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Objective: Capturing 'near miss' and severe maternal morbidity using standard definitions is challenging. Information about levels of care required by ill pregnant or recently pregnant women may be more informative. The aim of this study was to prospectively audit incidence, causes, categorisation of maternal morbidity and level of care required by patients admitted to a labour ward high dependency unit (HDU) in a stand-alone obstetric hospital.
Study Design: All women admitted to HDU from May 5th to November 5th 2014 were identified prospectively and morbidity was categorised according to the Scottish Audit of Severe Maternal Morbidity (SAMM) and World Health Organisation (WHO) definitions of 'near miss' (NM), and 'severe maternal complications' (SMC). Level of care was determined by the RCOG Maternal critical care working group recommendations [1].
Results: There were 128 admissions to HDU with 4502 live births (2.8%) during this period. There were 16 (12.5%) cases of NM; 83 (64.8%) of SMC and 29 'others' not meeting either criteria. Direct obstetric causes accounted for 79% of admissions. NM cases were more likely to be caused by haemorrhage (56.3%, p=0.009), postpartum (75%, p<0.05) and require blood transfusion (56.4%) compared to SMC cases, more likely to result from hypertension (39.8%, p=0.018) and be admitted antenatally (66.3%, p=0.039). Those admitted in the beneath NM and SMC group were more likely to be admitted antenatally (89.7%, p=0.039) and require specialist consultation (31%, p=0.022). Mean duration of HDU stay was 26.6 (±17 SD) hours. The perinatal mortality rate was 39/1000 total births. There were no maternal deaths. Level 2 care was required by 40 women (NM 25%; SMC 39% and others 14%) and two women required ICU transfer for Level 3 care.
Conclusions: Approximately one quarter of women requiring HDU care 'lie beneath' criteria for near miss or severe maternal complications. One third of women admitted to the HDU require Level 2 care and the remainder require higher levels of monitoring only. The majority of cases are antepartum and delivery is integral in their care. HDU care in a labour ward setting is a good model for care of the ill pregnant or recently pregnant woman.
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http://dx.doi.org/10.1016/j.ejogrb.2016.01.031 | DOI Listing |
Pediatr Obes
March 2025
Department of Epidemiology, Fielding School of Public Health, University of California, Los Angeles (UCLA), Los Angeles, California, USA.
Objectives: This study examined the impact of hypothetical interventions on (i) early life factors (prenatal and early postnatal) on rapid weight gain during infancy, and (ii) early life factors and child energy balance-related behaviours (EBRB) on children's body mass index (BMI)-for-age at 5 and 8 years.
Methods: Data from the Norwegian Mother, Father, and Child Cohort Study included participants aged 2 (n = 48 109), 5 (n = 18 810) and 8 (n = 10 830) years. Early life intervention variables were maternal smoking during pregnancy, maternal weight before and during pregnancy, exclusive/partial breastfeeding for 6 months, and introduction of complementary food at 6 months.
BMJ Glob Health
March 2025
Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA.
Background: Sub-Saharan Africa's rapid urbanisation has led to the sprawling of urban informal settlements. The urban poorest women are more likely to experience worse health outcomes and poor treatment during childbirth. This study measures levels of person-centred maternity care (PCMC) and identifies determinants of PCMC among women living in urban informal settlements in Nairobi, Lusaka and Ouagadougou.
View Article and Find Full Text PDFLancet Gastroenterol Hepatol
March 2025
Institut Pasteur, Université Paris Cité, Unité d'Épidémiologie des Maladies Émergentes, Paris, France; Pasteur International Unit at Kumamoto University/National Center for Global Health and Medicine, Japan; International Research Center for Medical Sciences, Kumamoto University, Kumamoto, Japan. Electronic address:
Background: Timely administration of the hepatitis B virus (HBV) birth dose vaccine, along with identifying high-risk pregnant individuals for antiviral prophylaxis, is essential for the global elimination of vertical transmission of HBV. However, in resource-limited settings, access to HBV DNA testing is scarce, and accurate rapid tests for HBeAg are lacking. We aimed to assess the diagnostic performance of a newly developed hepatitis B core-related antigen (HBcrAg) rapid diagnostic test (RDT) to identify women who are HBsAg-positive and eligible for antiviral prophylaxis.
View Article and Find Full Text PDFEnviron Pollut
March 2025
Department of Reproduction, Changzhou Maternity and Child Health Care Hospital, Changzhou Medical Center, Nanjing Medical University, Changzhou, Jiangsu, 213003, PR China. Electronic address:
Pentachlorophenol (PCP) is a pervasive endocrine-disrupting compound present in the environment. Limited research has explored the effects of PCP exposure on gestational diabetes mellitus (GDM), particularly the metabolites-related mechanism. Our study seeks to characterize the interrelationships between PCP exposure, plasma metabolomic markers, and GDM, aiming to elucidate the metabolomic profile mediating PCP-GDM relationship.
View Article and Find Full Text PDFMalar J
March 2025
Department of Clinical Midwifery, School of Midwifery, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia.
Background: Malaria is a major public health problem in Tanzania, accounting for 3.1% of the global cases, with under-five children being particularly vulnerable. Over half of malaria deaths in Tanzania occurred among under-five children.
View Article and Find Full Text PDFEnter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!