Obstetrics and Gynecology Commons^™

Infection Control In Labor And Delivery Room, Learning From The Small Hospital Based Project, Savera Aziz Ali, Sumera Aziz Ali

School of Nursing & Midwifery

Background: It has been estimated that around 36% of the neonatal deaths occur due to infection in the lower and middle income countries. Infection control is a more substantial area of concern, particularly in Labor and delivery room. Multiple factors can cause infection in the labor room, therefore it is important to assess various factors of maternal and neonatal infection. Hence we explored multiple factors through this project and developed the action plan to address those factors effectively.
Methods: During our Leadership and Management course, we conducted a project in Labor room pertaining to a prevalent issue. The whole process …

Effect Of Puerperal Infections On Early Neonatal Mortality: A Secondary Analysis Of Six Demographic And Health Surveys, Saverio Bellizzi, Quique Bassat, Howard L. Sobel, Mohamed M. Ali, Marleen Temmerman

Obstetrics and Gynaecology, East Africa

Background: Around 1.5 million annual neonatal deaths occur in the first week of life, and infections represent one of the major causes in developing countries. Neonatal sepsis is often strictly connected to infection of the maternal genital tract during labour.

Methods: The association between signs suggestive of puerperal infection and early neonatal mortality (life) was performed using Demographic and Health Surveys (DHS) data of six countries, conducted between 2010 and 2013. The population attributable fraction (PAF) was generated using the estimates on early neonatal mortality of a 1990-2013 systematic analysis for the Global Burden of Disease Study.

Results: Signs of …

Use Of Visual Inspection With Acetic Acid, Pap Smear, Or High-Risk Human Papillomavirus Testing In Women Living With Hiv/Aids For Posttreatment Cervical Cancer Screening Same Tests, Different Priorities, Elkanah Omenge, Tao Liu, Astrid Christoffersen-Deb, Peter Itsura, John Oguda, Sierra Washington, David Chumba, Latha Pisharodi, Susan Cu-Uvin, Anne F. Rositch

Obstetrics and Gynaecology, East Africa

Objectives: Few studies have addressed optimal follow-up for HIV-infected women after cervical treatment. This study aimed to compare performance of three available tests to detect posttreatment cervical disease in HIV-infected women in Kenya.

Design: This is a prospective cohort study.

Methods: At least 6 months following cryotherapy, 517 HIV-infected women were evaluated concurrently with visual inspection with acetic acid (VIA), papanicolaou (Pap) smear, and high-risk human papillomavirus (HR-HPV) testing. Women positive by any test (low-grade squamous intraepithelial lesion for Pap) were scheduled for colposcopy and biopsy. Among 248 with histological confirmation [and 174 assumed to be truly negative for …

Fmic Annual Report 2017 | English, French Medical Institute For Mothers And Children

FMIC Reports

No abstract provided.

The Impact Of A Referral Card-Based Intervention On Intimate Partner Violence, Psychosocial Health, Help-Seeking And Safety Behaviour During Pregnancy And Postpartum: A Randomized Controlled Trial, An-Sofie Van Parys, Ellen Deschepper, Kristien Roelens, Marleen Temmerman, Hans Verstraelen

Obstetrics and Gynaecology, East Africa

Background: We aimed to investigate the impact of a referral-based intervention in a prospective cohort of women disclosing intimate partner violence (IPV) on the prevalence of violence, and associated outcomes psychosocial health, help-seeking and safety behaviour during and after pregnancy.

Methods: Women seeking antenatal care in eleven Belgian hospitals were consecutively invited from June 2010 to October 2012, to participate in a single-blind randomized controlled trial (RCT) and handed a questionnaire. Participants willing to be interviewed and reporting IPV victimisation were randomised. In the Intervention Group (IG) participants received a referral card with contact details of services providing assistance and …

Prevalence And Determinants Of Unintended Pregnancies Amongst Women Attending Antenatal Clinics In Pakistan, Atif Habib, Camille Raynes- Greenow, Sidrah Nausheen, Sajid Bashir Soofi, Muhammad Sajid, Zulfiqar A Bhutta, Kirsten I Black

Department of Paediatrics and Child Health

Background: Unintended pregnancies are a global public health concern and contribute significantly to adverse maternal and neonatal health, social and economic outcomes and increase the risks of maternal deaths and neonatal mortality. In countries like Pakistan where data for the unintended pregnancies is scarce, studies are required to estimate its accurate prevalence and predictors using more specific tools such as the London Measure of Unplanned Pregnancies (LMUP).
Methods: We conducted a hospital based cross sectional survey in two tertiary care hospitals in Pakistan. We used a pre tested structured questionnaire to collect the data on socio-demographic characteristics, reproductive …

Globalization And Early Childhood Education: Urban Families Perceptions, Shelina Bhamani

Department of Obstetrics & Gynaecology

This study attempted to explore the belief patterns and opinions of families of young children in the context of globalization and its role in the provision of education. The paper’s particular focus was to argue how urban families perceive and practice globalization for their children’s education. Additionally, it briefly reviewed the school of thought (i.e. Modern or Traditional) sample families belong to. The research focuses on the narrative paradigm with a mixed methodical design through which quantitative and qualitative perspectives can be sought. A total sample of 104 family members was taken to carry out a quantitative survey and a …

Opportunities And Challenges In Realizing Universal Access To Obstetric Ultrasound In Sub-Saharan Africa, Sikolia Wanyonyi, Charles Muriuki Mariara, Sudhir Vinayak, William Stones

Obstetrics and Gynaecology, East Africa

The potential benefits of obstetric ultrasound have yet to be fully realized in sub-Saharan Africa (SSA), despite the region bearing the greatest burden of poor perinatal outcomes. We reviewed the literature for challenges and opportunities of universal access to obstetric ultrasound and explored what is needed to make such access an integral component of maternity care in order to address the massive burden of perinatal morbidity and mortality in SSA. Original peer-reviewed literature was searched in various electronic databases using a ‘realist’ approach. While the available data were inconclusive, they identify many opportunities for potential future research on the subject …

“The Co-Authors Of Pregnancy”: Leveraging Men’S Sense Of Responsibility And Other Factors For Male Involvement In Antenatal Services In Kinshasa, Drc, Michelle M. Gill, John Ditekemena, Aimé Loando, Vicky Ilunga, Marleen Temmerman, Franck Fwamba

Obstetrics and Gynaecology, East Africa

Background: Despite efforts to improve male involvement (MI), few male partners typically attend antenatal care (ANC). MI in ANC and interventions to prevent mother-to-child HIV transmission have been demonstrated to be beneficial for the HIV-positive mother and her child. This study aimed to explore factors influencing partner attendance and highlight interventions with potential to improve MI within a Congolese context.

Methods: This was an exploratory, qualitative study conducted in two urban and two semi-urban catchment areas of Kinshasa, DRC in June–September 2016. Two women-only and two men-only focus group discussions (FGDs) were held; participants were recruited from ANC clinics and …

Antenatal Corticosteroids For Women At Risk Of Imminent Preterm Birth In Low-Resource Countries: The Case For Equipoise And The Need For Efficacy Trials, Joshua P. Vogel, Olufemi T. Oladapo, Cynthia Pileggi-Castro, Ebunoluwa A. Adejuyigbe, Fernando Althabe, Shabina Ariff, Adejumoke Idowu Ayede, Abdullah H. Baqui, Anthony Costello, Davy M. Chikamata, Caroline Crowther, Bukola Fawole, Luz Gibbons, Alan H. Jobe, Monica Lulu Kapasa, John Kinuthia, Alka Kriplani, Oluwafemi Kuti, James Neilson, Janna Patterson, Gilda Piaggio, Rahat Qureshi, Zahida Qureshi, Mari Jeeva Sankar, Jeffrey S. A. Stringer, Marleen Temmerman, Khalid Yunis, Rajiv Bahl, A. Metin Gülmezoglu

Obstetrics and Gynaecology, East Africa

The scientific basis for antenatal corticosteroids (ACS) for women at risk of preterm birth has rapidly changed in recent years. Two landmark trials—the Antenatal Corticosteroid Trial and the Antenatal Late Preterm Steroids Trial—have challenged the long-held assumptions on the comparative health benefits and harms regarding the use of ACS for preterm birth across all levels of care and contexts, including resource-limited settings. Researchers, clinicians, programme managers, policymakers and donors working in low-income and middle-income countries now face challenging questions of whether, where and how ACS can be used to optimise outcomes for both women and preterm newborns.

In this article, …

Effects Of Injectable Progestogen Contraception Versus The Copper Intrauterine Device On Hiv Acquisition: Sub-Study Of A Pragmatic Randomised Controlled Trial, G. Justus Hofmeyr, Mandisa Singata-Madliki, Theresa A. Lawrie, Eduardo Bergel, Marleen Temmerman

Obstetrics and Gynaecology, East Africa

Background: Evidence from observational studies suggests an increased risk of HIV acquisition among women using depot medroxyprogesterone acetate (DMPA) contraception.

Methods: Within the context of a South African programme to increase women's access to the intrauterine contraceptive device (IUD), we conducted a pragmatic, open-label, parallel-arm, randomised controlled trial (RCT) of the IUD versus injectable progestogen contraception (IPC) at two South African hospitals. The primary outcome was pregnancy; secondary outcomes included HIV acquisition. Consenting women attending termination of pregnancy services were randomised after pregnancy termination between July 2009 and November 2012. Condoms were promoted for the prevention of sexually transmitted infections. …

Case Of Xanthogranulomatous Oophoritis, Bushra Khan, Aliya Aziz, Rashida Ahmed

Department of Obstetrics & Gynaecology

Xanthogranulomatous inflammation is characterized by destruction of the tissues of the organ involved and replacement by chronic inflammatory cells such as lymphocytes, plasma cells, occasional neutrophils with or without multinucleated or Touton giant cells. Exact aetiology is not known but the theory of infection with organisms like Proteus, E coli, and Bacteroides fragilis is most popular. Xanthogranulomatous inflammation of the female genital tract is not common and usually involves the endometrium; however, xanthogranulomatous inflammation of the ovaries is a rare entity.

Implementation Of Warning Tool To Improve Maternal Newborn Health Outcomes In A Developing Country, Sana Sheikh, Rahat Qureshi, Sidrah Nausheen, Rozina Sikandar Sultanali

Department of Obstetrics & Gynaecology

Objective: To improve health outcomes through the implementation of national early warning sign tool for babies delivered through emergency caesarean section in off-work hours.

Methods: This comparative clinical study was conducted at the Aga Khan Hospital for Women and Children, Karachi, from April to August 2014, and comprised women who had an emergency caesarean section. Maternal and perinatal outcomes were compared of patients in Group A and Group B which represented individuals before and after the implementation of the national early warning score respectively.

Results: Of the 200 participants, there were 100(50%) in each group. The overall mean age was …

Maternal And Fetal Outcome In Renal Transplant Recipients, Wajeeha Syed, Lumaan Sheikh

Department of Obstetrics & Gynaecology

Objective: To determine maternal and fetal outcome in renal transplant recipients.
Methodology: Retrospective analysis of the antenatal patients with renal transplant
was done between January 1st 2005 till December 31st 2015 and maternal
and fetal outcomes were determined. Data was entered and analyzed in SPSS
version 20.
Results: 08 pregnancies in 07 women who had undergone renal transplant
were included in this study. The mean age at the time of transplantation was
25.29 ±5.5 years (16-32 years). 25% cases had gestational diabetes mellitus,
75% had anemia and 50% had urinary tract infection. The mean birth weight
of babies was 2210 …

"The Co-Authors Of Pregnancy": Leveraging Men's Sense Of Responsibility And Other Factors For Male Involvement In Antenatal Services In Kinshasa, Drc, Michelle M. Gill, John Ditekemena, Aimé Loando, Vicky Ilunga, Marleen Temmerman, Franck Fwamba

Department of Obstetrics & Gynaecology

Background: Despite efforts to improve male involvement (MI), few male partners typically attend antenatal care (ANC). MI in ANC and interventions to prevent mother-to-child HIV transmission have been demonstrated to be beneficial for the HIV-positive mother and her child. This study aimed to explore factors influencing partner attendance and highlight interventions with potential to improve MI within a Congolese context.
Methods: This was an exploratory, qualitative study conducted in two urban and two semi-urban catchment areas of Kinshasa, DRC in June–September 2016. Two women-only and two men-only focus group discussions (FGDs) were held; participants were recruited from ANC clinics and …

Role Of Mhealth Applications For Improving Antenatal And Postnatal Care In Low And Middle Income Countries: A Systematic Review, Anam Shahil Feroz, Shagufta Perveen, Wafa Aftab

Community Health Sciences

Background: From 1990 to 2015, the number of maternal deaths globally has dropped by 43%. Despite this, progress in attaining MDG 5 is not remarkable in LMICs. Only 52% of pregnant women in LMICs obtain WHO recommended minimum of four antenatal consultations and the coverage of postnatal care is relatively poor. In recent years, the increased cellphone penetration has brought the potential for mHealth to improve preventive maternal healthcare services. The objective of this review is to assess the effectiveness of mHealth solutions on a range of maternal health outcomes by categorizing the interventions according to the types of mHealth …

Can Right To Health Help Policy Makers To Address Maternal Mortality?: A Short Communication, Sumera Aziz Ali, Nadir Suhail, Savera Aziz Ali

Community Health Sciences

No abstract provided.

Unintended Pregnancies Among Married Women In Sindh Pakistan: Role Of Lady Health Workers, Sumera Aziz Ali, Unaib Rabbani

Community Health Sciences

Background: Unintended pregnancies, which pose substantial risks to both mothers and children, account for 24% of all pregnancies in Pakistan. Door to door visits and service provision by lady health workers (LHWs) may be related to the reduction of such pregnancies, particularly in rural areas. This study aimed to determine the association of knowledge about Lady Health Visitors (LHWs) and door to door visits by LHWs with unintended pregnancies among rural women.
Methods: We conducted a community-based, nested case-control study of 800 pregnant women, identified from the database of an active surveillance mechanism, which registers and follows all pregnant women …

Predictors Of Modern Contraceptive Usage Among Women In Rural Pakistan: Physical Access To Services Stills A Major Barrier, Sumera Aziz Ali, Zafar Fatmi

Community Health Sciences

Background: The predictors of contraceptive use may vary in urban and rural areas. Studies have largely focused on the factors predicting contraceptive usage in urban areas. We studied the predictors of contraceptives in one of the rural districts of Pakistan.
Methods: A nested case-control design was used on The Global Network’s Maternal Newborn Health Registry (MNHR) in district Thatta Pakistan between June 2011 to July 2012. Pregnant women before their index pregnancy, who did not use (n = 200 cases) and those used any modern contraceptive method (n = 600 controls), were compared. Logistic regression was used to as certain …