Journal articles on the topic 'Obstetric'
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Barreto, Tyler W., Aimee Eden, Elizabeth Rose Hansen, and Lars E. Peterson. "Opportunities and Barriers for Family Physician Contribution to the Maternity Care Workforce." Family Medicine 51, no. 5 (May 7, 2019): 383–88. http://dx.doi.org/10.22454/fammed.2019.845581.
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Background and Objectives: The number of family physicians providing obstetric deliveries is decreasing, but high numbers of new graduates report they intend to include obstetric deliveries in their practices. The objective of this study was to understand barriers to providing obstetrical care faced by recent family medicine residency graduates who intended to provide obstetrical care at graduation. Methods: Email surveys were sent to graduating family medicine residents who indicated intention to include obstetrics in their practice on the American Board of Family Medicine (ABFM) Certification Examination Registration Survey (2014-2016). We used descriptive and bivariate statistics to analyze the data. Results: Of our sample of 2,098 early career family physicians, 1,016 (48.4%) responded. Seven hundred (68.9%) currently include obstetrics in their practices. Those currently including obstetrics were more likely to practice in a small rural or isolated (15.4% vs 5.2% and 4.6% vs 1.7%, P<0.001) community and report credentialing was easy (85.2% and 26.5%, respectively, P<0.001). Physicians not currently including obstetrics in their practice reported “found a job without OB” and “lifestyle concerns” as the most significant barriers. Respondents living in the Middle Atlantic and West South Central regions were least likely to provide obstetric deliveries, with fewer than 50% doing so. Conclusions: Among recent graduates who intended to practice obstetrics, finding a job without obstetrics and lifestyle concerns were the most significant barriers to realizing the scope of practice they intended.
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Jamal, Shehla, Archana Mehta, Neerja Goel, Mayuri Ahuja, Naima Afreen, and Sweety Malik. "Obstetrics ICU admissions: challenges faced at a tertiary referral centre." International Journal of Reproduction, Contraception, Obstetrics and Gynecology 7, no. 5 (April 28, 2018): 1840. http://dx.doi.org/10.18203/2320-1770.ijrcog20181914.
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Background: Management of critically ill patients in obstetrics is a challenge owing to the changed physiology and unpredictability of the disease behaviour. Stratification strategy for early admission to obstetric ICU is imperative to reduce maternal morbidity and mortality. Due to lack of formal surveys regarding obstetrical ICU in our country, there is lack of precise national data on obstetrical ICU mortality. Aim of the present study was to estimate the obstetric ICU admission rate, to study the pattern of causative aetiology and to study the complications developed in ICU.Methods: The present study is a retrospective analytical study done in the Department of Obstetrics and Gynecology, from January 2015 to August 2017.Results: During the study period there were a total of 8466 obstetrical admissions, 2508 deliveries and 104 ICU admissions. Out of 104, analysis was done on 71 patients. Hypertensive disorders of the pregnancy were associated with maximum number of admissions (47.8%), followed by postpartum haemorrhage (12.6%). Maximum admissions were in postpartum period (63.4%). Anaemia was associated with 35.2% of the cases and it was closely followed by sepsis (28.2%). Mechanical ventilation was required for 30.9% of the patients.Conclusions: Hypertensive disorders of the pregnancy, haemorrhage and sepsis are the major risk factors for ICU admission in obstetric population.
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Savel'eva, G. M., E. Yu Bugerenko, and O. B. Panina. "PROGNOSTIC VALUE OF UTEROPLACENTAL CIRCULATION IMPAIRMENT IN 1ST TRIMESTER OF PREGNANCY IN PATIENTS WITH COMPLICATED OBSTETRIC HISTORY." Annals of the Russian academy of medical sciences 68, no. 7 (July 19, 2013): 4–8. http://dx.doi.org/10.15690/vramn.v68i7.704.
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One of the urgent problems of modern obstetrics is the early detection of irregularities in the development of the uteroplacental vessels system in patients with severe disorders in the history. Aim: to evaluate the predictive value of re-development of obstetric pathology on the basis of the uterine artery Doppler on 11–14 weeks of pregnancy. Patients and methods. 410 patients in I trimester of pregnancy were examined with fetal growth restriction, preeclampsia and/or fetal death and/or a history of preterm delivery were. The influence of physical factors and obstetric history on the state of uterine blood flow in the I trimester of pregnancy was studied. Results. The optimal Doppler indexes was calculated; a high predictive ability of the pulsation index in the uterine arteries with respect to pregnancy complications with early clinical manifestation, severe preeclampsia and combined obstetric complications was detected. Conclusions. Our data support the possibility of preclinical diagnosis of obstetrical complications in patients with complicated obstetric history.
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Ataide, Maryanne Machado, Amuzza Aylla Pereira Dos Santos, Jovânia Marques De Oliveira e Silva, and Maria Elisângela Torres de Lima Sanches. "EXAME OBSTÉTRICO REALIZADO PELA ENFERMEIRA: DA TEORIA À PRÁTICA." Enfermagem em Foco 7, no. 2 (August 10, 2016): 67. http://dx.doi.org/10.21675/2357-707x.2016.v7.n2.798.
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Objetivo: analisar o conhecimento e a prática da enfermeira acerca do exame físico obstétrico. Metodologia: pesquisa descritiva, quantitativa, realizada com 24 enfermeiras que atuam na assistência obstétrica em maternidades públicas da cidade de Maceió/ AL, no período de junho a agosto de 2014. Foi aplicado um questionário e, após essa etapa, realizada a análise descritiva dos dados. Resultados: o exame das mamas e a palpação obstétrica são as técnicas mais negligenciadas pela enfermeira durante a realização do exame obstétrico. As únicas técnicas realizadas unanimemente por elas são a medição da altura de Fundo de útero e o toque vaginal. Conclusão: o exame obstétrico realizado pela enfermeira ainda é subutilizado nas parturientes. As enfermeiras demonstram conhecimento sobre o assunto, porém a prática realizada não condiz com a teoria informada. Descritores: Enfermagem; Obstetrícia; Assistência; Gestante.EXAMINATION EXAM BY OBSTETRIC NURSE: FROM THEORY TO PRACTICEObjective: analyze the knowledge and practice nurse about obstetrical physical examination. Methodology: descriptive, quantitative research among 24 nurses working in maternity care in public hospitals of the city of Maceió/AL from June to August 2014. It was used a questionnaire containing demographic data, working time and knowledge exam. After this step was carried out a descriptive analysis of data. Results: The breast examination and obstetric palpation are the most neglected by nurses techniques while performing the obstetrical examination. The only techniques unanimously carried by them are Asao measuring the height of the uterus Fund and the vaginal ring. Conclusion: Obstetric examination performed by the nurse is still underused in pregnant women. Nurses demonstrate knowledge on the subject, but the practice performed dismissive informed theory.Descriptors: Nursing; obstetrics; assistance; pregnant.EXPLORACIÓN OBSTETRICA REALIZADO POR LA ENFERMERA DE LA TEORÍA A LA PRÁCTICAObjetivo: analizar el conocimiento y la práctica enfermera acerca de la exploración física obstétrica. Metodología: Estudio descriptivo, la investigación cuantitativa entre 24 enfermeras que trabajan en la atención de maternidad en los hospitales públicos de la ciudad de Maceió/AL de junio a agosto de 2014. Se utilizó un cuestionario que contiene datos demográficos, tiempo de trabajo y el conocimiento examen. Después de este paso se llevó a cabo un análisis descriptivo de dados. Resultados: El examen de las mamas y la palpación obstétrica son los más desatendidos por técnicas enfermeras mientras se realiza el examen de gravidez. Las únicas técnicas realizadas por unanimidad por ellos son Asao medir la altura del fondo del útero y el anillo vaginal. Conclusión: Examen obstétrico realizado por la enfermera todavía no se usa mucho en las mujeres embarazadas. Las enfermeras demuestran conocimiento sobre el tema, pero la práctica la teoría realizaron informado desdeñoso.Descriptores: Enfermería; Obstetricia; Asistencia; Mujer embarazada.
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Boonratsamee, Nattinee, Sutham Pinjaroen, and Chitkasaem Suwanrath. "Completeness of data record in the obstetric record form." Songklanagarind Medical Journal 35, no. 2 (May 25, 2017): 169. http://dx.doi.org/10.31584/smj.2017.35.2.699.
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Objective: To survey the completeness of obstetric data records.Material and Method: A survey study was conducted to determine the completeness of obstetric data records of women who delivered at Songklanagarind Hospital from January 1, to June 30, 2012 in the obstetric data record forms of the Statistical Unit, Department of Obstetrics and Gynecology, Faculty of Medicine, Prince of Songkla University. The data consisted of 5 parts including general information, obstetric history, pregnancy outcome, complications andoperative obstetrics with indications. Rates of completeness by recorders were calculated.Results: A total of 1,698 obstetric data records were evaluated. The overall rate of completeness was 10.1%. The rates of completeness of the general information (part 1), recorded by nurses, and the clinical part (parts 2 to 5), recorded by physicians, were 36.7% and 26.1%. The intern had the highest rate of completeness, followed by the extern and the resident.Conclusion: The rate of completeness of obstetric data records was low. The feedback report will be sent to theDepartment of Obstetrics and Gynecology to find out an appropriate strategy to improve quality of electronic databasefor future use in research and quality service management.
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Singh, Saddam, Ashish Pratap Singh, Anil Chouhan, and Ajay Patidar. "Prevalence of operative complications in obstetric and gynecological surgeries requiring interventions by a general surgeon and their associated risk factors: A retrospective study in a tertiary care hospital in Vindhya region." Asian Journal of Medical Sciences 13, no. 9 (September 1, 2022): 178–82. http://dx.doi.org/10.3126/ajms.v13i9.44060.
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Background: Surgical complications can occur in any surgery despite the best possible efforts, thereby affecting the prognosis. Gynecological and obstetric surgeries also result in some complications which require interventions by a general surgeon. These complications can be either causing hemodynamic instability, urinary tract injury, gastrointestinal tract injury, or infections. Aims and Objectives: The present study designed to identify and classify the various complication in obstetric and gynecological surgeries requiring interventions by a general surgeon and to correlate the various risk factors that predispose to these complications. Materials and Methods: The present retrospective study was conducted in the Department of Obstetrics and Gynecology and Department of Surgery, Shyam Shah Medical College and associated hospitals, Rewa, M.P., for 6 months from January 2021 to June 2021. Gynecological and obstetric surgeries resulting in complications requiring surgical intervention were identified and classified based on patients’ demographic characteristics, comorbidities, and type of complications. Results: A total of 1356 cases undergoing an obstetrical or gynecological procedure in the department of obstetrics and gynecology were studied. About 2.14% of the patients had some kind of intraoperative or post-operative complications, which required intervention by a general surgeon. The mean age of females having complications was 37.17±3.71 years. Overall the most common complication was surgical site infection with 48% of the total cases. Conclusion: In this present study, the incidence of surgical complications in obstetrical and gynecological surgeries, which is associated with higher morbidity postoperatively. These complications can be prevented by proper vigilance and surgical technique in high-risk patients.
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taprial, Mrs Rosie Taprial. "ASSESSMENT OF THE ATTITUDE TOWARDS PAINLESS DELIVERY AMONG ANTENATAL MOTHERS AT SELECTED HOSPITALS OF DISTRICT PATIALA, PUNJAB." GENESIS 8, no. 2 (June 10, 2021): 36–39. http://dx.doi.org/10.47211/tg.2021.v08i02.006.
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The true perspectives of painless labour came into existence with advancements over the last three decades as the birth of obstetric anaesthesia as a sub-speciality has cemented a permanent place in the field of obstetrics and anaesthesia. Advancements in obstetrical anaesthesia have shifted the previous focus from simply abolishing the labour pain to providing a quality labour analgesia with a minimal of side effects.
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Prasad, Dipali, Huma Nishat, Bhawana Tiwary, Swet Nisha, Archana Sinha, and Neeru Goel. "Review of obstetrical emergencies and fetal out come in a tertiary care centre." International Journal of Research in Medical Sciences 6, no. 5 (April 25, 2018): 1554. http://dx.doi.org/10.18203/2320-6012.ijrms20181467.
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Background: Obstetric emergencies can occur suddenly and unexpectedly. Obstetrics is unique in that there are two patients to consider and care for, a mother and a baby or fetus. Identification and referral of high risk pregnancies are an integral part of maternal and child health services. Timeliness and appropriateness can reduce the incidence of obstetric emergencies. Present study was carried out to know the incidence, nature and outcome of obstetric emergencies.Methods: Retrospective study of obstetric emergencies admitted to Obstetrics and Gynaecology department of Indira Gandhi Institute of Medical science, Patna from March 2015 to September 2017.Results: The common clinical presentation was Ectopic Pregnancy (19.64%), Heart Disease (16.64%), Abortion (13.69%), Severe Anaemia (16.66%), Purpureal Sepsis (9.52%), Sever pregnancy induced hypertension (3.57%), Eclampsia/ HELLP Syndrome (2.38%), Multiple Pregnancy (1.19%) Malignancy Disorder with Pregnancy (2.97%) and HIV in pregnancy (0.59%). Intervention done include Dilation and evacuation (13.69%), Caesarean section (28.57%), Vaginal delivery (22.62%), Caesarean Hysterectomy (2.38%), Exploratory Laparotomy (20.83%) and conservative management in (11.90%) of patients. Maternal outcome include shock due to rupture ectopic and post-partum (16.68%), Blood Transfusion done in (27.99%), Septicaemia (15.48%), ICU admission (8.92%), HDU (12.5%), Pulmonary oedema (6.54%), DIC (4.16%), CCF (3.57%), Ventilatory Support (1.78%) and Maternal Mortality (2.38%). Fatal outcome includes live birth (58.8%), NICU Admission (27.45%), Ventilatory Support (7.84%) and Neonatal mortality (5.88%).Conclusions: High risk pregnancy identification and proper antenatal, intranatal and postnatal care will reduce the incidence of obstetrical emergencies. Peripheral health care system need to be strengthen and early referral need to be implemented for better maternal and fetal outcome.
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Ville, Y. "From obstetric ultrasound to ultrasonographic obstetrics." Ultrasound in Obstetrics and Gynecology 27, no. 1 (December 22, 2005): 1–5. http://dx.doi.org/10.1002/uog.2690.
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Al.Kaaky, Nahla S. "Emergency obstetric hysterectomy: five years review at Al Sadaqa teaching hospital." University of Aden Journal of Natural and Applied Sciences 23, no. 2 (October 31, 2019): 511–20. http://dx.doi.org/10.47372/uajnas.2019.n2.a21.
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Emergency hysterectomy in obstetrics is rarely indicated and is always debatable. The aim of the study is to determine the incidence, sociodemographic factors, indications, maternal characteristics and maternal and perinatal outcome of emergency obstetric hysterectomy. This is a retrospective hospital based study of the cases of emergency obstetric hysterectomy performed over a period of 5 years from Jan 2014 to November 2018. A total of 55 cases of emergency obstetric hysterectomy (EOH) were studied in the Department of Obstetrics and Gynecology, in a Al-Sadaqa Teaching Hospital, Aden. During the study period there were 55 emergency obstetric hysterectomies and 33903 deliveries, giving an incidence of 0.16% or 1.6/1000. The majority of the cases were unbooked (36.4%). It was more common in multipara and grandmultipara (57.3%). Ruptured uterus (60.0%) , atonics postpartum hemorrhage (10.9%) and morbidly adherent placenta (9.1%) were the common indications. Subtotal hysterectomy was performed in 69.1% of the cases and total hysterectomy in the rest. The perinatal mortality was (67.0%), and the maternal mortality was 1.8%. Emergency obstetric hysterectomy is a lifesaving procedure. Uterine rupture, uterine atonia and morbid adherent placenta are the leading indications for emergency obstetric hysterectomy.
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Jain, Mahima, and Devanshi Dave. "A prospective study of indications and maternal outcome in case of emergency obstetric hysterectomy in a tertiary care hospital of Gujarat, India." International Journal of Reproduction, Contraception, Obstetrics and Gynecology 8, no. 3 (February 26, 2019): 912. http://dx.doi.org/10.18203/2320-1770.ijrcog20190856.
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Background: Obstetric hysterectomy was developed as a heroic operation arising out of necessity to control post-partum haemorrhage thereby reducing maternal mortality. The objectives of this study are to examine the incidence, indications, outcomes and complications of obstetric hysterectomy in a tertiary care hospital. It also aims to study the changing trends in incidence and indications in present day obstetric practice.Methods: This is a one-year study including 31 cases of obstetric hysterectomy performed in the Department of Obstetrics and Gynecology in a tertiary care hospital of Gujarat. Each case is analyzed, computed and tabulated as per standard proforma including clinical assessment, questionnaire, examination and investigations.Results: In present study 68% cases were in 21-30 years which is peak reproductive age. 55% patients were from rural areas and 52% cases were having three or more parity. The incidence of obstetric hysterectomy is 0.432% in both vaginal and cesarean deliveries i.e. 1 in 231 deliveries. Major indication for obstetric hysterectomy is morbidly adherent placenta 32% followed by atonic PPH 25.8% and ante partum hemorrhage in 22.58% due to increase in rate of cesarean sections. Most common complication is DIC and maternal mortality in around 16.12%.Conclusions: Obstetric hysterectomy is still a lifesaving surgery in modern day obstetrics. Quick decision for obstetric hysterectomy reduces maternal morbidity and mortality. Most of the morbidity is attributable to its indication and underlying disorder rather than the procedure itself.
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Habek, Dubravko, Goran Pavlović, and Anis Cerovac. "Pelvic packing in the treatment of severe postpartum posthysterectomiam hemorrhage." Česká gynekologie 87, no. 6 (December 23, 2022): 412–15. http://dx.doi.org/10.48095/cccg2022412.
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Introduction: Pelvic packing (PP) as a simple method of ”damage control surgery” in severe abdominopelvic hemorrhage in gynecological and obstetric surgery after emergency obstetrics or gynecological hysterectomy. Objective: To present the case of successful PP as a simple and effective method in refractory pelvic bleeding after emergent peripartum hysterectomy and severe obstetric shock with consumptive coagulopathy. Case report: Acording to laboratory findings and clinical condition in a 30-year-old (G2 P2) parturient, it was most likely an obstetric embolism with uterine rupture as the cause of severe postparum hemorrhage with disseminated intravascular coagulopathy and obstetrics hemorrhagic shock development in the described case. Pelvic packing after postpartum hysterectomy was the definitive minimally invasive and simple hemostatic procedure. Conclusion: The use of pelvic packing and obstetrics skills should be included in the protocol as a necessary, life-saving, and uncomplicated vital indication procedure. Key words: postpartum hemorrhage – obstetrics shock – emergency postpartum hysterectomy – pelvic packing
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Vasava, Dipti C., Rajal V. Thaker, Aditi A. Tyagi, and Foram P. Patel. "Analysis of transfusion of blood and blood products and their utilization pattern at department of obstetrics of tertiary care hospital." International Journal of Reproduction, Contraception, Obstetrics and Gynecology 9, no. 1 (December 26, 2019): 261. http://dx.doi.org/10.18203/2320-1770.ijrcog20196030.
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Background: In developing countries, nutritional anaemia and obstetric complications are leading causes of transfusion of blood and blood products. The study was aimed to analyse utilization pattern and to identify the indications of transfusion of blood and blood products in obstetrics and to study outcome and management of pregnancy in patients who required blood and/or blood products.Methods: This retrospective study was carried out at department of obstetrics of tertiary care teaching hospital from September 2018 to November 2018 and data was collected from all patients who had received transfusion of blood and/or blood products for any obstetric cause.Results: A total of 164(6.8%) patients received blood and blood products transfusion. Department of obstetrics utilized maximum units of blood and FFP whereas PRC utilization was second highest. There were 62(37.8%) of patients who had not taken any antenatal care, whereas 64(39.0%) patients had less than 4 antenatal visits. Three most common indications for transfusion of blood and blood products were 63.4% in nutritional anaemia, 17.1% in obstetric haemorrhage and 11.6% in first trimester complications.Conclusions: Three most common indications for transfusion were nutritional anaemia, obstetric haemorrhage and first trimester complications. Majority of patients had inadequate or no antenatal care. Early and regular antenatal care, early diagnosis and management of high-risk pregnancies and obstetric complications, institutional delivery can reduce the rate of transfusion of blood and blood products.
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Nimun, Kalista Ina Dai, Frederika Rambu Ngana, Ali Warsito, and Jehunias Leonidas Tanesib. "Modeling Accessibility to Emergency Obstetric Care in Mountain Region on Adonara Island, Eastern Indonesia." Journal of Applied Geospatial Information 6, no. 2 (December 2, 2022): 700–704. http://dx.doi.org/10.30871/jagi.v6i2.4522.
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The geographical conditions of an area influence accessibility problems. The difficult geographical conditions caused travel time to the location of the obstetric emergency center to be very long. One of the causes of the high maternal mortality rate in Eastern Indonesia is the long time to travel to Basic Emergency Obstetrics Cares. This study aims to model the travel time to the PONED-Pelayanan Obstetri Neonatal Emergensi Dasar (Basic Emergency Obstetric and Neonatal Care-BEmONC) in a mountain region. The difficulties in access to obstetric care could cause maternal mortality in mountain regions. This study was done on the island of Adonara in the Flores Timur district. Adonara Island has a high maternal mortality rate. Modeling accessibility used a raster-based model to model travel time. The data used Landsat 8 imagery, Digital Elevation Model (DEM), and road network data to obtain a land cover layer. The Saga GIS travel time calculation tool is used to calculate the accumulated cost of travel time. The cost is based on the speed of travel through each land cover pixel to the location of the Puskesmas Waiwerang (PONED 1) and Puskesmas Waiwadan (PONED 2). The results of the travel time modeling show that people living in five sub-districts reach the two PONED locations in ≥ 1 hour. The longest time for people to travel to PONED is ≥ 6 hours from Ile Boleng sub-district because there is a mountain in the Ile Boleng sub-district. The scenario of adding one PONED shows that only people living in two sub-districts reach the PONED ≥ 1 hour. This spatial modeling of travel time to the location of the PONED (emergency obstetric care) can be used by local governments in eastern Indonesia to improve access to the location of basic obstetric emergency health centers in mountain areas.
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Høgh, Stinne, Line Thellesen, Thomas Bergholt, Ane Lilleøre Rom, Marianne Johansen, and Jette Led Sorensen. "How often will midwives and obstetricians experience obstetric emergencies or high-risk deliveries: a national cross-sectional study." BMJ Open 11, no. 11 (November 2021): e050790. http://dx.doi.org/10.1136/bmjopen-2021-050790.
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ObjectiveTo estimate how often midwives, specialty trainees and doctors specialised in obstetrics and gynaecology are attending to specific obstetric emergencies or high-risk deliveries (obstetric events).DesignA national cross-sectional study.SettingAll hospital labour wards in Denmark.ParticipantsMidwives (n=1303), specialty trainees (n=179) and doctors specialised in obstetrics and gynaecology (n=343) working in hospital labour wards (n=21) in Denmark in 2018.MethodsCategories of obstetric events comprised of Apgar score <7/5 min, eclampsia, emergency caesarean sections, severe postpartum haemorrhage, shoulder dystocia, umbilical cord prolapse, vaginal breech deliveries, vaginal twin deliveries and vacuum extraction. Data on number of healthcare professionals were obtained through the Danish maternity wards, the Danish Health Authority and the Danish Society of Obstetricians and Gynaecologists. We calculated the time interval between attending each obstetric event by dividing the number of events occurred with the number of healthcare professionals.Outcome measuresThe time interval between attending a specific obstetric event.ResultsThe average time between experiencing obstetric events ranged from days to years. Emergency caesarean sections, which occur relatively frequent, were attended on average every other month by midwives, every 9 days for specialty trainees and every 17 days by specialist doctors. On average, rare events like eclampsia were experienced by midwives only every 42 years, every 6 years by specialty trainees and every 11 years by specialist doctors.ConclusionsSome obstetric events occur extremely rarely, hindering the ability to obtain and maintain the clinical skills to manage them through clinical practice alone. By assessing the frequency of a healthcare professionals attending an obstetric emergency, our study contributes to assessing the need for supplementary educational initiatives and interventions to learn and maintain clinical skills.
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Narang, Ridhi, Gurpreet K. Nandmer, and Rekha Sapkal. "Factors affecting post-operative wound gaping and their outcome in obstetrical and gynecological abdominal surgeries." International Journal of Reproduction, Contraception, Obstetrics and Gynecology 6, no. 4 (March 30, 2017): 1530. http://dx.doi.org/10.18203/2320-1770.ijrcog20171422.
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Background: Postoperative wound gaping is a very traumatic event both for patient and treating doctor as it adds economical and psychological burden to the patient and the family. This study was conducted with the aim to find out the various factors affecting postoperative wound gaping and their outcome in obstetrical and gynecological abdominal surgeries.Methods: This Retrospective observational study was carried out in the Department of Obstetrics and Gynecology at Peoples College of medical sciences and research Centre, Bhopal, India from 1st May 2014 to 31st October 2015.Results: A total of 1310 patients underwent major obstetrical and gynecological abdominal surgeries, out of which 29 cases developed postoperative wound gaping with the percentage being 2.2%. The rate was found to be higher among the emergency obstetric case (51.7%). Associated risk factors being anemia (72%), obesity (65%), hypoproteinemia (62%) and diabetes (52%) among gynecological surgeries and prolonged rupture of membranes (53%), emergency LSCS and previous LSCS (47%) among the obstetric cases. The common causative organism was found to be E. coli (28.5%) followed by acinetobacter and pseudomonas.Conclusions: Anemia, obesity, hypoproteinemia, diabetes, history of previous surgeries, emergency operations are the high risk factors for wound gaping in both obstetrics and gynecology surgeries. Correction of anemia, diabetes preoperatively, high protein diet and prevention of other risk factors like avoiding prolonged labor, use potent antibiotics in cases of rupture of membrane, timely intervention, provide well equipped wards with clean environment would be rewarding for better outcome of the surgery.
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Acquah, L., and R. Burton. "Obstetric medicine: Interlinking obstetrics and internal medicine." South African Medical Journal 104, no. 9 (July 29, 2014): 636. http://dx.doi.org/10.7196/samj.8724.
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Kung, Adrienne, and Stephen D. Pratt. "Patient Safety in Obstetrics and Obstetric Anesthesia." International Anesthesiology Clinics 52, no. 2 (2014): 86–110. http://dx.doi.org/10.1097/aia.0000000000000017.
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Stroganov, V. "Sterility of macerated fruits and aseptic cadaver for phantom operations." Journal of obstetrics and women's diseases 11, no. 11 (December 22, 2020): 1323–29. http://dx.doi.org/10.17816/jowd11111323-1329.
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When studying obstetrics, a good obstetric phantom is of no small importance as a teaching aid. Teaching operational obstetrics is unthinkable even without it, since one reading cannot be so imprinted in the minds of listeners as the direct application of one or another technique by themselves, and one has to reckon with a number of details, like at the bedside of a woman in labor. No matter how great the clinic is, a number of obstetric operations, due to the rarity of their use, remains unseen by the majority of those involved. I will point out, for example, the operation spondylotomia, evisceratio, decapitatio, the imposition of forceps on the head when presenting the face, etc. That is why the obstetric phantom is an inevitable companion of the study of obstetrics. Recently, a number of improvements have been proposed in this direction. So ex. Schwabe arranged a device with a variable pelvis, on which you can get a normal and narrow pelvis.
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Iskandar. "Characteristics of Obstetric Patients at RSU Cut Meutia North Aceh During the 2020 Covid-19 Pandemic." Britain International of Exact Sciences (BIoEx) Journal 3, no. 3 (September 28, 2021): 159–71. http://dx.doi.org/10.33258/bioex.v3i3.497.
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Obstetrics is a medical science that specializes in the study of pregnancy and childbirth. This includes the process before during and after a woman gives birth. The scope of obstetrics includes, antepartum bleeding, postpartum hemorrhage, preterm pregnancy problems, complications in vaginal delivery, pregnancy with gastrointestinal disorders, hypertension in pregnancy, bleeding in the external and internal genitalia, and other diseases. Abortion was the most common disease group in this study, which was 71.4%. Abortion is the termination of pregnancy before the fetus can live outside the uterus at the age of <20 weeks or weight <500 grams. The incidence of abortion is roughly estimated to be 15-20% and 80% occur in the first trimester. This research is a descriptive study with the research design used is a cross-sectional study conducted in the Obstetrics Inpatient Room at the Cut Meutia Hospital, North Aceh. The study was carried out in June 2021 with a population and sample of all patients in the Obstetric Inpatient Room at the Cut Meutia Hospital, North Aceh in 2020. The variables of this study were types of obstetric diseases based on the size group. Univariate analysis was used to describe the characteristics of the types of obstetric diseases that existed in the Obstetric Inpatient Room at the Cut Meutia Hospital North Aceh in 2020. The patients treated in the Obstetric Inpatient Room at the Cut Meutia Hospital North Aceh in 2020 were 244 patients. The percentage of antepartum bleeding was the highest group of diseases in the Obstetrics Inpatient Room at RSU Cut Meutia in 2020, while post-partum bleeding and bleeding in the external and internal genitalia were the least group of diseases. The second most common disease in the Cut Meutia General Hospital in 2020 was hyperemesis gravidarum, then premature rupture of membranes, followed by retained placenta, blighted ovum and preeclampsia.
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Ahirwar, Neetu, and Rekha Wadhwani. "Analysis of obstetrics hysterectomy in tertiary care centre." International Journal of Reproduction, Contraception, Obstetrics and Gynecology 7, no. 6 (May 26, 2018): 2192. http://dx.doi.org/10.18203/2320-1770.ijrcog20182318.
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Background: Emergency peripartum hysterectomy (EPH) is an uncommon obstetric procedure, usually performed as a life-saving measure in cases of intractable obstetric hemorrhage. Obstetrics hysterectomy is performed on gravid uterus during pregnancy labor puerperium. It is a catastrophic inevitable lifesaving emergency procedure in cases of rupture uterus, uncontrollable post-partum haemorrhage, morbidly adherent placenta, and some cases of trauma, sever infection of pregnant uterus. Newer drug like prostaglandins, antibiotics and blood transfusion has brought down the incidence of obstetric hysterectomy.Methods: This retrospective study is performed in department of obstetrics and gynaecology SZH Gandhi medical college Bhopal. Retrospective analysis of record done.Results: In this study there were 51867 deliveries and 99 0bstetric hysterectomy giving the incidence as 1 in 524 deliveries. There were 17113 cesarean section performed hence the incidence as 1 in 173 cesaren section. Majority of patient belong to group para 4 and above i.e. 32.32%. Least incidence is among nullipara patient i.e. 2.02%. The most common indication of obstetric hysterectomy in this study was morbidly adherent placenta, 52 cases i.e. 52.52%% Rupture uterus was second common indication accounting for 36.36% of cases. Most common additional surgical procedure done during obstetric hysterectomy was repair of bladder tear and salpingoophrectomy done in 7 cases i.e. 7.07% of each. Repair of bowel injury done in 1 case i.e. 1.01%.Conclusions: Incidence of maternal mortality in cases of obstetric hysterectomy was 9.09%. most common cause of maternal mortality was haemorrhagic shock accounting for 55.55.
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Tsvelev, Y. V. ""Journal of Obstetrics and Women's Diseases". Yesterday. Today. Tomorrow." Journal of obstetrics and women's diseases 46, no. 1 (November 15, 1997): 4–5. http://dx.doi.org/10.17816/jowd80465.
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In domestic obstetrics and gynecology, the last quarter of the 19th century occupies a special place: the first obstetric-gynecological society in Russia appeared in St. Petersburg (03.03.1886) and the first domestic "Journal of Obstetrics and Women's Diseases" began to be published (trial issue was published on December 11 .1886). The initiator of the creation of the journal was the chairman of the St. Petersburg obstetric-gynecological society, professor A.Ya. Krassovsky, who believed that "society needs to have its own printed organ like a collection or a magazine, which would contain not only the works of society, but in general the work of domestic figures in obstetrics and gynecology ...".
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Annicchino, Giuliana, Helena Malvezzi, Carla de Azevedo Piccinato, and Sérgio Podgaec. "Is there an Increased Risk for Unfavorable Obstetric Outcomes in Women with Endometriosis? An Evaluation of Evidences." Revista Brasileira de Ginecologia e Obstetrícia / RBGO Gynecology and Obstetrics 42, no. 04 (April 2020): 200–210. http://dx.doi.org/10.1055/s-0040-1708885.
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Abstract Objective The present study is a systematic review of the literature to assess whether the presence of endometriosis determines or contributes to adverse obstetric outcomes. Data Sources The present work was carried out at the Hospital Israelita Albert Einstein, São Paulo, state of São Paulo, Brazil, in accordance to the PRISMA methodology for systematic reviews. A review of the literature was performed using PubMed, Web of Science and Scopus databases. The keywords used were: pregnancy outcome, pregnancy complications, obstetrical complications, obstetrics, obstetric outcomes and endometriosis. The survey was further completed by a manually executed review of cross-referenced articles, which was last performed on November 30, 2018. Selection of studies The survey disclosed a total of 2,468 articles, published from May 1946 to October 2017. A total of 18 studies were selected to be further classified according to their quality and relevance. Data Collection The Newcastle–Ottawa Quality Assessment Scale was used for classification. Five studies of greater impact and superior evidence quality and 13 studies of moderate evidence quality were selected. We analyzed the studies for the characteristics of their patients plus how endometriosis was diagnosed and their respective obstetric outcomes taking into account their statistical relevance. Data Synthesis Analyses of the higher impact and better quality studies have shown high incidence of preterm birth and placenta previa in patients with endometriosis. Conclusion Placenta previa and preterm birth are the most statistically significant outcomes related to endometriosis, as indicated by our systematic review. The present information is useful to alert obstetricians and patients about possible unfavorable obstetric outcomes.
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Samal, Sunil Kumar, Setu Rathod, and Kalaivani Thangavel. "A retrospective study of urological injuries during obstetrics and gynecological procedures." International Journal of Reproduction, Contraception, Obstetrics and Gynecology 9, no. 7 (June 25, 2020): 2746. http://dx.doi.org/10.18203/2320-1770.ijrcog20202563.
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Background: Urological injury in obstetrics and gynaecology are not uncommon because there is a close anatomical association between reproductive and urological system. The objective of this study was to find out the incidence and types of urological injuries in obstetric and gynaecological procedures, clinical presentation and various management option in a tertiary care hospital.Methods: The study was a retrospective analysis of all obstetric and gynecological surgeries over a period of 6 years from January 2014 to December 2019. Cases with the documented urological injuries during these procedures were analyzed further.Results: Total 8595 patients had undergone different obstetrics and gynecology procedures, out of which 5429 were obstetrics and 3166 were gynecology surgeries. Out of 3166 of gynecology procedures, there were 16 cases (0.5%) of bladder injuries and one case (0.03%) of ureteric injury. Out of 5429 cases of obstetric procedures there were 11 (0.2%) cases of bladder injury and one case (0.01%) of ureteric injury.Conclusions: The incidence urological injuries during obstetrics and gynecological procedures are rare but the morbidity associated these are significant. Therefor surgeons should be more cautious and high degree of suspicion can help in early diagnosis and avoid the sequel.
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Harper, Alice M., Elizabeth Wastnedge, Aparajithan Sivanathan, Aileen Jordan, Samuel Harper, Theodore Lim, and Fiona C. Denison. "Virtual reality as a distraction therapy in obstetrics and gynaecology." BMJ Innovations 7, no. 3 (May 14, 2021): 556–63. http://dx.doi.org/10.1136/bmjinnov-2019-000412.
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BackgroundVirtual reality (VR) is an effective distraction therapy across a variety of healthcare settings but there is minimal research on its potential applications within obstetrics and gynaecology.AimTo explore the acceptability and preferences for VR as distraction therapy within obstetrics and gynaecology.MethodsQuestionnaires were developed and administered to seek both obstetric and gynaecology women’s and staff members’ opinions on VR use within clinical settings and hardware and software options. Likert scales were used to explore opinions on VR. Data were analysed by descriptive statistics.Results247 questionnaires were completed (90 obstetric and 157 gynaecology). On average 57% of women and 75% of staff felt positively about trialling VR within obstetric and gynaecology clinical settings. For hardware, glasses were the preferred head equipment but there were no clear preferences for image viewing. For software, ‘beach’ was the most popular environment and accompanying audio favoured. Women’s and staff members’ opinion on complete immersion was largely negative.ConclusionsThere is wide acceptability for VR within obstetrics and gynaecology. Differing opinions for specific hardware and software preferences prompts consideration of clinical settings, end-users and healthcare professionals in the design of future VR technologies and clinical trials for obstetrics and gynaecology.
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Behera, Ritanjali, and Bibekananda Rath. "Emergency obstetric hysterectomy: a two-year observational study at tertiary care center in Berhampur, Odisha, India." International Journal of Reproduction, Contraception, Obstetrics and Gynecology 8, no. 12 (November 26, 2019): 4695. http://dx.doi.org/10.18203/2320-1770.ijrcog20195202.
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Background: Emergency obstetric hysterectomy is an unequivocal marker of severe maternal morbidity and, in many respects, the treatment of last resort for rupture uterus, severe postpartum hemorrhage (PPH) and other such life-threatening conditions. In no other gynaecological or obstetrical surgery is the surgeon in as much a dilemma as when deciding to resort to an emergency hysterectomy. On one hand it is the last resort to save a mother’s life, and on the other hand, the mother’s reproductive capability is sacrificed. This study is conducted with an aim to determine the frequency, demographic characteristics, indications, and feto-maternal outcomes associated with emergency obstetric hysterectomy in a tertiary care centre.Methods: We conducted a prospective, observational, and analytical study over a period of two years, from September 2017 till September 2019. A total of 56 cases of emergency obstetric hysterectomy (EOH) were studied in the Department of Obstetrics and Gynecology, MKCG Medical College, Berhampur.Results: The incidence of EOH in our study was 12 following vaginal delivery and 44 following caesarean section. The overall incidence was 56 per 21,128 deliveries. Uterine rupture (37.5%) was the most common indication followed by atonic postpartum hemorrhage (25%) and placenta accrete spectrum (10.7%). The most frequent sequelae were febrile morbidity (25.7%) and disseminated intravascular coagulation (21.4%). Maternal mortality was 17.1% whereas perinatal mortality was 51.7%.Conclusions: A balanced approach to EOH can prove to be lifesaving at times when conservative surgical modalities fail and interventional radiology is not immediately available. Our study highlights the place of extirpative surgery in modern obstetrics in the face of rising rates of caesarean section and multiple pregnancies particularly in urban settings in developing countries.
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Stumbar, Sarah E., Suzanne Minor, and Marquita Samuels. "A Prenatal Standardized Patient Experience for Medical Students on Their Family Medicine Clerkship." Family Medicine 50, no. 5 (May 2, 2018): 376–79. http://dx.doi.org/10.22454/fammed.2018.826159.
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Background and Objectives: Students on their family medicine clerkship at Herbert Wertheim College of Medicine get little clinical exposure to obstetric care, which is not commonly provided by family physicians in urban settings. To address this, we added to our clerkship didactic curriculum a 2-hour session involving a standardized patient (SP). The SP is collectively interviewed by the student group during four simulated prenatal visits, each of which present a different complication of pregnancy. The goal of this study was to evaluate the students’ perception of this session’s utility, the session’s ability to increase student self-confidence regarding obstetric issues, and perceived relevance of obstetrics to family medicine. Methods: During the 2016-2017 academic year, we evaluated this educational intervention using anonymous, immediate postsession surveys containing both Likert scale and open-ended questions. Qualitative answers were analyzed using a thematic analysis approach, with development of a codebook by consensus. Results: Students overwhelmingly found this session to be pertinent to their learning needs and reported an increase in their self-confidence level regarding obstetrical care. Continuity of care, comprehensive care, and an emphasis on health prevention were identified themes relating how obstetrics embodies the principles of family medicine. Conclusions: We developed this prenatal standardized patient experience to expose our clerkship students to full-spectrum family medicine, including primary care obstetrics. Our data suggests that this session increased students’ self-confidence with obstetrics management, filled in gaps in their clinical exposure to full-spectrum family medicine, and addressed a perceived learning need.
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Kozhimannil, Katy B., Julia D. Interrante, Mariana S. Tuttle, Carrie Henning-Smith, and Lindsay Admon. "Characteristics of US Rural Hospitals by Obstetric Service Availability, 2017." American Journal of Public Health 110, no. 9 (September 2020): 1315–17. http://dx.doi.org/10.2105/ajph.2020.305695.
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Objectives. To describe characteristics of rural hospitals in the United States by whether they provide labor and delivery (obstetric) care for pregnant patients. Methods. We used the 2017 American Hospital Association Annual Survey to identify rural hospitals and describe their characteristics based on the lack or provision of obstetric services. Results. Among the 2019 rural hospitals in the United States, 51% (n = 1032) of rural hospitals did not provide obstetric care. These hospitals were more often located in rural noncore counties (counties with no town of more than 10 000 residents). Rural hospitals without obstetrics also had lower average daily censuses, were more likely to be government owned or for profit compared with nonprofit ownership, and were more likely to not have an emergency department compared with hospitals providing obstetric care (P for all comparisons < .001). Conclusions. Rural US hospitals that do not provide obstetric care are located in more sparsely populated rural locations and are smaller than hospitals providing obstetric care. Public Health Implications. Understanding the characteristics of rural hospitals by lack or provision of obstetric services is important to clinical and policy efforts to ensure safe maternity care for rural residents.
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Miranda, Denismar Borges, Maria Eliane Liégio Matão, Pedro Humberto Faria Campos, Jeanne Teixeira Soares, Kátia Mara Sales Moreira, and Letícia Dos Santos Campos. "Factors leading to stress in the nursing obstetric area." Revista de Enfermagem UFPE on line 5, no. 4 (May 30, 2011): 901. http://dx.doi.org/10.5205/reuol.1302-9310-1-le.0504201107.
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ABSTRACTObjective: to describe the triggers of stress in nurses of the obstetrics. Method: this is a descriptive study, from qualitative approach, carried out after approved by the Ethics Committee of the Catholic University of Goiás (protocol number 0523/07), from a field research with the nurses working at least one year in the environment of two obstetric institutions, a philanthropic hospital in the capital city and a public hospital. An interview was open at depth, where treatment was received content analysis. Results: there was only the participation of female works with long experience in obstetrics minimum of two years. Four categories: Administrative functions, working conditions, welfare activities and satisfactory activities. Conclusions: the performance of daily activities performed by nurses in obstetric units has the greatest source of suffering, whether physical or psychic, the performance of certain administrative functions and welfare considered unsatisfactory due to inadequate working conditions. But although the contours of some psycho-emotional distress, symbolically, the nurses feel rewarded because of the actions linked to the birth of new lives. Possibly, the performance by specialists to work with specific issues and bureaucratic-administrative sphere of care can minimize the stress of working in obstetrics. Descriptors: burnout professional; nursing; obstetrical nursing.RESUMOObjetivo: descrever os fatores desencadeantes de stress em enfermeiros da área obstétrica. Método: trata-se de estudo descritivo, com abordagem qualitativa, realizado após ser aprovado pelo Comitê de Ética em Pesquisa da Pontifícia Universidade Católica de Goiás (protocolo número 0523/07), a partir de uma pesquisa de campo junto a enfermeiros com atuação de no mínimo um ano no ambiente obstétrico de duas instituições, um hospital filantrópico da capital e uma maternidade pública municipal. Utilizou-se entrevista aberta em profundidade, cujo tratamento recebido foi análise de conteúdo. Resultados: verificou-se a participação única de trabalhadoras mulheres com tempo de experiência mínimo na área obstétrica de dois anos. Emergiram quatro categorias: Funções administrativas, Condições de trabalho, Atividades assistenciais e Atividades satisfatórias. Conclusão: o desempenho das atividades diárias realizadas por enfermeiras em unidades obstétricas tem como fonte de maior sofrimento, seja físico ou psíquico, o desempenho de certas funções administrativas e assistenciais consideradas insatisfatórias devido às inadequadas condições de trabalho. Mas, apesar dos contornos de algum sofrimento psicoemocional, simbolicamente, as enfermeiras sentem-se recompensadas em razão da atuação vinculada ao nascimento de novas vidas. Possivelmente, o desempenho por profissionais especializados e específicos para atuar junto às questões burocrático-administrativas e esfera assistencial possa minimizar o estresse do trabalho obstétrico. Descritores: esgotamento profissional; enfermagem; enfermagem obstétrica. RESUMENObjetivo: describir los factores desencadenantes del estrés en las enfermeras de la obstetricia. Método: que es el enfoque descriptivo, cualitativo, realizado después de aprobado por el Comité de Ética de la Universidad Católica de Goiás (número de protocolo 0523/07), a partir de una investigación de campo con las enfermeras que trabajan al menos una años en el medio ambiente obstétrica de dos instituciones, un hospital filantrópico de la ciudad capital y en un hospital. Una entrevista fue abierta en profundidad, donde se recibe el tratamiento de análisis de contenido. Resultados: hubo sólo la participación de las mujeres trabajadoras con una larga experiencia en obstetricia mínimo de dos años. Cuatro categorías: las funciones administrativas, las condiciones de trabajo, el actividades bienestar y actividades satisfactoria. Conclusiones: la realización de las actividades diarias realizadas por los enfermeros en las unidades obstétricas tiene la mayor fuente de sufrimiento, ya sean físicos o psíquicos, el desempeño de ciertas funciones administrativas y de bienestar considera insatisfactorio, debido a condiciones de trabajo inadecuadas. Sin embargo, aunque los contornos de algunas dificultades psico-emocional, simbólicamente, las enfermeras se sienten recompensados por las acciones relacionadas con el nacimiento de una nueva vida. Posiblemente, el desempeño por parte de especialistas para trabajar con temas específicos y la esfera burocrático-administrativa de la atención puede reducir al mínimo el estrés de trabajar en obstetricia. Descriptores: agotamiento profesional; enfermería; enfermería obstétrica.
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Barreiros, Michele de Pinho, Hanna Ariane Monteiro Carrera, Elisângela da Silva Ferreira, Maria Elizabete de Castro Rassy, Regina Racquel dos Santos Jacinto, Carla Monique Lavareda Costa, Luiza Karla Alves de Paula, et al. "The use of technology in the classification of obstetric risk: An integrative literature review." International Journal of Advanced Engineering Research and Science 9, no. 9 (2022): 230–36. http://dx.doi.org/10.22161/ijaers.99.22.
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Objective: To analyze from scientific productions how technology with the insertion of Modified Obstetric Alert Scores (MEOWS) can support the health professional responsible for carrying out the reception and risk classification in obstetrics in maternity hospitals. Method: This is an integrative literature review that selected 20 articles in the MEDLINE, LILACS, SciELO and PUBMED databases, which were analyzed and the inclusion criteria applied: articles available in full, published in Portuguese, English and Spanish, that answered the research question. Results: The selected articles were grouped into thematic categories, 1) Nurse's role in welcoming with Obstetric Risk Classification; 2) Insertion of the Modified Obstetric Warning Scoring System (MEOWS) in the Obstetric Urgency and Emergency Unit; 3) Technology and its contribution to Nursing Care. Final considerations: The technology offers a better guarantee for patient safety, as it allows intervention and quick access to the obstetric care needed in the face of the evidenced risk.
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Castro, Roberto, and Sonia M. Frías. "Obstetric Violence in Mexico: Results From a 2016 National Household Survey." Violence Against Women 26, no. 6-7 (April 8, 2019): 555–72. http://dx.doi.org/10.1177/1077801219836732.
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Obstetric violence has not received the same amount of interest as other forms of violence against women (VAW). We assess the prevalence and factors associated with experiences of obstetric violence (obstetric abuse and violence, and nonconsensual care) among women between 15 and 49 years of age in their latest childbirth within the last 5 years by using the 2016 National Survey on Household Relationship Dynamics. ( N = 24,126 women). A total of 33.3% of Mexican women experienced obstetrical violence in their last childbirth: 23.6% experienced obstetric abuse and violence and 17.1% nonconsensual care. Gender interacts with other social stratification variables. Obstetric violence is an extended practice in health care services. It is a human rights problem that must be prevented and eradicated.
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Lee, Lorri A., Karen L. Posner, Karen B. Domino, Robert A. Caplan, and Frederick W. Cheney. "Injuries Associated with Regional Anesthesia in the 1980s and 1990s." Anesthesiology 101, no. 1 (July 1, 2004): 143–52. http://dx.doi.org/10.1097/00000542-200407000-00023.
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Background The authors used the American Society of Anesthesiologists Closed Claims Project database to identify specific patterns of injury and legal liability associated with regional anesthesia. Because obstetrics represents a unique subset of patients, claims with neuraxial blockade were divided into obstetric and nonobstetric groups for comparison. Methods The American Society of Anesthesiologists Closed Claims Project is a structured evaluation of adverse anesthetic outcomes collected from closed anesthesia malpractice insurance claims of professional liability companies. An in-depth analysis of 1980-1999 regional anesthesia claims was performed with a subset comparison between obstetric and nonobstetric neuraxial anesthesia claims. Results Of the total 1,005 regional anesthesia claims, neuraxial blockade was used in 368 obstetric claims and 453 of 637 nonobstetric claims (71%). Damaging events in 51% of obstetric and 41% of nonobstetric neuraxial anesthesia claims were block related. Obstetrics had a higher proportion of neuraxial anesthesia claims with temporary and low-severity injuries (71%) compared with the nonobstetric group (38%; P <or=0.01) and a lower proportion of claims with death or brain damage and permanent nerve injury compared with the nonobstetric group (P <or= 0.01). Cardiac arrest associated with neuraxial block was the primary damaging event in 32% of obstetric and 38% of nonobstetric neuraxial anesthesia claims involving death or brain damage. Eye blocks accounted for 5% of regional anesthesia claims. Conclusion Obstetric claims were predominately associated with minor injuries. Permanent injury from eye blocks increased in the 1990s. Neuraxial cardiac arrest and neuraxial hematomas associated with coagulopathy remain sources of high-severity injury.
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Gurung, BS, Y. Dongol, and H. Tuladhar. "Condom Tamponade in the Management of Massive Obstetric Hemorrhage: An Experience at a Teaching Hospital." Nepal Journal of Obstetrics and Gynaecology 9, no. 1 (September 28, 2014): 41–47. http://dx.doi.org/10.3126/njog.v9i1.11187.
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Aims:This study evaluates the effectiveness of condom tamponade in the management of massive obstetric hemorrhage. Methods: This hospital based prospective descriptive study was done in the department of obstetrics and gynecology of KIST Medical College Teaching Hospital, Lalitpur, Nepal from January 2013 to December 2013. During the study period, patients with obstetric hemorrhage(>500ml blood loss) were identified and the details of the patient and their treatment were acquired. Data analysis was done by descriptive statistics using mean, median and frequency cross tabulations. The decision for condom tamponade was made when active continuous hemorrhage persisted despite of initial conservative measures. Results: Among 39 patients of obstetric hemorrhage out of 1522 deliveries, eight were managed by condom tamponade which includes 6 postpartum hemorrhage cases, 1 incomplete abortion case and 1 antepartum case managed prophylactically in anticipation of postpartum hemorrhage. Conclusions: Despite of the small study sample, the study concludes the use of condom tamponade as an effective means of controlling massive obstetrical hemorrhage due to uterine atony (both in post partum and post abortion cases). It is safe, easily available, inexpensive, minimally invasive, does not require anesthesia, easy to use and can be performed by any level of health personnel with some training. DOI: http://dx.doi.org/10.3126/njog.v9i1.11187 NJOG 2014 Jan-Jun; 2(1):41-47
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Kodla, Chandrika S. "A study of prevalence, causes, risk factors and outcome of severe obstetrics haemorrhage." Journal of Scientific and Innovative Research 4, no. 2 (April 25, 2015): 83–87. http://dx.doi.org/10.31254/jsir.2015.4207.
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Severe obstetric hemorrhage is the most feared obstetric emergency that can occur to any woman at childbirth. If unattended, the hemorrhage can kill even a healthy woman. The Hemorrhage accounts for nearly one-quarter of all maternal deaths and for almost half of all postpartum deaths in low-income countries. The most common type of obstetric hemorrhage is postpartum hemorrhage (PPH), mainly primary. PPH occurring within 24 h postpartum. Primary PPH is the focus of this article. This was a cross sectional observational study conducted in a Tertiary care hospital conducted from November 2010 to June 2012 having high no of referrals from city as well as periphery. The cross tabulations were used to study the demographic, obstetrical and medical factors in women with severe obstetrical haemorrhage. Total number of patients admitted in labour room was 12,800 and 12,356 patients delivered during this period. Results showed that severe obstetrical haemorrhage (more than 1500 ml) was in 115 patients (prevalence of 0.9%). The prevalence of severe obstetric haemorrhage was 0.9 %. As 85.2% 0f the patients in study were unbooked, it contributed the high prevalence rate & antenatal care. A large proportion of the patients (62%) were multipara. Mortality in this study was 21.73% and morbidity was 78.26%. Most common cause of obstetric haemorrhage in this study was uterine atonic pph. The frequency and impact of severe hemorrhage can be effectively reduced by reducing avoidable risk factors, especially those related to obstetric interventions as increased Caesarean section rate and induction of labor. Other risk factors not amenable to change such as age, ethnic origin, and preexisting medical diseases or bleeding disorders can be minimized by extra vigilance and planned conjoined management.
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Sivakumar, Sudha, Sophia G. Xavarina, and Ashmitaa Srianand. "Maternal death audit at tertiary care centre: changing trends." International Journal of Reproduction, Contraception, Obstetrics and Gynecology 10, no. 3 (February 24, 2021): 915. http://dx.doi.org/10.18203/2320-1770.ijrcog20210707.
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Background: The aim of the study was to analyse the trend in maternal mortality ratio in a tertiary care centre.Methods: This was a four-year retrospective analysis of maternal deaths that occurred at Government Rajaji Hospital, Department of Obstetrics and Gynaecology, Madurai from January 2017 to December 2020. Cases were stratified based on cause of death. Epidemiological data was collected from the hospital register.Results: The total number of maternal deaths at GRH during the study period is 228, in which death due to obstetric cause was 82 (36%) and non-obstetric cause was 146 (64%). The most common cause in each year was PIH (23%-2017, 29%- 2018), heart disease (22%- 2019) and infection (46%- 2020).Conclusions: We concluded by this study that the maternal death due to non-obstetric causes were more than the obstetric causes due to improved antenatal, post-natal care, institutionalized deliveries and timely referral to the CEmONC (comprehensive emergency obstetric and new-born care) centres and management.
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Ghosh, Abantika, Suchita Mandal, Somasree Gharami, and Pritilata Show. "Fetomaternal outcomes of emergency obstetric hysterectomy in a tertiary care teaching hospital in eastern India: A prospective study." Indian Journal of Obstetrics and Gynecology Research 9, no. 4 (November 15, 2022): 532–36. http://dx.doi.org/10.18231/j.ijogr.2022.101.
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To evaluate frequency, indications, demographic characters and the fetomaternal outcomes of emergency obstetric hysterectomy in a tertiary care teaching hospital in Eastern India. Prospective, unicentric study. Records of all cases undergoing emergency obstetric hysterectomy in the emergency operation theatre of department of obstetrics and gynecology during the study period were analyzed as per required variables and data was processed to evaluate the results.: A total 22 obstetric hysterectomies were carried out during the study period, 7 (31.81%) cases following vaginal delivery and 15 (68.18%) cases during or following caesaren section. The incidence of obstetric hysterectomy was 0.63 per thousand deliveries. The mean age of the subjects was 26.81 ± 1.11 years. Placenta accreta spectrum was the most frequent indication for obstetric hysterectomy (36.36%). Hypotension requiring the use of vasopressors (77.27%) was the commonest complication faced by the subjects. Mortality rate amongst the subjects was 9.09%. Fetal outcomes were varied. 68.18% of the newborns were healthy. The mortality rate among the newborns was 9.09%.
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Saha, R., and P. Gautam. "Obstetric Emergencies: Feto-maternal Outcome at a Teaching Hospital." Nepal Journal of Obstetrics and Gynaecology 9, no. 1 (September 28, 2014): 37–40. http://dx.doi.org/10.3126/njog.v9i1.11186.
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Aims: This study was done to know the pattern of obstetric emergencies and its influence on maternal and fetal outcome. Methods: A descriptive study was carried out in the department of obstetrics and gynecology at Kathmandu Medical College Teaching Hospital from 1st June 2013 to 31st May 2014. Cases were categorized as early pregnancy emergencies (ruptured ectopic pregnancy, complications of abortion), ante-partum emergencies and intra-partum emergencies (antepartum haemorrhage, preeclampsia, eclampsia, preterm prelabor rupture of membranes, rupture uterus), post-partum emergencies (postpartum haemorrhage, retained placenta, placenta accreta, uterine inversion), puerperal emergencies (postpartum sepsis), fetal emergencies (cord prolapse, shoulder dystocia). Outcome noted were type of emergency, obstetric intervention done, maternal and perinatal morbidity and mortality. Results: A total of 80 (4.45%) obstetric emergencies occurred among 1796 deliveries .The most common obstetric emergencies were obstetric hemorrhage (62.5%), severe preeclampsia (23.5%) and preterm prelabor rupture of membranes (10%). The obstetric interventions done were cesarean section (43.75%), exploratory laparotomy (33.75%) and blood transfusion (40%). Obstetric emergencies were responsible for 66.6% of total maternal death and 24.56% of total perinatal death. Conclusions: In spite of best efforts, some obstetric emergencies do occur. Obstetric hemorrhage and severe preeclampsia are the frequent obstetric emergencies. Cesarean section, exploratory laparotomy and blood transfusion were the commonly performed interventions. A better outcome can be achieved by national policy of promoting utilization of antenatal care, institutional deliveries, skilled birth attendance at delivery, liberal blood transfusion and regular training of doctors and nurses. DOI: http://dx.doi.org/10.3126/njog.v9i1.11186 NJOG 2014 Jan-Jun; 2(1):37-40
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Moray, Arun P., Urmila A. Moray, Vaishali M. Patil, and Grishma A. Moray. "Changing trends in the indications of obstetric hysterectomies in teaching rural hospital." International Journal of Reproduction, Contraception, Obstetrics and Gynecology 7, no. 8 (July 26, 2018): 3184. http://dx.doi.org/10.18203/2320-1770.ijrcog20183314.
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Background: Obstetric hysterectomy (OH) still remains lifesaving procedure. OH still poses a major obstetrical morbidity in the developing world due to lack of human, infrastructural and monetary resources. Irrespective of attempts like good antenatal care and delivery planning in modern obstetrics to prevent major obstetric complications; unfortunately, OH needs to be performed at times even today. The aim of present study was to determine the changes in the indications of obstetric hysterectomy.Methods: A retrospective review based on hospital data of all the patients’ records subjected to OH from January 1994 to September 2001 (Gr. A) and from January 2006 to December 2015 (Gr. B) was done and analyzed for incidence and changing trends in the indications.Results: The incidence of OH during two periods from January 1994 to September 2001 (Group A) and from January 2006 to December 2015 (Group B) in the Department of Obstetrics and Gynecology at Shri. Bhausaheb Hire Govt. Medical College, Dhule was 3.27/1000 and 0.97/1000 deliveries. Incidence is reduced by more than three folds. In both groups maximum patients were below 30 yrs of age and multipara. The commonest indications for OH in both groups were uterine rupture, uncontrolled Atonic PPH and placental causes. The incidence of uterine rupture as a cause for OH was reduced from 78.16% to 43.24%, while that of Atonic PPH has increased from 16.09% to 28.37% and placental causes has increased from 4.59% to 9.45%. Among the risk factors for OH, the incidence of prolonged or obstructed labour has reduced from 66.66% to 21.62% and that of malpresentations has reduced from 27.58 to 5.4%.Conclusions: There is definite reduction in the incidence of OH, frequency of uterine rupture, obstructed labor and malpresentations in Gr. B due to timely referral, improved infrastructure and transportation facilities.
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Wium, Lizemarie, Valerie Vannevel, and Salome Bothma. "Obstetric medical care and training in South Africa." Obstetric Medicine 12, no. 1 (July 20, 2018): 27–30. http://dx.doi.org/10.1177/1753495x18783610.
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Obstetric medicine as a speciality is yet to be developed in South Africa. South Africa is regarded as a developing country. The burden of HIV and metabolic syndrome creates a need for advanced maternal care. An increase has been noted in hypertension and gestational diabetes due to increasing maternal age and increasing prevalence of obesity. The South African National Committee on Confidential Enquiry into Maternal Deaths’ 2015 Saving Mothers Report identified non-pregnancy-related infections as the leading cause of maternal deaths. Obstetric medicine care includes pre-conception, antepartum and postpartum care. This article aims to highlight the importance of obstetric medicine, even in a resource-poor setting. The current internal medicine and obstetrics and gynaecology training is discussed and emphasis is placed on the opportunity to create an obstetric medicine programme.
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Upadhyaya, I., and P. Chaudhary. "Severe Acute Maternal Morbidity and Intensive Care in Paropakar Maternity and Women’s Hospital." Nepal Journal of Obstetrics and Gynaecology 8, no. 2 (February 6, 2014): 38–41. http://dx.doi.org/10.3126/njog.v8i2.9768.
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Aims: Maternal morbidity occurs due to complications arising in pregnancy or within 42 days of delivery. Women with acute severe morbidity require admission in the intensive care unit (ICU). This study was done to explore the profile of those women requiring intensive care. Methods: A study was conducted at Paropakar Maternity and Women’s Hospital in which records of patients admitted in Maternal Intensive Care Unit (MICU) were evaluated for demographics, disease responsible for critical illness, complications that prompted MICU admissions, interventions required, length of MICU stay and resulting maternal morbidity and mortality. Results: Over the study period, 159 obstetric patients were transferred to MICU, representing 2.23% of 7109 deliveries. Hypertensive disorders of pregnancy (50%) and postpartum haemorrhage (14.46 %) were the two major obstetrical conditions responsible admission into MICU. Conclusions: Auditing of severe maternal morbidity will improve the quality of obstetric care and decrease the incidence of maternal morbidity and maternal mortality.Nepal Journal of Obstetrics and Gynaecology / Vol 8 / No. 2 / Issue 16 / July-Dec, 2013 / 38-41 DOI: http://dx.doi.org/10.3126/njog.v8i2.9768
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Jacob, Alpana, Sunita Goyal, and Tapasya Dhar. "Pattern of utilization of blood and blood components in obstetrics at a tertiary care center: a cross-sectional study." International Journal of Reproduction, Contraception, Obstetrics and Gynecology 10, no. 10 (September 27, 2021): 3901. http://dx.doi.org/10.18203/2320-1770.ijrcog20213859.
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Background: Blood transfusion is an essential lifesaving component in obstetrics. Extra blood loss in pregnancy can occur due to various gestational disorders and complications during labour and delivery. Reduction in maternal morbidity and mortality has been observed by increased use of comprehensive emergency obstetrics care in which blood transfusion has achieved recognition as one of the important components. In a developing country like India, the need for well maintained and readily available blood and transfusion services becomes paramount to decrease maternal morbidity and mortality. We wanted to determine the clinical characteristics and indication of blood transfusion in obstetrics and also determine any adverse blood transfusion reaction.Methods: This cross-sectional study was conducted in the department of obstetrics and gynaecology, Christian medical college, Ludhiana for a period of eighteen months from 15th October 2018. The study group included all the antenatal and postnatal patients up to 6 weeks postpartum who were admitted in the obstetric unit, requiring blood or component transfusions. Clinical characteristics, indication of blood transfusion and any adverse blood transfusion reaction were recorded.Results: In our study, about 7.84% of obstetric admission required blood and blood components. Most common indication for blood transfusion was anaemia either during antenatal or during postnatal period (33.91%). Majority of the patients were unbooked antenatally (63.91%) and were multiparous (93.91%). 4 or more blood transfusions were given in 28.26% of cases.Conclusions: Blood transfusion is live saving measure in many obstetric patients. Blood transfusion is an essential component of emergency obstetric care and appropriate blood transfusion significantly reduces maternal mortality. Severe anaemia is the most common condition requiring blood transfusion, which may be chronic due to nutritional deficiency or following acute blood loss, followed by postpartum haemorrhage, placental abruption and placenta previa. Availability of transfusion facility and blood products in obstetric care setting in peripheral health centres can reduce need for referral of patients and indirectly reduce the maternal morbidity and mortality.
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Miguel Ángel Ródenas Monteagudo, Odette Gutiérrez Pérez, Eva Romero García, and Pilar Argente Navarro. "Evaluación del trabajo en equipo en emergencias obstétricas, ¿contamos con las herramientas necesarias?" Revista Electrónica AnestesiaR 10, no. 11 (November 30, 2018): 5. http://dx.doi.org/10.30445/rear.v10i11.647.
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Las emergencias obstétricas son un escenario que aparece con relativa frecuencia. En los últimos años, diferentes trabajos orientan a que muchos eventos adversos en obstetricia se producen por un pobre trabajo en equipo durante las situaciones de crisis. Existen varias herramientas que evalúan las habilidades no técnicas de los equipos en estas situaciones. El objetivo de este trabajo fue valorar si estas herramientas son realmente válidas en el contexto obstétrico. ABSTRACT Obstetric emergencies are situations that appear relatively frequent. In the last years, some studies suggest that many adverse outcomes in obstetrics are produced by poor teamwork in emergencies. There are some assessment tools to evaluate the nontechnical skills of the teams in these situations. The purpose of this review was to find if these tools are valuable in obstetrics.
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Akbar, Rashida, Shabana Ramzan, Fozia Unar, Shaista Lashari, Rozina Mujeeb Sahito, and Yasmeen Joyo. "Frequency of Emergency Obstetric Hysterectomy in Patients Presenting at PMC Hospital Nawabshah." Pakistan Journal of Medical and Health Sciences 16, no. 2 (February 26, 2022): 1215–16. http://dx.doi.org/10.53350/pjmhs221621215.
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Objective: To determine the frequency of emergency obstetric hysterectomy among pregnant patients presenting at PMC hospital Nawabshah Study Setting: The study was conducted at Obstetrics & Gynecology Department, Peoples Medical College Hospital, Nawabshah. Duration of Study: 10th February, 2021 to 09th August, 2021 Study Design: Descriptive study Methodology: All 82 patients fulfilling the inclusion criteria were included in this study. All hysterectomies were performed after 24 week of gestation. We retrieved the proforma of all cases and emergency obstetric hysterectomy was done. The data were entered and analyzed in SPSS v25.0. Data were stratified for age, parity, socio-economic status, gravida, type of delivery, education status, booking status, BMI, booking status, diabetes mellitus (FBS >126mg/dl) and hypertension (BP >140/90mmHg) to address the effect modifiers. Chi-square test was used post-stratification with a p-value ≤0.05 considered as significant. Results: Total 82 pregnant women of 20-45 years of age having gestational age ≥24 weeks were selected for this study. Mean age of the patients was 31.95±8.06 year. Among 82 women who underwent cesarean section or vaginal delivery, 4 (4.9%) had emergency obstetric hysterectomy. Conclusion: Emergency obstetric hysterectomy is a necessary evil in obstetrics. Although it curtails the future child bearing potential of the woman, in many cases it saves the life of the mother. Most of its morbidity is attributable to its indications and underlying disorders rather than to the procedure itself. Keywords: Emergency Obstetric Hysterectomy, C-section, Vaginal Delivery.
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Kamble, Savita N., and Yuga M. Jamdade. "Obstetric hysterectomy: a retrospective study." International Journal of Reproduction, Contraception, Obstetrics and Gynecology 10, no. 12 (November 25, 2021): 4522. http://dx.doi.org/10.18203/2320-1770.ijrcog20214653.
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Background: Obstetric hysterectomy (OH) is last resort usually opted to save life of a mother in critical obstetric conditions compromising her reproductive potential. With increasing caesarean deliveries incidence of morbidly adhered placenta is increasing, thus increasing need of OH. We aimed to study socio-demographic factors, incidence, indications, complications and feto-maternal outcomes associated with obstetric hysterectomy. Also, we aimed to study factors which affect the maternal and fetal outcome in obstetric hysterectomy case so as to minimize maternal and neonatal mortality and morbidity.Methods: We conducted a retrospective analytical study of 2 years 6 months in Department of Obstetrics and Gynecology at a tertiary and teaching institute of western Maharashtra.Results: The incidence of obstetric hysterectomy was 0.4%. Majority of women were between 25-35 years age group and parity two or more. Most common indication was postpartum haemorrhage (PPH) (41.1%) followed by uterine rupture (29.4%) and adhered placenta (23.5%). Most common risk factor found was previous caesarean delivery. Most common complication was need of intensive care unit (ICU) and vasopressor support.Conclusions: Proper antenatal care, screening for high-risk obstetric cases and registration of those patients at a well-equipped hospital and early referral and delivery at tertiary hospital by expert surgeon with timely decision, timely and adequate transfusions can prevent maternal and fetal complications.
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Soliday, Elizabeth. "Autonomy in Maternal Accounts of Birth after Cesarean." Techné: Research in Philosophy and Technology 16, no. 1 (2012): 62–70. http://dx.doi.org/10.5840/techne20121616.
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Following decades of maltreatment of women in obstetric care, professional respect for maternal autonomy in obstetric decision making and care have become codified in global and national professional ethical guidelines. Yet, using the example of birth after cesarean, identifiable threats to maternal autonomy in obstetrics continue. This paper focuses on how current scientific knowledge and obstetric practice patterns factor into restricted maternal autonomy as evidenced in three representative maternal accounts obtained prior and subsequent to birth after cesarean. Short- and long-term remedies to improve the current state of restricted maternal autonomy in clinical practice surrounding decision making on birth after cesarean are provided.
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Hoppe, Kara K., and Linda O. Eckert. "Achieving High Coverage of H1N1 Influenza Vaccine in an Ethnically Diverse Obstetric Population: Success of a Multifaceted Approach." Infectious Diseases in Obstetrics and Gynecology 2011 (2011): 1–5. http://dx.doi.org/10.1155/2011/746214.
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Objective. To report on a multifaceted approach to increase uptake of the H1N1 vaccine in our ethnically diverse obstetrical population.Methods. A review of our obstetric clinic vaccine registry and the approaches used to increase vaccine uptake. We created a real-time vaccine registry, educated patients in their own language via educational videos and use of cultural case workers, facilitated patient appointments and transportation, educated staff, and used other interventions to enhance immunization uptake.Results. Within the first month of H1N1 availability, we vaccinated 120 of our total 157 obstetrics patients. Our overall coverage rate was 76% (number vaccinated/total number eligible.) Of the enrolled patients, the vaccine acceptance rates were similar in our English (59 (78%) of 76) versus non-English (59 (75%) of 79) speaking patients.Conclusions. High vaccine coverage is possible in an ethnically diverse, highly immigrant obstetrics population.
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Pokhrel, Sita, Ram Hari Ghimire, Ashima Ghimire, Prajmi Shrestha, and Amar Nath Chaudhary. "Clinical Profile and Outcome of Obstetric Patients Requiring Critical Care Support in a Tertiary Care Centre." Journal of Nobel Medical College 9, no. 2 (December 11, 2020): 18–22. http://dx.doi.org/10.3126/jonmc.v9i2.33351.
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Background: The maternal complications during pregnancy pose very serious challenge requiring multispeciality critical care approach. The objective of the study was to analyse clinical profile and outcome of these patients. Studies regarding above will add on existing knowledge that will help in improving patient outcome.
Materials and Methods: This was a prospective observational study conducted over a period of 1 year from April 2017 to March 2018 in the department of obstetrics and gynecology of Nobel Medical College, Biratnagar. All the consecutive patients requiring ICU care were enrolled.
Results: Among 7820 deliveries, 122 patients (1.56% of total deliveries) required critical care admission. Among them 61(50%) have causes related to obstetrics problems and 61 (50%) have non obstetric problems. Obstretic hemorrgage (24.59%) and hypertensive disorders (11.47%) of pregnancy were common obstetric complications whereas isolated renal failure 18(14.75%), cardiac disease 16 (13.1%), pulmonary disorders 11(9.1%) and sepsis 10 (8.19%) were common non obstetric complications. Maternal mortality rate was 24.59%.Renal failure 9(30%) was the commonest cause of death.
Conclusion: Obstetric hemorrhage and hypertensive disorders of pregnancy were the commonest risk factors requiring critical care support. Other risk factors requiring ICU were renal failure, cardiac disease, pulmonary disorders and sepsis.
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Ristanti, Adenia Dwi, and Nur Zuwariyah. "Penerapan Manajemen Rujukan Kegawatdaruratan Obstetri Dengan Insiden Kegawatdaruratan Obstetri Di Pusat Pelayanan Primer." Jurnal Ners dan Kebidanan (Journal of Ners and Midwifery) 7, no. 2 (August 5, 2020): 239–46. http://dx.doi.org/10.26699/jnk.v7i2.art.p239-246.
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Latar belakang: Indonesia merupakan suatu negara berkembang dengan masalah kesehatan yang masih menjadi perhatian khusus yaitu AKI yang masih tinggi. Sebanyak 99% kematian ibu akibat masalah persalinan atau kelahiran terjadi di negara-negara berkembang. Berdasarkan SUPAS masih 305 per 100.000 per kelahiran hidup pada tahun 2030. Tujuan: Menganalisis pengaruh manajemen rujukan kegawatdaruratan obstetric dengan insiden kegawatdaruratan obstetric di Pusat Pelayanan Primer. Metode penelitian: Penelitian ini menggunakan pendekatan kualitatif desain diskriptif fenomenologi serta restropective. Penelitian dilakukan di wilayah kerja puskesmas jagir dari bulan April sampai Juli 2019 informan utama yaitu Bidan. Pengumpulan informan dengan teknik wawancara mendalam, studi dokumentasi serta observasi. Hasil penelitian: Hasil penelitian ini sesuai dengan pedoman system rujukan nasional menyebutkan bahwa evaluasi internal perlu dilakukan dalam rangka peningkatan mutu pelayanan, dan memperbaiki ketaatan pelaksanaan rujukan oleh fasilitas kesehatan, memperbaiki serta mengevaluasi sarana serta SDM dipelayanan Kesehatan. Semua informan dalam manajemen rujukan kegawatdaruratan obstetri dengan insiden kegawatdaruratan obstetri di pusat pelayanan primer sudah cukup baik. Kesimpulan: Semua informan dalam pengetahuan tentang manajemen rujukan kegawatdaruratan obstetri dengan insiden kegawatdaruratan obstetri di pusat pelayanan primer sudah cukup baik. Pengetahuan sistem rujukan kasus kegawatdaruratan obstetric informan sudah baik. Sarana dan Prasarana yang tersedia di puskesmas sudah tersedia lengkap sesuai standar minimal untuk kegawatdaruratan obstetric dan dalam kondisi yang baik. SOP sudah sesuai dengan protap yang ada. Surat pengantar rujukan, transportasi serta penyerahan tanggung jawab sudah sesuai dan baik. Semua informan telah melakukan pencatatan serta pelaporan terkait kasus rujukan yang dilakukan. Mayoritas informan telah melakukan evaluasi internal untuk menilai apakah prosedur rujukan yang telah dilakukan sudah cukup baik. Saran: Diharapkan hasil penelitian ini menjadi sumber referensi dalam pengembangan ilmu kebidanan untuk meningkatkan kualitas pemberian asuhan kebidanan khususnya pada layanan kebidanan. Background: Indonesia is a developing country with health problems that are still a special concern is the high maternal mortality rate. As many as 99% of maternal deaths due to childbirth or birth problems occur in developing countries. Based on the inter-census population survey it is still 305 per 100,000 per live birth in 2030. Aims: to analyze the involvement of obstetric emergency referral management by reporting on obstetric emergencies at the Primary Service Center. Research Methods: This research uses descriptive qualitative design of phenomenology and restropective. The study was conducted in the working area of the Jagir public health center from April to July 2019, the main informant was Midwife Information gathering with in-depth interview techniques, study collection and collection. Results: The results of this study are in accordance with the national referral system guidelines stating that internal evaluation needs to be done in order to improve the quality of services, and improve compliance with referral services by health facilities, improve and evaluate facilities and human resources in health services. All informants in obstetric emergency referral management with obstetric emergency incidents in primary care centers are good enough. Conclusion: All informants in knowledge of obstetric emergency referral management with obstetric emergency incidents in primary care centers are good enough. Knowledge of the obstetric emergency case referral system is good. Facilities and infrastructure available at the public health center are fully available according to the minimum standards for obstetric emergencies and in good condition. Standard operational procedures are in accordance with existing procedures. Letter of reference for referral, transportation and assignment of responsibilities are appropriate and good. All informants have recorded and reported related to the referral case. The majority of informants have conducted internal evaluations to assess whether the referral procedures that have been carried out are good enough. Suggestion: It is hoped that the results of this study will become a reference source in developing midwifery to improve the quality of special midwifery care assistance in midwifery services.
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Bezhenar, V. F., Yu V. Tsveliov, I. В. Kaplun, А. I. Levshankov, А. V. Shchiogolev, D. V. Kandyba, and А. V. Savello. "Tromboembolic complications in obstetric- gynecological practices." Journal of obstetrics and women's diseases 53, no. 1 (January 14, 2004): 55–72. http://dx.doi.org/10.17816/jowd87146.
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In clinical lecture, etiology, pathogenesis, principles of diagnostics and methods for treatment of tromboembolic complications, which the most often an obstetric- gynecologist meets in its practice. Authors present their own clinical observations, which allow to them formulating the main principles of tromboembolism prophylaxis in obstetrics and gynecology.
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Gokhale, Ashish V., Shonali Agarwal, and Dimpi Modi. "Improving pregnancy outcomes in tertiary care institution in India through obstetric intensive care unit: three-year analysis." International Journal of Reproduction, Contraception, Obstetrics and Gynecology 9, no. 5 (April 28, 2020): 1965. http://dx.doi.org/10.18203/2320-1770.ijrcog20201789.
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Background: To analyse the requirement of high dependency unit (HDU)/intensive care unit (ICU) in an obstetric population in terms of utilization rate, indications for admission, interventions required and gestational outcome.Methods: Retrospective observational study was carried out from April 2015 to September 2018 at department of obstetrics and gynecology SSG Hospital, Vadodara India. Data related to indications for ICU admission, interventions required, length of stay and outcomes were collected, and results were analyzed.Results: Obstetric ICU utilization rate was 130 per 1000 deliveries. The major obstetric indications for admission were hypertensive disorders of pregnancy (42%) followed by anemia (25%) and post-partum hemorrhage (3%). In the rest of the patient’s majority (50%) had cardiovascular problems. Maternal mortality among these critically ill women was 3.76%. The death rate in the present study was high among patients admitted for non-obstetric (74.54%) as opposed to obstetric indications (25.46%).Conclusions: Establishment of well managed high dependency and intensive care unit in health care facilities dealing with high volumes of high-risk maternity cases reduces the maternal mortality significantly and results in improved maternal outcomes.