Subject(s)
Infant, Newborn , Intensive Care Units, Neonatal , Infant Health , Umbilical Cord , Breast FeedingABSTRACT
Background: Umbilical cord prolapse is an obstetric emergency that threatens the life and well-being of the fetus and also increases maternal morbidity. Fetal survival in umbilical cord prolapse can be enhanced by prevention where risk factors are identified and prompt diagnosis and decisive intervention.Objective: The aim of this study was to determine the incidence, identify the risk factors associated with umbilical cord prolapse and document the perinatal outcome of cases of cord prolapse.Methods: This was a 13-year retrospective case-control study of cases of umbilical cord prolapse seen at the OOUTH, Sagamu, Southwestern Nigeria between January 1, 2000 and December 31, 2012.Result: During the study period, the incidence of umbilical cord prolapse was 1 in 122 deliveries (0.82%). The umbilical cord prolapse occurred in association with breech presentation five times (33.3%) and transverse lie eleven times (18.5%). The occurrence of breech presentation among the control cases was 8.6% (p<0.001) and that of transverse lie was 1.9% (p<0.001). There were also significant statistical differences between the cases of cord prolapse and controls in terms of prematurity, low birth weight, unbooked status and multiparity. The perinatal rate was 222/1000 (22.2%) compared to the perinatal mortality of 68/1000 (6.8%) for the control group.Conclusion: It is suggested that pregnant women should be encouraged to register early in pregnancy for antenatal care as this will enhance early identification of the risk factors and appropriate management instituted to reduce perinatal mortality
Subject(s)
Emergency Treatment , Nigeria , Obstetric Labor Complications , Pregnancy Outcome , Prolapse , Risk Factors , Umbilical CordABSTRACT
Introduction: Hygienic umbilical cord care is necessary for the well-.being of the newborn. Health education is a strong tool for lifestyle modification aimed at healthy living. This ought to extend to mothers who care for their infants' umbilical cord stump in various ways especially after discharge from hospital. The content of health education on cord care given to mothers (if any) at various health institutions which they accessed for antenatal care is thus worth evaluating. Objective: To evaluate the content of health education on cord care given to mothers at various health facilities which served as their places of antenatal care in Benin City; Nigeria. Methods: The study subjects included mothers who brought their babies to Well Baby/Immunization Clinic of the University of Benin Teaching Hospital (UBTH); Benin City; Nigeria. A structured questionnaire was used to assess their biodata; places of antenatal care; whether health education on cord care constituted part of the services received in health facilities and the content of the cord care education. Results: Of the 497 subjects studied; 487 (98.0) received antenatal care (ANC) in both orthodox and unorthodox facilities. Amongst these; 352 (72.3) received health education on cord care while 135 (27.7) did not. Teaching and private hospitals contributed 116 (48.9) and 103 (43.5) respectively to the total documentation of the advice concerning use of methylated spirit alone. The relationship between content of health education on cord care and method of cord care practiced by mothers was statistically significant. Conclusion: Health education on cord care is lacking in some of our health facilities and where available; content may not be evidence-based. We must equip health workers with facts required to enlighten patients. A standard and universal method of cord care should be adopted to reduce or abolish the confusion which mothers presently encounter in caring for their babies' umbilical cords
Subject(s)
Health Education , Hospitals, Teaching , Hygiene , Mothers , Nigeria , Umbilical CordABSTRACT
Background: The anthropometric parameters of the umbilical cord have clinical significance. Current parameters of the cord, its correlates and related foetal outcome are lacking in our parturients. Objectives: To describe the anthropometric parameters and abnormalities of the umbilical cord; and determine their maternal correlates and foetal outcome. Design: A cross sectional analytical study. Setting: The Obstetric and Gynaecology Department of the University of Ilorin Teaching Hospital, between September 2012 and June 2013. Subjects: Healthy pregnant women with singleton pregnancies. Results: Four hundred and twenty- eight (428) singleton deliveries were studied. The respective mean values of the cord length and width were 526.87±115.5mm and 19.56±11.12mm. Short cord (< 40cm) occurred in 7.2% while long cord (> 69cm) was found in 9.3% of the parturient. The incidences of single umbilical artery, cord round the body and knots were 7%, 8.4% and 14.5% respectively. Nuchal cord was the most common (91.4%). Only gestational age had significant statistical relationship with cord length abnormalities (P = 0.0093). The cord length was an important correlate of cord helices, knots and vessels (P< 0.05).Parity had correlations with the number of vessels(R= 0.099, P=0.042). The cord coiling index was statistically related to the presence of congenital abnormalities (P=0.011). Other perinatal events were not related to umbilical cord parameters. Perinatal asphyxia was the most common indication for NICU admission (3.5%) but there was no significant statistical difference between NICU admission and cord parameters. Conclusion: The umbilical cord parameters in apparently healthy parturients in Ilorin were comparable with others elsewhere. The cord length and helix are important correlates of gestational age and congenital abnormalities. Parity may be related to abnormal umbilical vessels. Cord length, coils, coil index and umbilical vessels should be examined post-natally
Subject(s)
Asphyxia Neonatorum , Nigeria , Pregnant Women , Umbilical CordABSTRACT
Aim: The goal of this study was to identify risk factors associated with umbilical cord prolapse and to document the perinatal outcome of cases of cord prolapse. Materials and Methods: During the period of the study (from July 1; 2001 and June 30; 2007); forty-six cases of umbilical cord prolapse were identified from the labor ward record and analyzed retrospectively. Associations between cord prolapse and potential risk factors were evaluated by means of the odds ratio. Results: During the period of the study; 46 cases of cord prolapse were encountered out of 10;080 deliveries which was 0.46of all deliveries. Of the 46 fetuses with umbilical cord prolapse 32.6had a fetal weight of less than 2.5 kg compared with 15.2for fetuses in control group (P0.012). The umbilical cord prolapse occurred in association with breech presentation eleven times (23.9) and transverse presentation seven times (15.2). The occurrence of breech presentation among the control cases was 4.3(P0.00031); and that of transverse lie was 4.4(P0.02007). Among the women that had cord prolapse; 47.8had unbooked pregnancies compared with the control group with 14.5(P0.0000033). Multiparity accounted for 78.3in the cord prolapse cases and 68.1in the controls (P=0.19). The perinatal mortality rate was 413/1000. (41.3); compared to the perinatal mortality of 58/1000 for the control group. Conclusions: Our findings in this study has confirmed an association between increased risk of umbilical cord prolapse and abnormal fetal presentation; low birth weight and unbooked status. It is therefore suggested that pregnant women should be encouraged to register early in pregnancy for antenatal care and this will enhance the early identification of these risk factors and an appropriate management instituted to reduce perinatal mortality
Subject(s)
Hospitals , Prolapse , Risk Factors , Teaching , Umbilical CordABSTRACT
BACKGROUND: Umbilical cord blood analysis may give a clue to the state of health of both pregnant mothers and their neonates. However, there is paucity of literature on some of these indices from our area.OBJECTIVES:This present study determined the red blood indices of maternal and umbilical cord blood in Owerri, Nigeria.METHODS:Pregnant mothers aged 18 - 42 years who booked and received antenatal care until vaginal delivery at the antenatal clinics of two tertiary health care centres in Owerri, Nigeria were divided into five age groups I - V. Maternal blood samples were obtained immediately after delivery of the baby. The umbilical blood samples were collected from the umbilical cord of the baby at the end of the second stage of labour. The haemoglobin (Hb) concentration and packed cell volume (PCV) were determined using standard procedures. The mean corpuscular haemoglobin concentration (MCHC) was calculated mathematically.RESULTS:The result of the cord blood haemoglobin concentration and packed cell volume were significantly higher than the maternal values (14.22 ± 1.25 g/dl versus 11.20 ± 0.92g/d and 42.6 9± 3.80% versus 33.67 ± 2.71% respectively; (P < 0.0001).However, there was no significant differences between cord blood and maternal mean corpuscular haemoglobin concentration (33.24 ±0.23% versus 33.29 ± 0.45 % ;P = 0.310). Furthermore, a positive linear Pearson's correlation was observed between the mean Hb and PCV of cord blood and maternal blood (r=1.11 and r=1.15 respectively <0.0001).CONCLUSION:This result provides a baseline data for further studies on establishing a reference value for maternal and umbilical cord packed cell volume and haemoglobin concentration in our locality
Subject(s)
Blood , Blood Cells , Cues , Erythrocytes , Hematocrit , Nigeria , Umbilical CordABSTRACT
La procidence du cordon ombilical ou chute de celui-ci en avant de la presentation apres rupture spontanee ou artificielle de la poche des eaux constitue une extreme urgence obstetricale par le risque majeur de mortalite perinatale qu'il represente. La technique du remplissage vesical decrite depuis les annees 80 est unmoyen simple; efficace de reduction du risque de deces foetal; meme en cas de retard a la sanction chirurgicale. L'objectif de notre etude est de rapporter l'experience du service de Gynecologie Obstetrique de Befelatanana (CHU d'Antananarivo) sur cette technique; qui prouve sa fiabilite et son interet par des resultats identiques a ceux de la litterature. Sa simplicite de mise en oeuvre et son efficacite sur le risque foetal merite; tout particulierement dans les pays a faible infrastructure obstetricale; d'etre enseignee et utilisee
Subject(s)
Cesarean Section , Prolapse , Umbilical CordABSTRACT
Background: Published reports of haemorheological values of umbilical cord blood in Nigerian newborns are relatively scanty. The present study therefore aimed to determine the values of some basic haemorheological parameters in the umbilical cord blood of Nigerian neonates and in the venous blood of their respective mothers. The study also aimed to determine if any significant differences or correlations exist in these haemorheological parameters between maternal and umbilical cord blood. Design: Cross sectional prospective study involving 60 subjects consisting of 30 newborn neonates and their respective mothers. Methods: The values of haematocrit; erythrocyte sedimentation rate; haemoglobin concentration; red blood cell count; white blood cell count; whole blood relative viscosity; relative plasma viscosity; fibrinogen concentration; mean corpuscular volume; mean corpuscular haemoglobin and mean corpuscular haemoglobin concentration were determined in the umbilical cord blood of Nigeria neonates and in the respective mothers at the time of birth. Results: Significantly higher values of haematocrit; haemoglobin concentration; red blood cell count; whole blood relative viscosity and relative plasma viscosity and significantly lower values of erythrocyte sedimentation rates were found in umbilical cord blood compared to maternal blood (p0.05). Significant positive correlations were found only in the values of erythrocyte sedimentation rate (ESR); haemoglobin concentration; white blood cell count; whole blood relative viscosity and relative plasma viscosity between maternal and umbilical cord blood (p0.05). Both mean corpuscular haemoglobin and mean corpuscular haemoglobin concentration showed a negative but non-significant correlation between maternal and umbilical cord blood (p0.05). Conclusion: The present study reports values of basic haemorheological parameters in maternal and umbilical cord blood of newborn Nigerian neonates and reports significant differences and correlations in these parameters between the two groups. This we hope would provide information on umbilical cord haemorheology for Nigerian neonatologist since up to the present time similar studies have been scanty
Subject(s)
Hematology , Hemorheology , Infant , Infant, Newborn , Umbilical CordABSTRACT
The purpose of the study was to determine whether the training of TBAs had a beneficial impact on the way the TBAs attended to the reproductive health needs of mothers in Hoima District. a comparative cross-sectional study design was used to compare antenatal care; delivery; postnatal care and referral practices of trained and untrained TBAs; 94 TBAs per group were studied. Five FGDs were held with mothers; KIs with 15 health workers and 10 community leaders were held to obtain their comparative views on trained and untrained TBAs' services. Five TBA trainers' and 94 trainees' views on the training programme were also obtained. Results revealed that trained TBAs generally offered better ANC and delivery services. It was found that only 48.9of untrained TBAs compared to 96.4of the trained offered ANC services to mothers. less trained TBAs (20.7) compared to the untrained (50) reported administering herbal remedies to the pregnant women. Most of the TBAs in both groups were not advising mothers to get immunized against tetanus during pregnancy. More trained TBAs were assisting at least one delivery per month (91.4) compared to the untrained (41.8). Few TBAs in both groups (17.0and 9.6of trained the untrained TBAs respectively) were using a boiled instrument to cut the umbilical cord. More trained TBAs were applying nothing to the babies umbilical stump (63.8) trained and 40.9untrained) than the untrained; yet 29.0untrained compared to 2.2trained TBAs reported applying herbs to the umbilical stump of the babies. More trained TBAs (52.7) compared to untrained (29.0) were advising mothers to have their babies immunized. More trained TBAs than untrained were referring mothers with poor obstetric history to deliver in health units. The trained TBAs were also more likely to refer mothers with complications to health units. For severe bleeding of mothers after delivery; more trained TBAs (45.7) compared to untrained (32.2) were referring the mothers to health units for management; but more untrained TBAs (47.8) compared to the trained (23.9) were administering injectable ergometrine. However; more trained TBAs (26.7) compared to untrained (15.1) were referring mothers that developed fever in the postnatal period to health units. The community leaders; mothers and health workers were of the view that trained TBAs offered better services than their untrained colleagues despite the various constraints they were faced with. The TBA trainers and trained TBAs rated the scope of the training programme as sufficient; however; they suggested that facilities for training; equipment and perishables for TBAs needed to be availed to trainers and the TBAs for the success of the programme. They were also of the view that training duration should be increased. Overall; the training of TBAs seemed to have had a beneficial impact on the services trained TBAs offered to pregnant mothers in Hoima district. The recommendations included: continuing the training programme; equipping trainers and trainees with necessary logistics and supplies to effectively do their work; refresher courses and supervision for trainees; exploring a possibility of establishing a functional referral system and a maternity waiting home. The need to better equip helath units to handle referrals and to remunerate trained TBAs was also suggested. Emphasis on referring pregnant mothers to receive tetanus toxoid and cord management during training was suggest