal microflora and the development of wheezing and asthma in childhood. METHODS: We performed a population....... Maternal colonization with staphylococci (OR, 2.2; 95% CI, 1.4-3.4) and use of antibiotics in pregnancy (OR, 1.7; 95% CI, 1.1-2.6) were associated with asthma during the fifth year of life. CONCLUSION: The composition of the maternal vaginal micro-flora might be associated with wheezing and asthma...

  1. Comparing the odds of postpartum haemorrhage in planned home birth against planned hospital birth: results of an observational study of over 500,000 maternities in the UK

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    Nove Andrea

    2012-11-01

    Full Text Available Abstract Background The aim of this study is to compare the odds of postpartum haemorrhage among women who opt for home birth against the odds of postpartum haemorrhage for those who plan a hospital birth. It is an observational study involving secondary analysis of maternity records, using binary logistic regression modelling. The data relate to pregnancies that received maternity care from one of fifteen hospitals in the former North West Thames Regional Health Authority Area in England, and which resulted in a live or stillbirth in the years 1988–2000 inclusive, excluding ‘high-risk’ pregnancies, unplanned home births, pre-term births, elective Caesareans and medical inductions. Results Even after adjustment for known confounders such as parity, the odds of postpartum haemorrhage (≥1000ml of blood lost are significantly higher if a hospital birth is intended than if a home birth is intended (odds ratio 2.5, 95% confidence interval 1.7 to 3.8. The ‘home birth’ group included women who were transferred to hospital during labour or shortly after birth. Conclusions Women and their partners should be advised that the risk of PPH is higher among births planned to take place in hospital compared to births planned to take place at home, but that further research is needed to understand (a whether the same pattern applies to the more life-threatening categories of PPH, and (b why hospital birth is associated with increased odds of PPH. If it is due to the way in which labour is managed in hospital, changes should be made to practices which compromise the safety of labouring women.

  2. The struggle for inter-professional teamwork and collaboration in maternity care: Austrian health professionals' perspectives on the implementation of the Baby-Friendly Hospital Initiative.

    Science.gov (United States)

    Wieczorek, Christina C; Marent, Benjamin; Dorner, Thomas E; Dür, Wolfgang

    2016-03-14

    The health benefits of breastfeeding for mothers and babies are well documented in the scientific literature. Research suggests that support of breastfeeding during pre- and postnatal maternity care is an important determinant of breastfeeding initiation and duration. To support and promote breastfeeding on maternity units, the Baby-Friendly Hospital Initiative (BFHI) was launched in 1991. In Austria, however, less than one fifth of hospitals with a maternity unit are currently BFHI-certified. Implementation of BFHI and adjunct changes in work practices seem to represent a major challenge to maternity units. This article builds upon previous research that has identified a number of facilitators of and barriers to BFHI implementation in Austria. A major barrier has been the lack of intra- and inter-professional collaboration. Therefore, this article investigates the ways in which different healthcare professionals struggle to work together to successfully integrate the BFHI into practice. In this study, a qualitative research approach was used. Thirty-six semi-structured interviews with 11 midwives, 11 nurses, 13 physicians, and one quality manager, working across three maternity units, were interviewed on-site. Data analysis followed thematic analysis. Midwives, nurses, and physicians had diverse approaches to childbirth and breastfeeding (medicalization vs. naturalness) and worked along different jurisdictions that became manifest in strict spatial divisions of maternity units. In their engagement within the BFHI, midwives, nurses, and physicians pursued different strategies (safeguarding vs. circumvention strategies). These differences hindered inter-professional teamwork and collaboration and, therefore, the integration of BFHI into practice. Differing approaches to childbirth and breastfeeding, deep seated professional jurisdictions, as well as spatial constraints, challenge inter-professional teamwork and collaboration on maternity units. Inter

  3. A RETROSPECTIVE AND PROSPECTIVE STUDY OF MATERNAL MORTALITY IN A RURAL TERTIARY CARE HOSPITAL OF CENTRAL INDIA

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    Kalpana Yadav

    2013-05-01

    Full Text Available Objectives: The aim of present study was maternal death audit in rural tertiary care centre, GMH Rewa, to find out avoidable/unavoidable factors in each death and use information thus generated to reduce maternal mortality. Methods: Medical records of all maternal deaths occurring over a period of 4 years between Jan 2006 to Oct. 2009 were reviewed and from Nov. 2009 to Dec. 2010 all maternal deaths were followed and studied in details in respect to maternal age, parity, booking status, delivery status, residence, referral, socioeconomic class, admission death interval and cause of death. Results: Maternal mortality ratio ranged between 426 to 641/1,00,000 births in the study period. The causes of death were haemorrhage (31.9%, toxaemia (24.4%, anemia (14.94%, sepsis (9.27%, embolism (7.2%, jaundice (5.72% and other indirect causes (6.15%. Maximum of deaths (77.6% occurred in women between 20-29 years of age, multigravida had Maternal mortality ratio of 56.71%. 72.16% cases were postnatal cases, 94.32% were unbooked, 50.0% were referred cases & 88.65% cases were from rural areas. Conclusion: Overall maternal mortality was 555.5/1,00,000 live births. Maternal deaths due to direct obstetric causes were 73.19% and indirect obstetrics deaths 26.81%. The causes of potentially preventable deaths includes death due to anemia, sepsis, Disseminated Intravascular Coagulation, anaesthesia complications and non-availability of ICU bed and accounted for 40% of all deaths.

  4. Maternal Satisfaction about Prenatal and Postnatal Cares in Vaginal and Cesarean Section Delivery at Teaching and Non- teaching Hospitals of Tabriz/ Iran

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    Somayyeh Naghizadeh

    2014-02-01

    Full Text Available Objectives: The main goal of care services is provide and promote mankind's health. Patient satisfaction is recognized as an important parameter for assessing the quality of patient care services. Spatially mothers' satisfaction from delivery is very important because it influence on family and society psychological health. The aim of this study was comparing maternal satisfaction about prenatal and postnatal cares in vaginal and cesarean section delivery at teaching and nonteaching hospitals of Tabriz/ Iran. Materials and Methods: This is a descriptive-comparative study. We selected 454 women who had been hospitalized for delivery in Alzahra, Talegani (teaching and 29Bahman (nonteaching Tabriz/Iran hospitals. For data collection, we used a questionnaire. Spss/ver13, Descriptive statistic, Independent t test, ANOVA and correlation tests were used for data analysis. Results: Findings indicated the highest level of satisfaction in both kind of hospitals was about physical and the lowest one was about informational aspect in women who had vaginal delivery, accordingly these rates about cesarean section was about physical and about informational and emotional aspects in labor. The analysis of data showed significant difference between mothers' satisfaction with all aspects of care in the teaching and non- teaching hospitals (P < 0.001. Conclusion: The results showed that the highest rank from mothers' satisfaction was in the physical and the lowest rank was in informational category. Mothers were satisfied from vaginal delivery in all aspects. Rate of satisfaction in nonteaching were more than teaching hospitals.

  5. Thoughts about group construction of maternal and child health hospitals%妇幼保健院集团化建设的思考

    Institute of Scientific and Technical Information of China (English)

    胡祖斌

    2012-01-01

    我国医疗保健市场竞争日趋激烈,妇幼保健机构面临双重压力的考验:一方面其本身存在着投资少、规模小、设备落后、人才技术缺乏、先天禀赋不足的问题;另一方面医疗机构的迅猛发展和扩张,对市场空间的挤占,使得它更显得弱小和单薄.为了寻求生存和发展,适应市场的竞争,妇幼保健机构应该走集团化发展的道路.此研究分析了妇幼保健机构面临的形势,提出了走集团化发展道路的优势,并就如何推进妇幼保健机构集团化建设提出了设想.%The competition in medical health care market becomes fierce with each passing day, the maternal and child health institutions face double tests: On the one hand, they have the disadvantages of less investment, small scale, outdated facilities, a lack of talent and technology and inadequate congenital endowment; on the other hand, the rapid development and expansion of the medical institutions squeeze the market space and make the maternal and child health institutions seem more weaker and smaller. In order to seek for survival and development, the maternal and child health institutions should take the road of collectivization development to adapt to the market competition. The article analyzed the situation that the maternal and child health institutions faced, presented the advantages of collectivization development and proposed ideas of how to promote the collectivization construction of maternal and child health hospitals.

  6. Does Royal jelly affect tumor cells?

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    Shirzad Maryam

    2013-04-01

    Full Text Available Introduction: Royal jelly is a substance that appears to be effective on immune system and it appears to be effective on both prevention and growth of cancer cells. In this study, we aimed to carry out a research to investigate the effect of royal jelly on the growth of WEHI-164 fibrosarcoma cell in syngenic Balb/c mice. Methods: In an experimental study, 28 male Balb/c mice were designated into four equal groups. The mice were subcutaneously injected with 5x105 WEHI-164 tumor cells on the day zero in the chest area of the animal. Animals in groups 1 to 4 were orally given 100, 200, 300 mg/kg of royal jelly or vehicle, respectively. In every individual mouse, the tumour size was measured every 2 days from day 5 (days 5, 7, 9, 11, 13, 15 and 17. Data were statistically analyzed using Kruskal-Wallis and Mann Whitney-U tests. Result: Our results showed that the mean size of tumor in case group was significantly smaller than the control group in days 11, 13, 15 and 17 (P<0.05. No metastasis was seen in test and control groups. Conclusion: With emphasize on antitumor effect of royal jelly, it seems that royal jelly has important role in control and regression of fibrosarcoma cells. Since royal jelly showed a delayed effect in control of fibrosarcoma, we suggest that royal jelly be used at least 10 days before tumor inoculation.

  7. An audit of obstetric admissions to intensive care unit in a medical college hospital of central India: lessons in preventing maternal morbidity and mortality

    Directory of Open Access Journals (Sweden)

    Manisha Jain

    2015-02-01

    Full Text Available Background: The spectrum of causes leading to maternal morbidity and mortality may be well reflected in the clinical profile of obstetric patients admitted to the Intensive Care Unit (ICU. An audit of these patients may help in devising intervention strategies and implementing preventive measures. This is expected to contribute to the ongoing concerted multipronged efforts towards reducing maternal mortality as a step towards the millennium development goals. The aim was to study the clinical and demographic profile of antenatal and postpartum women requiring admission to the ICU, the interventions required in these women and the final outcome. The overall goal is to identify the contributing factors towards maternal morbidity and mortality. Methods: A retrospective analysis of hospital records of all antenatal, post-abortal and postpartum women admitted to the ICU at People's hospital, Bhopal over a period of 3 years (June 2011 to May 2014. Results: A total of 157 records were identified and analyzed: 22 (14% antenatal, seven (4% post-abortion, 114 (73% postpartum, and 14(9% post-laparotomy women. The mean age was 25 years (Range 18-38 years; SD 4.49, two thirds being from rural areas. Majority (78% had no earlier visit. The gestational age at admission to ICU ranged from 6-43 weeks (Mean 31 weeks; SD 9.06. One third (24% of patients had severe anemia, 18 patients needed ventilation, 25 required inotropic support, 4 required dialysis and 17 underwent surgical intervention. Blood or blood component therapy was needed in 60% cases with total blood units transfused being 225. The average duration of stay in intensive care unit was 79 hours. Analyzing as organ-system dysfunctions: Cardiovascular dysfunction (22%, hematological (20%, hepatic (16%, neurological (11%, septicemia (11%, renal (9%. There were 19 maternal deaths. Conclusions: Maternal anemia and consequences still contribute significantly to maternal morbidity. Non-utilization of

  8. Are Women of East Kazakhstan Satisfied with the Quality of Maternity Care? Implementing the WHO Tool to Assess the Quality of Hospital Services

    Science.gov (United States)

    DAULETYAROVA, Marzhan; SEMENOVA, Yuliya; KAYLUBAEVA, Galiya; MANABAEVA, Gulshat; KHISMETOVA, Zayituna; AKILZHANOVA, Zhansulu; TUSSUPKALIEV, Akylbek; ORAZGALIYEVA, Zhazira

    2016-01-01

    Background: To evaluate the satisfaction of mothers with the quality of care provided by maternity institutions in East Kazakhstan on the basis of the “Quality of hospital Care for mothers and newborn babies, assessment tool” (WHO, 2009). Methods: This cross-sectional study took place in 2013 and covered five maternity hospitals in East Kazakhstan (one referral, two urban and two rural). To obtain information, interviews with 872 patients were conducted. The standard tool covered 12 areas ranging from pregnancy to childcare. A score was assigned to each area of care (from 0 to 3). The assessment provided the semi-quantitative data on the quality of hospital care for women and newborns from the perception of mothers. Results: The average satisfaction score was 2.48 with a range from 2.2 to 2.7. The mean age of women was 27.4 yr. Forty-two percent were primiparas. Mean birth weight was 3455.4 g. All infants had ‘skin to skin’ contact with their mothers immediately after birth. Mean number of antenatal visits to family clinics was 8.6. Only 42.1% of the respondents used contraceptives while the rest were not aware of contraception, never applied it and could not distinguish between different methods and devices. Conclusion: The quality of care was substandard in all institutions. To improve the quality of care, WHO technologies in perinatal care could be applied. PMID:27648415

  9. A STUDY ON BREAST FEEDING PRACTICES AMONG POST- NA TAL MOTHERS ATTENDING GOVT MATERNITY HOSPITAL AT HYDE RABAD, ANDHRA PRADESH

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    Bhavani

    2013-05-01

    Full Text Available ABSTRACT: BACKGROUND: Breast feeding plays an essential and sometimes underestimate role in the treatment and prevention of infant and chi ldhood illness. Improving breast feeding is a highly feasible and cost effective approach to redu cing the number of infant who die from infectious disease and malnutrition early in their lives. Cont inuing to breastfeed alone could save 1 to 1.5 million lives a year. Well over 40% of 10.9 million deaths annually occur due to inappropriate feeding practices , during the 1 st year of life. Lack of breast feeding and especia lly exclusive breast feeding during the 1 st year of life are important risk factors for infant and child hood morbidity and mortality that are only compounded by inappropriat e complementary feeding . Current evidence that Breast feeding is beneficial for infant and ch ild health is based on exclusive observational studies. The experimental intervention increased th e duration and degree of breast feeding. These results provide a solid scientific under planning f or future interventions to promote Breast feeding. Breast feeding practices appear to be ineffective e ven in institutions due to lack of knowledge of importance of breast milk , colostrums, and pre-lac teal feeds. In the present study an effort is made to assess the knowledge of breast feeding practices am ong post natal women and mothers attending immunization clinic . OBJECTIVES: To study the sociodemografic factors influence on breast feeding behavior of post natal mothers and to study the awa reness of benefits of colostrums, and effect of media on breast feeding practices. MATERIALS AND METHODS : The present study is a cross- sectional, Descriptive Hospital based ,conducted i n the post natal ward at Govt Maternity Hospital, sultan Bazar, Hyderabad, A.P., participants are the Mothers who have delivered within 3days of interview, and the Mothers attending immunization c linic , having children below 1 year of age . sample

  10. Biological Activities of Royal Jelly - Review

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    Crenguţa I. Pavel

    2011-10-01

    Full Text Available Royal jelly is a secretion product of the cephalic glands of nurse bees that has been used for centuries for itsextraordinary properties and health effects. This bibliographic study aims to review many of the scientific findingsand research that prove many of the remarkable various actions, effects and some uses of royal jelly. There are takeninto consideration numerous biological properties and effects of royal jelly: antioxidant, neurotrophic, hipoglicemiant, hipocholesterolemiant and hepatoprotective, hypotensive and blood pressure regulatory, antitumor, antibiotic, anti-inflammatory, immunomodulatory and anti-allergic, general tonic and antiaging. Royal jelly is one ofthe most studied bee products, but there still remains much to reveal about its biochemistry and biological activity infuture research for our health and life benefit.

  11. Delay in the provision of adequate care to women who died from abortion-related complications in the principal maternity hospital of Gabon.

    Science.gov (United States)

    Mayi-Tsonga, Sosthene; Oksana, Litochenko; Ndombi, Isabelle; Diallo, Thierno; de Sousa, Maria Helena; Faúndes, Aníbal

    2009-11-01

    Deaths resulting from unsafe induced abortions represent a major component of maternal mortality in countries with restrictive abortion laws. Delays in obtaining care for maternal complications constitute a known determinant of a woman's risk of death. However, data on the role of delays in providing care at health care facilities are sparse. The association between the cause of maternal death (abortion versus post-partum haemorrhage or eclampsia) and the time interval between admission to hospital and the initiation of treatment were evaluated among women who died at the Maternité du Centre Hospitalier de Libreville, Gabon, between 1 January 2005 and 31 December 2007. The women's characteristics and the time between diagnosis of the condition that led to death and the initiation of treatment were compared for each cause of death. After controlling for selected variables, the mean time between admission and treatment was 1.2 hours (95% CI: 0.0-5.6) in the case of women who died from post-partum haemorrhage or eclampsia and 23.7 hours (95% CI: 21.1-26.3) in the case of women who died of abortion-related complications. In conclusion, delay in initiating care was far greater in cases of women with complications of unsafe abortion compared to other pregnancy-related complications. Such delays may constitute an important determinant of the risk of death in women with abortion-related complications.

  12. Syphilis serology in pregnancy: an eight-year study (2005-2012) in a large teaching maternity hospital in Dublin, Ireland.

    Science.gov (United States)

    McGettrick, Padraig; Ferguson, Wendy; Jackson, Valerie; Eogan, Maeve; Lawless, Mairead; Ciprike, Vaneta; Varughese, Alan; Coulter-Smith, Sam; Lambert, John S

    2016-03-01

    All cases of positive syphilis serology detected in antenatal and peripartum screening in a large teaching maternity hospital in inner city Dublin, Ireland over an eight-year period (2005-2012 inclusive) were reviewed and included in our study. Demographic, antenatal registration, laboratory (including co-infections), partner serology, treatment and delivery data were recorded in our database. Infant follow-up, treatment and outcome data were also collected. During this period, 194 women had positive syphilis serology, of which 182 completed their pregnancies at the institution. This accounts for 0.28% of the total number of women completing their pregnancies during this time (N = 66038); 79 had no previous diagnosis of infection. There was one case of re-infection during pregnancy. Thirty-two women were co-infected with human immunodeficiency virus, hepatitis B or hepatitis C. There was one case suggestive of congenital syphilis infection. Our study is a comprehensive analysis of the diagnosis, management and clinical outcomes of women testing positive for syphilis infection in pregnancy. It reveals the relatively high prevalence of syphilis infection in the population utilising the maternity services in north inner-city Dublin. It re-enforces the importance of continued active surveillance to prevent morbidity and mortality associated with maternal syphilis infection. It also highlights the importance of strategies such as re-testing high-risk groups and definitive screening of spouse serology.

  13. Hospitals

    Data.gov (United States)

    Department of Homeland Security — This database contains locations of Hospitals for 50 states and Washington D.C. , Puerto Rico and US territories. The dataset only includes hospital facilities and...

  14. A 10-year appraisal of cesarean delivery and the associated fetal and maternal outcomes at a teaching hospital in southeast Nigeria

    Directory of Open Access Journals (Sweden)

    Onoh RC

    2015-05-01

    Full Text Available Robinson Chukwudi Onoh,1 Justus Ndulue Eze,2 Paul Olisaemeka Ezeonu,1 Lucky Osaheni Lawani,1 Chukwuemeka Anthony Iyoke,3 Peter Onubiwe Nkwo3 1Department of Obstetrics and Gynaecology, Federal Teaching Hospital Abakaliki, Abakaliki, 2Department of Obstetrics and Gynaecology, College of Health Sciences, Ebonyi State University, Abakaliki, 3Department of Obstetrics and Gynaecology, University of Nigeria Teaching Hospital, Enugu, Nigeria Background: The global rise in cesarean delivery rate has been a major source of public health concern. Aim: To appraise the cesarean deliveries and the associated fetal and maternal outcomes. Materials and methods: The study was a case series with data collected retrospectively from the records of patients delivered by cesarean section at the Ebonyi State University Teaching Hospital, Abakaliki over a 10-year period, from January 2002 to December 2011. Ethical approval was obtained. Results: Of 14,198 deliveries, 2,323/14,198 (16.4% were by cesarean deliveries. The overall increase of cesarean delivery was 11.1/10 (1.1% per annum from 184/1,512 (12.2% in 2002 to 230/986 (23.3% in 2011. Of 2,097 case folders studied, 1,742/2,097 (83.1% were delivered at term, and in 1,576/2,097 (75.2%, the cesarean deliveries were emergencies. The common indications for cesarean delivery were previous cesarean scars 417/2,097 (19.9% and obstructed labor 331/2,097 (15.8%. There were 296 perinatal deaths, giving a perinatal mortality rate of (296/2,197 134.7/1,000 births. Also, 129/2,097 (6.1% maternal case fatalities occurred, giving a maternal mortality rate of 908.6/100,000 total births. Hemorrhage 57/129 (44.2% and sepsis 41/129 (32.6% were the major causes. Conclusion: The study recorded a significant increase in cesarean delivery rate. Previous cesarean scars and obstructed labors were the main indications. Perinatal and maternal case fatalities were huge. Hence, there is need for continued community education for its reduction

  15. A comparative study of feto-maternal outcome in instrumental vaginal delivery at tertiary health level hospital in Uttarakhand state

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    Priyanka Chaudhari

    2016-10-01

    Conclusions: Ventouse should be preferred over forceps whenever there is an indication for instrumental delivery (except in fetal distress as it is associated with less maternal trauma and most of the neonatal morbidities were insignificant in comparison with both instruments. [Int J Reprod Contracept Obstet Gynecol 2016; 5(10.000: 3294-3299

  16. Emergency and elective caesarean sections: comparison of maternal and fetal outcomes in a suburban tertiary care hospital in Puducherry

    Directory of Open Access Journals (Sweden)

    Valsa Diana

    2016-09-01

    Conclusions: It was inferred that both elective and emergency caesarean imposes certain complications to the mother and the fetes. However, maternal and fetal complications were felt very high in emergency caesarean than elective. Proper planning can help obstetric practitioners to avoid complications. [Int J Reprod Contracept Obstet Gynecol 2016; 5(9.000: 3060-3065

  17. Antibody formation in pregnant women with maternal-neonatal human platelet antigen mismatch from a hospital in northern Taiwan.

    Science.gov (United States)

    Yang, Wan-Hua; Cheng, Chuen-Sheng; Chang, Jin-Biou; Liu, Kuang-Ting; Chang, Junn-Liang

    2014-01-01

    Neonatal alloimmune thrombocytopenia (NAIT) is a clinical syndrome that resembles hemolytic disease of the newborn, affecting the platelets only. The thrombocytopenia results from the maternal alloantibodies reacting with specific human platelet antigens (HPAs) on the fetal platelets. Forty-four maternal plasma samples were screened for platelet alloantibodies using qualitative solid phase enzyme-linked immunosorbent assay (ELISA) commercial kit (LIFECODES Pakplus, Hologic Gen-Probe GTI Diagnostics, Waukesha, WI, USA), and both the maternal and the corresponding cord blood samples were genotyped (LIFECODES ThromboType, Hologic Gen-Probe GTI Diagnostics, Waukesha, WI, USA). HPA genotyping results correlated with the genetic frequencies in the Taiwan population. A total of 34 newborns (77.3%) had partial HPA genotyping mismatches with the corresponding mothers. The most common partial mismatches between mothers and neonates in HPA genotypes were 13 (29.5%) in both HPA-3b and HPA-15a, followed by 12 (27.3%) in HPA-15b, and 8 (18.2%) in HPA-3a. The frequencies of homozygotic mother with heterozygotic neonate were 15.9% in both HPA-3a and HPA-15b, 9.1% in HPA-15a, 6.8% in HPA-3b, and 2.3% in both HPA-2a and HPA-6a. In this study, maternal HPA antibodies were found in five samples, whereas HLA class I antibodies were found in seven maternal plasma samples from the antibody screen. The results from this study have demonstrated that HPA mismatch is not the main cause for the production of HPA alloantibodies.

  18. Lessons from the confidential enquiry into maternal deaths, Malaysia.

    Science.gov (United States)

    Ravichandran, J; Ravindran, J

    2014-09-01

    Malaysia has successfully reduced maternal mortality through several efforts which, in the broad sense, include (i) the overall socio-economic development of the country; (ii) strengthened health services; and (iii) specific efforts and initiatives for the reduction of maternal mortality, one of which is the audit of maternal deaths by the confidential enquiry into maternal deaths. © 2014 Royal College of Obstetricians and Gynaecologists.

  19. Morbidade materna grave em um hospital universitário de referência municipal em Campinas, Estado de São Paulo Severe maternal morbidity at a local reference university hospital in Campinas, São Paulo, Brazil

    Directory of Open Access Journals (Sweden)

    Adriana Gomes Luz

    2008-06-01

    Full Text Available OBJETIVO: avaliar a prevalência e os fatores de risco associados à morbidade materna grave numa maternidade terciária. MÉTODOS: trata-se de um estudo de corte transversal dos casos de morbidade materna grave atendidos no Hospital e Maternidade Celso Pierro entre outubro de 2005 e julho de 2006, identificados a partir dos livros de controle das unidades de internação, pronto atendimento e centro obstétrico. Foram estudadas gestantes e puérperas que apresentavam condições definidoras de morbidade materna grave a partir dos diagnósticos clínicos segundo critérios propostos por Waterstone. Posteriormente, os casos de maior gravidade clínica, chamados de morbidade extremamente grave, foram reclassificados utilizando-se os critérios definidores de Mantel, baseados em disfunção orgânica e manejo. RESULTADOS: foram identificadas 114 mulheres com morbidade materna grave entre 2.207 partos, com razão de outra morbidade grave e morbidade extremamente grave de 44,9 e 6,8 casos por 1.000 partos, respectivamente. A média da idade gestacional no parto foi de 35 semanas e 87% das mulheres vieram de área de cobertura da maternidade no município. A hipertensão (pré-eclâmpsia grave representou 96% de outras morbidades graves e a hemorragia esteve presente em 60% dos casos de morbidade extremamente grave, seguida de hipertensão. A prevalência de morbidade extremamente grave entre os casos de morbidade grave não se associou com estado marital, escolaridade, idade materna, tipo de parto, gestações, idade gestacional e distrito de saúde de moradia. CONCLUSÕES: as outras morbidades graves foram 6,6 vezes mais freqüentes que os casos extremamente graves, sem diferenças entre os grupos por fatores de risco epidemiológicos.PURPOSE: to assess the prevalence and risk factors associated with near miss and other severe maternal morbidity at a reference tertiary maternity. METHODS: this is a cross-sectional study on severe maternal morbidity

  20. [Women's complaint leadership in the Causa Kleinwächter. A contribution to patient history of the Innsbruck maternity hospital].

    Science.gov (United States)

    Hilber, Marina

    On the basis of the Innsbruck Maternity Clinic this paper deals with the individual and collective worlds of experience of obstetric patients. However, not only the patient's view on the proceedings in this specific medical space is being reconstructed, also the prevailing conventions surrounding the treatment of pregnant, parturient and puerperal patients serving as clinical material in obstetric research and education are critically scrutinised. At the centre of this paper stands Dr. Ludwig Kleinwächter's period of duty, who acted as professor for obstetrics and gynaecology in Innsbruck between 1877 and 1881. During this period numerous conflicts regarding the treatment of patients are documented. Concerned about the good reputation of the Maternity Clinic, the Tyrolean State Committee, as the Clinic's provider, tried to solve the crisis. The existing letters of complaint and protocols do not only give a voice to the women concerned, but also to the medical professions as well as the local political representatives involved.

  1. Intrahepatic cholestasis of pregnancy: diagnosis and management; a survey of Royal Australian and New Zealand College of Obstetrics and Gynaecology fellows.

    Science.gov (United States)

    Arthur, Chris; Mahomed, Kassam

    2014-06-01

    Intrahepatic cholestasis of pregnancy (ICP) is an uncommon obstetric condition characterised by intense maternal pruritis and biochemical abnormality. There is a degree of contention regarding the diagnosis and management of ICP, and currently, there are no nationally accepted guidelines. To conduct a survey of Fellows and Members of the Royal Australian and New Zealand College of Obstetricians and Gynaecologists (RANZCOG) regarding their diagnosis and management ICP. An online survey of currently practising RANZCOG Fellows and Members, utilising Survey Monkey. Thirty percent of those sent the survey responded, comprising approximately 40% of practising obstetricians. Fasting bile acid and serum transaminase elevation in association with the characteristic itch define the disease process for the majority of respondents and also inform management decisions. There was no critical level of bile acid elevation that mandated treatment for the majority of respondents. Nearly 90% of respondents induce women with ICP at 37-38 completed weeks of pregnancy, due to concerns regarding possible fetal demise. About one-third of respondents refer to the Royal College of Obstetricians and Gynaecologists (RCOG) Green-top Guideline to advise their decision-making process, and a similar proportion use local or hospital-based guidelines. Elevated fasting bile acids and abnormal liver function tests define the diagnosis and inform management of ICP by Australian obstetricians. Routine induction of labour for patients with ICP at 37-38 completed weeks of pregnancy is widely practised in Australia. An evidence-based guideline would assist clinicians who manage such cases in Australia. © 2014 The Royal Australian and New Zealand College of Obstetricians and Gynaecologists.

  2. Quality Parameters for Commercial Royal Jelly

    Directory of Open Access Journals (Sweden)

    Carmen Ioana Muresan

    2016-01-01

    Full Text Available Royal jelly has become a high-value commercial product and the standardization of this product is required to guarantee its quality on the market. The objective of the research activity was to pursue the chemical composition of commercial samples of Royal Jelly in Romania in order to propose standardization for this product. The physico-chemical composition of commercial Royal Jelly samples was analysed by determining quality parameters like: carbohydrates, lipids, proteins, 10-hydroxy-2-decenoic acid (10-HDA and mineral elements. Carbohydrates analysis showed values between 3.4 % and 5.87 % for fructose, 4.12 % and 7.05 % for glucose, while for sucrose the values ranged between 0.95 % and 2.56 % (determined by HPLC-RI. The lipids content ranged between 1.85 % and 6.32 % (determined by the Soxhlet method. The protein values extended from 13.10 % (RJ2 to 17.04 % (RJ10 (the total protein content was determined by the Kjeldahl method. The values for the major fatty acid in Royal Jelly, 10-HDA, ranged between 1.35 % (RJ8 and 2.03 % (RJ10 (determined by high-performance liquid chromatography. The concentration of minerals varied between 3188.70 mg/kg and 4023.39 mg/kg (the concentration of minerals was measured using flame atomic absorption spectrometry. Potassium, followed by magnesium, sodium and calcium, occurs in the highest concentrations. The commercial Royal Jelly samples analysed presented variable physico-chemical characteristics that correspond with the values given by international quality standard proposals for Royal Jelly.

  3. Qualidade da atenção ao parto em maternidades do Rio de Janeiro Quality of birth care in maternity hospitals of Rio de Janeiro, Brazil

    Directory of Open Access Journals (Sweden)

    Eleonora d'Orsi

    2005-08-01

    -control study was carried out in a public and a private maternity hospitals contracted by the Brazilian Health System in the city of Rio de Janeiro, Brazil, from October 1998 to March 1999. The sample comprised 461 women in the public maternity hospital (230 vaginal deliveries and 231 Cesarean sections and 448 women in the private one (224 vaginal deliveries and 224 Cesarean sections. Data was collected through interviews with puerperal women and review of medical records. A summarization score of quality of delivery care was constructed. RESULTS: There was low frequency of practices that should be encouraged, such as having an accompanying person (1% in the private hospital for both vaginal delivery and C-sections, freedom of movements throughout labor (9.6% of C-sections in the public hospital and 9.9% of vaginal deliveries in the private hospital and breastfeeding in the delivery room (6.9% of C-sections in the public hospital and 8.0% of C-sections in the private hospital. There was a high frequency of known harmful practices such as enema administration (38.4%; routine pubic shaving; routine intravenous infusion (88.8%; routine use of oxytocin (64.4%, strict bed rest throughout labor (90.1% and routine supine position in labor (98.7% in vaginal deliveries. The best summarizing scores were seen in the public maternity hospital. CONCLUSIONS: The two maternity hospitals have a high frequency of interventions during birth care. In spite of providing care to higher risk pregnant women, the public maternity hospital has a less interventionist profile than the private one. Procedures carried out on a routine basis should be pondered based on evidence of their benefits.

  4. Predictors of maternal mortality in institutional deliveries in Nigeria

    African Journals Online (AJOL)

    Administrator

    7. Hospital Services Management Board, Katsina, Nigeria. 8. Department of Obstetrics & Gynaecology, ... Key words: maternal mortality; maternal death; predictors .... instrumental delivery, symphysiotomy, or assisted ..... For this reason,.

  5. Maternal and fetal outcome among abruptio placentae cases at a rural tertiary hospital in Karnataka, India: a retrospective analysis

    Directory of Open Access Journals (Sweden)

    Vartika Shrivastava

    2014-08-01

    Conclusion: In our setup, frequency of abruptio placenta is comparable with local and international literature. Abruptio placenta is associated with high rate of maternal and fetal morbidity and mortality, Because of this association, the conditions predisposing it should be carefully evaluated in order to reduce the occurrence of placental abruption. Unfortunately neither accurate prediction nor prevention of abruption is possible at the present time. Despite advances in medical technology, the diagnosis of abruption is still a clinical one. [Int J Res Med Sci 2014; 2(4.000: 1655-1658

  6. ‘All Touched my Hand’: Queenly Sentiment and Royal Prerogative

    Directory of Open Access Journals (Sweden)

    Rachel Bates

    2015-05-01

    Full Text Available The Crimean War occurred during a formative period of ‘civic publicness’, a term used by John Plunkett to describe the press-mediated public duties undertaken by Victoria and Albert to affirm the monarchy’s popular constitution. The war triggered significant royal intervention into the condition of the army, one of the few sites of royal prerogative. At a time when aristocratic governance was being attacked and the privations of soldiers exposed to an unprecedented extent, the monarchy was keen both to legitimize its role as head of the army and to demonstrate its sensitivity to popular concern for the suffering of ordinary soldiers. This manifested in a highly publicized leaked letter from the Queen expressing her regard for ‘her troops’, the royal family’s visits to wounded soldiers, and the distribution of the Crimean Medal at a special ceremony, which portrayed the accessibility of the Queen through the use of touch. This article explores the symbolism and impetus of these occurrences and assesses the reception of royal intervention in the press. The few assessments of royal influence during the Crimean War have focused largely on Victoria’s personal fascination with the progress of the war and her soldiers. This article explores instead the wider, political significance of the army as extension of the royal family. The Liberal press and artists responded favourably to demonstrations of the Queen’s maternal sympathy for the troops, but my article will point to a hidden struggle to assert the Crown’s authority. Normal 0 false false false EN-GB X-NONE X-NONE

  7. hospital

    African Journals Online (AJOL)

    Pattern of congenital orthopaedic malformations in an African teaching hospital ... malformation in this environment while congenital hip dislocation (CDH) is rare when .... malformations of radial dysplasia and other congenital malformations.

  8. Margaret Cavendish and the Royal Society

    Science.gov (United States)

    Wilkins, Emma

    2014-01-01

    It is often claimed that Margaret Cavendish was an anti-experimentalist who was deeply hostile to the activities of the early Royal Society—particularly in relation to Robert Hooke's experiments with microscopes. Some scholars have argued that her views were odd or even childish, while others have claimed that they were shaped by her gender-based status as a scientific ‘outsider’. In this paper I examine Cavendish's views in contemporary context, arguing that her relationship with the Royal Society was more nuanced than previous accounts have suggested. This contextualized approach reveals two points: first, that Cavendish's views were not isolated or odd when compared with those of her contemporaries, and second, that the early Royal Society was less intellectually homogeneous than is sometimes thought. I also show that, although hostile to some aspects of experimentalism, Cavendish nevertheless shared many of the Royal Society's ambitions for natural philosophy, especially in relation to its usefulness and the importance of plain language as a means to disseminate new ideas. PMID:25254278

  9. Royal Ahold: A Failure Of Corporate Governance

    NARCIS (Netherlands)

    A. de Jong (Abe); D.V. DeJong; G.M.H. Mertens (Gerard); P.G.J. Roosenboom (Peter)

    2005-01-01

    textabstractRoyal Ahold (Koninklijke Ahold NV) was one of the major success stories in the 1990s and is one of the major failures in corporate governance, suffering a complete meltdown in 2003. This clinical study analyzes Ahold’s growth strategy through acquisitions and isolates the cause of the fa

  10. Royal Naval nursing: 'testing but worth it'.

    Science.gov (United States)

    Moore, Alison

    2014-08-19

    Inga Kennedy is the most senior nurse in the Royal Navy. She enjoys the commitment and discipline required by a career in the armed forces and says the work offers great opportunities for nurses. Her career highlights have included checking that injured personnel in Afghanistan were receiving the best care possible.

  11. Royal Ahold: A Failure Of Corporate Governance

    NARCIS (Netherlands)

    A. de Jong (Abe); D.V. DeJong; G.M.H. Mertens (Gerard); P.G.J. Roosenboom (Peter)

    2005-01-01

    textabstractRoyal Ahold (Koninklijke Ahold NV) was one of the major success stories in the 1990s and is one of the major failures in corporate governance, suffering a complete meltdown in 2003. This clinical study analyzes Ahold’s growth strategy through acquisitions and isolates the cause of the

  12. 'I used to fight with them but now I have stopped!': conflict and doctor-nurse anaesthetists' motivation in maternal and neonatal care provision in a specialist referral hospital

    NARCIS (Netherlands)

    Aberese-Ako, M.; Agyepong, I.A.; Gerrits, T.; van Dijk, H.

    2015-01-01

    Background and Objectives: This paper analyses why and how conflicts occur and their influence on doctors and nurse-anaesthetists' motivation in the provision of maternal and neonatal health care in a specialist hospital. Methodology: The study used ethnographic methods including participant observa

  13. Analysis on related factors of maternal death in Shengjing hospital in recent five years%盛京医院近5年孕产妇死亡相关因素分析

    Institute of Scientific and Technical Information of China (English)

    李秋玲; 刘彩霞; 胥数; 崔红; 那全

    2011-01-01

    目的:分析及探讨盛京医院孕产妇死亡的原因及影响因素,提高盛京医院产科质量,进一步降低孕产妇死亡率.方法:收集2004年1月~2008年12月盛京医院46例死亡孕产妇的临床资料,分析孕产妇死亡原因,了解孕产妇死亡的影响因素.结果:在盛京医院,妊娠合并内外科疾病是造成孕产妇死亡最主要的因素,导致孕产妇死亡的最终原因的前3位顺位是MODS、DIC、艾森曼格综合征,造成孕产妇死亡的前3位疾病顺位是先天性心脏病、妊娠期高血压疾病、产科出血.结论:加强社区和乡村孕产妇保健管理,加强各阶层产科医务人员业务素质,保证绿色通道的通畅,加强盛京医院产科与其他学科的共同协作,可明显降低孕产妇死亡率.%Objective: To analyze and explore the causes and effect factors of maternal death in Shengjing hospital, improve the quality of obstetric department, further reduce the maternal mortality. Methods: The clinical data of 46 dead pregnant women in Shengjing hospital from January 2004 to December 2008 were collected, the causes of maternal death were analyzed, the effect factors of maternal death was understood. Results: In Shengjing hospital, pregnancy combined with internal and surgical diseases was the most important factor of maternal death, the first three final reasons of maternal death were MODS, DIC and Eisenmenger syndrome, the first three diseases of maternal death were congenital heart disease, hypertensive disorder complicating pregnancy and obstetric hemorrhage. Conclusion: Enhancing maternal health care and management in communities and villages, strengthening the professional qualities of obstetrician at all levels, ensuring the patency of emergent medical services, reinforcing the cooperation between obstetric department and other departments in Shengjing hospital can reduce the maternal mortality obviously.

  14. Mobile in situ obstetric emergency simulation and teamwork training to improve maternal-fetal safety in hospitals.

    Science.gov (United States)

    Guise, Jeanne-Marie; Lowe, Nancy K; Deering, Shad; Lewis, Patricia O; O'Haire, Christen; Irwin, Lori K; Blaser, Molly; Wood, Laurie S; Kanki, Barbara G

    2010-10-01

    Evidence from other high-risk industries has demonstrated that teamwork skills can be taught and effective teamwork may improve safety. Increasingly, health care providers, hospital administrators, and quality and safety professionals are considering simulation as a strategy to improve quality and patient safety. A mobile obstetric emergency simulation and team training program was created to bring simulation technology and teamwork training used routinely in other high reliability fields directly to health care institutions. A mobile unit constituted a practical approach, given the expense of simulation equipment, the time required for staff to develop educational materials and simulation scenarios, and the need to have a standardized program to promote consistent evaluation across sites. Between 2007 and 2009, in situ simulation of obstetric emergencies and teamwork training was tested with more than 150 health care professionals in labor and delivery units across four rural and two community hospitals in Oregon. HOW DO ORGANIZATIONS DETERMINE WHICH TYPE OF SIMULATION IS BEST FOR THEM? Because simulation technologies are relatively costly to start and maintain, it can be challenging for hospitals and health care professionals to determine which format (send staff to a simulation center, develop in-house simulation program, develop a consortium of hospitals that run a simulation program, or use a mobile simulation program) is best for them. In situ simulation is an effective way to develop new skills, to maintain infrequently used clinical skills even among experienced clinical teams, and to uncover and address latent safety threats in the clinical setting.

  15. Summary of inaugural meeting of the Skin Care in Organ Recipients Group, UK, held at the Royal Society of Medicine, 7 October 2004.

    Science.gov (United States)

    Eedy, D J

    2005-07-01

    This summarizes a meeting held in London at the Royal Society of Medicine, which was brought together by Prof. Fenella Wojnarowska, Professor of Dermatology at Churchill Hospital, Oxford and cofounder of Skin Care in Organ Recipients, UK (SCOR.UK).

  16. The Royal Hospital Donnybrook, Morehampton Road, Donnybrook, Dublin 4.

    LENUS (Irish Health Repository)

    Spicer, Neil

    2011-07-13

    Abstract Background Despite massive scale up of funds from global health initiatives including the Global Fund to Fight AIDS, Tuberculosis and Malaria (Global Fund) and other donors, the ambitious target agreed by G8 leaders in 2005 in Gleneagles to achieve universal access to HIV\\/AIDS treatment by 2010 has not been reached. Significant barriers to access remain in former Soviet Union (FSU) countries, a region now recognised as a priority area by policymakers. There have been few empirical studies of access to HIV\\/AIDS services in FSU countries, resulting in limited understanding and implementation of accessible HIV\\/AIDS interventions. This paper explores the multiple access barriers to HIV\\/AIDS services experienced by a key risk group-injecting drug users (IDUs). Methods Semi-structured interviews were conducted in two FSU countries-Ukraine and Kyrgyzstan-with clients receiving Global Fund-supported services (Ukraine n = 118, Kyrgyzstan n = 84), service providers (Ukraine n = 138, Kyrgyzstan n = 58) and a purposive sample of national and subnational stakeholders (Ukraine n = 135, Kyrgyzstan n = 86). Systematic thematic analysis of these qualitative data was conducted by country teams, and a comparative synthesis of findings undertaken by the authors. Results Stigmatisation of HIV\\/AIDS and drug use was an important barrier to IDUs accessing HIV\\/AIDS services in both countries. Other connected barriers included: criminalisation of drug use; discriminatory practices among government service providers; limited knowledge of HIV\\/AIDS, services and entitlements; shortages of commodities and human resources; and organisational, economic and geographical barriers. Conclusions Approaches to thinking about universal access frequently assume increased availability of services means increased accessibility of services. Our study demonstrates that while there is greater availability of HIV\\/AIDS services in Ukraine and Kyrgyzstan, this does not equate with greater accessibility because of multiple, complex, and interrelated barriers to HIV\\/AIDS service utilisation at the service delivery level. Factors external to, as well as within, the health sector are key to understanding the access deficit in the FSU where low or concentrated HIV\\/AIDS epidemics are prevalent. Funders of HIV\\/AIDS programmes need to consider how best to tackle key structural and systemic drivers of access including prohibitionist legislation on drugs use, limited transparency and low staff salaries within the health sector.

  17. [The Royal Chemistry Laboratory (1694-1700)].

    Science.gov (United States)

    del Mar Rey Bueno, M; Alegre Pérez, M E

    1996-01-01

    One of the most interesting events of the trasformation of science in Spain toward the end of the XVII century was the foundation of the Royal Chemistry Laboratory. This institution, brillantly promoted by the physician Dionisio de Cardona, was condemned to failure from the very beginning, due to the opposition of the Protomedicato and the royal apothecaries in the service of King Charles II. The period studied here, between 1693 and 1700, comprises two different phases: an initial stage (1693-1697) characterized by the struggle between novatores and traditionalists, which ended in triumph for the latter; and a second stage (1697-1700) completely separate from the initial measures, in which the influence of alchemy was marked. This stage can be considered compatible with the series of spells and superstitions that characterized the court of Charles II.

  18. The Royal Navy and British Security Policy.

    Science.gov (United States)

    1983-12-01

    SCHOOL December 1983 Author Approved by: Tesis Avisor s" econd R e r Chafrman, Department of National Security Affairs -- and Policy Sciences " Dean of...8217s based on the 14 VULCAN , VICTOR and VALIANT bombers. Although cooperation with the American SAC was envisioned from the begining, the force did...British strategic nuclear deterrent. This responsibility was once the domain of the Royal Air Force and its VULCAN , VICTOR, and VALIANT bombers, but after

  19. Inca Royal Estates in the Sacred Valley

    Science.gov (United States)

    McKim Malville, J.

    The royal estates lying between Cusco and Machu Picchu illustrate the remarkable variety by which the sun was honored and worshipped in the Inca Empire. The terraced basins of Moray combine the sun at both solstices and, perhaps, the zenith sun, with flowing water and offerings to Pachamama. The complex astronomy at Urubamba involves the palace of Quespiwanka, horizon pillars, solstices, and mountain worship. Ollantaytambo contains horizontal shadow-casting gnomons with a major water shrine.

  20. Ottoman royal women's spaces: The acoustic dimension

    OpenAIRE

    Ergin, Nina

    2014-01-01

    In their discussion of space in relation to gender, historians of women in the Middle East so far have focused primarily on physical and visual access. This paper argues that women's acoustic space merits closer consideration, especially since acoustic methods of communication very often could and did exceed the limits of vision and visually bounded space. This argument is based on three different case studies concerning Ottoman royal women of the sixteenth and seventeenth centuries: (1) hare...

  1. Balanced scorecard at the Royal Library, Copenhagen

    Directory of Open Access Journals (Sweden)

    Karl Krarup

    2003-09-01

    Full Text Available The Royal Library is the national library of Denmark and University Library for Copenhagen University. In 2000 the Royal Library started using Balanced Scorecard as an instrument for creating a better connection between its day to day activities and its strategic goals. The Royal Library has a number of goals in choosing the Balanced Scorecard. Important goals are: to develop a strategic instrument which can be used to represent the strategic goals of the library in such a way that we can measure how close our actual performance comes in reaching these goals to create an instrument which can be used in negotiating the goals and performance of the departments in such a way that the department leaders keep a fair level of autonomy in running the departments and give the institution leader a good overview of the actual performance to make the individual department's contribution to the institutional performance explicit to personnel and leaders to formulate and monitor important strategic areas of the library's development to support steering the development to make the library and its performance more transparent to all interested actors in the library The article presents the main issues in developing the library's use of the Balanced Scorecard. It includes a number of concrete cases from the implementation of the method and its use as a strategic instrument in monitoring and developing the Royal Library as a library growing more digital and hybrid. To increase the digital part of its content, its services and its internal processes is among the library's major strategic goals.

  2. Morte materna em hospital terciário do Rio Grande do Sul - Brasil: um estudo de 20 anos Maternal mortality at a tertiary hospital in Rio Grande do Sul - Brazil: a twenty-year study

    Directory of Open Access Journals (Sweden)

    José Geraldo Lopes Ramos

    2003-07-01

    Full Text Available OBJETIVO: analisar os casos de morte materna ocorridos no Hospital de Clínicas de Porto Alegre (HCPA, hospital universitário de referência para gestação de alto risco no Rio Grande do Sul. MÉTODOS: realizamos estudo retrospectivo analisando os prontuários médicos das mulheres entre 10 e 49 anos que morreram no HCPA no período de 1980 a 1999. Foram analisadas apenas as mortes relacionadas a gestação e puerpério (até 365 dias após o término da gestação, independente do tipo e duração da gestação. As causas foram separadas em causas obstétricas diretas, obstétricas indiretas e causas não obstétricas. RESULTADOS: entre as causas obstétricas diretas (61,7%, destacaram-se a hipertensão arterial (18,5%, a infecção pós-cesariana (16% e o aborto séptico (12,3%. Dentre as causas obstétricas indiretas (23,5%, as mais prevalentes foram a cardiopatia (8,6%, o fígado gorduroso agudo (3,5% e o lúpus eritematoso sistêmico (2,5%. Dentre as causas não obstétricas (15,0%, destacam-se as neoplasias malignas (7,4% e a AIDS (3,7%. CONCLUSÕES: a prevalência das principais causas de morte materna não sofreu modificação nas últimas duas décadas, sendo que a principal causa continua sendo a hipertensão arterial. Também, há número significativo de mortes relacionadas à cesariana (relacionadas ao procedimento e às infecções. Podemos concluir que a prevalência de causas obstétricas diretas aponta para a baixa capacidade de prevenção de morte materna no nosso sistema de saúde.PURPOSE: to analyze maternal death cases that occurred at the "Hospital de Clínicas de Porto Alegre", a reference university hospital for high-risk pregnancies in the state of Rio Grande do Sul, Brazil. METHODS: we carried out a retrospective study of medical records of 10- to 49-year-old women who died at the hospital between 1980 and 1999. Deaths related to pregnancy and puerperium were analyzed independently of the kind and duration of

  3. Lowering infant mortality in Cuba: Fernando Domínguez MD PhD. Neonatologist, Ramón González Coro University Maternity Hospital, Havana.

    Science.gov (United States)

    Domínguez, Fernando; Gorry, Conner

    2015-01-01

    Neonatologist Dr Fernando Domínguez served two years in a remote municipality of Cuba's Guantánamo Province upon graduation from medical school in 1973. Continuing his commitment to vulnerable populations, he joined the Cuban team in the Democratic Republic of the Congo, serving as a family doctor attending neonates and children. After returning to Cuba, he completed his pediatric residency and later became head of the neurodevelopment department at Havana's Ramón González Coro University Maternity Hospital, where he has worked for over three decades. Dr Domínguez holds a doctorate in medical sciences, and since 1995 has served on the board of the Cuban Society of Pediatrics, where he was President from 2005-2011. He is also a member of the Ministry of Public Health's National Bioethics Commission; President of the Scientific Council of the Manuel Fajardo Medical School; on the Executive Board of the Latin American Association of Pediatrics; and a member of the Permanent Commission of the International Pediatric Association (IPA). Since 2010, he has served on IPA's Commission for Child Environmental Health and is the Editor-in-Chief of the pediatric section of Infomed, Cuba's national health portal.

  4. Prevalence of caries and is relationship with the type of feeding in babies in the Cândida Vargas Maternity hospital

    Directory of Open Access Journals (Sweden)

    Débora de Araújo Milfont

    2009-10-01

    Full Text Available Objective: Verify the prevalence of dental caries and its relationship with the type of feeding, oral hygiene habits, and gender of children at the Cândida Vargas Maternity hospital in João Pessoa, Paraíba, Brazil. Methods: The study population included 50 mentally and physically healthy children ranging from 12 the 48 months of age. This was descriptive study using direct documentation (forms and the clinical examinations performed by one calibrated examiner (Kappa = 1. Dental caries diagnosis was according to World Health Organization criteria. Interviews were conducted with the parents for information about the children’s oral hygiene and dietary habits. Data was analysed by means of descriptive statistics (frequencies and percentages and statistical analyses, using the Pearson Chi – Square and Fisher tests. Results: the prevalence of dental caries was 28%; the majority of the parents cared for the children’s daytime oral hygiene (60%, and the prevalent type of feeding was with powdered milk. The average dmf-t was 0.28 and 16% of children had early childhood caries. There was no statistically significant association with any of the variables studied.Conclusion: the prevalence of caries–free children was high. However, the poor oral hygiene after nocturnal breast-feeding and the early introduction of artificial milk, especially with bottle feeding suggests the need to reinforce educational strategies for the parents.

  5. Rare royal families in honeybees, Apis mellifera

    Science.gov (United States)

    Moritz, Robin F. A.; Lattorff, H. Michael G.; Neumann, Peter; Kraus, F. Bernhard; Radloff, Sarah E.; Hepburn, H. Randall

    2005-10-01

    The queen is the dominant female in the honeybee colony, Apis mellifera, and controls reproduction. Queen larvae are selected by the workers and are fed a special diet (royal jelly), which determines caste. Because queens mate with many males a large number of subfamilies coexist in the colony. As a consequence, there is a considerable potential for conflict among the subfamilies over queen rearing. Here we show that honeybee queens are not reared at random but are preferentially reared from rare “royal” subfamilies, which have extremely low frequencies in the colony's worker force but a high frequency in the queens reared.

  6. Maternal immunisation

    NARCIS (Netherlands)

    Verweij, Marcel; Lambach, Philipp; Ortiz, Justin R.; Reis, Andreas

    2016-01-01

    There has been increased interest in the potential of maternal immunisation to protect maternal, fetal, and infant health. Maternal tetanus vaccination is part of routine antenatal care and immunisation campaigns in many countries, and it has played an important part in the reduction of maternal and

  7. Necessidade de cuidados intensivos em maternidade pública terciária Necessity of intensive care in a tertiary public maternity hospital

    Directory of Open Access Journals (Sweden)

    Marcello Braga Viggiano

    2004-05-01

    mortalidade materna e duração da internação (48 horas nas UTI's (p=0,08. A RMI encontrada foi de 18,8/1.000 partos. CONCLUSÕES: a necessidade de cuidados intensivos estimada pela RMI foi de 18,8/1.000 partos, sendo que as síndromes hipertensivas induzidas pela gestação foram responsáveis pela maioria das indicações para as transferências maternas.OBJECTIVE: to evaluate the epidemiological and parturitional aspects of obstetric patients admitted to intensive care units (ICU, and analyze the frequency of intensive support needed by them. METHODS: observational and descriptive study of all obstetric patients' transfers to ICU from the Hospital Materno Infantil of Goiânia-Go, from January 1999 to December 2001. The analysis has included variables as maternal age, parity, obstetric and non-obstetric indications for ICU admissions, moment of transfer, mode of delivery, maternal death, and the frequency of ICU utilization per 1,000 deliveries (IDR - imminent death ratio. The statistical analysis was performed by the chi2 test or the Fisher exact test and a significant difference was set at a level of 5%. RESULTS: over the 36-month period analyzed, 86 pregnancy-associated ICU admissions were identified (among 4,560 deliveries. Of the 86 patients, 52.33% (n=45 were nulliparae and 63 (73.26% were between 19 and 35 years old. Hypertensive disorders accounted for 41 (57.75% of the admissions and hemorrhage for 14 (19.72%. Eclampsia (n=23, HELLP syndrome (n=13 and premature abruptio placentae (n=5 were the most common obstetric indications for ICU admissions. Maternal cardiac disorders accounted for 4 cases of non-obstetric indications. There was a predominance of postpartum transfers (82.35%. Fifty-five (72.37% patients needed delivery by caesarian section. The average time spent in the UCI by those patients was 5.1 days. Maternal mortality found in this study was 24.29%, hypertensive disorders being responsible for 52.94% (9/17 of all obstetric-associated deaths. There were

  8. Incidence of stillbirth and perinatal mortality and their associated factors among women delivering at Harare Maternity Hospital, Zimbabwe: a cross-sectional retrospective analysis

    Directory of Open Access Journals (Sweden)

    Welch Kathy

    2005-05-01

    Full Text Available Abstract Background Death of an infant in utero or at birth has always been a devastating experience for the mother and of concern in clinical practice. Infant mortality remains a challenge in the care of pregnant women worldwide, but particularly for developing countries and the need to understand contributory factors is crucial for addressing appropriate perinatal health. Methods Using information available in obstetric records for all deliveries (17,072 births at Harare Maternity Hospital, Zimbabwe, we conducted a cross-sectional retrospective analysis of a one-year data, (1997–1998 to assess demographic and obstetric risk factors for stillbirth and early neonatal death. We estimated risk of stillbirth and early neonatal death for each potential risk factor. Results The annual frequency of stillbirth was 56 per 1,000 total births. Women delivering stillbirths and early neonatal deaths were less likely to receive prenatal care (adjusted relative risk [RR] = 2.54; 95% confidence intervals [CI] 2.19–2.94 and RR = 2.52; 95% CI 1.63–3.91, which for combined stillbirths and early neonatal deaths increased with increasing gestational age (Hazard Ratio [HR] = 3.98, HR = 7.49 at 28 and 40 weeks of gestation, respectively. Rural residence was associated with risk of infant dying in utero, (RR = 1.33; 95% CI 1.12–1.59, and the risk of death increased with increasing gestational age (HR = 1.04, HR = 1.69, at 28 and 40 weeks of gestation, respectively. Older maternal age was associated with risk of death (HR = 1.50; 95% CI 1.21–1.84. Stillbirths were less likely to be delivered by Cesarean section (RR = 0.64; 95% CI 0.51–0.79, but more likely to be delivered as breech (RR = 4.65; 95% CI 3.88–5.57, as were early neonatal deaths (RR = 3.38; 95% CI 1.64–6.96. Conclusion The frequency of stillbirth, especially macerated, is high, 27 per 1000 total births. Early prenatal care could help reduce perinatal death linking the woman to the health

  9. Maternal oral health status and preterm low birth weight at Muhimbili National Hospital, Tanzania: a case-control study

    Directory of Open Access Journals (Sweden)

    Manji Karim P

    2007-06-01

    Full Text Available Abstract Background The study examined the relationship between oral health status (periodontal disease and carious pulpal exposure (CPE and preterm low-birth-weight (PTLBW infant deliveries among Tanzanian-African mothers at Muhimbili National Hospital (MNH, Tanzania. Methods A retrospective case-control study was conducted, involving 373 postpartum mothers aged 14–44 years (PTLBW – 150 cases and at term normal-birth-weight (TNBW – 223 controls, using structured questionnaire and full-mouth examination for periodontal and dentition status. Results The mean number of sites with gingival bleeding was higher in PTLBW than in TNBW (P = 0.026. No significant differences were observed for sites with plaque, calculus, teeth with decay, missing, filling (DMFT between PTLBW and TNBW. Controlling for known risk factors in all post-partum (n = 373, and primiparaous (n = 206 mothers, no significant differences were found regarding periodontal disease diagnosis threshold (PDT (four sites or more that had probing periodontal pocket depth 4+mm and gingival bleeding ≥ 30% sites, and CPE between cases and controls. Significant risk factors for PTLBW among primi- and multiparous mothers together were age ≤ 19 years (adjusted Odds Ratio (aOR = 2.09, 95% Confidence interval (95% CI: 1.18 – 3.67, P = 0.011, hypertension (aOR = 2.44, (95% CI: 1.20 – 4.93, P = 0.013 and being un-married (aOR = 1.59, (95% CI: 1.00 – 2.53, P = 0.049. For primiparous mothers significant risk factors for PTLBW were age ≤ 19 years (aOR = 2.07, 95% CI: 1.13 – 3.81, P = 0.019, and being un-married (aOR = 2.58, 95% CI: 1.42 – 4.67, P = 0.002. Conclusions These clinical findings show no evidence for periodontal disease or carious pulpal exposure being significant risk factors in PTLBW infant delivery among Tanzanian-Africans mothers at MNH, except for young age, hypertension, and being unmarried. Further research incorporating periodontal pathogens is recommended.

  10. Maternal and perinatal outcomes associated with a trial of labour after previous caesarean section in sub-Saharan countries.

    Science.gov (United States)

    Kaboré, C; Chaillet, N; Kouanda, S; Bujold, E; Traoré, M; Dumont, A

    2016-12-01

    To assess the risks of uterine rupture, maternal and perinatal outcomes associated with a trial of labour (TOL) after one previous caesarean were compared with having an elective repeated caesarean section (ERCS) without labour in low-resource settings. A prospective 4-year observational study. Senegal and Mali. A cohort of 9712 women with one previous caesarean delivery. Maternal and perinatal outcomes were compared between 8083 women who underwent a TOL and 1629 women who had an ERCS. Perinatal and maternal outcomes were then stratified according to the presence or absence of risk factors associated with vaginal birth after caesarean section. These outcomes were adjusted on maternal, perinatal and institutional characteristics. The risks of uterine rupture, maternal complication and perinatal mortality associated with TOL after one previous caesarean as compared with ERCS, RESULTS: The risks of hospital-based maternal complication [adjusted odds ratio (OR) 1.52; 95% CI 1.09-2.13; P = 0.013] and perinatal mortality (adjusted OR 4.53; 95% CI 2.30-9.92; P < 0.001) were significantly higher in women with a TOL compared with women who had an ERCS. However, when restricted to low-risk women, these differences were not significant (adjusted OR 0.90, 95% CI 0.55-1.46, P = 0.68, and adjusted OR 1.13; 95% CI 0.75-1.86; P = 0.53, for each outcome, respectively). Uterine rupture occurred in 25 (0.64%) of 3885 low-risk women compared with 70 (1.66%) of 4198 women with unfavourable risk factors. Low-risk women have no increased risk of maternal complications or perinatal mortality compared with women with one or more unfavourable factors. Low-risk women have a lower risk of maternal complications or perinatal mortality compared with high-risk women. © 2015 Royal College of Obstetricians and Gynaecologists.

  11. The evolving patient population at Europe's busiest maternity unit

    LENUS (Irish Health Repository)

    Heir, MP

    2011-02-01

    Institute of Obstetricians & Gynaecologists, RCPI Four Provinces Meeting Junior Obstetrics & Gynecology Society Annual Scientific Meeting, Royal Academy of Medicine in Ireland Dublin Matenity Hospitals Report Meeting Friday 26th Nov 2010

  12. It Gets Me Upset Talking about the Royal Albert: Collaborative Analysis of the Ethics of an Oral History Project

    Science.gov (United States)

    Mee, Steve

    2012-01-01

    An ongoing oral history project at the University of Cumbria seeks to uncover the lived experiences of people with learning difficulties who lived at the Royal Albert Hospital. A recently made video exposed the apparent distress this caused one of the participants. Ethical discussions about the project reached a point of being "stuck".…

  13. A Case Control Study to Elucidate Maternal Determinants of Intra Uterine Growth Retardation in a Tertiary Care Hospital of Sagar City of Madhya Pradesh

    Directory of Open Access Journals (Sweden)

    Pandey Shikha , Pandey Ramesh

    2012-09-01

    Full Text Available Objectives: To study the maternal determinants of intrauterine growth retardation among cases admitted for delivery in Bundelkhand Medical College, Sagar. Methods: A Case-control study was conducted in the year January 2010 to December 2010 in Bundelkhand Medical College (BMC Sagar M.P. The participants included mothers who underwent normal delivery in BMC Sagar. Mother's age, parity, maternal height, maternal weight, body mass index, hemoglobin level during pregnancy, birth weight of the baby were considered as study variables. Intrauterine growth retardation was taken as outcome variable. Chi square test. OR's with 95% CI was used as the method of statistical analysis. Results: Significant risk factors identified in univariate analysis included maternal height (<145 cm s., maternal weight (<45 kg s., body mass index (<18.5 and anemia in pregnancy. Multiple logistic regression analysis revealed that maternal age (>30 years, primiparity, maternal height (<145cms. maternal weight (<45 kg s., anemia in pregnancy (Hb <11gm % is the significant risk factors of intrauterine growth retardation.

  14. Sociomateriality at the Royal Court of IS

    DEFF Research Database (Denmark)

    Kautz, Karlheinz; Jensen, Tina Blegind

    2013-01-01

    The notion of ‘sociomateriality’ has recently gained in popularity among information systems (IS) scholars in their search for providing new ways of investigating and theorizing about IS in organizations and society at large. While some scholars put forward arguments and research accounts that lead...... for progressing the theorizing of ‘man–machine’ reconfigurations, we point to the necessity of a deeper exploration of the term. Inspired by the Alternative Genres Track at the European Conference on Information Systems 2012, the purpose here is to take a fresh look, to evoke new insights and to gain deeper...... understanding of the notion of sociomateriality and its use in the IS discipline. We invite the reader to attend a prolonged monologue – characterized by honesty, frank observations and wit – at the royal court of IS. The monologue is delivered by the court jester and directed to the two sovereigns who, based...

  15. Maternal temperature during labour

    NARCIS (Netherlands)

    Schouten, F. D.; Wolf, H.; Smjt, B. J.; Bekedam, D. J.; de Vos, R.; Wahlen, I.

    2008-01-01

    Objective The aim of this study was to describe the variation of normal maternal temperature during labour. Design A prospective cohort study. Setting Two hospitals in Amsterdam, the Netherlands. Population All women with a live singleton pregnancy and a gestational age of 36 weeks or more admitted

  16. 36 CFR 7.38 - Isle Royale National Park.

    Science.gov (United States)

    2010-07-01

    ... 36 Parks, Forests, and Public Property 1 2010-07-01 2010-07-01 false Isle Royale National Park. 7.38 Section 7.38 Parks, Forests, and Public Property NATIONAL PARK SERVICE, DEPARTMENT OF THE INTERIOR SPECIAL REGULATIONS, AREAS OF THE NATIONAL PARK SYSTEM § 7.38 Isle Royale National Park. (a)...

  17. The Royal pilgrimage of the Goddess Nanda

    Directory of Open Access Journals (Sweden)

    William S. Sax

    2010-01-01

    Full Text Available Once every twelve years, when it is thought that some calamity has taken place because of the curse of the goddess Nanda Devi, a four-horned ram is born in the fields of the former king of Garhwal, an erstwhile Central Himalayan kingdom in north India (see map of Garhwal. This four-horned ram leads a procession of priests and pilgrims on the most dangerous and spectacular pilgrimage in all of India: a three-week, barefoot journey of one-hundred and sixty-four miles, during some of the worst weather of the year, at the end of the rainy season. The procession reaches Rupkund, a small pond located at an altitude of more than 5,000 metres, which is surrounded by human­ skeletons, and from there it goes yet further, to Homkund, the ‘Lake of the Fire Sacrifice’. According to the faithful, the four-horned ram leaves the procession at that point and finds its way, unaided, to the summit of Mount Trishul. As its name suggests, the Royal Procession is closely associated with the ruler of this erstwhile Himalayan kingdom: he attends its inaugural rituals, the bones that litter the shores of Rupkund are believed to be those of one of his ancestors, and the chief sponsor of the event is a local ‘Prince’ who is thought to be descended from the first kings of Garhwal. This Prince traverses the domain of his ancestors and thereby lays claim to it in the name of the goddess Nanda, who is not only his lineage goddess but was also the royal goddess of the neighbouring kingdom of Kumaon, in pre-colonial times. Although the Royal Procession ideally fosters social integration, it was disrupted in 1987 by a quarrel between two factions of priests. The goddess’s itinerary, the culminating date of the pilgrimage, the type of sacrifice to be performed, the order of procession, the participation of previously excluded persons, and the competency of certain ritual specialists—all were subjects of heated dispute between the rival groups. What was the reason for

  18. Developing a successful alternative maternity unit.

    Science.gov (United States)

    Jones, C

    1987-07-01

    The users of maternity services are becoming increasingly interested in alternative delivery options, as a result hospitals are developing customer oriented, competitive maternity services. In this article, the author describes one hospital's efforts at developing a customer oriented family birthing center: the rationale, the benefits, the marketing and the satisfying results.

  19. The efficacy of topical Royal Jelly on diabetic foot ulcers healing: A case series

    Directory of Open Access Journals (Sweden)

    Mansour Siavash

    2011-01-01

    Full Text Available Background: Foot ulcers and infections are the major sources of morbidity in individuals with diabetes mellitus. This study aimed to evaluate the efficacy of topical Royal Jelly (a worker honey bee product on healing diabetic foot ulcers. Methods: Diabetic patients with foot ulcers that were referred to our clinic at Khorshid Hospital, Isfahan, Iran; were evaluated three times a week and treated according to standard treatments consisted of offloading, infection control, vascular improvement and debridement if required. In addition, all ulcers were measured and then topical sterile 5% Royal Jelly was applied on the total surface area of the wounds. Eventually, they were covered with sterile dressings. Each patient was followed for a period of three months or until the complete healing. Results: A total of eight patients were enrolled in this study. Of these, two had two ulcers and, therefore, ten ulcers were evaluated. Two ulcers were excluded. Seven of the remained eight ulcers healed. Mean duration of complete healing was 41 days. One ulcer did not completely heal but improved to 40% smaller in length, 32% in width and 28% in depth. The mean length, width and depth reduction rates were 0.35 mm/day, 0.28 mm/day and 0.11 mm/day, respectively. Conclusions: Royal Jelly dressing may be an effective method for treating diabetic foot ulcers besides standard treatments.

  20. Population Limitation and the Wolves of Isle Royale

    National Research Council Canada - National Science Library

    Rolf O. Peterson; Nancy J. Thomas; Joanne M. Thurber; John A. Vucetich; Thomas A. Waite

    1998-01-01

    Population regulation for gray wolves in Isle Royale National Park, Michigan, was examined in 1987-1995 when wolves were in chronic decline following a crash of the population in 1981-1982. Canine parvovirus (CPV-2...

  1. Apiology: royal secrets in the queen's fat body.

    Science.gov (United States)

    Yamanaka, Naoki; O'Connor, Michael B

    2011-07-12

    Royalactin, a component of royal jelly, induces queen differentiation in honeybees. Surprisingly, royalactin has a similar effect on growth in fruit flies, highlighting many unexpected features of growth regulation by the insect fat tissue.

  2. Physicochemical composition of pure and adulterated royal jelly

    National Research Council Canada - National Science Library

    Luis Henrique Garcia-Amoedo; Ligia Bicudo de Almeida-Muradian

    2007-01-01

    ... (10-hydroxy-2-decenoic acid). The solubility in alkaline medium was used to detect the main frauds for adulterating royal jelly which comprise addition of yogurt, water, egg white, sweet condensed milk mixed with propolis, unripe...

  3. Physicochemical composition of pure and adulterated royal jelly

    Directory of Open Access Journals (Sweden)

    Luis Henrique Garcia-Amoedo

    2007-04-01

    Full Text Available The physicochemical composition of pure royal jelly as well as of some adulterated samples was analyzed by determining moisture, ash, lipids, nitrogen/proteins, carbohydrates, starch and 10- HDA (10-hydroxy-2-decenoic acid. The solubility in alkaline medium was used to detect the main frauds for adulterating royal jelly which comprise addition of yogurt, water, egg white, sweet condensed milk mixed with propolis, unripe banana and corn starch slurry.

  4. Physicochemical composition of pure and adulterated royal jelly

    OpenAIRE

    Luis Henrique Garcia-Amoedo; Ligia Bicudo de Almeida-Muradian

    2007-01-01

    The physicochemical composition of pure royal jelly as well as of some adulterated samples was analyzed by determining moisture, ash, lipids, nitrogen/proteins, carbohydrates, starch and 10- HDA (10-hydroxy-2-decenoic acid). The solubility in alkaline medium was used to detect the main frauds for adulterating royal jelly which comprise addition of yogurt, water, egg white, sweet condensed milk mixed with propolis, unripe banana and corn starch slurry.

  5. Tropical storm Flossie and the Ark Royal storm

    Science.gov (United States)

    Peteherych, S.; Cunningham, G. F.; Davies, A. F.; Muttitt, G.

    1986-01-01

    The development of the tropical storm Flossie north of Scotland on September 16-17, 1978 from the Ark Royal storm is described. Land, marine, upper air data, satellite imagery, Seasat scatterometer (SASS) wind data, and SMMR moisture data were utilized to analyze the storms' development. The factors which contributed to the formation of the Ark Royal storm are discussed. Isobaric surface charts, isotachs and streamlines of the SASS winds, and SMMR water vapor contours are provided.

  6. Maternal mortality and serious maternal morbidity in Jehovah's witnesses in the Netherlands

    NARCIS (Netherlands)

    M.E. van Wolfswinkel; J.J. Zwart; J.M. Schutte; J.J. Duvekot; M. Pel; J. van Roosmalen

    2009-01-01

    To determine the risk of maternal mortality and serious maternal morbidity because of major obstetric haemorrhage in Jehovah's witnesses in the Netherlands. A retrospective study of case notes. All tertiary care centres, general teaching hospitals and other general hospitals in the Netherlands. All

  7. Maternal mortality and serious maternal morbidity in Jehovah's witnesses in the Netherlands

    NARCIS (Netherlands)

    Van Wolfswinkel, M. E.; Zwart, J. J.; Schutte, J. M.; Duvekot, J. J.; Pel, M.; Van Roosmalen, J.

    To determine the risk of maternal mortality and serious maternal morbidity because of major obstetric haemorrhage in Jehovah's witnesses in the Netherlands. A retrospective study of case notes. All tertiary care centres, general teaching hospitals and other general hospitals in the Netherlands. All

  8. MATERNAL MORTALITY IN A TERTIARY CARE CENTRE

    Directory of Open Access Journals (Sweden)

    Harpreet

    2013-06-01

    Full Text Available ABSTRACT: Maternal Mortality in A Tertiary Care Centre. OBJECTIVE: To study maternal mortality and the complications leading to maternal death. METHODS: A retrospective study of hospital record to study maternal mortality and its causes over 3 years from January 2010 to December 2012. RESULTS: There were a total of 58 maternal deaths out of 2823 live births giving a maternal mortality ratio of 2054.55 per one lakh live births. Unbooked and late referrals account for 77.58% of maternal deaths. The majority of deaths around 75.86% were in 20-30 years age group. Haemorrhage was the commonest causes of death (24.12% followed by sepsis (18.96% and pregnancy induced hypertension 15.51% Anemia contributed to the most common indirect cause of maternal morality. CONCLUSION: Haemorrhage, sepsis and pregnancy induced hypertension including eclampsia were the direct major causes of death. Anaemia and cardiac diseases were other indirect causes of death.

  9. [Precautionary maternity leave in Tirol].

    Science.gov (United States)

    Ludescher, K; Baumgartner, E; Roner, A; Brezinka, C

    1998-01-01

    Under Austrian law, precautionary maternity leave is a decree issued by the district public health physician. It forbids a pregnant woman to work and mandates immediate maternity leave. Regular maternity leave for all women employed in all jobs begins at 32 weeks of gestation. Women who work in workplaces deemed dangerous and women with a history of obstetric problems such as premature or growth-retarded babies from previous pregnancies are regularly 'sent' into precautionary maternity leave. The public health physicians of Tirol's nine administrative districts were interviewed and supplied data on precautionary maternity leave from their districts. In 100 women who attended the clinic for pregnancies at risk of the Obstetrics/Gynecology Department of Innsbruck University Hospital and who had already obtained precautionary maternity leave, the medical/administrative procedure was studied in each case and correlated with pregnancy outcome. The town district of Innsbruck and the district that comprises the suburbs of the provincial capital had the highest rates of precautionary maternity leave. The town district of Innsbruck had a rate of 24.3% of all pregnant women (employed and not employed) in precautionary maternity leave in 1997, whereas the whole province of Tirol had 13.4%. More than 80% of decrees for precautionary maternity leave are issued by district public health physicians on the basis of written recommendations from gynecologists. One third of women who are sent into precautionary maternity leave are issued the decree prior to 12 weeks of gestation - mostly cases of multiple pregnancies and women with previous miscarriages. The present system of precautionary maternity leave appears to work in the sense that most working pregnant women with risk factors are correctly identified - with most errors on the side of caution. As the system also helps employers - the employee's pay is paid from the federal family support fund and state insurance once she is in

  10. A cluster randomized controlled trial of a behavioral intervention to facilitate the development and implementation of clinical practice guidelines in Latin American maternity hospitals: the Guidelines Trial: Study protocol [ISRCTN82417627

    Directory of Open Access Journals (Sweden)

    Wright Linda

    2005-04-01

    Full Text Available Abstract Background A significant proportion of the health care administered to women in Latin American maternity hospitals during labor and delivery has been demonstrated to be ineffective or harmful, whereas effective interventions remain underutilized. The routine use of episiotomies and the failure to use active management of the third stage of labor are good examples. Methods/Design The aim of this trial is to evaluate the effect of a multifaceted behavioral intervention on the use of two evidence-based birth practices, the selective use of episiotomies and active management of the third stage of labor (injection of 10 International Units of oxytocin. The intervention is based on behavioral and organizational change theories and was based on formative research. Twenty-four hospitals in three urban districts of Argentina and Uruguay will be randomized. Opinion leaders in the 12 intervention hospitals will be identified and trained to develop and implement evidence-based guidelines. They will then disseminate the guidelines using a multifaceted approach including academic detailing, reminders, and feedback on utilization rates. The 12 hospitals in the control group will continue with their standard in-service training activities. The main outcomes to be assessed are the rates of episiotomy and oxytocin use during the third stage of labor. Secondary outcomes will be perineal sutures, postpartum hemorrhages, and birth attendants' opinions.

  11. 'I Used to Fight with Them but Now I Have Stopped!': Conflict and Doctor-Nurse-Anaesthetists' Motivation in Maternal and Neonatal Care Provision in a Specialist Referral Hospital.

    Directory of Open Access Journals (Sweden)

    Matilda Aberese-Ako

    Full Text Available This paper analyses why and how conflicts occur and their influence on doctors and nurse-anaesthetists' motivation in the provision of maternal and neonatal health care in a specialist hospital.The study used ethnographic methods including participant observation, conversation and in-depth interviews over eleven months in a specialist referral hospital in Ghana. Qualitative analysis software Nvivo 8 was used for coding and analysis of data. Main themes identified in the analysis form the basis for interpreting and reporting study findings.Ethical clearance was obtained from the Ghana Health Service Ethics Review board (approval number GHS-ERC:06/01/12 and from the University of Wageningen. Written consent was obtained from interview participants, while verbal consent was obtained for conversations. To protect the identity of the hospital and research participants pseudonyms are used in the article and the part of Ghana in which the study was conducted is not mentioned.Individual characteristics, interpersonal and organisational factors contributed to conflicts. Unequal power relations and distrust relations among doctors and nurse-anaesthetists affected how they responded to conflicts. Responses to conflicts including forcing, avoiding, accommodating and compromising contributed to persistent conflicts, which frustrated and demotivated doctors and nurse-anaesthetists. Demotivated workers exhibited poor attitudes in collaborating with co-workers in the provision of maternal and neonatal care, which sometimes led to poor health worker response to client care, consequently compromising the hospital's goal of providing quality health care to clients.To improve health care delivery in health facilities in Ghana, health managers and supervisors need to identify conflicts as an important phenomenon that should be addressed whenever they occur. Effective mechanisms including training managers and health workers on conflict management should be put in

  12. Pratiques d'allaitement à Port-Royal et aux Enfants-Assistés à la fin du XIXe siècle

    OpenAIRE

    Lauzier, Anne-Claire

    2011-01-01

    Newborn feeding is a responsibility at the heart of the midwifery profession. The story of its evolution is fascinating, which is why this work has been devoted to various feeding practices at Port Royal Maternity and Enfants-Assistés Hospice in the heart of Paris, during the second half of the nineteenth century. Filled with discoveries, experiments and literature, these years have been fundamental in the understanding of newborn feeding. From breastfeeding to donkeys milk, various protocols...

  13. Aspectos relacionados à escolha do tipo de parto: um estudo comparativo entre uma maternidade pública e outra privada, em São Luís, Maranhão, Brasil Aspects related to choice of type of delivery: a comparative study of two maternity hospitals in São Luís, State of Maranhão, Brazil

    Directory of Open Access Journals (Sweden)

    Natália Ribeiro Mandarino

    2009-07-01

    Full Text Available Esta pesquisa objetivou analisar aspectos relacionados à escolha do tipo de parto em uma maternidade do serviço público e outra do serviço privado, em São Luís, Maranhão, Brasil. Trata-se de um estudo transversal abordando comparativamente 163 primíparas de uma maternidade pública e 89 de maternidade privada, com médias de idade de 21,63 ± 5,24 e 28,8 ± 5,41 anos, respectivamente. Preferiam o parto vaginal 79,1% das gestantes da maternidade pública, e a cesariana 67,4% das da maternidade privada (p This study aimed to analyze aspects related to choice of type of delivery in two maternity hospitals, one public and the other private, in São Luís, Maranhão State, Brazil. This cross-sectional study compared 163 primiparous women in a public maternity hospital and 89 in a private hospital, with mean ages of 21.63 ± 5.24 and 28.8 ± 5.41 years, respectively. In the public hospital, 79.1% of the women reported preferring vaginal deliveries, while in the private hospital 67.4% of the women preferred cesareans (p < 0.0001. Cesareans were performed in 46% of the women in the public maternity hospital and 97.8% of those in the private hospital (p < 0.0001. Patient satisfaction was high for both modes of delivery, but the desire to repeat the same mode was reported more frequently by women with vaginal deliveries (71.6% vs. 41.3% in the public maternity hospital and 100% vs. 65.5% in the private. In the public maternity hospital, the cesarean subgroup included more white and higher-income women. The cesarean rate was thus high in both maternity hospitals and was significantly higher in the private hospital; the study also showed a preference for vaginal delivery in the public hospital and cesareans in the private.

  14. Estudo da morbidade e da mortalidade perinatal em maternidades: II - mortalidade perinatal segundo peso ao nascer, idade materna, assistência pré-natal e hábito de fumar da mãe A study of perinatal morbidity and mortality in maternity hospitals: II - perinatal mortality according to birth weight, maternal age, prenatal care and maternal smoking

    Directory of Open Access Journals (Sweden)

    Ruy Laurenti

    1985-06-01

    Full Text Available Analisa-se a influência de variáveis como peso ao nascer, idade materna, assistência pré-natal e tabagismo materno. Do estudo dos 12.999 nascimentos (vivos e mortos ocorridos em nove maternidades no período de um ano, verificou-se que a mortalidade perinatal é muito maior para os recém-nascidos de baixo peso (665,3 ‰ para peso até 1.500 g, diminuindo à medida que aumenta o peso ao nascer. Também nos casos de mães jovens (menores de 15 anos ou mães com idade superior a 35 anos esse coeficiente foi mais elevado (45,5 ‰ para mães com menos de 15 anos e 47,0 ‰ para mães entre 35 a 39 anos. A faixa imediatamente superior - 40 a 44 anos - apresentou a mais alta mortalidade perinatal: 61,3 ‰ nascidos vivos e nascidos mortos. O número de consultas realizadas no pré-natal tem importância para a diminuição da gestação de alto risco. Mães que fizeram 7 ou mais consultas no pré-natal tiveram a menor mortalidade no período (17,7‰ nascidos vivos e nascidos mortos. Já o hábito materno de fumar influencia a mortalidade quando a quantidade é de mais de 10 cigarros por dia. A mortalidade perinatal dos produtos de mães que fumavam menos de 10 cigarros por dia não diferiu das taxas de mortalidade para as mães não-fumantes.The influence of birth weight, maternal age, prenatal care and smoking during pregnancy are analysed. Of 12,999 births (live and stillbirths ocurring in nine maternity hospitals during one year, the greatest perinatal mortality rate (PM was that of low birth weight babies (665.3 ‰ for those weighing less than 1,500 g. The PM decreases with increasing weight. Young mothers (less than 15 years of age and women aged 35 or more also had higher Perinatal Mortality rates - 45.5 ‰ for the former and 47.0 ‰ for the latter. Prenatal care is important for the decrease of high risk in pregnancy. Mothers who had made 7 or more consultations during pregnancy had the lowest PM (17.7 ‰ live and stillbirths

  15. Maternal Guilt

    Directory of Open Access Journals (Sweden)

    Anna Rotkirch

    2010-01-01

    Full Text Available The recent emphasis on humans as cooperative breeders invites new research on human family dynamics. In this paper we look at maternal guilt as a consequence of conditional maternal investment. Solicited texts written by Finnish mothers with under school-aged children in 2007 (n = 63 described maternal emotions perceived as difficult and forbidden. Content analysis of guilt-inducing situations showed that guilt arose from diverging interest and negotiations between the mother and child (i.e., classic parent-offspring conflict. Also cultural expectations of extensive and perpetual high-quality maternal investment or the “motherhood myth” induced guilt in mothers. We argue that guilt plays an important role in maternal-investment regulation. Maternal guilt is predicted to vary with social and cultural context but also to show universal characteristics due to parent-offspring conflict and allomaternal manipulation. Results are preliminary and intended to stimulate research into the mechanisms, gender differences and cultural variations of guilt and other social emotions in human parenting.

  16. The Accounting Register of a Royal Secretary in Aragonese Naples

    Directory of Open Access Journals (Sweden)

    Enza Russo

    2013-04-01

    Full Text Available In the crucial years of the succession war that involved the Kingdom of Naples after Alfonso the Magnanimous’death (1459-1464, a secretary of the new king Ferrante I of Aragon, Antonello Petrucci, was entrusted with royal financial charges. He therefore compiled an account book, where receipts and payments of the royal finances were carefully recorded. It has been recently discovered: this paper aims at examining its actual framework as well as the relative volume of the state budget. Because of its new and comprehensive body of evidence, Petrucci’s account book is a very useful source, which may provide additional informations not only on the bulk of the state funds and expenditure but also on the structure of the king’s household and on the system of the royal financial administration, which appears now as characterized by a more complex organization than it was supposed to be in the past.

  17. [The Protomedicato Tribunal and the royal physicians (1665-1724)].

    Science.gov (United States)

    Pardo Tomás, J; Martínez Vidal, A

    1996-01-01

    This article tries to reconstruct the composition of the Board of Royal Physicians during the reign of Charles II (1665-1799) and the first part of the reign of Philip V (1700-1724), a crucial period in the introduction of modern science and medicine in the Spanish Kingdoms. Their personal records, to be found in the Archivo General de Palacio in Madrid, have been exhaustively consulted. Some of these royal physicians formed part of the Castilian Tribunal del Protomedicato, by means of which the Board of Royal Physicians was selected, promoted and controlled. The Protomedicato was an important battlefield in the conflict between traditional and modern medicine, in which Italian physicians played a decisive role.

  18. Octanoic acid confers to royal jelly varroa-repellent properties

    Science.gov (United States)

    Nazzi, Francesco; Bortolomeazzi, Renzo; Della Vedova, Giorgio; Del Piccolo, Fabio; Annoscia, Desiderato; Milani, Norberto

    2009-02-01

    The mite Varroa destructor Anderson & Trueman is a parasite of the honeybee Apis mellifera L. and represents a major threat for apiculture in the Western world. Reproduction takes place only inside bee brood cells that are invaded just before sealing; drone cells are preferred over worker cells, whereas queen cells are not normally invaded. Lower incidence of mites in queen cells is at least partly due to the deterrent activity of royal jelly. In this study, the repellent properties of royal jelly were investigated using a lab bioassay. Chemical analysis showed that octanoic acid is a major volatile component of royal jelly; by contrast, the concentration is much lower in drone and worker larval food. Bioassays, carried out under lab conditions, demonstrated that octanoic acid is repellent to the mite. Field studies in bee colonies confirmed that the compound may interfere with the process of cell invasion by the mite.

  19. Wolves, moose, and tree rings on isle royale.

    Science.gov (United States)

    McLaren, B E; Peterson, R O

    1994-12-01

    Investigation of tree growth in Isle Royale National Park in Michigan revealed the influence of herbivores and carnivores on plants in an intimately linked food chain. Plant growth rates were regulated by cycles in animal density and responded to annual changes in primary productivity only when released from herbivory by wolf predation. Isle Royale's dendrochronology complements a rich literature on food chain control in aquatic systems, which often supports a trophic cascade model. This study provides evidence of top-down control in a forested ecosystem.

  20. Impact of change in maternal age composition on the incidence of Caesarean section and low birth weight: analysis of delivery records at a tertiary hospital in Tanzania, 1999–2005

    Directory of Open Access Journals (Sweden)

    Kidanto Hussein L

    2009-07-01

    Full Text Available Abstract Background Previous studies on change in maternal age composition in Tanzania do not indicate its impact on adverse pregnancy outcomes. We sought to establish temporal changes in maternal age composition and their impact on annual Caesarean section (CS and low birth weight deliveries (LBWT at Muhimbili National Hospital in Tanzania. Methods We conducted data analysis of 91,699 singleton deliveries that took place in the hospital between 1999 and 2005. The data were extracted from the obstetric data base. Annual proportions of individual age groups were calculated and their trends over the years studied. Multiple logistic analyses were conducted to ascertain trends in the risks of CS and LBWT. The impact of age composition changes on CS and LBWT was estimated by calculating annual numbers of these outcomes with and without the major changes in age composition, all others remaining equal. In all statistics, a p value Results The proportion of teenage mothers (12–19 years progressively decreased over time while that of 30–34 years age group increased. From 1999, the risk of Caesarean delivery increased steadily to a maximum in 2005 [adjusted OR = 1.7; 95%CI (1.6–1.8] whereas that of LBWT declined to a minimum in 2005 (adjusted OR = 0.76; 95% CI (0.71–0.82. The current major changes in age trend were responsible for shifts in the number of CS of up to206 cases per year. Likewise, the shift in LBWT was up to 158 cases per year, but the 30–34 years age group had no impact on this. Conclusion The population of mothers giving birth at MNH is progressively becoming older with substantial impact on the incidence of CS and LBWT. Further research is needed to estimate the health cost implications of this change.

  1. Maternal and neonatal complications in pregnant patients adolescents and older than 35 years for july to september 2008. San Jose Universitary Hospital Popayan, Colombia.

    Directory of Open Access Journals (Sweden)

    Fernando Caicedo

    2010-06-01

    Full Text Available Introduction: The maternal and neonatal complications, presented a high morbidity and mortality, in the pregnant of the extreme ages, especially in developing countries. Objective: To determinate maternal and neonatal complications in pregnant patients teenagers and older 35, during of July to September of 2008. Materials and methods: Retrospective, descriptive and transversal study. It included 88 patients, 40 teenagers, younger’s 18, and 48 patients older 35, those who attended the delivery in the HUSJ between July to September of 2008. We reviewed every history and the information has documented in an instrument. Results: We found that average of delivery in teenagers was 16.1 years, and the oldest women was 38.27, the oldest women has a higher percent of pathological background 18.7% vs 15%. The complications incidence during the pregnancy in teenagers patients 77.5% and oldest women 68.8%, During the delivery and post-delivery, we show that teenagers had incidence major of complications 43% vs 31.25% in oldest woman. Conclusions: The pregnant in extreme ages are a population of high risk obstetric, determined for high incidence of pathologies during the pregnancy, delivery, post delivery and neonatal complications.

  2. Analysis on the demands of medical service quality of obstetrical department in maternal and child health hospital%妇幼保健院产科医疗服务质量需求分析

    Institute of Scientific and Technical Information of China (English)

    谭光明; 冯占春; 陈莉; 张小庄; 罗先琼

    2011-01-01

    Objective: To explore the demands of obstetrical customers on medical service quality in maternal and child health hospital.Methods: According to the questionnaire designed, the obstetrical customers were investigated randomly in maternal and child health hospital of Guangdong from March to May 2010, then the results were analyzed.Results: The demand of the customers on obstetric medical service quality was most above 80%; the demands on the technical level of medical workers, the equipment satisfying need, the fame of the hospital in local areas, no accidents, dealing with critical situations quickly and correctly, responsibility of the medical workers, accurate and timely diagnosis, good operation skills and conforming specification, contacting the patients (family members) for some special cases,good ethics, good service attitude, reasonable treatment, respecting the right to know and process quality of patients, satisfied service and reasonable funds were all above 90%.Conclusion: The obstetrical customers have higher requirement on medical service quality of maternal and child health hospital, and the hospital should improve the medical service quality and satisfy them.%目的:探讨妇幼保健院产科顾客对医疗服务质量的需求.方法:按照预先设计的调查问卷从2010年3月~2010年5月对广东省某妇幼保健院产科的顾客进行随机抽样调查并对结果进行分析.结果:顾客对妇幼保健院产科医疗服务质量的需求绝大部分均在80%以上,而对结构质量的医护人员技术水平、仪器设备能满足需要和医院在当地声誉及不出现医疗差错事故、危急情况能快速正确处理、医务人员有责任心、诊断准确及时、医务人员操作熟练且符合规范、有特殊情况随时与病人(家属)联系、医务人员医德、医风好、医务人员服务态度好、处理方案合理、医务人员尊重患者的知情权以及结果质量、服务满意

  3. Reconfiguring Maternity Care?

    DEFF Research Database (Denmark)

    Johannsen, Nis

    were not obstacles which the proposed changes should overcome, but are on the contrary necessary, as it is the alliances between the particular interests and the proposed changes that motor the initiatives. The interests were not invented through the initiatives but are formed through history. Although...... at a hospital and a group of researchers which included me. Both initiatives involved numerous seemingly different interests that were held together and related to reconfiguring maternity care. None of the initiatives can unequivocally be labelled a success, as neither managed to change maternity care, at least...... not in the intended manner. It was, however, an achievement to relate the different interests for a period. In this dissertation I will elucidate the proposed changes in the initiatives as well as expound on the manner in which they were proposed. It is argued that the different interests involved in the initiatives...

  4. Communication: the royal pathway to patient-centered medicine.

    NARCIS (Netherlands)

    Bensing, J.M.; Verhaak, P.F.M.; Dulmen, A.M. van; Visser, A.P.

    2000-01-01

    The papers in this special issue on communication in health care can be summarized in one easy and powerful message: communication is the royal pathway to patient-centerd medicine. Approached from differen angles, the linkage between communication and patient-centered medicine is the common theme th

  5. Re-engineering production systems: the Royal Netherlands Naval Dockyard

    NARCIS (Netherlands)

    Zijm, Willem H.M.

    1996-01-01

    Reengineering production systems in an attempt to meet tight cost, quality and leadtime standards has received considerable attention in the last decade. In this paper, we discuss the reengineering process at the Royal Netherlands Naval Dockyard. The process starts with a characterisation and a

  6. Royal Numico N.V. : Resurrecting shareholder value

    NARCIS (Netherlands)

    Lachotzki, F.W.I.; Olson, M.A.

    2008-01-01

    This case presents the extraordinary turn-around engineered at Royal Numico (a specialized nutrition company, previously covered in another Nyenrode case under its old name Nutricia) by a team of managers formed and led by Jan Bennink. Company fortunes were at a low ebb by the beginning of 2002, as

  7. Louise Bourgeois (1563-1636): royal midwife of France.

    Science.gov (United States)

    Dunn, P M

    2004-03-01

    Louise Bourgeois was the first practicing midwife to write of her experience of childbirth and of women's problems. She did much to enhance the respect in which her craft was held. For 26 years she was midwife to the royal court.

  8. [Reasons for the construction of Bispebjerg Hospital--a hospital with light, air and freedom of nature].

    Science.gov (United States)

    Permin, Henrik; Wagner, Peter

    2009-01-01

    Since the 1850ies the city of Copenhagen changed, ramparts were removed or remodelled as parks, industries were established. The new factories and wharfs expanded, labourers were needed; many country people moved into the city to find work and thus the population increased immensely. In Copenhagen a few hospitals only were present around 1850; The Royal Frederik Hospital (now the Museum of applied Arts) was the only hospital in the modern sense of the word. Other institutions with "hospital" as part of their name as e.g. General Hospital (Almindelig Hospital) or Ladegaarden were a mixture of hospital and workhouse and The Royal Maternity Hospital founded in 1750. The wealthy and the upper middle class citizens were nursed or cured at home. At the end of the nineteenth century medical doctors could successfully cure some diseases, and surgeons could after the introduction of the anesthetic and aseptic treatment carry out operations with diminished risks of complications. Copenhagen's first modern hospital, Municipal Hospital (Kommunehospitalet) opened 1863, but in a very short time it was permanently overcrowded. Although two small hospitals Blegdam Hospital (isolation hospital) and the Oresund Hospital (quarantine station) were established a large new hospital was needed. Although the financial situation of the city of Copenhagen was strained due to the expenditures caused by the rapidly growing population within the city itself and the villages incorporated into it, the first social democratic mayor Jens Jensen wanted to secure his voters the same care and treatment as citizens of better means. As this view was accepted by the majority of the city council a hospital in the then modern and functional pavilion system (ascribed to Florence Nightingale) with buildings surrounded by gardens was planned. The architect Martin Nyrop (1849-1921) who had just completed the monumental and beautiful Copenhagen City Hall along with the engineer AC Karsten (1857-1931) and

  9. Identification of a novel hypocholesterolemic protein, major royal jelly protein 1, derived from royal jelly.

    Directory of Open Access Journals (Sweden)

    Yuri Kashima

    Full Text Available Royal jelly (RJ intake lowers serum cholesterol levels in animals and humans, but the active component in RJ that lowers serum cholesterol level and its molecular mechanism are unclear. In this study, we set out to identify the bile acid-binding protein contained in RJ, because dietary bile acid-binding proteins including soybean protein and its peptide are effective in ameliorating hypercholesterolemia. Using a cholic acid-conjugated column, we separated some bile acid-binding proteins from RJ and identified the major RJ protein 1 (MRJP1, MRJP2, and MRJP3 as novel bile acid-binding proteins from RJ, based on matrix-assisted laser desorption ionization time-of-flight mass spectrometry. Purified MRJP1, which is the most abundant protein of the bile acid-binding proteins in RJ, exhibited taurocholate-binding activity in vitro. The micellar solubility of cholesterol was significantly decreased in the presence of MRJP1 compared with casein in vitro. Liver bile acids levels were significantly increased, and cholesterol 7α-hydroxylase (CYP7A1 mRNA and protein tended to increase by MRJP1 feeding compared with the control. CYP7A1 mRNA and protein levels were significantly increased by MRJP1 tryptic hydrolysate treatment compared with that of casein tryptic hydrolysate in hepatocytes. MRJP1 hypocholesterolemic effect has been investigated in rats. The cholesterol-lowering action induced by MRJP1 occurs because MRJP1 interacts with bile acids induces a significant increase in fecal bile acids excretion and a tendency to increase in fecal cholesterol excretion and also enhances the hepatic cholesterol catabolism. We have identified, for the first time, a novel hypocholesterolemic protein, MRJP1, in RJ. Interestingly, MRJP1 exhibits greater hypocholesterolemic activity than the medicine β-sitosterol in rats.

  10. [A case-control study of factors associated with repeat teen pregnancy based on a sample from a university maternity hospital].

    Science.gov (United States)

    Silva, Andréa de Albuquerque Arruda; Coutinho, Isabela C; Katz, Leila; Souza, Alex Sandro Rolland

    2013-03-01

    Repeat teen pregnancy is a frequent issue and is considered an aggravating factor for increased maternal and fetal morbidity and social problems. The aim of the study was to identify factors associated with repeat teen pregnancy. A case-control study was conducted in 90 postpartum adolescents with more than one pregnancy (cases) and 90 adult women with a history of only one pregnancy during adolescence (controls). Statistical analysis used hierarchical logistic regression with 5% significance. Early sexual initiation (< 15 years), early age at first pregnancy (< 16 years), not raising the children themselves, and low family income (< one minimum wage) were associated with repeat teenage pregnancy, while partner change was inversely associated. Repeat teen pregnancy was mainly associated with reproductive and socioeconomic factors. Partner change appeared as a protective factor. Measures should be adopted during the postpartum period of teenage mothers in order to avoid repeat pregnancy.

  11. Missed opportunities for breast awareness information among women attending the maternal and child health services of an urban tertiary hospital in Northern Nigeria

    Directory of Open Access Journals (Sweden)

    Lofty-John Chukwuemeka Anyanwu

    2016-01-01

    Conclusion: Most of the opportunities to educate women on breast awareness were missed at the postnatal and ICs of our hospital. Integrating breast health education into MCH care programs in developing countries will assist in the early detection of breast pathologies.

  12. Orientações adotadas nas maternidades dos hospitais-escola do Brasil, sobre posição de dormir Instructions from teaching hospital maternity wards to parents concerning the sleeping position of newborns

    Directory of Open Access Journals (Sweden)

    Magda Lahorgue Nunes

    2002-06-01

    Full Text Available A posição prona para dormir, tem sido relacionada como fator de risco para síndrome da morte súbita do lactente (SMSL. Com o objetivo de identificar qual a posição preferencial para dormir adotada nos hospitais, que orientações são fornecidas aos pais de recém-nascidos sobre a posição preferencial para dormir durante o primeiro ano de vida e prevenção de SMSL, realizamos estudo multicentrico por meio de questionário, sendo selecionados hospitais com programa de Residência Médica em Pediatria. Analisamos as informações referentes a 55 instituições, cuja média de nascimentos/ano variou entre 240 e 11.000 (mediana 2.750. O decúbito lateral é a posição preferencial para dormir (44,4% e a mais orientada para uso domiciliar (67%. Concluímos que, a recomendação da posição supina ao dormir e orientações para prevenção da SMSL, não têm sido realizadas na rotina dos hospitais pesquisados. Entretanto, na alta hospitalar, o incentivo ao aleitamento materno e a importância das imunizações, são enfatizados em 100% das instituições e recomendações sobre evitar fumo, em 85%.The prone sleeping position has been causally linked to sudden infant death syndrome (SIDS. This survey aimed to determine whether maternity hospitals in Brazil were promoting the prone sleeping position for newborns. Information was also collected on SIDS prevention messages. The study adopted a multicenter collaborative approach in hospitals with training in pediatrics, using questionnaires. Correctly completed questionnaires were received from 55 hospitals. The number of deliveries/year varied at the hospitals from 240 to 11,000 (median 2,750. The majority of hospitals encouraged the lateral (side sleeping position in the normal care nurseries (44.4% and at discharge (67%. In conclusion, the majority of hospitals surveyed are not promoting the supine sleeping position or any other intervention for SIDS prevention, although verbal information is

  13. 妇幼保健院住院患者抗菌药物横断面调查%Cross Section Investigation on Antibiotics Usage in Inpatients in Maternity and Child Health Care Hospital

    Institute of Scientific and Technical Information of China (English)

    刘辽; 王华飞; 徐文芳; 熊婷婷; 蒋丹; 贾萍

    2012-01-01

    目的 了解妇幼保健院住院患者抗菌药物应用情况.方法 采用横断面调查法,对2012年2月份患者的抗菌药物使用情况进行调查.结果 抗菌药物横断面使用率为71.14%,其中单用率为79.27%,二联使用率为20.73%;住院患者使用频率排行前10位的抗菌药物中应用最多的是头孢硫脒;儿科抗菌药物使用率最高为93.27%;产科抗菌药物使用频率强度最高为77.37,妇科为67.19;所有患者临床微生物检验样本送检率仅为39.3%.结论 抗菌药物使用率及抗菌药物使用强度不符合相关规定,需要加强其抗菌药物临床应用的管理.%Objective To investigate the clinical application of antibiotics for inpatients in maternity and child health care hospital. Methods A cross section investigation method was used to survey the clinical application of antibiotics for inpatients in maternity and child health care hospital within February 2012. Results The usage rate of antibiotics was 71.14 %, of which, single drug application consisted 79.27 %, and double-drug application consisted 20.73%. In the ten antibiotics of the highest usage frequency, cefathiamidinc was on the top. The usage rate of antibiotics in Department of Pediatrics was the maximum (93.27%). Department with top consumption intensity of antibiotics was Obstetrics (77.37). Among all patients, the rate of microbiological examination was 39.3%. Conclusions The usage rate of antibiotics and consumption of antibiotics do not comply with the relative regulations. It is necessary for hospitals to strengthen the management of clinical antibiotics.

  14. Morbidade materna extremamente grave: uso do Sistema de Informação Hospitalar Morbilidad materna extremadamente grave: uso del sistema de información hospitalaria Severe acute maternal morbidity: use of the Brazilian Hospital Information System

    Directory of Open Access Journals (Sweden)

    Maria da Consolação Magalhães

    2012-06-01

    mostraron útiles para la vigilancia de la morbimortalidad materna y para ampliar el conocimiento sobre los aspectos que las involucran, contribuyendo en la mejoría en la calidad de la asistencia a la mujer en el período embarazo-puerperio.OBJECTIVE: To estimate the prevalence of severe acute maternal morbitidy and identify its associated hospital procedures. METHODS: Data from the Hospital Information System, obtained from the Municipal Secretariat of Health of the city of Juiz de Fora, Southeastern Brazil, for the years 2006 and 2007, were used. The studied women included those admitted to the hospital for obstetric procedures (n = 8,620, and whose primary diagnosis was included within chapter XV: pregnancy, childbirth and puerperium of the International Classification of Diseases, 10th revision. Codes for routine procedures, special procedures, and professional acts that fulfilled the World Health Organization's criteria for severe acute maternal morbidity were identified, as well as other procedures infrequently employed during pregnancy and the postnatal period. Logistic regression analysis was employed to identify associations between the outcome and selected variables. RESULTS: Prevalence of maternal morbidity was 37.8/1000 women, and that of mortality was 12/100,000 women. Hospitalization for more than 4 days was 13 times more frequent among women with some form of morbidity. After adjustment, predictors of severe acute maternal morbidity were: duration of hospitalization, number of hospitalizations, and still births, and the most frequent procedures and conditions were blood product transfusions (15.7/1,000, "extended stay" (9.5/1.000 and severe pre-eclampsia/eclampsia (8.2/1,000. CONCLUSIONS: Prevalence of severe acute maternal morbidity was high, and was related especially to hospitalization and to newborn variables. The criterion for identifying cases and the use of the National Hospital Information System proved to be useful for monitoring maternal morbidity

  15. Exercise during Pregnancy Department of Obstetrics,Shanghai First Maternity and Infant Hospital, Affliated to Tongji University,Shanghai 200040,China%妊娠期运动

    Institute of Scientific and Technical Information of China (English)

    宋蒙九; 李婷(审校)

    2014-01-01

    缺乏妊娠期运动会导致母儿不良事件(子痫前期、妊娠期糖尿病、早产等)的发生率上升,在妊娠期进行适当的运动可以起到控制体质量增加、调控血糖、缓解疼痛、预防抑郁以及改善睡眠等作用。尽管关于妊娠期运动安全性问题的一部分细节尚有争论,但许多国家已经发布了妊娠期运动指南,建议没有产科并发症及其他基础疾病的妊娠妇女进行适当的运动。总结妊娠期运动的益处、安全性以及介绍适宜的妊娠期运动,并主张应尽快开展有关中国妊娠妇女妊娠期运动状况的调查与研究,并在研究的基础上形成针对中国妊娠妇女特点的妊娠期运动指南。%Women are at low risk for adverse fetal or maternal events (preeclampsia,gestational diabetes mellitus, premature labor),if they participate in routine physical activity during pregnancy. Benefits from exercise during pregnancy include weight management,therapy for GDM,relief from low back pain,improved sense of well-being and enhanced sleep. Although there are still some arguments about the potential risk of exercise during pregnancy ,many countries have published guidelines for exercise during pregnancy and the postpartum period ,these guidelines are made for women who do not have any additional risk factors for adverse maternal or perinatal outcome. The benefits and potential risks of exercise during pregnancy and the suitable exercise during pregnancy are reviewed in this article ,and also we think an investigation on the exercise during pregnancy of Chinese women should be carried out,and on the basis of that a guideline should be developed as soon as possible.

  16. Maternal adjustment and maternal attitudes in adolescent and adult pregnant women.

    Science.gov (United States)

    Figueiredo, Bárbara; Tendais, Iva; Dias, Cláudia C

    2014-08-01

    This study analyzes differences between adolescent and adult pregnant women and the contribution of maternal age to maternal adjustment and maternal attitudes during pregnancy. A sample of 398 Portuguese pregnant women (111 younger than 19 years) was recruited in a Portuguese Maternity Hospital and completed the Maternal Adjustment and Maternal Attitudes Questionnaire between the 24(th) and 36(th) weeks of gestation. Maternal Adjustment and Maternal Attitudes Questionnaire(1) RESULTS: Adolescent pregnant women show lower maternal adjustment (poorer body image and worse marital relationship) and poorer maternal attitudes (more negative attitudes to sex) than adult pregnant women. When controlling for socio-demographics, age at pregnancy predicts poorer body image and more negative attitudes to sex, but not a worse marital relationship, more somatic symptoms or negative attitudes to pregnancy and the baby. A worse marital relationship was better predicted by living without the partner, and more somatic symptoms and negative attitudes to pregnancy and the baby was predicted by higher education. Adolescent pregnant women show lower maternal adjustment and poorer maternal attitudes than adult pregnant women according to socio-demographics and unfavorable developmental circumstances. Copyright © 2014 North American Society for Pediatric and Adolescent Gynecology. Published by Elsevier Inc. All rights reserved.

  17. [Maternal and foetal prognostic during severe toxemia].

    Science.gov (United States)

    Rachdi, Radhouane; Kaabi, Mehdi; Zayene, Houssine; Basly, Mohamed; Messaoudi, Fathi; Messaoudi, Lotfi; Chibani, Mounir

    2005-02-01

    Severe gravidic toxemia gives heavy maternal and foetal morbidity and mortality. The purpose of our study is to loosen the factors of bad maternal and foetal prognostic. It's a retrospective study about 100 cases of severe and complicated gravidic toxemia repertorieted in the maternity of Military Hospital of Tunis. Maternal morbidity is dominated by the complications of hypertension and a blood disorders. We raised 4 cases of eclampsia, 9 cases of retro placental hematome and 5 cases of HELLP syndrome. We don't deplore any maternal death. Perinatal mortality is 28.8%. The rate of delay intra-uterine growth was 43.8% and the prematurity 65.9%. More toxemia appears early during pregnancy more maternal and foetal prognostic is compromised.

  18. Estimation of the incidence of bacterial vaginosis and other vaginal infections and its consequences on maternal/fetal outcome in pregnant women attending an antenatal clinic in a tertiary care hospital in North India

    Directory of Open Access Journals (Sweden)

    Lata Indu

    2010-01-01

    Full Text Available Aims: This study was undertaken to estimate the incidence of bacterial vaginosis (BV and other vaginal infections during pregnancy and its association with urinary tract infections (UTI and its consequences on pregnancy outcome, maternal and fetal morbidity and mortality. Settings and Design: Prospective cohort study. Materials and Methods: The present prospective cohort study was conducted on 200 women attending the antenatal clinic (ANC of a tertiary hospital. All pertinent obstetric and neonatal data covering antenatal events during the course of pregnancy, delivery, puerperium and condition of each newborn at the time of birth were collected. BV was detected by both Gram stain and gold standard clinical criteria (Amsel′s composite criteria. Statistical analysis used: Data were analyzed using SPSS version 9. Fischer′s exact test, chi square tests and Student′s′ test has been used for analysis. The probability of 5% was considered as significant for continuous variables such as age, period of gestation and birth weight. Odds ratio (OR and confidence interval (CI with 95% probability were determined. Results: The incidence of bacterial vaginosis was 41 in 200 patients. Adverse outcomes such as preterm labor, PROM and fetal complications were found more in pregnant women who had bacterial vaginosis (N=41, bacterial vaginosis with UTI (N=14 as compared to those without bacterial vaginosis (N=118. Conclusions: The incidence of poor pregnancy outcome was higher in bacterial vaginosis with UTI. Prevention of BV and UTI is cost effective to minimize the pregnancy-related complications and preterm labor to decrease in perinatal and maternal mortality and morbidity. We recommend all antenatal patients should be screened for the presence of bacterial vaginosis, other infections and UTI.

  19. The Acoustics of the Double Elliptical Vault of the Royal Palace of Caserta (Italy)

    OpenAIRE

    Umberto Berardi; Gino Iannace; Amelia Trematerra

    2017-01-01

    This work investigates the acoustic characteristics of the double elliptical vault, which overlooks the Grand Staircase of the Royal Palace of Caserta (Italy). The Royal Palace was built by the architect Luigi Vanvitelli in the Seventeenth Century and it is the largest royal building in Italy. The double elliptical vault presents a great scenography effect. Inside the vault, on the planking level, musicians used to play for the king and his guests when the royal procession, going up the grand...

  20. The WHO maternal near-miss approach and the maternal severity index model (MSI: tools for assessing the management of severe maternal morbidity.

    Directory of Open Access Journals (Sweden)

    Joao Paulo Souza

    Full Text Available OBJECTIVES: To validate the WHO maternal near-miss criteria and develop a benchmark tool for severe maternal morbidity assessments. METHODS: In a multicenter cross-sectional study implemented in 27 referral maternity hospitals in Brazil, a one-year prospective surveillance on severe maternal morbidity and data collection was carried out. Diagnostic accuracy tests were used to assess the validity of the WHO maternal near-miss criteria. Binary logistic regression was used to model the death probability among women with severe maternal complications and benchmark the management of severe maternal morbidity. RESULTS: Of the 82,388 women having deliveries in the participating health facilities, 9,555 women presented pregnancy-related complications, including 140 maternal deaths and 770 maternal near misses. The WHO maternal near-miss criteria were found to be accurate and highly associated with maternal deaths (Positive likelihood ratio 106.8 (95% CI 99.56-114.6. The maternal severity index (MSI model was developed and found to able to describe the relationship between life-threatening conditions and mortality (Area under the ROC curve: 0.951 (95% CI 0.909-0.993. CONCLUSION: The identification of maternal near-miss cases using the WHO list of pregnancy-related life-threatening conditions was validated. The MSI model can be used as a tool for benchmarking the performance of health services managing women with severe maternal complications and provide case-mix adjustment.

  1. Population limitation and the wolves of Isle Royale

    Science.gov (United States)

    Peterson, R.O.; Thomas, N.J.; Thurber, J.M.; Vucetich, J.A.; Waite, T.A.

    1998-01-01

    Population regulation for gray wolves in Isle Royale National Park, Michigan, was ex- amined in 1987-1995 when wolves were in chronic decline following a crash of the pop- ulation in 1981-1982. Canine parvovirus (CPV-2) was probably influential during the crash, but it disappeared by the lae 1980s. High mortality abruptly ceased after 1988, but low recruitment in the absence of disease and obvious shortage of food prevented recovery of the wolf population. In 1983-1995, with a comparable number of moose '10 years old as potential prey, wolves were only half as numerous as in 1959-1980. A simulation of annual fluctuations in effective population size (Ne) for wolves on Isle Royale suggests that their genetic heterozygosity has declined ca. 13% with each generation and ca. 80% in the 50- year history of this population. Inbreeding depression and stochastic demographic variation both remain possible explanations for recent low recruitment.

  2. The Royal College of Psychiatrists and the death penalty.

    Science.gov (United States)

    Gunn, John

    2004-01-01

    The Royal College of Psychiatrists recently issued a revised statement on its position concerning capital punishment. The College proposes to support psychiatrists who refuse to be involved in the capital process, but accepts that some may take up limited involvement in the manner set out in the document. The Royal College is the professional body for psychiatric practitioners in the United Kingdom and Ireland. Almost no public statements are issued from the College without first being deliberated on within at least two of its three major committees. The new document on capital punishment remains in the spirit of the previous ones. The topic of capital punishment is noncontroversial within the British medical profession. In all European countries, capital punishment is against the law, because there is an overarching directive from the Council of Europe (a wide group of nations, wider than the European Union) insisting that it be abolished.

  3. The trend of national advanced maternal age woman proportion in hospital-based surveillance%基于医院的全国高龄产妇比率变化趋势

    Institute of Scientific and Technical Information of China (English)

    李月花; 王艳萍; 代礼; 周光宣; 梁娟; 李琪; 朱军

    2009-01-01

    Objective To investigate the secular trend of advanced maternal age woman ( ≥35 year-old) in our country. Methods Data on maternal woman at different age were collected at surveillance hospital in Chinese Birth Defects Monitoring Network from 1996 to 2007 and retrospective analysis of the trend of advanced maternal women were carried out. Trend analysis of the advanced maternal age in urban and rural areas of west, middle and east areas was also conducted. Chi-square test was applied to test the differences and the fitting model analysis was also applied. Results A total of 6 308 594 parturient woman were monitored, included 354 511 woman (5.62%) of advanced maternal age. In 1996 and 2007, the proportion of the advanced maternal woman were 2.96% (12 508/422 486) and 8.56% (66 351/775 333) , respectively. It showed an increasing trend for the national woman proportion of advanced maternal age from 1996 to 2007 (χ~2 =45 376. 16,P<0. 01). In city, the proportion of advanced maternal age woman were 2. 95% (8755/296 975) and 7. 69% (40 197/522 596) in 1996 and 2007, respectively. In rural region, the proportion of advanced maternal age woman were 2. 99% (3753/125 511) and 10. 35% (26 154/252 737)in 1996 and 2007, respectively. It showed increasing both in city and rural areas(χ_(city)~2=24 152.86,P<0.01;χ_(rural)~2=20809.79, P<0. 01). And the proportions in urban area and rural area were 5. 13% ( 221 655/4 317 533) and 6. 67% (132 856/1 991 061), the proportions difference was significant in statistics (χ~2 =1536. 260,P<0.01). An Exponential model was established, In ( Y)=ln(2.52)+(0.103×t). In east areas, the proportion were 3.90% and 8.81% in 1996 and 2007, respectively, in middle areas the respective proportions were 2. 49% and 8. 56% , in west areas were 2. 11 % and 8. 21 % . They all showed increasing trend in proportion of advanced maternal age from 1996 to 2007 year in east areas, middle areas and west areas(χ_(east)~2, = 11 746. 87 ,P<0.01;χ_(middle)~2

  4. Victualling for Future Royal Australia Navy Platforms - Alternative Technologies

    Science.gov (United States)

    2014-11-01

    Electric Field QL Quick Look RAN Royal Australian Navy RPDE Rapid Prototyping, Development and Evaluation program SFE Supercritical Fluid ...however, to be suited to liquid or ‘pumpable’ foods such as milk , juices, sauces and soups. Many are used in the treatment of waste water in the food...the liquid, killing the cells and rendering them harmless. • Supercritical Fluids [8] – carbon dioxide is often used as a supercritical fluid . The

  5. Doctrine and Fleet Tactics in the Royal Navy.

    Science.gov (United States)

    1994-11-02

    embarrassed the Turks that it was diplomatically inexpedient and he was recalled and his career ruined. During the long wars with the continental powers in...amphibious operations, the Royal Navy fell somewhat short. A landing in German East Africa was successfully neutralized. The disastrous attempt at...Madrid, SP: Instituto de Historia y Cultura Naval, 1983 [original version written from 1520-1538]. 5. "Traditional tactics, 1530: ’A book of orders for the

  6. Royal Thai Army Personnel, Education and Training System.

    Science.gov (United States)

    2014-09-26

    north, Laos to the north and northeast and Cambodia to the eastj Thailand is approximately the size of France with a population of 50 million...paper focuses on the role played by the US, and US assistance to Thailand . ii k4 ROYAL THAI ARMY PERSONNEL, EDUCATION AND TRAINING SYSTEM Thailand ... Thailand history is as complex as a slow Thai classical dance. Thai beliefs, attitudes, political structures and customs have been molded by a remarkable

  7. The Ursula Faince Dinnerware Series by Royal Copenhagen

    DEFF Research Database (Denmark)

    Moeran, Brian

    This working paper is a case study about the development of a faience product line in Royal Copenhagen and illustrates several aspects of how, at what stages of development, and by whom, cultural products in general are evaluated. Three theoretical issues emerge. One concerns the constraints impo...... of a particular cultural product had to be negotiated within a particular organizational world embracing both management and workers, with differentiated skills. These issues lead to a more general discussion of craftsmanship and storytelling....

  8. Estudo da morbidade e da mortalidade perinatal em maternidades. I-Descrição do projeto e resultados gerais A study of perinatal morbidity and mortality in maternity-hospitals

    Directory of Open Access Journals (Sweden)

    Ruy Laurenti

    1984-12-01

    Full Text Available É descrito estudo sobre morbidade e mortalidade ocorridas no período perinatal por meio da coleta de dados referentes ao evento, ao produto e à mãe. O estudo foi feito, de maneira coordenada e padronizada, em nove maternidades, sendo sete no Estado de São Paulo, uma no Rio de Janeiro e outra em Florianópolis, SC, o que possibilitou a coleta de dados referentes à 13.130 eventos, dos quais 12.782 eram nascidos vivos; 217 nascidos mortos e 131 abortos. Esta apresentação é a primeira de uma série e que visou descrever detalhadamente o projeto, bem como apresentar alguns resultados globais, sendo que resultados mais específicos serão apresentados futuramente. Dentre os resultados globais chama a atenção a alta mortalidade perinatal, a alta percentagem de cesária e o baixo peso nos casos de nascidos mortos ser, aproximadamente, cinco vezes mais forte que o baixo peso ao nascer nos casos de nascidos vivos.Collecting data on deliveries, newborn and mothers, in maternity-hospitals, is the best way to conduct research into perinatal morbidity and mortality. The kind of study which was carried out in nine Brazilian maternity-hospitals, seven of then situated in cities in the State of S. Paulo, one in Rio de Janeiro and another in Florianópolis, Santa Catarina, is described. The study called for the collection of data on 13,130 deliveries, of which 12,782 were live births, 217 still-births and 131 abortions. This is the first of a series of papers; the aims of this one are to describe the project and to present some general results; however, more specific results will be presented in the future. The high perinatal mortality rate, the high proportion of cesarian sections and the several times greater incidence of low birth-weight in still-births as compared with live births, deserved particular attention.

  9. Maternal phenylketonuria

    Directory of Open Access Journals (Sweden)

    Kristina Štuikienė

    2013-04-01

    Full Text Available Phenylketonuria is a hereditary metabolic disorder inherited in an autosomal recessive pattern. Elevated phenylalanine levels in a pregnant woman with phenylketonuria result in phenylalanine embryopathy. Failure to follow special diets during gestation results in neonatal dysplasia. More favorable outcomes are observed when phenylalanine levels remain within normal ranges prior to conception, or at least when they reach normal levels by the 4th-10th weeks of gestation. We report the case of a newborn with maternal phenylketonuria.

  10. Geohydrologic data from Port Royal Sound, Beaufort County, South Carolina

    Science.gov (United States)

    Burt, R.A.; Belval, D.L.; Crouch, Michael; Hughes, W.B.

    1986-01-01

    Nine offshore wells were drilled through overlying sediments into the Upper Floridan aquifer in Port Royal Sound, South Carolina and the adjacent Atlantic Ocean, to obtain geologic, hydrologic, and water quality data. The Upper Floridan aquifer consists predominantly of light-gray, poorly consolidated, fossiliferous limestone. In the Port Royal Sound area, the Upper Floridan is overlain by olive-gray, medium to course sand and silty sand. Falling-head permeability tests on these overlying clastic sediments indicate permeabilities of 1,100 to 4.3 x 10 to the 7th power centimeters/sec. Other geologic and hydrologic data, including geophysical logs, sieve analyses, and detailed core descriptions were obtained, along with continuous water level records of the wells, tidal records, and barometric pressure records. Water collected from the Upper Floridan aquifer beneath Port Royal Sound and the ocean ranged in concentration of chloride from 54 to 12,000 mg/l. Measured pH ranged from 6.8 to 8.4, and alkalinity ranged from 122 to 368 mg/l as CaC03. Other water quality data obtained include temperature, specific conductance, carbon-13, carbon-14, tritium , deuterium, oxygen-18, dissolved oxygen, dissolved solids, nitrogen species, phosphorus, organic carbon, cyanide, sulfide, calcium, magnesium, sodium, potassium, sulfate, fluoride, silica , bromide, iodide, and selected trace metals. (USGS)

  11. Functional properties of honey, propolis, and royal jelly.

    Science.gov (United States)

    Viuda-Martos, M; Ruiz-Navajas, Y; Fernández-López, J; Pérez-Alvarez, J A

    2008-11-01

    Honey, propolis, and royal jelly, products originating in the beehive, are attractive ingredients for healthy foods. Honey has been used since ancient times as part of traditional medicine. Several aspects of this use indicate that it also has functions such as antibacterial, antioxidant, antitumor, anti-inflamatory, antibrowning, and antiviral. Propolis is a resinous substance produced by honeybees. This substance has been used in folk medicine since ancient times, due to its many biological properties to possess, such as antitumor, antioxidant, antimicrobial, anti-inflammatory, and immunomodulatory effects, among others. Royal jelly has been demonstrated to possess numerous functional properties such as antibacterial activity, anti-inflammatory activity, vasodilative and hypotensive activities, disinfectant action, antioxidant activity, antihypercholesterolemic activity, and antitumor activity. Biological activities of honey, propolis, and royal jelly are mainly attributed to the phenolic compounds such as flavonoids. Flavonoids have been reported to exhibit a wide range of biological activities, including antibacterial, antiviral, anti-inflammatory, antiallergic, and vasodilatory actions. In addition, flavonoids inhibit lipid peroxidation, platelet aggregation, capillary permeability and fragility, and the activity of enzyme systems including cyclo-oxygenase and lipoxygenase.

  12. Time-to-delivery after maternal transfer to a tertiary perinatal centre.

    Science.gov (United States)

    Hutchinson, Fiona H; Davies, Mark W

    2014-01-01

    To determine, in women transferred antenatally for acute admission with high risk pregnancies, the numbers who deliver, the average time from transfer to delivery, and whether the reason for transfer influences the time-to-delivery. A retrospective analysis of time-to-delivery was performed in a population of women transferred to the Royal Brisbane and Women's Hospital, QLD. Data were obtained from the hospital obstetric, neonatal, and admission databases. A total of 941 women were transferred antenatally with high risk pregnancies where delivery was deemed potentially imminent. Of these 821 (87%) delivered at RBWH. The remaining 120 women (13%) were discharged prior to delivery and then delivered elsewhere. Of the 821 maternal transfers that delivered, the median time to delivery was 24.4 hrs. There were 43% who delivered within 24 hours of admission and 29% who either delivered after 7 days or delivered elsewhere. Most transfers for fetal abnormality delivered in the first 24 hours while most transfers for antepartum haemorrhage and preterm prelabour membrane rupture delivered beyond 24 hours. There are significant differences in time-to-delivery following transfer depending on the reason for transfer and many infants transferred in utero will not deliver imminently.

  13. Time-to-Delivery after Maternal Transfer to a Tertiary Perinatal Centre

    Directory of Open Access Journals (Sweden)

    Fiona H. Hutchinson

    2014-01-01

    Full Text Available Objectives. To determine, in women transferred antenatally for acute admission with high risk pregnancies, the numbers who deliver, the average time from transfer to delivery, and whether the reason for transfer influences the time-to-delivery. Methods. A retrospective analysis of time-to-delivery was performed in a population of women transferred to the Royal Brisbane and Women’s Hospital, QLD. Data were obtained from the hospital obstetric, neonatal, and admission databases. Results. A total of 941 women were transferred antenatally with high risk pregnancies where delivery was deemed potentially imminent. Of these 821 (87% delivered at RBWH. The remaining 120 women (13% were discharged prior to delivery and then delivered elsewhere. Of the 821 maternal transfers that delivered, the median time to delivery was 24.4 hrs. There were 43% who delivered within 24 hours of admission and 29% who either delivered after 7 days or delivered elsewhere. Most transfers for fetal abnormality delivered in the first 24 hours while most transfers for antepartum haemorrhage and preterm prelabour membrane rupture delivered beyond 24 hours. Conclusion. There are significant differences in time-to-delivery following transfer depending on the reason for transfer and many infants transferred in utero will not deliver imminently.

  14. GP obstetricians' views of the model of maternity care in New Zealand.

    Science.gov (United States)

    Miller, Dawn L; Mason, Zara; Jaye, Chrystal

    2013-02-01

    The Lead Maternity Carer (LMC) model of maternity care, and independent midwifery practice, was introduced to New Zealand in the 1990s. The LMC midwife or general practitioner obstetrician (GPO) has clinical and budgetary responsibility for women's primary maternity care. To determine views of practising GPOs and former GPOs about the LMC model of care, its impact on maternity care in general practice, and future of maternity care in general practice. 10 GPOs and 13 former GPOs were interviewed: one focus group (n = 3), 20 semi-structured interviews. The qualitative data analysis program ATLAS.ti assisted thematic analysis. Participants thought the LMC model isolates the LMC - particularly concerning during intrapartum care, in rural practice, and covering 24-hour call; Is not compatible with or adequately funded for GP participation; Excludes the GP from caring for their pregnant patients. Participants would like a flexible, locally adaptable, adequately funded maternity model, supporting shared care. Some thought work-life balance and low GPO numbers could deter future GPs from maternity practice. Others felt with political will, support of universities, and Royal New Zealand College of General Practice and Royal Australian and New Zealand College of Obstetrics and Gynaecology, GPs could become more involved in maternity care again. Participants thought the LMC model isolates maternity practitioners, is incompatible with general practice and causes loss of continuity of general practice care. They support provision of maternity care in general practice; however, for more GPs to become involved, the LMC model needs review. © 2013 The Authors ANZJOG © 2012 The Royal Australian and New Zealand College of Obstetricians and Gynaecologists.

  15. Post discharge formula fortification of maternal human milk of very low birth weight preterm infants: an introduction of a feeding protocol in a University Hospital

    Directory of Open Access Journals (Sweden)

    Abeer El Sakka

    2016-10-01

    Full Text Available The objective of this study is to determine the growth parameters and nutritional biochemical markers and complications of fortification of human milk by post discharge formula of preterm very low birth weight newborns (VLBW. Fifty preterm infants less than 37 weeks with weight less than 1500 g were enrolled in the study. They received parental nutrition and feeding according to our protocol. When enteral feeding reached 100 cc/kg/day, infants were randomized into two groups: group I, Cases, n=25, where post discharge formula (PDF was used for fortification, group II, Controls, n=25 with no fortification. Infants of both groups were given 50% of required enteral feeding as premature formula. This protocol was used until infants’ weight reached 1800 g. Daily weight, weekly length and head circumference were recorded. Hemoglobin, albumin (Alb, electrolytes, blood urea nitrogen (BUN and clinical complications were documented. Human milk fortification with PDF resulted in better growth with increase in weight 16.8 and 13.78 g/kg/day (P=0.0430, length 0.76 and 0.58 cm/week (P=0.0027, and head circumference of 0.59 and 0.5 cm/week (P=0.0217 in cases and controls respectively. Duration of hospital stay was less in cases (22.76 versus 28.52 days in Controls, P=0.02. No significant changes were found in serum electrolytes, BUN, or Alb between both groups. Hemoglobin was significantly higher in Cases, P=0.04. There were no significant clinical complications. Our feeding protocol of fortification of human milk with PDF in preterm very low birth weight newborns resulted in better growth and decrease in length of hospital stay. The use of PDF could be an alternative option for fortification of mothers’ milk for preterm VLBW infants in developing countries with low resources.

  16. Post Discharge Formula Fortification of Maternal Human Milk of Very Low Birth Weight Preterm Infants: An Introduction of a Feeding Protocol in a University Hospital

    Science.gov (United States)

    El Sakka, Abeer; El Shimi, Mohamed Sami; Salama, Kareem; Fayez, Hend

    2016-01-01

    The objective of this study is to determine the growth parameters and nutritional biochemical markers and complications of fortification of human milk by post discharge formula of preterm very low birth weight newborns (VLBW). Fifty preterm infants less than 37 weeks with weight less than 1500 g were enrolled in the study. They received parental nutrition and feeding according to our protocol. When enteral feeding reached 100 cc/kg/day, infants were randomized into two groups: group I, Cases, n=25, where post discharge formula (PDF) was used for fortification, group II, Controls, n=25 with no fortification. Infants of both groups were given 50% of required enteral feeding as premature formula. This protocol was used until infants’ weight reached 1800 g. Daily weight, weekly length and head circumference were recorded. Hemoglobin, albumin (Alb), electrolytes, blood urea nitrogen (BUN) and clinical complications were documented. Human milk fortification with PDF resulted in better growth with increase in weight 16.8 and 13.78 g/kg/day (P=0.0430), length 0.76 and 0.58 cm/week (P=0.0027), and head circumference of 0.59 and 0.5 cm/week (P=0.0217) in cases and controls respectively. Duration of hospital stay was less in cases (22.76 versus 28.52 days in Controls), P=0.02. No significant changes were found in serum electrolytes, BUN, or Alb between both groups. Hemoglobin was significantly higher in Cases, P=0.04. There were no significant clinical complications. Our feeding protocol of fortification of human milk with PDF in preterm very low birth weight newborns resulted in better growth and decrease in length of hospital stay. The use of PDF could be an alternative option for fortification of mothers’ milk for preterm VLBW infants in developing countries with low resources. PMID:27777705

  17. 农村地区县妇幼保健院助产服务现状及优势分析%Analysis on current situation and advantages of midwifery service in maternal and child health care hospital at county level in rural area

    Institute of Scientific and Technical Information of China (English)

    罗荣; 金曦; 杜立燕; 胡文玲; 谷丽紧

    2013-01-01

    目的:调查农村地区不同类别助产机构产科服务提供情况及服务能力,对县妇幼保健院助产服务现状和优势进行分析.方法:在全国随机抽取44个地市全部助产服务机构2010年产科服务情况进行问卷调查,重点对农村地区(县和县级市)中不同类型助产机构进行分析.结果:农村助产服务机构中县妇幼保健院占6.5%,县妇幼保健院产科床位数占辖区产科总床位数的18.1%,分娩数量占辖区分娩量的42.9%,平均每个县妇幼保健院年分娩为1 259人,高于县级综合性医院和其他医疗机构.县妇幼保健院中能提供综合产科和综合新生儿科服务的比例最高分别为85.3%、61.9%,高于县级综合性医院83.1%、59.4%,并明显高于其他医疗机构32.4%、19.3%.结论:县妇幼保健院是农村地区助产服务的主要力量之一,与其他助产机构相比,县妇幼保健院在助产服务提供数量和能力方面都具有一定优势.应进一步加强对妇幼保健机构的规范化建设,以保证其职能的履行.%Objective:To investigate the obstetrical service providing status and service ability of different types of midwifery institutions in rural area,and analyze the current situation and advantages of midwifery service in county maternal and child health care hospitals.Methods:The whole midwifery institutions in 44 cities were randomly selected,the obstetrical service statuses of the midwifery institutions in 2010 were investigated by a questionnaire,different types of midwifery institutions in rural area (counties and county-level cities) were analyzed.Results:Among the midwifery service institutions in rural area,county maternal and child health care hospitals accounted for 6.5%,the number of beds in obstetrical departments of county maternal and child health care hospitals accounted for 18.1% of the total number of beds in obstetrical departments of county maternal and child health care hospitals

  18. [Maternal malnutrition. The nursing task].

    Science.gov (United States)

    Grotestán Liverpool, G; Grant, W A; Ibáñez Peña, E

    1990-01-01

    A retrospective study of 577 patients from urban and periurban areas of Las Tunas municipality is made. These patients were delivered in "Dr. Ernesto Guevara de la Serna" Hospital between January and April 1986, both inclusive; their characteristics included being single pregnancies and not having suffered maternal diseases that influenced fetal growth. The following variables were studied: state of maternal nutrition at implantation, initial weight and weight gain, newborn weight, as well as maternal age and place of residence; these variables were interrelated with the view to know their influence or lack of influence on fetal weight. A survey of 89 of these women is made; they had been classified as malnourished and the purpose of the survey is to analyze their knowledge and views on malnutrition, as well as the instructions received during pregnancy and after delivery. Conclusions are derived and nursing recommendations are made.

  19. AWARENESS ABOUT EMERGENCY CONTRACEPTIVE PILLS VERSUS CONVENTIONAL CONTRACEPTIVE METHODS AMONG MOTHERS ATTENDING MATERNAL AND CHILD HEALTH (MCH CLINIC, BAPUJI HOSPITAL, DAVANGERE, KARNATAKA

    Directory of Open Access Journals (Sweden)

    Vandana

    2015-02-01

    Full Text Available BACKGROUND: Unwanted pregnancies are a major public health problem for both developing and developed nations, which generally results from ineffective use of contraceptives and end up in induced abortions. Emergency contraception sometimes called “morning after”, “postcoital” or “second chance pills” can be used to prevent pregnancy after an unprotected sex. Attention has been focused on the potential for emergency contraception to reduce the number of unwanted pregnancies and thus abortion rate. OBJECTIVES: 1 . To compare the awareness about emergency contraceptive pills and conventional contraceptive methods among mothers attending MCH clinic, Bapuji Hospital, Davangere. 2. To study the socio - demographic profile of the above group. METHODS: A pre - tested, semi - structured questionnaire was used to know the awareness about emergency contraceptive pills versus conventional contraceptive methods among mothers attending MCH clinic, Bapuji hospital, Davangere from 1 st October 2011 to 31 st December 2011. Data was entered into Excel sheet and was analysed using SPSS software version 17. Data was described as proportions, categorical data using chi square test. RESULTS: A total of 500 mothers were included in the study for duration of 3months. Approximately 80% of the respondents were in the age group of 21 - 30yrs, 72.8% from urban background, 83.4% were Hindus, 55% were from joint family. Approximately 49% belonged to socioeconomic class II and III, 97.2% were literate and 86.6% were housewives. 31.8% had knowledge about emergency contraception which is very less when compared to 84.2% of conventional methods. 6.2% have practiced emergency contraception which is very poor when compared to 47.5% of conventional methods. 77.8% were aware of female sterilization. The most common known temporary method of contrac eption was Cu - T (71% followed by OCP (60.6%. Most common method used by couples was condom (21.8% followed by Cu - T (19

  20. Pregnancy Outcomes of Mothers with Detectable CMV-Specific IgM Antibodies: A Three-Year Review in a Large Irish Tertiary Referral Maternity Hospital

    Science.gov (United States)

    Drew, Richard J.; Stapleton, Patrick; Abu, Hala; Healy, Eibhlín; Ferguson, Wendy; De Gascun, Cillian; O'Gorman, Joanne; Eogan, Maeve

    2015-01-01

    A retrospective audit was performed for all obstetric patients who had positive CMV IgM results between January 2012 and December 2014 in the Rotunda Hospital, Ireland. In total, 622 CMV IgM positive tests were performed on samples from 572 patients. Thirty-seven patients had a positive CMV IgM result (5.9%) on the Architect system as part of the initial screening. Three patients were excluded as they were not obstetric patients. Of the 34 pregnant women with CMV IgM positive results on initial screening, 16 (47%) had CMV IgM positivity confirmed on the second platform (VIDAS) and 18 (53%) did not. In the 16 patients with confirmed positive CMV IgM results, four (25%) had acute infection, two (12.5%) had infection of uncertain timing, and ten (62.5%) had infection more than three months prior to sampling as determined by the CMV IgG avidity index. Two of the four neonates of women with low avidity IgG had CMV DNA detected in urine. Both these cases had severe neurological damage and the indication for testing their mothers was because the biparietal diameter (BPD) was less than the 5th centile at the routine 20-week gestation anomaly scan. PMID:26696757

  1. Maternal and neonatal colonisation of group B streptococcus at Muhimbili National Hospital in Dar es Salaam, Tanzania: prevalence, risk factors and antimicrobial resistance

    Directory of Open Access Journals (Sweden)

    Lyamuya Eligius F

    2009-12-01

    Full Text Available Abstract Background Group B streptococcus (GBS, which asymptomatically colonises the vaginal and rectal areas of women, is the leading cause of septicemia, meningitis and pneumonia in neonates. In Tanzania no studies have been done on GBS colonisation of pregnant women and neonates. This study was conducted in Dar es Salaam, Tanzania to determine the prevalence of GBS colonisation among pregnant women, the neonatal colonisation rate and the antimicrobial susceptibility, thus providing essential information to formulate a policy for treatment and prevention regarding perinatal GBS diseases. Methods This cross sectional study involved 300 pregnant women attending antenatal clinic and their newborns delivered at Muhimbili National Hospital (MNH between October 2008 and March 2009. High vaginal, rectal, nasal, ear and umbilical swabs were cultured on Todd Hewitt Broth and in 5% sheep blood agar followed by identification of isolates using conventional methods and testing for their susceptibility to antimicrobial agents using the Kirby-Bauer method. Results GBS colonisation was confirmed in 23% of pregnant women and 8.9% of neonates. A higher proportion of GBS were isolated from the vagina (12.3% as compared to the rectum (5%. Prolonged duration of labour (>12 hrs was significantly shown to influence GBS colonisation in neonates P Conclusion Our findings seem to suggest that a quarter of pregnant women attending ANC clinic at MNH and approximately 10% of their newborns are colonised with GBS. All isolates were found to be sensitive to vancomycin and ampicillin which seem to be the most effective antibiotics for the time being. However there is a need for continuous antibiotics surveillance of GBS to monitor trend of resistance. The high isolation frequency of GBS among pregnant women suggests routine antenatal screening at 35 to 37 weeks of gestation in order to provide antibiotic prophylaxis to GBS carrier.

  2. The geologic story of Isle Royale National Park

    Science.gov (United States)

    Huber, N. King

    1975-01-01

    Isle Royale is an outstanding example of relatively undisturbed northwoods lake wilderness. But more than simple preservation of such an environment is involved in its inclusion in our National Park System. Its isolation from the mainland provides an almost untouched laboratory for research in the natural sciences, especially those studies whose very nature depends upon such isolation. One excellent example of such research is the intensive study of the predator-prey relationship of the timber wolf and moose, long sponsored by the National Park Service and Purdue University. In probably no other place in North America are the necessary ecological conditions for such a study so admirably fulfilled as on Isle Royale. The development of a natural laboratory with such conditions is ultimately dependent upon geologic processes and events that although not unique in themselves, produced in their interplay a unique result, the island archipelago as we know it today, with its hills and valleys, swamps and bogs the ecological framework of the plant and animal world. Even the most casual visitor can hardly fail to be struck by the fiordlike nature of many of the bays, the chains of fringing islands, the ridge-and-valley topography, and the linear nature of all these features. The distinctive topography of the archipelago is, of course, only the latest manifestation of geologic processes in operation since time immemorial. Fragments of geologic history going back over a billion years can be read from the rocks of the island, and with additional data from other parts of the Lake Superior region, we can fill in some of the story of Isle Royale. After more than a hundred years of study by man, the story is still incomplete. But then, geologic stories are seldom complete, and what we do know allows a deeper appreciation of one of our most naturally preserved parks and whets our curiosity about the missing fragments.

  3. Visit of Her Royal Highness Princess Maha Chakri Sirindhorn, Thailand

    CERN Multimedia

    Patrice Loïez

    2000-01-01

    Her Royal Highness Princess Maha Chakri Sirindhorn of Thailand (left) visiting DELPHI with Spokesman, Tiziano Camporesi, and Prapol Assavavirulhakarn, Pattaratorn Chirapravati, Claude Détraz, CERN Director for Fixed Target andFuture Programmes and Richard Breedon, University of California. No. 05: Princess Maha Chakri Sirindhorn and Daniel Treille, former spokesman of Delphi. No. 31: in Delphi experiment. No. 35: H.E. Mr. Virasakdi Futrakul, Ambassador, Permanent Representative ofThailand, Geneva with H.E. Dr. Ronarong Nopakun, Ambassador of the Thai Embassy in Bern

  4. The Royal Society and the decline of magic.

    Science.gov (United States)

    Hunter, Michael

    2011-06-20

    Whereas some have asserted that the early Royal Society actively sought to discredit magical beliefs, others have seen ideas of this kind as integral to the Society's 'nature' in its early years. This paper argues that, whatever the magical commitments of individual Fellows, the Society's corporate policy simply sidelined such pursuits. Yet, insofar as the result was that magic was excluded by default from the proper realm of scientific enquiry, this attitude was to prove paradoxically influential (although its roots have been retrospectively misconstrued to an extent that is significant in itself).

  5. Creative IL embedding at Royal Holloway, University of London 2013

    OpenAIRE

    Burke, Russell; Coles, Kim; Downes, Sian; Woods, Emma

    2015-01-01

    n 2013, Helen Westwood and Russell Burke presented at LILAC about how information literacy was embedded in Geography courses at Royal Holloway. One of our plans for the future was to embed IL across the college. In May 2014, a paper was accepted at the College’s Learning, Teaching and Quality Committee making IL training and assessment a requirement for all first year undergraduate courses from 2014/15. This poster will show the steps involved in achieving this outcome, the challenges we have...

  6. La fondation royale des Dominicaines d'Aix-en-Provence

    OpenAIRE

    Richarté-Manfredi, Catherine; Barra, Catherine

    2016-01-01

    Notre-Dame de Nazareth, couvent de dominicaines, est fondé en 1292 à Aix-en-Provence par le comte d’Anjou et de Provence, roi de Naples et de Jérusalem. Les résultats archéologiques de plusieurs campagnes de fouilles conduites sur une partie de l’ancien domaine, associés aux informations apportées par les sources écrites, permettent dans une certaine mesure d’appréhender la vie dans cette institution originale. Couvent royal, d’un ordre mendiant apostolique de femmes contemplatives, le comple...

  7. [Beneficial effect of maternity leave on delivery].

    Science.gov (United States)

    Xu, Qian; Séguin, Louise; Goulet, Lise

    2002-01-01

    To identify the contribution of the duration of the prenatal maternity leave on term delivery. Characteristics of the prenatal maternity leave and delivery among 363 working women who had delivered a full-term infant at 1 of 4 hospitals in Montreal during 1996 were studied. The presence of an intervention or complication during delivery was observed in 68.9% of the participants. The average duration of the prenatal maternity leave was about 8 weeks (SD = 7). The adjusted risk of a difficult delivery decreased significantly with the duration of the prenatal maternity leave (OR = 0.96; 95% CI: 0.93-0.99). The duration of the maternity leave before delivery is associated with an easier term delivery for working women.

  8. Maternal deaths in the Nordic countries

    DEFF Research Database (Denmark)

    Vangen, Siri; Bødker, Birgit; Ellingsen, Liv

    2017-01-01

    INTRODUCTION: Despite the seriousness of the event, maternal deaths are substantially underreported. There is often a missed opportunity to learn from such tragedies. The aim of the study was to identify maternal deaths in the five Nordic countries, to classify causes of death based...... on internationally acknowledged criteria, and to identify areas that would benefit from further teaching, training or research to possibly reduce the number of maternal deaths. MATERIAL AND METHODS: We present data for the years 2005-2013. National audit groups collected data by linkage of registers and direct...... reporting from hospitals. Each case was then assessed to determine the cause of death, and level of care provided. Potential improvements to care were evaluated. RESULTS: We registered 168 maternal deaths, 90 direct and 78 indirect cases. The maternal mortality ratio was 7.2/100 000 live births ranging from...

  9. The Length of Maternity Leave and Family Health

    DEFF Research Database (Denmark)

    Beuchert-Pedersen, Louise Voldby; Humlum, Maria Knoth; Vejlin, Rune Majlund

    of maternity leave on a range of health indicators including the number of hospital admissions for both mother and child and the probability of the mother receiving antidepressants. The reform led to an increase in average post-birth maternity leave matters for child or maternal health outcomes and thus we...... complement the existing evidence on maternity leave expansions that tends to find limited effects on children's later deveopmental, educational, and labor market outcomes. Our results suggest that any beneficial effects of increasing the lenght of maternity leave are greater for low-resource families....

  10. Déclenchement artificiel du travail à terme à Port-Royal : Évaluation des pratiques professionnelles entre 1999 et 2009 en regard des recommandations de la HAS de 2008

    OpenAIRE

    Blanchot, Julia

    2011-01-01

    Term labor induction concerns, since 1995, one in five women. Medical or elective induction, this obstetrical practice should be evaluate regularly. The latest recommendations were made by HAS in 2008. What about Port-Royal practice's evolution ? Are the recommendations respected ? To answer this questions, we leaded a retrospective research, comparative to that made earlier by Brochard in the same maternity, including all low risk patients who had labor induction between July 1 and December ...

  11. Topical royal jelly alleviates symptoms of pruritus in a murine model of allergic contact dermatitis

    Directory of Open Access Journals (Sweden)

    Katsunori Yamaura

    2013-01-01

    Full Text Available Background: Royal jelly is widely used as a health tonic, especially in Asia. Royal jelly is commonly used in cosmetics as well as in dietary supplements and beverages. Little is known, however, about the pharmacologic efficacy of topical royal jelly. Therefore, we investigated the antipruritic activity of topical royal jelly on chronic pruritus in experimental allergic contact dermatitis in mice. Materials and Methods: Hairless mice (HOS: HR-1, with chronic allergic contact dermatitis induced by 5 weeks of repeated application of 2,4,6-trinitro-1-chlorobenzene (TNCB to the entire back skin were treated topically with royal jelly (0.01% or 1% for 5 weeks after sensitization with TNCB. The effects of royal jelly on pruritus and inflammation were evaluated by measurement of scratching behavior and skin inflammation score, respectively. Results: Repeated application of TNCB to the back skin of mice elicited frequent scratching behavior immediately and 24h after challenge. Topical royal jelly (0.01% or 1% and betamethasone (0.01% significantly ameliorated this chronic pruritus throughout the experimental period. The level of nerve growth factor mRNA in back skin was increased in the mice with dermatitis and reduced by betamethasone, but not by royal jelly. Conclusion: The inhibitory effect of royal jelly on chronic pruritus may occur through different mechanisms from those of betamethasone. Topical application of royal jelly, as used in cosmetics, might be beneficial for the alleviation of chronic pruritus.

  12. Retrospective Analysis of Patient Presentations at the Sydney (Australia) Royal Easter Show from 2012 to 2014.

    Science.gov (United States)

    Crabtree, Nathan; Mo, Shirley; Ong, Leon; Jegathees, Thuvarahan; Wei, Daniel; Fahey, David; Liu, Jia Jenny

    2017-04-01

    Introduction Comprehensive studies on the relationship between patient demographics and subsequent treatment and disposition at a single mass-gathering event are lacking. The Sydney Royal Easter Show (SRES; Sydney Olympic Park, New South Wales, Australia) is an annual, 14-day, agricultural mass-gathering event occurring around the Easter weekend, attracting more than 800,000 patrons per year. In this study, patient records from the SRES were analyzed to examine relationships between weather, crowd size, day of week, and demographics on treatment and disposition. This information would help to predict factors affecting patient treatment and disposition to guide ongoing training of first responders and to evaluate the appropriateness of staffing skills mix at future events. Hypothesis Patient demographics, environmental factors, and attendance would influence the nature and severity of presentations at the SRES, which would influence staffing requirements. A retrospective analysis of 4,141 patient record forms was performed for patients who presented to St John Ambulance (Australian Capital Territory, Australia) at the SRES between 2012 and 2014 inclusive. Presentation type was classified using a previously published minimum data set. Data on weather and crowd size were obtained from the Australian Bureau of Meteorology (Melbourne, Victoria, Australia) and the SRES, respectively. Statistical analyses were performed using SPSS v22 (IBM; Armonk, New York USA). Between 2012 to 2014, over 2.5 million people attended the SRES with 4,141 patients treated onsite. As expected, the majority of presentations were injuries (49%) and illnesses (46%). Although patient demographics and presentation types did not change over time, the duration of treatment increased. A higher proportion of patients were discharged to hospital or home compared to the proportion of patients discharged back to the event. Patients from rural/regional locations (accounting for 15% of all patients) were

  13. Processo de implantação de Programa de Saúde Auditiva em duas maternidades públicas Implantation process of a Hearing Health Program in two public maternity hospitals

    Directory of Open Access Journals (Sweden)

    Carmen Barreira-Nielsen

    2007-06-01

    qualification, test environment (noise and subject, false-negative, evasion and evaluation time were assessed in a cross-sectional study which included the hearing screening of all newborns in two public maternity hospitals, through otoacoustic emissions. RESULTS: Out of 4951 newborns in the period from 2002 to 2005, 3364 (67.9% were assessed; 425 (12.61% had risk indicators for hearing impairment. Hearing loss was confirmed in seven newborns (0.3% through the Brainstem Auditory Evoked Potential. CONCLUSIONS: The need for protocols with well defined "pass and fail" criterion for each target population was verified. Hearing screening should be carried out within 30 days following birth and should not be limited to maternity hospitals. Team training and supervision is crucial, as well as electronic appointment and monitoring system, in order to decrease evasion and to detect late hearing loss, associating screening programs with the responsibility of diagnostic confirmation and intervention. This way, one will be able to measure hearing deficiency in Brazil and compare it with epidemiological profiles of countries where such programs have already outlined the hearing health of their population.

  14. 广东省妇幼保健院门诊阴道炎处方分析%Analysis on Outpatient Prescriptions of Vaginitis Medication in Guangdong Maternal and Child Health Hospital

    Institute of Scientific and Technical Information of China (English)

    盛飞凤; 赵晶晶; 庄另发; 陈小葵

    2016-01-01

    目的:了解广东省妇幼保健院(以下简称“我院”)门诊阴道炎用药情况,促进临床合理用药。方法:对我院门诊7935例阴道炎患者的处方进行分析,统计各种药物的使用率、限定日剂量、限定日费用、用药频度和药物利用指数。结果:药品使用率居前2位的是双唑泰栓和硝呋太尔-制霉菌素阴道栓,其限定日费用分别为4.14元和10.02元;抗菌药物用药频度居前3位的是克霉唑(19151.60)、硝呋太尔(7614.00)、甲硝唑(5088.30)。结论:我院医师多选择双唑泰栓和硝呋太尔-制霉菌素阴道栓治疗阴道炎,此2种药物均为治疗混合感染的药物,用药存在不合理现象。%OBJECTIVE:To investigate the outpatient vaginitis medication in Guangdong Maternal and Child Health Hospital ( hereinafter referred to as “our hospital”) , and to promote the rational drug use in clinic .METHODS:7 935 outpatient prescriptions of vaginitis medication were statistically analyzed in terms of the use rate , defined daily dose system(DDDs), defined daily cost(DDC), frequency of drug use and drug use index (DUI).RESULTS:The top two drug use rate were metronidazole clotrimazole and chlorhexidine acetate suppositories -nifuratel nysfungin suppository , with DDC of 4.14 and 10.02 yuan.The top three antibiotics ranked by frequency of drug use were respectively forclotrimazole ( 19 151.60 ) , nifuratel ( 7 614.00 ) and metronidazole ( 5 088.30 ) .CONCLUSIONS: Clinists in our hospital prefer to choose metronidazole clotrimazole and chlorhexidine acetate suppositories -nifuratel nystatin vaginal suppository in treatment of vaginitis , both of which were used for mixed infection .Meanwhile , there are still some irrational drug use phenomenon .

  15. Improving adolescent maternal health

    African Journals Online (AJOL)

    a young girl's body, high rates of unintended ... often drop out and only a few return after .... had lower rates of virological suppression than ... Department for Children, Schools and Families, Department of Health, Royal College of Midwives.

  16. Mulheres hospitalizadas por abortamento em uma Maternidade Escola na Cidade do Recife, Brasil Mujeres hospitalizadas por aborto en una maternidad escuela en la ciudad de Recife, Brasil Women hospitalized due to abortion in a maternity teaching hospital in Recife, Brazil

    Directory of Open Access Journals (Sweden)

    Karla da Silva Ramos

    2010-09-01

    mujeres hospitalizadas por aborto en el servicio no se alteró en los últimos años. El método más conocido para la inducción del aborto continúa siendo el misoprostol.This cross-sectional study was performed with 160 women between 2005-2006. The objective was to describe the social-demographic and reproductive characteristics of women hospitalized due to abortions, and their knowledge about contraceptive methods and abortion induction. In order to determine the association between the abortion classification and social-demographic variables, Pearson's chi-square test was used, with a significance level of 5%. A frequency of 56.3% was found for probably induced abortions. Most cases of abortion occurred before 12 weeks (55.7%. As for the women's profiles: 48.9% were between 20-29 years old, 72.0% had eight years or more of schooling, 90.1% had a partner, 52.0% had 1-3 children, 100% knew about oral contraceptives and condoms and 80.0% had heard about misoprostol. The social-demographic and reproductive profile of women hospitalized at the referred service due to abortion did not change over the last years. Misoprostol remains the most known method for abortion induction.

  17. Maternal serum oestrogen and androgen concentrations in preeclamptic and uncomplicated pregnancies

    National Research Council Canada - National Science Library

    Troisi, Rebecca; Potischman, Nancy; Roberts, James M; Ness, Roberta; Crombleholme, William; Lykins, David; Siiteri, Pentti; Hoover, Robert N

    2003-01-01

    .... Pregnancy hormone concentrations were measured in maternal sera collected at hospital admission for labour and delivery from 86 preeclamptic and 86 uncomplicated, singleton pregnancies matched...

  18. Eclipsing Binary Stars: the Royal Road to Stellar Astrophysics

    CERN Document Server

    Southworth, John

    2012-01-01

    Russell (1948) famously described eclipses as the "royal road" to stellar astrophysics. From photometric and spectroscopic observations it is possible to measure the masses and radii (to 1% or better!), and thus surface gravities and mean densities, of stars in eclipsing binary systems using nothing more than geometry. Adding an effective temperature subsequently yields luminosity and then distance (or vice versa) to high precision. This wealth of directly measurable quantities makes eclipsing binaries the primary source of empirical information on the properties of stars, and therefore a cornerstone of stellar astrophysics. In this review paper I summarise the current standing of eclipsing binary research, present an overview of useful analysis techniques, and conclude with a glance to the future.

  19. Fibrous osteodystrophy in two Northern Royal albatross chicks (Diomedea sanfordi).

    Science.gov (United States)

    Morgan, K J; Alley, M R; Gartrell, B D; Thompson, K G; Perriman, L

    2011-09-01

    In February 2004, two Northern Royal albatross chicks aged 20 and 25 days old were presented for necropsy. Both chicks had been hand-fed in situ at a breeding colony, from 2-3 days post-hatch. The hand-rearing diet consisted of boneless hoki fillets (Macraronus novaezelandiae), electrolytes, and sooty shearwater (Puffinus griseus) proventricular oil obtained as a by-product of cultural harvest. Routine necropsies on the affected chicks revealed many bones were soft and easily bent. Radiography and histopathology revealed decreased bone density, pathological fractures, and extensive remodelling suggestive of fibrous osteodystrophy. Nutritional secondary hyperparathyroidism, resulting from an imbalance in the dietary Ca:P ratio. The imbalance in the dietary Ca:P ratio was a result of feeding deboned and eviscerated fish. This investigation also highlighted potential health risks associated with the practice of feeding stored rancid proventricular oil, including the destruction of fat-soluble vitamins. It is therefore possible that oxidative degradation of vitamin D may have contributed to the development of nutritional secondary hyperparathyroidism. Subsequently, dietary recommendations for supplementary feeding of orphaned Northern Royal albatross chicks include the feeding of whole human-grade fish with an appropriate Ca:P ratio, and the exclusion of proventricular oil. These cases highlight the need for scientific input into wildlife conservation projects, as lack of appropriate nutritional advice resulted in the feeding of a nutritionally inadequate diet. Following the recommended changes in diet, no further cases of osteodystrophy have been diagnosed in hand-raised chicks in the albatross colony.

  20. Access to Maternal Health Care Services in the Cape Coast Metropolitan Area, Ghana

    Directory of Open Access Journals (Sweden)

    D. Adei

    2012-02-01

    Full Text Available Maternal mortality can be prevented if mothers had routine obstetric care and access to emergency obstetric services. However, in accessing healthcare most expecting mothers will have to struggle with distance and financial problems. The study sought to; assess the barriers that discourage women from accessing antenatal, delivery and postnatal services in the Cape coast Metropolis and give recommendations to inform policy. Questionnaire was administered to 150 pregnant women and nursing mothers with babies less than one year from ten communities in the Cape Coast Metropolis. An institutional questionnaire was administered at the University of Cape Coast Hospital which provides health care services to the communities. The study revealed that challenges such as money (16.7%, distance (15.4%, and the behaviour of health personnel (20% were the dominant barriers to accessing antenatal, delivery and post natal services in the Cape Cost Metropolis. These barriers lead to the inability of 14% of pregnant women and nursing mothers with babies less than one year to adhere to the minimum antenatal visitation number of 5 recommended by the Royal College of Obstetricians and Gynaecologists. Again 15.3% of these respondents were delivered by Traditional Birth Attendants and family members, whiles 5.8% were unable to adhere to the minimum postnatal visitation of two times. NGO’s and government organizations for women should organize training programmes aimed at improving the livelihood or employment for women in these communities.

  1. Impact of maternal intrapartum antibiotics, method of birth and breastfeeding on gut microbiota during the first year of life: a prospective cohort study.

    Science.gov (United States)

    Azad, M B; Konya, T; Persaud, R R; Guttman, D S; Chari, R S; Field, C J; Sears, M R; Mandhane, P J; Turvey, S E; Subbarao, P; Becker, A B; Scott, J A; Kozyrskyj, A L

    2016-05-01

    Dysbiosis of the infant gut microbiota may have long-term health consequences. This study aimed to determine the impact of maternal intrapartum antibiotic prophylaxis (IAP) on infant gut microbiota, and to explore whether breastfeeding modifies these effects. Prospective pregnancy cohort of Canadian infants born in 2010-2012: the Canadian Healthy Infant Longitudinal Development (CHILD) Study. General community. Representative sub-sample of 198 healthy term infants from the CHILD Study. Maternal IAP exposures and birth method were documented from hospital records and breastfeeding was reported by mothers. Infant gut microbiota was characterised by Illumina 16S rRNA sequencing of faecal samples at 3 and 12 months. Infant gut microbiota profiles. In this cohort, 21% of mothers received IAP for Group B Streptococcus prophylaxis or pre-labour rupture of membranes; another 23% received IAP for elective or emergency caesarean section (CS). Infant gut microbiota community structures at 3 months differed significantly with all IAP exposures, and differences persisted to 12 months for infants delivered by emergency CS. Taxon-specific composition also differed, with the genera Bacteroides and Parabacteroides under-represented, and Enterococcus and Clostridium over-represented at 3 months following maternal IAP. Microbiota differences were especially evident following IAP with emergency CS, with some changes (increased Clostridiales and decreased Bacteroidaceae) persisting to 12 months, particularly among non-breastfed infants. Intrapartum antibiotics in caesarean and vaginal delivery are associated with infant gut microbiota dysbiosis, and breastfeeding modifies some of these effects. Further research is warranted to explore the health consequences of these associations. Maternal #antibiotics during childbirth alter the infant gut #microbiome. © 2015 Royal College of Obstetricians and Gynaecologists.

  2. 妇幼保健院新生儿早发型血流感染分析%Analysis of neonatal early-onset blood stream infections in maternal and children's hospital

    Institute of Scientific and Technical Information of China (English)

    黄小艺; 刘志伟

    2012-01-01

    目的 探讨妇幼保健院新生儿早发型血流感染的病原菌、药敏率以及临床特点,为临床诊疗提供指导帮助.方法 回顾性分析1999年12月-2009年5月医院65例新生儿早发型血流感染病例血培养病原菌分布及药敏率;根据有无临床症状分为新生儿败血症组和菌血症组,比较两组新生儿胎龄、出生体重、性别、分娩方式、窒息史、母亲产前抗菌药物应用情况及预后.结果 医院新生儿早发型血流感染发病率为0.88%;新生儿早发型血流感染革兰阳性菌占73.85%,病原菌前5位依次为无乳链球菌、大肠埃希菌、李斯特菌属、肠球菌属及凝固酶阴性葡萄球菌,分别占26.15%、24.61%、16.93%、15.38%、9.23%;单核李斯特菌及大肠埃希菌是引起新生儿早发型败血症死亡的主要病原菌;青霉素G、万古霉素对革兰阳性菌耐药率为0;败血症组早产儿、低出生体重儿、窒息率及死亡率均高于菌血症组(P<0.05),母体宫内感染确诊率、新生儿生后抗菌药物预防性使用率低于菌血症组(P<0.05).结论 妇幼保健院新生儿早发型血流感染以革兰阳性菌为主,青霉素类抗菌药物可作为新生儿早发型感染预防及治疗首选经验性药物,各医院应根据该院菌群分布特点及耐药性合理选择抗菌药物;对母亲具有宫内感染高危因素的新生儿尤其是早产儿,低出生体重儿预防性应用抗菌药物可缓解新生儿早发型血流感染临床症状及降低其死亡率.%OBJECTIVE To investigate the distribution, antibiotic resistance of positive results and clinical characteristics of neonatal early-onset blood stream infections in maternal &. children's hospital so as to provide evidence for prophylactic and therapeutic use of antibiotics. METHODS A retrospective analysis was conducted on 65 neonates with neonatal early-onset blood stream infections, which were confirmed by hemoculture and

  3. Birthing Centers and Hospital Maternity Services

    Science.gov (United States)

    ... necessary to treat sick babies and moms. A birth center can provide natural pain control and pain control with mild narcotic medications, ... be an option. Women who want a natural birth with minimal medical intervention or pain control may feel more comfortable in a birth ...

  4. 建立地市级妇幼保健院危重孕产妇救治院级质量管理体系的成效%Effect of establishing hospital - level quality management system for rescue of critically ill pregnant women in prefecture -level maternal and child health hospitals

    Institute of Scientific and Technical Information of China (English)

    高建慧; 杨孜; 崔仁忠; 万波; 叶光福

    2012-01-01

    目的:建立持续有效可行的危重孕产妇救治的院级质量管理体系,提高抢救成功率,降低孕产妇死亡率.方法:分析2005~2009年该院危重孕产妇抢救及25例死亡孕产妇情况.结果:①5年危重孕产妇共2054例,占年分娩数的8.12%,其中81.60%的危重孕产妇由全市各医院转运而来.②5年危重孕产妇死亡率逐年降低,分别为:5.08%、1.57%、1.36%、0.68%、0.44%,主要死亡原因是产前子痫、产后出血、重症感染及妊娠合并内外科疾病.死亡的影响因素以外籍户口非计划生育管理人员为主,且非第一胎占多数(84.00%),48.00%未进行产检,发现问题未进行就诊处理的占64.00%.各级医疗保健知识技能占36.00%.③中山地区孕产妇系统管理率、产前检查率及住院分娩率5年平均为90.80%、96.25%和99.98%,而25例死亡孕产妇明显低于平均水平,分别为76.00%、40.00%和60.00%.结论:落实危重病人院级质量管理、发挥抢救团队的作用,各级医院密切配合,保健部门与医疗部门形成有效的合力机制,提高医务人员知识技能、严格执行分级诊疗及系统的孕产妇保健管理,是提高抢救成功率的保证.%Objective: To establish sustainable and effective hospital - level quality management system for rescue of critically ill pregnant women, increase the success rate of rescue, and reduce mortality of pregnant women. Methods; The rescue conditions of critically ill pregnant women and the conditions of 25 maternal deaths in the hospital from 2005 to 2009 were analyzed. Results: A total of 2 054 critically ill pregnant women were rescued from 2005 to 2009, accounting for 8. 12% of the whole pregnant women, 81. 60% of the critically ill pregnant women were transferred from other hospitals in Zhongshan city. The mortalities of critically ill pregnant women from 2005 to 2009 decreased year by year, which were 5. 08% , 1.57% , 1.36% , 0. 68% , and 0

  5. Giving birth at a maternity hospital: the key strategic option to be adopted in order to combat maternal and neonatal mortality in Mali Faire de l’accouchement en maternité l’option stratégique essentielle pour lutter contre la mortalité maternelle et néonatale au Mali Dar a luz en un hospital maternal: la opción estratégica clave a adoptar para combatir la mortalidad materna y neonatal en Malí

    Directory of Open Access Journals (Sweden)

    Hubert Balique

    2012-04-01

    Full Text Available The end result of the past 40 years of experience in combating maternal mortality in Mali suggests that the emphasis should be changed, and that giving birth at a maternity hospital should be the basic strategic option chosen. This means creating “compounds set aside for mothers-to-be”, where women approaching the end of their pregnancy will be invited to come and await the onset of labour, and at the same time enjoy the rest they need. However, the prerequisites for such an initiative will be first to guarantee the necessary quality of care in maternity hospitals, by virtue of an accreditation system, and second to ensure that the system is fully operational in terms of referring obstetric emergencies. Giving birth in the woman’s home village will then no longer be regarded as a clearly expressed strategic choice, but as an unintended course of events. The introduction of a subsidised system of fixed-charge obstetric care will remove any financial obstacles, and is a necessary step to ensure the feasibility of such a programme.Le bilan des 40 ans d’expérience du Mali en matière de lutte contre la mortalité maternelle plaide pour un recentrage faisant de l’accouchement en maternité l’option stratégique fondamentale. Pour cela, doivent être créées des « concessions des mamans » où les femmes en fin de grossesse seront invitées à se rendre pour y attendre le début du travail en bénéficiant notamment du repos qui doit s’imposer à elles. Le préalable à cette initiative sera cependant de garantir d’une part la qualité des soins dans les maternités grâce à un mécanisme d’accréditation, d’autre part la pleine fonctionnalité du système de référence des urgences obstétricales. Ainsi, l’accouchement au village ne devra-t-il être plus considéré comme un choix stratégique affirmé, mais comme un incident de parcours. La mise en place d’un forfait obstétrical subventionné permettra de lever l

  6. The portrait of Dr William Harvey in the Royal Society since 1683.

    Science.gov (United States)

    Keynes, Milo

    2006-09-22

    A portrait of William Harvey in the Royal Society since 1683 is a copy by an unknown artist after a portrait, now lost, painted by Sir Peter Lely ca. 1650. Three other unattributed copies besides a copy bought from Lely's studio on his death by the Earl of Bradford have been located. The present labelling of the Royal Society portrait should be corrected.

  7. A STUDY ABOUT PHYSICOCHEMICAL COMPOSITION OF FRESH AND LYOPHILIZED ROYAL JELLY

    Directory of Open Access Journals (Sweden)

    OLIMPIA POPESCU

    2013-12-01

    Full Text Available This paper contents a summery about physicochemical composition of frash and lyophilized royal jelly. Royal jelly (RJ is a yellowish and creamy secretion from hypo pharyngeal and mandibular glands of young worker bees (Apis mellifera L. to feed all larvae for the first three days of their life and the queen bee for both her larval life and adulthood.. Royal jelly is a honey bee secretion that is used in the nutrition of the larvae. Queen bees are made, not born, and their feeding with royal jelly is the key to that process. The geographical authenticity of royal jelly can be determined also by pollen analysis (Ricciardelli d'Albore et al., 1978; Ricciardelli d'Albore, 1986. The physicochemical composition of pure royal jelly are analyzed by determining moisture, ash, lipids, proteins, carbohydrates, 10-HDA; and for lyophilized royal jelly are analyzed by determining ash, lipids, protein, carbohydrates, 10-HDA, sugars. 10-HDA content is the criteria of royal jelly quality analysis and it is a freshness parameter(Antinelli J.F., Sarah Zeggane, Renee Davico, Catherine Rognone, Jean Paul Faucon, Louisette Lizzani.

  8. Quality of royal jelly produced by Africanized honeybees fed a supplemented diet

    Directory of Open Access Journals (Sweden)

    Maria Josiane Sereia

    2013-06-01

    Full Text Available This study was carried out to evaluate the effect of artificial supplements prepared with soybean protein isolate, brewer's yeast, mixture of soybean protein isolate with brewer's yeast, linseed oil, palm oil, and a mixture of linseed oil with palm oil on the physicochemical and microbiological composition of royal jelly produced by Africanized honey bee colonies. Considering these results, providing supplements for Africanized honeybee colonies subjected to royal jelly production can help and strengthen the technological development of the Brazilian beekeeping industry increasing its consumption in the national market. This research presents values of royal jelly a little different from those established by the Brazilian legislation. This fact shows that is important to discuss or change the official method for royal jelly analysis. The characterization of physicochemical and microbiological parameters is important in order to standardize fresh, frozen, and lyophilized royal jelly produced by Africanized honeybees.

  9. A Comparison of Medical Birth Register Outcomes between Maternity Health Clinics and Integrated Maternity and Child Health Clinics in Southwest Finland

    Directory of Open Access Journals (Sweden)

    Miia Tuominen

    2016-07-01

    Full Text Available Introduction: Primary maternity care services are globally provided according to various organisational models. Two models are common in Finland: a maternity health clinic and an integrated maternity and child health clinic. The aim of this study was to clarify whether there is a relation between the organisational model of the maternity health clinics and the utilisation of maternity care services, and certain maternal and perinatal health outcomes. Methods: A comparative, register-based cross-sectional design was used. The data of women (N = 2741 who had given birth in the Turku University Hospital area between 1 January 2009 and 31 December 2009 were collected from the Finnish Medical Birth Register. Comparisons were made between the women who were clients of the maternity health clinics and integrated maternity and child health clinics. Results: There were no clinically significant differences between the clients of maternity health clinics and integrated maternity and child health clinics regarding the utilisation of maternity care services or the explored health outcomes. Conclusions: The organisational model of the maternity health clinic does not impact the utilisation of maternity care services or maternal and perinatal health outcomes. Primary maternity care could be provided effectively when integrated with child health services.

  10. Maternal mortality in Denmark, 1985-1994

    DEFF Research Database (Denmark)

    Andersen, Betina Ristorp; Westergaard, Hanne Brix; Bødker, Birgit

    2008-01-01

    OBJECTIVES: In Denmark, maternal mortality has been reported over the last century, both locally through hospital reports and in national registries. The purpose of this study was to analyze data from national medical registries of pregnancy-related deaths in Denmark 1985-1994 and to classify them...

  11. Maternal deaths in Denmark 2002-2006

    DEFF Research Database (Denmark)

    Bødker, Birgit; Hvidman, Lone; Weber, Tom

    2009-01-01

    OBJECTIVE: To describe a method for identification, classification and assessment of maternal deaths in Denmark and to identify substandard care. DESIGN: Register study and case audit based on data from the Registers of the Danish Medical Health Board, death certificates and hospital records. SET...

  12. RETROSPECTIVE REVIEW OF MATERNAL DEATH IN JIMMA ...

    African Journals Online (AJOL)

    User

    Hospital based reports in Addis and Jimma more than a decade ago also documented a ratio of 9.6 and 26 per 1000 ... There is no updated information on maternal death in the study area. ... This study was undertaken to analyze the current.

  13. PRESIDENT'S ADDRESS: PSYCHIATRY AND THE REPORT OF THE ROYAL COMMISSION.

    Science.gov (United States)

    Langdon-Down, R

    1927-12-01

    The principal reference of the Royal Commission was certification and detention, and treatment without certification of persons suffering from mental disorder.The general principles laid down as the result of the inquiry are set forth and shown to accord with the views of the medical profession.The Commission supports the medical view that greater facilities should be granted for treating mental disorders in their early stages without certification and repudiates the contention that grave abuses exist.It makes proposals for avoiding the stigma of certification by admitting patients to treatment under a provisional order without full certification. The real objection of the public to certification appears to lie in the judicial intervention and the legal formalities. Since these are accentuated in the proposed method, it is very little different from the present procedure. The reason for this anomaly appears to be adherence to what is said to be "an inviolable principle of law."This principle is violated in the present law, in the proposals of the Royal Commission and was disregarded prior to 1890.A scheme is put forward to avoid these objections by extending the present facilities on the lines of the Report and simplifying the procedure, thus eliminating the magistrate from the proceedings prior to admission unless the patient desires his intervention, and placing the authorization for treatment on the relatives and friends in all cases where the patient does not apply voluntarily for treatment. The Board of Control is the safeguard in these matters. These two procedures would be applicable to all cases in the first instance; but should the friends prefer full certification, that should be possible at any stage.The proposals for voluntary boarders are approved with the proviso that it should not be necessary to apply these proposals where restraint is neither necessary nor, in fact, applied.The protection that doctors signing certificates need is considered and it

  14. Goodbye, Mandatory Maternity Leaves

    Science.gov (United States)

    Nation's Schools, 1972

    1972-01-01

    In precedent-setting decrees, courts and federal and State authorities have branded compulsory maternity leaves either unconstitutional or illegal. School administrators are urged to prod boards of education to adopt more lenient maternity leave policies -- now. (Author)

  15. Maternal anxiety, maternal sensitivity, and attachment

    NARCIS (Netherlands)

    Stevenson-Hinde, J.; Chicot, R.; Schouldice, A.; Hinde, C.A.

    2013-01-01

    Previous research has related maternal anxiety to insecurity of attachment. Here we ask whether different aspects of maternal sensitivity mediate this link. From a community sample of intact families with 1-3 children, mothers with 4.5-year-olds were selected for low, medium, or high anxiety levels

  16. Maternal anxiety, maternal sensitivity, and attachment

    NARCIS (Netherlands)

    Stevenson-Hinde, J.; Chicot, R.; Schouldice, A.; Hinde, C.A.

    2013-01-01

    Previous research has related maternal anxiety to insecurity of attachment. Here we ask whether different aspects of maternal sensitivity mediate this link. From a community sample of intact families with 1-3 children, mothers with 4.5-year-olds were selected for low, medium, or high anxiety levels

  17. Healthy Maternal Ambivalence

    OpenAIRE

    Raphael-Leff, Joan

    2010-01-01

    This paper critically reviews the psychoanalytic omission in theorizing maternal subjectivity and the subsequent idealisation of the early mother-baby bond that excludes negative maternal feelings. It suggests that painful maternal experiences of resentment, persecution and hatred remain under-explored. Perhaps, even more alarming, this exclusion compels mothers to hide conflictual and shameful feelings from professionals – and from themselves. The paper suggests that healthy maternal ambival...

  18. Incidence and Correlates of Maternal Near Miss in Southeast Iran

    Directory of Open Access Journals (Sweden)

    Tayebeh Naderi

    2015-01-01

    Full Text Available This prospective study aimed to estimate the incidence and associated factors of severe maternal morbidity in southeast Iran. During a 9-month period in 2013, all women referring to eight hospitals for termination of pregnancy as well as women admitted during 42 days after the termination of pregnancy were enrolled into the study. Maternal near miss conditions were defined based on Say et al.’s recommendations. Five hundred and one cases of maternal near miss and 19,908 live births occurred in the study period, yielding a maternal near miss ratio of 25.2 per 1000 live births. This rate was 7.5 and 105 per 1000 in private and tertiary care settings, respectively. The rate of maternal death in near miss cases was 0.40% with a case:fatality ratio of 250 : 1. The most prevalent causes of near miss were severe preeclampsia (27.3%, ectopic pregnancy (18.4%, and abruptio placentae (16.2%. Higher age, higher education, and being primiparous were associated with a higher risk of near miss. Considering the high rate of maternal near miss in referral hospitals, maternal near miss surveillance system should be set up in these hospitals to identify cases of severe maternal morbidity as soon as possible.

  19. Incidence and correlates of maternal near miss in southeast iran.

    Science.gov (United States)

    Naderi, Tayebeh; Foroodnia, Shohreh; Omidi, Samaneh; Samadani, Faezeh; Nakhaee, Nouzar

    2015-01-01

    This prospective study aimed to estimate the incidence and associated factors of severe maternal morbidity in southeast Iran. During a 9-month period in 2013, all women referring to eight hospitals for termination of pregnancy as well as women admitted during 42 days after the termination of pregnancy were enrolled into the study. Maternal near miss conditions were defined based on Say et al.'s recommendations. Five hundred and one cases of maternal near miss and 19,908 live births occurred in the study period, yielding a maternal near miss ratio of 25.2 per 1000 live births. This rate was 7.5 and 105 per 1000 in private and tertiary care settings, respectively. The rate of maternal death in near miss cases was 0.40% with a case:fatality ratio of 250 : 1. The most prevalent causes of near miss were severe preeclampsia (27.3%), ectopic pregnancy (18.4%), and abruptio placentae (16.2%). Higher age, higher education, and being primiparous were associated with a higher risk of near miss. Considering the high rate of maternal near miss in referral hospitals, maternal near miss surveillance system should be set up in these hospitals to identify cases of severe maternal morbidity as soon as possible.

  20. Domingos Vandelli and the deficit in royal Portuguese treasury

    Directory of Open Access Journals (Sweden)

    Ricardo Dalla Costa

    2015-12-01

    Full Text Available This work aims to discuss the economic situation and policy recommendations of Vandelli to solve the difficulties in economic situation in Portugal at the end of seven hundred. Starting with a prior proposal for Vandelli on institutionalization of knowledge in Sciencia of Finance to further expose the difficulties in maintaining the Kingdom in not justifiable times as costly ordered and even military expenditures, investments in manufacturing, arts and science without there being at that time a real war economy. As a result, it failed to materialize the idea of a Portuguese Economic Society since it was transmuted into a Science Academy. With regard to the deficit in the Royal Treasury, there was an increase of Portuguese State spending concurrently with the drop in revenue from overseas, and finally opportunism behind the financial difficulties of the metropolis led Vandelli to do harsh criticism to financial managers and usurers who took advantage of an emblematic situation and suggest economic policies to balance public finances

  1. BOOK REVIEW: Robert Hooke and the Royal Society

    Science.gov (United States)

    Brown, Neil

    2000-01-01

    Many physics students only come across Hooke when they learn his law of stretching springs, which is a pity because it is just one of his contributions to progress in science, and a minor one at that. His, Micrographia, the first great book of microscopical observations, arouses admiration to this day. He was also active in horology, astronomy, geology and surveying, and he took part in biological experiments, transfusing blood between animals. Much of his work was done while he was curator of experiments for the Royal Society, in which he was involved almost from its foundation. This was by no means a full-time occupation, however. After the Great Fire of London, Hooke was appointed one of the three surveyors for the rebuilding of the city. One of the others was Christopher Wren, a lifelong friend. In this role Hooke was responsible for the design of several buildings, including the Monument. Nichols writes about all these activities, as well as Hooke's childhood, his education at Westminster School, the University of Oxford when Hooke was an undergraduate, and the founding of the Royal Society. The book draws on research for a master's degree. Turning a dissertation into a popular book is risky. The author has avoided the pitfall of making it too academic, but the result is not satisfying. Nichols seems overawed by Hooke and his work, frequently seeming to credit Hooke with a far-reaching influence that he did not necessarily have. There may be a case for lauding Hooke as the father of English microscopy, the father of English meteorology, and the founder of English geology and earth sciences, but it needs to be made much more critically, even in a popular work. Hooke was full of good ideas, but he rarely continued long enough to put them into practice. There is no doubt that Hooke proposed using a balance wheel and spring to improve the timekeeping of a watch, for example, but he did not have a watch made to his design until after Christiaan Huygens had

  2. Community level risk factors for maternal mortality in Madagascar.

    Science.gov (United States)

    Hernandez, Julio C; Moser, Christine M

    2013-12-01

    This paper explores the effect of risk and socioeconomic factors on maternal mortality at the community level in Madagascar using a unique, nationwide panel of communes (i.e., counties). Previous work in this area uses individual or cross-country data to study maternal mortality, however, studying maternal mortality at the community level is imperative because this is the level at which most policy is implemented. The results show that longer travel time from the community to the hospital leads to a high level of maternal mortality. The findings suggest that improvement to transportation systems and access to hospitals with surgery rooms are needed to deal with obstetric complications and reduce maternal mortality.

  3. Surgical patients travel longer distances than non-surgical patients to receive care at a rural hospital in Mozambique.

    Science.gov (United States)

    Faierman, Michelle L; Anderson, Jamie E; Assane, Americo; Bendix, Peter; Vaz, Fernando; Rose, John A; Funzamo, Carlos; Bickler, Stephen W; Noormahomed, Emilia V

    2015-01-01

    Surgical care is increasingly recognised as an important component of global health delivery. However, there are still major gaps in knowledge related to access to surgical care in low-income countries. In this study, we compare distances travelled by surgical patients with patients seeking other medical services at a first-level hospital in rural Mozambique. Data were collected on all inpatients at Hospital Rural de Chókwè in rural Mozambique between 20 June 2012 and 3 August 2012. Euclidean distances travelled by surgical versus non-surgical patients using coordinates of each patient's city of residence were compared. Data were analysed using ArcGIS 10 and STATA. In total, 500 patients were included. Almost one-half (47.6%) lived in the city where the hospital is based. By hospital ward, the majority (62.0%) of maternity patients came from within the hospital's city compared with only 35.2% of surgical patients. The average distance travelled was longest for surgical patients (42 km) compared with an average of 17 km for patients on all other wards. Patients seeking surgical care at this first-level hospital travel farther than patients seeking other services. While other patients may have access to at community clinics, surgical patients depend more heavily on the services available at first-level hospitals. © The Author 2014. Published by Oxford University Press on behalf of Royal Society of Tropical Medicine and Hygiene. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  4. Body-enlarging effect of royal jelly in a non-holometabolous insect species, Gryllus bimaculatus

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    Atsushi Miyashita

    2016-06-01

    Full Text Available Honeybee royal jelly is reported to have body-enlarging effects in holometabolous insects such as the honeybee, fly and silkmoth, but its effect in non-holometabolous insect species has not yet been examined. The present study confirmed the body-enlarging effect in silkmoths fed an artificial diet instead of mulberry leaves used in the previous literature. Administration of honeybee royal jelly to silkmoth from early larval stage increased the size of female pupae and adult moths, but not larvae (at the late larval stage or male pupae. We further examined the body-enlarging effect of royal jelly in a non-holometabolous species, the two-spotted cricket Gryllus bimaculatus, which belongs to the evolutionarily primitive group Polyneoptera. Administration of royal jelly to G. bimaculatus from its early nymph stage enlarged both males and females at the mid-nymph and adult stages. In the cricket, the body parts were uniformly enlarged in both males and females; whereas the enlarged female silkmoths had swollen abdomens. Administration of royal jelly increased the number, but not the size, of eggs loaded in the abdomen of silkmoth females. In addition, fat body cells were enlarged by royal jelly in the silkmoth, but not in the cricket. These findings suggest that the body-enlarging effect of royal jelly is common in non-holometabolous species, G. bimaculatus, but it acts in a different manner than in holometabolous species.

  5. Associação entre via de parto e complicações maternas em hospital público da Grande São Paulo, Brasil Association between mode of delivery and maternal complications in a public hospital in Greater Metropolitan São Paulo, Brazil

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    Luís Carlos Machado Junior

    2009-01-01

    Full Text Available O estudo objetivou avaliar associação entre via de parto e complicações maternas. Realizou-se coorte retrospectiva com partos ocorridos durante o ano de 2003, em um hospital público. As complicações avaliadas foram: infecção, hemorragia, histerectomia, rotura uterina, lesão de órgão contíguo, trombose venosa profunda e embolia pulmonar. Utilizou-se a odds ratio (OR e os testes de qui-quadrado de Pearson e de Fisher, além da regressão logística. Estabeleceu-se o nível de 0,05 como significante. Foram encontradas 15 complicações. Tomando-se o parto vaginal como referência, encontrou-se associação entre cesárea e as complicações tomadas em conjunto. Analisando-se variáveis confundidoras, encontrou-se associação das complicações com hipertensão, soropositividade para HIV, placenta prévia e descolamento prematuro de placenta. Após controle para estas quatro variáveis, manteve-se a associação entre cesárea e complicações (OR = 9,7; p = 0,04. Encontrou-se também associação entre complicações e cesárea eletiva comparada ao parto vaginal (OR = 4,7; p = 0,02, e maior proporção de complicações, no limite da significância estatística, nas cesáreas eletivas comparadas à "tentativa de parto vaginal" (OR = 3; p = 0,058. Conclui-se que a cesárea associa-se a complicações maternas, mesmo após a realização de vários ajustes.The purpose of this study was to assess the relationship between mode of delivery and maternal complications, based on a retrospective cohort of all births at a public hospital in 2003. Complications included: infection, hemorrhage, hysterectomy, uterine rupture, lesions in adjacent organs, deep venous thrombosis, and pulmonary embolism. The analysis used odds ratio (OR, chi-squared test, and Fisher's exact test, besides logistic regression. Fifteen complications were identified. Taking vaginal delivery as the reference, an association was found between cesarean section and overall

  6. The Madrid Royal Schools of St. Elisabeth and Loreto according Constitutions of 1715 and 1718

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    Beatriz COMELLA GUTIÉRREZ

    2013-02-01

    Full Text Available The Madrid Royal Schools of Saint Elizabeth and Loreto were founded by Philip II at the end of 16th Century. Both institutions provided education for orphan girls. They still exist as Catholic coeducational schools granted by the Education Department. These two Schools were Royal Sponsorship belonging to Palace ecclesiastical jurisdiction. The Schools Constitutions sanctioned by Philip V have been preserved until now. Although these Schools have a parallel history, the mentioned Constitutions are completely different for each School. According to these Norms, the Madrid Royal Schools of Saint Elizabeth and Loreto have many differences between them.

  7. What is Maternal Labour?

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    Stella Sandford

    2011-07-01

    Full Text Available What happens when we attempt to draw together the concepts of 'the maternal' and of 'labour' in the category of 'maternal labour'? What is the specificity of maternal labour as 'labour' and what is its specificity as 'maternal'? This paper argues that there is a peculiar difficulty in the category of 'maternal labour', even a fundamental contradiction, but that this is not a reason to reject it. Beginning with a brief discussion of Marx's comments, in the Introduction to the 'Grundrisse', on the category of labour, the paper then considers some classic Marxist feminist literature from the 1970s and 1980s on the relation between Marxism and feminism and on the domestic labour debates in order to try to explain the nature of the contradiction in the category of 'maternal labour' and its significance for thinking the possibility of a non-capitalist maternal subject.

  8. Utilização de serviços de reabilitação pelas crianças e adolescentes dependentes de tecnologia de um hospital materno-infantil no Rio de Janeiro, Brasil Use of rehabilitation services by technology-dependent children and adolescents in a maternal and child hospital in Rio de Janeiro, Brazil

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    Cláudia Zornoff Gavazza

    2008-05-01

    Full Text Available O objetivo deste estudo é caracterizar descritivamente a dependência tecnológica e a utilização de serviços de reabilitação pela população de crianças e adolescentes de um hospital materno-infantil do Rio de Janeiro, Brasil. O estudo transversal descreveu as características demográficas da criança e sócio-econômicas do cuidador e família, como também o tipo de dependência tecnológica e a utilização de serviços de reabilitação. A população do estudo é composta de pré-escolares (56,3%, do sexo masculino (58,3%, residentes na região metropolitana do Estado do Rio de Janeiro (89,6%. São oriundos de famílias com rendimentos mensais até dois salários mínimos (70,9%, cuidados sobretudo por suas mãe (93,8%, que possuem escolaridade menor ou igual ao ensino fundamental (54,2% e não trabalham (89,6%. Dos entrevistados, um total de 22,9% depende de três tipos diferentes de tecnologias, sendo o suporte medicamentoso (87,5% a mais utilizada. O tratamento de reabilitação é financiado preponderantemente pelo Sistema Único de Saúde (SUS e instituições filantrópicas, sendo o fisioterapeuta motor (60,4% o profissional de maior demanda nesse tratamento. O hospital estudado concentra todos os atendimentos médicos especializados e a maior parte dos tratamentos em reabilitação.The objective of this study was to describe the dependence on technology and use of rehabilitation services by children and adolescents in a maternal and child hospital in Rio de Janeiro, Brazil. Using a cross-sectional design, the following variables were analyzed: gender and age of the children and adolescents, socioeconomic characteristics of the family, technology dependence, and use of rehabilitation services. The majority of the study population consisted of preschoolers (56.3%, boys (58.3%, residing in Greater Metropolitan Rio de Janeiro (89.3%, from low-income families (70.9%, and cared for mainly by their mothers (93.8%, who in turn have

  9. Concours annuels Academie Royale des Sciences d'Outre-mer

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    Royal Academy for Overseas Sciences

    2011-01-01

    Full Text Available Yearly competitions Royal Academy for Overseas Sciences. L'Organisation des Nations Unies, face aux inégalités croissantes a initié le processus des Objectifs du Millénaire pour le Développement (OMD qui doivent être réalisés d'ici 2015. L'atteinte des huit OMD devrait permettre de réduire la pauvreté et d'améliorer les conditions de vie des populations. L'élevage est pratiqué par une grande partie de la population mondiale surtout les plus pauvres. Il est pourvoyeur d'emplois et contribue à l'émancipation des femmes grâce aux revenus générés par la vente des produits animaux. Les animaux d'élevage sont également utilisés pour le transport et la culture attelée. La forte densité en nutriments des produits animaux en fait des aliments de choix pour améliorer l'état nutritionnel des enfants. La domestication des espèces animales sauvages et le développement de l'aquaculture contribuent à réduire les prélèvements dans la nature et à protéger la biodiversité. Le développement d'un élevage durable et raisonné peut donc positivement impacter plusieurs secteurs et doper la croissance économique des pays. Ce qui peut aider les pays en développement à se rapprocher des OMD d'ici 2015. La note présente également les pré-requis pour rendre effective la contribution de l'élevage aux.

  10. Royal London space analysis: plaster versus digital model assessment.

    Science.gov (United States)

    Grewal, Balpreet; Lee, Robert T; Zou, Lifong; Johal, Ama

    2016-08-10

    With the advent of digital study models, the importance of being able to evaluate space requirements becomes valuable to treatment planning and the justification for any required extraction pattern. This study was undertaken to compare the validity and reliability of the Royal London space analysis (RLSA) undertaken on plaster as compared with digital models. A pilot study (n = 5) was undertaken on plaster and digital models to evaluate the feasibility of digital space planning. This also helped to determine the sample size calculation and as a result, 30 sets of study models with specified inclusion criteria were selected. All five components of the RLSA, namely: crowding; depth of occlusal curve; arch expansion/contraction; incisor antero-posterior advancement and inclination (assessed from the pre-treatment lateral cephalogram) were accounted for in relation to both model types. The plaster models served as the gold standard. Intra-operator measurement error (reliability) was evaluated along with a direct comparison of the measured digital values (validity) with the plaster models. The measurement error or coefficient of repeatability was comparable for plaster and digital space analyses and ranged from 0.66 to 0.95mm. No difference was found between the space analysis performed in either the upper or lower dental arch. Hence, the null hypothesis was accepted. The digital model measurements were consistently larger, albeit by a relatively small amount, than the plaster models (0.35mm upper arch and 0.32mm lower arch). No difference was detected in the RLSA when performed using either plaster or digital models. Thus, digital space analysis provides a valid and reproducible alternative method in the new era of digital records.

  11. The difficulties of conducting maternal death reviews in Malawi

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    van den Broek Nynke

    2008-09-01

    Full Text Available Abstract Background Maternal death reviews is a tool widely recommended to improve the quality of obstetric care and reduce maternal mortality. Our aim was to explore the challenges encountered in the process of facility-based maternal death review in Malawi, and to suggest sustainable and logically sound solutions to these challenges. Methods SWOT (strengths, weaknesses, opportunities and threats analysis of the process of maternal death review during a workshop in Malawi. Results Strengths: Availability of data from case notes, support from hospital management, and having maternal death review forms. Weaknesses: fear of blame, lack of knowledge and skills to properly conduct death reviews, inadequate resources and missing documentation. Opportunities: technical assistance from expatriates, support from the Ministry of Health, national protocols and high maternal mortality which serves as motivation factor. Threats: Cultural practices, potential lawsuit, demotivation due to the high maternal mortality and poor planning at the district level. Solutions: proper documentation, conducting maternal death review in a blame-free manner, good leadership, motivation of staff, using guidelines, proper stock inventory and community involvement. Conclusion Challenges encountered during facility-based maternal death review are provider-related, administrative, client related and community related. Countries with similar socioeconomic profiles to Malawi will have similar 'pull-and-push' factors on the process of facility-based maternal death reviews, and therefore we will expect these countries to have similar potential solutions.

  12. The difficulties of conducting maternal death reviews in Malawi

    Science.gov (United States)

    Kongnyuy, Eugene J; van den Broek, Nynke

    2008-01-01

    Background Maternal death reviews is a tool widely recommended to improve the quality of obstetric care and reduce maternal mortality. Our aim was to explore the challenges encountered in the process of facility-based maternal death review in Malawi, and to suggest sustainable and logically sound solutions to these challenges. Methods SWOT (strengths, weaknesses, opportunities and threats) analysis of the process of maternal death review during a workshop in Malawi. Results Strengths: Availability of data from case notes, support from hospital management, and having maternal death review forms. Weaknesses: fear of blame, lack of knowledge and skills to properly conduct death reviews, inadequate resources and missing documentation. Opportunities: technical assistance from expatriates, support from the Ministry of Health, national protocols and high maternal mortality which serves as motivation factor. Threats: Cultural practices, potential lawsuit, demotivation due to the high maternal mortality and poor planning at the district level. Solutions: proper documentation, conducting maternal death review in a blame-free manner, good leadership, motivation of staff, using guidelines, proper stock inventory and community involvement. Conclusion Challenges encountered during facility-based maternal death review are provider-related, administrative, client related and community related. Countries with similar socioeconomic profiles to Malawi will have similar 'pull-and-push' factors on the process of facility-based maternal death reviews, and therefore we will expect these countries to have similar potential solutions. PMID:18786267

  13. Impacto das malformações congênitas na mortalidade perinatal e neonatal em uma maternidade-escola do Recife Impact of congenital malformations on perinatal and neonatal mortality in an university maternity hospital in Recife

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    Melania Maria Ramos de Amorim

    2006-05-01

    Full Text Available OBJETIVOS: determinar a incidência de malformações congênitas em recém-nascidos assistidos em uma maternidade-escola de Recife e avaliar o impacto destas malformações na mortalidade perinatal e neonatal. MÉTODOS: realizou-se um estudo longitudinal durante os meses de setembro de 2004 a maio de 2005, analisando-se todos os partos assistidos no Instituto Materno Infantil Prof. Fernando Figueira, IMIP. Determinou-se a freqüência e o tipo de malformações congênitas e foram calculados os coeficientes de mortalidade fetal, mortalidade perinatal, mortalidade neonatal precoce e tardia. RESULTADOS: a freqüência de malformações foi de 2,8% (em 4043 nascimentos. O percentual de malformações entre os nativivos foi de 2,7%, e entre os natimortos foi de 6,7%. Dentre as malformações, as mais freqüentes foram as do sistema nervoso central (principalmente hidrocefalia e meningomielocele, as do sistema osteomuscular e as cardiopatias. Não houve associação entre malformações e sexo, porém a freqüência de prematuridade e baixo peso foi maior entre os casos de malformações. Constatou-se, entre os malformados, mortalidade neonatal precoce de 32,7% e tardia de 10,6%. Os casos de malformações representaram 6,7% dos natimortos, 24,2% das mortes neonatais precoces e 25,8% do total de mortes neonatais. CONCLUSÕES: a freqüência de malformações correspondeu a 2,8% dos nascimentos. As malformações representaram a segunda causa mais freqüente de mortes neonatais, depois da prematuridade.OBJECTIVES: to determine the incidence of congenital malformations in newborns in a university maternity hospital in Recife and assess the impact of malformation in perinatal and neonatal mortality. METHODS: a longitudinal study was performed from September 2004 to May 2005 with all deliveries at the Instituto Materno Infantil Prof. Fernando Figueira, IMIP analyzed. The type and incidence of congenital malformations were determined, and fetal mortality

  14. 某妇幼保健院医院感染现患率调查%Pevalence rate of healthcare-associated infection in a maternal and child health care hospital

    Institute of Scientific and Technical Information of China (English)

    李晖; 高晓玲; 钟巧; 刘珺; 林春燕; 沈嘉茵

    2015-01-01

    目的:了解某妇幼保健院2014年医院感染情况,为进一步目标性监控提供科学循征依据。方法采用床旁调查与在架运行病历调查相结合的方法,对该院住院患者进行医院感染横断面调查。结果实查住院患者768例,发现医院感染9例,医院感染现患率为1.18%;现患率排名居前3位的科室依次为产科重症监护室(ICU,9.09%)、新生儿 ICU(NICU,5.80%)、妇二区(2.22%);抗菌药物使用率为30.34%(233例),其中预防性使用抗菌药物134例,占57.51%;单一用药者165例,占70.82%。医院感染患者共检出病原菌5株,其中无乳链球菌2株,肺炎克雷伯菌、粪肠球菌、腐生葡萄球菌各1株,除无乳链球菌外,其余3株均为多重耐药菌。结论医院应高度重视多重耐药菌的感染监控,采取目标性监测与集束化干预的方法,以降低多重耐药菌医院感染的发生。%Objective To understand healthcare-associated infection(HAI)in a maternal and child health care hos-pital,so as to provide scientific evidences for further targeted surveillance.Methods A cross-sectional survey was performed by bedside visiting and medical record reviewing.Results Of 768 hospitalized patients,9(1 .18%)had HAI,the top 3 highest prevalence rates were found in obstetrical intensive care unit (9.09%),neonatal intensive care unit (5.80%)and gynecological department II(2.22%).Antimicrobial usage rate was 30.34%(n=233),134 of which (57.51 %)were prophylactic use,165 were mono-therapy(70.82%).A total of 5 pathogenic bacteria were isolated,the number of Streptococcus agalactiae ,Klebsiella pneumonia ,Enterococcus faecalis ,and Staphylococcus saprophyticus was 2,1 ,1 ,and 1 respectively,except Streptococcus agalactiae ,the other 3 strains were multidrug-resistant organisms(MDROs).Conclusion Surveillance on MDRO infection should be paid much attention,the oc-currence of MDRO infection

  15. Maternal obesity and preeclampsia

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    Azar Aghamohammadi

    2011-03-01

    Full Text Available Background: Obesity is a modern day epidemic. The incidence appears to be rapidly increasing in bothdeveloped and developing countries and has become much more obvious in the last decade.Aim& Objective: The present research was done with the aim of studying the effects of obesity definedas a first trimester maternal body mass index >30 on the preeclampsia.Methods: This study was a descriptive-comparative study two hundred fifty singleton pregnancies ofwomen with first trimester BMI >30 who delivered at Emam Hospital, Sari Iran during 2008–2009 werestudied A control group with two hundred fifty nine women of normal body mass index matched for ageand parity were selected and incidence of preeclampsia were compared between groups. χ2 and Oddsratioand 95% confidence were used to analyze the data. Statistical significance was defined as P < 0.05.Results: There was a significant relation between obesity and preeclampsia (20.8 vs. 5.8%, P<0.0001compared to non-obese women.Conclusion: Obesity in pregnant women appears to be a risk factor for adverse perinatal outcomes.

  16. Pouvoir et religion à la chapelle royale de Versailles sous Louis XIV Power and religion at the royal chapel of Versailles under Louis XIV

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    Alexandre Maral

    2007-12-01

    Full Text Available D’une manière peut‑être plus sensible que partout ailleurs, les objets et les insignes du pouvoir prennent une importance particulière dans le contexte du cérémonial liturgique de la religion catholique. À la chapelle royale de Versailles, la présence régulière du monarque et de sa cour complique encore la situation, d’autant que la desserte est assurée par deux corps distincts d’ecclésiastiques. Dépassant le simple cadre des préséances, Louis XIV a défini autour de sa personne royale un système rituel susceptible d’en manifester le caractère épiscopal dérivé du sacre. De même, l’enjeu juridictionnel représenté par la Chapelle royale se traduit par un jeu subtil d’attitudes, de gestes et de rites, chorégraphie sacrée qui accompagne et exprime les revendications des partisans et des adversaires de l’exemption du lieu de culte royal au regard du diocèse de Paris. Ce discours trouve un écho partiel dans le programme décoratif de la chapelle définitive du palais, achevée en 1710.Objects and symbols of power take on a particular importance in the liturgical ceremony of the Catholic Church, perhaps more so than in any other context. At the royal chapel of Versailles, the regular presence of the king and his court complicated the situation further, all the more so in that religious ceremony was administered by two distinct ecclesiastic bodies. Beyond the rules of precedence, Louis XIV had introduced around his royal persona a system of ritual that would manifest the episcopal identity conferred upon him by his coronation. Similarly, the jurisdictional authority represented by the royal chapel was conveyed in a subtle play of attitudes, gestures and rites, a symbolic choreography that accompanied and expressed the claims of the partisans and adversaries of the exemption of the royal place of worship with regard to the diocese of Paris. This stance was reflected in the decorative scheme of the palace

  17. Fetal and maternal complications in macrosomic pregnancies

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    Cheng YK

    2014-03-01

    Full Text Available Yvonne Kwun-Yue Cheng, Terence T LaoDepartment of Obstetrics and Gynaecology, The Chinese University of Hong Kong, Prince of Wales Hospital, Hong KongAbstract: The prediction and management of fetal macrosomia remains an obstetric challenge. Significant maternal and neonatal complications can result from the birth of a macrosomic infant, and include prolonged labor, operative delivery, postpartum hemorrhage, perineal trauma, shoulder dystocia, birth trauma, chorioamnionitis, meconium aspiration, perinatal asphyxia, low Apgar scores, neonatal hypoglycemia, and perinatal mortality. This review article discusses these maternal and perinatal risks and the management of suspected macrosomia.Keywords: macrosomia, large for gestational age, shoulder dystocia, birth trauma, perineal tear

  18. Care of adolescents sheltered in maternity hospitals from the perspective of health professionals Asistencia a las adolescentes albergadas en una maternidad bajo la óptica de profesionales de salud Assistência às adolescentes abrigadas em maternidade sob a ótica de profissionais de saúde

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    Lucia Helena Garcia Penna

    2012-01-01

    Full Text Available OBJECTIVE: Discuss determinant aspects of quality care of pregnant adolescents sheltered in a maternity hospital, according to the perspective of health professionals. METHODS: Study with a qualitative, exploratory approach, conducted in a maternity hospital in the Municipality of Rio de Janeiro - RJ, reference for sheltered youngsters. The subjects of the study were 14 health professionals. The data were treated according to the Content Analysis technique. RESULTS: Two categories of analysis emerged: Characteristics of care provided by health professionals at the maternity hospital directed towards the sheltered adolescent mother and her child; Characteristics of the organization/structure of the maternity hospital that affected the care of the sheltered pregnant adolescents. CONCLUSION: It is necessary to incorporate the guiding practices of integrality/interdisciplinarity into the service. The stigmatization of these youngsters is one of the greatest challenges to full assistance and care. The maternity hospital space is a rich environment for the nurse-adolescent dialogic process.OBJETIVO: Discutir aspectos determinantes de una asistencia de calidad a adolescentes embarazadas, albergadas en una maternidad, conforme la óptica de profesionales de salud. MÉTODOS: Estudio de abordaje cualitativo, exploratorio, realizado en una maternidad del Municipio de Rio de Janeiro - RJ, referencia para jóvenes albergadas. Los sujetos del estudio fueron 14 profesionales del equipo de salud. Los datos fueron tratados, conforme a la técnica del análisis de contenido. RESULTADOS: Emergieron del análisis dos categorías: Características de la atención de los profesionales de salud de la maternidad direccionadas a la madre adolescente albergada y su hijo; Características de la organización/estructura de la maternidad que afectan la atención a las adolescentes albergadas embarazadas. CONCLUSIÓN: Se hace necesario incorporar las prácticas norteadoras

  19. 'Any style but gothic': Building a home for the Royal College of Physicians of Ireland.

    Science.gov (United States)

    Wheelock, H

    2016-06-01

    On 15 July 1864 the Royal College of Physicians of Ireland held its first business meeting in its newly built home at 6 Kildare Street, Dublin. Although the Royal College of Physicians of Ireland had been in existence for over 200 years this was the first occasion that a College meeting had been held in a building owned by the College. This paper looks at the history behind the construction of a home for the Royal College of Physicians of Ireland. It will examine why it took over 200 years for the Physicians to find a permanent home, how they ended up with the building they did, and what they borrowed from the Royal College of Physicians in Edinburgh in the process.

  20. Royal Service on Eesti mainekaim üritusturundusfirma / Eda-Liis Kann

    Index Scriptorium Estoniae

    Kann, Eda-Liis, 1979-

    2005-01-01

    Turu-uuringute AS-i korraldatud üritusturunduse ettevõtete maineuuringust selgus, et kõige mainekamad Eestis on Royal Service, Event Masters, Broadline ja Sinine Elevant. Kõige madalama mainega on Tequila

  1. Royal Service on Eesti mainekaim üritusturundusfirma / Eda-Liis Kann

    Index Scriptorium Estoniae

    Kann, Eda-Liis, 1979-

    2005-01-01

    Turu-uuringute AS-i korraldatud üritusturunduse ettevõtete maineuuringust selgus, et kõige mainekamad Eestis on Royal Service, Event Masters, Broadline ja Sinine Elevant. Kõige madalama mainega on Tequila

  2. Presence of women in Royal Economic Society of Friends of the Country (1775-1808

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    María Consolación Calderón España

    2010-11-01

    Full Text Available In this work we present the performance of women in the work of the Royal Economic Society of Friends of the Country, institutions of the eighteenth century who sought to lift the economy of Spain in that century. Women’s participation in the Royal Economic So- ciety was carried out by the Boards of Damas and supervisory work of the Schools «patriotism» and the first letters. The first schools to be named, according to Campomanes conceived of yarn and fabric and should be established in major cities throughout the kingdom. Participation in the Royal Economic Society from all social classes and genders with equal rights, was a fact. There is no comprehensive study on all of the Royal Economic Society of Friends of the Country, therefore there is no one on women in one way or another took part in them. With this work we present the work done by some.

  3. Maternal mortality in Denmark, 1985-1994.

    Science.gov (United States)

    Andersen, Betina Ristorp; Westergaard, Hanne Brix; Bødker, Birgit; Weber, Tom; Møller, Margrete; Sørensen, Jette Led

    2009-02-01

    In Denmark, maternal mortality has been reported over the last century, both locally through hospital reports and in national registries. The purpose of this study was to analyze data from national medical registries of pregnancy-related deaths in Denmark 1985-1994 and to classify them according to the UK Confidential Enquiry into Maternal Deaths (CEMD). All deaths of women with a registered pregnancy within 12 months prior to the death were identified by comparing the Danish medical registries, death certificates, and relevant codes according to International Classification of Diseases (ICD-10). All cases were classified using the UK CEMD classification. Cases of maternal death were further evaluated by an audit group. 311 cases were classified. 92 deaths (29.6%) occurred 42 days), 1 woman died from a direct obstetric cause, 46 from indirect causes, and 172 from fortuitous causes. Hypertensive disorders of pregnancy were the major cause of direct maternal deaths. The rate of maternal deaths constituted 9.8/100,000 maternities (i.e. the number of women delivering registrable live births at any gestation or stillbirths at 24 weeks of gestation or later). This is the first systematic report on deaths in Denmark based on data from national registries. The maternal mortality rate in Denmark is comparable to the rates in other developed countries. Fortunately, statistics are low, but each case represents potential learning. Obstetric care has changed and classification methods differ between countries. Prospective registration and registry linkage seem to be a way to ensure completion. This retrospective study has provided the background for a prospective study on registration and evaluation of maternal mortality in Denmark.

  4. Study of maternal deaths in Kerian (1976 - 1980).

    Science.gov (United States)

    Yadav, H

    1982-06-01

    An investigation was conducted of all maternal deaths by residence which occurred in the district of Kerian, Malaysia over the 1976-1980 period. All female deaths between the years 15-45 were investigated to identify whether it was a maternal death due to obstetrical cause or otherwise. Each of the cases was investigated by the public health nurse, public health sister, and the medical officer of health before a report was made. All the maternal death reports from 1976-1980 were studied and a report compiled. The health infrastructure of Kerian district consists of 1 district hospital with 141 beds, 8 health centers, and 32 midwife clinics. The total number of deliveries in Kerian from 1976-1980 was 22,977. The hospital deliveries constituted 7040 (30.6%), the government midwives 6395 (27.8%), and traditional birth attendants (TBAs) 9505 (41.4%). The period 1976-1980 showed a decline in the various mortality rates. The infant mortality rate which is 27.11/1000 declined by 33% from 1976-1980 and toddler mortality rate declined by 37.7% from 1976-1980. The most significant decline was maternal mortality which declined from 1.89/1000 live births to 1.10/1000 live births which registered a 41.8% decline. There were a total of 35 maternal deaths registered from 1976-1980 in the district. Ethnically the Malays constituted 32 (91.4%) of all deaths and Chinese 2 (5.7%) of all deaths with Indians with 1 death (2.8%). Most of the women were from the lower income group. 19 (54.3%) of the women died at home, and 15 (42.8%) died in the hospitals. Most of the women died at gravida 6-9. Gravida 1 had 8 or 22.8% of all maternal deaths. Para 0 consisted of 9 (25.7%) of all maternal deaths and para 6 and above consisted of 11 (31.4%) of all maternal deaths. Women in the 31-40 year age group had 57.2% of the maternal deaths. PPH and PPH with retained placenta were the main causes of the maternal deaths, constituting 60% of the maternal deaths. In 1980 all 5 maternal deaths were due

  5. Predicting early epidurals: association of maternal, labor, and neonatal characteristics with epidural analgesia initiation at a cervical dilation of 3 cm or less

    Directory of Open Access Journals (Sweden)

    Moore AR

    2013-08-01

    Full Text Available Albert R Moore, William Li Pi Shan, Roupen Hatzakorzian Department of Anaesthesia, McGill University Health Centre, Royal Victoria Hospital, Montreal, Quebec, Canada Background: Retrospective studies have associated early epidural analgesia with cesarean delivery, but prospective studies do not demonstrate a causal relationship. This suggests that there are other variables associated with early epidural analgesia that increase the risk of cesarean delivery. This study was undertaken to determine the characteristics associated with early epidural analgesia initiation. Methods: Information about women delivering at 37 weeks or greater gestation with epidural analgesia, who were not scheduled for cesarean delivery, was extracted from the McGill Obstetric and Neonatal Database. Patients were grouped into those who received epidural analgesia at a cervical dilation of ≤3 cm and >3 cm. Univariable and multivariable logistic regression was used to determine the maternal, neonatal, and labor characteristics that increased the risk of inclusion in the early epidural group. Results: Of the 13,119 patients analyzed, multivariable regression demonstrated odds ratios (OR of 2.568, 5.915 and 10.410 for oxytocin augmentation, induction, and dinoprostone induction of labor (P < 0.001. Increasing parity decreased the odds of early epidural analgesia (OR 0.780, P < 0.001, while spontaneous rupture of membranes (OR 1.490 and rupture of membranes before labor commenced (OR 1.288 were also associated with early epidural analgesia (P < 0.001. Increasing maternal weight (OR 1.049, P = 0.002 and decreasing neonatal weight (OR 0.943, P < 0.001 were associated with increasing risk of early epidural analgesia. Conclusion: Labor augmentation and induction, nulliparity, rupture of membranes spontaneously and before labor starts, increasing maternal weight, and decreasing neonatal weight are associated with early epidural analgesia. Many of these variables are also

  6. The Royal Industrial Institute of Madrid (1850-1867). A Historical Overview

    OpenAIRE

    Cano Pavón, Jose Manuel

    2002-01-01

    This paper reviews the history, structure, evolution and salient activities of the Royal Industrial Institute of Madrid. This was the first higher engineering school established in Spain and also the key to the teaching system devised by Spain's moderate liberal government of the 1850s to gather the human resources (engineers, intermediate technicians and skilled workers) needed to face the industrialization process under way in the country. The Royal Industrial Institute was foun...

  7. The Queens' estates: fiscal properties and royal policy ( 9th -10th centuries

    Directory of Open Access Journals (Sweden)

    Tiziana Lazzari (a cura di

    2012-10-01

    Full Text Available The special condition of the queens of italic Kingdom during the 9th and 10th centuries is exemplified by the title of consors regni and by the exceptionally copious dowers bestowed to them when compared to those entrusted to other European queens. Through the accurate reconstruction of these dowries, composed of royal fiscal assets, this anomaly is explained within the context of specific royal governmental strategies.

  8. Honey, Propolis, and Royal Jelly: A Comprehensive Review of Their Biological Actions and Health Benefits

    OpenAIRE

    Visweswara Rao Pasupuleti; Lakhsmi Sammugam; Nagesvari Ramesh; Siew Hua Gan

    2017-01-01

    Background. There are several health benefits that honeybee products such as honey, propolis, and royal jelly claim toward various types of diseases in addition to being food. Scope and Approach. In this paper, the effects of honey, propolis, and royal jelly on different metabolic diseases, cancers, and other diseases have been reviewed. The modes of actions of these products have also been illustrated for purposes of better understanding. Key Findings and Conclusions. An overview of honey, p...

  9. Bedrock, soil, and lichen geochemistry from Isle Royale National Park, Michigan

    Science.gov (United States)

    Woodruff, Laurel G.; Cannon, William F.; Dicken, Connie L.; Bennett, James P.; Nicholson, Suzanne W.

    2003-01-01

    Isle Royale National Park, Michigan, is a large island in northeastern Lake Superior that became a national park in 1940 and was designated as a wilderness area in 1976. The relative isolation of Isle Royale (Figure 1), 25 kilometers out in Lake Superior from the Canadian mainland, its generally harsh climate, and its status as a wilderness national park have minimized human influence on the geochemical evolution of its landscape.

  10. The Royal Navy’s New-Generation Type 45 Destroyer. Acquisition Options and Implications

    Science.gov (United States)

    2002-01-01

    Future Offshore Patrol Vessel FPSO Floating Production, Storage and Offloading vessel xxiii xxiv The Royal Navy’s New-Generation Type 45 Destroyer FSC...the conversion of a Floating Production, Storage and Offloading ( FPSO ) vessel, and a naval order for two Alternative Landing Ships Logistics (ALSL...Frigates, various Marine (OPVs) for Royal Brunei design work Navy Offshore SupplyVessel, ALSL, Landing Craft Utility, miscellaneous module and Auxiliary

  11. Maternity waiting facilities for improving maternal and neonatal outcome in low-resource countries

    NARCIS (Netherlands)

    van Lonkhuijzen, L.; Stekelenburg, J.; van Roosmalen, J.

    2009-01-01

    Background A Maternity Waiting Home (MWH) is a facility, within easy reach of a hospital or health centre which provides Emergency Obstetric Care (EmOC). Women may stay in the MWH at the end of their pregnancy and await labour. Once labour starts, women move to the health facility so that labour and

  12. The Acoustics of the Double Elliptical Vault of the Royal Palace of Caserta (Italy

    Directory of Open Access Journals (Sweden)

    Umberto Berardi

    2017-03-01

    Full Text Available This work investigates the acoustic characteristics of the double elliptical vault, which overlooks the Grand Staircase of the Royal Palace of Caserta (Italy. The Royal Palace was built by the architect Luigi Vanvitelli in the Seventeenth Century and it is the largest royal building in Italy. The double elliptical vault presents a great scenography effect. Inside the vault, on the planking level, musicians used to play for the king and his guests when the royal procession, going up the grand staircase, entered the royal apartments, creating astonishment among the guests who heard the music without understanding from where it was coming. Since the musicians were inside the vault, the long reverberation made the listeners perceive the vault to be enveloped by the music. To investigate this effect, the acoustic characteristics of the double vault were measured, putting the sound source on the planking level of the vault, while the microphones were put along the staircase and in the vestibule towards the royal apartments. Finally, the spatial distribution of several acoustic parameters is evaluated also using architectural acoustic simulations.

  13. The Sigiriya Royal Gardens. Analysis of the Landscape Architectonic Composition

    Directory of Open Access Journals (Sweden)

    Jude Nilan Cooray

    2012-11-01

    Full Text Available Besides the efforts that are of descriptive and celebrative nature, studies related to Sri Lanka’s historical built heritage are largely to view material remains in historical, sociological, socio-historical and semiological perspectives. But there is hardly any serious attempt to view such material remains from a technical-analytical approach to understand the compositional aspects of their designs. The 5th century AC royal complex at Sigiriya is no exception in this regard.The enormous wealth of information and the unearthed material remains during more than hundred years of field-based research by several generations of archaeologists at Sigiriya provide ideal opportunity for such an analysis. The present study is, therefore, to fill the gap in research related to Sri Lanka’s historical built heritage in general and to Sigiriya in particular. Therefore the present research attempts to read Sigiriya as a landscape architectonic design to expose its architectonic composition and design instruments.The study which is approached from a technical-analytical point of view follows a methodological framework that is developed at the Landscape Design Department of the Faculty of Architecture at Delft University of Technology. The study reveals that the architectonic design of Sigiriya constitutes multiple design layers and multiple layers of significance with material-spatial-metaphorical-functional coherence, and that it has both general and unique landscape architectonic elements, aspects, characteristics and qualities.The richness of its composition also enables to identify the landscape architectural value of the Sigiriya, which will help re-shape the policies related to conservation and presentation of Sigiriya as a heritage site as well as the protection and management as a green monument. The positive results of the study also underline that the methodology adapted in this research has devised a framework for the study of other examples of

  14. HIV and maternal mortality.

    Science.gov (United States)

    Lathrop, Eva; Jamieson, Denise J; Danel, Isabella

    2014-11-01

    The majority of the 17 million women globally that are estimated to be infected with HIV live in Sub-Saharan Africa. Worldwide, HIV-related causes contributed to 19 000-56 000 maternal deaths in 2011 (6%-20% of maternal deaths). HIV-infected pregnant women have two to 10 times the risk of dying during pregnancy and the postpartum period compared with uninfected pregnant women. Many of these deaths can be prevented with the implementation of high-quality obstetric care, prevention and treatment of common co-infections, and treatment of HIV with ART. The paper summarizes what is known about HIV disease progression in pregnancy, specific causes of HIV-related maternal deaths, and the potential impact of treatment with antiretroviral therapy on maternal mortality. Recommendations are proposed for improving maternal health and decreasing maternal mortality among HIV-infected women based on existing evidence.

  15. Maternal intake of antioxidant vitamins in pregnancy in relation to maternal and fetal plasma levels at delivery.

    Science.gov (United States)

    Scaife, Alison R; McNeill, Geraldine; Campbell, Doris M; Martindale, Sheelagh; Devereux, Graham; Seaton, Anthony

    2006-04-01

    The aim of the present study was to test the hypothesis that maternal intake of antioxidant vitamins is associated with maternal and cord plasma levels at delivery. Women were recruited in early pregnancy in Aberdeen Maternity Hospital and habitual diet during pregnancy was assessed by a food-frequency questionnaire mailed at 34 weeks gestation. Blood samples were taken at recruitment (n 1149) and maternal (n 1149) and cord blood samples (n 747) taken at delivery for analyses of vitamins A, C, E and beta-carotene. Maternal plasma levels of vitamin E and beta-carotene at delivery were significantly higher than levels in early pregnancy while levels of vitamins A and C were significantly lower. Positive correlations were observed for maternal levels of all the vitamins between early pregnancy and delivery. At delivery, maternal plasma concentrations of vitamins A, E and beta-carotene were significantly higher than cord levels, while maternal levels of vitamin C were significantly lower. There were significant correlations between maternal and cord plasma concentrations for beta-carotene and vitamin C but not for vitamins A or E. Maternal dietary intakes were positively correlated with maternal plasma levels of vitamins C, E and beta-carotene in early pregnancy, with maternal plasma levels of beta-carotene and vitamin C at delivery and with cord plasma levels of beta-carotene and vitamin C. The results from the present study show that, in this population, maternal diet influences cord plasma levels of beta-carotene and vitamin C, but not vitamins A and E.

  16. Maternal mortality and severe maternal morbidity surveillance in Canada.

    Science.gov (United States)

    Allen, Victoria M; Campbell, Melanie; Carson, George; Fraser, William; Liston, Robert M; Walker, Mark; Barrett, Jon

    2010-12-01

    The Canadian Perinatal Surveillance System has provided a comprehensive review of maternal mortality and severe maternal morbidity in Canada, and has identified several important limitations to existing national maternal data collection systems, including variability in the detail and quality of mortality data. The Canadian Perinatal Surveillance System report recommended the establishment of an ongoing national review and reporting system, as well as consistency in definitions and classifications of maternal mortality and severe maternal morbidity, in order to enhance surveillance of maternal mortality and severe maternal morbidity. Using review articles and studies that examined maternal mortality in general as opposed to maternal mortality associated with particular management strategies or conditions, maternal mortality and severe morbidity classifications, terminology, and comparative statistics were reviewed and employed to evaluate deficiencies in past and current methods of data collection and to seek solutions to address the need for enhanced and consistent national surveillance of maternal mortality and severe maternal morbidity in Canada.

  17. Maternal Mortality in Women with Epilepsy

    LENUS (Irish Health Repository)

    Holohan, M

    2016-10-01

    It is estimated that, in Ireland, there are 10,000 women with epilepsy of childbearing potential1. In this paper the maternal mortality rate for women with epilepsy attending the Rotunda Hospital Epilepsy Clinic 2004 - 2013 was determined. There were 3 maternal deaths in women with epilepsy during this time, which represents a mortality rate of 0.8%. In those women who died, there were concerns in relation to risks to the foetus by taking Anti-Epileptic Drugs (AED) and also issues with access to neurology services before pregnancy, acceptance of specialist support and lack of consistency in advice from health care professionals outside of Ireland. Implementing the nationally agreed care plan for women with epilepsy will improve the quality of care given and potentially we will see a reduction in maternal mortality in these women.

  18. Le don de lait personnalisé chez le grand prématuré : facteurs associés et accompagnement des mères à la maternité de Port Royal

    OpenAIRE

    Remani-Rafa, Souad

    2015-01-01

    Background and aim: Personalized Breast Milk Gift (PBMG) from a mother to her premature infant, is a way to restore the link between mother and child in the technological environment of the Neonatal Intensive Care Unit. Despite the benefits of mother’s milk for premature infants, breastfeeding rate is very low in this category. In 2013, at Port-Royal Maternity, only 54% of premature newborn fewer than 32 weeks of amenorrhea received milk from their own mothers at least once during hospitaliza...

  19. Recommendations for saving mothers' lives in Japan: Report from the Maternal Death Exploratory Committee (2010-2014).

    Science.gov (United States)

    Hasegawa, Junichi; Ikeda, Tomoaki; Sekizawa, Akihiko; Tanaka, Hiroaki; Nakamura, Masamitsu; Katsuragi, Shinji; Osato, Kazuhiro; Tanaka, Kayo; Murakoshi, Takeshi; Nakata, Masahiko; Ishiwata, Isamu

    2016-12-01

    To make recommendations for saving mothers' lives, issues related to maternal deaths including diseases, causes, treatments, and hospital and regional systems are analyzed by the Maternal Death Exploratory Committee in Japan. In this report, we present ten clinical important recommendations based on the analysis of maternal deaths between 2010 and 2014 in Japan. © 2016 Japan Society of Obstetrics and Gynecology.

  20. 广西基层妇幼保健院卫生技术人员流失情况分析%Analysis on the floating character of the health technical personnel of county's maternal and child health care hospitals in Guangxi

    Institute of Scientific and Technical Information of China (English)

    漆光紫; 黄高明; 任美璇

    2013-01-01

    目的:分析广西基层妇幼保健院卫生技术人员流失情况,为新医改进程中妇幼保健机构的建设和发展提供参考依据.方法:采用分层随机抽样方法对广西28家县级妇幼保健院进行调查.结果:5年中广西县级妇幼保健院进入与流失人员比为3.9∶1;总体上流失人员年龄、职业技能、学历和职称均比进入人员高(P<0.05);流失人员主要是流向其他医疗卫生机构,占89.9%;人员流失的首要原因是报酬和待遇低,其次是不能入编制,缺乏保障,以及专业发展受限,不能发挥个人能力和特长,感觉不受重视,没有发展前途也占一定比例.结论:广西基层妇幼保健院高层次、高素质卫生技术人员流失严重,应采取各种有效措施吸引人才、留住人才、激励人才,以提高基层妇幼保健院人才队伍建设水平.%Objective: To analyze the floating character of the health technical personnel of county's maternal and child health care hospitals in Guangxi, provide a reference for the construction and development of maternity and child care institutions in the course of new medical reform. Methods: A survey was taken in 28 county's maternal and child health care hospitals in Guangxi by the stratified random sampling. Results: The ratio of the inflow staffs and the outflow staffs was 3. 9: 1 in the past 5 years. In general, the age, vocational skills, education level and technical post level of the outflow staffs were higher than that of the inflow staffs (P < 0. 05) . 89. 9% of the outflow staffs decide to work in other medical institutes. The first cause of personnel loss of county's women and children's health hospitals was slender earning and bad welfare. The second cause came from non - institution personnel. Third, subject construction in hospital was backward, which limits fully develop of ability and expertise of the health technical personnel. Conclusion: The phenomenon of the outflow of the senior

  1. Exercise in pregnancy - should we do more?

    LENUS (Irish Health Repository)

    NiGhabhann, S

    2011-02-01

    Institute of Obstetricians & Gynaecologists, RCPI Four Provinces Meeting, Junior Obstetrics & Gynaecology Society Annual Scientific Meeting, Royal Academy of Medicine in Ireland Dublin Maternity Hospitals Reports Meeting, Nov 2010

  2. Multiple pregnancies - A 25 year review in a tertiary referral centre

    LENUS (Irish Health Repository)

    Kennelly, M

    2011-02-01

    Institute of Obstetricians & Gynaecologists, RCPI Four Provinces Meeting, Junior Obstetrics & Gynaecology Society Annual Scientific Meeting, Royal Academy of Medicine in Ireland Dublin Maternity Hospitals Reports Meeting, Nov 2011

  3. The effects of the term breech trial on vaginal breech delivery 8 years on

    LENUS (Irish Health Repository)

    Hehir, MP

    2011-02-01

    Institute of Obstetricians & Gynaecologists, RCPI Four Provinces Meeting, Junior Obstetrics & Gynaecology Society Annual Scientific Meeting, Royal Academy of Medicine in Ireland Dublin Maternity Hospitals Reports Meeting, Nov 2011

  4. The proportion of in utero transfers (IUT) significantly influences outcome among a preterm delivery population

    LENUS (Irish Health Repository)

    Wall, V

    2011-02-01

    Institute of Obstetricians & Gynaecologists, RCPI Four Provinces Meeting, Junior Obstetrics & Gynaecology Society Annual Scientific Meeting, Royal Academy of Medicine in Ireland Dublin Maternity Hospitals Reports Meeting, Nov 2010

  5. Does ultrasonic alteration of estimated date of delivery increase perinatal mortality

    LENUS (Irish Health Repository)

    Moore, R

    2011-02-01

    Institute of Obstetricians & Gynaecologists, RCPI Four Provinces Meeting, Junior Obstetrics & Gynaecology Society Annual Scientific Meeting, Royal Academy of Medicine in Ireland Dublin Maternity Hospitals Reports Meeting, Nov 2010

  6. Interventions and outcomes infetal hydrops - a ten year experience

    LENUS (Irish Health Repository)

    O'Sullivan, C

    2011-02-01

    Institute of Obstetricians & Gynaecologists, RCPI Four Provinces Meeting, Junior Obstetrics & Gynaecology Society Annual Scientific Meeting, Royal Academy of Medicine in Ireland Dublin Maternity Hospitals Reports Meeting, Nov 2010

  7. Leptin in diabetic pregnancy

    LENUS (Irish Health Repository)

    Higgins, M

    2011-02-01

    Institute of Obstetricians & Gynaecologists, RCPI Four Provinces Meeting, Junior Obstetrics & Gynaecology Society Annual Scientific Meeting, Royal Academy of Medicine in Ireland Dublin Maternity Hospitals Reports Meeting, Nov 2011

  8. Insulin like growth factor axis in type 1 diabetic pregnancy

    LENUS (Irish Health Repository)

    Higgins, M

    2011-02-01

    Institute of Obstetricians & Gynaecologists, RCPI Four Provinces Meeting, Junior Obstetrics & Gynaecology Society Annual Scientific Meeting, Royal Academy of Medicine in Ireland Dublin Maternity Hospitals Reports Meeting, Nov 2011

  9. ECSSIT - Elective caesarean section Syntocinon infusion trial a multi-centre randomized controlled trial oxytocin Syntocinon % iu bolus and placebo infusion versus oxtocin 5 iu bolus and 40 iu infusion for the control of blood loss at elective caesarean section

    LENUS (Irish Health Repository)

    Sheehan, S

    2011-02-01

    Institute of Obstetricians & Gynaecologists, RCPI Four Provinces Meeting, Junior Obstetrics & Gynaecology Society Annual Scientific Meeting, Royal Academy of Medicine in Ireland Dublin Maternity Hospitals Reports Meeting, Nov 2010

  10. Brainstem encephalitis in pregnancy a rare but potentially fatal occurrence: A case report

    LENUS (Irish Health Repository)

    Maher, N

    2011-02-01

    Institute of Obstetricians & Gynaecologists, RCPI Four Provinces Meeting, Junior Obstetrics & Gynaecology Society Annual Scientific Meeting, Royal Academy of Medicine in Ireland Dublin Maternity Hospitals Reports Meeting, Nov 2010

  11. Placental stereology in diabetic pregnancy

    LENUS (Irish Health Repository)

    Higgins, M

    2011-02-01

    Institute of Obstetricians & Gynaecologists, RCPI Four Provinces Meeting, Junior Obstetrics & Gynaecology Society Annual Scientific Meeting, Royal Academy of Medicine in Ireland Dublin Maternity Hospitals Reports Meeting, Nov 2011

  12. Representações e experiências sobre aborto legal e ilegal dos ginecologistas-obstetras trabalhando em dois hospitais maternidade de Salvador da Bahia Representations and experiences of obstetrician/gynecologists with legal and illegal abortion in two maternity-hospitals in Salvador da Bahia

    Directory of Open Access Journals (Sweden)

    Silvia De Zordo

    2012-07-01

    Full Text Available O objetivo deste estudo qualitativo, realizado em dois hospitais-maternidade de Salvador da Bahia, foi investigar a experiência e as representações do aborto legal, analisadas em contraste com as representações do aborto ilegal, dos profissionais de saúde, em particular dos ginecologistas-obstetras.Usou-se como instrumentos um questionário e entrevistas semi-estruturadas com 25 profissionais de saúde (dos quais 13 ginecologistas-obstetras num hospital que oferece um serviço de aborto legal (P, e 20 profissionais de saúde (dos quais 9 ginecologistas-obstetras em outro hospital, que não oferece este serviço (F. Os fatores que mais influenciam as representações dos ginecologistas-obstetras entrevistados acerca do aborto e que explicam a alta taxa de objeção de consciencia no hospital P foram: 1- a criminalização do aborto e o medo de serem denunciados; 2- a estigmatização do aborto por certos grupos religiosos e pelos proprios médicos; 3- o treinamento em obstetrícia e a falta de uma formação boa no campo da epidemiologia da morbi-mortalidade materna e do aborto; 4- as representações acerca das relações de gênero. Os fatores principais associados à atitudes liberais foram: a idade - abaixo de 30/acima de 45 anos - a experiência com altas taxas de mortalidade materna devidas ao aborto e a experiência com o aborto legal.The objective of this qualitative study, carried out in two maternity-hospitals in Salvador da Bahia, was to investigate the experience and representations of health professionals, and particularly obstetricians-gynecologists, regarding legal abortion in comparison with their representations and experience with illegal abortion. A questionnaire was distributed and semi-structured interviews were conducted with 25 health professionals (13 obstetricians-gynecologists in a hospital providing legal abortion (P and with 20 health professionals (9 obstetricians-gynecologists in another hospital that does not

  13. Maternal propensity for infections and risk of childhood asthma

    DEFF Research Database (Denmark)

    Stokholm, Jakob; Sevelsted, Astrid; Bønnelykke, Klaus;

    2014-01-01

    BACKGROUND: Maternal use of antibiotics during pregnancy has been associated with the development of asthmatic disorders in the offspring. The human microbiome has been suggested to act as an intermediary in this process. To provide clarification on this theory, we studied the temporal relation...... between maternal use of antibiotics and the risk of childhood asthma. METHODS: According to national registries, during the observation period (1997-2010), 910,301 children were born in Denmark and were included in the analysis. From these registries, data for cases of childhood asthma were obtained based...... on hospital admissions, outpatient attendance at a hospital, or use of inhaled corticosteroids. The effect of timing of maternal antibiotic use on the risk of asthma in the offspring was studied by analysis of maternal antibiotic use in the 80 weeks before pregnancy, during pregnancy, and the 80 weeks after...

  14. Análise dos resultados maternos e fetais dos procedimentos invasivos genéticos fetais: um estudo exploratório em Hospital Universitário Analysis of fetal and maternal results from fetal genetic invasive procedures: an exploratory study at a University Hospital

    Directory of Open Access Journals (Sweden)

    Mario Kohatsu

    2012-12-01

    Full Text Available OBJETIVO: Caracterizar as indicações das gestantes que procuraram o serviço de Medicina Fetal do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo para realização de procedimentos invasivos diagnósticos e avaliar os resultados dos cariótipos fetais e de suas gestações. MÉTODOS: Estudo observacional retrospectivo das gestantes que realizaram biópsia de vilo corial (BVC, amniocentese e cordocentese no período de fevereiro de 2005 a dezembro de 2009. Não foram incluídos outros procedimentos diagnósticos ou procedimentos terapêuticos. O resultado da gestação foi obtido através de consulta de prontuário eletrônico e/ou físico e/ou contato telefônico. RESULTADOS: Foram realizados 713 procedimentos (113 BVC, 340 amniocenteses e 260 cordocenteses. A principal indicação para a realização dos procedimentos invasivos foi a presença de alterações estruturais nos fetos, seguido por valores aumentados da translucência nucal e pela idade materna avançada. O cariótipo fetal esteve alterado em 186 casos (26,1%. A trissomia do cromossomo 18 foi a aneuploidia mais comum, seguida pela trissomia do 21, a monossomia do X e a trissomia do cromossomo 13. Ocorreram 4,9% de abortamento, 25,7% de natimortos e 13% de neomortos. Oito gestantes optaram pela interrupção judicial, e 99% das gestantes cujos fetos não apresentavam malformação e que apresentavam cariótipo fetal normal tiveram nativivos.OBJECTIVE: To characterize the indications of pregnant women who sought the Fetal Medicine Services of the Hospital das Clínicas, at the Medical School of the Universidade de São Paulo for performing invasive diagnostic procedures, and to evaluate the results of fetal karyotypes and their pregnancies. METHODS: A retrospective and observational study on pregnant women who underwent chorionic villus sampling (CVS, amniocentesis, and cordocentesis in the period from February, 2005 to December, 2009. Other diagnostic

  15. Auto-exame de mama: conhecimento de usuárias atendidas no ambulatório de uma maternidade escola Auto-examen de la mama: conocimiento de las usuarias atendidas en el ambulatorio de un hospital universitario Breast self-examination: the knowledge of users assisted in the outpatient unit of a university maternity hospital

    Directory of Open Access Journals (Sweden)

    Rejane Marie Barbosa Davim

    2003-02-01

    Full Text Available Estudo descritivo desenvolvido no ambulatório de uma Maternidade Escola em, Natal/RN. Objetivou-se identificar o conhecimento e as alterações encontradas no auto-exame de mama e descrever como as mulheres se auto-examinam. A população foi constituída por mulheres referenciadas de outros serviços de saúde, e a amostra constou de 109 mulheres que tinham entre 15 a 83 anos de idade. O instrumento para a coleta de dados foi um formulário de entrevista contendo dados de identificação e acerca do auto-exame de mama. A partir dos dados coletados, identificamos que, das 109 participantes do estudo, 36 (33% estavam entre 15 a 39 anos de idade; 58 (53% entre 40 a 58 anos, e 15 (14%, na faixa entre 60 a 83 anos. 75% referem se auto-examinarem e, ao detectarem alguma alteração nas mamas durante o auto-exame, procuraram o médico para o tratamento correto.Estudio descriptivo desarrollado en el Servicio de Consulta Externa de un Hospital Universitario de la ciudad de Natal/RN. Tuvo como objetivo identificar el conocimiento y las alteraciones encontradas en el auto-examen de mama y describir con esas mujeres si se autoexaminan. La población estuvo constituida por mujeres remitidas de otros servicios de salud y la muestra constó de 109 mujeres que tenían entre de 15 y 83 años de edad. El instrumento utilizado para la recolección de datos fue un formulario de entrevista contiendo datos de la identificación acerca de el auto-examen de mama. A partir de los datos recolectados identificamos que de las 109 participantes del estudio, 36 (33% estaban entre 15 y 39 años de la edad; 58 (53% entre 40 y 58 años y 15 (14% entre 60 y 83 años. 75% informaron que se autoexaminan y al detectar alguna alteración en las mamas durante el auto-examen, procuran el médico para el tratamiento correcto.This is a descriptive study developed in the outpatient unit of a university maternity hospital in the city of Natal/RN. It aimed at identifying the knowledge

  16. MATERNAL AND FOETAL OUTCOME IN PLACENTA PREVIA

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    Basa Akkamamba

    2016-11-01

    Full Text Available BACKGROUND The aim of the study is to study the-  Risk factors for placenta previa.  Signs of placenta previa.  Modes of delivery.  Maternal and foetal outcome.  Incidence of placenta previa. MATERIALS AND METHODS This is a longitudinal prospective study group consisting of 75 cases of pregnancies with placenta previa. Analysis of maternal and neonatal outcome in cases of placenta previa occurring over a period of 2 years from November 2013 to October 2016. This study was carried out at Government General Hospital, Kakinada, attached to Rangaraya Medical College. RESULTS Maternal morbidity in placenta previa is due to antepartum, intrapartum and postpartum complications. Maternal mortality due to placenta previa was nil. Perinatal death with minor placenta previa was 5.12% with major placenta previa was 47.22%. The general perinatal mortality was 28 per 1000 live births and that due to placenta previa 280 per 1000 live births, i.e. approximately 4 times higher than general perinatal mortality rate. The maternal mortality rate due to placenta previa in this study was nil. CONCLUSIONS In the present study, incidence of antepartum haemorrhage was 0.87% and placenta previa contributed to 37.12% of cases. The general perinatal mortality was 28 per 1000 live births and that due to placenta previa 280 per 1000 live births, i.e. approximately 4 times higher than general perinatal mortality rate. The maternal mortality rate due to placenta previa in this study was nil. But, maternal morbidity was high that is more than 60% of cases had antenatal, intranatal and postnatal complications and anaemia worsened the clinical state of patient.

  17. An autopsy study of maternal mortality: A tertiary healthcare perspective

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    Panchabhai T

    2009-01-01

    Full Text Available Background: An audit of autopsies of maternal deaths is important for the establishment of accurate cause of maternal deaths and to determine the contribution of various etiologies responsible in a given community. Aim: To study the causes of maternal deaths as determined by a pathological autopsy. Settings and Design: A retrospective study of all the cases of maternal deaths that underwent a pathological autopsy in a tertiary healthcare center from January 1998 to December 2006. Materials and Methods: The autopsy records with clinical notes were retrieved; gross and histopathology specimens and slides were studied to establish the accurate cause of maternal deaths. The variables like age (years, stay in the hospital, gravidity, trimester of pregnancy and method of delivery were used to classify and analyze the data from the autopsies. The causes of maternal deaths were divided in to direct and indirect; each being classified into subgroups based on the most evident pathology on autopsy. Results: The Maternal Mortality Rate (MMR over a nine-year period (1998-2006 was 827/100000 live births (471 maternal deaths against 56944 live births. An autopsy was performed in 277 cases (58.8%. In the autopsy group, the most common causes of maternal mortality were pre-ecclampsia/ecclampsia (40 of 277, 14.44% and hemorrhage (32 of 277; 11.55%; However, indirect causes like infectious diseases (27 of 277; 9.75% and cardiac (27 of 277; 9.75% disease also contributed to maternal deaths. Conclusion: Indirect causes like rheumatic heart disease and infections like tuberculosis, malaria or leptospirosis and nutritional anemia are still major causes of maternal mortality in developing countries like India. Intensive efforts need to be taken in these areas to reduce the maternal mortality in developing countries like India.

  18. Direct maternal deaths in Norway 1976-1995

    DEFF Research Database (Denmark)

    Andersgaard, Alice Beate; Langhoff-Roos, J.; Oian, P.

    2008-01-01

    AIMS: To report direct maternal mortality ratio (MMR) in Norway between 1976 and 1995 including a description of the underlying complications in pregnancy, the causes of death and assessment of standard of care. METHODS: The maternal deaths were identified through the Cause of Death Registry......, Statistics Norway, and Medical Birth Registry of Norway. We requested copies of the hospital case records and the maternal death autopsies. The direct maternal deaths were classified on the basis underlying causes and assessed for substandard care according to the guidelines at the time of death...... and preventability provided optimal conditions and up to date guidelines. RESULTS: In the period 1976-1995 we identified 61 direct maternal deaths in Norway. The direct MMR was 5.5/100,000 births. Sufficient information was available for analysis in 51 of these cases. Six deaths occurred in early pregnancy. Among...

  19. Maternal thyroid dysfunction and risk of seizure in the child

    DEFF Research Database (Denmark)

    Andersen, Stine Linding; Laurberg, Peter; Wu, Chunsen

    2013-01-01

    Thyroid hormones are essential for brain development, and maternal thyroid disease may affect child neurocognitive development. Some types of seizures may also depend upon early exposure of the developing central nervous system, and we hypothesized that maternal thyroid dysfunction could increase...... the risk of seizure in the child. In a Danish population-based study we included 1,699,693 liveborn singletons, and from the Danish National Hospital Register we obtained information on maternal diagnosis of hyper- or hypothyroidism and neonatal seizure, febrile seizure, and epilepsy in the child. Maternal...... diagnosis of thyroid dysfunction before or after birth of the child was registered in two percent of the singleton births. In adjusted analyses, maternal hyperthyroidism and hypothyroidism first time diagnosed after birth of the child were associated with a significant increased risk of epilepsy...

  20. The Role of Obstetrics/Gynecology Hospitalists in Reducing Maternal Mortality.

    Science.gov (United States)

    Stevens, Tobey A; Swaim, Laurie S; Clark, Steven L

    2015-09-01

    The United States experienced a 6.1% annual increase in the maternal death rate from 2000 to 2013. Maternal deaths from hemorrhage and complications of preeclampsia are significant contributors to the maternal death rate. Many of these deaths are preventable. By virtue of their continuous care of laboring patients, active involvement in hospital safety initiatives, and immediate availability, obstetric hospitalists are uniquely positioned to evaluate patients, initiate care, and coordinate a multidisciplinary effort. In cases of significant maternal hemorrhage, hypertensive crisis, and acute pulmonary edema, the availability of an obstetrics hospitalist may facilitate improved patient safety and fewer maternal deaths.

  1. Maternal and neonatal outcomes of pregnancies in women with Addison's disease: a population-based cohort study on 7.7 million births.

    Science.gov (United States)

    Schneiderman, M; Czuzoj-Shulman, N; Spence, A R; Abenhaim, H A

    2017-10-01

    To assess if pregnancies among women with Addison's disease (AD) are at higher risk of adverse maternal and neonatal outcomes. Population-based retrospective cohort study. All births in the United States' Healthcare Cost and Utilization Project-Nationwide Inpatient Sample from 2003 to 2011. Baseline characteristics were compared between women with AD and those without, and prevalence over time was measured. Logistic regression was used to estimate the effect of AD on maternal and neonatal outcomes by calculating the crude and adjusted odds ratios (OR) and corresponding 95% confidence intervals (95% CI). We calculated a prevalence of AD in pregnancy of 5.5/100 000, increasing from 5.6 to 9.6/100 000 (P = 0.0001) over the 9-year study period. Compared with women without AD, women with AD were more likely to deliver preterm (OR 1.50, 95% CI 1.16-1.95), deliver by caesarean section (OR 1.32, 95% CI 1.08-1.61), have impaired wound healing (OR 4.28, 95% CI 2.55-7.18), develop infections (OR 2.44, 95% CI 1.66-3.58) and develop thromboembolism (OR 5.21, 95% CI 2.15-12.63), require transfusions (OR 6.69, 95% CI 4.69-9.54), and have prolonged postpartum hospital admissions (OR 5.71, 95% CI 4.37-7.47). Maternal mortality was significantly higher than in the comparison group (OR 22.30, 95% CI 6.82-72.96). Congenital anomalies (OR 3.62, 95% CI 2.05-6.39) and small-for-gestational age infants (OR 1.78, 95% CI 1.15-2.75) were more likely in these pregnancies. Addison's disease significantly increases the risk of severe adverse maternal and neonatal outcomes, so pregnant women with AD are best managed in tertiary-care centres. Pregnancies complicated by Addison's disease have an increased risk of adverse maternal and neonatal outcomes. © 2016 Royal College of Obstetricians and Gynaecologists.

  2. Pregnancy, Maternal Tobacco Smoking, and Early Age Leukemia in Brazil

    OpenAIRE

    2012-01-01

    Background: Cigarette smoking has been associated with acute myeloid leukemia but hypothesis on the association between maternal smoking during pregnancy and childhood leukemia is unclear. Objectives: To investigate the association between maternal exposure to tobacco smoking during pregnancy and early age (< 2 yr.) leukemia (EAL). Methods: A hospital-based multicenter case-control study aiming to explore EAL risk factors was carried out in Brazil during 1999-2007. Data were collected by ...

  3. Chlamydia trachomatis infection and maternal outcomes in Southern Ghana

    OpenAIRE

    2016-01-01

    Background: Despite the fact that Chlamydia trachomatis (CT) infection in pregnancy is known to have grave impact on maternal and neonatal health, routine CT screening in pregnancy is not available in Ghana The main aim of this study was to determine the prevalence and adverse maternal outcomes of CT infection among pregnant women attending antennal clinic at the Cape Coast Teaching Hospital. Methods: Two hundred and thirty two (232) pregnant women screened for CT infection by PCR were pur...

  4. Nephroprotective effect of bee honey and royal jelly against subchronic cisplatin toxicity in rats.

    Science.gov (United States)

    Ibrahim, Abdelazim; Eldaim, Mabrouk A Abd; Abdel-Daim, Mohamed M

    2016-08-01

    Cisplatin is one of the most potent and effective chemotherapeutic agents. However, its antineoplastic use is limited due to its cumulative nephrotoxic side effects. Therefore, the present study was undertaken to examine the nephroprotective potential of dietary bee honey and royal jelly against subchronic cisplatin toxicity in rats. Male Wistar rats were randomly divided into controls, cisplatin-treated, bee honey-pretreated cisplatin-treated and royal jelly-pretreated cisplatin-treated groups. Bee honey and royal jelly were given orally at doses of 20 and 100 mg/kg, respectively. Subchronic toxicity was induced by cisplatin (1 mg/kg bw, ip), twice weekly for 10 weeks. Cisplatin treated animals revealed a significant increase in serum level of renal injury products (urea, creatinine and uric acid). Histopathologically, cisplatin produced pronounced tubulointerstitial injuries, upregulated the fibrogenic factors, α-smooth muscle actin (α-SMA) and transforming growth factor β1(TGF-β1), and downregulated the cell proliferation marker, bromodeoxyuridine (Brdu). Dietary bee honey and royal jelly normalized the elevated serum renal injury product biomarkers, improved the histopathologic changes, reduced the expression of α-SMA and TGF-β1 and increased the expression of Brdu. Therefore, it could be concluded that bee honey, and royal jelly could be used as dietary preventive natural products against subchronic cisplatin-induced renal injury.

  5. Honey, Propolis, and Royal Jelly: A Comprehensive Review of Their Biological Actions and Health Benefits

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    Visweswara Rao Pasupuleti

    2017-01-01

    Full Text Available Background. There are several health benefits that honeybee products such as honey, propolis, and royal jelly claim toward various types of diseases in addition to being food. Scope and Approach. In this paper, the effects of honey, propolis, and royal jelly on different metabolic diseases, cancers, and other diseases have been reviewed. The modes of actions of these products have also been illustrated for purposes of better understanding. Key Findings and Conclusions. An overview of honey, propolis, and royal jelly and their biological potentials was highlighted. The potential health benefits of honey, such as microbial inhibition, wound healing, and its effects on other diseases, are described. Propolis has been reported to have various health benefits related to gastrointestinal disorders, allergies, and gynecological, oral, and dermatological problems. Royal jelly is well known for its protective effects on reproductive health, neurodegenerative disorders, wound healing, and aging. Nevertheless, the exact mechanisms of action of honey, propolis, and royal jelly on the abovementioned diseases and activities have not been not fully elucidated, and further research is warranted to explain their exact contributions.

  6. Honey, Propolis, and Royal Jelly: A Comprehensive Review of Their Biological Actions and Health Benefits.

    Science.gov (United States)

    Pasupuleti, Visweswara Rao; Sammugam, Lakhsmi; Ramesh, Nagesvari; Gan, Siew Hua

    2017-01-01

    There are several health benefits that honeybee products such as honey, propolis, and royal jelly claim toward various types of diseases in addition to being food. In this paper, the effects of honey, propolis, and royal jelly on different metabolic diseases, cancers, and other diseases have been reviewed. The modes of actions of these products have also been illustrated for purposes of better understanding. An overview of honey, propolis, and royal jelly and their biological potentials was highlighted. The potential health benefits of honey, such as microbial inhibition, wound healing, and its effects on other diseases, are described. Propolis has been reported to have various health benefits related to gastrointestinal disorders, allergies, and gynecological, oral, and dermatological problems. Royal jelly is well known for its protective effects on reproductive health, neurodegenerative disorders, wound healing, and aging. Nevertheless, the exact mechanisms of action of honey, propolis, and royal jelly on the abovementioned diseases and activities have not been not fully elucidated, and further research is warranted to explain their exact contributions.

  7. "I was on the way to the hospital but delivered in the bush": Maternal health in Ghana's Upper West Region in the context of a traditional birth attendants' ban.

    Science.gov (United States)

    Rishworth, Andrea; Dixon, Jenna; Luginaah, Isaac; Mkandawire, Paul; Tampah Prince, Caesar

    2016-01-01

    This study examines perceptions and experiences of mothers, traditional birth attendants (TBA), and skilled birth attendants (SBA) regarding Ghana's recent policy that forbids TBAs from undertaking deliveries and restricts their role to referrals. In the larger context of Ghana's highly underdeveloped and geographically uneven health care system, this study draws on the political ecology of health framework to explore the ways global safe motherhood policy discourses intersect with local socio-cultural and political environments of Ghana's Upper West Region (UWR). This study reveals that futile improvements in maternal health and the continued reliance on TBAs illustrate the government's inability to understand local realities marked by poor access to SBAs or modern health care services. Using focus group discussions (FGDs) (n = 10) and in-depth interviews (IDIs) (n = 48) conducted in Ghana's UWR, the findings suggest that mothers generally perceive TBAs as better placed to conduct deliveries in rural isolated communities, where in most cases no SBAs are present or easily accessible. The results indicate that by adhering to the World Health Organization's guidelines, the local government may be imposing detrimental, unintended consequences on maternal and child health in remote rural locations. In addition, the findings suggest that the new policy has resulted in considerable confusion among TBAs, many of whom remain oblivious or have not been officially notified about the new policy. Furthermore, participant accounts suggest that the new policy is seen as contributing to worsening relations and tensions between TBAs and SBAs, a situation that undermines the delivery of maternal health services in the region. The study concludes by suggesting relevant policy recommendations.

  8. Maternal near miss and quality of maternal health care in Baghdad, Iraq

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    Jabir Maysoon

    2013-01-01

    Full Text Available Abstract Background The maternal near-miss concept has been developed as an instrument for assisting health systems to evaluate and improve their quality of care. Our study aimed at studying the characteristics and quality of care provided to women with severe complications in Baghdad through the use of the World Health Organization (WHO near-miss approach for maternal health. Methods This is a facility-based, cross-sectional study conducted in 6 public hospitals in Baghdad between March 1, 2010 and the June 30, 2010. WHO near-miss approach was utilized to analyze the data in terms of indicators of maternal near miss and access to and quality of maternal care. Results The maternal near-miss rate was low at 5.06 per 1,000 live births, while the overall maternal near miss: mortality ratio was 9:1. One third of the near-miss cases were referred from other facilities and the mortality index was the same for referred women and for in-hospital women (11%. The intensive care unit (ICU admission rate was 37% for women with severe maternal outcomes (SMO, while the overall admission rate was 0.28%. Anemia (55% and previous cesarean section (45% were the most common associated conditions with severe maternal morbidity. The use of magnesium sulfate for treatment of eclampsia, oxytocin for prevention and treatment of postpartum hemorrhage, prophylactic antibiotics during caesarean section, and corticosteroids for inducing fetal lung maturation in preterm birth is suboptimum. Conclusions The WHO near-miss approach allowed systematic identification of the roadblocks to improve quality of care and then monitoring the progress. Critical evidence-based practices, relevant to the management of women experiencing life-threatening conditions, are underused. In addition, possible limitations in the referral system result in a very high proportion of women presenting at the hospital already in a severe health condition (i.e. with organ dysfunction. A shortage of ICU

  9. [A Maternal Health Care System Based on Mobile Health Care].

    Science.gov (United States)

    Du, Xin; Zeng, Weijie; Li, Chengwei; Xue, Junwei; Wu, Xiuyong; Liu, Yinjia; Wan, Yuxin; Zhang, Yiru; Ji, Yurong; Wu, Lei; Yang, Yongzhe; Zhang, Yue; Zhu, Bin; Huang, Yueshan; Wu, Kai

    2016-02-01

    Wearable devices are used in the new design of the maternal health care system to detect electrocardiogram and oxygen saturation signal while smart terminals are used to achieve assessments and input maternal clinical information. All the results combined with biochemical analysis from hospital are uploaded to cloud server by mobile Internet. Machine learning algorithms are used for data mining of all information of subjects. This system can achieve the assessment and care of maternal physical health as well as mental health. Moreover, the system can send the results and health guidance to smart terminals.

  10. Maternal help-seeking for child developmental concerns: Associations with socio-demographic factors.

    Science.gov (United States)

    Eapen, Valsamma; Walter, Amelia; Guan, Jane; Descallar, Joseph; Axelsson, Emma; Einfeld, Stewart; Eastwood, John; Murphy, Elisabeth; Beasley, Deborah; Silove, Natalie; Dissanayake, Cheryl; Woolfenden, Sue; Williams, Katrina; Jalaludin, Bin; The 'Watch Me Grow' Study Group

    2017-06-29

    To examine socio-demographic factors associated with maternal help-seeking for child developmental concerns in a longitudinal birth cohort study. An understanding of these factors is critical to improving uptake of services to maximise early identification and intervention for developmental concerns. A birth cohort was recruited from the post-natal wards of two teaching hospitals and through community nurses in South Western Sydney, Australia, between November 2011 and April 2013. Of the 4047 mothers approached, 2025 consented to participate (response rate = 50%). Socio-demographic and service use information was collected after the child's birth and when the child was 18 months of age. Sources of help were divided into three categories (formal health services, other formal services and informal supports) and compound variables were created by summing the number of different sources identified by mothers. Significantly more sources of help were intended to be used and/or actually accessed by mothers born in Australia, whose primary language was English, with higher levels of education and annual household income, and among mothers of first-born children. Developmental concerns are known to increase with increased psychosocial adversity. Our findings of reduced intent to access and use of services by socio-economically disadvantaged families and those from culturally and linguistically diverse backgrounds suggests that an inverse care effect is in operation whereby those children with the greatest health needs may have the least access to services. Possible explanations for this, and recommendations for improving service accessibility for these populations through targeted and culturally appropriate services, are discussed. © 2017 Paediatrics and Child Health Division (The Royal Australasian College of Physicians).

  11. Mortes perinatais e avaliação da assistência ao parto em maternidades do Sistema Único de Saúde em Belo Horizonte, Minas Gerais, Brasil, 1999 Perinatal deaths and childbirth healthcare evaluation in maternity hospitals of the Brazilian Unified Health System in Belo Horizonte, Minas Gerais, Brazil, 1999

    Directory of Open Access Journals (Sweden)

    Sônia Lansky

    2006-01-01

    Full Text Available Este trabalho analisa a associação entre a morte perinatal e o processo de assistência hospitalar ao parto, considerando-se que grande parte das mortes perinatais pode ser prevenível pela atenção qualificada de saúde e que a avaliação da qualidade da assistência perinatal ao parto é necessária para a redução da morbi-mortalidade perinatal. Realizou-se estudo caso-controle de base populacional dos óbitos perinatais (n = 118 e nascimentos (n = 492, ocorridos em maternidades do Sistema Único de Saúde (SUS de Belo Horizonte, Minas Gerais, Brasil. Sexo masculino, prematuridade, doenças na gravidez, baixo peso ao nascer, doenças do recém-nascido, não realização de pré-natal, não utilização de partograma e menos de uma avaliação fetal por hora durante o trabalho de parto apresentaram associação estatisticamente significativa com o óbito perinatal. No modelo de regressão logística múltipla, não utilização do partograma durante o trabalho de parto e tipo de maternidade apresentaram-se como fatores de risco independentes para a morte perinatal. O estudo indica que é deficiente a qualidade da assistência hospitalar ao parto e que aspectos da estrutura dos serviços e do processo de assistência relacionam-se com a mortalidade perinatal por causas evitáveis.This paper analyzes the association between perinatal mortality and factors related to hospital care during labor, considering that healthcare assessment is needed in order to reduce perinatal mortality. A population-based case-control study was conducted with 118 perinatal deaths (cases and 492 births (controls that took place in maternity hospitals of the Brazilian Unified Health System (SUS in Belo Horizonte, Minas Gerais, Brazil. Male sex, prematurity, diseases during pregnancy, low birth weight, newborn diseases, lack of prenatal care, lack of partograph use during labor, and less than one fetus assessment per hour during labor were significantly associated

  12. Identifications of ancient Egyptian royal mummies from the 18th Dynasty reconsidered.

    Science.gov (United States)

    Habicht, M E; Bouwman, A S; Rühli, F J

    2016-01-01

    For centuries, ancient Egyptian Royal mummies have drawn the attention both of the general public and scientists. Many royal mummies from the New Kingdom have survived. The discoveries of the bodies of these ancient rulers have always sparked much attention, yet not all identifications are clear even nowadays. This study presents a meta-analysis to demonstrate the difficulties in identifying ancient Egyptian royal mummies. Various methods and pitfalls in the identification of the Pharaohs are reassessed since new scientific methods can be used, such as ancient DNA-profiling and CT-scanning. While the ancestors of Tutankhamun have been identified, some identities are still highly controversial (e.g., the mystery of the KV-55 skeleton, recently most likely identified as the genetic father of Tutankhamun). The meta-analysis confirms the suggested identity of some mummies (e.g., Amenhotep III, Thutmosis IV, and Queen Tjye).

  13. Varroa destructor mite in Africanized honeybee colonies Apis mellifera L. under royal jelly or honey production

    Directory of Open Access Journals (Sweden)

    Pedro da Rosa Santos

    2015-08-01

    Full Text Available This study evaluated the level of invasion of Varroa mite into worker brood cells, the infestation rate on adult worker honeybees, total and effective reproduction rates of the mite in Africanized honeybee colonies under royal jelly or honey production. Invasion and infestation rates were not statistically different between honeybee colonies producing honey or royal jelly and the averages for these parameters were 5.79 and 8.54%, respectively. Colonies producing honey presented a higher (p < 0.05 total and effective reproduction of Varroa than colonies producing royal jelly. There was a negative correlation between levels of invasion and infestation with minimum external temperature, relative humidity and rainfall. The variables month and season influenced the development of the mite, but rates were low and within the range normally found in Brazil for Africanized honeybee colonies, which confirm the greater resistance of these honeybees to Varroa destructor than European honeybees.

  14. Costs of publicly provided maternity services in Rosario, Argentina

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    Borghi Josephine

    2003-01-01

    Full Text Available OBJECTIVE: This study estimates the costs of maternal health services in Rosario, Argentina. MATERIAL AND METHODS: The provider costs (US$ 1999 of antenatal care, a normal vaginal delivery and a caesarean section, were evaluated retrospectively in two municipal hospitals. The cost of an antenatal visit was evaluated in two health centres and the patient costs associated with the visit were evaluated in a hospital and a health centre. RESULTS: The average cost per hospital day is $114.62. The average cost of a caesarean section ($525.57 is five times greater than that of a normal vaginal delivery ($105.61. A normal delivery costs less at the general hospital and a c-section less at the maternity hospital. The average cost of an antenatal visit is $31.10. The provider cost is lower at the health centre than at the hospital. Personnel accounted for 72-94% of the total cost and drugs and medical supplies between 4-26%. On average, an antenatal visit costs women $4.70. Direct costs are minimal compared to indirect costs of travel and waiting time. CONCLUSIONS: These results suggest the potential for increasing the efficiency of resource use by promoting antenatal care visits at the primary level. Women could also benefit from reduced travel and waiting time. Similar benefits could accrue to the provider by encouraging normal delivery at general hospitals, and complicated deliveries at specialised maternity hospitals.

  15. The Royal Treasury of the Kingdom of Majorca during the War of the Spanish Succession (1701-1715

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    Eduardo PASCUAL RAMOS

    2014-02-01

    Full Text Available The royal treasury of the kingdom of Majorca during the War of the Spanish Succession suffered an economic downturn caused mainly by its logistical contribution to the war. This article shows the evolution of the taxation carried out by the Royal Treasury of Majorca during the war, and is divided into three parts. The first one is a description of the Royal Treasury as an institution. The second one analyses revenues and expenses and shows the evolution of the institution’s finances during the conflict. The third part is a general inventory of the royal accounts during the war.

  16. CDC Vital Signs: Hospital Actions Affect Breastfeeding

    Science.gov (United States)

    ... mothers to community programs for support once they leave the hospital. Hospitals can Implement the Ten Steps to Successful Breastfeeding and work towards achieving Baby-Friendly designation. Use CDC’s Maternity Practices in Infant Nutrition and Care (mPINC) survey ...

  17. Maternal mortality from hemorrhage.

    Science.gov (United States)

    Haeri, Sina; Dildy, Gary A

    2012-02-01

    Hemorrhage remains as one of the top 3 obstetrics related causes of maternal mortality, with most deaths occurring within 24-48 hours of delivery. Although hemorrhage related maternal mortality has declined globally, it continues to be a vexing problem. More specifically, the developing world continue to shoulder a disproportionate share of hemorrhage related deaths (99%) compared with industrialized nations (1%). Given the often preventable nature of death from hemorrhage, the cornerstone of effective mortality reduction involves risk factor identification, quick diagnosis, and timely management. In this monograph we will review the epidemiology, etiology, and preventative measures related to maternal mortality from hemorrhage.

  18. Severe maternal morbidity in Canada, 1991–2001

    Science.gov (United States)

    Wen, Shi Wu; Huang, Ling; Liston, Robert; Heaman, Maureen; Baskett, Tom; Rusen, I.D.; Joseph, K.S.; for, Michael S. Kramer

    2005-01-01

    Background Although death rates are often used to monitor the quality of health care, in industrialized countries maternal deaths have become rare. Severe maternal morbidity has therefore been proposed as a supplementary indicator for surveillance of the quality of maternity care. Our purpose in this study was to describe severe maternal morbidity in Canada over a 10-year period, among women with or without major pre-existing conditions. Methods We carried out a retrospective cohort study of severe maternal morbidity involving 2 548 824 women who gave birth in Canadian hospitals between 1991 and 2000. Thirteen conditions that may threaten the life of the mother (e.g., eclampsia) and 11 major pre-existing chronic conditions (e.g., diabetes) that could be identified from diagnostic codes were noted. Results The overall rate of severe maternal morbidity was 4.38 per 1000 deliveries. The fatality rate among these women was 158 times that of the entire sample. Rates of venous thromboembolism, uterine rupture, adult respiratory distress syndrome, pulmonary edema, myocardial infarction, severe postpartum hemorrhage requiring hysterectomy, and assisted ventilation increased substantially from 1991 to 2000. The presence of major pre-existing conditions increased the risk of severe maternal morbidity to 6-fold. Interpretation Severe maternal morbidity occurs in about 1 of 250 deliveries in Canada, with marked recent increases in certain morbid conditions such as pulmonary edema, myocardial infarction, hemorrhage requiring hysterectomy, and the use of assisted ventilation. PMID:16186582

  19. The Case of the Royal School of Library and Information Science

    DEFF Research Database (Denmark)

    Borlund, Pia

    2010-01-01

    The present paper forms the basis of the invited talk to be given by the author at the International Symposium on the Transformation and Innovation of Library and Information Science, November 16-17, 2010, Taipei, Taiwan. The paper introduces the Royal School of Library and Information Science......, Denmark, as a European School of Library and Information Science and a member of iSchool Caucus. The paper outlines some of the current challenges of the Royal School of Library and Information Science and how these challenges are met, including how the membership of the iSchool movement is considered...

  20. Presidential addresses of the Royal Society of Tropical Medicine and Hygiene: 1907–2013

    Science.gov (United States)

    Hay, Simon I.; McHugh, Gerri M.

    2013-01-01

    Presidents have been required to give an inaugural address on commencing office at the Royal Society of Tropical Medicine and Hygiene (RSTMH) since its foundation in 1907. All presidential addresses were identified, sourced and assembled into an annotated bibliography. The majority of presidential addresses have been published in Transactions of the Royal Society of Tropical Medicine and Hygiene. Unpublished and in some cases ‘lost’ contributions have now been sourced where possible and archived at the RSTMH. This unique, rich and rewarding archive provides a vista into the development of the RSTMH and the discipline of tropical medicine. The archive is freely available to all. PMID:24026462

  1. The Role of the Royal Navy in Counter-Insurgency Campaigns since 1945

    OpenAIRE

    Guoth, Maroš

    2014-01-01

    The aim of this work is to prove that a navy can play an important role during a counter-insurgency campaign and be involved in many different tasks both at sea and from sea, particularly due to its flexibility, mobility and versatility. The main research question of the thesis is: what role can a navy play in a counter-insurgency campaign? The decision to focus on the role of the Royal Navy is based on the fact, that the Royal Navy is probably the most experienced navy in the world in the fi...

  2. Alternative sources of supplements for Africanized honeybees submitted to royal jelly production

    OpenAIRE

    Sereia, Maria Josiane; Toledo,Vagner de Alencar Arnaut de; Furlan,Antonio Claudio; Faquinello,Patrícia; Maia,Fabiana Martins Costa; Wielewski,Priscila

    2013-01-01

    This study was carried out to evaluate the effect of supplements with isolated soy protein, brewer's yeast, a mixture of isolated soy protein with brewer's yeast, linseed oil, palm oil and mixture of linseed oil with palm oil in the production of royal jelly by Africanized honeybee colonies. Total royal jelly production was higher (p < 0.05) in colonies fed with isolated soy protein and brewer's yeast (11.68 g colony-1), followed by linseed oil and palm oil (11.30 g colony-1) and palm oil (9....

  3. Cienfuegos’ Linguistic Anxieties. Notes on the Author’s Papers Held at the Spanish Royal Academy

    Directory of Open Access Journals (Sweden)

    Pedro ÁLVAREZ DE MIRANDA DE LA GANDARA

    2011-01-01

    Full Text Available This article looks at the relationship between Nicasio Álvarez de Cienfuegos and the Spanish Royal Academy. Cienfuegos was inducted in 1799 and remained more or less active until 1805. He had an abiding interest in linguistic questions, and his membership in the Academy give him a chance to work on both grammatical and lexicographic issues. Few of the studies ever reached the light of day, however. Here, both the published works and the unpublished manuscripts that are held in the Library and the Archive of the Spanish Royal Academy are described in detail.

  4. FacilitiesHospitals_HOSPITAL

    Data.gov (United States)

    Vermont Center for Geographic Information — This data layer contains point locations of all major community, regional, comprehensive health, and healthcare provider hospitals in the state of Vermont. The...

  5. Hospitals; hospitals13

    Data.gov (United States)

    University of Rhode Island Geospatial Extension Program — Hospital Facilities information was compiled from several various sources. Main source was the RI Department of Health Facilities Regulation database, License 2000....

  6. Cesarean delivery in Finland: maternal complications and obstetric risk factors.

    Science.gov (United States)

    Pallasmaa, Nanneli; Ekblad, Ulla; Aitokallio-Tallberg, Ansa; Uotila, Jukka; Raudaskoski, Tytti; Ulander, Veli-Matti; Hurme, Saija

    2010-07-01

    To assess the rate of maternal complications related to cesarean section (CS) and to compare morbidity between elective, emergency and crash-emergency CS. To establish risk factors associated with maternal CS morbidity. A prospective multicenter cohort study. Twelve delivery units in Finland. Women delivering by CS (n = 2,496) during a 6 months period in the study hospitals. Data on pregnant women, CS, and maternal recovery during the hospital stay was collected prospectively on report forms. The complication rates by different CSs were calculated, and factors associated with morbidity were analyzed by odds ratios (OR). Maternal complication rates in different types of CS. The association of risk factors with morbidity. About 27% of women delivering by CS had complications; 10% had severe complications. The complication rate was higher in emergency CS than in elective CS, and highest in crash-emergency CS. Significant independent risk factors for maternal morbidity were emergency CS and crash-emergency CS compared to elective CS (OR 1.8; 95% confidence interval (CI) 1.5-2.2), pre-eclampsia (OR 1.5; CI 1.1-2.0), maternal obesity (OR 1.4; CI 1.1-1.8) and maternal increasing age (OR 1.1; CI 1.03-1.2 per each 5 years). Maternal complications are frequent in CS, and although performing CS electively reduces the occurrence of complications, the frequency is still high. The complication rate depends on the degree of emergency, and increases with maternal obesity, older age and pre-eclampsia.

  7. Impact of stillbirths on international comparisons of preterm birth rates: a secondary analysis of the WHO multi-country survey of Maternal and Newborn Health.

    Science.gov (United States)

    Morisaki, N; Ganchimeg, T; Vogel, J P; Zeitlin, J; Cecatti, J G; Souza, J P; Pileggi Castro, C; Torloni, M R; Ota, E; Mori, R; Dolan, S M; Tough, S; Mittal, S; Bataglia, V; Yadamsuren, B; Kramer, M S

    2017-08-01

    To evaluate the extent to which stillbirths affect international comparisons of preterm birth rates in low- and middle-income countries. Secondary analysis of a multi-country cross-sectional study. 29 countries participating in the World Health Organization Multicountry Survey on Maternal and Newborn Health. 258 215 singleton deliveries in 286 hospitals. We describe how inclusion or exclusion of stillbirth affect rates of preterm births in 29 countries. Preterm delivery. In all countries, preterm birth rates were substantially lower when based on live births only, than when based on total births. However, the increase in preterm birth rates with inclusion of stillbirths was substantially higher in low Human Development Index (HDI) countries [median 18.2%, interquartile range (17.2-34.6%)] compared with medium (4.3%, 3.0-6.7%), and high-HDI countries (4.8%, 4.4-5.5%). Inclusion of stillbirths leads to higher estimates of preterm birth rate in all countries, with a disproportionately large effect in low-HDI countries. Preterm birth rates based on live births alone do not accurately reflect international disparities in perinatal health; thus improved registration and reporting of stillbirths are necessary. Inclusion of stillbirths increases preterm birth rates estimates, especially in low-HDI countries. © 2017 World Health Organization, licensed by John Wiley & Sons Ltd on behalf of Royal College of Obstetricians and Gynaecologists.

  8. Severe Maternal Morbidity Among Hispanic Women in New York City: Investigation of Health Disparities.

    Science.gov (United States)

    Howell, Elizabeth A; Egorova, Natalia N; Janevic, Teresa; Balbierz, Amy; Zeitlin, Jennifer; Hebert, Paul L

    2017-02-01

    To investigate differences in severe maternal morbidity between Hispanic mothers and three major Hispanic subgroups compared with non-Hispanic white mothers and the extent to which differences in delivery hospitals may contribute to excess morbidity among Hispanic mothers. We conducted a population-based cross-sectional study using linked 2011-2013 New York City discharge and birth certificate data sets (n=353,773). Rates of severe maternal morbidity were calculated using a published algorithm based on diagnosis and procedure codes. Mixed-effects logistic regression with a random hospital-specific intercept was used to generate risk-standardized severe maternal morbidity rates for each hospital taking into consideration patient sociodemographic characteristics and comorbidities. Differences in the distribution of Hispanic and non-Hispanic white deliveries were assessed among these hospitals in relation to their risk-adjusted morbidity. Sensitivity analyses were conducted after excluding isolated blood transfusion from the morbidity composite. Severe maternal morbidity occurred in 4,541 deliveries and was higher among Hispanic than non-Hispanic white women (2.7% compared with 1.5%, PNew York City hospitals. Hispanic compared with non-Hispanic white mothers are more likely to deliver at hospitals with higher risk-adjusted severe maternal morbidity rates and these differences in site of delivery may contribute to excess morbidity among Hispanic mothers. Our results suggest improving quality at the lowest performing hospitals could benefit both non-Hispanic white and Hispanic women and reduce ethnic disparities in severe maternal morbidity rates.

  9. Royal Ahold : A Failure of Corporate Governance and an Accounting Scandal

    NARCIS (Netherlands)

    de Jong, A.; DeJong, D.V.; Mertens, G.M.H.; Roosenboom, P.G.J.

    2005-01-01

    Royal Ahold (Koninklijke Ahold NV) was one of the major success stories in the 1990s and is one of the major failures, suffering a complete meltdown, in 2003.We investigate the strategy, accounting transparency and corporate governance of Ahold; elements which jointly drive the firm s performance

  10. MANAGEMENT ART - The Royal Danish Opera's Artistic Director Kasper Bech Holten as case

    DEFF Research Database (Denmark)

    Nørreklit, Hanne

    successful Artistic Director of the Royal Danish Opera, Kasper Bech Holten. The analysis shows that conventional management models primarily use the symbolic forms of science and myth, while Kasper integrates the symbolic forms of art and science. In what Kasper has to say on management, features...

  11. Dr. Steve Thompson, Chief Executive, The Royal Society of New Zealand

    CERN Multimedia

    Maximilien Brice

    2002-01-01

    L. to r.: Dr Austin Ball, Deputy Technical Coordinator, CMS experiment; Dr Roland Horisberger, Paul Scherrer Institute and CERN, CMS experiment; Dr Steve Thompson, Chief Executive, The Royal Society of New Zealand; Dr Michel Della Negra, Spokesman, CMS experiment and Dr Alick Macpherson, Paul Scherrer Institute and CERN, CMS experiment, in the CMS Silicon Tracker assembly hall.

  12. Berta and Adelaide: the policy of consolidation of the royal power of Hugh of Arles

    Directory of Open Access Journals (Sweden)

    Giacomo Vignodelli

    2012-10-01

    Full Text Available Both twins dowers made up by Hugh of Provence, king of Italic Kingdom, for his betrothal with Berta and that of his son Lothair with Adelaide, have to be understood within the policy of strengthening the royal power led by the king in the Thirties of the Tenth century: the dowers are in fact the crown of that policy. The double dower constitution supplies the king of Italy the opportunity to reserve for himself (and for the new formed young royal couple a strong control of the center of the Po valley around Pavia and dismantles (for the benefit of the royal domain ducal bases of power in Tuscia. The analysis of the work of Hugh allows us to understand its policy towards the aristocracy and the mechanisms for the promotion of new families (Aleramici, Obertenghi, Canossa. The original documents of dower were kept in the monastery of St. Salvatore of Pavia, founded by Adelaide; this locations isn’t due to the goods endowment of the monastery but to their importance as instrument of political legitimacy of the new Ottonian royal family.

  13. Reflections on a Degree Initiative: The UK's Birmingham Royal Ballet Dancers Enter the University of Birmingham

    Science.gov (United States)

    Benn, Tansin

    2003-01-01

    This paper provides an opportunity to share experiences and perceptions of the first 5 years of a degree programme for professional dancers. A partnership developed in the mid-1990s between the UK's Birmingham Royal Ballet and the University of Birmingham, Westhill (now School of Education), to provide a part-time, post-experience, flexible study…

  14. Ruptured-yolk peritonitis and organochlorine residues in a royal tern

    Science.gov (United States)

    Blus, L.J.; Locke, L.N.; Stafford, C.J.

    1977-01-01

    Ruptured-yolk peritonitis was responsible for the death of a royal tern. Lodgment of eggs in the oviduct was probably due to reverse peristalsis brought about by breakage of the thin-shelled eggs and secondary bacterial infection. The thin shells were apparently not related to the low levels of DDE and other organochlorine pollutants found in tissues and egg contents.

  15. Royal Service tegutseb üheksas riigis / Paavo Pilv ; interv. Eda-Liis Kann

    Index Scriptorium Estoniae

    Pilv, Paavo

    2004-01-01

    Äripäeva üritusturundusfirmade TOP-is I koha saavutanud Royal Service-i juht ettevõtte edukuse põhjustest, olulisematest töödest 2003. aastal, üritusturunduse tulevikutrendidest ja EL-iga liitumise mõjust valdkonna arengule

  16. Integrating Social Sustainability in Engineering Education at the KTH Royal Institute of Technology

    Science.gov (United States)

    Björnberg, Karin Edvardsson; Skogh, Inga-Britt; Strömberg, Emma

    2015-01-01

    Purpose: The purpose of this paper is to investigate what are perceived to be the main challenges associated with the integration of social sustainability into engineering education at the KTH Royal Institute of Technology, Stockholm. Design/methodology/approach: Semi-structured interviews were conducted with programme leaders and teachers from…

  17. Royal Ahold : A Failure of Corporate Governance and an Accounting Scandal

    NARCIS (Netherlands)

    de Jong, A.; DeJong, D.V.; Mertens, G.M.H.; Roosenboom, P.G.J.

    2005-01-01

    Royal Ahold (Koninklijke Ahold NV) was one of the major success stories in the 1990s and is one of the major failures, suffering a complete meltdown, in 2003.We investigate the strategy, accounting transparency and corporate governance of Ahold; elements which jointly drive the firm s performance ov

  18. Integrating Social Sustainability in Engineering Education at the KTH Royal Institute of Technology

    Science.gov (United States)

    Björnberg, Karin Edvardsson; Skogh, Inga-Britt; Strömberg, Emma

    2015-01-01

    Purpose: The purpose of this paper is to investigate what are perceived to be the main challenges associated with the integration of social sustainability into engineering education at the KTH Royal Institute of Technology, Stockholm. Design/methodology/approach: Semi-structured interviews were conducted with programme leaders and teachers from…

  19. Royal Ahold : A Failure of Corporate Governance and an Accounting Scandal

    NARCIS (Netherlands)

    de Jong, A.; DeJong, D.V.; Mertens, G.M.H.; Roosenboom, P.G.J.

    2005-01-01

    Royal Ahold (Koninklijke Ahold NV) was one of the major success stories in the 1990s and is one of the major failures, suffering a complete meltdown, in 2003.We investigate the strategy, accounting transparency and corporate governance of Ahold; elements which jointly drive the firm s performance ov

  20. Royal Patronage and Religious Tolerance : The Formative Period of Gupta-Vakataka Culture

    NARCIS (Netherlands)

    Bakker, H.T.

    2010-01-01

    Patronage by the royal court of religious institutions and foundations is one of the hallmarks of the development of India under the rule of the Gupta and Vakataka kings (4th-5th centuries). This patronage was extended also to religious movements other than the king's own persuasion. The evolving cu

  1. 78 FR 42512 - Application to Export Electric Energy; Royal Bank of Canada

    Science.gov (United States)

    2013-07-16

    ... Application to Export Electric Energy; Royal Bank of Canada AGENCY: Office of Electricity Delivery and Energy... authority to transmit electric energy from the United States to Canada pursuant to section 202(e) of the... transmit electric energy from the United States to Canada as a power marketer for a five-year term...

  2. Linguistica Neerlandica: a Dutch translation of the Port-Royal Grammar

    NARCIS (Netherlands)

    Noordegraaf, J.

    1978-01-01

    In this note it is pointed out that the first translation of the so-called Port-Royal Grammar, the Grammaire générale et raisonnée (1660), was a Dutch one. The translator was the Amsterdam Johanna Corleva (1698-1752); the translation appeared in Amsterdam in 1740.

  3. [Maternal mortality in France, 2007-2009].

    Science.gov (United States)

    Saucedo, M; Deneux-Tharaux, C; Bouvier-Colle, M-H

    2013-11-01

    To monitor the maternal mortality which is an indicator of the quality of obstetric and intensive care, France has a specific approach since 1996. Recently linkages have been introduced to improve the inclusion of cases. Here are the results for the 2007 to 2009 period. The identification of the pregnancy associated deaths is lying on different data bases that are medical causes of death, birth register and hospital discharges. To document the cases, confidential enquiries are conducted by two assessors on the field; a committee of medical experts analyses the documents, select the underlying cause and assess the quality of health care. Two hundred and fifty-four obstetric deaths were identified from 2007 to 2009 giving the maternal mortality ratio (MMR) of 10.3 per 100,000 births. The maternal age and nationality, the region of deaths are associated to the MMR. The haemorrhages are the leading cause but their ratio is 1.9 versus 2.5 previously; this decrease results from the postpartum haemorrhage by uterine atony going down. The suboptimal care are still frequent (60%) but slightly less than before. The linkage method should be pursued. Maternal mortality is rather stable in France. We may reach more reduction as deaths due to atony decreased as suboptimal care did.

  4. [A tale of 2 cities. The dispute over the true origins of the Royal Society].

    Science.gov (United States)

    Beeley, Philip

    2008-01-01

    When the Royal Society was founded in November 1660 it took scientific societies already existing in other European countries as its model. However, at a time when the new mathematical and experimental sciences were still generally without a secure institutional foundation there was also great interest in the new society on the part of scientists and scholars abroad. Soon visitors such as Christiaan Huygens and Balthazar de Monconys were able to report positively on its practical orientation, while among others Johannes Hevelius and Philipp Jacob Sachs von Lewenhaimb in letters to the founder member John Wallis and to the secretary Henry Oldenburg requested more information on its origins and statutes. Meanwhile, in England the Royal Society found itself the object of vociferous criticism, especially from the universities, which saw their own role as centres of learning increasingly compromised by the existence of an institution dedicated to the promotion of modern science. The Royal Society responded to this interest from abroad and criticism at home by commissioning an official history written by Thomas Sprat, a man with a university as well as a literary background. However, despite the author's good credentials, the History of the Royal Society presents a one-sided account of the institution, mainly from the perspective of the circle around John Wilkins to which Sprat had belonged. According to their point of view the Royal Society arose from meetings which Wilkins had organized at Wadham College in Oxford in the early 1650s. For members of the old guard, such as Wallis and William Brouncker, the origins of the Royal Society were, however, not in Oxford but rather in London, where meetings involving a significant number of members of the future institution had taken place already in the mid-1640s. This was not simply a question of historical accuracy, but also of the way in which the Royal Society conceived itself: while the circle around Wilkins was in

  5. 78 FR 23316 - The Royal Bank of Scotland plc, et al.; Notice of Application and Temporary Order

    Science.gov (United States)

    2013-04-18

    ... COMMISSION The Royal Bank of Scotland plc, et al.; Notice of Application and Temporary Order April 12, 2013.... APPLICANTS: The Royal Bank of Scotland plc (``RBS plc''), Citizens Investment Advisors (``Citizens IA''), a... Exchange Commission, 100 F Street NE., Washington, DC 20549-1090. Applicants: RBS plc, RBS, Gogarburn,...

  6. The Effects of Royal Jelly on In-Vitro Cytotoxicity of K562 Cells and Peripheral Blood Mononuclear Cells

    Directory of Open Access Journals (Sweden)

    SE Hosseini

    2014-02-01

    Full Text Available Abstract Background & aim: Royal jelly, secreted by worker bees, has different biological activities on cells and tissues. The aim of this study was to evaluate the effects of royal jelly on peripheral blood mononuclear cells and on the tumor category of K562 cell line. Methods: In the present experimental study, three subjects were selected separately with three repetitions. K562 (104 cells and PBMC (105 cells with different concentrations of royal jelly (5, 10, 25, 50 and 100 mg/ml were cultured under standard conditions for 48 and 72 h separately. The fatality rate on PBMC cells and K562 cancer cells was evaluated by using MTT (Tetrazolium Dye-Reduction Assay. The number of viable cells in PBMC that were exposed for 48 hours with Royal Jelly was evaluated by trypan blue staining. Data were analyzed by ANOVA. Results: The royal jelly had no cytotoxicity effect on PBMC cells but at concentration of 50 and 100 mg/mL the cytotoxicity effect were observed on k562 cells whereas, at 10 and 25 mg/ml the number of PBMC viable cells increased. Conclusion: Due to the lack of lethality of royal jelly on PBMC cells and PBMC cell viability and an increase in the fatality rate of cancer cells in the future, royal jelly can be used as a potential candidate for treatment of leukemia. Keywords: Royal jelly, K562, peripheral blood mononuclear cell

  7. Rural maternity care.

    Science.gov (United States)

    Miller, Katherine J; Couchie, Carol; Ehman, William; Graves, Lisa; Grzybowski, Stefan; Medves, Jennifer

    2012-10-01

    To provide an overview of current information on issues in maternity care relevant to rural populations. Medline was searched for articles published in English from 1995 to 2012 about rural maternity care. Relevant publications and position papers from appropriate organizations were also reviewed. This information will help obstetrical care providers in rural areas to continue providing quality care for women in their communities. Recommendations 1. Women who reside in rural and remote communities in Canada should receive high-quality maternity care as close to home as possible. 2. The provision of rural maternity care must be collaborative, woman- and family-centred, culturally sensitive, and respectful. 3. Rural maternity care services should be supported through active policies aligned with these recommendations. 4. While local access to surgical and anaesthetic services is desirable, there is evidence that good outcomes can be sustained within an integrated perinatal care system without local access to operative delivery. There is evidence that the outcomes are better when women do not have to travel far from their communities. Access to an integrated perinatal care system should be provided for all women. 5. The social and emotional needs of rural women must be considered in service planning. Women who are required to leave their communities to give birth should be supported both financially and emotionally. 6. Innovative interprofessional models should be implemented as part of the solution for high-quality, collaborative, and integrated care for rural and remote women. 7. Registered nurses are essential to the provision of high-quality rural maternity care throughout pregnancy, birth, and the postpartum period. Maternity nursing skills should be recognized as a fundamental part of generalist rural nursing skills. 8. Remuneration for maternity care providers should reflect the unique challenges and increased professional responsibility faced by providers in

  8. Iraqi Nurses’ Perspectives on Safety Issues in Maternity Services

    Directory of Open Access Journals (Sweden)

    Jamil Piro

    2015-09-01

    Full Text Available Background Studies introduce maternal and neonatal safety phenomena as important challenges to the public health, particularly in low-income countries. However, few researches are conducted on the identification of safety issues in maternity hospitals in Iraq. It was the first study on nurses’ perspectives on safety issues in Kurdistan, Iraq. Objectives The current study aimed to describe nurses’ perspectives on what constitutes a safe maternity service in Kurdistan, Iraq. Patients and Methods A qualitative design, based on a content analysis approach, was used. Ten Kurdish nurses who worked in the delivery room of Kurdistan, Iraq maternity hospital were recruited through purposive sampling. Semi-structured interviews were performed to collect data. All interviews were audiotaped and transcribed verbatim. Sampling continued to the level of data saturation. Data analysis was performed based on the steps suggested by Graneheim and Lundman. Results Thematic analysis led to the identification of six main categories including stressful job, lack of schedule and job description, providing care with limited resources, professional unaccountability, regional sociopolitical factors, and inadequate training. Conclusions Iraqi nurses identified factors such as limited health resources, lack of job description, and professional unaccountability as major safety issues in maternity services. These findings alarm the need to ensure the provision of females and neonates with appropriate care. This, however, would require coordination between Iraqi Kurdistan health authorities to provide midwifery care facilities, high-quality and relevant staff training, and an effective healthcare system in the maternity units.

  9. Maternal heart rate patterns in the first and second stages of labor

    NARCIS (Netherlands)

    Van Veen, Teelkien R.; Belfort, Michael A.; Kofford, Shalece

    Objective. To analyze typical maternal heart rate (MHR) patterns in the first and second stages of labor. Design. Observational study. Setting. Tertiary care community hospital. Population. Normal term parturients with epidural anesthesia. Methods. Confirmed MHR and uterine activity were

  10. Anti-inflammatory effects of royal jelly on ethylene glycol induced renal inflammation in rats.

    Science.gov (United States)

    Aslan, Zeyneb; Aksoy, Laçine

    2015-01-01

    In this study, anti-inflammatory effects of Royal Jelly were investigated by inducing renal inflammation in rats with the use of ethylene glycol. For this purpose, the calcium oxalate urolithiasis model was obtained by feeding rats with ethylene glycol in drinking water. The rats were divided in five study groups. The 1st group was determined as the control group. The rats in the 2nd group received ethylene glycol (1%) in drinking water. The rats in the 3rd group were daily fed with Royal Jelly by using oral gavage. The 4th group was determined as the preventive group and the rats were fed with ethylene glycol (1%) in drinking water while receiving Royal Jelly via oral gavage. The 5th group was determined as the therapeutic group and received ethylene glycol in drinking water during the first 2 weeks of the study and Royal Jelly via oral gavage during the last 2 weeks of the study. At the end of the study, proinflammatory/anti-inflammatory cytokines, TNF-a, IL-1ß and IL-18 levels in blood and renal tissue samples from the rats used in the application were measured. The results have shown that ethylene glycol does induce inflammation and renal damage. This can cause the formation of reactive oxygen species. Royal Jelly is also considered to have anti-inflammatory effects due to its possible antiradical and antioxidative effects. It can have positive effects on both the prevention of urolithiasis and possible inflammation during the existing urolithiasis and support the medical treatment.

  11. MRJP microsatellite markers in Africanized Apis mellifera colonies selected on the basis of royal jelly production.

    Science.gov (United States)

    Parpinelli, R S; Ruvolo-Takasusuki, M C C; Toledo, V A A

    2014-08-28

    It is important to select the best honeybees that produce royal jelly to identify important molecular markers, such as major royal jelly proteins (MRJPs), and hence contribute to the development of new breeding strategies to improve the production of this substance. Therefore, this study focused on evaluating the genetic variability of mrjp3, mrjp5, and mrjp8 and associated allele maintenance during the process of selective reproduction in Africanized Apis mellifera individuals, which were chosen based on royal jelly production. The three loci analyzed were polymorphic, and produced a total of 16 alleles, with 4 new alleles, which were identified at mrjp5. The effective number of alleles at mrjp3 was 3.81. The observed average heterozygosity was 0.4905, indicating a high degree of genetic variability at these loci. The elevated FIS values for mrjp3, mrjp5, and mrjp8 (0.4188, 0.1077, and 0.2847, respectively) indicate an excess of homozygotes. The selection of Africanized A. mellifera queens for royal jelly production has maintained the mrjp3 C, D, and E alleles; although, the C allele occurred at a low frequency. The heterozygosity and FIS values show that the genetic variability of the queens is decreasing at the analyzed loci, generating an excess of homozygotes. However, the large numbers of drones that fertilize the queens make it difficult to develop homozygotes at mrjp3. Mating through instrumental insemination using the drones of known genotypes is required to increase the efficiency of Africanized A. mellifera-breeding programs, and to improve the quality and efficiency of commercial royal jelly apiaries.

  12. Contextual determinants of maternal mortality in rural Pakistan.

    Science.gov (United States)

    Midhet, F; Becker, S; Berendes, H W

    1998-06-01

    Maternal mortality is high in Pakistan, particularly in the rural areas which have poor access to health services. We investigated the risk factors associated with maternal mortality in sixteen rural districts of Balochistan and the North-West Frontier (NWFP) provinces of Pakistan. We designed a nested case-control study comprising 261 cases (maternal deaths reported during last five years) and 9135 controls (women who survived a pregnancy during last five years). Using contextual analysis, we estimated the interactions between the biological risk factors of maternal mortality and the district-level indicators of health services. Women under 19 or over 39 yr of age, those having their first birth, and those having a previous history of fetal loss were at greater risk of maternal death. Staffing patterns of peripheral health facilities in the district and accessibility of essential obstetric care (EOC) were significantly associated with maternal mortality. These indicators also modified the effects of the biological risk factors of maternal mortality. For example, nulliparous women living in the under-served districts were at greater risk than those living in the better-served districts. Our results are consistent with several studies which have pointed out the role of health services in the causation of maternal mortality. Many such studies have implicated distance to hospital (an indicator of access to EOC) and lack of prenatal care as major determinants of maternal mortality. We conclude that better staffing of peripheral health facilities and improved access to EOC could reduce the risk of maternal mortality among women in rural Balochistan and the NWFP.

  13. Condensation system with seawater in the Royal Solaris Hotel of Cancun; Sistema de condensacion con agua salada en el hotel Royal Solaris de Cancun

    Energy Technology Data Exchange (ETDEWEB)

    Herrero, Juan F.; Hernandez A, David [Celsol, S.A. de C.V., Nuevo Leon (Mexico)

    1999-07-01

    After performing a technical study, during the month of September of 1998, in the facilities of Villas Solaris, S.A. de C.V., specifically in the Royal Solaris Hotel, towers Royal and Caribe, important opportunities of saving were found, which were evaluated technical and economically to be able to present to Villa Solaris, S.A. of C.V., an energy saving project highly profitable that allows to obtain great economic benefits, a better service for the hosts and an important step to the reduction of the operative expenses (energy), that guaranteed the future competitiveness of the hotel in the zone. The base of the energy saving opportunities is the substitution of the air conditioning equipment, since the installed ones in the Hotel, are very deficient equipment (piston in Caribbean Tower) or because of by International ecological Norms they will be obsolete in short time (centrifugal R-11 Torre Royal). In addition the service machine area of the Hotel was centralized in a single site. The substitution measure of the air conditioning systems, contemplated the installation of centrifugal equipment of high efficiency (0.65kW/Ton at full load) cooled with brackish water, that is a very abundant resource in the zone and does not represent any cost for the Hotel. The waste heat of the refrigeration machines is contemplated to be used to preheat the service water and the swimming pool water by means of heat exchange equipment. In order to arrive to the desired optimal temperatures the advantage of the installation of the already existing in the Hotel thermo solar systems was taken into consideration. When implementing this global system, the use of cooling towers was eliminated, that was the equipment that cools the condensation water of the air conditioning equipment. In addition the use of the steam boilers was eliminated that made the function of warming up the service water, reason why an important saving of fuel was generated. [Spanish] Despues de haber realizado un

  14. Respiratory syncytial virus neutralizing antibodies in cord blood, respiratory syncytial virus hospitalization, and recurrent wheeze

    DEFF Research Database (Denmark)

    Stensballe, Lone Graff; Ravn, Henrik; Kristensen, Kim

    2008-01-01

    BACKGROUND: Respiratory syncytial virus (RSV) hospitalization is associated with wheeze. OBJECTIVE: To examine the influence of maternally derived RSV neutralizing antibodies in cord blood on RSV hospitalization and recurrent wheeze in infancy. METHODS: Among children from the Danish National Bir...

  15. Maxillofacial injuries in military personnel treated at the Royal Centre for Defence Medicine June 2001 to December 2007.

    Science.gov (United States)

    Breeze, J; Gibbons, A J; Opie, N J; Monaghan, A

    2010-12-01

    Since its formation in June 2001, the Royal Centre for Defence Medicine (RCDM) at Birmingham University Hospitals NHS Foundation Trust has treated most of the British military personnel who have sustained serious maxillofacial injuries while serving abroad. We retrospectively analysed all recorded maxillofacial injuries of personnel evacuated to the RCDM between June 2001 and December 2007. We know of no existing papers that describe oral and maxillofacial injuries of military personnel, or workload in the 21st century. During the period 119 personnel with maxillofacial injuries were evacuated to the RCDM for treatment 83% of whom were injured in Iraq or Afghanistan. In total 61% (72/119) of injuries were caused by improvised explosive devices, 9% (11/119) were gun shot wounds, and 1% were caused by aircraft incidents. A further 29% (35/119) of patients had injuries not associated with battle. The most common injuries were facial lacerations (106/119). There were 54 facial fractures of which 17 primarily affected the maxilla, and 15 the mandible. Associated injuries were to the brain (24%), torso (26%), upper limb (39%), and lower limb (31%). The number of maxillofacial injuries has risen over the last 7 years, and has also increased in proportion to the total number of injured soldiers evacuated between 2005 and 2007.

  16. Maternal factors in predicting low birth weight babies.

    Science.gov (United States)

    Yadav, Hematram; Lee, Nagarajah

    2013-01-01

    This study examines the association between maternal factors and low birth weight among newborns at a tertiary hospital in Malaysia. This was a cross-sectional study where mothers were followed through from first booking till delivery. There were 666 mothers who delivered from May 2007 to March 2008. Infants' birth weight were compared with maternal age, pre-pregnancy BMI, fathers BMI, parity, ethnicity, per capita monthly income, and maternal blood pressure during pregnancy. A multiple logistic regressions was used to determine the relationship of maternal factors and low birth weight, while the ROC curve was constructed to assess the sensitivity and specificity of the predictive model. Among the significant risk factors of low birth weight were older age (35 years and above), low pre-pregnancy BMI (per capita monthly income were included in the analysis.

  17. Maternal infection in pregnancy and risk of asthma in offspring.

    Science.gov (United States)

    Collier, Charlene H; Risnes, Kari; Norwitz, Errol R; Bracken, Michael B; Illuzzi, Jessica L

    2013-12-01

    This study estimates the effect of maternal infections during pregnancy on childhood asthma. One-thousand four-hundred and twenty-eight pregnant women were prospectively followed using structured interviews and chart review until their child's 6th year of life. Infections were identified from outpatient and hospital visits. Childhood asthma was defined as physician diagnosis with symptoms at age six. Adjusted odds ratios were calculated from multivariable logistic regression models. Six-hundred and thirty-five women experienced an infection during pregnancy. Among antepartum infections, maternal urinary tract infections were significantly associated with childhood asthma (aOR 1.60, 95 % CI 1.12-2.29). Chorioamnionitis and maternal group beta streptococcus colonization were not significantly associated with an increased risk in childhood asthma. This study found an increased risk of asthma in children of women diagnosed with urinary tract infections during pregnancy, while other maternal infections did not increase the risk.

  18. Adequacy of public maternal care services in Brazil

    OpenAIRE

    2016-01-01

    Abstract Background In Brazil, hospital childbirth care is available to all, but differences in access and quality of care result in inequalities of maternal health. The objective of this study is to assess the infrastructure and staffing of publicly financed labor and birth care in Brazil and its adequacy according to clinical and obstetric conditions potentially associated with obstetric emergencies. Methods Nationwide cross-sectional hospital-based study “Birth in Brazil: national survey i...

  19. Hospital Compare

    Data.gov (United States)

    U.S. Department of Health & Human Services — Hospital Compare has information about the quality of care at over 4,000 Medicare-certified hospitals across the country. You can use Hospital Compare to find...

  20. HCAHPS - Hospital

    Data.gov (United States)

    U.S. Department of Health & Human Services — A list of hospital ratings for the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS). HCAHPS is a national, standardized survey of hospital...

  1. Maternal and neonatal complications of macrosomia.

    Science.gov (United States)

    Nkwabong, Elie

    2014-10-01

    This case control study, aimed at identifying complications of macrosomia, was conducted in two major hospitals of Yaoundé, Cameroon over a 6-month period from 1 October 2012. Maternity records were compared of births weighing ≥4000 g with those weighing between 3000 g and 3500 g. The main outcome variables were mode of delivery, low genital lacerations, Apgar score, birth injuries, postpartum haemorrhage and early neonatal death. Data were analysed using SPSS 18.0. Chi-square test or Fisher's exact test and t-test were used for comparison. P macrosomia is associated with increased maternal and neonatal complications. © The Author(s) 2014 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav.

  2. Maternal and neonatal tetanus

    Science.gov (United States)

    Thwaites, C Louise; Beeching, Nicholas J; Newton, Charles R

    2017-01-01

    Maternal and neonatal tetanus is still a substantial but preventable cause of mortality in many developing countries. Case fatality from these diseases remains high and treatment is limited by scarcity of resources and effective drug treatments. The Maternal and Neonatal Tetanus Elimination Initiative, launched by WHO and its partners, has made substantial progress in eliminating maternal and neonatal tetanus. Sustained emphasis on improvement of vaccination coverage, birth hygiene, and surveillance, with specific approaches in high-risk areas, has meant that the incidence of the disease continues to fall. Despite this progress, an estimated 58 000 neonates and an unknown number of mothers die every year from tetanus. As of June, 2014, 24 countries are still to eliminate the disease. Maintenance of elimination needs ongoing vaccination programmes and improved public health infrastructure. PMID:25149223

  3. Norovirus - hospital

    Science.gov (United States)

    Gastroenteritis - norovirus; Colitis - norovirus; Hospital acquired infection - norovirus ... fluids ( dehydration ). Anyone can become infected with norovirus. Hospital patients who are very old, very young, or ...

  4. Maternal Competition in Women.

    Science.gov (United States)

    Linney, Catherine; Korologou-Linden, Laurel; Campbell, Anne

    2017-03-01

    We examined maternal competition, an unexplored form of competition between women. Given women's high investment in offspring and mothers' key role in shaping their reproductive, social, and cultural success as adults, we might expect to see maternal competition between women as well as mate competition. Predictions about the effect of maternal characteristics (age, relationship status, educational background, number of children, investment in the mothering role) and child variables (age, sex) were drawn from evolutionary theory and sociological research. Mothers of primary school children (in two samples: N = 210 and 169) completed a series of questionnaires. A novel nine-item measure of maternal competitive behavior (MCQ) and two subscales assessing Covert (MCQ-C) and Face-to-Face (MCQ-FF) forms of competition were developed using confirmatory factor analysis. Competitiveness (MCQ score) was predicted by maternal investment, single motherhood, fewer children, and (marginally) child's older age. The effect of single motherhood (but not other predictors) was partially mediated by greater maternal investment. In response to a scenario of their child underperforming relative to their peers, a mother's competitive distress was a positive function of the importance she ascribed to their success and her estimation of her child's ability. Her competitive distress was highly correlated with the distress she attributed to a female friend, hinting at bidirectional dyadic effects. Qualitative responses indicated that nonspecific bragging and boasting about academic achievements were the most common irritants. Although 40% of women were angered or annoyed by such comments, less than 5% endorsed a direct hostile response. Instead, competitive mothers were conversationally shunned and rejected as friends. We suggest that the interdependence of mothers based on reciprocal childcare has supported a culture of egalitarianism that is violated by explicit competitiveness.

  5. Royal Australian and New Zealand College of Psychiatrists clinical practice guidelines for the treatment of eating disorders.

    Science.gov (United States)

    Hay, Phillipa; Chinn, David; Forbes, David; Madden, Sloane; Newton, Richard; Sugenor, Lois; Touyz, Stephen; Ward, Warren

    2014-11-01

    This clinical practice guideline for treatment of DSM-5 feeding and eating disorders was conducted as part of the Royal Australian and New Zealand College of Psychiatrists (RANZCP) Clinical Practice Guidelines (CPG) Project 2013-2014. The CPG was developed in accordance with best practice according to the National Health and Medical Research Council of Australia. Literature of evidence for treatments of anorexia nervosa (AN), bulimia nervosa (BN), binge eating disorder (BED), other specified and unspecified eating disorders and avoidant restrictive food intake disorder (ARFID) was sourced from the previous RANZCP CPG reviews (dated to 2009) and updated with a systematic review (dated 2008-2013). A multidisciplinary working group wrote the draft CPG, which then underwent expert, community and stakeholder consultation, during which process additional evidence was identified. In AN the CPG recommends treatment as an outpatient or day patient in most instances (i.e. in the least restrictive environment), with hospital admission for those at risk of medical and/or psychological compromise. A multi-axial and collaborative approach is recommended, including consideration of nutritional, medical and psychological aspects, the use of family based therapies in younger people and specialist therapist-led manualised based psychological therapies in all age groups and that include longer-term follow-up. A harm minimisation approach is recommended in chronic AN. In BN and BED the CPG recommends an individual psychological therapy for which the best evidence is for therapist-led cognitive behavioural therapy (CBT). There is also a role for CBT adapted for internet delivery, or CBT in a non-specialist guided self-help form. Medications that may be helpful either as an adjunctive or alternative treatment option include an antidepressant, topiramate, or orlistat (the last for people with comorbid obesity). No specific treatment is recommended for ARFID as there are no trials to

  6. Fatores de risco maternos para prematuridade em uma maternidade pública de Imperatriz-MA Los factores maternos de riesgo de parto prematuro en una maternidad pública de Imperatriz-MA Maternal risk factors for premature births in a public maternity hospital in Imperatriz-MA

    Directory of Open Access Journals (Sweden)

    Adriana Carvalho de Almeida

    2012-06-01

    Full Text Available Apesar dos avanços da obstetrícia, a prematuridade ainda se configura como um dos grandes problemas de saúde pública, em virtude da morbidade e da mortalidade neonatal que causa. O objetivo deste estudo foi investigar fatores de risco maternos para nascimentos de prematuros em uma maternidade pública de Imperatriz-MA. Um estudo comparativo transversal foi realizado com 116 puérperas, por meio de entrevistas estruturadas. Os dados coletados foram analisados através do Software Epi-Info, versão 3.5.1. As variáveis que tiveram associação estatisticamente significante com a prematuridade foram: renda mensal inferior a 2 salários mínimos (p=0,046; estresse na gestação (p=0,027; primiparidade (p=0,044; assistência pré-natal ausente ou inadequada (pA pesar de los avances en la obstetricia y la prematuridad sigue siendo un problema importante de salud pública debido a la morbilidad y mortalidad neonatal que causa. El objetivo de este estudio fue investigar los factores de riesgo maternos para los nacimientos prematuros en una maternidad pública en Imperatriz, MA. Un estudio comparativo de la sección transversal se llevó a cabo con 116 madres, a través de entrevistas estructuradas. Estudio caso-control se realizó con 116 mujeres, agrupadas en el caso de (58 y control (58, a través de entrevistas estructuradas. Los datos fueron analizados con Epi-Info versión 3.5.1. Las variables que mostraron una asociación estadísticamente significativa con el parto prematuro fueron ingresos mensuales Despite advances in obstetrics, prematurity is still a major public health problem because of the neonatal morbidity and mortality it causes. The objective of this study was to investigate maternal risk factors for premature births in a public maternity in the city of Imperatriz-MA. A cross-sectional comparative study was conducted with 116 mothers, through structured interviews. The data were analyzed using Epi-Info version 3.5.1. The variables

  7. Maternal and perinatal complications in triplet compared with twin pregnancy

    NARCIS (Netherlands)

    J.G. Santema (Job); P. Bourdrez (Petra); H.C.S. Wallenburg (Henk)

    1995-01-01

    textabstractObjective: To compare maternal and perinatal complications in triplet and twin pregnancies. Study design: Case-controlled study in the setting of a University Hospital. Each pregnancy of a consecutive series of 40 triplet pregnancies of 20 weeks or more was matched for parity and materna

  8. Estudo da morbidade e da mortalidade perinatal em maternidades: III - Anomalias congênitas em nascidos vivos A study of perinatal morbidity and mortality in maternity hospitals: III - Congenital anomalies in live briths

    Directory of Open Access Journals (Sweden)

    José Maria Pacheco de Souza

    1987-02-01

    Full Text Available Realizou-se estudo das anomalias congênitas encontradas em recém-nascidos vivos, em nove maternidades, durante o ano de 1981-1982. O material é parte de uma pesquisa desenvolvida em sete maternidade do Estado de São Paulo, uma do Rio de Janeiro e uma de Florianópolis, Santa Catarina (Brasil, no período de agosto de 1981 a julho de 1982, quando foram coletados dados sobre todos os nascimentos ocorridos nesses nove serviços. As anomalias congênitas foram definidas como as descritas no XIV.° capítulo da Classificação Internacional de Doenças - 1975, 9ª Revisão, tendo sido utilizada essa classificação para codificá-las. Na análise estatística foram utilizados o X² (com um grau de liberdade, o teste de inclinação para proporções ("Trend test" e a técnica de Berkson para a verificação da hipótese de aderência à distribuição de Poisson. Em 12.782 recém-nascidos vivos, 286 (2,24% apresentavam algum tipo de anomalia congênita, tendo havido 26 (0,20% crianças com duas anomalias, 9 (0,07% com três e duas (0,02 apresentando quatro tipos de malformações congênitas. As deformidades osteomusculares congênitas (código 754 da CID foram as mais freqüentes (19%;segue-se as outras anomalias congênitas do coração (746 com uma freqüência de 14,1%. Ao se analisar a prevalência dessas malformações pela idade da mãe nota-se que há um aumento da prevalência à medida que a idade avança, apenas para Sindrome de Down (758.Congenital anomalies in live births in nine maternities in the period 1981-1982 were studied. This was one aspect of a research project carried out in seven maternities in the State of S.Paulo, one in Rio de Janeiro and another in Florianópolis (Brazil, from which data on all births occurring between August 1981 and July 1982 were obtained. Congenital anomalies were classified according to the XIVth chapter of the CID-1975 - 9thRevision. Chi square for associations and for trend and Berkson

  9. Second Trimester Maternal Serum Screening

    Science.gov (United States)

    ... page: Was this page helpful? Also known as: AFP Maternal; Maternal Serum AFP; MSAFP; msAFP; Triple Screen; Triple Test; Quad Screen; ... Free Fetal DNA Were you looking instead for AFP tumor markers , used to help diagnose and monitor ...

  10. Reduction of severe acute maternal morbidity and maternal mortality in Thyolo District, Malawi: the impact of obstetric audit.

    Directory of Open Access Journals (Sweden)

    Thomas van den Akker

    Full Text Available BACKGROUND: Critical incident audit and feedback are recommended interventions to improve the quality of obstetric care. To evaluate the effect of audit at district level in Thyolo, Malawi, we assessed the incidence of facility-based severe maternal complications (severe acute maternal morbidity (SAMM and maternal mortality during two years of audit and feedback. METHODOLOGY/PRINCIPAL FINDINGS: Between September 2007 and September 2009, we included all cases of maternal mortality and SAMM that occurred in Thyolo District Hospital, the main referral facility in the area, using validated disease-specific criteria. During two- to three-weekly audit sessions, health workers and managers identified substandard care factors. Resulting recommendations were implemented and followed up. Feedback was given during subsequent sessions. A linear regression analysis was performed on facility-based severe maternal complications. During the two-year study period, 386 women were included: 46 died and 340 sustained SAMM, giving a case fatality rate of 11.9%. Forty-five cases out of the 386 inclusions were audited in plenary with hospital staff. There was a reduction of 3.1 women with severe maternal complications per 1000 deliveries in the district health facilities, from 13.5 per 1000 deliveries in the beginning to 10.4 per 1000 deliveries at the end of the study period. The incidence of uterine rupture and major obstetric hemorrhage reduced considerably (from 3.5 to 0.2 and from 5.9 to 2.6 per 1000 facility deliveries respectively. CONCLUSIONS: Our findings indicate that audit and feedback have the potential to reduce serious maternal complications including maternal mortality. Complications like major hemorrhage and uterine rupture that require relatively straightforward intrapartum emergency management are easier to reduce than those which require uptake of improved antenatal care (eclampsia or timely intravenous medication or HIV-treatment (peripartum

  11. Neuroendocrine control of maternal behaviour

    OpenAIRE

    Caughey, Sarah Dawn

    2011-01-01

    Maternal behaviour during the peri-partum period, albeit in differing forms, can be observed in all mammals, thus it must serve an important evolutionary purpose in enabling the successful raising of offspring. Maternal behaviour is comprised of a large suite of behaviours; in rodents these are generally defined as lactation, pup retrieval, maternal aggression and pup grooming. The maternal behaviour circuitry involves many brain regions including the hypothalamus and the limbi...

  12. Are women birthing in New South Wales hospitals satisfied with their care?

    OpenAIRE

    Ford, Jane B.; Hindmarsh, Diane M; Browne, Kim M; Todd, Angela L.

    2015-01-01

    Background Surveys of satisfaction with maternity care have been conducted using overnight inpatient surveys and dedicated maternity surveys in a number of Australian settings, however none have been used to report on satisfaction with maternity care among women in New South Wales. The aims of this study were to investigate the association between: 1) parity (first and subsequent births) and patient experience of hospital care at birth, and 2) other patient, birth and hospital characteristics...

  13. Analysis of risk factors of stillbirth: a hospital based study in a tertiary care centre

    OpenAIRE

    Paresh Shyam

    2016-01-01

    Background: Stillbirth is an indicator of maternal health and maternal health care services. Developing countries have high stillbirth rate. Documentation and evaluation of the risk factors for stillbirth is required for management of the risk factors and to devise plan in maternal health sector. Methods: It was a hospital based retrospective study carried out in a tertiary care hospital. Inclusion criteria were a case of fetal death with gestational age and #8805;20 weeks or fetal weight...

  14. Alarmingly High Maternal Mortality in 21st Century

    Directory of Open Access Journals (Sweden)

    Dilpreet Kaur, Vaneet Kaur, Veronica Irene Yuel

    2007-07-01

    Full Text Available The study was conducted to determine the maternal mortality rate (MMR, various factors affecting itand possible prevention of maternal deaths in Christian Medical College & Hospital, a tertiary careinstitute during the past five years (2001- 2005. The individual record of maternal deaths was studiedregarding their socio-demographic features, causes, modes of management and ultimate outcome. TheMaternal Mortality rate was 1470 per lac live births. The major obstetrical complications accounted formore than three fourth of maternal deaths with hemorrhage (33%, sepsis (21.7% and eclampsia (7.5%playing an important role. Anemia (44.3% and jaundice (16.0% were two important indirect causes ofmaternal deaths. Un-booked cases accounted for majority of maternal deaths. Only two maternal mortalitypatients were showing regularly in our institute, rest all of the patients either had no antenatal check-up orwere having ANC in private clinics and were referred as an emergency in critical condition. More than90% of maternal deaths hailed from rural and urban slum areas. 61 (57.8% cases received primary carefrom untrained birth attendants and 11 (10.4% did not receive primary care in any form. There wasdelayed referral by the untrained personnel, 49 (46.2% patients were referred after more than 48 hours ofacute emergency, 51 (48.1% died between 24 to 48 hours and 25 (23.6% died within 24 hours ofadmission in spite of all resuscitative measures. It is concluded that providing good antenatal care, findingappropriate ways of preventing and dealing with the consequences of unwanted pregnancies, and improvingthe way society looks after pregnant women are three most important ways to reduce maternal mortality.

  15. Re-significando a dor e superando a solidão: experiências do parto entre adolescentes de classes populares atendidas em uma maternidade pública de Salvador, Bahia, Brasil Re-signifying pain, overcoming loneliness: childbirth experiences among working-class adolescents in a public maternity hospital in Salvador, Bahia, Brazil

    Directory of Open Access Journals (Sweden)

    Cecilia McCallum

    2006-07-01

    Full Text Available Este artigo examina o parto em uma maternidade pública de Salvador, Bahia, Brasil, com base na perspectiva de mulheres jovens e adolescentes, a maioria das quais negras e de classes populares. O estudo, de caráter antropológico, baseia-se na análise de entrevistas e na etnografia do hospital, particularmente do centro obstétrico. As mulheres descrevem o trabalho de parto como dominado pelo medo, solidão e dor, sensações que se transformam em amor com o nascimento da criança. Enfocando o parto como um processo biossocial, o trabalho mostra como as jovens produzem significados durante o processo de parturição, enquanto se encontram envolvidas nas interações sociais próprias ao parto hospitalar, particularmente com os profissionais de saúde. Do ponto de vista simbólico, as parturientes experienciam o parto como um rito de passagem que legitima a maternidade, em um contexto social e institucional que, ao contrário, deslegitima a reprodução sexual de mulheres negras, jovens e de baixa renda e estigmatiza a maternidade na adolescência.This article examines childbirth in a public maternity hospital in Salvador, Bahia, Brazil, from the perspective of young and adolescent women, mostly black and working-class. As an anthropological study, it is based on the analysis of birth narratives and hospital ethnography, especially in the obstetric ward. The women describe labor as dominated by fear, loneliness, and pain. These feelings are transformed into love with the birth of the child. Viewing childbirth as a biosocial process, the authors show how the young women construct meanings during the birth; meanwhile, social interactions specific to hospital birth develop, particularly with healthcare professionals. Symbolically, women construct birth as a rite of passage legitimating motherhood, against the institution's effective de-legitimization of sexual reproduction in low-income black mothers and stigmatization of adolescent motherhood.

  16. Qualitative study on maternal referrals in rural Tanzania: decision making and acceptance of referral advice.

    Science.gov (United States)

    Pembe, Andrea B; Urassa, David P; Darj, Elisabeth; Carlsted, Anders; Olsson, Pia

    2008-08-01

    The aim of this study was to describe perceptions of maternal referrals in a rural district in Tanzania. Focus group discussions (FGDs) with health workers and community members, stratified by age and gender, were conducted. The FGDs revealed that husbands and relatives are the decision makers in maternal referrals, whereas the women had limited influence, especially on emergency referrals. The process in deciding to seek referral care is envisaged within community perception of seriousness of the condition, difficulty to access and cost involved in transport, living expenses at the hospital, and perceived quality of care at facility level. The hospitals were seen as providing acceptable quality of care, whereas, the health centres had lower quality than expected. To improve maternal referral compliance and reduce perinatal and maternal morbidity and mortality, community views of existing referral guidelines, poverty reduction, women's empowerment and male involvement in maternal care are necessary.

  17. The ICT-Integrated Pedagogy in the Colleges of Royal University of Bhutan

    DEFF Research Database (Denmark)

    Choeda, Par-Ola Zander; Penjor, Tandin; Dukpa, Dorji

    2014-01-01

    lecturers who actually attained training. The status of ICT integrated pedagogy in higher education in Bhutan is at an early stage being affected by low speed internet connectivity and lack of adequate resource as well as training in ICT integrated pedagogy. However, lecturers are highly motivated......This paper reports a research study on the integration of ICT and pedagogy in the colleges of the Royal University of Bhutan. It investigates whether ICT is integrated into the pedagogy, and if so, in what way. The samples (Faculty members) of the study were picked up randomly from ten colleges...... under Royal University of Bhutan. The study identifies the use of Virtual Learning Environments (VLE), used as part of ICT-integrated pedagogy. However, the use of VLE has been found to be confined to be a platform where activities such as work plan, module descriptors, uploading assignments have been...

  18. Sir William Burnett (1779-1861), professional head of the Royal Naval Medical Department and entrepreneur.

    Science.gov (United States)

    Penn, Christopher

    2004-08-01

    Sir William Burnett (1779-1861) had an active career as a Royal Navy surgeon in the French Revolutionary and Napoleonic Wars, including service at the battles of St Vincent, the Nile and Trafalgar. From 1822 to 1855 he was professional head of the Royal Naval Medical Department, when he provided effective leadership in a time of great change. Although his official work earned him the reputation of a "hard-working, unimaginative, somewhat harsh man", his correspondence shows a very humane centre under the official carapace. His official performance and reputation were both eroded towards the end of his career by his determined promotion of zinc chloride, for which he held lucrative patents.

  19. Maternity Leave in Taiwan

    Science.gov (United States)

    Feng, Joyce Yen; Han, Wen-Jui

    2010-01-01

    Using the first nationally representative birth cohort study in Taiwan, this paper examines the role that maternity leave policy in Taiwan plays in the timing of mothers returning to work after giving birth, as well as the extent to which this timing is linked to the amount of time mothers spend with their children and their use of breast milk…

  20. Maternity Leave Policies

    Science.gov (United States)

    Strang, Lucy; Broeks, Miriam

    2017-01-01

    Abstract Over recent years many European Union countries have made changes to the design of the maternity leave provision. These policy developments reflect calls for greater gender equality in the workforce and more equal share of childcare responsibilities. However, while research shows that long period of leave can have negative effects on women's labour market attachment and career advancements, early return to work can be seen as a factor preventing exclusive breastfeeding, and therefore, potentially having negative health impacts for babies. Indeed, the World Health Organisation recommends exclusive breastfeeding up to 6 months of age to provide babies with the nutrition for healthy growth and brain development, protection from life-threatening ailments, obesity and non-communicable diseases such as asthma and diabetes. Therefore, labour market demands on women may be at odds with the health benefits for children gained by longer periods of maternity leave. The aim of this article is to examine the relationship between leave provision and health benefits for children. We examine maternity and parental leave provision across European countries and its potential impact on the breastfeeding of very young babies (up to 6-months of age). We also consider economic factors of potential extension of maternity leave provision to 6 months, such as costs to businesses, effects on the female labour market attachment, and wider consequences (benefits and costs) for individuals, families, employers and the wider society. PMID:28983432

  1. maternal mortality in Malawi

    African Journals Online (AJOL)

    Malawi; however there has been a lack of effective imple- mentation. ... the SWAp Programme of Work. 3”. Methods ... the current maternal mortality strategy may be implement- ... point of delivery. ... include the cost of a new chitenje (sarong) necessary for child- ..... nomic status and access to care for TB in urban Lilongwe.

  2. Maternal Sexuality and Breastfeeding

    Science.gov (United States)

    Bartlett, Alison

    2005-01-01

    In this paper I consider the ways in which lactation has been discussed as a form of maternal sexuality, and the implications this carries for our understanding of breastfeeding practices and sexuality. Drawing on knowledge constructed in the western world during the last half of the twentieth century, the paper identifies a shift between the…

  3. EFFECT OF MATERNAL SOCIOECONOMIC CONDITIONS ON MATERNAL HEALTH INDICATORS AND NEONATAL PARAMETERS IN PAKISTAN

    Directory of Open Access Journals (Sweden)

    Muhammad Usman

    2015-12-01

    Full Text Available Infant mortality rate is a serious issue worldwide. Pakistan being a developing country comprises of diverse socioeconomic classes. Various studies have suggested some association of maternal anthropometric parameters with neonatal outcomes. The aim behind this research is to determine the impact of socioeconomic conditions on maternal health indicators and neonatal parameters in the population of Pakistan. This study included 90 pregnant females belonging to different socioeconomic conditions and were grouped according to their socioeconomic classes. Data was collected from the case histories of participants admitted in different hospitals of Karachi. The data of maternal and neonatal parameters was assessed statistically and their associations with the socioeconomic conditions were assessed. Maternal hemoglobin and maternal gravidity have shown a strong association with socioeconomic conditions with high significance (p < 0.05. However, neonatal parameters have shown diverse results among the three classes. Neonatal gestational age was found to be significant in comparison between upper versus lower (p = 0.001 and upper versus middle classes (p = 0.006, but it was insignificant in case of middle versus lower class (p = 0.88. Likewise, neonatal birth weight is significant between upper versus lower (p = 0.001 and upper versus middle classes (p = 0.019, but it was insignificant in case of middle versus lower class (p = 0.258. Neonatal apgar score is found to be significant in upper versus lower (p = 0.001 and middle versus lower classes (p = 0.001 and insignificant between middle and lower class (p = 0.125. This study concludes that socioeconomic factors play a vital role in determining the maternal health characteristics which in turn affects the neonatal outcomes. It is therefore recommended that antenatal care should be provided to all pregnant females. The whole community should work hand in hand to establish good health care centers, create

  4. The Effects of Feeding Pollen Cake Containing Royal Jelly on Bombus terrestris L. (Hymenoptera: Apidae) Colony Development

    OpenAIRE

    GÜREL, Fehmi; GÖSTERİT, Ayhan

    2008-01-01

    This study was performed to determine the effects of feeding pollen cake containing honeybee royal jelly on Bombus terrestris colony development. In total, 125 bumblebee queens, 68 of which were fed pollen cake containing 10% royal jelly and 57 of which were fed normal pollen cake, were used. We found that 84% of the queens fed pollen cake containing royal jelly and 82% of those fed normal pollen cake laid eggs; 56% of the queens fed normal pollen cake established colonies, whereas queens fed...

  5. The Ancient Near Eastern Glyptic Collections of the Royal Museums of Art and History Reconsidered

    OpenAIRE

    Hameeuw, Hendrik; Boschloos, Vanessa; Devillers, Anne; Gubel, Eric; Cynthia, JeanCynthia; Van Goethem, Laurence; Van Overmeire, Sam; Overlaet, Bruno

    2014-01-01

    The Royal Museums of Art and History of Brussels (RMAH) boast a rich and world-renowned collection of glyptic material from the Ancient Near East. The collection consists of stamp and cylinder seals, seal impressions and sealings, originating from a broad range of cultures and dating from the beginning of their production down to the Roman period. They illustrate the entire historical development of a type of object that provides unique insights into the economic, cultural, enviromental and p...

  6. Ground water for public water supply at Windigo, Isle Royale National Park, Michigan

    Science.gov (United States)

    Grannemann, N.G.; Twenter, F.R.

    1982-01-01

    Three test holes drilled at Windigo in Isle Royale National Park in 1981 indicate that the ophitic basaltic lava flows underlying the area contain little water and cannot be considered a source for public water supply. The holes were 135, 175, and 71 feet deep. One hole yielded about 1 gallon of water perminute; the other two yielded less. Glacial deposits seem to offer the best opportunity for developing a ground-water supply of 5 to 10 gallons per minute.

  7. The transfer of the Portuguese royal family to Brazil: historical explanation in Portuguese and Brazilian students

    Directory of Open Access Journals (Sweden)

    Ronaldo Cardoso Alves

    2012-03-01

    Full Text Available Based on the relationship between the concept of Historical Consciousness, as Jörn Rüsen and Reinhart Koselleck proposed, and the concept of Historical Explanation, proposed by Isabel Barca, the article presents an analytical course that allows you to check levels of explanation in historical narratives produced by students Brazilian and Portuguese from the interpretation of sources related to a historical fact: the transfer of the Portuguese royal family to Brazil (1808.

  8. Noise and sleep on board vessels in the Royal Norwegian Navy

    OpenAIRE

    Erlend Sunde; Magne Bratveit; Stale Pallesen; Bente Elisabeth Moen

    2016-01-01

    Previous research indicates that exposure to noise during sleep can cause sleep disturbance. Seamen on board vessels are frequently exposed to noise also during sleep periods, and studies have reported sleep disturbance in this occupational group. However, studies of noise and sleep in maritime settings are few. This study's aim was to examine the associations between noise exposure during sleep, and sleep variables derived from actigraphy among seamen on board vessels in the Royal Norwegian ...

  9. Effect of Royal Jelly on Improving Passive Avoidance Learning and Spatial Learning and Memory in Rats

    Directory of Open Access Journals (Sweden)

    H Alaei

    2012-06-01

    Full Text Available Introduction: Studies have proposed that royal jelly(RJ has various biological activities in different cells and tissues. Since it has been demonstrated that RJ contains compounds having desirable effects on central neurons system and neural functions, the present study aimed to investigate the effect of royal jelly on learning and memory in rats. Methods: Male wistar rats were divided into two groups, the royal jelly and the control. In the RJ group, the rats received a food that contained 3% RJ instead of regular food for 10 days. Then learning and memory were investigated in these animals through both passive avoidance learning test(1 day and 1 week after receiving electrical shock and Morris water maze test(1 day and 1 week after a 4-day learning period. Results: The study results indicated that the food containing RJ in the RJ group significantly increased the time of the first entrance to the dark room one week after the electrical shock in passive avoidance learning test. In other words, the findings suggest an improvement of learning and memory in RJ group. In the acquisition phase of Morris water maze test, rats receiving RJ found the underwater escape plate during less time and distance comparing with the control group. Furthermore, one week after the acquisition phase, in the retention phase, rats spent more time in the quadrant in which the escape plate was previously located. Conclusion: The present study findings propose that Royal Jelly can improve cognitive processes through positive effects on neural functions and probably has a significant influence on prevention and therapy of some neuronal disorders.

  10. Medical audit: a Well Woman Clinic in the Royal Naval training practice, Gibraltar.

    Science.gov (United States)

    Westwood, P R

    1991-01-01

    In order to assess the effectiveness of patient self-selection, and the value of dedicating surgery time to a specific clinic, attendances at a Well Woman Clinic were compared with attendances for the same reasons at other times. During the nine month audit period the opportunity was also taken to overhaul the Age/Sex Register, and assess the uptake of Cervical Screening at the Garrison Medical Centre. This unit is part of the Royal Naval Training Practice in Gibraltar.

  11. Royal Observatory extension will teach the wonder of the night sky

    CERN Multimedia

    Jury, L

    2004-01-01

    "The Royal Observatory in Greenwich is gearing up for a massive pounds 15m extension next year, to capitalise on growing interest in outer space. A Victorian building which has been used for administration for decades is to be renovated, with new galleries and a 120-seat planetarium to treble the space for visitors to gaze at the stars. The Observatory hopes to complete the extension by 2007" (1 page).

  12. A Proteomic Approach for Investigation of Bee Products: Royal Jelly, Propolis and Honey

    Directory of Open Access Journals (Sweden)

    Peter Raspor

    2012-01-01

    Full Text Available Bee products such as royal jelly, honey and propolis have been reported to possess several biological activities. In order to better understand their mechanism of action and, consequently, their efficiency and safety, 'omic' approaches are used. Here cases with proteomic approach are indicated. In addition to studying biological activity at a proteome level, a proteomic approach for investigation of bee products has also been applied in analyzing proteins as their (bioactive components.

  13. Estrogenic Activities of Fatty Acids and a Sterol Isolated from Royal Jelly

    OpenAIRE

    Kazu-Michi Suzuki; Yoichiro Isohama; Hiroe Maruyama; Yayoi Yamada; Yukio Narita; Shozo Ohta; Yoko Araki; Takeshi Miyata; Satoshi Mishima

    2008-01-01

    We have previously reported that royal jelly (RJ) from honeybees (Apis mellifera) has weak estrogenic activity mediated by interaction with estrogen receptors that leads to changes in gene expression and cell proliferation. In this study, we isolated four compounds from RJ that exhibit estrogenic activity as evaluated by a ligand-binding assay for the estrogen receptor (ER) β. These compounds were identified as 10-hydroxy-trans-2-decenoic acid, 10-hydroxydecanoic acid, trans-2-decenoic acid a...

  14. Incidence of Boxing Injuries in the Royal Air Force in the United Kingdom 1953—66

    Science.gov (United States)

    Brennan, T. N. N.; O'Connor, P. J.

    1968-01-01

    Statistics of injuries arising in amateur boxing in the Royal Air Force in the 14 years 1953-66 are given. There were 240 injuries including two deaths in the 14 years. During the seven years 1960-66, four men out of every thousand entering the ring received injuries to the head or neck which kept them off work for 48 hours or more. No case of the punch-drunk syndrome was seen. PMID:5723355

  15. Technological Advancements in EW: A Way Forward for Royal Saudi Naval Force

    Science.gov (United States)

    2013-09-01

    Middle East and North Africa MSBU Military system business unit MODA Ministry of Defense and Aviation MBET Missile borne ECM technology NEWAC NATO...organized under the Ministry of Defence and Aviation ( MODA ) to defend the Kingdom against any external aggression. The RSNF is an operational force of... MODA . Another force, the Saudi Arabian National Guard, is responsible for maintaining the internal stability of the Kingdom. The Royal Saudi Naval

  16. Towards e-Government: End-User Satisfaction with IT Implementation at Royal Malaysian Customs

    OpenAIRE

    Abbul Hamid Abu Bakar; Chong Siong Choy; Binshan Lin; Najmi Mohd Radzi

    2014-01-01

    This paper examines the extent of end-user satisfaction on the service delivery process by the Royal Malaysian Customs (RMC) as the agency moves toward implementing electronic government (e-government) initiatives. The RMC has in fact been identified as one of the prominent and technology-pioneering government agencies in the country and therefore suitable for delivering electronic public services. Data were collected in mid-2009 from two types of customers, i.e., internal (Customs officers) ...

  17. Users' and providers' perspectives on technological procedures for 'normal' childbirth in a public maternity hospital in Salvador, Brazil Perspectivas de usuarios y proveedores sobre procedimientos tecnológicos para el parto 'normal' en una maternidad pública de Salvador, Brasil

    Directory of Open Access Journals (Sweden)

    Cecilia McCallum

    2008-02-01

    Full Text Available OBJECTIVE: To reveal the effect of cultural practices on the way in which normal birth is conducted in a public hospital in Brazil. MATERIAL AND METHODS: This article about a public maternity hospital in Salvador, Brazil, compares the points of view of providers and users on four technological normal childbirth procedures: trichotomy, episiotomy, oxytocin infusion, and epidural analgesia. Fieldwork carried out from 2002 to 2003 combined qualitative and quantitative methods. RESULTS: Institutional practices make childbirth unnecessarily difficult for women. Nonetheless, most women accept the conditions because the medical procedures make sense according to their cultural understandings. Service providers support the use of such procedures, although doctors are aware that they contradict recommendations found in scientific medical literature. This article argues that from the perspective of both providers and users, the technological procedures are infused with a culturally specific set of meanings and values. CONCLUSIONS: Policymakers must address the cultural understandings of both users and health care professionals in order to improve maternal healthcare in public hospitals in Brazil.OBJETIVO: Revelar el efecto de las prácticas culturales en el parto normal en un hospital público en Brasil. MATERIAL Y MÉTODOS: Este artículo sobre el parto en una maternidad pública de Salvador, Brasil, compara el punto de vista de los proveedores de servicios de salud y los usuarios de dichos servicios con respecto a cuatro procedimientos para el parto normal: tricotomía, episiotomía, infusión de oxitocina y analgésico epidural. La investigación, realizada entre 2002 y 2003, utilizó métodos cualitativos y cuantitativos. RESULTADOS: La práctica institucional hace que el parto sea innecesariamente dificultoso para las mujeres, sin embargo, la mayoría de ellas aceptan las condiciones, porque los procedimientos médicos tienen sentido dentro de su

  18. Resultados maternos e neonatais em Centro de Parto Normal peri-hospitalar na cidade de São Paulo, Brasil Resultados maternos y neonatales en un Centro de Parto Normal perihospitalario en la ciudad de São Paulo, Brasil Maternal and perinatal outcomes of an alongside hospital Birth Center in the city of São Paulo, Brazil

    Directory of Open Access Journals (Sweden)

    Sheila Fagundes Lobo

    2010-09-01

    describe the maternal and perinatal results of care in the alongside hospital birth center Casa de Maria (CPN-CM, located in the city of São Paulo. The random sample included 991 women and their newborns, attended between 2003 and 2006. The results showed that 92.2% of women had a companion of her choice during childbirth and the practices commonly used were shower or immersion bath (92.9%, amniotomy (62.6%, walking (47.6%, massage comfort (29.8% and episiotomy (25.7%. Regarding newborns, 99.9% of them had Apgar scores =7 in the fifth minute, 9.3% received aspiration of the upper airway, no one needed to be intubated and 1.4% were removed to the hospital. The model of care in the CPN-CM provides maternal and perinatal outcomes expected for low obstetric risk women, and means a safe option and less interventionist model in normal childbirth.

  19. Effectiveness and safety of 1 vs 4 h blood pressure profile with clinical and laboratory assessment for the exclusion of gestational hypertension and pre-eclampsia: a retrospective study in a university affiliated maternity hospital.

    Science.gov (United States)

    McCarthy, Elizabeth Anne; Carins, Thomas A; Hannigan, Yolanda; Bardien, Nadia; Shub, Alexis; Walker, Susan P

    2015-11-18

    We asked whether 60 compared with 240 min observation is sufficiently informative and safe for pregnancy day assessment (PDAC) of suspected pre-eclampsia (PE). A retrospective study of 209 pregnant women (475 PDAC assessments, 6 months) with routinely collected blood pressure (BP), symptom and laboratory information. We proposed a 60 min screening algorithm comprising: absence of symptoms, normal laboratory parameters and ≤1high-BP reading (systolic blood pressure, SBP 140 mm Hg or higher or diastolic blood pressure, DBP 90 mm Hg or higher). We also evaluated two less inclusive screening algorithms. We determined short-term outcomes (within 4 h): severe hypertension, proteinuric hypertension and pregnancy-induced hypertension, as well as long-term outcome: PE-related diagnoses up to the early puerperium. We assessed performance of alternate screening algorithms performance using 2×2 tables. 1 in 3 women met all screen negative criteria at 1 h. Their risk of hypertension requiring treatment in the next 3 h was 1.8% and of failing to diagnose proteinuric hypertensive PE at 4 h was 5.1%. If BP triggers were 5 mm Hg lower, 1 in 6 women would be screen-negative of whom 1.1% subsequently develops treatment-requiring hypertension and 4.5% demonstrate short-term proteinuric hypertension. We present sensitivity, specificity, negative and positive likelihood ratios for alternate screening algorithms. We endorse further research into the safest screening test where women are considered for discharge after 60 min. Safety, patient and staff satisfaction should be assessed prospectively. Any screening test should be used in conjunction with good clinical care to minimise maternal and perinatal hazards of PE. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

  20. Her Royal Highness Princess Maha Chakri Sirindhorn: her activities in humanity and medicine.

    Science.gov (United States)

    Chauluxananan, Somrat; Chentanez, Vilai

    2005-09-01

    Her Royal Highness Princess Maha Chakri Sirindhorn, the Executive Vice-President of the Thai Red Cross Society has followed the footsteps of her fore-bears, carrying the noble humanitarian work they began, particularly the work of the Thai Red Cross society and the Faculty of Medicine, Chulalongkorn University. Her contributions have been a benefit to all, and she has earned great love and is held in high esteem by her people. Her ideas, thoughts, words, and activities have been of immense value to the faculty in both tangible and intangible ways. A selfless, dedicated women who is willing to make sacrifices for the common good, Her Royal Highness serves as a model humanitarian for the staff of the Faculty of Medicine, Chulalongkorn University, whose morale she has boosted and whose operations she has planned with the foresight ofa first-class administrator. Her devotion to the Thai Red Cross, and thus her devotion to her people, have indeed made her the royal gem within Thai hearts, with sparkling brilliance of her humanitarian deeds instilling the warmth of her love in our spirits.