ABSTRACT
A field-based assessment was conducted to assess maternal and newborn health-care services, perinatal and newborn outcomes and associated risk factors at Bint Al-Huda Maternal and Newborn Teaching Hospital, a large referral hospital in southern Iraq. The multi-method approach used interviews, discussions, observation and review of perinatal and newborn outcome data. There is limited assessment of maternal vital signs, labour pattern, fetal response, and complications during pregnancy and labour. Perinatal and neonatal mortality rates are 27.4/1000 births and 30.9/1000 live births respectively. Associated neonatal mortality factors were gestational age < 37 weeks, male sex, birth weight < 2.5 kg, maternal age > 35 years, rural maternal residence and vaginal delivery. Improving birth outcomes in southern Iraq requires evidence-based clinical guidelines, additional supplies and equipment, quality improvement initiatives and in-service training.
Subject(s)
Hospitals, General , Maternal Health Services , Perinatal Care , Warfare , Adolescent , Adult , Female , Focus Groups , Humans , Infant, Newborn , Interviews as Topic , Iraq , Male , Needs Assessment , Pregnancy , Qualitative Research , Young AdultSubject(s)
Deglutition Disorders/diagnosis , Diverticulum, Esophageal/diagnosis , Esophageal Atresia/surgery , Postoperative Complications/diagnosis , Adolescent , Child , Deglutition Disorders/etiology , Deglutition Disorders/surgery , Diagnosis, Differential , Diverticulum, Esophageal/etiology , Diverticulum, Esophageal/surgery , Humans , Mucous Membrane/pathology , Postoperative Complications/etiology , Postoperative Complications/surgeryABSTRACT
BACKGROUND: Childhood aerophagia is defined by the Rome III criteria as two or more of the following symptoms; air swallowing, abdominal distension due to intraluminal air, or repetitive belching and/or flatus. The aim of this study was to determine the multichannel intraesophageal impedance (MII) pattern in children suffering from aerophagia. METHODS: We compared the MII tracings of five children with aerophagia according to Rome III criteria (three girls, median age 7 years) to five controls (three girls, median age 8 years). Controls underwent MII for symptoms of gastro-esophageal reflux, and had normal findings. Liquid swallows (LS), air swallows (AS), mixed swallows (MS) and supragastric belching (SGB) were recorded. Meals were excluded from the analysis. All MII parameters were separately analyzed in the upright and recumbent position. All data are reported as median number of events per hour. KEY RESULTS: There was no difference in the total number of LS and MS between the two groups. However, the total number of AS in patients was significantly higher than in controls (26/h vs 5.5/h, p < 0.05) but only in the upright position (46/h vs 8.2 in control group, p < 0.05). SGB was noted only in patients with aerophagia (2.6/h vs 0/h, p < 0.01). CONCLUSIONS & INFERENCES: Children suffering from aerophagia have a specific MII pattern with an increased frequency of air swallows in the upright position and supragastric belching. MII may be used as a tool to confirm diagnosis of aerophagia in children.
Subject(s)
Aerophagy/diagnosis , Eructation/diagnosis , Esophagus/physiopathology , Gastroesophageal Reflux/diagnosis , Adolescent , Aerophagy/physiopathology , Child , Child, Preschool , Electric Impedance , Eructation/physiopathology , Female , Gastroesophageal Reflux/physiopathology , Humans , Male , Manometry , Retrospective StudiesABSTRACT
A field-based assessment was conducted to assess maternal and newborn health-care services, perinatal and newborn outcomes and associated risk factors at Bint Al-Huda Maternal and Newborn Teaching Hospital, a large referral hospital in southern Iraq. The multi-method approach used interviews, discussions, observation and review of perinatal and newborn outcome data. There is limited assessment of maternal vital signs, labour pattern,fetal response, and complications during pregnancy and labour. Perinatal and neonatal mortality rates are 27.4/1000 births and 30.9/1000 live births respectively. Associated neonatal mortality factors were gestational age < 37 weeks, male sex,birth weight < 2.5 kg, maternal age > 35 years, rural maternal residence and vaginal delivery. Improving birth outcomes in southern Iraq requires evidence-based clinical guidelines, additional supplies and equipment, quality improvement initiatives and in-service training
Une évaluation sur le terrain a été menée afin d'analyser les services de soins de santé pour la mère et le nouveau-né, les issues périnatales et néonatales et les facteurs de risque associés au centre hospitalier universitaire pour la mère et l'enfant Bint Al-Huda, un grand hôpital de recours dans le sud de l'Iraq. L'approche reposait sur de multiples méthodes et a eu recours à des entretiens semi-structurés avec des informateurs clés, à des petits groupes de discussion, à l'observation de la pratique des soins et à l'examen des données concernant l'issue des soins périnatals et néonatals.Les signes vitaux chez la mère, le déroulement du travail, la réponse foetale et les complications pendant la grossesse et le travail sont peu évalués. Les taux de mortalité périnatale et néonatale sont de 27,4/1000 naissances et de 30,9/1000 naissances vivantes respectivement; les facteurs de mortalité néonatale associés étaient un âge gestationnel inférieur à 37 semaines,le sexe masculin, un poids de naissance inférieur à 2,5 kg, l'âge de la mère supérieur à 35 ans, un lieu de résidence rural, et un accouchement par voie basse. L'amélioration des issues néonatales dans le sud de l'Iraq passe par des recommandations cliniques fondées sur des bases factuelles,des fournitures et des équipements supplémentaires, des initiatives visant à améliorer la qualité et des formations en cours d'emploi
