Length of Hospital Stay After Cesarean Delivery and Its Determinants Among Women in Eastern Sudan

Hassan, Bahaeldin; Mandar, Omer; Alhabardi, Nadiah; Adam, Ishag

doi:10.2147/ijwh.s356855

Cited by 10 publications

(7 citation statements)

References 23 publications

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“…The present study found maternal complications were an independent determinant of longer LOS following VD. The finding is consistent with Prior literature reports [ 29 , 34 ]. The provision of post-partum care is essential for mothers following childbirth, even more so for mothers who experience complications during labor.…”

Section: Discussionsupporting

confidence: 94%

“…Prior Reports have documented that LOS following CD has large variability (2.5–9.3 days) across different contexts [ 10 ]. Lower median LOS following CD has been reported in Sudan [ 29 ], Australia [ 30 ], and the US [ 25 , 31 ]. On the other hand, comparable LOS in mothers who delivered via CD has been reported in India [ 21 ], Malawi, and Ghana [ 9 ].…”

Section: Discussionmentioning

confidence: 99%

“…The results of our study collaborate with existing evidence. Indeed, previous investigators have noted that neonatal complications result in a longer duration of stay [ 29 ]. The Apgar score is a simple and replicable method to quickly and summarily assess the health of newborn children immediately after birth [ 35 ].…”

Section: Discussionmentioning

confidence: 99%

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Determinants of maternal length of stay following childbirth in a rural health facility in Eritrea

Ghebremeskel,

Kahsay,

Gulbet

et al. 2023

BMC Pregnancy Childbirth

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Background The days following childbirth are a critical phase in the lives of mothers and newborns. Postpartum length of stay is a critical indicator of the efficiency of health care delivery. This study aims to explore maternal length of hospital stay (LOS) following childbirth and associated factors in a rural health facility in Eritrea. Methodology A retrospective study of all mothers who delivered at Nakfa Hospital between 2020 and 2022 was conducted. Sociodemographic, past obstetric, and neonatal factors associated with postpartum LOS were evaluated for both vaginal delivery (VD) and cesarean delivery (CD). The determinants of LOS following VD were explored using negative binomial regression. Results A total of 2025 mothers [1975 (97.5%) VD and 50 (2.5%) CD] were included in the study. The median LOS following childbirth was 1 (IQR: 0–1) day for VD and 6 (IQR: 4–8) days for CD. A substantial proportion of mothers were found to have inadequate stays following VD [29% (95% CI: 27–31)], whereas 68% (95% CI: 54-81%) stayed for > 4 days following CD. In this study, VD that were attended by physicians had no inadequate stay, whereas 27.4% of deliveries attended by midwives and 31.3% by associate nurses resulted in inadequate stay (P-value < 0.001). Determinants of LOS following VD were: the presence of maternal complications (IRR = 2.8, 95% CI: 1.6-5, p-value < 0.001), delivery years 2020 and 2021 (IRR = 1.5, 95% CI: 1.2–1.8, p-value < 0.001 and IRR = 1.4, 95% CI: 1.2–1.7, p-value < 0.001, respectively), and delivery hour interval 23:00–7:00 (IRR = 0.8, 95% CI: 0.7–0.9, p-value = 0.03). Conclusion A substantial proportion of mothers stay too short post-VD to allow adequate postnatal care, which can have untoward consequences for maternal and child health. Going forward, improved coverage of antenatal care for early diagnosis of maternal complications in pregnancy as well as assessing the level of knowledge and provisions of training and refresher courses for birth attendants should be worked upon. In addition, efforts to conduct studies that explore maternal and health care provider perspectives on LOS should be emphasized.

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Section: Discussionsupporting

confidence: 94%

Section: Discussionmentioning

confidence: 99%

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Determinants of maternal length of stay following childbirth in a rural health facility in Eritrea

Ghebremeskel,

Kahsay,

Gulbet

et al. 2023

BMC Pregnancy Childbirth

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“…This study was however conducted in a surgical ward. The median length of hospital stay was the same as a study that conducted Eastern Sudan among mothers following cesarean delivery (10). The components of clerkship that were signi cantly associated with days of hospitalization include vital examination, abdominal examination, history of presenting complaint and treatment plan.…”

Section: Discussion Of Resultsmentioning

confidence: 99%

Improving Clerkship to Enhance Patients’ Quality of Care (ICEPACQ): A Baseline Study

Kennedy,

Kagoya,

Nsubuga

et al. 2023

Preprint

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Background: Proper and complete clerkship of patients has long been shown to contribute to correct diagnosis and improved care of patients. All sections for clerkship must be carefully and completely done, to guide the diagnosis and the plan of management; moreover, one section guides the next. Failure to perform a complete clerkship has been shown to lead to misdiagnoses with its unpleasant outcomes like delayed recovery, prolonged inpatient stay, high cost of care and at worst death. Objective: The objectives of the study are; to determine the gap in clerkship of patients admitted, treated and discharged at the gynecological ward in Mbale RRH, the impact of incomplete clerkship on the length of hospital stay of the patients, to explore the causes of the gap in clerkship of the patients and the strategies which can be used to improve clerkship of the patients. Methodology: This was a mixed methods study involving collection of secondary data by review of patients’ files and collection of qualitative data by key informant interviews. The files of patients who were admitted from August 2022 up to December 2022, treated and discharged were reviewed by use of a data extraction tool. Data analysis was done using STATA version 15 by descriptive statistics, while qualitative data was analyzed by deductive thematic analysis using Atlas ti version 9. Results: Data was collected from 612 patient files. Social history had the most participants with no information provided at all (83.5 % not captured), with biodata and vital sign examination (20% not captured) having the least number. On patients’ biodata, at least each parameter was captured in all the patients, with the most gap noted in capturing the nearest health facility of the patient (91 % not captured). In the past history, the most gap was noted in the history of current pregnancy (37.5 % not provided at all); however, there was also a big gap in the past gynecological history (71 % not captured at all), past medical history (71 % not captured at all), past surgical history (73 % not captured at all) and family history (80% not captured at all). The physical examination had the most gap on abdominal examinational (43 %), with also substantial gaps in general examination (38.5 % not captured at all) and vaginal examination (40.5 % not captured at all) and vital sign examination having the least gap. There is no patient that received a complete clerkship. There was a significant association between clerkship and the length of hospital stay. The causes of the gap in clerkship were multifactorial from those related to the hospital, those related to the health worker, those related to the health care system and those related to the patient. The strategies to improve the clerkship of patients also ranged from measures to be taken by the health care worker, measures to be taken by hospital and measures to be taken by the government. Conclusion and recommendation: There is a gap in clerkship of patients on the gynecological ward, that is recognized by the stakeholders on the ward, with some components of clerkship captured better than others, with no patients that received a complete clerkship. There was a significant association between clerkship and the length of hospital stay. The following is recommended provision of clerkship tools, like the standardized clerkship guide and equipment for patient examination, continuous education of the health workers on clerkship and training them on how to use the available tools, developing SOPs for patient clerkship, promoting clerkship culture and supervision of the health workers.

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“…This risk is particularly relevant when considering the underdeveloped neonatal immune system, emphasizing the importance of meticulous adherence to proper aseptic procedures. [40][41][42] Neonates born from cesarean section also receive less skin-to-skin contact and a later initiation of breastfeeding. 43 Colostrum or the first milk contains high concentrations of immune components, including antibodies, immune cells, cytokines, lactoferrins and complements, which are essential for protection against infectious diseases.…”

Section: Discussionmentioning

confidence: 99%

Factors Associated With Culture-proven Neonatal Sepsis and Resistance to First-line Antibiotics in Indonesia

Permana,

Widodo,

Setyaningtyas

et al. 2023

Pediatric Infectious Disease Journal

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Background: Neonatal sepsis is one of the leading causes of neonatal morbidity and mortality in low- and middle-income countries. Blood culture positivity rates and antibiotic resistance pattern of neonatal sepsis differs across various regions. This study aims to identify clinical cofactors associated with blood culture-proven neonatal sepsis and in vitro resistance to first-line antibiotics (ampicillin and gentamicin) from cases originating in a tertiary healthcare center in Surabaya, Indonesia. Methods: A retrospective cohort study was conducted from January 2020 to August 2022 by utilizing secondary data collected from standardized electronic medical records. Microbiological characteristics and associated factors were statistically analyzed using multivariable logistic regression. Results: Across 266 neonatal sepsis cases, 46.9% were culture-proven and 79.2% of confirmed sepsis were resistant to first-line antibiotics. The most common isolated pathogen is Klebsiella pneumoniae, followed by coagulase-negative Staphylococci, Acinetobacter baumannii and Enterobacter cloacae. Extremely preterm delivery [adjusted odds ratio (aOR): 5.813; 95% confidence interval (CI): 1.70–19.91] and late-onset sepsis (aOR: 9.165; 95% CI: 5.12–16.40) were associated with culture-proven neonatal sepsis. Increased odds of resistance to first-line antibiotics were identified in extremely preterm (<28 weeks) or very-preterm delivery (28 to <32 weeks) (aOR: 50.80; 95% CI: 1.66–1554.21 and aOR: 45.679; 95% CI: 3.22–647.46, respectively), cesarean section (aOR: 4.149; 95% CI: 1.04–16.53) and an absence of antenatal corticosteroid use (aOR: 0.233; 95% CI: 0.07–0.76). Conclusions: The association between clinical cofactors with culture-proven sepsis and antibiotic resistance emphasizes the importance for clinicians to adjust empirical antibiotic regimens based on the local antibiogram and resource availability.

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Length of Hospital Stay After Cesarean Delivery and Its Determinants Among Women in Eastern Sudan

Cited by 10 publications

References 23 publications

Determinants of maternal length of stay following childbirth in a rural health facility in Eritrea

Determinants of maternal length of stay following childbirth in a rural health facility in Eritrea

Improving Clerkship to Enhance Patients’ Quality of Care (ICEPACQ): A Baseline Study

Factors Associated With Culture-proven Neonatal Sepsis and Resistance to First-line Antibiotics in Indonesia

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