Heart failure(HF)during pregnancy presents unique challenges due to the complex interplay between physiological changes and underlying cardiac conditions.Pregnancy-induced increases in blood volume,cardiac output,and ...Heart failure(HF)during pregnancy presents unique challenges due to the complex interplay between physiological changes and underlying cardiac conditions.Pregnancy-induced increases in blood volume,cardiac output,and heart rate can exacerbate pre-existing heart diseases or trigger new-onset HF,such as peripartum cardiomyopathy and preeclampsia-related HF.With pregnancy-related physiological changes altering pharmacokinetics,dosage adjustment becomes crucial,making its application limited to carefully selected cases where benefits outweigh the risks.Medication management for these patients requires a meticulous approach.Beta-blockers like metoprolol and bisoprolol are preferred despite limited evidence,and carvedilol may be cautiously used per clinical experience;atenolol is contraindicated for low-birth-weight risk.Diuretics(furosemide,bumetanide)are safe for congestion relief but warrant judicious dosing.Digoxin is generally safe but requires dose adjustment and regular monitoring due to pregnancy-induced pharmacokinetic alterations.Among positive inotropes,dobutamine exhibits favorable safety in pregnancy,whereas milrinone should be used cautiously for hypotension risk.Renin-angiotensin system inhibitors,mineralocorticoid receptor antagonists and sodium-glucose cotransporter 2 inhibitors are all contraindicated owing to risks of fetal malformations,male fetal feminization,and insufficient safety evidence,respectively.展开更多
Introduction: Obstetric Fistulas (OF) constitute a major public health problem in developing countries in general and in Central African Republic (CAR) in particular because of its numerous consequences. The objective...Introduction: Obstetric Fistulas (OF) constitute a major public health problem in developing countries in general and in Central African Republic (CAR) in particular because of its numerous consequences. The objective of this work is to contribute to the management of OF cases in CAR. Patients and Methods: This was a retrospective, descriptive and analytical study, including data from several OF care services. The study included 245 cases of OF, operated on from 2009 to 2018. The parameters studied were maternal and obstetrical data, sociodemographic data, the specific characteristics of the fistulas as well as the modalities and outcome of surgical treatment. The data collected came from six (6) OF surgical repair campaigns organized by the Ministry of Health and Population with the support of UNFPA. Results: We recorded 245 patients, representing a prevalence of 0.77% of OF per year. Among these patients, almost half (45.3%) were treated at the Sino-Central African Friendship University Hospital Center (CHUASC). The average age of the patients was 30 years (range 14 to 78 years). They were unschooled (53.9%) and primigravidas (35%). The fistulas had an average duration of evolution of 7.58 years. They were vesicovaginal in 25.3%. Types V and I dominated in 17.4% and 9.2%, respectively. In 85.9% of cases, fistulorrhaphy was performed, half of which (50.2%) via the upper route. The cure rate was 83.3%. Note that our study reveals statistically significant links between the evolution after surgery with age (p = 0.04 Conclusion: OF mainly affected women of childbearing age, uneducated, primiparous. Vesicovaginal fistula was the frequently encountered type and was manifested by urine loss clinically with a positive methylene blue test.展开更多
BACKGROUND Antenatal depression is a disabling mental disorder among pregnant women and may cause adverse outcomes for both the mother and the offspring.Early identification and intervention of antenatal depression ca...BACKGROUND Antenatal depression is a disabling mental disorder among pregnant women and may cause adverse outcomes for both the mother and the offspring.Early identification and intervention of antenatal depression can help to prevent adverse outcomes.However,there have been few population-based studies focusing on the association of social and obstetric risk factors with antenatal depression in China.AIM To assess the sociodemographic and obstetric factors of antenatal depression and compare the network structure of depressive symptoms across different risk levels based on a large Chinese population.METHODS The cross-sectional survey was conducted in Shenzhen,China from 2020 to 2024.Antenatal depression was assessed using the Chinese version of the Edinburgh Postnatal Depression Scale(EPDS),with a score of≥13 indicating the presence of probable antenatal depression.Theχ2 test and binary logistic regression were used to identify the factors associated with antenatal depression.Network analyses were conducted to investigate the structure of depressive symptoms across groups with different risk levels.RESULTS Among the 44220 pregnant women,the prevalence of probable antenatal depression was 4.4%.An age≤24 years,a lower level of education(≤12 years),low or moderate economic status,having a history of mental disorders,being in the first trimester,being a primipara,unplanned pregnancy,and pregnancy without pre-pregnancy screening were found to be associated with antenatal depression(all P<0.05).Depressive symptom networks across groups with different risk levels revealed robust interconnections between symptoms.EPDS8("sad or miserable")and EPDS4("anxious or worried")showed the highest nodal strength across groups with different risk levels.CONCLUSION This study suggested that the prevalence of antenatal depression was 4.4%.Several social and obstetric factors were identified as risk factors for antenatal depression.EPDS8("sad or miserable")and EPDS4("anxious or worried")are pivotal targets for clinical intervention to alleviate the burden of antenatal depression.Early identification of highrisk groups is crucial for the development and implementation of intervention strategies to improve the overall quality of life for pregnant women.展开更多
This study focuses on the relationship between job stress and intention to leave among obstetric(OB)nurses in the context of China's birth policy adjustment,and provides a scientific basis for policymakers and hea...This study focuses on the relationship between job stress and intention to leave among obstetric(OB)nurses in the context of China's birth policy adjustment,and provides a scientific basis for policymakers and healthcare administrators.This study used a non-experimental descriptive correlation design with a purposive sampling of 230 OB nurses from three tertiary hospitals in Jinan,Shandong Province.Participants were surveyed using three questionnaires and descriptive analysis;ANOVA and correlation analyses were used to analyze the relationship between participants'stressor levels and turnover intention.Pearson's correlation coefficient analysis showed that there was a positive correlation between nurses‘work stressors and turnover intention,with a correlation coefficient of r=0.53,a moderate positive correlation(P<0.001).Based on the survey data from three tertiary hospitals in Shandong Province,the obstetric nurses group has a medium level of work stressors,but a high turnover intention,highlighting the professional identity crisis.展开更多
This paper analyzes the current research status of job satisfaction among obstetric nurses at home and abroad,including research methods,influencing factors,correlation relationships,and countermeasures to improve job...This paper analyzes the current research status of job satisfaction among obstetric nurses at home and abroad,including research methods,influencing factors,correlation relationships,and countermeasures to improve job satisfaction of obstetric nurses.It aims to provide a reference for subsequent studies on job satisfaction of obstetric nurses.展开更多
Introduction: Access to the best quality of obstetrical care sometimes conceals acts and behaviors that fail to respect women’s physical, mental and social integrity. These negative experiences are referred to as obs...Introduction: Access to the best quality of obstetrical care sometimes conceals acts and behaviors that fail to respect women’s physical, mental and social integrity. These negative experiences are referred to as obstetrical violence. The aim of this study is to contribute to improving the quality of maternal health care. Patient and Method: This was a cross-sectional study with a quantitative component carried out in the obstetrics and gynecology department of the Maman Elisabeth Domitien University Hospital from November 1 to 30, 2024. All women in childbed seen for postnatal consultations within 42 days of delivery were included. Results: We included 109 women. Age ranged from 16 to 44 years with a mean of 26.9 (±6.02). The majority of women were living in common-law unions with 79.8% and 57.8% of mothers having a secondary education level. More than half of the participants (52.9%) said that they had not been prepared for childbirth during prenatal follow-up and 44.0% had not freely chosen their path of delivery. The vaginal route was the most observed route of delivery (97.3%). Of all vaginal deliveries, episiotomy was performed in 21.7% and uterine revision in 66.0%. For episiotomies, 26.1% of women in childbed were informed about its performance and 87.0% had had a bad experience with this event. For women who had undergone a uterine revision, 52.9% had been informed of its performance and 77.1% had a bad experience with the event. Women in childbed had been victims of inappropriate acts and verbal aggression in 18.4% and 14.7% respectively. Of all the participants, 45.0% said they had experienced the birth episode badly. Conclusion: This study has given us an idea of the subject. However, a large-scale study will enable us to understand the different facets of this subject.展开更多
Objective Great obstetrical syndrome(GOS)represents a group of pregnancy-related diseases that result in inadequate placentation.Most GOS cases end in preterm,either spontaneously or indicatively,and the use of antena...Objective Great obstetrical syndrome(GOS)represents a group of pregnancy-related diseases that result in inadequate placentation.Most GOS cases end in preterm,either spontaneously or indicatively,and the use of antenatal corticosteroids(ACS)is inevitably discussed.The placenta is an important,transient fetal-derived organ and is the embodiment of maternal or fetal well-being.However,few studies provide histological evidence of the placenta in GOS.This study aims to address these issues.Methods A total of 831 pregnant women were prospectively recruited.Placenta tissue was collected immediately and fixed with 4%paraformaldehyde solution for future H&E analysis.A novel checklist was devised to evaluate maternal vascular malperfusion sections on the basis of the commonly accepted Amsterdam placental workshop group consensus statement.Results A total of 131 patients were classified as having GOS.Comparisons between those with and without GOS revealed significant differences,including higher levels of distal villous hypoplasia,increased syncytial knots,accelerated villous maturation,and higher total scores in GOS.We found significant negative associations between GOS and neonatal weight,neonatal height,head circumference,placental surface area,placental volume,and placenta gross examination score.GOS neonates were 1.25 times more likely to have hyperbilirubinemia.Regarding the effect of ACS,a significant reduction in birthweight,height,and head circumference was observed,along with an increased risk of hyperbilirubinemia.Conclusion This study provides histological evidence of the GOS that supports the defective deep placentation hypothesis.Our research also contributes to benefit-risk consultation in the GOS,such as in cases of PE and FGR,where a balance between fetal lung maturation and short-term neonatal outcomes is crucial.展开更多
In the new era,curriculum ideological and political education has become one of the core approaches for higher education to implement the fundamental task of moral education.Obstetrics and gynecology nursing is a prof...In the new era,curriculum ideological and political education has become one of the core approaches for higher education to implement the fundamental task of moral education.Obstetrics and gynecology nursing is a professional basic course for medical nursing majors,featuring professionalism,humanism,and sociality,which has a natural fit with the integration of curriculum ideological and political education.Based on the professional characteristics of obstetrics and gynecology nursing teaching,this paper constructs a“six-in-one”integration path from six dimensions:integration goals,element excavation,content penetration,method innovation,evaluation system,and teacher team construction.It provides a reference for cultivating obstetrics and gynecology nursing talents with both exquisite professional skills and noble professional literacy.展开更多
Clinical nursing in obstetrics and gynecology is far more than mere disease treatment and technical operations;it also carries profound humanistic care connotations.Through clinical practice analysis,this study system...Clinical nursing in obstetrics and gynecology is far more than mere disease treatment and technical operations;it also carries profound humanistic care connotations.Through clinical practice analysis,this study systematically elaborates on the risks existing in clinical obstetrics and gynecology nursing,analyzes the importance of humanized nursing,and proposes corresponding application countermeasures.It is found that the application of the humanized nursing model in clinical obstetrics and gynecology nursing can effectively meet the physical,psychological,and social needs of patients,establish a harmonious nurse-patient relationship,and have positive clinical value in promoting the physical and mental rehabilitation of patients.It is worthy of extensive promotion and application in clinical practice.展开更多
Objectives: The aim of this study is to introduce protocols for choosing trans-arterial embolization (TAE) or surgical hemostasis as an initial therapy for obstetric hemorrhage. Materials and Methods: From 2002 to 201...Objectives: The aim of this study is to introduce protocols for choosing trans-arterial embolization (TAE) or surgical hemostasis as an initial therapy for obstetric hemorrhage. Materials and Methods: From 2002 to 2011 at our hospital, the medical records of the patients who underwent TAE or surgical hemostasis for obstetric hemorrhage were reviewed to assess the following data: The causes of obstetric hemorrhage, Shock Index (SI) and obstetrical disseminated intra-vascular coagulation (DIC) score, amount of bleeding, transfusion, and operation time. Results: Twenty-five patients underwent TAE and six underwent surgical hemostasis. SI and obstetrical DIC score of the TAE group were 1.0 (0.4 - 2.2) and 6.0 (1 - 32), respectively. They were significantly lower than those of the surgical hemostasis group (SI: 1.6, obstetrical DIC score: 12.5, p < 0.05). Though the hemorrhage could be controlled sufficiently in 23 cases of the TAE group, 5 cases went into shock during TAE. The SI and obstetrical DIC score of shock group were 1.2 (1 - 2) and 10 (2 - 32), respectively. Conclusion: Though TAE is a useful therapy to control obstetric inevitable hemorrhage, special attention should be paid to the vital signs during TAE, especially in cases where SI and/or obstetrical DIC score are higher than 1.2 and 10, respectively.展开更多
<strong>Background</strong><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;"><strong>:</stron...<strong>Background</strong><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;"><strong>:</strong> Complications linked to postpartum & pregnancy are one of the major causes of female death. In order to understand the causes of complications and encourage women to take sufficient action in order to receive emergency treatment, a critical step should therefore be taken to minimize complications related to pregnancy, in order to ensure the safety of both women and newborns.</span></span></span><span><span><span style="font-family:""> </span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><b><span style="font-family:Verdana;">Aim of the work</span></b></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">:</span></span></span><span><span><span style="font-family:""> </span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">Evaluate the effectiveness of the education programs for pregnant women on obstetric danger signs in rural areas and help minimize the incidence of pregnancy loss and comorbidities.</span></span></span><span><span><span style="font-family:""> </span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><b><span style="font-family:Verdana;">Methods</span></b></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">: A quasi-experimental design on 70 women from a population of through 372 women in six-month in antenatal clinics recruited from the previously mentioned settings with pre- and post-test was conducted at antenatal clinics (M.C.H centers) affiliated to the available geographical health zones in EL-fayoum rural area including: Al-sheikh hassan at sanorse. We collected the data of women characteristics by a self-administered interview questionnaire & a structured reported knowledge and practices checklist to evaluate pregnant women practices and knowledge. Follow up was done to the studied groups & histopathology assessments of the product of conception in cases of abortion secondary to the complications to compare between effect of antenatal care program on the woman who followed the program and those who did not.</span></span></span><span><span><span style="font-family:""> </span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><b><span style="font-family:Verdana;">Results</span></b></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">: There is an improvement in 63% of pregnant women knowledge and practices after educational program in all aspects.</span></span></span><span><span><span style="font-family:""> </span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">The most common danger signs that may occur during pregnancy were miscarriage and vaginal bleeding, intrauterine fetal death as reported by women</span></span></span><span><span><span style="font-family:""> </span></span></span><span><span><span style="font-family:""><span style="font-family:Verdana;">& confirmed by the histopathology reports. </span><b><span style="font-family:Verdana;">Conclusion</span></b><span style="font-family:Verdana;">: The educational program had an efficient improving women knowledge and practice regarding danger signs for pregnant women in rural areas, with highly statically significant differences in all the tested items between pre/post program implementation (P</span></span></span></span><span><span><span style="font-family:""> </span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;"><</span></span></span><span><span><span style="font-family:""> </span></span></span><span><span><span style="font-family:""><span style="font-family:Verdana;">0.001). </span><b><span style="font-family:Verdana;">Recommendations</span></b><span style="font-family:Verdana;">: Establishment of in-service training programs and continuous supervision in rural areas to a raise women knowledge and practice regarding educational pregnant women and developing antenatal classes for all pregnant women about obstetric danger signs.</span></span></span></span>展开更多
Introduction: the demand for urgent obstetric and gynecology care has progressively increased: in the United States approximately 1.4 million gynecologic visits are made to the emergency department (ED) annually, whil...Introduction: the demand for urgent obstetric and gynecology care has progressively increased: in the United States approximately 1.4 million gynecologic visits are made to the emergency department (ED) annually, while almost 75% of women make at least 1 unscheduled visit during pregnancy. Moreover, research has recently focused on setting standards in unscheduled care, and developing quality indicators to improve patients’ health. Therefore, we investigated the characteristics of women with acute gynecological or pregnancy complaints using quality indicators developed for emergency medicine, to better define the needs of this population and improve care. Methods: Retrospective cohort study on ED, and Obstetrics and Gynecology (ObGyn) triage visits, at a tertiary care hospital in Italy, during 2012. Data were analyzed with population-averaged logistic regression and Poisson regression. Results: When compared to the 33,557 ED visits, the 9245 ObGyntriage referrals were more frequently associated with pregnancy (≤12 weeks’ gestation, OR: 30.7, 95%CI;24.5 - 38.4;>12 weeks’ gestation, OR 81.2, 95%CI;64.8 - 101.4), vaginal bleeding (OR 156.6, 95%CI;82.7 - 294.4), diurnal (night access OR 0.87, 95% CI;0.78 - 0.96) and weekday access (holiday access OR 0.87, 95%CI;0.78 - 0.95), frequent users (recurrent ED visits IRR 0.87, 95%CI;0.83 - 0.9) and lower hospital admissions (ED admission OR 1.6, 95%CI;1.4 - 1.8). Conclusion: ObGyn triage patients differed from ED users, and were at higher risk of “crowding”. Such diversities should be considered to improve female healthcare services and allocate resources more efficiently.展开更多
Introduction: Insecurity can be an obstacle to access to emergency obstetric and newborn care, that is why we proposed to study obstetrical emergencies in Ouahigouya Regional Teaching Hospital, a referral hospital in ...Introduction: Insecurity can be an obstacle to access to emergency obstetric and newborn care, that is why we proposed to study obstetrical emergencies in Ouahigouya Regional Teaching Hospital, a referral hospital in a region plagued by insecurity linked to armed groups. Method: This was an analytical cross-sectional study with prospective data collection over a 4-month period, from June 10 to October 10, 2020. Patients from precarious security areas were compared to those from safer areas. The Chi squared and Fisher tests were used for comparison of variables. Results: Obstetric emergencies accounted for 38.62% of admissions, from which 25.59% came from precarious security zones. Age was similar in both comparison groups. However, patients from unsafe areas were more likely to reside in rural areas (p 0.001) and more likely to be in unpaid occupations (p 0.001). Prenatal visits were less frequent (p 0.01) and women were more often multigravidae (p 0.01) in the precarious security group of patients. Apart from the more frequent uterine rupture (p = 0.02) in the group from precarious security zones, diagnosed complications and maternal mortality were similar in the 2 groups, while perinatal mortality was higher in the group of patients from precarious security zones (p 0.01). Conclusion: The precarious security situation has negative consequences on maternal and perinatal morbidity and mortality. Further studies are needed for better understanding of these consequences, and improvement of health system resilience strategies, to reduce related maternal and fetal morbidity and mortality.展开更多
<strong>Introduction</strong><span style="font-family:Tahoma;"><span style="font-family:Tahoma;"><span style="font-family:Tahoma;"><strong>:</strong...<strong>Introduction</strong><span style="font-family:Tahoma;"><span style="font-family:Tahoma;"><span style="font-family:Tahoma;"><strong>:</strong> Maternal mortality is a robust indicator of human development. Most of it occurs in developing countries.</span></span></span><span><span><span style="font-family:""> </span></span></span><span style="font-family:Tahoma;"><span style="font-family:Tahoma;"><b><span style="font-family:Tahoma;">Objectives</span></b></span></span><span><span><span style="font-family:""><span style="font-family:Tahoma;">: This study aims to determine the factors associated with maternal mortality in </span><span style="font-family:Tahoma;">Gynecology</span><span style="font-family:Tahoma;"> and Obstetrics Department of Borgou Departmental University Hospital Center (CHUD-B).</span></span></span></span><span><span><span style="font-family:""> </span></span></span><span style="font-family:Tahoma;"><span style="font-family:Tahoma;"><b><span style="font-family:Tahoma;">Study method</span></b></span></span><span><span><span style="font-family:""><span style="font-family:Tahoma;">: Our study took place at Gynecology and Obstetrics Department in Borgou Departmental University Hospital Center. This was a descriptive and analytical case-control study, covering a period of 7 years from January 1, </span><span style="font-family:Tahoma;">2012</span><span style="font-family:Tahoma;"> to December 31, 2018.</span></span></span></span><span><span><span style="font-family:""> </span></span></span><span style="font-family:Tahoma;"><span style="font-family:Tahoma;"><b><span style="font-family:Tahoma;">Results</span></b></span></span><span style="font-family:Tahoma;"><span style="font-family:Tahoma;"><span style="font-family:Tahoma;">: Two hundred and twelve patients have been recruited consisting of 106 deceased women and 106 controls. The intra-hospital mortality ratio was 1100 deaths per 100,000 live births (LB). The mean age of deceased women was 27.06 ± 6.45 years with the extremes of 15 and 45 years. Direct obstetric causes were the most frequent causes of maternal death. They were dominated by immediate postpartum hemorrhage (32.93%), followed by High Blood Pressure (26.83%) and infections (17.07%). The general condition of patients on admission (p-0.000) and inadequate management (p-0.001) w</span></span></span><span style="font-family:Tahoma;"><span style="font-family:Tahoma;"><span style="font-family:Tahoma;">as</span></span></span><span style="font-family:Tahoma;"><span style="font-family:Tahoma;"><span style="font-family:Tahoma;"> associated with maternal mortality.</span></span></span><span><span><span style="font-family:""> </span></span></span><span style="font-family:Tahoma;"><span style="font-family:Tahoma;"><b><span style="font-family:Tahoma;">Conclusion</span></b></span></span><span><span><span style="font-family:""><span style="font-family:Tahoma;">: </span><span style="font-family:Tahoma;">Patients</span></span></span></span><span style="font-family:Tahoma;"><span style="font-family:Tahoma;"><span style="font-family:Tahoma;">’</span></span></span><span><span><span style="font-family:""><span style="font-family:Tahoma;"> general condition on admission and inadequate management </span><span style="font-family:Tahoma;">w</span></span></span></span><span style="font-family:Tahoma;"><span style="font-family:Tahoma;"><span style="font-family:Tahoma;">as</span></span></span><span style="font-family:Tahoma;"><span style="font-family:Tahoma;"><span style="font-family:Tahoma;"> factors associated with maternal mortality.</span></span></span>展开更多
The aim was to evaluate obstetric emergencies at the Gao hospital. Materials and Methods: This was a descriptive, cross-sectional, analytical, prospective study from January 1 to December 31, 2015, i.e. a period of 12...The aim was to evaluate obstetric emergencies at the Gao hospital. Materials and Methods: This was a descriptive, cross-sectional, analytical, prospective study from January 1 to December 31, 2015, i.e. a period of 12 months. Results: During our study period, we registered 1853 patients among whom were 88 cases of obstetric emergencies, i.e. a frequency of 4.75%. The age group between 15 and 19 years old was the most concerned. Obstetric emergencies are dominated by: placenta previa 20.45%, retroplacental hematoma (RPH) 12.5%, fetal distress (FAS) 12.5%, postpartum hemorrhage (PPH) due to uterine atony 13.63%. Caesarean section was the most used mode of delivery with 70.45%. The maternal death rate was 6.82%. The cause of maternal death was haemorrhage. We say that obstetric emergencies are a public health problem in the world. The conditions of evacuations and the unfavorable socio-economic conditions are the main problems in our context. Conclusion: Urgent care and an improvement in the standard of living of the population are necessary to reduce fetal-maternal mortality.展开更多
In this paper, the author mainly discusses and analyzes the common hidden dangers of nursing safety and matters needing attention in community obstetrics and gynecology nursing. Methods: this study randomly selected 2...In this paper, the author mainly discusses and analyzes the common hidden dangers of nursing safety and matters needing attention in community obstetrics and gynecology nursing. Methods: this study randomly selected 200 pregnant and lying-in women from July 2018 to June 2021 in our community health service center as the research object, and randomly divided them into the control group and the experimental group, with 100 pregnant and lying-in women in each group. The control group selected the conventional health care model, and the experimental group based on the potential safety hazard and preventive countermeasures. We will implement the potential safety hazard and preventive publicity care model, and compare the situation of the two groups of patients under different care education models, and compare the satisfaction of the two groups of pregnant and lying-in women. Results: the study found that the experimental group, which implemented safety risks and preventive measures on the basis of daily health care, had a rich nursing model with statistical significance, while the control group's pure daily health care model was significantly lower than that of the experimental group. Conclusion: according to the research in this paper, the community is taking targeted preventive measures against common safety problems in obstetrics and gynecology, which not only improves the level of care, but also carries out comprehensive health education and care for pregnant and lying-in women, improves the satisfaction of pregnant and lying-in women to nursing staff, and reduces the incidence of problems.展开更多
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 considerab...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.展开更多
Vasopressors are routinely used to counteract hypotension after neuraxial anesthesia in Obstetrics. The understanding of the mechanism of hypotension and the choice of vasopressor has evolved over the years to a point...Vasopressors are routinely used to counteract hypotension after neuraxial anesthesia in Obstetrics. The understanding of the mechanism of hypotension and the choice of vasopressor has evolved over the years to a point where phenylephrine has become the preferred vasopressor. Due to the absence of definitive evidence showing absolute clinical benefit of one over the other, especially in emergency and high-risk Cesarean sections, our choice of phenylephrine over the other vasopressors like mephentermine, metaraminol, and ephedrine is guided by indirect evidence on fetalacid-base status. This review article evaluates the present day evidence on the various vasopressors used in obstetric anesthesia today.展开更多
Purpose: This study was conducted to audit prophylactic antibiotic use and to quantify the rate of wound infection. Methods: Across-sectional prospective study was conducted in the Obstetrics and Gynecology Department...Purpose: This study was conducted to audit prophylactic antibiotic use and to quantify the rate of wound infection. Methods: Across-sectional prospective study was conducted in the Obstetrics and Gynecology Department in Khartoum Teaching Hospital, Sudan during March 1st to 31st October 2010. All Patients (aged >18 years) were included. Results: Overall 725 patients were included. The performed surgical procedures were 751;of these 578 (76.9%) were Caesarean sections. Overall rate of wound infection was 7.8%. The rate of wound infection among patients operated on for caesarean section and abdominal hysterectomy was 8.3%, and 9.2%, respectively. Multivariate logistic analysis showed that body mass index [BMI] ≥ 30 kg/m2 OR 2.1, 95% CI (1.1 - 4.0), (P = 0.019) was the major independent risk factor for occurrence of wound infection. Evaluation of prescriptions’ parameters against the stated criteria showed that 113 (15.8%) patients were given antibiotics with adequate spectrum of activity, 611 (85.3%) given sub-dose/s, 83 (11.6%) received the first preoperative dose/s in a proper time window, and 716 (100%) had prophylaxis for extended duration. Overall conformity to the stated criteria for the evaluation of prescription’s parameters was not achieved in all prescriptions. Conclusions: In this setting, antibiotics were irrationally used and wound infection rate was high, and the situation calls for multiple interventions to correct the situation, through the activation of the infection control committee in the hospital and development of antimicrobial subcommittee to develop policies for the use and auditing of prophylactic antibiotics.展开更多
Objective: The aim of this study was to explore the correlation between psychological resilience and social support and anxiety in obstetric nurses and to provide theoretical basis for improving the mental health of o...Objective: The aim of this study was to explore the correlation between psychological resilience and social support and anxiety in obstetric nurses and to provide theoretical basis for improving the mental health of obstetric nurses.Methods: In this study, 190 obstetric nurses were included, using the general information questionnaire and The Connor-Davidson Resilience Scale(CD-RISC), Social Support Rating Scale, and survey of Self-evaluation of Anxiety Scale.Results: There are differences in the type of work and the score of psychological resilience(P<0.05), obstetric nurses’ resilience score was 65.58±10.65; self-rating anxiety score of obstetric nurses was 36.89±6.87; and social support score of obstetric nurses was44.3717.86. The psychological elasticity score and anxiety were negatively related(P<0.01), whereas the resilience score and total score of social support were positively related(P<0.01).Conclusions: Obstetric nurses have many responsibilities and stress. Nursing managers should focus on obstetric nurses’ mental health, lighten the obstetric nurses’ anxiety, and thus improve their mental flexibility and optimize the quality of nursing service better,with more passion into work.展开更多
基金Supported by National Key R and D Program of China,No.2022YFC3500704National Natural Science Foundation of China,No.82305376+1 种基金Project of Supporting Young Scientific and Technological Talents in Jiangsu Province in 2024,No.JSTJ-2024-380College Students'Innovative Entrepreneurial Training Plan Program,No.202310315029Z.
文摘Heart failure(HF)during pregnancy presents unique challenges due to the complex interplay between physiological changes and underlying cardiac conditions.Pregnancy-induced increases in blood volume,cardiac output,and heart rate can exacerbate pre-existing heart diseases or trigger new-onset HF,such as peripartum cardiomyopathy and preeclampsia-related HF.With pregnancy-related physiological changes altering pharmacokinetics,dosage adjustment becomes crucial,making its application limited to carefully selected cases where benefits outweigh the risks.Medication management for these patients requires a meticulous approach.Beta-blockers like metoprolol and bisoprolol are preferred despite limited evidence,and carvedilol may be cautiously used per clinical experience;atenolol is contraindicated for low-birth-weight risk.Diuretics(furosemide,bumetanide)are safe for congestion relief but warrant judicious dosing.Digoxin is generally safe but requires dose adjustment and regular monitoring due to pregnancy-induced pharmacokinetic alterations.Among positive inotropes,dobutamine exhibits favorable safety in pregnancy,whereas milrinone should be used cautiously for hypotension risk.Renin-angiotensin system inhibitors,mineralocorticoid receptor antagonists and sodium-glucose cotransporter 2 inhibitors are all contraindicated owing to risks of fetal malformations,male fetal feminization,and insufficient safety evidence,respectively.
文摘Introduction: Obstetric Fistulas (OF) constitute a major public health problem in developing countries in general and in Central African Republic (CAR) in particular because of its numerous consequences. The objective of this work is to contribute to the management of OF cases in CAR. Patients and Methods: This was a retrospective, descriptive and analytical study, including data from several OF care services. The study included 245 cases of OF, operated on from 2009 to 2018. The parameters studied were maternal and obstetrical data, sociodemographic data, the specific characteristics of the fistulas as well as the modalities and outcome of surgical treatment. The data collected came from six (6) OF surgical repair campaigns organized by the Ministry of Health and Population with the support of UNFPA. Results: We recorded 245 patients, representing a prevalence of 0.77% of OF per year. Among these patients, almost half (45.3%) were treated at the Sino-Central African Friendship University Hospital Center (CHUASC). The average age of the patients was 30 years (range 14 to 78 years). They were unschooled (53.9%) and primigravidas (35%). The fistulas had an average duration of evolution of 7.58 years. They were vesicovaginal in 25.3%. Types V and I dominated in 17.4% and 9.2%, respectively. In 85.9% of cases, fistulorrhaphy was performed, half of which (50.2%) via the upper route. The cure rate was 83.3%. Note that our study reveals statistically significant links between the evolution after surgery with age (p = 0.04 Conclusion: OF mainly affected women of childbearing age, uneducated, primiparous. Vesicovaginal fistula was the frequently encountered type and was manifested by urine loss clinically with a positive methylene blue test.
基金Supported by the Joint Funds of the National Natural Science Foundation of China,No.U23A20434National Natural Science Foundation of China,No.82301738,No.82371535,and No.82171518+1 种基金the National Key Research and Development Program of China,No.2021YFF1201204the Science and Technology Innovation Program of Hunan Province,No.2023RC3083.
文摘BACKGROUND Antenatal depression is a disabling mental disorder among pregnant women and may cause adverse outcomes for both the mother and the offspring.Early identification and intervention of antenatal depression can help to prevent adverse outcomes.However,there have been few population-based studies focusing on the association of social and obstetric risk factors with antenatal depression in China.AIM To assess the sociodemographic and obstetric factors of antenatal depression and compare the network structure of depressive symptoms across different risk levels based on a large Chinese population.METHODS The cross-sectional survey was conducted in Shenzhen,China from 2020 to 2024.Antenatal depression was assessed using the Chinese version of the Edinburgh Postnatal Depression Scale(EPDS),with a score of≥13 indicating the presence of probable antenatal depression.Theχ2 test and binary logistic regression were used to identify the factors associated with antenatal depression.Network analyses were conducted to investigate the structure of depressive symptoms across groups with different risk levels.RESULTS Among the 44220 pregnant women,the prevalence of probable antenatal depression was 4.4%.An age≤24 years,a lower level of education(≤12 years),low or moderate economic status,having a history of mental disorders,being in the first trimester,being a primipara,unplanned pregnancy,and pregnancy without pre-pregnancy screening were found to be associated with antenatal depression(all P<0.05).Depressive symptom networks across groups with different risk levels revealed robust interconnections between symptoms.EPDS8("sad or miserable")and EPDS4("anxious or worried")showed the highest nodal strength across groups with different risk levels.CONCLUSION This study suggested that the prevalence of antenatal depression was 4.4%.Several social and obstetric factors were identified as risk factors for antenatal depression.EPDS8("sad or miserable")and EPDS4("anxious or worried")are pivotal targets for clinical intervention to alleviate the burden of antenatal depression.Early identification of highrisk groups is crucial for the development and implementation of intervention strategies to improve the overall quality of life for pregnant women.
文摘This study focuses on the relationship between job stress and intention to leave among obstetric(OB)nurses in the context of China's birth policy adjustment,and provides a scientific basis for policymakers and healthcare administrators.This study used a non-experimental descriptive correlation design with a purposive sampling of 230 OB nurses from three tertiary hospitals in Jinan,Shandong Province.Participants were surveyed using three questionnaires and descriptive analysis;ANOVA and correlation analyses were used to analyze the relationship between participants'stressor levels and turnover intention.Pearson's correlation coefficient analysis showed that there was a positive correlation between nurses‘work stressors and turnover intention,with a correlation coefficient of r=0.53,a moderate positive correlation(P<0.001).Based on the survey data from three tertiary hospitals in Shandong Province,the obstetric nurses group has a medium level of work stressors,but a high turnover intention,highlighting the professional identity crisis.
文摘This paper analyzes the current research status of job satisfaction among obstetric nurses at home and abroad,including research methods,influencing factors,correlation relationships,and countermeasures to improve job satisfaction of obstetric nurses.It aims to provide a reference for subsequent studies on job satisfaction of obstetric nurses.
文摘Introduction: Access to the best quality of obstetrical care sometimes conceals acts and behaviors that fail to respect women’s physical, mental and social integrity. These negative experiences are referred to as obstetrical violence. The aim of this study is to contribute to improving the quality of maternal health care. Patient and Method: This was a cross-sectional study with a quantitative component carried out in the obstetrics and gynecology department of the Maman Elisabeth Domitien University Hospital from November 1 to 30, 2024. All women in childbed seen for postnatal consultations within 42 days of delivery were included. Results: We included 109 women. Age ranged from 16 to 44 years with a mean of 26.9 (±6.02). The majority of women were living in common-law unions with 79.8% and 57.8% of mothers having a secondary education level. More than half of the participants (52.9%) said that they had not been prepared for childbirth during prenatal follow-up and 44.0% had not freely chosen their path of delivery. The vaginal route was the most observed route of delivery (97.3%). Of all vaginal deliveries, episiotomy was performed in 21.7% and uterine revision in 66.0%. For episiotomies, 26.1% of women in childbed were informed about its performance and 87.0% had had a bad experience with this event. For women who had undergone a uterine revision, 52.9% had been informed of its performance and 77.1% had a bad experience with the event. Women in childbed had been victims of inappropriate acts and verbal aggression in 18.4% and 14.7% respectively. Of all the participants, 45.0% said they had experienced the birth episode badly. Conclusion: This study has given us an idea of the subject. However, a large-scale study will enable us to understand the different facets of this subject.
基金supported by the National Science Foundation of China(No.81873843)the National Science and Technology Pillar Program of China during the Twelfth Five-Year Plan Period(No.2014BA105B05)the Fundamental Research Funds for the Central Universities(No.2017 KFYXJJ102 and No.2019 KFYXKJC053).
文摘Objective Great obstetrical syndrome(GOS)represents a group of pregnancy-related diseases that result in inadequate placentation.Most GOS cases end in preterm,either spontaneously or indicatively,and the use of antenatal corticosteroids(ACS)is inevitably discussed.The placenta is an important,transient fetal-derived organ and is the embodiment of maternal or fetal well-being.However,few studies provide histological evidence of the placenta in GOS.This study aims to address these issues.Methods A total of 831 pregnant women were prospectively recruited.Placenta tissue was collected immediately and fixed with 4%paraformaldehyde solution for future H&E analysis.A novel checklist was devised to evaluate maternal vascular malperfusion sections on the basis of the commonly accepted Amsterdam placental workshop group consensus statement.Results A total of 131 patients were classified as having GOS.Comparisons between those with and without GOS revealed significant differences,including higher levels of distal villous hypoplasia,increased syncytial knots,accelerated villous maturation,and higher total scores in GOS.We found significant negative associations between GOS and neonatal weight,neonatal height,head circumference,placental surface area,placental volume,and placenta gross examination score.GOS neonates were 1.25 times more likely to have hyperbilirubinemia.Regarding the effect of ACS,a significant reduction in birthweight,height,and head circumference was observed,along with an increased risk of hyperbilirubinemia.Conclusion This study provides histological evidence of the GOS that supports the defective deep placentation hypothesis.Our research also contributes to benefit-risk consultation in the GOS,such as in cases of PE and FGR,where a balance between fetal lung maturation and short-term neonatal outcomes is crucial.
文摘In the new era,curriculum ideological and political education has become one of the core approaches for higher education to implement the fundamental task of moral education.Obstetrics and gynecology nursing is a professional basic course for medical nursing majors,featuring professionalism,humanism,and sociality,which has a natural fit with the integration of curriculum ideological and political education.Based on the professional characteristics of obstetrics and gynecology nursing teaching,this paper constructs a“six-in-one”integration path from six dimensions:integration goals,element excavation,content penetration,method innovation,evaluation system,and teacher team construction.It provides a reference for cultivating obstetrics and gynecology nursing talents with both exquisite professional skills and noble professional literacy.
文摘Clinical nursing in obstetrics and gynecology is far more than mere disease treatment and technical operations;it also carries profound humanistic care connotations.Through clinical practice analysis,this study systematically elaborates on the risks existing in clinical obstetrics and gynecology nursing,analyzes the importance of humanized nursing,and proposes corresponding application countermeasures.It is found that the application of the humanized nursing model in clinical obstetrics and gynecology nursing can effectively meet the physical,psychological,and social needs of patients,establish a harmonious nurse-patient relationship,and have positive clinical value in promoting the physical and mental rehabilitation of patients.It is worthy of extensive promotion and application in clinical practice.
文摘Objectives: The aim of this study is to introduce protocols for choosing trans-arterial embolization (TAE) or surgical hemostasis as an initial therapy for obstetric hemorrhage. Materials and Methods: From 2002 to 2011 at our hospital, the medical records of the patients who underwent TAE or surgical hemostasis for obstetric hemorrhage were reviewed to assess the following data: The causes of obstetric hemorrhage, Shock Index (SI) and obstetrical disseminated intra-vascular coagulation (DIC) score, amount of bleeding, transfusion, and operation time. Results: Twenty-five patients underwent TAE and six underwent surgical hemostasis. SI and obstetrical DIC score of the TAE group were 1.0 (0.4 - 2.2) and 6.0 (1 - 32), respectively. They were significantly lower than those of the surgical hemostasis group (SI: 1.6, obstetrical DIC score: 12.5, p < 0.05). Though the hemorrhage could be controlled sufficiently in 23 cases of the TAE group, 5 cases went into shock during TAE. The SI and obstetrical DIC score of shock group were 1.2 (1 - 2) and 10 (2 - 32), respectively. Conclusion: Though TAE is a useful therapy to control obstetric inevitable hemorrhage, special attention should be paid to the vital signs during TAE, especially in cases where SI and/or obstetrical DIC score are higher than 1.2 and 10, respectively.
文摘<strong>Background</strong><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;"><strong>:</strong> Complications linked to postpartum & pregnancy are one of the major causes of female death. In order to understand the causes of complications and encourage women to take sufficient action in order to receive emergency treatment, a critical step should therefore be taken to minimize complications related to pregnancy, in order to ensure the safety of both women and newborns.</span></span></span><span><span><span style="font-family:""> </span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><b><span style="font-family:Verdana;">Aim of the work</span></b></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">:</span></span></span><span><span><span style="font-family:""> </span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">Evaluate the effectiveness of the education programs for pregnant women on obstetric danger signs in rural areas and help minimize the incidence of pregnancy loss and comorbidities.</span></span></span><span><span><span style="font-family:""> </span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><b><span style="font-family:Verdana;">Methods</span></b></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">: A quasi-experimental design on 70 women from a population of through 372 women in six-month in antenatal clinics recruited from the previously mentioned settings with pre- and post-test was conducted at antenatal clinics (M.C.H centers) affiliated to the available geographical health zones in EL-fayoum rural area including: Al-sheikh hassan at sanorse. We collected the data of women characteristics by a self-administered interview questionnaire & a structured reported knowledge and practices checklist to evaluate pregnant women practices and knowledge. Follow up was done to the studied groups & histopathology assessments of the product of conception in cases of abortion secondary to the complications to compare between effect of antenatal care program on the woman who followed the program and those who did not.</span></span></span><span><span><span style="font-family:""> </span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><b><span style="font-family:Verdana;">Results</span></b></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">: There is an improvement in 63% of pregnant women knowledge and practices after educational program in all aspects.</span></span></span><span><span><span style="font-family:""> </span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">The most common danger signs that may occur during pregnancy were miscarriage and vaginal bleeding, intrauterine fetal death as reported by women</span></span></span><span><span><span style="font-family:""> </span></span></span><span><span><span style="font-family:""><span style="font-family:Verdana;">& confirmed by the histopathology reports. </span><b><span style="font-family:Verdana;">Conclusion</span></b><span style="font-family:Verdana;">: The educational program had an efficient improving women knowledge and practice regarding danger signs for pregnant women in rural areas, with highly statically significant differences in all the tested items between pre/post program implementation (P</span></span></span></span><span><span><span style="font-family:""> </span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;"><</span></span></span><span><span><span style="font-family:""> </span></span></span><span><span><span style="font-family:""><span style="font-family:Verdana;">0.001). </span><b><span style="font-family:Verdana;">Recommendations</span></b><span style="font-family:Verdana;">: Establishment of in-service training programs and continuous supervision in rural areas to a raise women knowledge and practice regarding educational pregnant women and developing antenatal classes for all pregnant women about obstetric danger signs.</span></span></span></span>
文摘Introduction: the demand for urgent obstetric and gynecology care has progressively increased: in the United States approximately 1.4 million gynecologic visits are made to the emergency department (ED) annually, while almost 75% of women make at least 1 unscheduled visit during pregnancy. Moreover, research has recently focused on setting standards in unscheduled care, and developing quality indicators to improve patients’ health. Therefore, we investigated the characteristics of women with acute gynecological or pregnancy complaints using quality indicators developed for emergency medicine, to better define the needs of this population and improve care. Methods: Retrospective cohort study on ED, and Obstetrics and Gynecology (ObGyn) triage visits, at a tertiary care hospital in Italy, during 2012. Data were analyzed with population-averaged logistic regression and Poisson regression. Results: When compared to the 33,557 ED visits, the 9245 ObGyntriage referrals were more frequently associated with pregnancy (≤12 weeks’ gestation, OR: 30.7, 95%CI;24.5 - 38.4;>12 weeks’ gestation, OR 81.2, 95%CI;64.8 - 101.4), vaginal bleeding (OR 156.6, 95%CI;82.7 - 294.4), diurnal (night access OR 0.87, 95% CI;0.78 - 0.96) and weekday access (holiday access OR 0.87, 95%CI;0.78 - 0.95), frequent users (recurrent ED visits IRR 0.87, 95%CI;0.83 - 0.9) and lower hospital admissions (ED admission OR 1.6, 95%CI;1.4 - 1.8). Conclusion: ObGyn triage patients differed from ED users, and were at higher risk of “crowding”. Such diversities should be considered to improve female healthcare services and allocate resources more efficiently.
文摘Introduction: Insecurity can be an obstacle to access to emergency obstetric and newborn care, that is why we proposed to study obstetrical emergencies in Ouahigouya Regional Teaching Hospital, a referral hospital in a region plagued by insecurity linked to armed groups. Method: This was an analytical cross-sectional study with prospective data collection over a 4-month period, from June 10 to October 10, 2020. Patients from precarious security areas were compared to those from safer areas. The Chi squared and Fisher tests were used for comparison of variables. Results: Obstetric emergencies accounted for 38.62% of admissions, from which 25.59% came from precarious security zones. Age was similar in both comparison groups. However, patients from unsafe areas were more likely to reside in rural areas (p 0.001) and more likely to be in unpaid occupations (p 0.001). Prenatal visits were less frequent (p 0.01) and women were more often multigravidae (p 0.01) in the precarious security group of patients. Apart from the more frequent uterine rupture (p = 0.02) in the group from precarious security zones, diagnosed complications and maternal mortality were similar in the 2 groups, while perinatal mortality was higher in the group of patients from precarious security zones (p 0.01). Conclusion: The precarious security situation has negative consequences on maternal and perinatal morbidity and mortality. Further studies are needed for better understanding of these consequences, and improvement of health system resilience strategies, to reduce related maternal and fetal morbidity and mortality.
文摘<strong>Introduction</strong><span style="font-family:Tahoma;"><span style="font-family:Tahoma;"><span style="font-family:Tahoma;"><strong>:</strong> Maternal mortality is a robust indicator of human development. Most of it occurs in developing countries.</span></span></span><span><span><span style="font-family:""> </span></span></span><span style="font-family:Tahoma;"><span style="font-family:Tahoma;"><b><span style="font-family:Tahoma;">Objectives</span></b></span></span><span><span><span style="font-family:""><span style="font-family:Tahoma;">: This study aims to determine the factors associated with maternal mortality in </span><span style="font-family:Tahoma;">Gynecology</span><span style="font-family:Tahoma;"> and Obstetrics Department of Borgou Departmental University Hospital Center (CHUD-B).</span></span></span></span><span><span><span style="font-family:""> </span></span></span><span style="font-family:Tahoma;"><span style="font-family:Tahoma;"><b><span style="font-family:Tahoma;">Study method</span></b></span></span><span><span><span style="font-family:""><span style="font-family:Tahoma;">: Our study took place at Gynecology and Obstetrics Department in Borgou Departmental University Hospital Center. This was a descriptive and analytical case-control study, covering a period of 7 years from January 1, </span><span style="font-family:Tahoma;">2012</span><span style="font-family:Tahoma;"> to December 31, 2018.</span></span></span></span><span><span><span style="font-family:""> </span></span></span><span style="font-family:Tahoma;"><span style="font-family:Tahoma;"><b><span style="font-family:Tahoma;">Results</span></b></span></span><span style="font-family:Tahoma;"><span style="font-family:Tahoma;"><span style="font-family:Tahoma;">: Two hundred and twelve patients have been recruited consisting of 106 deceased women and 106 controls. The intra-hospital mortality ratio was 1100 deaths per 100,000 live births (LB). The mean age of deceased women was 27.06 ± 6.45 years with the extremes of 15 and 45 years. Direct obstetric causes were the most frequent causes of maternal death. They were dominated by immediate postpartum hemorrhage (32.93%), followed by High Blood Pressure (26.83%) and infections (17.07%). The general condition of patients on admission (p-0.000) and inadequate management (p-0.001) w</span></span></span><span style="font-family:Tahoma;"><span style="font-family:Tahoma;"><span style="font-family:Tahoma;">as</span></span></span><span style="font-family:Tahoma;"><span style="font-family:Tahoma;"><span style="font-family:Tahoma;"> associated with maternal mortality.</span></span></span><span><span><span style="font-family:""> </span></span></span><span style="font-family:Tahoma;"><span style="font-family:Tahoma;"><b><span style="font-family:Tahoma;">Conclusion</span></b></span></span><span><span><span style="font-family:""><span style="font-family:Tahoma;">: </span><span style="font-family:Tahoma;">Patients</span></span></span></span><span style="font-family:Tahoma;"><span style="font-family:Tahoma;"><span style="font-family:Tahoma;">’</span></span></span><span><span><span style="font-family:""><span style="font-family:Tahoma;"> general condition on admission and inadequate management </span><span style="font-family:Tahoma;">w</span></span></span></span><span style="font-family:Tahoma;"><span style="font-family:Tahoma;"><span style="font-family:Tahoma;">as</span></span></span><span style="font-family:Tahoma;"><span style="font-family:Tahoma;"><span style="font-family:Tahoma;"> factors associated with maternal mortality.</span></span></span>
文摘The aim was to evaluate obstetric emergencies at the Gao hospital. Materials and Methods: This was a descriptive, cross-sectional, analytical, prospective study from January 1 to December 31, 2015, i.e. a period of 12 months. Results: During our study period, we registered 1853 patients among whom were 88 cases of obstetric emergencies, i.e. a frequency of 4.75%. The age group between 15 and 19 years old was the most concerned. Obstetric emergencies are dominated by: placenta previa 20.45%, retroplacental hematoma (RPH) 12.5%, fetal distress (FAS) 12.5%, postpartum hemorrhage (PPH) due to uterine atony 13.63%. Caesarean section was the most used mode of delivery with 70.45%. The maternal death rate was 6.82%. The cause of maternal death was haemorrhage. We say that obstetric emergencies are a public health problem in the world. The conditions of evacuations and the unfavorable socio-economic conditions are the main problems in our context. Conclusion: Urgent care and an improvement in the standard of living of the population are necessary to reduce fetal-maternal mortality.
文摘In this paper, the author mainly discusses and analyzes the common hidden dangers of nursing safety and matters needing attention in community obstetrics and gynecology nursing. Methods: this study randomly selected 200 pregnant and lying-in women from July 2018 to June 2021 in our community health service center as the research object, and randomly divided them into the control group and the experimental group, with 100 pregnant and lying-in women in each group. The control group selected the conventional health care model, and the experimental group based on the potential safety hazard and preventive countermeasures. We will implement the potential safety hazard and preventive publicity care model, and compare the situation of the two groups of patients under different care education models, and compare the satisfaction of the two groups of pregnant and lying-in women. Results: the study found that the experimental group, which implemented safety risks and preventive measures on the basis of daily health care, had a rich nursing model with statistical significance, while the control group's pure daily health care model was significantly lower than that of the experimental group. Conclusion: according to the research in this paper, the community is taking targeted preventive measures against common safety problems in obstetrics and gynecology, which not only improves the level of care, but also carries out comprehensive health education and care for pregnant and lying-in women, improves the satisfaction of pregnant and lying-in women to nursing staff, and reduces the incidence of problems.
基金supported by agrant of Key Research Center for Humanities and Social Sciences in Hubei Province
文摘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.
文摘Vasopressors are routinely used to counteract hypotension after neuraxial anesthesia in Obstetrics. The understanding of the mechanism of hypotension and the choice of vasopressor has evolved over the years to a point where phenylephrine has become the preferred vasopressor. Due to the absence of definitive evidence showing absolute clinical benefit of one over the other, especially in emergency and high-risk Cesarean sections, our choice of phenylephrine over the other vasopressors like mephentermine, metaraminol, and ephedrine is guided by indirect evidence on fetalacid-base status. This review article evaluates the present day evidence on the various vasopressors used in obstetric anesthesia today.
文摘Purpose: This study was conducted to audit prophylactic antibiotic use and to quantify the rate of wound infection. Methods: Across-sectional prospective study was conducted in the Obstetrics and Gynecology Department in Khartoum Teaching Hospital, Sudan during March 1st to 31st October 2010. All Patients (aged >18 years) were included. Results: Overall 725 patients were included. The performed surgical procedures were 751;of these 578 (76.9%) were Caesarean sections. Overall rate of wound infection was 7.8%. The rate of wound infection among patients operated on for caesarean section and abdominal hysterectomy was 8.3%, and 9.2%, respectively. Multivariate logistic analysis showed that body mass index [BMI] ≥ 30 kg/m2 OR 2.1, 95% CI (1.1 - 4.0), (P = 0.019) was the major independent risk factor for occurrence of wound infection. Evaluation of prescriptions’ parameters against the stated criteria showed that 113 (15.8%) patients were given antibiotics with adequate spectrum of activity, 611 (85.3%) given sub-dose/s, 83 (11.6%) received the first preoperative dose/s in a proper time window, and 716 (100%) had prophylaxis for extended duration. Overall conformity to the stated criteria for the evaluation of prescription’s parameters was not achieved in all prescriptions. Conclusions: In this setting, antibiotics were irrationally used and wound infection rate was high, and the situation calls for multiple interventions to correct the situation, through the activation of the infection control committee in the hospital and development of antimicrobial subcommittee to develop policies for the use and auditing of prophylactic antibiotics.
基金supported by The National Social Science Fund of China(No.15BRK023)
文摘Objective: The aim of this study was to explore the correlation between psychological resilience and social support and anxiety in obstetric nurses and to provide theoretical basis for improving the mental health of obstetric nurses.Methods: In this study, 190 obstetric nurses were included, using the general information questionnaire and The Connor-Davidson Resilience Scale(CD-RISC), Social Support Rating Scale, and survey of Self-evaluation of Anxiety Scale.Results: There are differences in the type of work and the score of psychological resilience(P<0.05), obstetric nurses’ resilience score was 65.58±10.65; self-rating anxiety score of obstetric nurses was 36.89±6.87; and social support score of obstetric nurses was44.3717.86. The psychological elasticity score and anxiety were negatively related(P<0.01), whereas the resilience score and total score of social support were positively related(P<0.01).Conclusions: Obstetric nurses have many responsibilities and stress. Nursing managers should focus on obstetric nurses’ mental health, lighten the obstetric nurses’ anxiety, and thus improve their mental flexibility and optimize the quality of nursing service better,with more passion into work.
