scholarly journals Pre-referral management of patients with severe preeclampsia and eclampsia in a district hospital, Southeast Sulawesi, Indonesia

2020 ◽  
Vol 28 (3) ◽  
pp. 104
Author(s):  
Daniel Yoseph Pardomuan ◽  
Budi Prasetyo ◽  
Rizki Pranadyan
Keyword(s):  
Patient Safety ◽  
Pregnant Women ◽  
Antihypertensive Drugs ◽  
District Hospital ◽  
Referral System ◽  
Not Given ◽  
Urine Protein ◽  
Referral Management ◽  
Level I ◽  
Referral Letters

Objective: This study aims to determine the enforcement of diagnosis, management and description of the referral system of PEB and eclampsia patients at Level I Health Facilities and South Konawe Hospital in January-December 2017Materials and Methods: This study used an observational descriptive design, carried out in the Maternity Room of South Konawe Hospital on 1 January-31 December 2017. There were 47 cases of PEB/Eclampsia from 420 total cases. Most cases of PEB/Eclampsia in Konsel Hospital suffered by pregnant women aged> 35 years, as many as 27 cases (59%). age 21- 34 years, 15 (31%) and the lowest among women aged <20 years, as many as 5 cases (10%). Multigravida, which is 38 cases (81%) and 9 cases 19%) in primigravida. Pregnancy> 34 weeks is 46 cases (98%) and 1 case (2%) at <34 weeks gestation. There were 39 referral cases (83%) all of which were counseled and 8 non-referral cases (17%), where completeness of the tools, medicines and referral letters obtained 39 cases (100%) incomplete.Results: The administration of antihypertensive drugs was given to 89% of cases, and MgSO4 was not given to 100% of cases of PEB/Eclampsia referred to RSUD Konawe Selatan due to fear of officers in providing such therapy to PEB/Eclampsia patients. Examination of urine protein as a support for PEB/Eclampsia cases was recorded in 69% of referral cases at the Konawe Selatan General Hospital.Conclusion: From the whole data, it was found that the pre-requisite conditions had not been fulfilled properly. Referral should be well prepared in order to achieve patient safety and decrease in MMR.

scholarly journals Effectiveness of Communication Interventions in Obstetrics—A Systematic Review

2021 ◽  
Vol 18 (5) ◽  
pp. 2616
Author(s):  
Sonia Lippke ◽  
Christina Derksen ◽  
Franziska Maria Keller ◽  
Lukas Kötting ◽  
Martina Schmiedhofer ◽  
...  
Keyword(s):  
Systematic Review ◽  
Patient Safety ◽  
Pregnant Women ◽  
Healthcare Providers ◽  
Level Of Evidence ◽  
Good Communication ◽  
Evidence Level ◽  
Level I ◽  
State Of Research ◽  
Communication Interventions

(1) Background: Obstetric work requires good communication, which can be trained through interventions targeting healthcare providers and pregnant women/patients. This systematic review aims to aggregate the current state of research on communication interventions in obstetrics. (2) Methods: Using the PICOS scheme, we searched for studies published in peer-reviewed journals in English or German between 2000 and 2020. Out of 7018 results, 71 studies were included and evaluated in this synthesis using the Oxford Level of Evidence Scale. (3) Results: The 63 studies that included a communication component revealed a positive effect on different proximal outcomes (i.e., communication skills). Three studies revealed a beneficial effect of communication trainings on distal performance indicators (i.e., patient safety), but only to a limited extent. Most studies simultaneously examined different groups, however, those addressing healthcare providers were more common than those with students (61 vs. 12). Only nine studies targeted expectant mothers. Overall, the evidence level of studies was low (only 11 RCTs), with 24 studies with an evidence level I-II, 35 with level III, and 10 with level IV. (4) Conclusions: Communication trainings should be more frequently applied to improve communication of staff, students, and pregnant women and their partners, thereby improving patient safety.

scholarly journals A randomized controlled trial of combination of peppermint, lavender, and turmeric oil for antipruritic agent in pregnant women

2021 ◽  
Vol 30 (1) ◽  
pp. 39-44
Author(s):  
Fransisca Retno Asih ◽  
Farid Husin ◽  
Oki Suwarsa ◽  
Irda Fidrianny ◽  
Dany Hilmanto
Keyword(s):  
Pregnant Women ◽  
Controlled Trial ◽  
Control Groups ◽  
Analog Scale ◽  
Chi Square ◽  
Herbal Products ◽  
Randomized Controlled ◽  
Level I ◽  
And Control ◽  
Single Blind

BACKGROUND Pruritus is the most common dermatological complaint that occurs during pregnancy, which is around 14–20%. No research related to herbal products to reduce some of the characteristics of pruritus at once has been conducted. This study aimed to assess the effect of blending oil to reduce pruritus based on visual analog scale (VAS). METHODS This was a single-blind, randomized clinical trial that included 57 pregnant women who were at 25–38 weeks of gestation, had a pruritus during pregnancy, a single pregnancy, a level I and II pruritus and a moderate to severe pruritus based on VAS. Pruritus scores were measured using VAS in both the treatment and control groups. The treatment and control groups applied blending oil and placebo, respectively, twice a day after bathing for 2 weeks. Mann–Whitney U, paired t, and chi-square tests were used for the analysis. RESULTS Pruritus reduction in pregnant women who received blending oil was higher than those using placebo (61.08% versus 12.41%, p<0.05). 83% of subjects using blending oils had a reduction of pruritus by >25 mm. Pregnant women who used placebo had a six times greater risk of experiencing pruritus than those who used blending oil (RR = 5.8, 95% CI = 2.613–12.874). CONCLUSIONS Blending oil can be used topically to treat a pruritus in pregnant women.

miR-27b-3p is highly expressed in serum of patients with preeclampsia and has clinical significance

2021 ◽  
Vol 21 ◽  
Author(s):  
Yang Yang ◽  
Fang Tang ◽  
Xuezhi Zhao
Keyword(s):  
Blood Pressure ◽  
Birth Weight ◽  
Serum Creatinine ◽  
Pregnant Women ◽  
Clinical Significance ◽  
Roc Curve ◽  
Late Pregnancy ◽  
Healthy Controls ◽  
Urine Protein ◽  
Fetal Birth Weight

Background: Preeclampsia (PE) is defined as a salient complication of late pregnancy. microRNAs (miRNAs) have emerged as critical biological regulators in PE. This study determined miR-27b-3p expression in serum of PE patients and investigated its clinical significance in PE. Methods: Totally 130 pregnant women including 90 PE patients (51 mild PE and 39 severe PE) and 40 healthy controls were enrolled in this study. miR-27b-3p expression in the serum of PE patients and healthy controls was detected using RT-qPCR. The correlation among miR-27b-3p expression and 24-h urine protein, systolic blood pressure (SBP), diastolic blood pressure (DBP), serum creatinine, and fetal birth weight was analyzed using Pearson's correlation coefficient. The targeting relationship between miR-27b-3p and PPARG was verified. PPARG protein level in PE patients was detected using ELISA kits. The predictive efficiency of miR-27b-3p and PPARG in PE was analyzed using the receiver operating characteristic (ROC) curve. Results: Compared to normal pregnant women, PE pregnant women, especially severe PE patients had higher miR-27b-3p expression. miR-27b-3p was positively correlated with 24-h urine protein, SBP, DBP, and serum creatinine, but negatively correlated with fetal birth weight. PPARG was poorly expressed in PE patients and negatively correlated with miR-27b-3p. ROC curve showed that both miR-27b-3p and PPARG had good predictive efficacy on PE. Conclusion: miR-27b-3p expression in serum of pregnant women with PE was positively correlated with the severity of PE symptoms, suggesting the involvement of miR-27b-3p in PE occurrence.

scholarly journals The Referral System between Primary and Secondary Health Care in Saudi Arabia for Patients with Type 2 Diabetes: A Systematic Review

2017 ◽  
Vol 2017 ◽  
pp. 1-8 ◽  
Author(s):  
Mohammed Senitan ◽  
Ali Hassan Alhaiti ◽  
James Gillespie ◽  
Badar Faiz Alotaibi ◽  
George Binh Lenon
Keyword(s):  
Systematic Review ◽  
Type 2 Diabetes ◽  
Saudi Arabia ◽  
Systematic Approach ◽  
Referral System ◽  
Secondary Health Care ◽  
Referral Systems ◽  
Referral Letters

Background. In Saudi Arabia, the mortality of diabetes is currently reported at 6%. A well-administered referral system is crucial in aiding the management of this disease. Method. A single reviewer employed a systematic approach to searching the literature databases with regard to the question: what are the attributes of referral systems in Saudi Arabia for patients with type 2 diabetes (T2D)? The results were analysed in order to provide recommendations to improve the Saudi health system. Results. Twelve primary studies were identified from a systematic search. Overall, the 12 studies did not clearly mention any of the factors of a good referral system. The referral problems identified by this study included patients’ unnecessary requests for referral, unstructured referral letters, and unclear dissemination guidelines for referral. Conclusions. This research attempted to identify the efficiency of the referral processes that were implemented for patients with T2D. The majority of the included studies were completely silent on the main referral factors for patients. If this review is representative of the referral system in Saudi Arabia, then, in the context of T2D, current referrals are unsafe. Further research on the quality of the referral system, taking into account at least some of the WHO referral guidelines, is required.

Analysis of referral letters to a department of old age psychiatry

2008 ◽  
Vol 25 (1) ◽  
pp. 24-28 ◽  
Author(s):  
Fiona Campbell ◽  
Brian Parsons ◽  
Ruth Loane
Keyword(s):  
Old Age ◽  
Referral Letter ◽  
Ageing Population ◽  
Next Of Kin ◽  
Referral Management ◽  
Referral Form ◽  
Outpatient Departments ◽  
Old Age Psychiatry ◽  
Clinical Records ◽  
Referral Letters

AbstractObjective: There is a paucity of literature on the content of referral letters to psychiatric services and few relating specifically to referrals to a department of old age psychiatry. There has been a significant increase in referrals over the last five years to this service, which may reflect the ageing population and a greater awareness of the service. Our objective was to evaluate the quality and legibility of information received, clarity of reason for referral and details of pre-referral management.Methodology: The clinical records of the first 100 referrals in 2002 to this department were analysed. The referral letters were examined for the documentation of a number of demographic variables, reason for referral, interventions to date and level of urgency.Results: The clinical records of nine patients did not have an identifiable referral letter at the time of this analysis. Of the remaining 91 analysed, 59% were referred by their GP, 33% were inpatient liaison referrals and 8% from outpatient departments. In the majority, patients' details were given, however, only 30% included a phone number. Next-of-kin was mentioned in 29%. GP's name was included in 71% of referrals from OPD and 7% of liaison referrals. The level of urgency was stated in 19%. Whether a domiciliary or OPD visit would be more appropriate was stated in 22%. The reason for referral was clear in 75%, with 43% including some aspect of Mental State Examination, 7% had included a MMSE score, 1% mentioned level of suicide risk.Thirty-one per cent had pre-referral investigations and 45% had pre-referral treatment documented. The letters were clearly legible in 73%.Conclusion: The information in the referral letter in many cases was insufficient to prioritise and expedite appropriate assessment. It is planned to introduce a proforma referral form, specific to old age psychiatry, which would include the information which is required and which would, hopefully, lead to a more efficient service.

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