Objective:?To describe blood transfusion practices in obstetric at the Sylvanus Olympio University Hospital in Lomé. Patients and method: Prospective, cross-sectional and descriptive study, conducted from 1 June ...Objective:?To describe blood transfusion practices in obstetric at the Sylvanus Olympio University Hospital in Lomé. Patients and method: Prospective, cross-sectional and descriptive study, conducted from 1 June 2017 to 31 May 2018 at the gynecology-obstetrics department. The study focused on transfused pregnant, parturient and delivered women. Study parameters were sociodemographic, clinical, therapeutic and prognostic. Results: 252 patients, aged 16 to 49 with an average age of 30.4 years, referred in 74% of cases. Hemorrhage was observed in 238 cases (94.4%) and anemia in 14 cases (5.6%). Blood transfusion was urgently used in 89.7% of cases and hemorrhagic abortion was the main indication. Blood group O+ (34.5%) was the most used and blood products were obtained after two hours in 81% of cases. Conclusion: Blood transfusion is often performed urgently and for bleeding. But the Gynecology-Obstetrics department does not have any blood in reserve, whereas the Sylvanus Olympio University Hospital collection and distribution station covers less than 10% of the needs.展开更多
Introduction: the demand for urgent obstetric and gynecology care has progressively increased: in the United States approximately 1.4 million gynecologic visits are made to the emergency department (ED) annually, whil...Introduction: the demand for urgent obstetric and gynecology care has progressively increased: in the United States approximately 1.4 million gynecologic visits are made to the emergency department (ED) annually, while almost 75% of women make at least 1 unscheduled visit during pregnancy. Moreover, research has recently focused on setting standards in unscheduled care, and developing quality indicators to improve patients’ health. Therefore, we investigated the characteristics of women with acute gynecological or pregnancy complaints using quality indicators developed for emergency medicine, to better define the needs of this population and improve care. Methods: Retrospective cohort study on ED, and Obstetrics and Gynecology (ObGyn) triage visits, at a tertiary care hospital in Italy, during 2012. Data were analyzed with population-averaged logistic regression and Poisson regression. Results: When compared to the 33,557 ED visits, the 9245 ObGyntriage referrals were more frequently associated with pregnancy (≤12 weeks’ gestation, OR: 30.7, 95%CI;24.5 - 38.4;>12 weeks’ gestation, OR 81.2, 95%CI;64.8 - 101.4), vaginal bleeding (OR 156.6, 95%CI;82.7 - 294.4), diurnal (night access OR 0.87, 95% CI;0.78 - 0.96) and weekday access (holiday access OR 0.87, 95%CI;0.78 - 0.95), frequent users (recurrent ED visits IRR 0.87, 95%CI;0.83 - 0.9) and lower hospital admissions (ED admission OR 1.6, 95%CI;1.4 - 1.8). Conclusion: ObGyn triage patients differed from ED users, and were at higher risk of “crowding”. Such diversities should be considered to improve female healthcare services and allocate resources more efficiently.展开更多
Objectives:To describe and compare fear of childbirth and in-labor pain intensity between primiparas and multiparas and explore the association between the amount of actual pain relief and fear of childbirth.Methods:A...Objectives:To describe and compare fear of childbirth and in-labor pain intensity between primiparas and multiparas and explore the association between the amount of actual pain relief and fear of childbirth.Methods:A convenience sampling method was used.A total of 260 women undergoing spontaneous or induced labor,including 97 primiparas and 163 multiparas,were recruited in a large academic specialized hospital in Guangzhou,China,from February 2018 to August 2019.The clinical data of maternal and neonatal were extracted from a structured electronic medical record system.Other demographic information,such as employment and family monthly income,was collected by a questionnaire.The Numeric Rating Scale(NRS)and the Chinese version of the Childbirth Attitude Questionnaire(C-CAQ)were applied to assess maternal in-labor pain intensity and fear of childbirth.The analgesic consumption and the frequency of manual boluses as rescue analgesia were stored and collected from the analgesia pump.Results:Eighty-two(84.5%)primiparas and ninety-nine(60.7%)multiparas received epidural analgesia(P<0.001).In the epidural subgroup,the primiparous average fear of childbirth(36.46±10.93)was higher than that of the multiparas(32.06±10.23)(P¼0.007).However,multiparas reported more intense in-labor pain[8.0(8.0,9.0)vs.8.0(7.0,8.0)],had more successful manual boluses per hour[2.68(1.65,3.85)vs.1.77(0.90,2.47)],more hourly analgesic consumption[23.00(16.00,28.25)vs.17.24(11.52,21.36)mL]and more average analgesic consumption[0.35(0.24,0.45)vs.0.26(0.19,0.35)mL/(h$kg)]than the primiparas(P<0.05).Spearman’s correlation analysis showed that the maximum in-labor pain was weakly positively correlated with fear of childbirth(r¼0.09)(P<0.05),hourly analgesic consumption(r¼0.16)(P<0.01)and average analgesic consumption(r¼0.17)(P<0.05).No statistically significant association was uncovered between analgesic consumption and maternal fear of childbirth.Conclusions:Fear of childbirth is a potential predictor of labor pain intensity.Further study is needed to explore its role and value in pain management during delivery.Parity is not a determinant of pain relief use and should not be a preconceived preference of obstetric care team members to determine the distribution of epidural analgesia,especially when analgesia resources are insufficient.展开更多
目的分析以案例为基础的教学法(Case Based Learning,CBL)联合纠错教学应用于妇产科规范化培训中的价值。方法选取2022年1月—2023年12月在潍坊医学院附属医院妇产科轮转的40名规范化培训医师为研究对象,采用随机数表法将其分为两组,每...目的分析以案例为基础的教学法(Case Based Learning,CBL)联合纠错教学应用于妇产科规范化培训中的价值。方法选取2022年1月—2023年12月在潍坊医学院附属医院妇产科轮转的40名规范化培训医师为研究对象,采用随机数表法将其分为两组,每组20名。对照组实施传统规范化培训,观察组实施CBL联合纠错教学规范化培训,对比两组医师专业理论知识考试成绩、临床技能操作考核成绩及满意度。结果观察组专业理论知识考试成绩高于对照组,差异有统计学意义(P<0.05);观察组病例问询、查体、病例分析、治疗计划分数及总分均高于对照组,差异有统计学意义(P均<0.05);观察组教学模式、学习兴趣、自学能力、表达沟通能力、团队协作能力评分均高于对照组,差异有统计学意义(P均<0.05)。结论在妇产科规范化培训中,采用CBL联合纠错教学方法具有显著的价值,能够提高住培医师的专业理论知识水平,增强他们在实践中的能力,并促进他们的自主学习和团队合作能力。展开更多
文摘Objective:?To describe blood transfusion practices in obstetric at the Sylvanus Olympio University Hospital in Lomé. Patients and method: Prospective, cross-sectional and descriptive study, conducted from 1 June 2017 to 31 May 2018 at the gynecology-obstetrics department. The study focused on transfused pregnant, parturient and delivered women. Study parameters were sociodemographic, clinical, therapeutic and prognostic. Results: 252 patients, aged 16 to 49 with an average age of 30.4 years, referred in 74% of cases. Hemorrhage was observed in 238 cases (94.4%) and anemia in 14 cases (5.6%). Blood transfusion was urgently used in 89.7% of cases and hemorrhagic abortion was the main indication. Blood group O+ (34.5%) was the most used and blood products were obtained after two hours in 81% of cases. Conclusion: Blood transfusion is often performed urgently and for bleeding. But the Gynecology-Obstetrics department does not have any blood in reserve, whereas the Sylvanus Olympio University Hospital collection and distribution station covers less than 10% of the needs.
文摘Introduction: the demand for urgent obstetric and gynecology care has progressively increased: in the United States approximately 1.4 million gynecologic visits are made to the emergency department (ED) annually, while almost 75% of women make at least 1 unscheduled visit during pregnancy. Moreover, research has recently focused on setting standards in unscheduled care, and developing quality indicators to improve patients’ health. Therefore, we investigated the characteristics of women with acute gynecological or pregnancy complaints using quality indicators developed for emergency medicine, to better define the needs of this population and improve care. Methods: Retrospective cohort study on ED, and Obstetrics and Gynecology (ObGyn) triage visits, at a tertiary care hospital in Italy, during 2012. Data were analyzed with population-averaged logistic regression and Poisson regression. Results: When compared to the 33,557 ED visits, the 9245 ObGyntriage referrals were more frequently associated with pregnancy (≤12 weeks’ gestation, OR: 30.7, 95%CI;24.5 - 38.4;>12 weeks’ gestation, OR 81.2, 95%CI;64.8 - 101.4), vaginal bleeding (OR 156.6, 95%CI;82.7 - 294.4), diurnal (night access OR 0.87, 95% CI;0.78 - 0.96) and weekday access (holiday access OR 0.87, 95%CI;0.78 - 0.95), frequent users (recurrent ED visits IRR 0.87, 95%CI;0.83 - 0.9) and lower hospital admissions (ED admission OR 1.6, 95%CI;1.4 - 1.8). Conclusion: ObGyn triage patients differed from ED users, and were at higher risk of “crowding”. Such diversities should be considered to improve female healthcare services and allocate resources more efficiently.
文摘Objectives:To describe and compare fear of childbirth and in-labor pain intensity between primiparas and multiparas and explore the association between the amount of actual pain relief and fear of childbirth.Methods:A convenience sampling method was used.A total of 260 women undergoing spontaneous or induced labor,including 97 primiparas and 163 multiparas,were recruited in a large academic specialized hospital in Guangzhou,China,from February 2018 to August 2019.The clinical data of maternal and neonatal were extracted from a structured electronic medical record system.Other demographic information,such as employment and family monthly income,was collected by a questionnaire.The Numeric Rating Scale(NRS)and the Chinese version of the Childbirth Attitude Questionnaire(C-CAQ)were applied to assess maternal in-labor pain intensity and fear of childbirth.The analgesic consumption and the frequency of manual boluses as rescue analgesia were stored and collected from the analgesia pump.Results:Eighty-two(84.5%)primiparas and ninety-nine(60.7%)multiparas received epidural analgesia(P<0.001).In the epidural subgroup,the primiparous average fear of childbirth(36.46±10.93)was higher than that of the multiparas(32.06±10.23)(P¼0.007).However,multiparas reported more intense in-labor pain[8.0(8.0,9.0)vs.8.0(7.0,8.0)],had more successful manual boluses per hour[2.68(1.65,3.85)vs.1.77(0.90,2.47)],more hourly analgesic consumption[23.00(16.00,28.25)vs.17.24(11.52,21.36)mL]and more average analgesic consumption[0.35(0.24,0.45)vs.0.26(0.19,0.35)mL/(h$kg)]than the primiparas(P<0.05).Spearman’s correlation analysis showed that the maximum in-labor pain was weakly positively correlated with fear of childbirth(r¼0.09)(P<0.05),hourly analgesic consumption(r¼0.16)(P<0.01)and average analgesic consumption(r¼0.17)(P<0.05).No statistically significant association was uncovered between analgesic consumption and maternal fear of childbirth.Conclusions:Fear of childbirth is a potential predictor of labor pain intensity.Further study is needed to explore its role and value in pain management during delivery.Parity is not a determinant of pain relief use and should not be a preconceived preference of obstetric care team members to determine the distribution of epidural analgesia,especially when analgesia resources are insufficient.
文摘目的分析以案例为基础的教学法(Case Based Learning,CBL)联合纠错教学应用于妇产科规范化培训中的价值。方法选取2022年1月—2023年12月在潍坊医学院附属医院妇产科轮转的40名规范化培训医师为研究对象,采用随机数表法将其分为两组,每组20名。对照组实施传统规范化培训,观察组实施CBL联合纠错教学规范化培训,对比两组医师专业理论知识考试成绩、临床技能操作考核成绩及满意度。结果观察组专业理论知识考试成绩高于对照组,差异有统计学意义(P<0.05);观察组病例问询、查体、病例分析、治疗计划分数及总分均高于对照组,差异有统计学意义(P均<0.05);观察组教学模式、学习兴趣、自学能力、表达沟通能力、团队协作能力评分均高于对照组,差异有统计学意义(P均<0.05)。结论在妇产科规范化培训中,采用CBL联合纠错教学方法具有显著的价值,能够提高住培医师的专业理论知识水平,增强他们在实践中的能力,并促进他们的自主学习和团队合作能力。
