Influence of blood donation before pregnancy on neonatal birth weight / 中国输血杂志

【Objective】 To explore the influence of maternal blood donation before pregnancy on neonatal birth weight. 【Methods】 A total of 6 428 full-term (gestational age ≥37 weeks) singleton pregnant women in Ningbo Medical Center Lihuili Hospital and Ningbo Women and Children′s Hospital from January 2020 to October 2020 were enrolled in this study. The cumulative whole blood donations before pregnancy were obtained through Alipay software. The relevant data of parturients and their fetuses were collected from electronic medical records. 【Results】 The maternal blood donation rate in Zhejiang Province before pregnancy was 14.69%. The average age of women was 29 (27-32), and the median of cumulative blood donation (except 0 mL) before pregnancy was 300 mL. Univariate analysis showed that there was no significant difference in neonatal gender, neonatal birth weight, proportion of low birth weight infants and proportion of macrosomia among non blood donation group, low blood donation group and high blood donation group (P>0.05). After multiple linear regression analysis, it was found that there was no correlation between blood donation before pregnancy and the neonatal birth weight (B=0.123, 95%CI: -1.013-8.461, P>0.05). Multivariate Logistic regression analysis showed that, compared with the non blood donation group, the occurrence of macrosomia was higher in both the low blood donation group and the total blood donation group (OR=1.366, 95%CI: 1.007-1.766, P<0.05; OR=1.369, 95%CI: 1.019-1.851, P<0.05). 【Conclusion】 Maternal blood donation before pregnancy may not be related to neonatal birth weight, but may be related to the probability of macrosomia in their offspring.

Effectiveness of Shiatsu Massage on First Stage Labour Pain among Parturient Mothers

Childbirth is an experience in a woman' s life that holds the power to transform her forever. The objective of the study was to assess the effectiveness of Shiatsu massage upon rst stage Labour pain among the parturient mothers. In this pre-test, post-test experimental study, 60 parturient mothers were selected by simple random sampling technique among which 30 were assigned to the control group and 30 mothers to the experimental group. The labour pain level was assessed by the visual pain analogue scale, and foeto maternal parameters using modi- ed WHO partograph before and after intervention for both control and experimental group of parturient mothers. The experimental group was provided with Shiatsu massage on UB30 of the sacro-meridian region for 10 minutes for every two hours along with the routine care and the control group was treated only with the routine care during the labour process. The results showed a signi cant difference in after therapy pain score, at p'lt;0.001 between the control and experimental group. The foeto maternal parameters like foetal heart rate, uterine contraction and cervical dilatation was stable throughout the labour process. The Shiatsu massage was effective in reducing the level of labour pain perception. The management of labour pain is a primary responsibility of the nurse. Midwives can be empowered to provide Shiatsu massage as non-pharmacological pain management during childbirth.

Intravenous Dexmedetomidine For The Management Of Shivering Post Sub Arachnoid Blockade For Conduction Of Caesarean Delivery: A Randomised Controlled Trial

Background:About 52% of patients who undergo Cesarean delivery under spinal or epidural anesthesia will experience shivering, which may interfere with the monitoring of vital signs. Recent studies have shown that dexmedetomidine could potentially help to mitigate shivering associated with anesthesia. In accordance with them we decided to investigate the capability of dexmedetomidine, an alpha 2-adrenergic agonist, in reducing the duration of shivering associated with spinal anesthesia during Cesarean delivery. Material And Methods:Forty parturient going through Cesarean delivery under spinal anesthesia and experiencing shivering were included in this randomized, double-blind, prospective trial. After delivery, the intervention group (n = 20) was administered a single intravenous bolus of dexmedetomidine (20 microgram) while the control group (n =20) was given normal saline. Randomization and allocation were based on a computer-generated list. The primary outcome parameter was the time required for an observable reduction in shivering after the intervention. Result:Eighty patients were recruited, 40 of whom presented with shivering and underwent randomization. Our study recorded that dexmedetomidine alleviated the mean duration of shivering after a single intravenous bolus to 2.2 (2.07) min after dexmedetomidine from 18.9 (12.72) min after saline (95% confidence interval [CI],). The effect of dexmedetomidine was sustained 15 min after the bolus was administered, and shivering had completely stopped in 90% of the patients in the intervention group vs. 22.6% in the control group. No adverse effects were recorded. Conclusion:Our study found that a single intravenous bolus of dexmedetomidine reduced the duration of shivering for up to 15 min during Cesarean delivery under spinal anesthesia when compared against a placebo.

Analysis of treatment for 360 critically ill pregnant and parturient women in intensive care unit / 中华危重病急救医学

Objective:To analyze the clinical characteristics and outcomes of critically ill pregnant and parturient women in intensive care unit (ICU), and to provide clinical experience for the subspecialty construction of critical obstetrics.Methods:The clinical data of critically ill pregnant and parturient women admitted to the department of critical care medicine, the Second Affiliated Hospital of Kunming Medical University from January 2011 to December 2019 were collected. The main reasons for maternal transfer to ICU, the causes of maternal death, and organ support measures, etc. were summarized.Results:A total of 39 567 critically ill pregnant and parturient women were admitted to the department of obstetrics in our hospital, and 360 were transferred to ICU, with an average ICU transfer rate of 0.91%. Since 2016, the number of obstetric admissions, the number of ICU transfers and the ICU transfer rate had increased significantly. The average age of severe maternals admitted to ICU was (30.9±5.7) years old. The average acute physiology and chronic health evaluation Ⅱ(APACHEⅡ) score was 7 (4, 10). The average length of ICU stay was 1 (1, 2) day. The average ventilator duration was 9.0 (3.0, 17.5) hours. The main delivery mode of pregnant women in ICU was cesarean section (84.72%). Forty-eight patients (13.33%) underwent hysterectomy, of which 42 (87.5%) due to postpartum hemorrhage. The top 3 causes of ICU admission were severe postpartum hemorrhage [36.94% (133/360)], hypertensive disorders of pregnancy [21.67% (78/360)], pregnancy with cardiac disease [15.00% (54/360)]. The leading cause of postpartum hemorrhage in women transferred to ICU was placental abnormality [63.98% (103/161)], followed by uterine atony [28.57% (46/161)]. The average blood loss was (4 019±2 327) mL within 24 hours after delivery, and the number of women who underwent hysterectomy due to postpartum hemorrhage decreased year by year. During the study period, there were 2 maternal deaths, which were indirect obstetric deaths, 3 cases were discharged against-advice (expected death), including 1 indirect death and 2 direct obstetric death; the mortality in ICU was 1.39% (5/360).Conclusions:The most common reasons for pregnant and parturient women to be admitted to ICU were severe postpartum hemorrhage and hypertensive disorders of pregnancy. The leading cause of postpartum hemorrhage was placental problem. Indirect obstetric deaths exceeded direct obstetric deaths, mainly due to pregnancy complicated with cardiac disease and severe pneumonia. ICU has become an important battlefield for rescuing critically ill maternal and an important guarantee for reducing the maternal mortality.

Impact of evidence-based humanistic care on psychological status and pregnancy outcome in high-risk parturient women / 中国实用护理杂志

Objective:To observe the effects of evidence-based humanistic care on psychological status and pregnancy outcome in high-risk parturient women.Methods:A total of 92 high-risk pregnant women admitted to the First People′s Hospital of Lianyungang City from January 2019 to January 2020 were selected. According to the method of drawing samples from a random number table, the control group (46 cases) was given care according to the clinical nursing path of childbirth, and the observation group (46 cases) implemented evidence-based humanistic care on this basis.Scores of Chinese Perceived Stress Scale(CPSS) and Self-rating Anxiety Scale(SAS) before and after the intervention, and cesarean section rate, neonatal asphyxia rate, 2 h and 24 h postpartum blood loss were compared.Results:After the intervention, CPSS score (12.28 ± 4.34) and SAS score (47.32 ± 6.61) in observation group were lower than those in control group (16.26 ± 3.39) and (53.60 ± 5.46) ( t values were 4.902, 4.968, P< 0.05); cesarean section rate and neonatal asphyxia rate in observation group were 23.91% (11/46), 2.17%(1/46) lower than 45.65%(21/46)and 19.57%(9/46) in control group ( χ2 values were 4.791, 5.954, P<0.05), and postpartum hemorrhage volume in 2 hours (173.63±61.46) ml and 24 h blood loss (246.37±67.24) ml were less than those in control group (272.45 ±57.92) ml and (368.34±72.47) ml ( t values were 7.936, 8.368, P<0.05). Conclusions:Evidence-based humanistic care can relieve the psychological pressure and anxiety of high-risk parturient women and improve their pregnancy outcome.

Abdominal Aortic Aneurysm in pre-term pregnancy: A case report

@#Cardiovascular diseases during pregnancy account for significant morbidity and mortality. An abdominal aortic aneurysm posts high mortality for otherwise healthy patients, more so for conditions that alter normal physiology such as in preterm pregnancy. Abdominal aortic dissection during pregnancy is a rare and life-threatening condition for both the mother and the fetus. An understanding of physiologic maternal changes and surgical stress responses is important to attenuate perioperative hemodynamic changes and prevent progression of aortic expansion and aortic rupture. As an anesthesiologist, one is positioned to facilitate communication among the internist, obstetrician and vascular surgeon for surgical success. This case report presents the anesthetic considerations in the perioperative management of a preterm pregnancy for a major abdominal surgery.

Práticas exitosas à parturiente quanto a satisfação no partejar e puerpério imediato / Successful practices for parturients regarding satisfaction in childbirth and immediate puerperium / Prácticas exitosas para parturientas sobre la satisfacción en el parto y puerperio inmediato

Objetivo: Conhecer as práticas exitosas e satisfação de parturientes quanto ao partejar e puerpério imediato. Método: Estudo bibliográfico, descritivo, tipo revisão integrativa. Pesquisaram-se artigos baseados em consultas de estudos científicos inseridos no Portal Periódicos Capes entre os anos de 2013 a 2018, analisados de forma descritiva e resultados apresentados em formas de figuras. Resultados: Totalizaram-se 1260 publicações referentes à temática e, após rigoroso refinamento da busca, foram elegíveis na íntegra, quando excluídos 1253 estudos por não responderem aos critérios de inclusão, sete artigos, determinando a amostra final para discussão com a literatura. Conclusão: Conclui-se que há evidências de que a satisfação com o atendimento recebido pelas mulheres em Centro de Parto Normal está diretamente relacionada ao acolhimento, satisfação no autocuidado, perspectiva em relação a ambiência onde encontram-se as parturientes, puérperas e acompanhantes, como ocorreu o processo do trabalho de parto, parto e puerpério imediato

Objective: To know the successful practices and parturients' satisfaction regarding childbirth and immediate puerperium period. Method: Bibliographic and descriptive study, typified as integrative review. We sought articles based on consultations of scientific studies inserted in the Capes Periodicals Portal from 2013 to 2018, analyzed descriptively, with their results displayed through figures. Results:A total of 1,260 publications related to the theme and, after accurate search refinement, seven articles were fully eligible, when 1,253 studies were excluded because did not meet the inclusion criteria, thereby providing the final sample for discussion with literature. Conclusion: We conclude that there is evidence that the satisfaction with the care received by women in the Normal Birth Center is directly related to the welcoming, satisfaction in self-care, perspective directed to the environment where the parturients, puerperal women and companions are hosted, as well as the way the labor, birth and immediate puerperium process occurred

Objetivo: Conocer prácticas exitosas y satisfacción de parturientas sobre el parto y puerperio inmediato. Método: Estudio descriptivo y bibliográfico, tipo revisión integradora. Se realizaron búsquedas en artículos basados en consultas de estudios científicos insertados en el Portal Periódicos Capes de 2013 a 2018, analizados descriptivamente, con resultados presentados en figuras. Resultados: Se totalizaron 1.260 publicaciones referentes al tema y, tras un riguroso refinamiento de búsqueda, se escogieron íntegramente siete artículos, cuando se excluyeron 1.253 estudios por no satisfacer los criterios de inclusión, determinando la muestra final para discusión con la literatura. Conclusión: Se concluye que existe evidencia de que la satisfacción con la atención recibida por las mujeres en el Centro de Parto Normal está directamente relacionada con la acogida, la satisfacción en la autoatención, la perspectiva dirigida al entorno donde se encuentran las parturientas, puérperas y acompañantes, así como la ocurrencia del proceso de parto, nacimiento y puerperio inmediato

The effect of anaesthesia and antenatal care on feto-maternal outcome after caesarean section in a developing country

Background: The feto-maternal outcome after delivery is precarious in developing country. The anaesthetic technique and antenatal care as it affect this outcome is assessed.Methods: This is a 5-year retrospective study carried out at the University of Nigeria Teaching Hospital Enugu. Obstetric theatre records of patients who had caesarean section between January 1st 2011 and December 31st 2015 were reviewed. Data extracted from the records using a proformer included socio-dermographic characteristics, indications for surgery, maternal and neonatal outcome, and anaesthetic technique. The data were analyzed using SPSS Version 17 [SPSS Inc., Chicago, IL, USA].Results: A total of 1574 patients had caesarean section within the study period and 1158 (73.6%) of the patients were booked, while 416 (26.4%) were unbooked. The total number of deliveries during this period was 6235 giving a caesarean section rate of 39.6%. More deaths on the operating table were recorded in the unbooked patients as compared to booked parturient (x2=20.013, p<0.001). More babies of the unbooked patients died perioperatively (17.3%) when compared to booked paturient (3.4%) p<0.001.Conclusions: The commonest anaesthesia administered was subarachnoid block. Maternal and neonatal mortality was significantly higher in paturient who did not attend antenatal care compared to those who attended.

Seroprevalence and factors associated with Human Immunodeficiency virus, Human T lymphotropic virus and Hepatitis B/C infections in parturient women of Salvador - Bahia, Brazil

Abstract Background The heterogeneity in detection rates of Human immunodeficiency virus, (HIV), Human T lymphotropic virus (HTLV) and Hepatitis B and C infections among pregnant women and the continuous exposure to risk factors limits the adoption of preventive and control actions. Objective To evaluate the HIV, HTLV, Hepatitis B and C seroprevalence rates, and associated risk factors in parturient women in Salvador, Brazil. Methods This was a cross-sectional study in 2099 parturient women attended in two public maternity hospitals in Salvador, Brazil. One blood sample was drawn for serological screening and socio-demographic, obstetric and clinical data were collected. Results HIV seroprevalence rate was 1.5% (of which 0.6% were new cases); seroprevalence rates for HTLV, HBV, and HCV were 0.4%, 0.4%, and 0.1%, respectively. Univariate analysis showed a significant association between socio-demographic and behavioral factors with retroviral infections, while viral hepatitis was mainly associated with parenteral exposure. In a multivariate analysis, multiple sexual partners (OR 3.3; 95% CI: 1.1-9.2), history of sexual/domestic violence (OR 2.8; 95% CI: 1.1-6.9), syphilis co-infection (OR 2.6; 95% CI: 1.0-6.9), use of alcohol or drugs (OR 2.5; 95% CI: 1.2-5.5), and low schooling level (OR 2.3; 95% CI: 1.1-4.9) were independent risk factors for HIV infection. History of stillbirth and low birth weight infants was significantly associated with HTLV positive status, showing a negative impact on gestation. Conclusions The seroprevalence rates for HIV, HCV, HBV, and HTLV were similar to that found in previous studies in other Brazilian regions. The high individual, socioeconomic, and social vulnerability detected in seropositive parturient women indicates the need to improve coverage and effectiveveness of STDs control with prevention, detection and monitoring strategies, focusing in pregnant women exposed to high biopsychosocial risk.

Assessment of labor room communication skills among postgraduate students of obstetrics and gynecology

Background: “Communication with patients” is an important skill needed for every physician in their clinical practice.  These soft skills are required in dealing with patients at every step which include history taking from the patients, explaining them the diagnosis, the prognosis of the disease with associated complications. Dealing with empathy, taking informed consent, explaining the operative procedure and the complications associated with surgery, the art of breaking bad news are the mandatory skills for a good clinician. Labouring women like other patients also require special attention and empathy. So, the residents working in labor room need commitment to develop these soft skills in order to improve the labor room experience of expectant mothers. Objective of this study was to analyse role of a formal training in labor room communication skills among post graduate students of the department of obstetrics and gynecology.Methods: Faculty and students’ sensitization was done after approval from institutional ‘ethics committee’ for conducting this study. Pre-workshop assessment of residents for communication skills attitude and effective communication was done through ‘communication skill attitude scale’ (CSAS) and ‘GAP-KALAMAZOO scale’. Workshop for communication skills on the framework of Calgary Cambridge patient interview model and online teaching of students through what’s app videos, role-play demonstrations was followed by reassessment of the residents through above used scales.Results: Results depicted both improvements in attitude and effective communication skills among residents. 100% of the students were convinced and opined that good communication skills necessary for perfect clinical practice.Conclusions: The skill to communicate with patients is a fine art and needs to be mastered to be a good clinician. A formal training in effective communication skills is absolutely necessary to bring professionalism in medical practice.

Effect of different doses of dexamethasone on labor in Santa Inês ewes and its influence on the onset of labor and the expulsion of fetal membranes / Efeito de diferentes doses de dexametasona para a indução do parto em ovelhas Santa Inês e sua influência sobre as características do parto

The induction of labor aims to concentrate births to follow up better the parturient and the first care to the neonates. However, even if the labor induction technique with dexamethasone administration has been successfully described since the late 1970s, few studies report the technique of birth development and neonatal vitality in Santa Inês sheep. This study aimed to evaluate the efficiency of dexamethasone use in two doses (8 and 16mg) in labor induction of Santa Inês ewes at 145 days of gestation and to evaluate its effects on the birth characteristics. In this study, 58 ewes were used, raised in an extensive system in the experimental farms of UFBA, with confirmation pregnancy after fixed-time artificial insemination or controlled breeding. These female ewes were separated into three groups according to the dose of dexamethasone administered (G1 = 0mg, G2 = 8mg, and G3 = 16mg). From these births, 79 lambs were born. This study analyzed the period from induction of labor to birth, fetal presentation at birth, the weight of the placenta, and the period for placenta expulsion. The data were analyzed by the Statistical Analysis System (SAS v.9.1.3®, 2002), and the significance level considered for all analyzes was 5%. Births of induced groups occurred on average at 48.4±22.17 hours after induction, while the females with non-induced labor gave birth 131.96±41.9 hours on average after the placebo application (P<0.05), confirming the efficiency of both doses for induction of labor. The period from induction to birth did not differ (P>0.05) between the doses used. There were no differences in delivery about the fetal static relation, time to placental attachment, and weight. With this study, it can be concluded that the induction at 145 days of gestation with eight or 16mg of dexamethasone is a useful technique and does not alter the labor in Santa Inês sheep.(AU)

A indução do parto visa concentrar os nascimentos para melhor acompanhamento das parturientes e primeiros cuidados aos neonatos. Contudo, mesmo que a técnica de indução de parto, com administração de dexametasona, tenha sido descrita com sucesso desde o final da década de 70, existem estudos escassos que relatam a influência desta técnica sobre o parto em ovinos da raça Santa Inês. Dessa forma, o objetivo do estudo foi avaliar a eficácia da dexametasona em duas doses (8 e 16mg), para a indução do parto de ovelhas Santa Inês com 145 dias de gestação e avaliar os seus efeitos nas características de desencadeamento e finalização do parto. Para este estudo foram utilizadas 58 ovelhas, criadas em sistema extensivo nas fazendas experimentais da UFBA, com prenhez confirmada após inseminação artificial em tempo fixo ou monta controlada. Essas fêmeas foram separadas em três grupos, de acordo com a dose de dexametasona administrada (G1 = 0mg, G2 = 8mg e G3 = 16mg). Destes partos nasceram 79 cordeiros. Foram avaliados o período em horas da indução do parto aos nascimentos, a apresentação fetal ao nascimento, assim como o peso da placenta e o período para o delivramento. Os dados foram analisados pelo pacote estatístico Statistical Analysis System (SAS v.9.0®, 2002) sendo considerado para todas as análises o nível de significância de 5%. Os nascimentos dos grupos induzidos ocorreram em média com 48,4±22,1 horas após a indução, enquanto que as fêmeas com parto não induzido pariram em média 131,96±41,9 horas após aplicação do placebo (P<0,05), confirmando a eficácia de ambas as doses para indução do parto. O período da indução até o parto não diferiu (P>0,05) entre as doses utilizadas. Não ocorreram diferenças no parto em relação à estática fetal, tempo para o delivramento e peso da placenta nos diferentes grupos. Com este estudo, conclui-se que a indução de parto em ovelhas aos 145 dias de gestação com oito e 16 mg de dexametasona é uma técnica eficaz e que não altera o trabalho de parto nas ovelhas da raça Santa Inês.(AU)

Comparative evaluation of continuous epidural infusion of 0.0625% Bupivacaine + 0.0002% Fentanyl and 0.1% Ropivacaine + 0.0002% Fentanyl for labour analgesia

Aim& Objectives: To compare the total dose of Fentanyl and Bupivacaine with total dose of Ropivacaine and fentanyl in terms of total volume delivered-loading, infusion and top ups. Also, to compare Analgesic efficacy (VAS score) and adverse events if any. Methods: 60 ASA physical status I or II parturients in labour who were either primigravidae or gravida 2 were included in a randomized, single blind, prospective study. After a bolus dose of 0.125 % Bupivacaine and 25 mcg Fentanyl, the group BF received a continuous epidural infusion of 0.0625% Bupivacaine and 0.0002% Fentanyl whereas the group RF received a bolus of 0.2% Ropivacaine and 25 mcg Fentanyl followed by an infusion of 0.1% Ropivacaine and 0.0002% Fentanyl. Results: The Group BF and Group RF were comparable with respect to their physical parameters. It was seen that the pain relief in the group BF was excellent for 8 out of 30 patients (26.67%) whereas for the group RF it was excellent for 9 of 30 patients (30%). After that till delivery, both the groups had a comparable mean maternal pulse rate (p value >0.05). None of the parturient in study or control group ever had an episode of bradycardia. Throughout the remaining period of analgesia, the mean foetal heart rate was comparable between the two groups. In the present study groups only 2 parturients from group BF and only one parturient from group RF underwent caesarean section due to foetal distress. 6 parturients (20%) from group BF and 5 parturients (16.67%) from group RF developed hypotension. Conclusion: Continuous infusion of 0.1% Ropivacaine + 0.0002 % Fentanyl provides equipotent labour analgesia and maternal satisfaction as 0.0625% Bupivacaine + 0.0002% Fentanyl infusion can provide.

Acupuncture at Ciliao (BL 32) for prevention of postpartum urinary retention in elderly parturient women: a randomized controlled trial / 中国针灸

OBJECTIVE@#To explore the preventive effect of acupuncture at Ciliao (BL 32) on postpartum urinary retention as well as the time and volume of the first urination after delivery in elderly parturient women undergoing vaginal delivery.@*METHODS@#A total of 180 elderly parturient women (≥35 years old) undergoing vaginal delivery were randomly divided into a blank control group, a conditional control group and an observation group, 60 cases in each group. The patients in the blank control group were treated with routine nursing plan; based on the treatment of the blank control group, the patients in the conditional control group were treated with additional intervention measures such as applying hot towel on the bladder and fingers pressing to stimulate urination; based on the treatment of the blank control group, the patients in the observation group were treated with acupuncture at bilateral Ciliao (BL 32) one hour after delivery for 20 min (the acupuncture was given only once). The incidence rate of postpartum urinary retention as well as the time and volume of the first urination among the women without urinary retention were observed; the satisfaction rate of the 3 groups was recorded.@*RESULTS@#The incidence rate of postpartum urinary retention in the observation group was 5.0% (3/60), which was significantly lower than 26.7% (16/60) in the blank control group (<0.01) and 16.7% (10/60) in the conditional control group (<0.05); the incidence rate of postpartum urinary retention in the conditional control group was significantly lower than that in the blank control group [16.7% (10/60) vs 26.7%(16/60), <0.05]. In the elderly women without urinary retention, the first urination time in the observation group was significantly earlier than that in the blank control group and conditional control group (<0.01), and the first urination time in the conditional control group was earlier than that in the blank control group (<0.01). The volume of first urination in the observation group was higher than that in the blank control group and the conditional control group (<0.05, <0.01). The satisfaction rates in the observation group and conditional control group were higher than that in the blank control group (<0.01).@*CONCLUSION@#Acupuncture at Ciliao (BL 32) could effectively prevent the postpartum urinary retention, improve the time and volume of the first urination in elderly parturient women undergoing vaginal delivery.

Infant feeding practices among parturient women in rural communities of Anambra State, Nigeria

Background: Infant feeding is an integral part of the reproductive process with important implications for the health of mothers and their babies. However, various practices exist in different communities. It is therefore pertinent to know the infant feeding practices among rural dwellers, as well as the factors that influence them.Methods: This study was a cross sectional survey. A total of 372 volunteering parturient women were recruited using a multi-stage stratified sampling technique. Ethical approval and respondents’ informed consent was obtained. A self-developed and validated questionnaire was used to collect data. Descriptive and inferential statistics was used to analyse data.Results: Findings revealed that majority (84.4%) of the respondents were aware of exclusive breastfeeding (EBF), but only about half (50.5%) ever practiced exclusive breastfeeding. Also, a significant percentage of the respondents introduced complimentary feeding to the baby immediately after birth while 29.3% of participants reported drinking palm wine which is mainly alcoholic to stimulate breast milk secretion. Occupation of parturient women was associated with the practice of EBF (p=0.002).Conclusions: Almost half of our studied parturient women do not engage in EBF. There is need for health care workers to strategically educate parturient women and their significant others on the numerous benefits of exclusive breast feeding.

Effects of pregnancy associated with diabetes on the duration of subarachnoid block with Ropivacaine in the parturient / 实用医学杂志

Objective To make comparison of duration of subarachnoid block with intrathecal ropivacaine between gravidas with diabetes mellitus and non-diabetic pregnancy, to evaluate the sensitivity of parturient with diabetes to ropivacaine. Methods 75 parturients who were presenting for elective cesarean section were randomly divided into pregestational diabetes mellitus group (group P, n=15) , gestational diabetes mellitus group (group G, n=30) and non-diabetic parturients group (group N, n=30). After entering the operating room, parturients were given spinal anesthesia spinal at the L3～4 interspace with 0.5％ hyperbaric ropivacaine 3 ml with left lateral decubitus position. To determine the level of sensory block by 10 g monofilament and evaluate the motor block with modified Bromage score. To record the time T6 sensory level was obtained, the onset time of sensory block, motor block, the duration of the motor block and sensory block. Results The time T6 sensory level was obtained of Group P were significantly shortened (P < 0.001). Compared with Group N and Group G, the duration of sensory (P < 0.001) and motor (P < 0.001) block were significantly prolonged. Conclusion Parturients with pregestational diabetes mellitus are more sensitive to 0.5％ hyperbaric ropivacaine compared to non-diabetic parturients. Compared with non-diabetic parturients, there are no difference in the sensitivity of parturient with gestational diabetes mellitus to 0.5％hyperbaric ropivacaine.

Study on prevalence and vertical transmission rate of Toxoplasma gondii infections among parturient women in Wuhu City / 中国血吸虫病防治杂志

Objective To investigate the prevalence and vertical transmission rate of Toxoplasma gondii infections among in parturient women in Wuhu City, so as to provide reference for the prevention and control of toxoplasmosis among pregnant women in the city. Methods Parturient women’s venous blood samples and neonatal heel blood samples were collected in Wuhu City and prepared into filter-paper blood samples. The prevalence and vertical transmission rate of T. gondii infections were detected using the loop -mediated isothermal amplification (LAMP) assay among the parturient women. Results There were three positive samples detected in the 475 filter-paper blood samples from the parturient women, with a mean positive rate of 0.63%. The prevalence of T. gondii infection was 0 in pregnant women at ages of < 20 years (0/5) and at an advanced maternal age (0/24), while the prevalence was 0.67% (3/446) in pregnant women at an appropriate maternal age. T. gondii infection was detected in 2 filter-paper blood samples from newborns, with a vertical transmission rate of 66.67%. Conclusions There is T. gondii infection in the parturient women and a high vertical transmission rate of T. gondii infection is detected in Wuhu City. The awareness of the potential risk factors of toxoplasmosis should be improved among pregnant women to prevent the damages of toxoplasmosis to humans.

Study on prevalence and vertical transmission rate of Toxoplasma gondii infections among parturient women in Wuhu City / 中国血吸虫病防治杂志

Objective To investigate the prevalence and vertical transmission rate of Toxoplasma gondii infections among in parturient women in Wuhu City, so as to provide reference for the prevention and control of toxoplasmosis among pregnant women in the city. Methods Parturient women’s venous blood samples and neonatal heel blood samples were collected in Wuhu City and prepared into filter-paper blood samples. The prevalence and vertical transmission rate of T. gondii infections were detected using the loop -mediated isothermal amplification (LAMP) assay among the parturient women. Results There were three positive samples detected in the 475 filter-paper blood samples from the parturient women, with a mean positive rate of 0.63%. The prevalence of T. gondii infection was 0 in pregnant women at ages of < 20 years (0/5) and at an advanced maternal age (0/24), while the prevalence was 0.67% (3/446) in pregnant women at an appropriate maternal age. T. gondii infection was detected in 2 filter-paper blood samples from newborns, with a vertical transmission rate of 66.67%. Conclusions There is T. gondii infection in the parturient women and a high vertical transmission rate of T. gondii infection is detected in Wuhu City. The awareness of the potential risk factors of toxoplasmosis should be improved among pregnant women to prevent the damages of toxoplasmosis to humans.

The effectiveness of utilizing the Zhang's criteria compared to Friedman's criteria in increasing the rate of successful vaginal delivery among primigravid parturient in a tertiary hospital / Philippine Journal of Obstetrics and Gynecology

Objective@#To determine the effectiveness of utilizing the Zhang's criteria as compared to Friedman's criteria in increasing the rate of successful vaginal delivery among primigravid parturient in a tertiary government hospital. @*Material and Methods@#This is a prospective cohort study conducted in a tertiary hospital. The population consisting of primigravid parturient of any age admitted at term pregnancy with a gestational age between 37 and 42 weeks. Included were singleton pregnancy, with no co-morbidities, vertex position on admission, with intact amniotic membranes, and in active phase of labor (either 4cm or 6cm cervical dilatation), who consulted at the emergency room of the institution. Multigravid patients, those with multiple pregnancy and ruptured membranes were excluded from the study. Two groups of cohorts were recruited based on the internal examination of the principal investigator upon admission. Cohort A is composed of pregnant women admitted at 6cm cervical dilatation fulfilling the Zhang's criteria whereas Cohort B is composed of pregnant women admitted at 4cm cervical dilatation fulfilling the Friedman's criteria. Socio-demographic characteristics were recorded. Their course of labor was monitored; contractions were augmented accordingly if needed. The mode of delivery was noted such as spontaneous vaginal delivery or cesarean section. The neonatal outcome was recorded as to apgar scores obtained for both groups. @*Results@#A greater proportion of parturients were young, single and with normal body mass index. A higher proportion of those under Friedman's group was augmented with oxytocin (100% vs. 53.4%). A greater proportion of those in Zhang's group had successful vaginal delivery (98.2% vs. 81.8%) (p=0.011, OR=18.167, 95% CI: 1.943, 169.867). Parturients under Zhang's group had achieved less hours of active labor. @*Conclusion@#The rate of successful vaginal delivery is significantly different between the two groups. A greater proportion of pregnant women under Zhang's group achieved successful vaginal delivery as compared to Friedman's group.

Prevalencia de la depresión post parto en Arequipa, Perú / Prevalence of postpartum depression in Arequipa, Peru

Objetivos: Determinar la prevalencia de la depresión postparto en mujeres puérperas de la ciudad de Arequipa. Material y métodos: Estudio descriptivo. Se evaluaron a 113 madres que acudieron a sus controles postnatales en una posta de salud de la ciudad. Se utilizó la Escala de Depresión Postparto de Edimburgo, previo consentimiento informado. Para efectos del estudio, se valoraron las propiedades psicométricas del instrumento, reportándose adecuados niveles de validez y confiabilidad para la muestra evaluada. Resultados: Los resultados indican que aproximadamente, el 41% de las madres no tiene riesgo de depresión postparto, 14% presenta riesgo y 45% tiene síntomas de depresión postparto. Asimismo, se encontró que el grado de instrucción se relaciona de manera negativa con los niveles de depresión postparto, pero no hubo diferencias significativas en función del tipo de parto ni el estado civil de las madres. Conclusiones: Se concluye que el 45% de las mujeres puérperas evaluadas tienen síntomas de depresión postparto y que el grado de instrucción presenta correlaciones negativas con esta variable. (AU)

Objectives: To determine the prevalence of postpartum depression in puerperal women in the city of Arequipa. Methods: A descriptive study was conducted in 113 puerperal women that attended peripheral health care centers for postpartum control. Edinburgh scale for depression was used after getting inform consent. Psychometric properties of the tool were evaluated. Results: Our results indicate that 41% of mothers are not at risk of postpartum depression; 14% are at risk and 45% have symptoms of postpartum depression; the degree of education was inversely correlated with postpartum depression and we did not find statistical association with route of delivery and marital status. Conclusions: We conclude that 45% of puerperal women evaluated had depression and that the degree of education inversely correlated with it. (AU)

Predictive effect of the difference of brachial artery peak velocity in different positions on Supine hypo-tension syndrome of parturient after spinal anesthesia / 临床麻醉学杂志

Objective To investigate the effectiveness of predicting the incidence of supine hy-potension syndrome (SHS)after spinal anesthesia measured by ultrasonic measurement of the varia-tion of brachial artery peak velocity in different positions of parturient.Methods Parturient scheduled for elective cesarean section,ASA physical status Ⅰ or Ⅱ,were divided into SHS group and no-SHS group (SBP in the upper extremity decreased by > 30 mm Hg or decreased to < 80 mm Hg)after spinal anesthesia.HR,SBP,DBP of supine position and left lateral position before anesthesia were re-corded,and brachial artery peak velocity were measured by Ultrasonic.The differences of the above indexs before and after the transformation position were calculated.The receiver operating characteris-tic curve (ROC)was plotted by indexs of which P values were less than 0.05,to evaluate the predic-tive effect of each index on SHS after spinal anesthesia.Results Among the 196 patients,89 cases (45.4%)developed SHS after spinal anesthesia.SBP,DBP,peak velocity of brachial artery (Vpmin) and brachial artery peak velocity variation (ΔVp)were different before and after the transformation position (P<0.05).The difference in SHS group was significantly higher than no-SHS group.The areas under ROC curve (AUC)of ΔSBP,ΔDBP,ΔVpmin,ΔΔVp were 0.711 (95%CI 0.575-0.846), 0.573 (95%CI 0.419-0.727),0.948 (95% CI 0.895-0.987),0.864 (95% CI 0.770-0.958),and the cut-off values were 17.5 mm Hg,7.6 mm Hg,17.8 cm/s,and 13.1%.Conclusion The differ-ence of brachial artery peak velocity measured by ultrasonic in different positions of parturient can ef-fectively predict the occurrence of SHS,in which ΔVpmin≥ 17.8 cm/s has better predictive effect.