The knowledge, practice of mothers and community health workers on antenatal care in Tien Du district, Bac Ninh province

The knowledge and practice of mothers and CHWs will strengthen quality of antenatal care. Objectives: To describe knowledge, practice of mothers and practice of CHWs on antenatal care in Tien Du district, Bac Ninh province in 2003. Methods: 150 mothers and 16 CHWs were included in a cross-sectional study using interviews and check lists. Results: (a) The knowledge of mothers on antenatal care including: the necessary of antenatal check up is 63.1%; vaccination of tetanus: 61.3%; use acid folic and iron: 37.3%; good nutrition: 58.7%. (b) The practice of mothers on prenatal care: get antenatal check up 3 times or more are 70.7%; vaccination of tetanus is 98.7% but the pregnant women who completed two doses get up 90.7%. The mothers had been provided iron supplementation is 64%. 62% of mothers had been supplied a good nutrition during pregnancy. 36.7% pregnancies had decrease in working time and 36% had withdrawn from work just before delivery. (c) The quality and practice skills of CHWs is no attained yet according to the National Standard on RH servies, in particular all pregnant women had not tested for proteinuria. Conclusion: It is needed to strengthen knowledge, practice of mothers and practice of CHWs on antenatal care according to the National standard on RH servies.

Caesarean section indication in the first pregnant women at the Central of Obstretics Hospital, 2002

Retrospective, cross-sectional study on all subjects undergone Caesarean section at the Central Hospital of Gynecology and Obstetrics from January 2001 to December 2002. Caesarean section on mother of first pregnancy accounted for 36.97%, a non-significant increase versus the last year or by other word, the increased rate of caesarean section operations was slowering down. Among women of first pregnancy, the rate of caesarean section was 33.44%, the increased significant by versus that of previous studies. There were 37 indication for caesarean section in 4 main causal groups: fetal causes 83.16%, cause from mother 53.05%, annex part causes 16.5%, social causes 2.22%. It must considered more strictly these indications.

Caesarean section indication in the first pregnant women in the Central of Obstetric Hospital, 2002

A cross sectional retrospective study was conducted on all cases and case reports of cesarian section at the Central Hospital of Gynecology and Obstetrics from January to December 2002. In the year 2002, there were 36.9 of cases were ceasarian section, non-significant increase versus the past year. Ceasarian section in first pregnancy was 33.4%, dramatically increased. There were 37 indications of ceasarian section dividing into 4 main groups: group 1: causes from fetus 83%, large fetus 23.8%, large fetal head 18%, fetal heart failure 17.5%, abnormal presentation 18.9%. Group 2: causes from mother 53%, causes from annexes 16.5%. Group 3: Social causes 2.22% (increased in comparing with previous study).

Caesarean section indication in former Caesarean section pregnant women at Central of Obstetric Hospital, 2002

A retrospective study was performed on 1094 cases of previous history of ceasarian operation at the National Hospital of Gynecology and Obstetrics from January to December 2002. The investigation at the age of mother, the period between 2 operations, the age of the fetus, the causes of conditions, the causes related to fetal annexis. The results showed a rate of 36.9% of cases underwent the operation. Highest rate was found at the age of 30-34 years old. Ceasarian operations were usually carried intently in the weeks 38-40 of pregnancy. The most common causes were premature amniotic breakage, large fetus, previous operated scars spasm.

The value of sonographic imaging in the early diagnosis of ectopic pregnancy

The sectional-cross study was conducted from Jan 1999 to Nov 2000 on 120 subjects suspected to have ectopic pregnancy. Subjects underwent a serum betahCG quantification, an uktrasonic examination with vaginal detector and a laparoscopy to diagnose early. Results showed that 100/120 subjects (83.33%) had ectopic pregnancy, 20/100 (16.67%) had not. At the threshold of beta hCG 700 mUI/ml, in the uterin there is not fetus beg, diagnosis value with a sensitivity of 93% and a prognosis value of 87.7% with positive value of 87.7%. Annex with a masse isolated to ovary accupied the rate of 72% and its sensitivity and prognosis value of 87.7%. If beta hCG serum level 700 mUI/ml, ultrasonographic immage doesn’t detected intrauterin ammnion bag, aring-shape masse was detected in the annex, isolated to ovary, thus early diagnostic value of ectopic pregnancy with a sensitivity of 80% and prognostic value of 93%

Study of factors which attributed of early diagnostis of ectopic pregnancy

A cross-sectional descriptive study on 120 patients suspected with ectopic pregnancy were conducted in the Institute of Protection of Mother and Newborns from Jan 1999 to Nov 2000. 83.3% (100 cases) have accurate diagnosis. Abnormal hemorrhage with dirty excretion mixed with blood was an sign of value, in 65% of patients there was a hypogastric pain, then located at the iliac hole. No amniotic sac in uterine cavity at the threshold of serum hCG  700mUI/ml. Laparoscopy and serum hCG quantifying were recommended for early diagnosing.

The value of the sonographic imaging in the early diagnosis of ectopic pregnancy

120 cases suspected of ectopic pregnancy (EP) were studied. Sonographic imaging gave early diagnosis: - No intrauterine gestation sac at βhCG serum ≥ 700mlU/ml was the valuable sign with sensitivity of 93,0% and a positive predictive value of 87,7% (p< 0,01) - Sonographic imaging with an adnexal mass has got a sensitivity of 72% and positive predictive value of 85,7% in early diagnosis - In combining 3 factors: the concentration of βhCG serum ≥ 700mlU/ml, no intrauterine gestation sac with an adnexal mass separated from the ovary, the value of early diagnosis of EP has got sensitivity of 80% and positive predictive value of 93% (P< 0,01)