Pub Date : 2013-02-03DOI: 10.4172/2167-0420.1000121
Z. Mumtaz, N. Merchant, A. Levay
Despite critics of the ‘opt-out’ policy surrounding HIV testing during antenatal care visits in Uganda suggesting that women may be deterred from seeking antenatal care at facilities with on-site testing, empirical evidence suggests the acceptability of HIV testing during antenatal care has been significantly increasing over the last decade. Furthermore, there is a disconnect between high rates of antenatal care and low rates of facility births implying that there are other reasons women use antenatal care besides to prepare for a facility delivery. The aim of this paper is to investigate the role HIV testing has in the high rates of antenatal care uptake in Uganda. A focused ethnographic study was undertaken in two areas of Kabarole district between the period of September 2009 and January 2010. Data collection consisted of in-depth interviews, focus groups and participant observation.
{"title":"Factors Influencing the Uptake of HIV Testing During Antenatal Care inRural Uganda","authors":"Z. Mumtaz, N. Merchant, A. Levay","doi":"10.4172/2167-0420.1000121","DOIUrl":"https://doi.org/10.4172/2167-0420.1000121","url":null,"abstract":"Despite critics of the ‘opt-out’ policy surrounding HIV testing during antenatal care visits in Uganda suggesting that women may be deterred from seeking antenatal care at facilities with on-site testing, empirical evidence suggests the acceptability of HIV testing during antenatal care has been significantly increasing over the last decade. Furthermore, there is a disconnect between high rates of antenatal care and low rates of facility births implying that there are other reasons women use antenatal care besides to prepare for a facility delivery. The aim of this paper is to investigate the role HIV testing has in the high rates of antenatal care uptake in Uganda. A focused ethnographic study was undertaken in two areas of Kabarole district between the period of September 2009 and January 2010. Data collection consisted of in-depth interviews, focus groups and participant observation.","PeriodicalId":17626,"journal":{"name":"Journal of Womens Health Care","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2013-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83444647","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2013-01-01DOI: 10.4172/2167-0420.1000119
S. Pinzauti, N. Conti, I. D. Blasis, S. Vannuccini, Cinzia Orl, ini, L. Sabbioni, A. Testa, F. Petraglia
Background: Nulliparity is a condition that has been associated with some oncological gynecological diseases. Since religious community is a realistic example of nulliparous women, the present study aims to evidence if nulliparity is a risk factor for developing menstrual disorders and benign gynecological diseases. Materials and Methods: The present observational retrospective study enrolled 442 women divided in Group A (n=216; Catholic nuns) and Group B (n=226; parous women). All eligible women filled in standardized questionnaires, to obtain data on physiological and pathological aspects of menstrual cycle and related gynecological data. Statistical analysis was performed using univariate statistical analyses, Mann-Whitney U test or Fisher exact test. P<0.05 was considered statistically significant. Results: The results showed that nulliparity is not correlated with a different incidence of menstrual cycle disorders (in term of length or bleeding), or gynecological disorders (ovarian or uterine). Dysmenorrhea is more common in pluriparous women, with a higher use of painkillers in nulliparous women. Conclusion: Therefore, the present study suggests that nulliparity does not represent a risk factor for the development of menstrual irregularity and painful symptomatology, compared with pluriparous women.
{"title":"Incidence of Menstrual Disorders is Not Influenced by Nulliparity","authors":"S. Pinzauti, N. Conti, I. D. Blasis, S. Vannuccini, Cinzia Orl, ini, L. Sabbioni, A. Testa, F. Petraglia","doi":"10.4172/2167-0420.1000119","DOIUrl":"https://doi.org/10.4172/2167-0420.1000119","url":null,"abstract":"Background: Nulliparity is a condition that has been associated with some oncological gynecological diseases. Since religious community is a realistic example of nulliparous women, the present study aims to evidence if nulliparity is a risk factor for developing menstrual disorders and benign gynecological diseases. Materials and Methods: The present observational retrospective study enrolled 442 women divided in Group A (n=216; Catholic nuns) and Group B (n=226; parous women). All eligible women filled in standardized questionnaires, to obtain data on physiological and pathological aspects of menstrual cycle and related gynecological data. Statistical analysis was performed using univariate statistical analyses, Mann-Whitney U test or Fisher exact test. P<0.05 was considered statistically significant. Results: The results showed that nulliparity is not correlated with a different incidence of menstrual cycle disorders (in term of length or bleeding), or gynecological disorders (ovarian or uterine). Dysmenorrhea is more common in pluriparous women, with a higher use of painkillers in nulliparous women. Conclusion: Therefore, the present study suggests that nulliparity does not represent a risk factor for the development of menstrual irregularity and painful symptomatology, compared with pluriparous women.","PeriodicalId":17626,"journal":{"name":"Journal of Womens Health Care","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2013-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85316508","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2013-01-01DOI: 10.4172/2167-0420.1000120
M. Lopes
In the USA, about 12.8% of babies (more than half a million a year) are born prematurely. The rate of premature birth has increased by 36% since the early 1980’s, [1] and is now responsible for an estimated $26 billion in costs to the American healthcare system annually [2]. Unfortunately, little progress has been made to decrease prevalence in so serious condition. From a managed care perspective, a premature birth constitutes a potential high cost episode of care and high-risk pregnancies constitute a major category of high-cost for payers. In Medicaid, 27% of all inpatient charges and 60% of all hospital procedures covered by Medicaid [3] are related to pregnancy and although only 10% of pregnancies are considered high risk, they account for 57% of total newborn costs [4]. A recent analysis found that overall, 4% of the Medicaid population was responsible for 48% of program spending in 2001 [5]. These high-cost members translate into highly concentrated spending on only a small fraction of the entire population. In this paper we will identify ways in which new technology can improve the diagnostic accuracy of pregnancy-related disorders and assist in managing the costs of high risk obstetrics.
{"title":"Managing Costs in High Risk Obstetrics: The Value of Technology thatImproves Diagnostic Accuracy","authors":"M. Lopes","doi":"10.4172/2167-0420.1000120","DOIUrl":"https://doi.org/10.4172/2167-0420.1000120","url":null,"abstract":"In the USA, about 12.8% of babies (more than half a million a year) are born prematurely. The rate of premature birth has increased by 36% since the early 1980’s, [1] and is now responsible for an estimated $26 billion in costs to the American healthcare system annually [2]. Unfortunately, little progress has been made to decrease prevalence in so serious condition. From a managed care perspective, a premature birth constitutes a potential high cost episode of care and high-risk pregnancies constitute a major category of high-cost for payers. In Medicaid, 27% of all inpatient charges and 60% of all hospital procedures covered by Medicaid [3] are related to pregnancy and although only 10% of pregnancies are considered high risk, they account for 57% of total newborn costs [4]. A recent analysis found that overall, 4% of the Medicaid population was responsible for 48% of program spending in 2001 [5]. These high-cost members translate into highly concentrated spending on only a small fraction of the entire population. In this paper we will identify ways in which new technology can improve the diagnostic accuracy of pregnancy-related disorders and assist in managing the costs of high risk obstetrics.","PeriodicalId":17626,"journal":{"name":"Journal of Womens Health Care","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2013-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89191084","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2012-11-05DOI: 10.4172/2167-0420.1000E107
A. Ali
I am honored to have been invited to write an editorial to the Journal of Woman’s Health Care. I would like in this article to discuss one of the harmful practice to woman’s health. Female Genital Mutilation (FGM) or Female Genital Cutting represents a violation of human and child rights and outlawed in many countries [1]. Female Genital Mutilation (FGM) or cutting is defined as “all procedures involving partial or total removal of the external female genitalia or other injury to the female organs whether for cultural or other non-therapeutic reasons” [2]. Even to date, the governments of many developing countries where the practice is highly prevalent are not taking strong stand against female genital cutting, this might be explained by the fear of the government from the society which accept circumcision as necessary, natural and adopt the rationale for its existence [3]. In Sudan, where I am working there is a very high prevalence rate of FGM (ranged between 87%-100%) [4]. It is little bit of low prevalence (50.3%) in neighboring Egypt and ranged between 23.3%-45.2% in Nigeria. In some African and Asian countries for example Eritrea, Djibouti, Mali and Somalia, the prevalence rate of FGM is more than 90% [5]. Generally the girls undergo the procedures between the age of 6 and 12 year old before they become decisive persons, thus the practice is against the child and human rights. Female genital cutting always performed by midwives without anesthesia, moreover it is practiced without precaution concerning the septic conditions is putting the girls at a greater risk of complications. FGM is a public health issue with recognized complications such as hemorrhage, shock, infection, necrotizing fasciitis, pain and psychological morbidities [6].
{"title":"Female Genital Mutilation (FGM) is Still a Challenge in DevelopingCountries","authors":"A. Ali","doi":"10.4172/2167-0420.1000E107","DOIUrl":"https://doi.org/10.4172/2167-0420.1000E107","url":null,"abstract":"I am honored to have been invited to write an editorial to the Journal of Woman’s Health Care. I would like in this article to discuss one of the harmful practice to woman’s health. Female Genital Mutilation (FGM) or Female Genital Cutting represents a violation of human and child rights and outlawed in many countries [1]. Female Genital Mutilation (FGM) or cutting is defined as “all procedures involving partial or total removal of the external female genitalia or other injury to the female organs whether for cultural or other non-therapeutic reasons” [2]. Even to date, the governments of many developing countries where the practice is highly prevalent are not taking strong stand against female genital cutting, this might be explained by the fear of the government from the society which accept circumcision as necessary, natural and adopt the rationale for its existence [3]. In Sudan, where I am working there is a very high prevalence rate of FGM (ranged between 87%-100%) [4]. It is little bit of low prevalence (50.3%) in neighboring Egypt and ranged between 23.3%-45.2% in Nigeria. In some African and Asian countries for example Eritrea, Djibouti, Mali and Somalia, the prevalence rate of FGM is more than 90% [5]. Generally the girls undergo the procedures between the age of 6 and 12 year old before they become decisive persons, thus the practice is against the child and human rights. Female genital cutting always performed by midwives without anesthesia, moreover it is practiced without precaution concerning the septic conditions is putting the girls at a greater risk of complications. FGM is a public health issue with recognized complications such as hemorrhage, shock, infection, necrotizing fasciitis, pain and psychological morbidities [6].","PeriodicalId":17626,"journal":{"name":"Journal of Womens Health Care","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2012-11-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78948482","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2012-07-21DOI: 10.4172/2167-0420.1000114
F. Khojasteh, A. Safarzadeh, Burayri
Background: Preeclampsia, is a multisystem disorder unique to human pregnancy. It is one of the main complications during pregnancy and one of the three major causes of matenal mortality. The aim of this study was to evaluate the preeclampsia correlation with season and its risk factors in 15-45 year old women. Methods: The hospital records of consecutive patients (July 2004 - June2007) with preeclampsia were used for this study. This case - control study, the patients of the case group were 2488 persons who had the requirements of the study (age: 15- 45 year, gravid: 1-3), and then other 2488 pregnant women without preeclampsia were selected as the control group. Data achieved through filling questionnaires through the patients file. The SPSS info software program was used for statistical analysis. Results: The results showed that there is an inverse correlation between preeclampsia and seasons. At the start of spring it gradually began to increase and reached to a sudden peak in Autumn and then it suddenly decreased in the winter.The most important factors of the prevalenee of preeclampsia were hypertension, diabetes and previous preeclampsia, respectively.
{"title":"Survey of Correlation between Preeclampsia and Season & Some of itsRisk Factor In Pregnant Women","authors":"F. Khojasteh, A. Safarzadeh, Burayri","doi":"10.4172/2167-0420.1000114","DOIUrl":"https://doi.org/10.4172/2167-0420.1000114","url":null,"abstract":"Background: Preeclampsia, is a multisystem disorder unique to human pregnancy. It is one of the main complications during pregnancy and one of the three major causes of matenal mortality. The aim of this study was to evaluate the preeclampsia correlation with season and its risk factors in 15-45 year old women. Methods: The hospital records of consecutive patients (July 2004 - June2007) with preeclampsia were used for this study. This case - control study, the patients of the case group were 2488 persons who had the requirements of the study (age: 15- 45 year, gravid: 1-3), and then other 2488 pregnant women without preeclampsia were selected as the control group. Data achieved through filling questionnaires through the patients file. The SPSS info software program was used for statistical analysis. Results: The results showed that there is an inverse correlation between preeclampsia and seasons. At the start of spring it gradually began to increase and reached to a sudden peak in Autumn and then it suddenly decreased in the winter.The most important factors of the prevalenee of preeclampsia were hypertension, diabetes and previous preeclampsia, respectively.","PeriodicalId":17626,"journal":{"name":"Journal of Womens Health Care","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2012-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83789385","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2012-02-28DOI: 10.4172/2167-0420.1000105
C. Pafumi, Leanza, A. Carbonaro, M. Stracquadanio, G. Leanza, A. Iemmola, A. D. Agati
Introduction: Uterine rupture occurs when the integrity of the myometrial wall is compromised. It could interest the uterine body (prior to labour) or the lower segment (during labour). The main causes of uterine rupture are obstetric anamnestic factors and/or the administration of oxytocin. Case presentation:The authors report the case of a 42 years old patient without risk factors for uterine rupture. After the expulsion of the placenta the mother had continuous blood loss, for this reason she was subjected to subtotal hysterectomy. Histological examination revealed the absence of decidua in the uterine fundus and thinning of the myometrium. Histological examination of the lesion at the site commented that there was infiltration of the chorionic villi into the endometrium and this is undoubtedly the features of placenta accreta. Conclusion: The authors emphasize the importance of careful observation of the placenta after delivery for the absence of even small placental cotyledons in order to eliminate a rare risk factor for silent uterine rupture.
{"title":"Focal Placenta Accreta and Spontaneous Uterus Rupture in the Post-Partum","authors":"C. Pafumi, Leanza, A. Carbonaro, M. Stracquadanio, G. Leanza, A. Iemmola, A. D. Agati","doi":"10.4172/2167-0420.1000105","DOIUrl":"https://doi.org/10.4172/2167-0420.1000105","url":null,"abstract":"Introduction: Uterine rupture occurs when the integrity of the myometrial wall is compromised. It could interest the uterine body (prior to labour) or the lower segment (during labour). The main causes of uterine rupture are obstetric anamnestic factors and/or the administration of oxytocin. Case presentation:The authors report the case of a 42 years old patient without risk factors for uterine rupture. After the expulsion of the placenta the mother had continuous blood loss, for this reason she was subjected to subtotal hysterectomy. Histological examination revealed the absence of decidua in the uterine fundus and thinning of the myometrium. Histological examination of the lesion at the site commented that there was infiltration of the chorionic villi into the endometrium and this is undoubtedly the features of placenta accreta. Conclusion: The authors emphasize the importance of careful observation of the placenta after delivery for the absence of even small placental cotyledons in order to eliminate a rare risk factor for silent uterine rupture.","PeriodicalId":17626,"journal":{"name":"Journal of Womens Health Care","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2012-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"91544347","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2012-02-21DOI: 10.4172/2167-0420.1000104
T. Waters, J. Bailit
Objective: To determine the most common non-obstetric indications for admission during the antepartum and postpartum period of pregnancy. Methods: This is a population-based investigation of the primary diagnoses for admission in the antepartum and postpartum periods of pregnancy. Data was obtained from the Healthcare Cost and Utilization Project’s State Inpatient Database for the state of California for 2005. The frequency of each primary diagnosis was determined. Diagnoses were classified as obstetric or non-obstetric and compared for differences in maternal race, age and insurance provider. Results: 576,846 total maternal admissions were identified with 35,158 antepartum (6.1%), 536,415 intrapartum (93.0%) and 5273 postpartum (0.9%). Overall, 26.6% of admissions were non-obstetric in nature. The most common non-obstetric indication for antenatal admission was urinary tract infections. The most common postpartum non-obstetric indication for admission was psychiatric/substance abuse disorders. Conclusions: Many admissions during pregnancy are non-obstetric in nature and may be amenable to outpatient screening.
{"title":"Obstetric and Non-Obstetric Indications for Admission in the Antepartum and Postpartum Periods of Pregnancy","authors":"T. Waters, J. Bailit","doi":"10.4172/2167-0420.1000104","DOIUrl":"https://doi.org/10.4172/2167-0420.1000104","url":null,"abstract":"Objective: To determine the most common non-obstetric indications for admission during the antepartum and postpartum period of pregnancy. \u0000Methods: This is a population-based investigation of the primary diagnoses for admission in the antepartum and postpartum periods of pregnancy. Data was obtained from the Healthcare Cost and Utilization Project’s State Inpatient Database for the state of California for 2005. The frequency of each primary diagnosis was determined. Diagnoses were classified as obstetric or non-obstetric and compared for differences in maternal race, age and insurance provider. \u0000Results: 576,846 total maternal admissions were identified with 35,158 antepartum (6.1%), 536,415 intrapartum (93.0%) and 5273 postpartum (0.9%). Overall, 26.6% of admissions were non-obstetric in nature. The most common non-obstetric indication for antenatal admission was urinary tract infections. The most common postpartum non-obstetric indication for admission was psychiatric/substance abuse disorders. \u0000Conclusions: Many admissions during pregnancy are non-obstetric in nature and may be amenable to outpatient screening.","PeriodicalId":17626,"journal":{"name":"Journal of Womens Health Care","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2012-02-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87519788","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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