Decision-to-delivery interval in emergency cesarean delivery in tertiary care hospital in Thailand

OBJECTIVE: To determine the decision-to-delivery interval (DDI) in emergency cesarean delivery and associated factors. METHODS: A total of 431 pregnant women who were indicated for emergency cesarean delivery were included. Clinical information and timing of process after decision until delivery and pregnancy outcomes were evaluated. RESULTS: Mean age was 30 years, and 59.4% were nulliparous. Mean gestational age at delivery was 37.9 weeks. The decision was made during normal office hour in 33.2%. Median decision-to-operating room interval, decision-to-incision interval, and DDIs were 45, 70, and 82 minutes, respectively. Only 3.5% of patients had DDI ≤30 minutes, while 52.0% had DDI >75 minutes. During after office hours, every time interval was significantly shorter and 4.9% had DDI ≤30 minutes compared to 0.7% in normal office hours (P=0.001). Compared to other indications, time intervals were significantly shorter in those with non-reassuring fetal heart rate (FHR), and DDI ≤30 minutes was achieved in 18.8% vs. 0.8% (P < 0.001). Shortest DDI was observed among those with non-reassuring FHR during after office hours. Neonatal outcomes were comparable between different DDIs. CONCLUSION: Only 3.5% of emergency cesarean delivery had a DDI ≤30 minutes (median 82 minutes). Significant shorter time intervals were observed in those with non-reassuring FHR during after office hours.

Court-type Traditional Thai Massage and Hot Herbal Compress: Effectiveness in Relieving Early Postpartum Backache

Objective: To evaluate the effectiveness of the court-type Thai traditional massage and hot herbal compress in addition to the standard management for the relief of back pain during the early postpartum period (within 24 hours after having given birth).Methods: One hundred patients were randomly divided into two groups. The test group was treated with court-type Thai traditional massage and hot herbal compress for 60 minutes. The control group receivedonly standard postpartum management. Patients were asked to rate the intensity of their back pain using apain numeric rating scale before and after treatment.Results: Before receiving treatment, the pain intensity was equal among the two groups [5(5-6) and 5(5-6); p\>0.365]. When comparing the pain intensity after having received treatment, the difference between thegroups showed statistical significance: [4(3-4.25) and 5(3.75-5.25); p

The Rate of Loss to Postpartum Follow-up in Mothers with HIV Infection and Associated Factors

The objective of this epidemiological study with cross-sectional design was to examine the rate of loss to postpartum follow-up in mothers with HIV infection and associated factors. This study comprised 468 mothers with HIV infection, both symptomatic and asymptomatic, who delivered their babies at a university hospital in Bangkok during the 4-year period from November 1, 2000 to October 31, 2004. The Risk Factors Assessment and Counseling Record Forms of the mothers were reviewed. Data were analyzed using frequency distributions, percentages, means, standard deviations, chi-square test, odds ratio calculation with 95% confidence interval (OR, 95% CI), and multiple logistic regression analysis. Results showed that, from 2001 to 2004, the rates of loss to postpartum follow-up in mothers with HIV infection were 32.8, 40.2, 46.5, and 37.0%, respectively, with a 4-year average of 38.7%. Factors significantly associated with the loss to postpartum follow-up in mothers with HIV infection included marital status (OR=3.5, 95% CI=1.94-6.33), adequacy of income (OR=2.13, 95% CI=1.45-3.14), antenatal care (OR=7.32, 95% CI=4.82-11.12), disclosure of HIV infection (OR=3.26, 95% CI=2.21-4.81), and marital relationship (OR=2.12, 95% CI=1.45-3.10). Multiple logistic regression analysis showed that two factors were predictive factors to the loss-to-postpartum follow-up rate in mothers with HIV infection including poor antenatal care (adjusted OR=5.15, 95% CI=3.29-8.05) and non disclosure of HIV infection (adjusted OR=2.15, 95% CI=1.38-3.36). Both factors could explain approximately 28.1% of the variance in the loss-to-follow-up rate in mothers with HIV infection. It is suggested that disclosure of HIV infection is another important issue that nurses should be concerned about. Nurses should be aware about the impacts of disclosing the infection status on mothers with HIV. Nurses should help the mother to explore the problems and barriers related to this issue for continuing of care in the future.