scholarly journals Is Selective Mediolateral Episiotomy Protective Against Spontaneous Perineal Trauma and OASIS in Malaysian Tertiary hospitals? A Cross Sectional Study from the National Obstetrics Registry.

2020 ◽  
Author(s):  
Shamala Devi Karalasingam ◽  
Ravichandran Jeganathan ◽  
Ravindran Jegasothy ◽  
Sharul Aiman Soelar ◽  
Daniel Reidpath
Keyword(s):  
Medical Officer ◽  
Peninsular Malaysia ◽  
Primary Objective ◽  
Perineal Trauma ◽  
Contributing Factors ◽  
Cross Sectional ◽  
Vaginal Deliveries ◽  
Multiparous Women ◽  
Tertiary Hospitals ◽  
Primiparous Women

Abstract Introduction: Perineal trauma has short- and long-term debilitating effects on women. This study aimed to determine if selective episiotomy is protective against spontaneous perineal trauma and Obstetric anal sphincter injury following singleton vaginal birth in Malaysian tertiary hospitals and to identify the contributing factors.Methods: This study used data from the Malaysian National Obstetrics Registry (NOR)which collects data from 11 tertiary hospitals in Peninsular Malaysia, 1 hospital in the Federal Territory Kuala Lumpur and in 2 from East Malaysia from 2010 to 2017. A total of 1,109,856 deliveries were analyzed of which 731,475 singleton vaginal deliveries with complete variables were included in this study. The primary objective were to identify contributing factors to spontaneous perineal trauma and Obstetric anal splinter injury (OASIS) and if selective episiotomy was effective in reducing perineal trauma.Results: Prevalence of spontaneous perineal trauma in primiparous women was 23% while in multiparous women was 49.7%. First and second-degree perineal tears were the commonest perineal injury followed by vaginal wall tears and labial tears. Less than 0.5% of the subjects had OASIS. Average episiotomy rate was 33.3%. In both primiparous (OR = 0.06; 95% CI; 0.06) and multiparous women (OR 0.08; 95% CI: 0.03), selective episiotomy significantly reduces the risk spontaneous perineal trauma. The risk of OASIS, is reduced by episiotomy in primiparous women (OR 0.06; 95% CI: 0.05–0.07) and in multiparous women (OR 0.19; 95% CI: 0.14–0.26).Conclusion: Women have a higher risk of spontaneous perineal trauma when the accoucheur is a medical officer with less than 6 months’ experience. In primiparous women spontaneous vaginal delivery is a risk for vaginal trauma and selective episiotomy appears to reduce the risk. All women with instrumental delivery are at risk of OASIS and selective episiotomy appears to reduce risk.

scholarly journals Sociodemographic Factors Associated with Request for Labor Epidural Analgesia in a Tertiary Obstetric Hospital in Vietnam

2021 ◽  
Vol 2021 ◽  
pp. 1-5
Author(s):  
Lam D. Nguyen ◽  
Anh D. Nguyen ◽  
Michaela K. Farber ◽  
Chi T. Phan ◽  
Luong T. Khuat ◽  
...  
Keyword(s):  
Epidural Analgesia ◽  
Sociodemographic Factors ◽  
Cross Sectional Study ◽  
Educational Outreach ◽  
Cross Sectional ◽  
Factors Associated ◽  
Vaginal Deliveries ◽  
Multiparous Women ◽  
Education Levels ◽  
Labor Epidural

This study is aimed at examining the sociodemographic factors associated with the utilization of labor epidural analgesia at a large obstetric and gynecology hospital in Vietnam. This was a cross-sectional study of women who underwent vaginal delivery in September 2018 at the Hanoi Obstetrics and Gynecology Hospital. The utilization of epidural analgesia during labor was determined. Univariate and multivariate regression models were applied to evaluate the association between patient demographic and socioeconomic factors and request for labor epidural analgesia. A total of 417 women had vaginal deliveries during the study period. 207 women utilized epidural analgesia for pain relief during labor, and 210 did not. Parturients older than 35 years of age (OR 2.84, 95% CI 1.11-8.17), multiparous women (OR 2.8 95% CI 1.85-4.25), women living from an urban area, women with higher income (OR 6.47, 95% CI 2.59-19.23), and women with higher level of education were more likely to utilize labor epidurals. Factors related to a parturient request for epidural analgesia during labor at our tertiary obstetric hospital included age greater than 35 years, multiparity, and high income and education levels. Educational outreach to women about the benefits of epidural analgesia can target women who do not share these demographic characteristics.

scholarly journals ROBSON’S CLASSIFICATION OF CAESAREAN SECTION CONDUCTED AT A TERTIARY CARE WOMEN’S HOSPITAL

2020 ◽  
Vol 4 (9) ◽  
Author(s):  
Nishtha Agrawal ◽  
Neha Agrawal
Keyword(s):  
Cesarean Section ◽  
Tertiary Care ◽  
Total Duration ◽  
Primary Source ◽  
World Health ◽  
Care Hospital ◽  
Cross Sectional ◽  
Vaginal Deliveries ◽  
The World ◽  
Primiparous Women

Background: Despite the World Health Organization’s recommendation and caution the cesarean section rates are continuously rising across the world. This despite the evidence indicating that this increase in c-section rate is not leading to a decline in the maternal and child mortality rates. The objective of this study was to classify and categories all the primary c-section conducted among multi-parous women delivering at a tertiary care hospital.  Material and Methods: An observational, cross-sectional, single centre study was conducted at the Sultania Zanana Hospital affiliated to Gandhi Medical College, Bhopal. The total duration of the study was one year from April 2013 to March 2014.  The study population comprised of the multi-parous women coming or referred to SHZ.  The primary source of the data for this study where the patient’s interview, treatment records and operation theatre delivery register.  Results: During the period between April 2013 to March 2014, a total of 10,271 deliveries were conducted at SZH; of these 7,570 were normal vaginal deliveries and 3,151 were c-section. The prevalence of primary cesarean section in multipara in the present study is 5.6 %.  Most (62.0%) women were categorized as belonging to the III group while only 2.1% of women were categorized in the VIII group. Discussion:  A large number of primary c-section among primiparous women can be prevented. In comparison to primiparous women, the prevalence of primary c-section was less among multiparous women.

scholarly journals Differences in Inter-Rectus Distance and Abdominopelvic Function between Nulliparous, Primiparous and Multiparous Women

2021 ◽  
Vol 18 (23) ◽  
pp. 12396
Author(s):  
Mercè Balasch-Bernat ◽  
Sofía Pérez-Alenda ◽  
Juan J. Carrasco ◽  
Begoña Valls-Donderis ◽  
Lirios Dueñas ◽  
...  
Keyword(s):  
Muscle Function ◽  
Cross Sectional Study ◽  
Postpartum Women ◽  
Abdominal Muscles ◽  
Sectional Study ◽  
Cross Sectional ◽  
Nulliparous Women ◽  
Multiparous Women ◽  
Ultrasound Assessment ◽  
Primiparous Women

Widening of the inter-rectus distance (IRD) is highly prevalent among postpartum women and can lead to dysfunction of abdominopelvic muscles. The aim of this study was to evaluate the differences in IRD and abdominopelvic function between nulliparous, primiparous and multiparous women. A cross-sectional study was conducted on 75 women (25 nulliparous, 25 primiparous and 25 multiparous at 6 months postpartum). The participants underwent ultrasound assessment under three conditions (at rest, abdominal draw-in maneuver (ADIM) and curl-up) at two locations (2 cm above and 2 cm below the umbilicus). Furthermore, abdominopelvic muscle function was determined by prone, supine and side bridge tests. In all conditions and locations, the IRD were significantly higher (p < 0.05) in the primiparous and multiparous women than in the nulliparous. The multiparous women presented greater (p > 0.05) IRD at rest and during ADIM compared to the primiparous women. Regarding abdominopelvic muscle function, differences were only significant (p < 0.05) between the nulliparous with primiparous women in prone and supine conditions. These findings suggest that parity influences IRD: women at 6 months postpartum present greater IRD compared to nulliparous women; multiparous women present greater IRD at rest and during the activation of deep abdominal muscles than primiparous women; and primiparous women exhibit worse abdominopelvic muscle function than nulliparous women.

scholarly journals Association between perineal trauma and pain in primiparous women

2014 ◽  
Vol 48 (spe) ◽  
pp. 39-44 ◽  
Author(s):  
Adriana Amorim Francisco ◽  
Mirian Hiromi Kinjo ◽  
Caroline de Souza Bosco ◽  
Renata Luana 
da Silva ◽  
Edilaine de Paula Batista Mendes ◽  
...  
Keyword(s):  
High Frequency ◽  
Cross Sectional Study ◽  
Pain Scale ◽  
Perineal Trauma ◽  
Perineal Pain ◽  
Sectional Study ◽  
Cross Sectional ◽  
Mean Intensity ◽  
Numeric Scale ◽  
Primiparous Women

Objective To identify the association between perineal trauma and pain in 473 primiparous women. Method Cross-sectional study in which pain was measured by the numerical pain scale (0 to 10 - 0 being no pain and 10 maximal pain). Results The prevalence and mean intensity of pain were 33.0% and 4.7 points (standard deviation = 2.0) in the numeric scale, respectively. Episiotomy represented the most frequent trauma (46.7%). The occurrence and intensity of the pain were associated with perineal trauma and postpartum time. Having perineal trauma tripled the chance of pain. Each hour elapsed following the birth reduced the chance of pain by 4.8%. Conclusion Primiparous women are subject to a high frequency of perineal trauma, with episiotomy being the most prominent. Perineal pain affects approximately one-third of primiparous women and is associated with the postpartum time and perineal traumas.

scholarly journals Perceptions and prevention practices on malaria among the indigenous Orang Asli community in Kelantan, Peninsular Malaysia

2021 ◽  
Vol 20 (1) ◽  
Author(s):  
Mohd Bakhtiar Munajat ◽  
Mohd Amirul Fitri A. Rahim ◽  
Wathiqah Wahid ◽  
Mohd Ikhwan Mukmin Seri Rakna ◽  
Paul C. S. Divis ◽  
...  
Keyword(s):  
Malaria Elimination ◽  
Indoor Residual Spraying ◽  
Cross Sectional Study ◽  
Peninsular Malaysia ◽  
Bed Nets ◽  
Self Healing ◽  
Contributing Factors ◽  
Cross Sectional ◽  
Orang Asli ◽  
Attitudes And Practices

Abstract Background Malaysia is on track towards malaria elimination. However, several cases of malaria still occur in the country. Contributing factors and communal aspects have noteworthy effects on any malaria elimination activities. Thus, assessing the community’s knowledge, attitudes and practices (KAP) towards malaria is essential. This study was performed to evaluate KAP regarding malaria among the indigenous people (i.e. Orang Asli) in Peninsular Malaysia. Methods A household-based cross-sectional study was conducted in five remote villages (clusters) of Orang Asli located in the State of Kelantan, a central region of the country. Community members aged six years and above were interviewed. Demographic, socio-economic and KAP data on malaria were collected using a structured questionnaire and analysed using descriptive statistics. Results Overall, 536 individuals from 208 households were interviewed. Household indoor residual spraying (IRS) coverage and bed net ownership were 100% and 89.2%, respectively. A majority of respondents used mosquito bed nets every night (95.1%), but only 50.2% were aware that bed nets were used to prevent malaria. Nevertheless, almost all of the respondents (97.9%) were aware that malaria is transmitted by mosquitoes. Regarding practice for managing malaria, the most common practice adopted by the respondents was seeking treatment at the health facilities (70.9%), followed by self-purchase of medication from a local shop (12.7%), seeking treatment from a traditional healer (10.5%) and self-healing (5.9%). Concerning potential zoonotic malaria, about half of the respondents (47.2%) reported seeing monkeys from their houses and 20.1% reported entering nearby forests within the last 6 months. Conclusion This study found that most populations living in the villages have an acceptable level of knowledge and awareness about malaria. However, positive attitudes and practices concerning managing malaria require marked improvement.

scholarly journals Perceptions and prevention practices on malaria among the indigenous Orang Asli community in Kelantan, Peninsular Malaysia

2020 ◽  
Author(s):  
Mohd Bakhtiar Munajat ◽  
Mohd Amirul Fitri A. Rahim ◽  
Wathiqah Wahid ◽  
Mohd Ikhwan Mukmin Seri Rakna ◽  
Paul C. S. Divis ◽  
...  
Keyword(s):  
Malaria Elimination ◽  
Indoor Residual Spraying ◽  
Cross Sectional Study ◽  
Peninsular Malaysia ◽  
Bed Nets ◽  
Self Healing ◽  
Contributing Factors ◽  
Cross Sectional ◽  
Orang Asli ◽  
Attitudes And Practices

Abstract Background Malaysia is on track towards malaria elimination. However, several cases of malaria still occur in the country. Contributing factors and communal aspects have noteworthy effects on any malaria elimination activities. Thus, assessing the community’s knowledge, attitudes and practices (KAP) towards malaria is essential. This study was performed to evaluate KAP regarding malaria among the indigenous people (i.e. Orang Asli) in Peninsular Malaysia. Methods A household-based cross-sectional study was conducted in five remote villages (clusters) of Orang Asli located in the State of Kelantan, a central region of the country. Communities aged 6 years and above were interviewed. Demographic, socio-economic and KAP data on malaria were collected using a structured questionnaire and analysed using descriptive statistics. Results Overall, 536 individuals from 208 households were interviewed. Household indoor residual spraying (IRS) coverage and bednet ownership were 100% and 89.2%, respectively. A majority of respondents used mosquito bed nets every night (95.1%), but only 50.2% aware of bednets were use to prevent malaria. Nevertheless, almost all of the respondents (97.9%) were aware that malaria is transmitted by mosquitoes. Regarding practice for managing malaria, the most common practice adopted by the respondents was seeking treatment at the health facilities (70.9%), followed by self-purchase of medication from a local shop (12.7%), seeking treatment from a traditional healer (10.5%) and self-healing (5.9%). Concerning potential zoonotic malaria, about half of the respondents (47.2%) reported seeing monkeys from their house and 20.1% reported entering nearby forests within the last six months. Conclusion We conclude that most populations living in the villages have an acceptable level of knowledge and awareness about malaria. However, positive attitudes and practices with respect to managing malaria require marked improvement.

scholarly journals Bulky Uterus and Multiparity are Important Contributing Factors for Dysfunctional Uterine Bleeding among Bangladeshi Women

2016 ◽  
Vol 6 (1) ◽  
pp. 23-27
Author(s):  
Nahid Sultana ◽  
Nasima Akhter ◽  
TA Chowdhury
Keyword(s):  
Cross Sectional Study ◽  
Uterine Bleeding ◽  
Contributing Factors ◽  
Dysfunctional Uterine Bleeding ◽  
Hormonal Stimulation ◽  
Cross Sectional ◽  
Tertiary Hospitals ◽  
Microsoft Office ◽  
Almost All

Background: Dysfunctional uterine bleeding (DUB) is irregular uterine bleeding that occurs in the absence of recognizable pelvic pathology, general medical disease, or pregnancy. It reflects a disruption in the normal cyclic pattern of ovulatory hormonal stimulation to the endometrial lining. About 1–2% of women with improperly managed anovulatory bleeding eventually may develop endometrial cancer but determinants behind the disease are largely unknown.Objective: The present study aimed to find out the determinants of dysfunctional uterine bleeding.Materials and Methods: In this cross-sectional study 50 patients of dysfunctional uterine bleeding (DUB) were recruited from different tertiary hospitals in Dhaka city. Clinical parameters have been recorded using a predesigned questionnaire and analyzed using SPSS for Windows version 16.0 and Microsoft Office Excel.Results: In the studied patients, about 38% were suffering from type 2 diabetes mellitus, 12% from obesity and 18% from hypertension. Almost all the patients (96%) were suffering from anemia. Histological findings have shown that endometrium of 63% patients were in proliferative phase, about 16% were in secretory phase and 11% patients were with cystic hyperplasia. Ultrasonographic results have shown that about 72% of the patients had bulky uterus. Ninety two percent patients carried more than two pregnancies, and 40% patients carried >5 pregnancies.Conclusion: Bulky uterus and multiple pregnancies may be associated with dysfunctional uterine bleeding in Bangladeshi women.J Enam Med Col 2016; 6(1): 23-27

scholarly journals Depression Associated with Diabetes in Patients in Attended At Katutura Sate Hospital, Windhoek Namibia

2020 ◽  
pp. 1-3
Author(s):  
Sheehama J ◽  
◽  
Zeko B ◽  
Nghoshi S ◽  
◽  
...  
Keyword(s):  
Depressive Symptoms ◽  
Psychosocial Support ◽  
Primary Objective ◽  
P Value ◽  
Depression Symptoms ◽  
Formal Schooling ◽  
Contributing Factors ◽  
Cross Sectional ◽  
Female Ratio ◽  
Diagnosed Diabetes

This study sought to describe the level of severity of depressive symptoms in adults with diagnosed diabetes. Primary objective was calculating the prevalence of depressive symptoms with secondary objectives of severity and contributing factors to development of depressive symptoms. A cross-sectional study design was used, focussing on the relationships between the outcome of disease (depression) and exposure (factors contributing to development of depression). A three-part questionnaire on demographics, health parameters and depression symptoms was given to adults with diagnosed Diabetes at the Katutura State Hospital Outpatient Department over the course of six weeks, chosen by systemic sampling. Patients on first visit (undiagnosed DM) or with Gestational Diabetes were excluded from the study. Of the 113 individuals who met the inclusion criteria, 101 were included in this study. Only 2 patients (1.98%) had no symptoms of depression whatsoever, the rest categorized into having mild, moderate and severe symptoms. Severe depressive symptoms were present in 19.8% of the total group (20/101), with a male to female ratio of 2:3 (Risk Ratio - 0.98, p-value 0.48), with 40% above the age of 65 (RR - 1.57, p-value 0.14), and 80% had Type 2 Diabetes Mellitus (RR - 1.85, p-value 0.11). Socio-economic factors such as no formal schooling and only having pension as a sole source of income, were most common in the group with severe depression. Health care workers should be able to identify signs of depression and refer accordingly, as psychosocial support is needed in patients with chronic, often incurable conditions

scholarly journals Perinatal outcomes, maternal age, parity and fetal sex – searching for the “optimal” maternal age

2018 ◽  
Author(s):  
Šárka Kaňková ◽  
Jaroslav Flegr ◽  
Radim Kuba ◽  
Pavel Calda
Keyword(s):  
Birth Weight ◽  
Preterm Delivery ◽  
Maternal Age ◽  
Perinatal Outcomes ◽  
Cross Sectional Study ◽  
University Hospital ◽  
Cross Sectional ◽  
Fetal Sex ◽  
Multiparous Women ◽  
Primiparous Women

AbstractBackgroundMaternal age, parity and fetal sex are each known to affect obstetric and birth outcomes. The objective of the present study was to investigate the influence of the combination of maternal age, parity and fetal sex on outcomes of pregnancies._The aim of the study was to analyze the influence of maternal age on perinatal outcomes in both primiparous and multiparous women with different fetal sex.MethodsThe cross-sectional study was performed on data from 11,780 women, who have given birth at the General University Hospital in Prague, Czech Republic between 2008-2012.ResultsMaternal age significantly (P<0.01) influenced pregnancy weight gain, duration of pregnancy, birth weight and birth length. Primiparous women with female newborns aged ≤19 had higher rates of preterm delivery than comparable women 20-39 (P=0.012). Similarly, women with male newborns aged ≥40 had higher rates of preterm delivery than comparable women 20-39 (P=0.003). Women aged ≤24 expressed higher rates of low birth weight than women aged >24 (P<0.001), regardless of parity and fetal sex. The older (≥35) primiparous women with male newborns expressed a higher incidence of macrosomia (P=0.021) compared to other groups of women. The probability of caesarean delivery increased with age (P<0.001) and it was significantly affected by the parity and sex of the newborn with higher rates of caesarean section in primiparous women as well as in mothers carrying male fetuses.ConclusionsOur results indicate that “optimal” maternal age without obstetrics and birth complications is 25-34 years, older age is associated with increased complications with a male fetus, especially in primiparous women. Our data suggests that not just the age of women, but the combination of age, parity, and fetal sex should be taken into consideration during assessment of health risks of pregnancy.

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