Introduction:
Maternal birthing positions refer to the various physical postures a pregnant mother may assume at the time of delivery. The World Health Organisation recommends that woman should be given an opportunity to make a choice on the type of position to use during labour. Alternative birth positions are associated with lower incidence rates of performing episiotomy, less perineal tears and less use of instrumental deliveries. Nurses' perspective on women's positions has rarely been explored in India. Present study aims at assessing the knowledge regarding alternative birth positions among nursing officers.
Materials and Methods:
This cross-sectional observational study was conducted on 52 nursing officers who were posted in the labour room. A pretested questionnaire was administered to them. Data analysis was done using SPSS software version 22.
Results:
Majority (82.7%) of nursing officers felt that there is a need of giving a choice to the woman regarding alternate birth position. 76.9% of them were aware of position other than lithotomy. Around 48.1% would recommend squatting position to a woman in labour. Ease and convenience in conducting the delivery was the foremost reason chosen in advocating a birth position. Whereas overcrowding in the labour room, ignorance about alternate positions and difficulty in converting to instrumental delivery were cited as reasons of not recommending these positions.
Conclusion:
Educating nursing officers about emerging evidence regarding birthing positions will enable them to give accurate information to women.
Introduction:
Reduction in maternal mortality has been a top priority in low- and lower middle-income countries of Asia-Pacific region. India, being one of them, has a major responsibility of reducing maternal mortality especially in light of the commitment on the part of the Sustainable Development Goals. Despite massive efforts and availability of technology needed to avert maternal deaths, the maternal mortality ratio (MMR) in India continues to be high especially in remote areas. This study aims at collecting the MMR data and analyzing in the context of island infrastructure.
Material and Methods:
This was a hospital-based cross-sectional study. The records of maternal deaths from January 2010 to December 2019 were collected from the medical record section and analyzed.
Results:
The MMR was estimated to be 95.63 per 100,000 live births. Majority of the patients were multigravida (82%) in the age group of 21 to 30 years (75%). Around 64% of them were referred cases. Majority (86%) of the deaths occurred in the postpartum period. Hemorrhage was the leading direct cause of maternal deaths (35.7%) followed by hypertensive disorders of pregnancy (HDP) (21.4%).
Conclusion:
Most maternal deaths are preventable. Early detection of high-risk pregnancies and early referral of such patients to a well-equipped center is the key to curb the catastrophe of mortality. Adopting methods like qSOFA (quick sequential organ failure assessment) for identifying patients requiring intensive care and miniPIERS (Preeclampsia Integrated Estimate of RiSk) model for predicting adverse outcome in HDP is the need of hour. More efforts should be made to retain the specialists in the islands.
Among our sample of women, we found a prevalence of domestic violence (32.5%), with the most common form being verbal abuse and the majority of abuse committed by the spouse or mother-in-law. n Only 6.8% of these women reported calling helplines or lodged a formal complaint.n While the medical community focuses on controlling the spread of coronavirus disease (COVID-19), women who experience domestic violence may be neglected in light of health care system challenges caused by the pandemic.
Introduction
Incomplete initial surgery complicates subsequent management of ovarian tumors. This study aimed to study demographic and clinical factors associated with incompletely staged ovarian tumor patients.
Materials and methods
Twenty five patients who had undergone incomplete staging surgery for ovarian tumors outside Gujarat Cancer & Research Institute, Ahmedabad, Gujarat, India, were included in this study. Their demographic and clinical features were studied in detail. Patients were either subjected to restaging or were referred for chemotherapy initially.
Results
Mean age of patients was 42 years (23—60 years); 64% of patients had abdominal pain as initial complaint; 64% patients were operated initially using a transverse incision. Only four patients were managed laparoscopically initially, others by laparotomy. Single/part of one ovary was removed in 60% of patients as part of initial surgery. Infundibulopelvic ligament was tied distally in 40% of patients. Omentectomy (Om) and lymphadenectomy were not done in most of the patients. Nineteen patients were found to have malignancy on final histopathological examination; 3 borderline malignancy; 1 granulosa cell tumor; and 2 benign tumors; 52% (n = 13) patients were subjected to chemotherapy; 4% (n = 1) were observed, and rest underwent restaging procedures.
Conclusion
Incompletely staged ovarian tumor patients, especially those with malignant histopathology, should be managed by gynecologic oncologists. The management needs to be individualized and cannot be a blanket therapy.
How to cite this article
Kamath A, Dave P, Mankad M. Evaluation of Incompletely Staged Ovarian Malignancy: A Study in Western India. J South Asian Feder Menopause Soc 2017;5(2):133-137.
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