Rozprawy doktorskie na temat „Obstetric complications”
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McConville, Pauline Mary. "Obstetric complications and functional psychosis". Thesis, University of Edinburgh, 2007. http://hdl.handle.net/1842/24928.
Pełny tekst źródłaDonohoe, Siobhan. "An investigation of antiphospholipid antibody associated obstetric complications". Thesis, University College London (University of London), 1999. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.312964.
Pełny tekst źródłaHirschi, Budge Kelsey May. "RAGE and Gas6/Axl Signaling in Obstetric Complications". BYU ScholarsArchive, 2020. https://scholarsarchive.byu.edu/etd/8409.
Pełny tekst źródłaSikder, Shegufta Shefa. "Obstetric complications in rural Bangladesh| Risk factors for reported morbidity, determinants of care seeking, and service availability for emergency obstetric care". Thesis, The Johns Hopkins University, 2013. http://pqdtopen.proquest.com/#viewpdf?dispub=3571743.
Pełny tekst źródłaBackground: In settings such as rural Bangladesh, where the majority of births occur at home, population-based data are lacking on the burden and risk factors for obstetric complications, as well as care-seeking behavior. This dissertation seeks to describe the prevalence and risk factors for obstetric complications, explore factors affecting care seeking for complications, and describe the availability of obstetric care among health facilities in rural Bangladesh.
Methods: We used extant data from a community-randomized maternal micronutrient supplementation trial which ascertained reported morbidities and care seeking among 42,214 pregnant women between 2007 and 2011 in rural northwest Bangladesh. Multivariate multinomial logistic regression was used to analyze the association of biological, socioeconomic, and psychosocial factors with reported obstetric complications and near misses. Multivariate logistic regression of socioeconomic, demographic, perceived need, and service factors on care seeking was performed. Primary data on availability and readiness to provide obstetric services at 14 health facilities was collected through surveys.
Results: Of the 42,214 married women of reproductive age, 73% (n=30,830) were classified as having non-complicated pregnancies, 25% (n=10,380) as having obstetric complications, and 2% (n=1,004) with reported near misses. In multivariate analysis, women's age less than 18 years (Relative Risk Ratio 1.26 95% CI 1.14-1.39), obstetric history of stillbirth or abortion (RRR 1.15 CI 1.07-1.22), and neither partner wanting the pregnancy (RRR 1.33 CI 1.20-1.46) significantly increased the risk of obstetric complications. Out of 9,576 women with data on care seeking, 77% sought any care, with only 23% seeking at least one formal provider. Socioeconomic factors and service factors, such as facility availability of comprehensive obstetric services (OR 1.25 CI 1.16- 1.34), improved care seeking from formal providers. Average facility readiness for emergency obstetric care was 81% in private clinics compared to 67% in public facilities (p=0.045).
Conclusions: These analyses indicate a high burden of obstetric morbidity, with a quarter of women reporting obstetric complications. Policies to reduce early marriage and unmet need for contraception may address risk factors including adolescent pregnancy and unwanted pregnancies. Improvements in socioeconomic factors, coupled with strategies to increase service availability at health facilities, could increase care seeking from formal providers.
Paparelli, Alessandra. "Obstetric complications, genetic liability and psychosis : a study of Gene X Environment interaction". Thesis, King's College London (University of London), 2014. https://kclpure.kcl.ac.uk/portal/en/theses/obstetric-complications-genetic-liability-and-psychosis(dbe046d3-8191-46d3-a3dd-d971462314d2).html.
Pełny tekst źródłaSiregar, Kemal Nazaruddin. "Social and programme factors influencing maternal morbidity in Indonesia". Thesis, University of Exeter, 1999. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.297578.
Pełny tekst źródłaVoloshynovych, N. S. "Assessment of the obstetric complications’ risk as a result of surgical treatment of ovaries in anamnesis". Thesis, БДМУ, 2022. http://dspace.bsmu.edu.ua:8080/xmlui/handle/123456789/19742.
Pełny tekst źródłaPaulsen, Carrie. "Incidence and nature of complications post primary repair of Obstetric Anal Sphincter Injury (OASI): Retrospective chart review". Master's thesis, Faculty of Health Sciences, 2019. https://hdl.handle.net/11427/31687.
Pełny tekst źródłaNystedt, Astrid. "Utdragen förlossning : kvinnors upplevelser och erfarenheter". Umeå : Omvårdnad, 2005. http://urn.kb.se/resolve?urn=urn:nbn:se:umu:diva-579.
Pełny tekst źródłaLougue, Siaka. "Methodological approach of the spatial distribution of maternal mortality in Burkina Faso and explanatory factors associated". University of the Western Cape, 2013. http://hdl.handle.net/11394/4368.
Pełny tekst źródłaMaternal mortality is one of the most important problems related to the reproductive health. This is why the reduction by three quarters of maternal mortality by 2015 has been fixed as target No. 5 of the Millennium Development Goals (MDGs). Achieving this goal requires an annual decline of 5.5% of maternal mortality between 1990 and 2015. Unfortunately, the reduction as estimated in 1997 was less than 1% per year. Africa is the continent most affected by this problem. In 2010, the number of maternal mortality in the world was estimated to 287 000 and Africa was hosting more than 52 % (148 000) of the occurrence in the world In Burkina Faso, maternal mortality ratio decreased from 566 in 1991 to 484 in 1998 and 341 in 2010 according to the DHS data while the census estimate was 307 in 2006 and United Nation agencies provided the number of 300 maternal deaths per 100 000 live births in 2010. Statistics provided by the different sources vary considerably. This situation creates confusion among data users. In addition, researches made on the issue remain very insufficient because of the complexity of the issue, lack of data and poor quality of existing data on maternal mortality. This study has been initiated to fill the gap of knowledge about the determinants and estimates of maternal mortality at national and sub-national levels. Results of this research highlighted explanatory factors of maternal mortality at national and regional level with a focus on factors of regional disparities. Findings also provided estimate by adjusting the census 2006 data from missingness and incoherences, improving the census method and testing different other methods. Finally, projection of maternal mortality level is made from 2006 to 2050.
Varol, Nesrin. "Towards the abandonment of female genital mutilation – healthcare provision in Australia within the framework of global collaboration on health system response, prevention, and prosecution". Thesis, The University of Sydney, 2016. http://hdl.handle.net/2123/16402.
Pełny tekst źródłaByrskog, Ulrica, Eva Eriksson i Annica Sundell. "Kvinnlig Könsstympning : Litteraturstudie om praktisk handläggning och komplikationsrisker vid förlossning". Thesis, Högskolan Dalarna, Omvårdnad, 2005. http://urn.kb.se/resolve?urn=urn:nbn:se:du-1636.
Pełny tekst źródłaGrälls, Jenny. "Sätesförlossningar : Handläggning och utfall hos mödrar och barn vid vaginal förlossning och kejsarsnitt". Thesis, Uppsala universitet, Institutionen för kvinnors och barns hälsa, 2013. http://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-200521.
Pełny tekst źródłaHirose, Atsumi. "A cross-sectional study of the first and the second delays among women admitted to a maternity hospital with severe obstetric complications ('near-miss') in Afghanistan". Thesis, London School of Hygiene and Tropical Medicine (University of London), 2010. http://researchonline.lshtm.ac.uk/1649007/.
Pełny tekst źródłaMbola, Mbassi Symplice. "Soins obstétricaux d'urgence et mortalité maternelle dans les maternités de troisième niveau du Cameroun : approche évaluative d'une intervention visant à améliorer le transfert obstétrical et la prise en charge des complications maternelles". Thesis, Paris 6, 2014. http://www.theses.fr/2014PA066352/document.
Pełny tekst źródłaDespite numerous initiatives undertaken by health authorities in the past years, maternal mortality remains a major public health issue in Cameroon. Against this background, research was conducted (i) to determine the maternal mortality patterns in 7 tertiary maternity centers in Cameroon, (ii) to document various stages of an intervention for improving referral system and the management of obstetric emergencies and (ii) evaluate the effect of these measures on maternal mortality and propose future actions. The research was conducted in three phases. A retrospective review of the aggregate data for the period 2004-2006 was performed including all births, obstetric complications, caesarean sections and maternal deaths. Then 33 months intervention has been set up in 22 peripheral maternities and in three tertiary maternity centers where maternal mortality was very high. The evaluation of the intervention was made using the quasi-Experimental design. This method combined the pre- and post- intervention study as well as the study of the maternities where there was intervention compared to the control group. Two years after the intervention, maternal deaths recorded in the target tertiary maternity centers decreased by more than half (P = 0.000001). The case fatality rate decreased from 2.2 to 0.7% in the same group (P = 0.000001). Moreover, the number of deaths among referred women decreased significantly and the case fatality rate was less than 1%. The research findings highlight the impact of capacity building providers, improvement of the referral system and quality of care on maternal mortality
Douteaud, Stéphanie. "Déterminants et effets des trajectoires de stress prénatal sur les issues de la grossesse et la dépression postpartum". Thesis, Montpellier 3, 2014. http://www.theses.fr/2014MON30099.
Pełny tekst źródłaIntroduction : In France, as well as in other countries, the prevalence of postpartum depression (PPD) (about 10% of women) is not more important than other forms of depression, but it is a major problem of screening, because women less consult, making prevention difficult. Researches to improve the prevention of DPP are essentially based on two models, the stress-vulnerability model and the bio-psycho-social model. The both models describe the prenatal psychological stress as an important determinant of the PPD. However, if stress is frequently assessed, it is usually measured only once and late in pregnancy. So, by now, it is not possible to know its evolution or to know its effects on PPD. Accordingly, a primary objective of this doctoral work is to identify and characterize trajectories of stress to assess their effects on the DPP. Moreover, some researches showed that obstetric complications during childbirth have a deleterious effect on the psychological health of postpartum women. Others proved that prenatal stress increases the risk of obstetric complications. So we assume that an elevated stress associated with obstetric complications in childbirth significantly increases the risk of PPD. Neverthless it differs from one woman to another depending on the level of stress determinants.Method: The health of mothers, their anxiety-trait level and socio-economic variables were recorded among 164 women before the end of two months of pregnancy (T0). Perceived stress, state anxiety, social support and coping strategies were evaluated at 2, 6 and 9 months of pregnancy for 163 women and at 1 and 6 months postpartum for 91 of them. Moreover, the results of prenatal screening for fetal pathologies, the term of pregnancy, baby's birth weight, results of Apgar and type of delivery (dystocic versus eutocic) were recorded. Finally, the measurement of the PPD was performed 6 months after delivery. We calculated trajectories of stress and we measured the effect of these trajectories on the variables related to childbirth for 163 women and on DPP for 91 of them.Results: Three trajectories were identified in prepartum and postpartum. A first trajectory where the stress is low in early pregnancy, increases until early postpartum and decreased slightly at the end of the postnatal period. A second where the stress is moderate in early pregnancy decreases until the middle of pregnancy, increases in late pregnancy and postpartum. A final trajectory where stress is high in early pregnancy and then decreases until the end of pregnancy and continues to decrease in postpartum. When the stress follows the paths 2 and 3, the gestation period is shorter, F(2,138) = 3.45, p <0.05, η2 = 0.048, the use of cesarean section is more common, OR = 2.62, p < 0.05, CI 95% = [1.01- 6.75] as well as dystocic labor, OR = 3.54, p <0.005, CI 95% = [1.18-10.52]. In contrast, the trajectories of stress does not have an effect on the PPD.Discussion: Our results are encouraging and show that the perception of stress during pregnancy has an effect on the duration of pregnancy, obstetric complications and the use of cesarean section. However it has no effect on the DPP, but our results suggest that stress may have an effect only among vulnerable women and that the DPP would fit into a depressive continuum, while adjacent to the vulnerability to stress. In conclusion, future researches should assess the link between trajectories of stress and depression from early pregnancy to late postpartum to test this hypothesis
Urassa, David Paradiso. "Quality Aspects of Maternal Health Care in Tanzania". Doctoral thesis, Uppsala : Acta Universitatis Upsaliensis : Univ.-bibl. [distrubutör], 2004. http://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-4221.
Pełny tekst źródłaUustal, Fornell Eva. "Pelvic floor dysfunction : a clinical and epidemiological study /". Linköping : Univ, 2003. http://www.bibl.liu.se/liupubl/disp/disp2003/med822s.pdf.
Pełny tekst źródłaOliveira, Lenice Fortunato de. "Estudo das alterações placentárias de gestantes com síndrome antifosfolípide: correlações anátomo-clínicas". Universidade de São Paulo, 2004. http://www.teses.usp.br/teses/disponiveis/5/5139/tde-13102014-105103/.
Pełny tekst źródłaObjective: Evaluate the placental injuries found in pregnant women with SAF and correlate with the morbidity in pregnancy and fetal repercussions. Methods: 72 pregnant women with SAF diagnosis were followed, except the twin pregnancies and inadequate formed fetus. Gathered placenta to histological examination. The SAF group was distributed in three subgroups based on the previous clinic history, aCL and aL titles, risk of thrombosis development and the placentary insuffiency in pregnancy to know: moderated, A (n=20); high risk, B (n=37) and even higher risk, C (n=15). The patients were treated with AAS 100mg/day, suspended within 36 weeks and enoxaparin which portion was modified according to the fetal placental circulation alteration on obstetric dopplervelocimetria. The outcome of pregnancy and placental pathological findings studies with the application of the therapeutic protocol were noted down.32 normal pregnant women were the control group. In subgroup A the patients did not presented any disease colagen or heritable thrombophilia.In subgroup B,17(46%) pacients presented LES; 15(40%) Raynaud phenomena; 13(35%) preeclampsia; 12(32%) had previous thrombosis; nine(24.3%) had other thrombophilia and seven(19%) HAC. In subgroup C, 14 (93%) pacients presented previous thrombosis; 4(26%) LES; 4(26%) HAC; 3(20%) preeclampsia; 3(20%) Raynaud phenomena and 2(13.3%) others thrombophilia. The previous fetus losses were 85%, 80% and 79% to subgroups A, B and C respectively. Prenatal started around 12 weeks with no advantage among the groups. Introduction of AAS and enoxaparin was 12 and 14 weeks respectively the same in subgroups. Results: 1. The main maternal complications in general were: TPP (49%) and toxemia (25%). 2. The fetal results presented: 44% early childbirth; 41% reduced ILA; 40% SFA; 34% RCF; 31% oligohydramnios. (1) e (2) similar between the subgroups and expressive statistic with the control group. 3. The pregnant age was in avarage 35,8 weeks with fetus weigh 2493g with no statistic differences between the subgroups and the control group. 4. In the microscopy analysis predominated infarcts with 60% of the placentas affected, correlated with the high incidence of adverse results in pregnancies, so as 44,6% reduction or obliteration of fetal stem vessels by mural hyperplasia; 60% RCF predominance and 80% early childbirth in subgroup C, fibrinoid necrosis trophoblast with reduced ILA predominance (60%) in subgroup B, massive perivillous fibrin deposition with SFA predominance (100%) in subgroup A, fetal thrombotic vasculopathy with SFA predominance (100%) and early birth (75%) in subgroup A and RCF (77%) in subgroup B. All the placental injuries with statistics significance related to the group control. Among the subgroups the massive perivillous fibrin deposition presented statistic significance in the subgroup C related to the others. Conclusions: The therapeutic protocol was effective, but is still high the morbidity indices among the pregnancies. The high incidences of infarcts and other thrombotic complications in the placenta confirm the placental aggression and the necessity of the adequation in the anticoagulation protocols
Söderquist, Johan. "Posttraumatic stress after childbirth /". Linköping : Univ, 2002. http://www.bibl.liu.se/liupubl/disp/disp2002/med761s.pdf.
Pełny tekst źródłaÖstlund, Ingrid. "Aspects of Gestational Diabetes : Screening System, Maternal and Fetal Complications". Doctoral thesis, Uppsala University, Department of Women's and Children's Health, 2003. http://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-3267.
Pełny tekst źródłaThe appropriateness of universal screening for gestational diabetes mellitus (GDM) has been strongly questioned, since it does not satisfy ethical principles for screening.
The aims of these studies were to determine the prevalence of GDM, expressed in terms of impaired glucose tolerance (IGT) and diabetes mellitus (DM), to evaluate different screening models using traditional anamnestic risk factors and repeated random B-glucose, to determine whether GDM increases risks for maternal complications such as preeclampsia, and to determine whether IGT during pregnancy, if left untreated, is associated with increased maternal or neonatal morbidity.
Of 4,918 pregnant non-diabetic women attending maternal health care, 73.5% agreed to have a 75 g oral glucose tolerance test (OGTT). GDM was diagnosed in 1.7%, IGT in 1.3% and DM in 0.4%. Traditional risk factor criteria were fulfilled by 15.8%. Prior GDM and a prior macrosomic infant showed the highest association with GDM. No selective or two-step universal screening model would have detected all cases of GDM. A constructed model comprising prior GDM, a prior LGA/macrosomic infant, or a cut-off random B-glucose level of 8 mmol/l as an indication for OGTT reduced the need for OGTT to 7.3% compared to the selective screening model with traditional risk factors. Such a universal two-step screening model had 100% sensitivity for DM, and 44.7% sensitivity for IGT.
The Swedish Medical Birth Register was used to evaluate GDM as risk factor for preeclampsia. GDM occurred in 0.8% and preeclampsia in 2.9% of 430,852 singleton pregnancies. There is an independent and significant association between GDM and preeclampsia. Obesity is a major confounding factor, but cannot explain the total excess risk.
In a prospective population-based case-control study 213 women with untreated IGT during pregnancy were identified. For each case, four controls were recruited from the same delivery department. The analyses confirmed that maternal and fetal morbidity were increased in the cases in terms of cesarean section rate, pre-term delivery, Erb’s palsy and admission to NICU. There was a marked, independent increase in the proportion of LGA infants (OR 7.3; 95% CI 4.1-12.7). To determine whether treatment has an effect when IGT is diagnosed during pregnancy, a randomized study is required.
Huang, Pinchia. "Implications of False-Positive Trisomy 18 or 21 Screening Test Results in Predicting Adverse Pregnancy Outcomes". Case Western Reserve University School of Graduate Studies / OhioLINK, 2009. http://rave.ohiolink.edu/etdc/view?acc_num=case1247627814.
Pełny tekst źródłaMoura, Bárbara Laisa Alves. "Gestantes usuárias do Sistema Único de Saúde no município de São Paulo: desfechos de uma coorte de dados secundários". Universidade de São Paulo, 2017. http://www.teses.usp.br/teses/disponiveis/6/6132/tde-23052017-164937/.
Pełny tekst źródłaIntroduction: Despite the improvement in maternal and child health indicators, values are still high, with neonatal mortality accounting for infant mortality and perinatal fetal mortality. Despite improved coverage and data quality of information systems on live births and mortality, these do not have information on maternal and newborn morbidity, available in the SUS Hospital Information System and possible to be linked. General objective: Describe and analyze the follow-up of gestation, delivery and outcomes of the births of pregnant women users of SUS residents in the city of São Paulo from August 12, 2011 to January 27, 2013. Specific objectives: Obtain a cohort of SUS pregnant women with secondary data. Identify hospitalizations prior to delivery for obstetric complications, prevalence of high-risk pregnancies, type of delivery after childbirth (discharge, hospitalization and use of ICU and maternal death) and length of hospital stay during the period of August 12, 2011 to December 31, 2012. Characterize and estimate the fetal death rate and early neonatal mortality of live births extracted from the cohort of pregnant women SUS in the city of São Paulo from June 1, 2012 to January 27, 2013. Identify if there is difference in survival of neonatal deaths according to birth weight and neonatal ICU use. Identify potential risk factors for early fetal and neonatal mortality for the births of the SUS pregnant cohort. METHODS: This was a retrospective cohort study of the fixed population of pregnant women whose births (live birth and fetal death) occurred in hospitals of the SUS network in the city of São Paulo from June 1, 2012 to December 31, 2012. The hospitalizations and the hospital readmissions of the pregnant women attended in the SUS hospitals were investigated during the period from August 12, 2011 to December 2012. As well as the hospitalizations of the newborns that occurred in the period from June 1, 2012 to 27 Of January of 2013. Links were made through the deterministic and probabilistic method of the basic documents of the health information systems (SIS). Cox regression and logistic regression analyzes were performed. Results: 98.3 per cent of live birth certificates (DNV) were linked to hospital admission authorization (AIH), 93.8 per cent of fetal deaths to AIHs, 93 per cent of AIHs of newborns hospitalized at the previous pair, and 99, 4 per cent of neonatal deaths in the sequence of events mentioned above. 4.3 per cent of pregnant women were hospitalized prior to delivery due to obstetric complications. Higher neonatal mortality, fetal death rate and hospitalization of newborns after birth occurred in pregnant women hospitalized for obstetric complications. In the survival study, there was an increase in survival with an increase in birth weight. RNs hospitalized at the NICU after birth had lower survival rates than the non-hospitalized NB. The risk factors for neonatal mortality were: insufficient number of prenatal visits, hospital birth with low birth volume, prematurity, low birth weight, APGAR 5 <7, presence of congenital anomaly and hospitalization after birth. Preterm consultation, extreme prematurity (<32 weeks), low birth weight (<2499 grams) and presence of congenital malformation were common risk factors for fetal deaths and early neonatal deaths. Race / color of non-white mother and maternal age equal to or greater than 35 years were risk factors only for fetal deaths. Births in hospitals with low and medium volume of delivery were associated with higher preterm neonatal mortality. Conclusion: Pregnant women who presented obstetric complications had more unfavorable outcomes of pregnancy, such as postpartum hospitalization and maternal mortality. Also in this group, greater readmission of the newborns of the newborns, greater prevalence of prematurity and of low birth weight, greater fetal and neonatal mortality were also identified. Nursing admission and hospital readmission of the newborn should be considered as sentinel events in the monitoring of delivery care and the newborn in the SUS population. The concentration of deaths in the first days of life reflects weaknesses in the care of newborns, the severity of newborn diseases, poor birth conditions and the presence of malformations incompatible with life. Early fetal and neonatal deaths are influenced by the same proximal characteristics of newborns. Efforts should be directed towards increasing adherence to prenatal consultations in basic health units, with special attention to non-white women. Key Words: Linkage, hospital admissions for obstetric complications, neonatal mortality, fetal mortality
M’Rithaa, Doreen K. M. "A framework for information communication that contributes to the improved management of the intrapartum period". Thesis, Cape Peninsula University of Technology, 2015. http://hdl.handle.net/20.500.11838/1414.
Pełny tekst źródłaBackground: Daily activities within a health care organization are mediated by information communication processes (ICP), which involve multiple health care professionals. During pregnancy, birth and motherhood a woman may encounter different professionals including midwives, doctors, laboratory personnel and others. Effective management requires critical information to be accurately communicated. If there is a breakdown in this communication patient safety is at risk for various reasons such as; inadequate critical information, misconception of information and uninformed decisions being made. Method: Multi method, multiple case study approach was used to explore and describe the complexities involved in the (ICP), during the management of the intrapartum period. During the study the expected ICP, the actual ICP, the challenges involved and the desired ICP were analysed. 24 In-depth interviews with skilled birth attendants were conducted, observer- as- participant role was utilized during the observation, fild notes, reflective diaries and document review methods were used to gather the data. Thematic analysis and activity analysis were applied to analyse the data. Findings: The findings illuminated that there are expectations of accessibility to care of the woman during pregnancy birth and the intrapartum, especially linked to referral processes. The actual ICP focused on documentation and communication of the information within and between organizations. Communication was marked by inadequate documentation and therefore errors in the information communicated. The desires for communication were illuminated by the need to change the current situation. Further a framework for effective information communication was developed: the FAAS framework for the effective management of the intrapartum period. Conclusion: In conclusion what is expected is not what is actually happening. The skilled birth attendants (SBAs) do not necessarily have the answers for change but the challenges were identified as desires for change. I urge that the framework will provide a basis for the evaluation of the effectiveness involved in the ICP for the effective management of the intrapartum period.
Paiva, Leticia Vieira de. "Estado nutricional em gestações de alta risco: complicações do parto, puerpério e análise do consumo dietético". Universidade de São Paulo, 2012. http://www.teses.usp.br/teses/disponiveis/5/5139/tde-13062012-113155/.
Pełny tekst źródłaOBJECTIVE: To assess the association between maternal obesity and the occurrence of delivery and postpartum complications in high risk pregnancies, and to analyze the dietary intake of these pregnant women. METHODS: Prospective and observational study conducted from August 2009 to August 2010, with the following inclusion criteria: admission to the 5th day, maternal age 18-year-old, high-risk pregnancy, single pregnancy, fetus alive at the beginning of labor, birth at the institution, maternal weight measured at birth. Nutritional status in late pregnancy was assessed by body mass index (BMI), and applying the curve Atalah. The patients were classified as: underweight, appropriate, overweight and obesity. The dietary intake was evaluated applying a food frequency questionnaire. The complications of delivery and postpartum, investigated during the hospitalization and 30 days after discharge, were: infection and / or secretion in the surgical wound, urinary tract infection, puerperal infection, fever, hospitalization, antibiotics, and composite morbidity (at least one puerperal complication). RESULTS: We included 374 postpartum women classified by the final BMI: underweight (n=54, 14.4%), appropriate (n=126, 33.7%), overweight (n=105, 28.1%) and obesity (n=89, 23.8%). There was no significant difference in the proportion of cesarean when compared the following groups: underweight and appropriate (68.3%), overweight (76.2%) and obesity (78.6%, P=0.201). Maternal obesity was significantly associated with the following puerperal complications: surgical wound infection (16.8%, P=0.042), urinary tract infection (9.0%, P= 0.004), antibiotic use (12.3%, P<0.001) and composite morbidity (25.6%, P=0.016). The logistic regression model showed that obesity in late pregnancy is an independent variable in predicting the composite morbidity (OR: 2.09, 95% CI: 1.15 to 3.80, P=0.015). The analysis of dietary intake showed average energy consumption similar in the groups: underweight and appropriate (2344 cal/day), overweight (2433 cal/day) and obesity (2450 cal/day, P=0.640). There was no significant difference in the average daily consumption of macro-and micronutrients among the groups studied. CONCLUSION: Maternal obesity at the end of high-risk pregnancy is independently associated with the occurrence of postpartum infectious complications, showing the need for more efficient monitoring of maternal weight gain in these pregnancies
Bourque, Danielle Kathleen. "Imprinted genes in the placenta and obstetrical complications". Thesis, University of British Columbia, 2010. http://hdl.handle.net/2429/25509.
Pełny tekst źródłaZetterström, Karin. "Chronic Hypertension and Pregnancy : Epidemiological Aspects on Maternal and Perinatal Complications". Doctoral thesis, Uppsala University, Department of Women's and Children's Health, 2007. http://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-7755.
Pełny tekst źródłaThese studies were undertaken to investigate risks of maternal and perinatal complications in pregnant women with chronic hypertensive disease, and to investigate future risk of preeclampsia in women born small for gestational age (SGA). Population based cohort studies using the Swedish Medical Birth Register from different years were performed.
The maternal complications mild and severe preeclampsia, gestational diabetes and abruptio placenta were studied in a population of 681 515 women, with a prevalence of 0,5% for chronic hypertension. Risk estimates were adjusted for differences in maternal characteristics as age, parity, BMI, ethnicity and smoking habits. Chronic hypertensive women wore found to have significantly increased risks of all complications.
The perinatal complication SGA was studied in a population of 560 188, with a prevalence of 0,5% for chronic hypertension. Risk estimates were adjusted for differences in maternal characteristics and for the secondary complications mild and severe preeclampsia. Chronic hypertensive women were found to suffer a significantly increased risk of giving birth to an offspring that is SGA.
The perinatal complication fetal/infant mortality was studied in a population of 1 222 952 with a prevalence of 0,6% for chronic hypertension. Risk estimates were adjusted for differences in maternal characteristics and for the complications mild and severe preeclampsia, gestational diabetes, abruptio placenta and offspring being SGA In the analysis an effect modification by gender was included. Chronic hypertensive women were found to have a significantly increased risk for stillbirth and neonatal death in male, but not in female, offspring. Thus a clear gender difference in mortality was revealed. The risk of mortality of offspring was mediated by severe preeclampsia, abruptio placenta and offspring being SGA. Mild preeclampsia and gestational diabetes did not affect the risk. No increased risk of post neonatal mortality was found.
A generation study was performed in 118 634 girls of which 5.8% were born SGA. Their future risk for mild and severe preeclampsia in first pregnancy was analysed. Risk estimates were adjusted for age, smoking, BMI and for preeclampsia in the mothers while pregnant with the study population. Women who were born SGA were shown to have a significantly increased risk for severe preeclampsia, but not for mild preeclampsia.
Elliott, Catherine. "Complications of anticoagulation in pregnant women with mechanical heart valves". Master's thesis, University of Cape Town, 2012. http://hdl.handle.net/11427/3043.
Pełny tekst źródłaMajoko, Franz. "Assessing Antenatal Care in Rural Zimbabwe". Doctoral thesis, Uppsala : Acta Universitatis Upsaliensis : Univ.-bibl. [distributör], 2005. http://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-6018.
Pełny tekst źródłaButt, Jennifer Leigh. "Hysterectomy at a tertiary hospital in South Africa : indications, pathology and complications". Master's thesis, University of Cape Town, 2009. http://hdl.handle.net/11427/3033.
Pełny tekst źródłaMorgan, Vera Anne. "Intellectual disability co-occurring with schizophrenia and other psychiatric illness : epidemiology, risk factors and outcome". University of Western Australia. School of Psychiatry and Clinical Neurosciences, 2008. http://theses.library.uwa.edu.au/adt-WU2008.0209.
Pełny tekst źródłaBortolotto, Maria Rita de Figueiredo Lemos. "Estudo dos fatores relacionados à determinação da via do parto em gestantes portadoras de cardiopatias". Universidade de São Paulo, 2006. http://www.teses.usp.br/teses/disponiveis/5/5139/tde-18042007-112300/.
Pełny tekst źródłaThis study reviewed the data of 571 pregnancies in 556 pregnant women with heart disease admitted for delivery in a tertiary university hospital between 2001 and 2005. The objectives were to assess the prevalence of cesarean sections and vaginal births among the whole group of cases and in three subgroups: patients with arrhythmias (A - 57 cases / 10%), congenital diseases (CD - 163 cases / 28,6%) and acquired diseases (AD - 351 cases / 61,4%), and to determine the clinical and obstetrical factors related to the mode of delivery in the whole population and in the subgroups, as well as the association between the mode of delivery and clinical and obstetrical complications. The frequencies of cesarean sections were: 57,2% (whole population), 45,6% (A), 64,2% (CD) and 55,7% (AD); the cesarean sections were performed due to obstetrical reasons in 77% of the cases. In the 425 cases with no previous cesarean sections, the frequencies of c-sections deliveries were 47,1% (whole group), 37,8% (A), 57,8% (CD) and 43,3% (AD). The factors related to a higher probability of cesarean section were: previous cesarean section, gestational age at delivery of less than 37 weeks, presence of obstetrical events, diagnosis of congenital heart disease, heart failure (NYHA functional class III/IV) and use of cardiovascular drugs. The parity above 1 was related to a lesser probability of csections, and previous cesarean was the main factor related to the risk of abdominal delivery. In the cases with no previous cesarean sections, according to the subgroups of heart disease, the probability of cesarean section was heightened in the presence of the following factors: group A: use of cardiovascular drugs, CD: functional class III/IV and obstetrical events and AD: obstetrical events and gestational age in delivery less than 37 weeks. The rate of obstetrical complications was 6,8%, most of them in group A and in vaginal birth. Major clinical complications occurred in 2,5% of the cases, and were more related to cesarean sections (3,8%). Conclusion: the rates of cesarean sections observed in pregnant women with heart disease were high (mainly in the CD group), and related to previous cesarean sections, heart failure, use of cardiovascular drugs, presence of obstetrical events and gestational age at delivery less than 37 weeks.
Cluver, Catherine Anne. "Maternal position during caesarean section for preventing maternal and neonatal complications : a cochrane review". Thesis, Stellenbosch : Stellenbosch University, 2011. http://hdl.handle.net/10019.1/17831.
Pełny tekst źródłaENGLISH ABSTRACT: Background: During caesarean section mothers can be in different positions. Theatre tables could be tilted laterally, upwards, downwards or flexed and wedges or cushions could be used. There is no consensus on the best positioning at present. Objectives: We assessed all available data on positioning of the mother to determine if there is an ideal position during caesarean section that would improve outcomes. Search methods: We searched the Cochrane Pregnancy and Childbirth Group's Trials Register (September 2009), PubMed (1966 to 14 September 2009) and manually searched the references of retrieved articles. Selection criteria: Randomised trials of women undergoing caesarean section comparing different positions. Data collection and analysis: Two authors assessed eligibility, trial quality and extracted data. Results: We identified 17 studies with a total of 683 woman included. We included nine studies and excluded eight studies. Included trials were of variably quality with small sample sizes. Most comparisons had data from single trials. This is a shortcoming and applicability of results is limited. The incidence of air embolism was not affected by head up versus horizontal position (risk ratio (RR) 0.91; 95% confidence interval (CI) 0.65 to 1.26). We found no change in hypotensive episodes when comparing left lateral tilt (RR 0.11; 95% CI 0.01 to 1.94), right lateral tilt (RR 1.25; 95% CI 0.39 to 3.99) and head down tilt (mean difference (MD) -3.00; 95% CI -8.38 to 2.38) with horizontal positions or full lateral tilt with 15-degree tilt (RR 1.20; 95% CI 0.80 to 1.79). Hypotensive episodes were decreased with manual displacers (RR 0.11; 95% CI 0.03 to 0.45), a right lumbar wedge compared to a right pelvic wedge (RR 1.64; 95% CI 1.07 to 2.53) and increased in right lateral tilt (RR 3.30; 95% CI 1.20 to 9.08) versus left lateral tilt. Position did not affect systolic blood pressure when comparing left lateral tilt (MD 2.70; 95% CI -1.47 to 6.87) or head down tilt (RR 1.07; 95% CI 0.81 to 1.42) to horizontal positions, or full lateral tilt with 15-degree tilt (MD -5.00; 95% CI -11.45 to 1.45). Manual displacers showed decreased fall in mean systolic blood pressure compared to left lateral tilt (MD -8.80; 95% CI -13.08 to -4.52). Position did not affect diastolic blood pressures when comparing left lateral tilt versus horizontal positions. (MD-1.90; 95% CI -5.28 to 1.48). The mean diastolic pressure was lower in head down tilt (MD -7.00; 95% CI -12.05 to -1.95) when compared to horizontal positions. There were no statistically significant changes in maternal pulse rate, five-minute Apgars, maternal blood pH or cord blood pH when comparing different positions. Authors' conclusions There is limited evidence to support or clearly disprove the value of the use of tilting or flexing the table, the use of wedges and cushions or the use of mechanical displacers. Larger studies are needed.
AFRIKAANSE OPSOMMING: Agtergrond: Tydens keisersnitte kan moeders in verskillende posisies wees. Teater tafels kan lateraal, opwaarts, afwaarts of gebuig word, of 'n wig en kussings kan gebruik word. Op die oomblik is daar geen konsensus oor die beste posisie nie. Doelwitte: Ons het alle beskikbare data oor die plasing van die moeder ondersoek, met die doel om 'n ideale posisie vir 'n verbeterde uitkoms tydens 'n keisersnit vas te stel. Metodes: Ons het die “Cochrane Pregnancy and Childbirth Group's Trials Register“ (September 2009), PubMed (1966 tot 14 September 2009) deursoek en die herwinde artikels se verwysings per hand nagegaan. Keuringskriteria: Gerandomiseerde proewe van vroue wat keisersnitte ondergaan het, is in verskillende posisies vergelyk. Data insameling en analise: Twee outeurs het die kwaliteit, die geskiktheid en data van die studie beoordeel. Resultate: Ons het 17 studies geidentifiseer wat 'n totaal van 683 vroue ingesluit het. Ons het nege studies ingesluit en agt uitgesluit. Die ingeslote studies was van wisselvallige gehalte en die monster groepe was klein. Die meeste vergelykings het data van enkele studies gegee. Dit is 'n tekortkoming en die bruikbaarheid van die resultate is beperk. Die plasing van kop-op teenoor horisontale posisie het die voorkomssyfer van lug embolisme nie geaffekteer nie.(risiko verhouding RR 0.91;95% 95% vertroue interval Cl 0.65 tot 1.26). Daar is geen hipotensiewe veranderinge gevind toe 'n vergelyking gemaak is tussen linker laterale kantel (RR 0.11; 95% Cl 0.01 tot 1.94) regter laterale kantel (RR 1.25; 95% Cl 0.39 tot 3.99) en kop-af kantel (“mean difference” MD -3.00; 95%Cl -8.38 tot 2.38) teenoor horisontale posisies of volle laterale kantel met 'n 15 grade kantel nie (RR 1.20;95% Cl 0.8. tot 1.79). Hipotensiewe episodes het verminder met hand verplasers (RR 0.11; 95% Cl 0.03 tot 0.45), 'n regter lumbale wig in vergelyking met 'n regter bekken wig (RR 1.64; 95% Cl 1.07 tot 2.53) en 'n vermeerdering van die regter laterale kantel (RR3.30; 95% Cl 1.20 tot 9.08) teenoor die linker laterale kantel. In die vergelyking tussen die posisie van linker laterale kantel (MD 2.70; 95% Cl -1.47 tot 6.87) of kop-af kantel (RR 1.07; 95% Cl 0.81 tot 1.42) teenoor horisontale posisies, of volle laterale kantel met 15 grade kantel (MD -5.00; 95% Cl -11.45 tot 1.45) het die posisie nie die sistoliese bloeddruk geaffekteer nie. Hand verplasers het 'n verminderde daling in gemiddelde sistoliese bloeddruk veroorsaak in vergelyking met linker laterale kantel plasing (MD -8.80;95% Cl-13.08 tot -4.52). In die vergelyking tussen linker laterale kantel en horisontale posisie was daar geen effek op die diastoliese bloeddruk nie (MD -1.90; 95% Cl -5.28 tot1.48). Die gemiddelde diastoliese druk was laer in die kop-af kantel (MD -7.00; 95% Cl -12.05 tot -1.95) in vergelyking met horisontale posisies. In die vergelyking tussen die verskillende posisies was daar geen betekenisvolle statistiese veranderinge in die moeder se polstempo, vyf minute Apgartellings, moederlike bloed pH of naelstringbloed pH nie. Outeur se gevolgtrekkings: Daar is beperkte getuienis om die waarde van kantel, buiging van tafel, die gebruik van wieë en kussings of die gebruik van maganiese verplasers te ondersteun of totaal te verwerp. Groter studies is nodig.
Womack, Lindsay Shively. "Severe Maternal Morbidity in Florida: Risk Factors and Determinants of the Increasing Rate". Scholar Commons, 2017. http://scholarcommons.usf.edu/etd/6783.
Pełny tekst źródłaShokane, Morogwana Anna. "The utilization of the partograph by midwives in Lebowakgomo and Zebediela level 1 hospitals in the Capricorn District of the Limpopo Province, South Africa". Thesis, University of Limpopo (Turfloop Campus), 2011. http://hdl.handle.net/10386/627.
Pełny tekst źródłaIntroduction and aim: Globally it is of paramount importance that all pregnant women in labour are monitored by midwives utilizing a partograph so that a live baby is delivered. Midwives seemed not to utilize the partograph correctly when monitoring women in labour. The purpose of this study was to determine the utilization of the partograph by midwives in the labour wards of Lebowakgomo and Zebediela level 1 hospitals in the Capricorn District of the Limpopo Province, South Africa. The research question was, “What skills and knowledge do midwives have on the utilization of the partograph for monitoring pregnant women in labour”. The objectives of this study were to explore and describe the utilization of the partograph by midwives in Lebowakgomo and Zebediela level 1 hospitals in the Capricorn District of the Limpopo Province, and to develop guidelines that would assist midwives to effectively utilize the partograph hence provision of quality midwifery care. Research Design and method: The research design was qualitative, descriptive, explorative and contextual in nature. The population comprised all midwives registered with the South African Nursing Council and practicing as such in Lebowakgomo and Zebediela level 1 hospitals. A purposive sampling technique was used to select 15 participants. Data were collected using semi-structured in–depth interviews with a guide. The semi-structured in-depth interviews were conducted until data were saturated. Trustworthiness was ensured by credibility, dependability, transferability and confirmability. Ethical clearance to conduct the study was obtained from the University of Limpopo and from the Department Health and Social Development. The principles of informed consent, confidentiality and anonymity were observed during the study. Data were analyzed using the Tesch’s approach as described by Creswell (1994) cited in de Vos (2005:333). Conclusions: The following themes emerged during data analysis: monitoring of foetal status during intrapartum, monitoring of the progress of labour during intrapartum, monitoring of the maternal status during intrapartum, and shortage of staff in the labour wards. Guidelines which aimed at improving midwifery care were formulated.
Hsu, Lorena. "The comparison of obstetric complication histories of individuals with childhood-onset schizophrenia vs. adult-onset schizophrenia, a multi-site feasibility study". Thesis, National Library of Canada = Bibliothèque nationale du Canada, 1999. http://www.collectionscanada.ca/obj/s4/f2/dsk1/tape9/PQDD_0006/MQ45907.pdf.
Pełny tekst źródłaViljoen, J. E. (Johanna E. ). "The R563Q mutation of the β-subunit of the epithelial sodium channel gene associated with hypertensive disease and related complications in pregnancy". Thesis, Stellenbosch : University of Stellenbosch, 2010. http://hdl.handle.net/10019.1/5443.
Pełny tekst źródłaENGLISH ABSTRACT: Introduction: Hypertensive disease is one of the cardinal causes of maternal morbidity and mortality in South Africa. According to the National Confidential Enquiry into Maternal Deaths (NCEMD) report for 2005-2007, the “big five” causes of maternal death have remained the same as in the previous triennium, with hypertensive disease in second place, being the causative factor in 15.7% of cases.1 Women under 20 years of age were at greater risk of dying due to complications of hypertension. In this light, the early identification and treatment of hypertensive disease remains important priorities in improving maternal care. Various serum markers have been studied to identify women at risk of pre-eclampsia, including biological markers and genetic factors.2 It is also well known that chronic hypertension is one of the major predisposing factors to the development pre-eclampsia.2 A continued search for a genetic screening test to assist in early diagnosis could facilitate a reduction of maternal morbidity and mortality. Aims: The aim of this project is to determine the prevalence of the R563Q mutation of the -subunit of the epithelial sodium channel (-ENaC) gene in a cohort of primigravid women with hypertensive disease in pregnancy and to compare pregnancy outcomes in this group of hypertensive patients to those not identified to be carriers of the mutation. Methodology: A retrospectively collected study cohort of patients with early onset pre-eclampsia, obtained from pooled samples and data from the GAP study (Genetic Aspects of Pre-eclampsia, project number C99/025), was used. The planned sample size was 200, with 200 controls who were ethnic-matched, normotensive women. Exclusion criteria were gestation 34 weeks, multiple pregnancy, known underlying collagen vascular disease and type I Diabetes Mellitus. Outcome criteria: The pregnancy outcomes were analysed with respect to the degree of hypertensive disease and related complications (maternal, placental and neonatal). Results: Blood samples form 104 patients and 80 control samples were analysed. Pre-eclamptic patients were significantly younger than controls (p<0.0001). The presence of the mutation was not significantly increased in the pre-eclamptic group (p=0.33). The mutation bearers did not exhibit a significant tendency towards a specific degree of pre-eclampsia (p=0.51). There were no significant differences in the other studied maternal or fetal outcome measures. A composite outcome (the presence of 1 adverse outcome compared to no adverse outcome) was created which did not differ between the mutation positive and negative pre-eclamptic patients. Data of the index study was combined with the data form a prior relevant study9 and combined odds ratios were calculated. The increased mutation frequency amongst pre-eclamptics compared to healthy controls then remains significant, OR 2.57(95%CI 1.23-5.36). Conclusion: In this study the R563Q mutation of the ß-subunit of the epithelial sodium channel gene was not linked to pre-eclampsia. No significant negative correlation could be established between the presence of the R563Q mutation and the outcomes of pre-eclampsia. Further research aimed at chronic hypertensive patients in pregnancy and unstable pre-eclampsia in larger study groups could shed more light on the relation between the mutation and the pre-eclamptic phenotype.
AFRIKAANSE OPSOMMING: Inleiding: Hipertensie-verwante siektes is een van die hoof oorsake van moederlike morbiditeit en mortaliteit in Suid-Afrika. Volgens die Nasionale Vertroulike Ondersoek insake Moederlike Sterftes (NCEMD) verslag vir 2005-2007, is die “groot vyf” oorsake van moedersterftes dieselfe as in die vorige triënnium, met hipertensie-verwante siektes in tweede plek, as die oorsaak van 15.7 % van die sterfgevalle. 1 Vroue jonger as 20 jaar het ‘n groter risiko om te sterf aan die komplikasies van hipertensie-verwante siektes. In die lig hiervan is die vroeë identifikasie en behandeling van hipertensie-verwante siektes ‘n priorteit in die verbetering van moedersorg. Verskeie serum merkers is al bestudeer met die hoop om vroue met verhoogde risiko vir die ontwikkelling van pre-eklampsie te identifiseer, wat biologiese merkers en genetiese faktore insluit. 2 Dit is ook welbekend dat chroniese hipertensie een van die hoof predisponerende faktore is vir die ontwilkkeling van pre-eklampsie.2 ‘n Voortgesette soektog na ‘n genetiese siftingstoets wat kan bydra tot vroeë identifisering, sou moederlike morbiditeit en mortaliteit kon verminder. Doelwittle: Die doelwit van hierdie projek is om die prevalensie van die R563Q mutasie van die -subeenheid van die epiteliële natrium kanaal (-ENaC) geen te bepaal in ‘n kohort primigravida vroue met hipertensie-verwante siekte in swangerskap en om die swangerskapsuitkomste van hierdie groep te vergelyk met pasiente wat nie draers van die mutasie is nie. Metodologie: ‘n Retrospektief versamelde studie kohort met vroeë aankoms pre-eklampsie, verkry van die monsterbank en data van die GAP studie (Genetic Aspects of Pre-eclampsia, projek nommer C99/025) is gebruik. Die beplande steekproef grootte was 200, met 200 kontroles, wat etnies- en ouderdomvergelykbare normotensiewe vroue was. Uitsluitingskriteria was gestasie 34 weke, onderliggende bindweefselsiekte en tipe I Diabetes Mellitus. Uitkomskriteria: Swangerskap uitkomste was geanaliseer met betrekking tot die graad van hipertensiewe siekte en verwante kompliksies (moederlik, plasentaal en neonataal). Resultate: Bloed monsters van 104 pasiënte en 80 kontroles is ontleed. Pre-eklampsie pasiënte was betekenisvol jonger as kontroles (p<0.0001). Die teenwoordigheid van die mutasie was nie betekenisvol verhoog in die pre-eklampsie groep nie (p=0.33). Die mutasie-draers het nie ‘n geneigdheid tot ‘n spesifieke graad van pre-eklampsie getoon nie (p=0.51). Daar was geen betekenisvolle verskille tussen die ander moederlike of fetale uitkomste wat bestudeer is nie. ‘n Gesamentlike uitkoms (teenwoordigheid van 1 swak uitkoms vergeleke met geen swak uitkoms) is geskep; daar was geen verskil tussen die mutasie-positief en negatiewe pasiënte met pre-eklampsie nie. Data van die indeks studie en relevante data uit ‘n vorige studie9 is saamgevoeg en die gesamentlike kansverhouding is bereken. Die verhoogde mutasie frekwensie onder pasiënte met pre-eklampsie vergeleke met gesonde kontroles was betekenisvol, KV 2.57(95%VI 1.23 - 5.36). Gevolgtrekking: In hierdie projek was daar nie ‘n verband tussen die R563Q mutasie van die -subeenheid van die epiteliële natrium kanaal (-ENaC) geen en pre-eklampsie nie. Geen betekenisvolle negatiewe korrelasie tussen die R563Q mutasie en pre-eklampsie uitkomste kon aangetoon word nie. Verdere navorsing gerig op pasiënte met chroniese hipertensie of akute, onstabiele pre-eklampsie in groter studiegroepe kan die verband tussen die mutasie en die pre-eklampsie fenotipe moontlik beter toelig.
Сухарєв, Анатолій Борисович, Анатолий Борисович Сухарев i Anatolii Borysovych Sukhariev. "Клініко-імунологічні аспекти післяпологових гнійно-запальних захворювань". Thesis, Видавництво СумДУ, 2004. http://essuir.sumdu.edu.ua/handle/123456789/9020.
Pełny tekst źródłaHesselman, Susanne. "Caesarean Section : Short- and long-term maternal complications". Doctoral thesis, Uppsala universitet, Obstetrik & gynekologi, 2017. http://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-327934.
Pełny tekst źródłaDuhn, Lenora Jane. "The impact of a maternity cooperative care program on maternal and infant complications, maternal competence, social support, and stress". Thesis, McGill University, 1996. http://digitool.Library.McGill.CA:80/R/?func=dbin-jump-full&object_id=23999.
Pełny tekst źródłaMasters, Heather R. "Maternal Obesity is an Independent Risk Factor for ICU Admission during Hospitalization for Delivery". University of Cincinnati / OhioLINK, 2017. http://rave.ohiolink.edu/etdc/view?acc_num=ucin1491559250082122.
Pełny tekst źródłaLundgren, Ingela. "Releasing and relieving encounters : Experiences of pregnancy and childbirth". Doctoral thesis, Uppsala : Acta Universitatis Upsaliensis : Univ.-bibl. [distributör], 2002. http://publications.uu.se/theses/91-554-5292-2/.
Pełny tekst źródłaWipplinger, Petro. "Is an educational intervention effective in improving the diagnosis and management of suspected ectopic pregnancy in a tertiary referral hospital in South Africa". Thesis, Stellenbosch : University of Stellenbosch, 2010. http://hdl.handle.net/10019.1/5241.
Pełny tekst źródłaENGLISH ABSTRACT: Study objective: To investigate whether an educational intervention in the Gynaecology Department of Tygerberg Hospital (TBH) was effective in improving the accuracy of the diagnosis and appropriateness of treatment options offered to women with suspected Ectopic Pregnancy (EP). Methods: A retrospective cross-sectional before-and-after study was performed, including 335 consecutive patients with suspected EP before (1/3 - 30/6/2008) and after (1/9 - 31/12/2008) “the intervention”. From the gynaecological admissions register all pregnant patients with symptoms potentially compatible with EP were selected and these were cross referenced with beta-hCG requests, entries in the theatre register for surgery for possible EP and methotrexate prescriptions for EP in these time periods. “The intervention” consisted of a formal lecture presented to the registrars and consultants regarding the latest evidence-based guidelines concerning the diagnosis and management of EP. An algorithm based on this information was introduced in the emergency unit and ultrasound unit together with a prescribed ultrasound reporting form containing all the pertinent information required to follow the algorithm. Clinical decisions were left to the registrar and consultant on duty. Primary outcomes: Time from presentation to treatment, number and appropriateness of special investigations, surgical procedures or medical management. Secondary outcomes: Number of in-patient days and visits, adherence to the algorithm. Results: There was a non-significant trend towards improved reporting of the uterine content and significantly less reports of definite signs of an intrauterine pregnancy (IUP) (p<0.001, RR 0.46, 95% CI 0.31-0.70) due to stricter ultrasound criteria being followed. There was a significant change in the spectrum of uterine findings (p=0.001), the spectrum of adnexal findings (p=0.006) and the spectrum of free fluid noted (p=0.05). There was a reduction in the total number of beta-hCG levels requested at presentation (patients with no beta-hCG: 24 vs 34, p=0.05, RR 1.60, 95% CI 0.99-2.59) with a significant reduction in the number of inappropriate beta-hCG requests (77 vs 40, p<0.001, RR 0.60, 95% CI 0.43-0.81). There was a significant difference in the spread of the number of beta-hCG tests per patient with less repeat tests in the study group (p=0.021). Significantly less manual vacuum aspirations (MVAs) were performed (47 vs 21, p=0.003, RR 0.51, 95% CI 0.32-0.81) but there was no change in the other treatment modalities offered nor in the time from presentation to treatment, number of visits or in-patient days. Adherence to the algorithm was poor (59 %). Conclusions: Except for a significant decrease in the MVAs performed, with possibly less interrupted early intrauterine pregnancies, the improvement in the use of special investigations after “the intervention” did not translate into fewer inappropriate diagnoses and management. This could be due to frequent non-adherence to the algorithm, and widespread implementation of the algorithm as well as continuous audits would be necessary before a future study could be attempted to assess the efficacy of the algorithm.
AFRIKAANSE OPSOMMING: Studiedoelwit: Die hoofdoel van hierdie studie is om te ondersoek of „n opvoedkundige intervensie in die Ginekologiese afdeling van Tygerberg Hospitaal (TBH) doeltreffend sou wees in die verbetering van die akkuraatheid van diagnose en die gepastheid van behandelingsopsies wat aan vroue gebied word met „n vermoedelike ektopiese swangerskap (ES). Metodes: „n Retrospektiewe, kruisdeursnee voor-en-na studie rakende 335 opeenvolgende pasiënte wat ‟n vermoedelike ES het voor (1/3/2008 – 30/6/2008) en na (1/9/2008 – 31/12/2008) “die intervensie”. Swanger pasiënte is uit die ginekologiese toelatingsregister geselekteer indien hulle simptome gehad het wat moontlik verbind kon word met ES. Hulle is kruisverwys met die beta-hCG‟s aangevra, inskrywings in die teaterregister vir chirurgie vir moontlike ES en ginekologie-pasiënte wat metotrexate vir ES binne hierdie tydperke ontvang het. “Die intervensie” het bestaan uit „n formele lesing aan die kliniese assistente en konsultante ten opsigte van die jongste bewysgebaseerde riglyne rakende die diagnose en hantering van ES. „n Algoritme gegrond op hierdie inligting is in die noodeenheid en ultraklank-afdeling ten toon gestel asook „n voorgeskrewe ultraklank rapporteringsvorm met al die toepaslike inligting wat vereis word om die algoritme te volg. Kliniese besluite is aan die kliniese assistent en konsultant aan diens oorgelaat. Primêre uitkomste: Tydsduur vanaf aanmelding tot behandeling, aantal en gepastheid van spesiale ondersoeke, chirurgiese prosedures en mediese hantering. Sekondêre uitkomste: Die aantal binnepasiëntdae en besoeke, nakoming van die algoritme. Resultate: Daar was „n nie-betekenisvolle neiging tot beter rapportering van die uteriene-inhoud en betekenisvol minder rapportering van definitiewe tekens van „n intra-uteriene swangerskap (IUS) (p<0.001, RR 0.46, 95% CI 0.31-0.70) as gevolg van strenger ultraklankstandaarde gevolg. Daar was „n betekenisvolle verandering in die spektrum van uteriene bevindinge (p=0.001), die spektrum van die adneksale bevindinge (p=0.006) en die spektrum van die vrye vog aangeteken (p=0.05). Daar was „n vermindering in die totale aantal beta-hCG-vlakke aangevra met aanmelding (pasiënte met geen hCG: 24 vs 34, p=0.05, RR 1.60, 95% CI 0.99-2.59) met „n betekenisvolle vermindering in die aantal onvanpaste beta-hCGs aangevra (77 vs 40, p<0.001, RR0.60, 95% CI 0.43-0.81). Daar was „n betekenisvolle verskil in die verspreiding van die aantal beta-hCG-toetse per pasiënt, met minder herhalende toetse in die studiegroep (p=0.021). Betekenisvol minder manuele vakuum aspirasies (MVAs) is uitgevoer (47 vs 21, p=0.003, RR 0.51, 95% CI 0.32-0.81), maar geen verskil in ander behandelingsmodaliteite is aangebied nie, asook geen verskil in die tydsduur vanaf aanmelding, die aantal besoeke of die aantal binnepatiëntdae nie. Nakoming van die algoritme was swak (59%). Gevolgtrekkings: Behalwe vir „n betekenisvolle afname in die MVAs uitgevoer, met moontlik minder onderbroke vroeë IUS, het die verbetering in die gebruik van spesiale ondersoeke ná “die intervensie” nie minder onvanpaste diagnoses en hantering tot gevolg gehad nie. Dit kan die gevolg wees van gereelde nie-nakoming van die algoritme, en uitgebreide implementering van die algoritme asook voortdurende oudits sal nodig wees voor „n verdere studie aangepak kan word om die doeltreffendheid van die algoritme te bepaal.
Massawe, Siriel Nanzia. "Anaemia in women of reproductive age in Tanzania : A study in Dar es Salaam". Doctoral thesis, Uppsala : Acta Universitatis Upsaliensis : Univ.-bibl. [distributör], 2002. http://publications.uu.se/theses/91-554-5308-2/.
Pełny tekst źródłaPereira, Caetano. "Task-shifting of major surgery to midlevel providers of health care in Mozambique and Tanzania a solution to the crisis in human resources to enhance maternal and neonatal survival /". Stockholm, 2010. http://diss.kib.ki.se/2010/978-91-7409-826-6/.
Pełny tekst źródłaJantjes, Louisa. "Inter-level health service referral of women in labour". Thesis, Nelson Mandela Metropolitan University, 2008. http://hdl.handle.net/10948/986.
Pełny tekst źródłaAugust, Furaha. "Effect of Home Based Life Saving Skills education on knowledge of obstetric danger signs, birth preparedness, utilization of skilled care and male involvement : A Community-based intervention study in rural Tanzania". Doctoral thesis, Uppsala universitet, Internationell mödra- och barnhälsovård (IMCH), 2016. http://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-272245.
Pełny tekst źródłaOlefile, Kabelo Monicah. "Misoprostol for prevention and treatment of postpartum hemorrhage : a systematic review". Thesis, Stellenbosch : Stellenbosch University, 2011. http://hdl.handle.net/10019.1/17900.
Pełny tekst źródłaENGLISH ABSTRACT: Background: Misoprostol, a prostaglandin E1 analogue with its uterotonic properties has entered as an integral part of management of the third stage of labour, helping to prevent postpartum haemorrhage (PPH). Objective: To assess evidence on the effectiveness of misoprostol compared to a placebo for the prevention and treatment of postpartum haemorrhage. Methods: Databases searched included; MEDLINE, Google Scholar and Cochrane Central Register of Controlled Trials (CENTRAL). Other sources were also searched. All articles were screened for methodological quality by two reviewers independently by standardized instrument. Data was entered in Review Manger 5.1 software for analysis. Results: Three Misoprostol studies were included (2346 participants), Oral (2 trials) and sublingual (1 trial). Misoprostol has shown not to be effective in reducing PPH (RR 0.65: 95% CI 0.40-1.06). Only one trial reported on need for blood transfusion (RR 0.14; 95% CI 0.02-1.15). Misoprostol use is associated with significant increases in shivering (RR 2.75; 95% CI 2.26-3.34) and pyrexia (RR 5.34; 95% CI 2.86-9.96) than with placebo. No maternal deaths were reported in included trials. Compared to placebo, misoprostol was coupled with less hysterectomies and additional used of uterotonics (RR 0.45; 95%CI 0.21-0.96) compared to placebo. Conclusion: Results of this review shows that the use of misoprostol in combination with some components of active management was not associated with any significant reduction in incidence of PPH. However oral administration showed a significant reduction in incidence of PPH. For its use for treatment of postpartum haemorrhage, there is a need for research focus in optimal dose and route of administration for a clinically significant effect and acceptable side effects.
AFRIKAANSE OPSOMMING: Agtergrond: Misoprostol, 'n prostaglandien E1 analoog met sy uterotonic eienskappe het ingeskryf as' n integrale deel van die bestuur van die derde stadium van kraam, help postpartum bloeding (PPH) te voorkom. Doelwit: Om bewyse oor die effektiwiteit van Misoprostol in vergelyking met 'n placebo vir die voorkoming en behandeling van postpartum bloeding te evalueer. Metodes: Databases gesoek ingesluit, Medline, CINHAL, Google Scholar en Cochrane Sentrale Register van gecontroleerde studies (Sentraal). Ander bronne is ook deursoek. Alle artikels is gekeur vir die metodologiese kwaliteit deur twee beoordelaars onafhanklik deur die gestandaardiseerde instrument. Data is opgeneem in Review Manger 5.1 sagteware vir ontleding. Hoof Resultate: Drie Misoprostol studies were ingesluit (2346 deelnemers). Mondeling (2 proe) en sublinguale (1 verhoor). Misoprostol het getoon nie doeltreffend te wees in die vermindering van PPH (RR 0,65: 95% CI 0,40-1,06). Slegs een verhoor berig oor die noodsaaklikheid vir 'n bloedoortapping (RR 0,14, 95% CI 0,02-1,15). Misoprostol gebruik word geassosieer met 'n aansienlike toename in bewing (RR 2,75, 95% CI 2,26- 3,34) en koors (RR 5,34, 95% CI 2,86-9,96) as met' n placebo. Geen moederlike sterftes is aangemeld in proewe. In vergelyking met placebo, was Misoprostol tesame met minder hysterectomies en addisionele gebruik van uterotonics (RR 0,45, 95% CI,21-,96) in vergelyking met placebo. Gevolgtrekking: Resultate van hierdie studie toon dat die gebruik van Misoprostol in kombinasie met 'n paar komponente van aktiewe bestuur is wat nie verband hou met' n beduidende afname in die voorkoms van PPH. Vir die gebruik vir die behandeling van postpartum bloeding, daar is 'n behoefte vir navorsing fokus in die optimale dosis en die roete van administrasie vir' n klinies beduidende uitwerking en aanvaarbare neweeffekte.
Tong, Stephen. "Investigation of novel endocrine markers of early pregnancy and later pregnancy health". Monash University, Dept. of Obstetrics and Gynaecology, 2004. http://arrow.monash.edu.au/hdl/1959.1/9689.
Pełny tekst źródłaBerg, Marie. "Genuine Caring in Caring for the Genuine : Childbearing and high risk as experienced by women and midwives". Doctoral thesis, Uppsala : Acta Universitatis Upsaliensis : Univ.-bibl. [distributör], 2002. http://publications.uu.se/theses/91-554-5299-X/.
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