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Effect of New Peripudendal Block (PPB) in the Second Stage of Labour on Perineal Relaxation and on the Reduction of Episiotomy Rate: A Randomized Control Trial 分娩第二阶段新阴部周围阻滞(PPB)对会阴松弛和降低会阴切开率的影响:一项随机对照试验
IF 1.9 Q3 OBSTETRICS & GYNECOLOGY Pub Date : 2022-03-26 DOI: 10.1155/2022/9352540
A. Beke
Methods In a prospective randomized study, we examined the extent to which the PPB we developed changed the rate of episiotomies, injury rates. Results A total of 333 primiparas and 324 multiparas were included in the study. In the case of primiparas, we used the PPD procedure in 133 cases, while in the case of multiparas, we used it in 103 cases. The rate of episiotomy in primiparas was 89/133 (66.9%) with PPD and 181/200 (90.5%) without PPD (p < 0.02). In multiparas, the episiotomy rate was 30/103 (29.1%) with PPD and 140/221 (63.3%) without PPD (p < 0.02). In the case of primiparas, the rate of perineal injury and lesion was 33/133 (24.8%) with PPD, while without PPD it was 12/200 (6.0%). Examining the need for all surgical care (due to episiotomy and/or injury), a total of 103/133 cases of operative surgery were required with PPD (77/4%) while 183/200 cases were required without PPD (91.5%)(p < 0.02). In the case of multiparas, the rate of perineal injury and lesion was 11/103 (10.7%) with PPD, while without PPD it was 9/221 (4.1%). In the case of multiparas, a total of 41/103 cases required surgical care with PPD (39.8%), while without PPD, 147/221 cases required surgical care (66.5%)(p < 0.02). Conclusion The PPB is simpler, requires less medication, can be easily mastered, and perineal relaxation can also be observed, reducing the need for an episiotomy.
方法在一项前瞻性随机研究中,我们研究了我们开发的PPB在多大程度上改变了外阴切开术的发生率和损伤率。结果共纳入初产妇333例,多产妇324例。在初产妇的病例中,我们使用了133例PPD程序,而在多产妇的病例中,我们使用了103例。有PPD的初产妇会阴切开术率为89/133(66.9%),无PPD的初产妇会阴切开术率为181/200 (90.5%)(p < 0.02)。有PPD的会阴切开率为30/103(29.1%),无PPD的会阴切开率为140/221 (63.3%)(p < 0.02)。在初产妇中,PPD组会阴损伤及病变发生率为33/133(24.8%),未PPD组为12/200(6.0%)。检查所有手术护理的需要(由于外阴切开和/或损伤),共有103/133例PPD患者需要手术治疗(77/4%),而183/200例无PPD患者需要手术治疗(91.5%)(p < 0.02)。在多宫病例中,有PPD的会阴损伤及病变发生率为11/103(10.7%),无PPD的会阴损伤及病变发生率为9/221(4.1%)。在多囊卵巢病例中,有PPD的41/103例需要手术治疗(39.8%),无PPD的147/221例需要手术治疗(66.5%)(p < 0.02)。结论PPB操作简单,用药少,易于掌握,可观察到会阴松弛,减少会阴切开术的需要。
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引用次数: 0
Comparison of Expectant and Excisional/Ablative Management of Cervical Intraepithelial Neoplasia Grade 2 (CIN2) in the Era of HPV Testing HPV检测时代宫颈上皮内瘤变2级(CIN2)的预期治疗与切除/消融治疗的比较
IF 1.9 Q3 OBSTETRICS & GYNECOLOGY Pub Date : 2022-03-24 DOI: 10.1155/2022/7955290
K. Tjandraprawira, A. Olaitan, A. Petrie, N. Wilkinson, A. Rosenthal
Objective To investigate conservative and excisional/ablative treatment outcomes for cervical intraepithelial neoplasia grade 2 (CIN2) following introduction of virological test of cure. Methods This was a retrospective study of prospectively collected data at a teaching hospital colposcopy unit. 331 sequential biopsy-proved CIN2 cases were involved. CIN2 cases diagnosed between 01/07/2014 and 31/12/2017 were either conservatively managed or treated with excision/ablation and then were followed up until discharge from colposcopy clinic and then using the national cervical cytology database. Outcomes were defined: cytological/histological regression was absence of high-grade CIN on biopsy and/or high-grade dysplasia; virological regression was cytological/histological regression and negative human papillomavirus testing; persistence was biopsy-proven CIN2 and/or moderate dyskaryosis; progression was biopsy-proven CIN3+ and/or severe dyskaryosis. Results Median follow-up was 22.6 months (range: 1.9–65.1 months). Among 175 (52.9%) patients initially managed conservatively, 77.3% (133/172) regressed, 13.4% (23/172) persisted, 9.3% (16/172) progressed to CIN3+, and 97 (56.4%) patients achieved virological regression. 156 (47.1%) patients underwent initial excision/ablation, with an 89.4% (110/123) virological cure rate. After discharge, 7 (4.0%) and 3 (1.9%) patients redeveloped CIN in the conservative and treatment groups, respectively, during a median period of 17.2 months. Conclusion Conservative management is a reasonable and effective management strategy in appropriately selected women with CIN2. High rates of histological and virological regression should be expected. The previously mentioned data provide useful information for deciding management options.
目的探讨宫颈上皮内瘤变2级(CIN2)引入病毒学治疗后的保守和切除/消融治疗效果。方法回顾性分析某教学医院阴道镜检查科室的前瞻性资料。331例经序贯活检证实为CIN2。2014年7月1日至2017年12月31日诊断的CIN2例患者,要么保守治疗,要么切除/消融治疗,然后随访至阴道镜诊所出院,然后使用国家宫颈细胞学数据库。结果被定义为:细胞学/组织学倒退是活检中没有高级别CIN和/或高级别不典型增生;病毒学消退为细胞学/组织学消退和人乳头瘤病毒检测阴性;活检证实持续存在CIN2和/或中度核发育不良;活检证实CIN3+和/或严重核发育不良。结果中位随访时间为22.6个月(范围1.9 ~ 65.1个月)。175例(52.9%)患者最初采用保守治疗,77.3%(133/172)患者病情好转,13.4%(23/172)患者持续,9.3%(16/172)进展为CIN3+, 97例(56.4%)患者病毒学好转。156例(47.1%)患者接受了初始切除/消融治疗,病毒学治愈率为89.4%(110/123)。出院后,保守组和治疗组分别有7例(4.0%)和3例(1.9%)患者再次发生CIN,中位时间为17.2个月。结论选择合适的CIN2患者,保守治疗是合理有效的治疗策略。高的组织学和病毒学退化率是可以预料的。前面提到的数据为决定管理方案提供了有用的信息。
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引用次数: 2
Factors Associated with Ruptured Ectopic Pregnancy: A 10-Year Review at a District Hospital in Ghana 与宫外孕破裂相关的因素:加纳一家地区医院的10年回顾
IF 1.9 Q3 OBSTETRICS & GYNECOLOGY Pub Date : 2022-03-07 DOI: 10.1155/2022/1491419
Promise E. Sefogah, Nana E Oduro, A. Swarray-Deen, H. G. Nuamah, Raphael B. Takyi, M. Nuamah, S. Oppong
Background Approximately 1–2% of all pregnancies are ectopic. Despite a decline in ectopic pregnancy-related mortality, there is still a paucity of information on the factors associated with clinical presentation and outcomes in Sub-Saharan Africa which is essential in determining the most appropriate treatment modalities. Methods We performed a ten-year retrospective chart review of cases of ectopic pregnancies managed at the Lekma hospital and assessed them for peculiar risk factors, clinical presentation, and outcomes. Associations between patients' sociodemographic characteristics, clinical presentation, and treatment outcome were evaluated using multiple logistic regression and reported as adjusted odds ratios (AOR). The confidence interval (CI) was set at 95%, and a p value <0.05 were considered significant. Results Over the ten-year period, there were 115 ectopic pregnancies and 14,450 deliveries (7.9/1,000). The mean age ± standard deviation of the 115 patients was 27.61 ± 5.56. More than half of the patients were single (59/115, 51.3%). The majority (71.3%) of the patients presented with a ruptured ectopic pregnancy. After adjusting for covariates, the odds of an ectopic pregnancy presenting as ruptured among single patients was 2.63 times higher than that of married patients (AOR = 3.63, 95% CI: 1.33–9.93, p=0.01). Ectopic pregnancies located in the isthmic region of the tube had a 77% lower odds of presenting as ruptured than those located in the ampullary region (AOR = 0.23, 95% CI: 0.07–0.74, p=0.01). The odds of rupturing were 1.69 times increased for every additional week after the missed period (AOR = 2.69, 95% CI: 1.56–4.64, p < 0.01). No mortalities were reported as a result of an ectopic pregnancy. Conclusion Most of the cases of ectopic pregnancy presented ruptured. Marital status and period of amenorrhoea were significantly associated with rupture.
背景:大约1-2%的妊娠是异位妊娠。尽管异位妊娠相关的死亡率有所下降,但在撒哈拉以南非洲,与临床表现和结果相关的因素的信息仍然缺乏,这对于确定最适当的治疗方式至关重要。方法:我们对Lekma医院的异位妊娠病例进行了十年的回顾性分析,并评估了其特殊的危险因素、临床表现和结局。患者的社会人口学特征、临床表现和治疗结果之间的关联使用多重逻辑回归进行评估,并以调整优势比(AOR)报告。置信区间(CI)为95%,p值<0.05为显著性。结果10年间宫外孕115例,分娩14450例(7.9/ 1000)。115例患者的平均年龄±标准差为27.61±5.56。超过一半的患者为单身(59/115,51.3%)。大多数(71.3%)患者表现为宫外孕破裂。调整协变量后,单身患者宫外孕破裂的几率是已婚患者的2.63倍(AOR = 3.63, 95% CI: 1.33-9.93, p=0.01)。位于峡部的异位妊娠比位于壶腹区的异位妊娠出现破裂的几率低77% (AOR = 0.23, 95% CI: 0.07-0.74, p=0.01)。漏经后每延长1周,破裂几率增加1.69倍(AOR = 2.69, 95% CI: 1.56 ~ 4.64, p < 0.01)。没有因异位妊娠而死亡的报告。结论异位妊娠以破裂为主。婚姻状况和闭经时间与破裂有显著关系。
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引用次数: 2
A Qualitative Study to Explore the Determinants of Risky Sexual Behaviors and Pregnancy among Female Adolescents in Sabah, Malaysia. 一项探讨马来西亚沙巴州女性青少年危险性行为和怀孕决定因素的定性研究。
IF 1.9 Q3 OBSTETRICS & GYNECOLOGY Pub Date : 2022-01-01 DOI: 10.1155/2022/1866326
Idayu Badilla Idris, Shameer Khan Bin Sulaiman, Rozita Hod, Hamed Khazaei, Nik Nairan Abdullah

This investigation was performed in Kota Kinabalu, Sabah state, where the highest number of pregnancies is recorded. The purpose of this study was to determine variables associated with hazardous sexual activity and adolescent pregnancy in Sabah, Malaysia. The findings indicate that familial variables, peer interactions, self-esteem, psychiatric concerns, economic considerations, and sex knowledge all play a significant role in hazardous sexual conduct and adolescent pregnancy in Sabah, Malaysia. Information obtained from this study will help the Malaysian government and other officials to design and establish proper interventions that will help alleviate the challenge of high prevalence of teenage pregnancy. It is suggested that sex education be included in the high school curriculum, along with physical and health education in Sabah, Malaysia.

这项调查是在沙巴州的哥打京那巴鲁进行的,那里记录的怀孕人数最多。本研究的目的是确定与马来西亚沙巴的危险性活动和青少年怀孕相关的变量。研究结果表明,家庭变量、同伴互动、自尊、精神问题、经济考虑和性知识都在马来西亚沙巴的危险性行为和青少年怀孕中起着重要作用。从这项研究中获得的信息将有助于马来西亚政府和其他官员设计和建立适当的干预措施,这将有助于缓解青少年怀孕高流行率的挑战。在马来西亚的沙巴州,有人建议将性教育与体育和健康教育一起纳入高中课程。
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引用次数: 2
Ferric Carboxymaltose in the Management of Iron Deficiency Anemia in Pregnancy: A Subgroup Analysis of a Multicenter Real-World Study Involving 1191 Pregnant Women. 羧基麦芽糖铁治疗妊娠期缺铁性贫血:一项涉及1191名孕妇的多中心真实世界研究的亚组分析
IF 1.9 Q3 OBSTETRICS & GYNECOLOGY Pub Date : 2022-01-01 DOI: 10.1155/2022/5759740
Prakash Trivedi, S Chitra, Suma Natarajan, Vandana Amin, Shilpi Sud, Priti Vyas, Meenakshi Singla, Ajinkya Rodge, Onkar C Swami

Background: Real-world evidence of the efficacy and safety of ferric carboxymaltose (FCM) infusion in Indian pregnant women with iron deficiency anemia (IDA) is lacking.

Objective: To assess the efficacy and safety of intravenous (IV) FCM in Indian pregnant women with IDA in 4 weeks in a real-life scenario.

Methods: This is a subgroup analysis of our previously conducted retrospective, multicenter, observational, real-world PROMISE study. Data on demographic and hematological parameters, patient-reported adverse events, and physicians' clinical impressions of efficacy and safety were analysed at 4 ± 1 week.

Results: This subgroup analysis included 1191 pregnant women in whom IV FCM resulted in a significant increase in hemoglobin (Hb) by 2.8 g/dL and serum ferritin by 30.03 μg/L at 4 weeks (P < 0.001 for both). In 103 pregnant women with severe IDA, there was a significant increase in Hb by 3.6 g/dL (P < 0.001), and serum ferritin by 16.96 μg/L (P=0.12). In 978 pregnant women with moderate IDA, significant improvement in Hb by 2.74 g/dL and serum ferritin by 33 μg/L (P < 0.001 for both) was noted. Similarly, there was a significant increase in red blood cell count, hematocrit, mean corpuscular volume, and mean corpuscular hemoglobin (P < 0.001 for all). In pregnant women with mild IDA (n = 26), Hb increased significantly by 1.99 g/dL (P < 0.001). Adverse effects were reported in 8.6% of pregnant women. No new safety signals or serious adverse effects were observed. Based on physicians' global assessment, good to very good efficacy and safety of IV FCM was noted in 99.2% and 98.6% of pregnant women, respectively.

Conclusions: IV FCM rapidly corrected anemia in a short period of 4 weeks with favorable safety in the second and third trimester of pregnancy with all severities of IDA (severe, moderate, and mild). The physicians' favorable global assessment of FCM's efficacy and safety in pregnant women with IDA supports its use in daily clinical practice. This trial is registered with CTRI/2021/12/039065.

背景:印度孕妇缺铁性贫血(IDA)缺乏羧基麦芽糖铁(FCM)输注的有效性和安全性的实际证据。目的:在真实情况下评估印度妊娠4周内静脉(IV) FCM的有效性和安全性。方法:这是我们之前进行的回顾性、多中心、观察性、真实世界PROMISE研究的亚组分析。在4±1周时,对人口统计学和血液学参数、患者报告的不良事件以及医生对疗效和安全性的临床印象进行分析。结果:该亚组分析包括1191名孕妇,IV FCM导致血红蛋白(Hb)在4周时显著增加2.8 g/dL,血清铁蛋白增加30.03 μg/L(两者均P < 0.001)。103例重度IDA孕妇Hb升高3.6 g/dL (P < 0.001),血清铁蛋白升高16.96 g/L (P=0.12)。在978例中度IDA孕妇中,Hb显著改善2.74 g/dL,血清铁蛋白显著改善33 g/L(两者均P < 0.001)。同样,红细胞计数、红细胞压积、平均红细胞体积和平均红细胞血红蛋白均显著增加(P < 0.001)。在轻度IDA的孕妇中(n = 26), Hb显著增加1.99 g/dL (P < 0.001)。8.6%的孕妇报告了不良反应。未观察到新的安全信号或严重的不良反应。根据医生的整体评估,99.2%和98.6%的孕妇认为IV FCM的疗效好到非常好,安全性好。结论:在妊娠中晚期(重度、中度和轻度),静脉流式细胞术可在短时间内快速纠正贫血,且安全性较好。医生对FCM在IDA孕妇中的有效性和安全性的总体评价支持其在日常临床实践中的使用。该试验注册号为CTRI/2021/12/039065。
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引用次数: 2
Determinants of Antenatal Care Service Satisfaction among Women in Ethiopia: A Systematic Review and Meta-Analysis 埃塞俄比亚妇女产前护理服务满意度的决定因素:系统回顾和荟萃分析
IF 1.9 Q3 OBSTETRICS & GYNECOLOGY Pub Date : 2021-04-13 DOI: 10.1155/2022/9527576
Kenbon Seyoum
Background Antenatal care service satisfaction is a measure of the degree to which a woman seeking care is happy with the antenatal care service provided to her. Thus, this systematic review and meta-analysis aims to identify factors that determine antenatal care service satisfaction among women in Ethiopia. Methods PubMed, Hinari, and Google Scholar were systematically searched for eligible studies. In addition, national university digital libraries were also searched. The Joanna Briggs Institute's (JBI) critical appraisal tools were used to assess the quality of the included articles. The Cochrane Q-statistics and I2 tests were used to assess heterogeneity among the included studies. Publication bias was assessed using Egger's test. Joanna Briggs Institute Critical Appraisal Checklist for Analytical Cross-Sectional Studies. The extracted data were analyzed using STATA version 14 software and the results were presented using the forest plot. Results Of the 274 articles identified through the systematic search of the literature, 13 studies fulfilling the inclusion criteria were included in this meta-analysis. First antenatal care visit (AOR: 0.62 and 95% CI: 0.40, 0.96), women waited <60 min (AOR: 1.87 and 95% CI: 1.40–2.50), women whose privacy was maintained (AOR: 3.91 and 95% CI: 1.97–7.77), women treated respectfully (AOR: 5.07 and 95% CI: 2.34–10.96), and unplanned pregnancies (AOR = 0.28 and 95% CI: 0.10–0.77) were significantly associated with antenatal care service satisfaction. Conclusion The study assessed the determinants of antenatal care service satisfaction in Ethiopia. First antenatal care visit, waiting time (<60 min) to see the care provider, maintenance of privacy, respectful treatment, and pregnancy unplanned were found to be determinants of antenatal care service satisfaction. Counseling a woman to comply with a minimum required antenatal care visits and compassionate and respectful maternity care will increase maternal satisfaction with the antenatal care services.
产前保健服务满意度是衡量寻求保健的妇女对提供给她的产前保健服务感到满意的程度。因此,这个系统的回顾和荟萃分析的目的是确定因素,决定产前保健服务满意度的妇女在埃塞俄比亚。方法系统检索PubMed、Hinari和Google Scholar,寻找符合条件的研究。此外,还检索了国家大学数字图书馆。乔安娜布里格斯研究所(JBI)的关键评估工具被用来评估纳入文章的质量。采用Cochrane q -统计量和I2检验评估纳入研究之间的异质性。采用Egger’s检验评估发表偏倚。乔安娜布里格斯研究所关键评估清单分析横断面研究。提取的数据使用STATA version 14软件进行分析,结果用森林图表示。结果在系统检索的274篇文献中,13篇符合纳入标准的研究被纳入meta分析。首次产前检查(AOR: 0.62, 95% CI: 0.40, 0.96)、等待<60分钟的妇女(AOR: 1.87, 95% CI: 1.40-2.50)、保持隐私的妇女(AOR: 3.91, 95% CI: 1.97-7.77)、受到尊重的妇女(AOR: 5.07, 95% CI: 2.34-10.96)和意外怀孕(AOR = 0.28, 95% CI: 0.10-0.77)与产前护理服务满意度显著相关。结论本研究评估了埃塞俄比亚产前保健服务满意度的决定因素。首次产前检查、等待时间(<60分钟)、隐私维护、尊重对待和意外怀孕是产前护理服务满意度的决定因素。向妇女提供咨询,使其遵守最低要求的产前保健检查和富有同情心和尊重的产妇保健,将提高产妇对产前保健服务的满意度。
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引用次数: 2
Exclusive Breastfeeding and Normative Belief among Rural Mothers in Ethiopia, 2019: A Cross-Sectional Survey Embedded with Qualitative Design. 2019年埃塞俄比亚农村母亲的纯母乳喂养和规范信念:一项嵌入定性设计的横断面调查。
IF 1.9 Q3 OBSTETRICS & GYNECOLOGY Pub Date : 2021-01-01 DOI: 10.1155/2021/5587790
Wolde Melese Ayele

Background: Exclusive breastfeeding has an irrepressible benefit to a child. However, the practice is still low with salient factors in Ethiopia. Therefore, this study aimed to assess exclusive breastfeeding practice and normative beliefs among mothers who have children less than two years of age in Ethiopia, 2019.

Methods: A community-based cross-sectional study was conducted with a sample size of 423 in Ethiopia from March 12 to December 18, 2019. An interviewer-administered questionnaire was used to collect the data. Gender-matched six Focus Group Discussions were conducted. Semistructured guiding questions were used to carry out the discussion. The binary logistic regression model was used to determine the association between dependent and independent variables of the quantitative part.

Results: The prevalence of exclusive breastfeeding practice was 77.5% (95% CI: 73.5, 81.5%). Married mothers (AOR = 2.57; 95% CI: 1.68, 5.65), mothers with antenatal care follow-up (AOR = 4.11; 95% CI: 2.66, 11.17), mothers who delivered at a health institution (AOR = 4.07; 95% CI: 2.99, 10.72), and mothers counseled during antenatal care (AOR = 1.96; 95% CI: 1.12, 4.73) had a positive association, whereas mothers who were unable to read and write (AOR = 0.11; 95% CI: 0.06, 0.99) and employed mothers (AOR = 0.22; 95% CI: 0.16, 0.56) were the variables that had a negative association with exclusive breastfeeding practice.

Conclusions: Although the prevalence of exclusive breastfeeding was good when compared with other studies, rigorous interventions are needed to achieve the WHO recommendation of all infants should exclusively be breastfed. Marital status, educational status, occupation, antenatal care service, place of birth, and counseling of mothers during ANC were factors associated with the exclusive breastfeeding practice.

背景:纯母乳喂养对儿童有不可抑制的好处。然而,由于埃塞俄比亚的突出因素,这种做法仍然很低。因此,本研究旨在评估2019年埃塞俄比亚两岁以下儿童母亲的纯母乳喂养做法和规范信念。方法:于2019年3月12日至12月18日在埃塞俄比亚开展以社区为基础的横断面研究,样本量为423人。使用访谈者填写的问卷来收集数据。进行了六次性别匹配的焦点小组讨论。采用半结构化导向性问题进行讨论。采用二元logistic回归模型确定定量部分因变量与自变量之间的关联关系。结果:纯母乳喂养的患病率为77.5% (95% CI: 73.5, 81.5%)。已婚母亲(AOR = 2.57;95% CI: 1.68, 5.65),母亲进行产前保健随访(AOR = 4.11;95% CI: 2.66, 11.17),在医疗机构分娩的母亲(AOR = 4.07;95% CI: 2.99, 10.72),母亲在产前保健期间得到咨询(AOR = 1.96;95% CI: 1.12, 4.73)有正相关,而不能读写的母亲(AOR = 0.11;95% CI: 0.06, 0.99)和有工作的母亲(AOR = 0.22;95% CI: 0.16, 0.56)是与纯母乳喂养实践负相关的变量。结论:尽管与其他研究相比,纯母乳喂养的患病率较高,但需要严格的干预措施来实现世卫组织关于所有婴儿都应纯母乳喂养的建议。婚姻状况、教育状况、职业、产前保健服务、出生地和非分娩期间母亲的咨询是与纯母乳喂养做法相关的因素。
{"title":"Exclusive Breastfeeding and Normative Belief among Rural Mothers in Ethiopia, 2019: A Cross-Sectional Survey Embedded with Qualitative Design.","authors":"Wolde Melese Ayele","doi":"10.1155/2021/5587790","DOIUrl":"https://doi.org/10.1155/2021/5587790","url":null,"abstract":"<p><strong>Background: </strong>Exclusive breastfeeding has an irrepressible benefit to a child. However, the practice is still low with salient factors in Ethiopia. Therefore, this study aimed to assess exclusive breastfeeding practice and normative beliefs among mothers who have children less than two years of age in Ethiopia, 2019.</p><p><strong>Methods: </strong>A community-based cross-sectional study was conducted with a sample size of 423 in Ethiopia from March 12 to December 18, 2019. An interviewer-administered questionnaire was used to collect the data. Gender-matched six Focus Group Discussions were conducted. Semistructured guiding questions were used to carry out the discussion. The binary logistic regression model was used to determine the association between dependent and independent variables of the quantitative part.</p><p><strong>Results: </strong>The prevalence of exclusive breastfeeding practice was 77.5% (95% CI: 73.5, 81.5%). Married mothers (AOR = 2.57; 95% CI: 1.68, 5.65), mothers with antenatal care follow-up (AOR = 4.11; 95% CI: 2.66, 11.17), mothers who delivered at a health institution (AOR = 4.07; 95% CI: 2.99, 10.72), and mothers counseled during antenatal care (AOR = 1.96; 95% CI: 1.12, 4.73) had a positive association, whereas mothers who were unable to read and write (AOR = 0.11; 95% CI: 0.06, 0.99) and employed mothers (AOR = 0.22; 95% CI: 0.16, 0.56) were the variables that had a negative association with exclusive breastfeeding practice.</p><p><strong>Conclusions: </strong>Although the prevalence of exclusive breastfeeding was good when compared with other studies, rigorous interventions are needed to achieve the WHO recommendation of all infants should exclusively be breastfed. Marital status, educational status, occupation, antenatal care service, place of birth, and counseling of mothers during ANC were factors associated with the exclusive breastfeeding practice.</p>","PeriodicalId":19439,"journal":{"name":"Obstetrics and Gynecology International","volume":"2021 ","pages":"5587790"},"PeriodicalIF":1.9,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7987461/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10390869","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 4
Risk of Selected Fetal Adverse Pregnancy Outcomes at Advanced Maternal Age: A Retrospective Cohort Study in Debre Markos Referral Hospital, Northwest Ethiopia. 高龄产妇选择胎儿不良妊娠结局的风险:埃塞俄比亚西北部Debre Markos转诊医院的回顾性队列研究。
IF 1.9 Q3 OBSTETRICS & GYNECOLOGY Pub Date : 2020-12-24 eCollection Date: 2020-01-01 DOI: 10.1155/2020/1875683
Bikila Tefera Debelo, Melaku Hunie Asratie, Abayneh Aklilu Solomon

Introduction: Pregnancy at an advanced maternal age is defined as pregnancy at 35 years or older. Today, women postpone pregnancy due to different socioeconomic and personal reasons. However, there was limited evidence on fetal adverse outcomes' association with pregnancy at an advanced maternal age in Ethiopia and particularly in the study area. This study was aimed at assessing the effect of pregnancy at an advanced age on selected neonatal adverse pregnancy outcomes in Debre Markos Referral Hospital, Ethiopia, 2019.

Methods: Institution-based retrospective cohort study was conducted on 303 exposed (35 years and older) and 604 nonexposed (20-34 years old) immediate postpartum women who delivered at Debre Markos Referral Hospital after 28 weeks of gestation. All exposed women who fulfilled the inclusion criteria were sampled, and systematic random sampling was employed for those in the nonexposed group. The data were collected from 1st of July to 30th of December, 2019, by face-to-face interview and extraction from maternal chart using a structured questionnaire and data extraction checklist, respectively. Binary logistic regression (bivariate and multivariable) model was fitted, and wealth index was analyzed by principal component analysis. Adjusted relative risk with respect to 95% confidence interval was employed for the strength and directions of association between advanced maternal age and selected adverse pregnancy outcomes, respectively. P-value of <0.05 was used to declare statistical significance.

Results: The incidence of adverse neonatal outcomes including stillbirth, preterm birth, and low birth weight in the advanced maternal age group was 13.2%, 19.8%, and 16.5%, respectively. The incidence of stillbirth, preterm birth, and low birth weight in the nonexposed group was 3.1%, 8.4%, and 12.4%, respectively. The advanced maternal age group had three times the risk of stillbirth compared with the nonexposed group (ARR = 3.14 95% CI (1.30-7.00)). The advanced maternal age group had 2.66 times the risk of delivering preterm fetus (ARR = 2.66 95% CI (1.81-3.77)) compared with the younger counterparts. Low birth weight was not significantly associated with pregnancy at an advanced maternal age.

Conclusion: Fetal adverse outcomes including stillbirth and preterm birth were significantly associated with pregnancy at an advanced maternal age.

导读:高龄妊娠定义为35岁或以上妊娠。今天,由于不同的社会经济和个人原因,妇女推迟怀孕。然而,在埃塞俄比亚,特别是在研究地区,胎儿不良后果与高龄妊娠的关联证据有限。本研究旨在评估高龄妊娠对2019年埃塞俄比亚Debre Markos转诊医院选定的新生儿不良妊娠结局的影响。方法:以机构为基础的回顾性队列研究,对妊娠28周后在Debre Markos转诊医院分娩的303名暴露(35岁及以上)和604名未暴露(20-34岁)的产后妇女进行研究。所有符合纳入标准的暴露妇女均被抽样,未暴露组采用系统随机抽样。数据收集于2019年7月1日至12月30日,分别采用结构化问卷和数据提取清单从产妇图表中提取数据。拟合二元logistic回归(双变量和多变量)模型,采用主成分分析法对财富指数进行分析。采用相对于95%置信区间的校正相对危险度分别来确定高龄产妇与所选不良妊娠结局之间的关联强度和方向。结果p值:高龄产妇组死胎、早产、低出生体重新生儿不良结局发生率分别为13.2%、19.8%、16.5%。未接触组的死胎、早产和低出生体重的发生率分别为3.1%、8.4%和12.4%。高龄产妇组的死产风险是未暴露组的3倍(ARR = 3.14 95% CI(1.30-7.00))。高龄产妇早产风险是年轻产妇的2.66倍(ARR = 2.66 95% CI(1.81-3.77))。低出生体重与高龄孕妇妊娠无显著关联。结论:包括死胎和早产在内的胎儿不良结局与高龄产妇妊娠显著相关。
{"title":"Risk of Selected Fetal Adverse Pregnancy Outcomes at Advanced Maternal Age: A Retrospective Cohort Study in Debre Markos Referral Hospital, Northwest Ethiopia.","authors":"Bikila Tefera Debelo,&nbsp;Melaku Hunie Asratie,&nbsp;Abayneh Aklilu Solomon","doi":"10.1155/2020/1875683","DOIUrl":"https://doi.org/10.1155/2020/1875683","url":null,"abstract":"<p><strong>Introduction: </strong>Pregnancy at an advanced maternal age is defined as pregnancy at 35 years or older. Today, women postpone pregnancy due to different socioeconomic and personal reasons. However, there was limited evidence on fetal adverse outcomes' association with pregnancy at an advanced maternal age in Ethiopia and particularly in the study area. This study was aimed at assessing the effect of pregnancy at an advanced age on selected neonatal adverse pregnancy outcomes in Debre Markos Referral Hospital, Ethiopia, 2019.</p><p><strong>Methods: </strong>Institution-based retrospective cohort study was conducted on 303 exposed (35 years and older) and 604 nonexposed (20-34 years old) immediate postpartum women who delivered at Debre Markos Referral Hospital after 28 weeks of gestation. All exposed women who fulfilled the inclusion criteria were sampled, and systematic random sampling was employed for those in the nonexposed group. The data were collected from 1st of July to 30th of December, 2019, by face-to-face interview and extraction from maternal chart using a structured questionnaire and data extraction checklist, respectively. Binary logistic regression (bivariate and multivariable) model was fitted, and wealth index was analyzed by principal component analysis. Adjusted relative risk with respect to 95% confidence interval was employed for the strength and directions of association between advanced maternal age and selected adverse pregnancy outcomes, respectively. <i>P</i>-value of <0.05 was used to declare statistical significance.</p><p><strong>Results: </strong>The incidence of adverse neonatal outcomes including stillbirth, preterm birth, and low birth weight in the advanced maternal age group was 13.2%, 19.8%, and 16.5%, respectively. The incidence of stillbirth, preterm birth, and low birth weight in the nonexposed group was 3.1%, 8.4%, and 12.4%, respectively. The advanced maternal age group had three times the risk of stillbirth compared with the nonexposed group (ARR = 3.14 95% CI (1.30-7.00)). The advanced maternal age group had 2.66 times the risk of delivering preterm fetus (ARR = 2.66 95% CI (1.81-3.77)) compared with the younger counterparts. Low birth weight was not significantly associated with pregnancy at an advanced maternal age.</p><p><strong>Conclusion: </strong>Fetal adverse outcomes including stillbirth and preterm birth were significantly associated with pregnancy at an advanced maternal age.</p>","PeriodicalId":19439,"journal":{"name":"Obstetrics and Gynecology International","volume":"2020 ","pages":"1875683"},"PeriodicalIF":1.9,"publicationDate":"2020-12-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7775157/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39139062","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 2
Placenta Creta: A Spectrum of Lesions Associated with Shallow Placental Implantation. Creta胎盘:与浅胎盘植入相关的一系列病变。
IF 1.9 Q3 OBSTETRICS & GYNECOLOGY Pub Date : 2020-11-24 eCollection Date: 2020-01-01 DOI: 10.1155/2020/4230451
Jerzy Stanek

Background: On placental histology, placenta creta (PC) ranges from clinical placenta percreta through placenta increta and accreta (clinical and occult) to myometrial fibers with intervening decidua. This retrospective study aimed to investigate the clinicopathologic correlations of these lesions.

Methods: A total of 169 recent consecutive cases with PC (group 1) were compared with 1661 cases without PC examined during the same period (group 2). The frequencies of 25 independent clinical and 40 placental phenotypes were statistically compared between the groups using chi-square test or analysis of variance where appropriate.

Results: Group 1 placentas, as compared with group 2 placentas, were statistically significantly (p < 0.05) associated with caesarean sections (11.2% vs. 7.5%), antepartum hemorrhage (17.7% vs 11.6.%), gestational hypertension (11.2% vs 4.3%), preeclampsia (11.8% vs 2.6%), complicated third stage of labor (18.9% vs 6.4%), villous infarction (14.2% vs 8.9%), chronic hypoxic patterns of placental injury, particularly the uterine pattern (14.8%, vs 9.6%), massive perivillous fibrin deposition (9.5% vs 5.3%), chorionic disc chorionic microcysts (21.9% vs 15.9%), clusters of maternal floor multinucleate trophoblasts (27.8% vs 21.2%), excessive trophoblasts of chorionic disc (24.3% vs 17.3%), segmental fetal vascular malperfusion (27.8% vs 19.9%), and fetal vascular ectasia (26.2% vs 15.2%).

Conclusion: Because of the association of PC with gestational hypertensive diseases, acute and chronic placental hypoxic lesions, increased extravillous trophoblasts in the chorionic disc, chorionic microcysts, and maternal floor trophoblastic giant cells, PC should be regarded as a lesion of abnormal placental implantation and abnormal trophoblast invasion rather than decidual deficiency only.

背景:在胎盘组织学上,creta (PC)的范围从临床的percreta到临床的increta和增生的胎盘(临床的和隐匿的),再到子宫肌纤维并其间有蜕膜。本回顾性研究旨在探讨这些病变的临床病理相关性。方法:将近期连续发生PC的169例患者(第一组)与同期未发生PC的1661例患者(第二组)进行比较,采用卡方检验或方差分析对两组间25种独立临床表型和40种胎盘表型的频率进行统计学比较。结果:与2组胎盘相比,1组胎盘与剖宫产(11.2% vs. 7.5%)、产前出血(17.7% vs. 11.6%)、妊娠高血压(11.2% vs. 4.3%)、先兆子痫(11.8% vs. 2.6%)、分娩第三期并发症(18.9% vs. 6.4%)、绒毛梗死(14.2% vs. 8.9%)、胎盘损伤的慢性缺氧模式,特别是子宫模式(14.8% vs. 9.6%)的相关性有统计学意义(p < 0.05)。大量绒毛周围纤维蛋白沉积(9.5%比5.3%),绒毛膜盘绒毛膜微囊(21.9%比15.9%),母体底多核滋养细胞聚集(27.8%比21.2%),绒毛膜盘滋养细胞过多(24.3%比17.3%),节段性胎儿血管灌注不良(27.8%比19.9%),胎儿血管扩张(26.2%比15.2%)。结论:由于PC与妊娠期高血压疾病、急、慢性胎盘缺氧病变、绒毛膜盘外滋养细胞增多、绒毛膜微囊、母体底滋养细胞巨细胞增多有关,PC应视为胎盘着床异常和滋养细胞侵袭的病变,而不仅仅是蜕膜缺乏。
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引用次数: 2
Live Experiences of Adolescent Mothers Attending Mbale Regional Referral Hospital: A Phenomenological Study. 青少年母亲在Mbale地区转诊医院的生活经验:现象学研究。
IF 1.9 Q3 OBSTETRICS & GYNECOLOGY Pub Date : 2020-11-20 eCollection Date: 2020-01-01 DOI: 10.1155/2020/8897709
Violet Chemutai, Julius Nteziyaremye, Gabriel Julius Wandabwa

Background: Adolescence is a period of transition from childhood to adulthood, and is a critical stage in ones' development. It is characterized by immense opportunities and risks. By 2016, 16% of the world's population was of adolescents, with 82% residing in developing countries. About 12 million births were in 15-19 year olds. Sub-Saharan Africa, particularly East Africa, has high adolescent pregnancy rates, as high as 35.8% in eastern Uganda. Maternal mortality ratio (MMR) attributable to 15-19 years olds is significant with 17.1% of Uganda's MMR 336/100.000 live births being in this age group. Whereas research is awash with contributing factors to such pregnancies, little is known about lived experiences during early motherhood. This study reports the lived experiences of adolescent mothers attending Mbale Hospital.

Materials and methods: A phenomenological study design was used in which adolescent mothers that were attending Young Child Clinic were identified from the register and simple random sampling was used to select participants. We called these mothers by way of phone numbers and asked them to come for focus group discussions that were limited to 9 mothers per group and lasting about 45 minutes-1 hour. Ethical approval was sought and informed written consent obtained from participants. At every focus group discussion, the data which had largely been taken in local languages was transcribed and translated verbatim into English.

Results: The research revealed that adolescent mothers go through hard times especially with the changes of pregnancy and fear of unknown during intrapartum and immediate postpartum period and are largely treated negatively by family and other community members in addition to experiencing extreme hardships during parenting. However, these early mothers' stress is alleviated by the joy of seeing their own babies.

Conclusion: Adolescent motherhood presents a high risk group and efforts to support them during antenatal care with special adolescent ANC clinics and continuous counseling together with their household should be emphasized to optimize outcome not only during pregnancy but also thereafter. Involving these mothers in technical courses to equip them with skills that can foster self-employment and providing support to enable them pursue further education should be explored.

背景:青春期是一个人从童年向成年过渡的时期,是一个人发展的关键阶段。它的特点是巨大的机遇和风险。到2016年,青少年占世界人口的16%,其中82%居住在发展中国家。大约有1200万新生儿在15-19岁之间。撒哈拉以南非洲,特别是东非,青少年怀孕率很高,乌干达东部高达35.8%。15-19岁的产妇死亡率很高,乌干达每10万例活产336例产妇死亡率中有17.1%发生在这一年龄组。虽然研究充斥着导致这种怀孕的因素,但对早期母亲的生活经历知之甚少。本研究报告青少年母亲在Mbale医院的生活经验。材料与方法:采用现象学研究设计,从登记簿中确定到幼儿诊所就诊的青春期母亲,采用简单随机抽样的方法选择参与者。我们通过电话号码给这些母亲打电话,请她们来参加焦点小组讨论,每组限制为9名母亲,持续约45分钟至1小时。寻求伦理批准,并获得参与者的书面同意。在每次焦点小组讨论中,大部分以当地语文收集的资料都被抄录并逐字翻译成英文。结果:研究发现,青春期母亲经历了艰难的时期,特别是在分娩期间和产后期间,由于怀孕的变化和对未知的恐惧,在很大程度上受到家庭和其他社区成员的负面对待,并且在育儿过程中经历了极大的困难。然而,这些早期母亲的压力被看到自己孩子的快乐所缓解。结论:未成年母亲是高危人群,应加强对其产前护理的支持,建立专门的青少年产前护理诊所,并与家庭一起进行持续的咨询,以优化其孕期和产后的预后。应探讨让这些母亲参加技术课程,使她们掌握能够促进自营职业的技能,并向她们提供支助,使她们能够继续接受教育。
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引用次数: 6
期刊
Obstetrics and Gynecology International
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