Health literacy of mothers on factors associated to pre-rupture of membranes on perinatal outcomes in Vhembe district, South Africa

Pre-rupture of membranes prior labour initiation could complicate approximately 5% of pregnancies and could be associated with a high incidence of perinatal morbidity and mortality complications. The major complications could be chorioamnionitis and cord compression resulting in hypoxia. This study aimed to assess the health literacy of mothers on perinatal outcomes following prerupture of membranes at Thulamela B clinics of Vhembe district. A quantitative research approach with a cross-sectional descriptive design was used. The study population comprised a total of 210 lactating mothers within 6 weeks following delivery,irrespective of the mode of delivery were purposively selected. Data were collected by the researchers through self-administered questionnaires. The Statistical Package for Social Sciences (SPSS) version 25 was used for data analysis. The results are presented in the form of tables and graphs based on probability allowing judgment to be made on variables. Validity and reliability were ensured. Ethical clearance was obtained from the University of Venda Research Ethics Committee and permission to access health facilities from the Limpopo Province Department of Health. Findings revealed that limited and inadequate health literacy towards pre-rupture of membranes contributes to perinatal morbidity and mortality, with associated factors like poor antenatal care attendance, delayed health seeking, defaulting, and loss of follow-up. Recommendations emphasise the provision of preconception and antenatal care where health information on risks and danger signs of PROM to perinatal outcomes are given were made. (Afr J Reprod Health 2022; 26[7]: 90-101).

Prioritising maternal mental health and infant neurodevelopment research in Africa ­ A call for action amidst the backdrop of the COVID­19 pandemic

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Perinatal Outcomes of Newborns by Women Presenting with Maternal Complications in Pregnancy at a County Referral Hospital in Lower Eastern Kenya

BACKGROUND Maternal complications during pregnancy and labor have been the leading cause of maternal and neonatal death globally. The aim of the study was to observe and compare the differences in the perinatal outcomes of newborns born to women with maternal complications to those born to women without complications. MATERIALS AND METHODS This was a prospective hospital-based paired cohort study. A total of 510 pregnant women were followed up and their newborns' outcomes recorded. 102 had complications and 408 did not have complications. RESULTS Thirteen percent (n=17) of women with complications and 9% (n=34) of women without complications were aged between 13 to 19 years. Forty five percent n=45 of the respondents were followed for maternal care related to fetus and amniotic cavity and possible delivery-related complications. CONCLUSION Teenagers and women aged above 34 years in pregnancy were at a higher risk of presenting with maternal complications. Women referred from hard to reach constituencies of the county were more likely to present with complications in pregnancy. Maternal care related to amniotic fluid cavity complications was the leading maternal complications in pregnancy followed by edema with proteinuria complications. RECOMMENDATIONS Governments and non-governmental organizations should put more emphasis on youth friendly services to reduce maternal complications associated with teenage pregnancy. There should also be more investment on infrastructure to make referral systems easy and avoid the second delay among women with maternal complications. African Journal of Health Sciences Volume 34, Issue No.4, July- August 2021 438 Moreover, women presenting with maternal complications in pregnancy at all levels of care should be closely followed up to avert cases of intra-uterine fetal deaths before and during labor.

Short-term outcomes of inborn v. outborn very-low-birth-weight neonates (<1 500 g) in the neonatal nursery at Groote Schuur Hospital, Cape Town, South Africa

Background. The Groote Schuur Hospital (GSH) neonatal nursery provides level 3 care for the Metro West Health District in the Western Cape Province of South Africa. Worldwide, very-low-birth-weight (VLBW) neonates delivered in level 3 neonatal units have better outcomes than those transported from other facilities.Objectives. To identify the characteristics and outcomes of VLBW neonates at GSH, with emphasis on differences between inborns and outborns. Methods. This was a retrospective cohort study. VLBW neonates admitted to the GSH neonatal nursery between 1 January 2012 and 31 December 2013 were enrolled on the Vermont Oxford Network database and reviewed.Results. Of 1 032 VLBW neonates enrolled, 906 (87.8%) were delivered at GSH and 126 (12.2%) were outborn. Access to antenatal care, antenatal steroids and inborn status were statistically significant predictors of mortality and survival without morbidity. The mothers of inborn patients were more likely than those of outborn patients to have received antenatal care (89.1% v. 57.9%; p<0.0001) and antenatal steroids (64.2% v. 15.2%; p<0.0001). Inborns required less ventilatory support (16.2% v. 57.9%; p<0.0001) and surfactant administration than outborns (25.3% v. 65.1%; p<0.0001), and developed less late infection (8.8% v. 23.4%; p<0.0001), severe intraventricular haemorrhage (3.7% v. 13.9%; p<0.0001) and chronic lung disease (5.3% v. 13.4%; p=0.003). The incidence of necrotising enterocolitis was similar in the two groups (5.9% v. 8.7%; p=0.227). The mortality rate was 18.4% for inborns and 33.3% for outborns (p<0.0001). Mortality declined as birth weight increased. Of the survivors, 85.0% of inborns and 70.2% of outborns did not develop serious morbidity (p=0.003).Conclusions. VLBW neonates delivered at GSH had better outcomes than their outborn counterparts. Perinatal regionalisation is beneficial to our patients, with antenatal care, timeous transfer in utero and antenatal steroids contributing to excellent outcomes

Techniques of perinatal care in ancient Egypt: wider perspective

Background : Maternity resembled an important issue in ancient Egyptian life and medicine. Ancient Egyptian papyri contained different prescriptions for care of both pregnant women, birthing moms and their fetus/infant babies. The interventions included both: 1) remedies of different origins, and, 2) incantations. Material/Methods:Different Egyptian papyri and temple representation were studied for the variable remedies for specific cases of maternal/ perinatal problems in relation to pregnancy, birth, breast milk and babycare.Incantation approach was also analyzed. We tried to define the specific material used, and the possible "psychogenic influence of the incantation. Results 1. Some of the remedies could be identified and correlated to current time agents. Practical extrapolation of some of these agents proved of value in modern obstetric practice andtherapeutics. 2. Other remedies could not be characterized, and, up-till now, it was not possible to detect whether they could be corresponding to existing material, 3. The incantation approach could be, in some way, correlated to the "deep psychoanalysis" of modern psychiatry. 4. Many of the "non-medical" ancient Egyptian approaches for maternity/baby care are still resembled in some way of use by current time Egyptian women. Conclusion Ancient Egyptian maternal/infant care is a composite approach. Some of the recognized remedies used proved of value in modern clinical application Identification of further remedies seems to open further promise of extra-benefit. Modification of the of the "non-remedy" line might provide a form of "psychotherapy" better tailored for our societies' concepts

Effects of mother related factors on perinatal outcomes-a study of mothers seeking antenatal care at public and non-public health facilities in Kisii County, Kenya

The study sought to determine client level and facility-level factors that affect perinatal outcomes among women attending comparable public (government owned) and non-public health facilities (non-government owned) in Kisii County-Kenya in the context of free maternity care. A total of 365 pregnant mothers recruited in 4 health facilities during their ANC visit and followed up to 2 weeks post-delivery but only 287 attended all follow-up visits. Study subjects were recruited proportionate to number of deliveries each of the facilities had conducted in the preceding 6 months. The dependent variable was perinatal outcome; independent variables were demographic and clinical factors. Analysis was done using χ2, logistic regression, paired t and McNemar's tests. Maternal BMI and a mother's parity were statistically correlated with perinatal outcome (χ2= 8.900, d.f =3, P=0.031 and (χ2= 13.232, d.f =4, P=0.039) respectively. Mothers with 1 parity were 4.5 times more likely to have normal perinatal outcomes (OR =4.5, 95% CI 2.25-14.29, P=0.012). There was a significant relationship between a mother's knowledge of pregnancy-related issues and the baby's weight (t=-67.8 d.f. 213 P<0.001). Mothers' knowledge on pregnancy issues and spousal involvement influences perinatal outcomes. Dietary Diversity Score (DDS) of a mother does not have a direct influence on the outcome of a pregnancy. There is need to focus on maternal factors that affect perinatal outcomes besides free maternity care

A comparative study of pregnancy complications and outcomes for the years 1999 and 2004 at a rural hospital in South Africa: implications for antenatal care

Background: Detection and management of high-risk pregnancies, all the way through antenatal care, have been advocated as a high-quality mean of reducing maternal and perinatal morbidity and mortality. Objectives: This study reviewed the demographic variables, pregnancy and obstetric complications and perinatal outcomes for the years 1999 and 2004 in a rural hospital in KwaZulu-Natal Province, South Africa, with the aim of evaluating trends and gaps that may enhance appropriate strategies for improvement of antenatal care. Method: A retrospective comparative study, with representative samples of pregnant women, were randomly selected for the respective years 1999 and 2004. Descriptive statistics were calculated depending on measurement scale. A Z-test was carried out to assess the significant difference (p < 0.05) in proportions between pregnancy complications and outcomes of the groups. Multivariate logistic regression analysis was undertaken to determine the significant predictors for outcome variables. Results: The numbers of pregnancies among young women (< 25 years) increased significantly by 8% (p < 0.05) in the year 2004. Compared with 1999, the reduction in the numbers of pregnancies (1%) among higher parity (parity 5 or more) women in 2004 was remarkable. There were significant reductions of eclampsia, anaemia and post partum haemorrhage. Women with breech presentation were 3.75 times more likely to deliver preterm, and 5.45 times more likely to deliver low birth-weight babies. Similarly, women with pregnancy-induced hypertension were more likely to have preterm (OR = 3.50, 95% CI 2.83; 4.35) and low birth-weight babies (OR = 2.09, 95% CI 1.62; 2.71). Eclampsia was also a risk factor associated with preterm deliveries (OR = 6.14, 95% CI 3.74; 10.09) and low birth-weight babies (OR = 3.40, 95% CI 1.83; 6.28). Conclusion: This study suggests that further research is needed to find the causes of higher rate of teenage pregnancies and an increase in quality of antenatal care is more important in improving maternal and perinatal health. Training of staff to standard protocol and guidelines on antenatal care and care during delivery, and adherence to it, should be encouraged to improve maternal and child health in South Africa

Iatrogenic burns injury complication neonatal resuscitation

A case of iatrogenic thermal injury in a newborn infant during resuscitation for perinatal asphyxia at a secondary health facility is described. The injury; with surface area coverage of about 4; involved the lower limbs. This report highlights the poor newborn resuscitation skills of traditional medical practice

Risk scoring antenatal care

The paper discusses the aim of antenatal care and identifies the characteristics associated with increase in maternal and fetal morbidity and mortality. Risk assessment is useful in antenatal care to identify women who are likely to develop complications during pregnancy; labour; delivery and puerperium. A useful risk scoring system should be able to discriminate between high risk and low risk pregnancies. Risk assessment can be of greater benefit if it is backed by a good referral system and referral centers equipped to handle all mothers who are referred;cheap liable transport; manpower;facilities; blood and community participation