A study was conducted to describe midwives’ adherence to preoperative care during emergency caesarian section at Bwaila Maternity Wing in 2012 in Malawi. The study utilized a descriptive prospective and retrospective...A study was conducted to describe midwives’ adherence to preoperative care during emergency caesarian section at Bwaila Maternity Wing in 2012 in Malawi. The study utilized a descriptive prospective and retrospective design. A structured questionnaire was administered to all 28 midwives who were directly involved in the preparation of clients for emergency caesarean section. Clients charts were also reviewed using a standard checklist to determine adherence to preoperative care. Data were analyzed using SPSS version 16.0 and descriptive statistics in the form of frequencies and percentages were computed for the dataset. A midwife was supposed to score at least 80% on each component of preoperative care guidelines to be compliant to the stipulated pre-operation standards. The midwives scored above 80% on only four of the 14 preoperative care guidelines which were;bladder catheterization (100%, n = 14), obtaining informed consent (92.9%, n = 12), administration of IV (96.4%, n = 13) and administration of preoperative antibiotics (82.1%, n = 11). Midwives however scored less than 80% on preoperative procedures that dealt with vital signs (28.6%, n = 4): BP check (28.6%, n = 4);Pulse rate check (25%, n = 3.5);respiration check (25%, n = 3.5) and temperature check (25%, n = 3.5). The midwives scored further below standard on blood specimen collection (78.6%, n = 11). Psychological support to clients was also below standard at 60.7%, n = 8. Other components of psychological support such as surgery information (57.1%, n = 8), allowing clients ask questions (28.6%, n = 4) and answering clients’ questions (25%, n = 3.5) were also scored below standard. Overall the standard of preoperative care was below standard at the facility. Most of the midwives were new graduates, who had never received any in-service training on preoperative care. Therefore in service training it is recommended for the midwives to provide good quality of care.展开更多
Background: Caesarean Section done in emergency basis can result some adverse outcome to both the fetus & mother & complications may arise. Objective: The purpose of the present study was to see the fetal &...Background: Caesarean Section done in emergency basis can result some adverse outcome to both the fetus & mother & complications may arise. Objective: The purpose of the present study was to see the fetal & maternal outcome or any complications among the pregnant woman who had undergone emergency caesarean section. Methodology: This descriptive type of cross sectional study was conducted in the Department of Gynaecology & Obstetrics at Dhaka Medical College Hospital during the period from July 2006 to December 2006. The patients underwent emergency caesarean section for any indication during the mentioned period of study was selected as study population. Among them, 100 cases were recruited in this study. Result: Among the cases, maternal morbidity was as high as 64% which were due to haemorrhage, post-operative infection, rise of blood pressure and other complications. Regarding fetal outcome, 92% babies were born with normal birth weight, 33% babies were developed complications which were mostly due to birth asphyxia and prematurity. Conclusion: In conclusion, emergency caesarean section has maternal morbidity as well as fetal and neonatal adverse outcome.展开更多
Objective: To study emergency cesarean section in teenagers with the goal of reducing morbidity and maternal-fetal mortality. Methods: This was a descriptive cross-sectional study with prospective collection of data o...Objective: To study emergency cesarean section in teenagers with the goal of reducing morbidity and maternal-fetal mortality. Methods: This was a descriptive cross-sectional study with prospective collection of data on 248 cases collected from July 1st to December 31st, 2016. Results: The incidence of cesarean section in teenagers was 56.4%. The average age was 18 ± 0.4 years old. The vast majority were primiparous (92.7%). The main indications for emergency Caesarean section were: pre-eclampsia and its complications (20.2%), acute fetal distress (18.5), pre-rupture syndrome (14.1%) and bone dystocia (11.7%). The maternal mortality rate was 1.6% and perinatal mortality was 134 per 1000 live births. Conclusion: The rate of caesarean section is high at Yalgado OUéDRAOGO Teaching Hospital of Ouagadougou. Postoperative complications are sometimes serious and compromise the maternal and fetal outcome. There is a need for increased surveillance of all pregnant and recently delivered women to reduce maternal and perinatal mortality in teenagers.展开更多
A 18-year-old local Han Chinese primigravida woman suffered with severe pre-eclampsia.After blood pressure stabilization,convulsion prophylaxis and fetal lung maturity enhancement,emergency cesarean section was perfor...A 18-year-old local Han Chinese primigravida woman suffered with severe pre-eclampsia.After blood pressure stabilization,convulsion prophylaxis and fetal lung maturity enhancement,emergency cesarean section was performed for inntractable headache at 32 weeks.Uterine inversion spontaneously occured at cesarean section.Immediately,uterine inversion was corrected manually without difficulty.Uterine atony and postpartum haemorrhage did not occur,and the patient made an remarkable recovery.This case report provides residents with excellent case-based learning.The management of uterine inversion requires immediate treatment for uterine repositioning.All staff members in the maternal unit should be updated with skills and knowledge about uterine inversion.展开更多
Objectives: To assess the fate of newborns born by emergency Cesarean section during the early neonatal period at the University Hospital Centre (UHC) in Brazzaville, with a view to improving neonatal prognosis. Patie...Objectives: To assess the fate of newborns born by emergency Cesarean section during the early neonatal period at the University Hospital Centre (UHC) in Brazzaville, with a view to improving neonatal prognosis. Patients and methods: This was a descriptive and cross-sectional analytical study of exposed and unexposed type, which took place from 24 March 2018 to 24 May 2018. All cases of newborns born by Cesarean section were included. Children born by extreme emergency and urgent Cesarean section were considered as exposed, and the others not exposed. The variables studied were the epidemiological characteristics of the mothers, the history of pregnancy and its management, anthropometric data on the newborn, the state of the child at birth and monitoring up to the seventh day. The test for comparing the proportions of target groups related to the child’s condition was used. Results: The mothers were aged 20 to 29 years (extreme 16 to 44 years);32 of them (22.5%) had a scarred uterus;29 pregnant women (20.4%) had a pathology associated with pregnancy. The distance travelled to consult was between 5 and 10 Km (63 cases or 44.3%). Emergency Caesarean sections were performed in 110 patients (77.5%) and scheduled Caesarean sections in 32 pregnant women (22.5%). Localoregional anaesthesia by spinal anaesthesia predominated (78.9%), by the association Bipivancaine + Fentanyl (69 cases or 48.6%) whose practitioner was often the nurse anaesthetist (131 cases or 92.3%). No accidents have occurred intraoperatively. At birth we noticed: 4.2% stillbirth, 19.7% bad, requiring resuscitation of at least 5 minutes for 16 newborns (57.1%). 26 newborns (18.3%) required care in the Neonatology Department. Early neonatal morbidity was dominated by respiratory distress (10 cases or 38.5%), early neonatal infection (5 cases or 19.1%) and a lethality rate of 19.2%. Conclusion: The future of the newborn, born by emergency Cesarean section is mixed;emergency control can improve the situation.展开更多
目的:探讨妊娠合并心力衰竭患者急诊剖宫产手术的麻醉管理经验。方法:回顾性分析妊娠合并心力衰竭患者急诊剖宫产手术15例,心功能Ⅲ或Ⅳ级,均在气管插管静脉全身麻醉复合局部麻醉下行剖宫产。记录患者麻醉开始前(T1)、手术开始时(T2)、...目的:探讨妊娠合并心力衰竭患者急诊剖宫产手术的麻醉管理经验。方法:回顾性分析妊娠合并心力衰竭患者急诊剖宫产手术15例,心功能Ⅲ或Ⅳ级,均在气管插管静脉全身麻醉复合局部麻醉下行剖宫产。记录患者麻醉开始前(T1)、手术开始时(T2)、胎儿娩出时(T3)、麻醉结束后(T4)的平均动脉压(MAP)、心率(HR)、脉搏氧饱和度(SpO_2)。记录新生儿娩出后1 min和5 min的Apgar评分。结果:全部产妇手术顺利,生命体征平稳,麻醉效果满意。与麻醉前相比,胎儿娩出后MAP显著降低(P<0.05);麻醉后各时点患者SpO_2显著高于麻醉前(P<0.05);观察各时点HR差异无统计学意义(P>0.05)。患者流产1例,极低体重儿,家属放弃治疗。早产和足月产16例新生儿,出生体重(2 222.81±596.43)g,1 min Apgar评分(7.13±1.67)分,5 min Apgar评分(8.75±1.00)分。结论:丙泊酚复合瑞芬太尼静脉全身麻醉可安全应用于妊娠合并心力衰竭患者急诊剖宫产手术。展开更多
文摘A study was conducted to describe midwives’ adherence to preoperative care during emergency caesarian section at Bwaila Maternity Wing in 2012 in Malawi. The study utilized a descriptive prospective and retrospective design. A structured questionnaire was administered to all 28 midwives who were directly involved in the preparation of clients for emergency caesarean section. Clients charts were also reviewed using a standard checklist to determine adherence to preoperative care. Data were analyzed using SPSS version 16.0 and descriptive statistics in the form of frequencies and percentages were computed for the dataset. A midwife was supposed to score at least 80% on each component of preoperative care guidelines to be compliant to the stipulated pre-operation standards. The midwives scored above 80% on only four of the 14 preoperative care guidelines which were;bladder catheterization (100%, n = 14), obtaining informed consent (92.9%, n = 12), administration of IV (96.4%, n = 13) and administration of preoperative antibiotics (82.1%, n = 11). Midwives however scored less than 80% on preoperative procedures that dealt with vital signs (28.6%, n = 4): BP check (28.6%, n = 4);Pulse rate check (25%, n = 3.5);respiration check (25%, n = 3.5) and temperature check (25%, n = 3.5). The midwives scored further below standard on blood specimen collection (78.6%, n = 11). Psychological support to clients was also below standard at 60.7%, n = 8. Other components of psychological support such as surgery information (57.1%, n = 8), allowing clients ask questions (28.6%, n = 4) and answering clients’ questions (25%, n = 3.5) were also scored below standard. Overall the standard of preoperative care was below standard at the facility. Most of the midwives were new graduates, who had never received any in-service training on preoperative care. Therefore in service training it is recommended for the midwives to provide good quality of care.
文摘Background: Caesarean Section done in emergency basis can result some adverse outcome to both the fetus & mother & complications may arise. Objective: The purpose of the present study was to see the fetal & maternal outcome or any complications among the pregnant woman who had undergone emergency caesarean section. Methodology: This descriptive type of cross sectional study was conducted in the Department of Gynaecology & Obstetrics at Dhaka Medical College Hospital during the period from July 2006 to December 2006. The patients underwent emergency caesarean section for any indication during the mentioned period of study was selected as study population. Among them, 100 cases were recruited in this study. Result: Among the cases, maternal morbidity was as high as 64% which were due to haemorrhage, post-operative infection, rise of blood pressure and other complications. Regarding fetal outcome, 92% babies were born with normal birth weight, 33% babies were developed complications which were mostly due to birth asphyxia and prematurity. Conclusion: In conclusion, emergency caesarean section has maternal morbidity as well as fetal and neonatal adverse outcome.
文摘Objective: To study emergency cesarean section in teenagers with the goal of reducing morbidity and maternal-fetal mortality. Methods: This was a descriptive cross-sectional study with prospective collection of data on 248 cases collected from July 1st to December 31st, 2016. Results: The incidence of cesarean section in teenagers was 56.4%. The average age was 18 ± 0.4 years old. The vast majority were primiparous (92.7%). The main indications for emergency Caesarean section were: pre-eclampsia and its complications (20.2%), acute fetal distress (18.5), pre-rupture syndrome (14.1%) and bone dystocia (11.7%). The maternal mortality rate was 1.6% and perinatal mortality was 134 per 1000 live births. Conclusion: The rate of caesarean section is high at Yalgado OUéDRAOGO Teaching Hospital of Ouagadougou. Postoperative complications are sometimes serious and compromise the maternal and fetal outcome. There is a need for increased surveillance of all pregnant and recently delivered women to reduce maternal and perinatal mortality in teenagers.
基金This work was supported by grants from the Open Fundation of Key Laboratory of Birth Regulation and Control Technology of National Health Commission of China(grant numbers 2018KF003)Medical and Health Science Technology Development Plan of Shandong Province(grant numbers 2018WS274).
文摘A 18-year-old local Han Chinese primigravida woman suffered with severe pre-eclampsia.After blood pressure stabilization,convulsion prophylaxis and fetal lung maturity enhancement,emergency cesarean section was performed for inntractable headache at 32 weeks.Uterine inversion spontaneously occured at cesarean section.Immediately,uterine inversion was corrected manually without difficulty.Uterine atony and postpartum haemorrhage did not occur,and the patient made an remarkable recovery.This case report provides residents with excellent case-based learning.The management of uterine inversion requires immediate treatment for uterine repositioning.All staff members in the maternal unit should be updated with skills and knowledge about uterine inversion.
文摘Objectives: To assess the fate of newborns born by emergency Cesarean section during the early neonatal period at the University Hospital Centre (UHC) in Brazzaville, with a view to improving neonatal prognosis. Patients and methods: This was a descriptive and cross-sectional analytical study of exposed and unexposed type, which took place from 24 March 2018 to 24 May 2018. All cases of newborns born by Cesarean section were included. Children born by extreme emergency and urgent Cesarean section were considered as exposed, and the others not exposed. The variables studied were the epidemiological characteristics of the mothers, the history of pregnancy and its management, anthropometric data on the newborn, the state of the child at birth and monitoring up to the seventh day. The test for comparing the proportions of target groups related to the child’s condition was used. Results: The mothers were aged 20 to 29 years (extreme 16 to 44 years);32 of them (22.5%) had a scarred uterus;29 pregnant women (20.4%) had a pathology associated with pregnancy. The distance travelled to consult was between 5 and 10 Km (63 cases or 44.3%). Emergency Caesarean sections were performed in 110 patients (77.5%) and scheduled Caesarean sections in 32 pregnant women (22.5%). Localoregional anaesthesia by spinal anaesthesia predominated (78.9%), by the association Bipivancaine + Fentanyl (69 cases or 48.6%) whose practitioner was often the nurse anaesthetist (131 cases or 92.3%). No accidents have occurred intraoperatively. At birth we noticed: 4.2% stillbirth, 19.7% bad, requiring resuscitation of at least 5 minutes for 16 newborns (57.1%). 26 newborns (18.3%) required care in the Neonatology Department. Early neonatal morbidity was dominated by respiratory distress (10 cases or 38.5%), early neonatal infection (5 cases or 19.1%) and a lethality rate of 19.2%. Conclusion: The future of the newborn, born by emergency Cesarean section is mixed;emergency control can improve the situation.
文摘目的:探讨妊娠合并心力衰竭患者急诊剖宫产手术的麻醉管理经验。方法:回顾性分析妊娠合并心力衰竭患者急诊剖宫产手术15例,心功能Ⅲ或Ⅳ级,均在气管插管静脉全身麻醉复合局部麻醉下行剖宫产。记录患者麻醉开始前(T1)、手术开始时(T2)、胎儿娩出时(T3)、麻醉结束后(T4)的平均动脉压(MAP)、心率(HR)、脉搏氧饱和度(SpO_2)。记录新生儿娩出后1 min和5 min的Apgar评分。结果:全部产妇手术顺利,生命体征平稳,麻醉效果满意。与麻醉前相比,胎儿娩出后MAP显著降低(P<0.05);麻醉后各时点患者SpO_2显著高于麻醉前(P<0.05);观察各时点HR差异无统计学意义(P>0.05)。患者流产1例,极低体重儿,家属放弃治疗。早产和足月产16例新生儿,出生体重(2 222.81±596.43)g,1 min Apgar评分(7.13±1.67)分,5 min Apgar评分(8.75±1.00)分。结论:丙泊酚复合瑞芬太尼静脉全身麻醉可安全应用于妊娠合并心力衰竭患者急诊剖宫产手术。
