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Mahfouz IA, Asali F, Ziara FMI, Samara B, Qudsieh S, Al-Rshoud F. Enema Administration During Labor: Pregnant Women's Perspective and Knowledge. SAGE Open Nurs 2022; 8:23779608221139148. [DOI: 10.1177/23779608221139148] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2022] [Revised: 10/02/2022] [Accepted: 10/30/2022] [Indexed: 11/22/2022] Open
Abstract
Introduction Current evidence does not support the routine use of rectal enemas (REs) because they have not been associated with reduced rates of puerperal infection, degree of perineal tear, or duration of labor. A recent literature review recognized knowledge gaps regarding the uses of RE during labor including women's perceptions, pain, and satisfaction. Objectives To report pregnant women's knowledge, attitudes, perceptions, pain, and satisfaction associated with the use of RE during labor. Methods A prospective study was conducted between 20 October 2019 and 20 October 2020. Women were included if they were 37 weeks or more pregnant, had a viable pregnancy, were admitted in labor, and had an RE. Characteristic data and data about knowledge, perceptions, attitudes, pain, and satisfaction associated with its use were recorded. Women were regrouped based on their level of knowledge into low- and high-level groups. Attitudes, perceptions, inconveniences, pain, and satisfaction were regrouped into two categories: low and high on the Likert scale. Results A total of 300 women were recruited, with means (SD) for age and gestational age of 27.8 (4.8) years, and 40 (1.1) weeks, respectively, and 45.7% were knowledgeable or very knowledgeable, 76% had a positive attitude, and 88.7% perceived enemas as important. The mean scores (SD) for pain and satisfaction as measured on visual analogue scales were 1.5 (1.8) and 5.4 (1.8), respectively. Women with high knowledge about RE were older and multiparous. Recruited women were more likely to report lower inconvenience and pain scores and higher satisfaction scores (all P<.05). Conclusion Most recruited women were knowledgeable about REs, perceived them as important, and expressed a positive attitude toward their administration. The low levels of inconvenience, pain, and complications and the high satisfaction rates may be used when counseling women about when an RE is required during labor.
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Affiliation(s)
- Ismaiel Abu Mahfouz
- Faculty of Medicine, Department of Obstetrics and Gynaecology, Al-Balqa Applied University, Al Salt, Jordan
| | - Fida Asali
- Faculty of Medicine, Department of Obstetrics and Gynaecology, The Hashemite University, Zarqa, Jordan
| | - Fedaa M. I. Ziara
- Department of Obstetrics and Gynaecology, Specialty Hospital, Amman, Jordan
| | - Batool Samara
- Department of Obstetrics and Gynaecology, Specialty Hospital, Amman, Jordan
| | - Suhair Qudsieh
- Department of Obstetrics and Gynaecology, Yarmouk University, Irbid, Jordan
| | - Firas Al-Rshoud
- Faculty of Medicine, Department of Obstetrics and Gynaecology, The Hashemite University, Zarqa, Jordan
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Das P, Samad N, Sapkota A, Al-Banna H, A Rahman NA, Ahmad R, Haque M, Godman B. Prevalence and Factors Associated With Caesarean Delivery in Nepal: Evidence From a Nationally Representative Sample. Cureus 2021; 13:e20326. [PMID: 35028222 PMCID: PMC8743029 DOI: 10.7759/cureus.20326] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/10/2021] [Indexed: 12/16/2022] Open
Abstract
Background Caesarian sections (CS) are life-saving management for a pregnant mother and fetus subject to obstetric complications. The World Health Organization (WHO) expected CS rates not to exceed 10 to 15 per 100 live births in any country. This study aimed to assess the prevalence of CS and its associated factors from the 2016 Nepal Demographic and Health Survey (NDHS), building on previous studies mentioned in detail in the latter part of the paper. Methods This study analyzed the secondary data from the 2016 Nepal Demographic and Health Survey (NDHS), conducted from June 19, 2016, to January 31, 2017. The survey is undertaken every five years; consequently, the data capture the information in the previous five years from the data collection period. We used the 2016 NDHS, which is implemented by the new Enumeration Area (EA) under the support of the Ministry of Health (MOH) and funded by the U.S. Agency for International Development (USAID). In the rural areas, the sample is stratified and selected in two stages. In the first stage, wards are selected as the primary sampling units (PSU), with households subsequently chosen from the PSUs. In the urban areas, the sample is nominated in three stages. In the first stage, wards are selected as PSUs; in the second stage, one EA is chosen from each PSU, and finally, households are selected from the EAs. Then data were collected from the women in the reproductive age group within the selected households. Results The prevalence of CS in Nepal conforms to the WHO standard with 7.8, 7.5, and 8.1 per 100 deliveries, or 9.8, 8.9, and 9.1 per women's last births in the previous one, three, and five years, respectively. Older mothers of 30 years old or more, having high incomes, being overweight and obese, using the internet, ante-natal care (ANC) visits of more than four times, ANC by doctors, twin delivery, and having babies of 4 kg or more, had higher odds for a CS while having two or more children seemed to be protective towards CS. Conclusion These findings can be used to update health policies surrounding CS delivery to limit unnecessary CS and ensure better health as CS is not without complications.
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Affiliation(s)
- Pranta Das
- Statistics, University of Dhaka, Dhaka, BGD
| | | | - Ashmita Sapkota
- Public Health, School of Health and Allied Science, Pokhara University, Pokhara, NPL
| | - Hasan Al-Banna
- Social Welfare, Institute of Social Welfare and Research, University of Dhaka, Dhaka, BGD
| | | | - Rahnuma Ahmad
- Physiology, Medical College for Women and Hospital, Dhaka, BGD
| | - Mainul Haque
- Pharmacology and Therapeutics, National Defence University of Malaysia, Kuala Lumpur, MYS
| | - Brian Godman
- Centre of Medical and Bio-allied Health Sciences Research, Ajman University, Ajman, ARE
- Pharmacoepidemiology, Strathclyde Institute of Pharmacy and Biomedical Sciences, Glasgow, GBR
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Lotfi F, Lohivash S, Kavosi Z, Owjimehr S, Bayati M. The impact of Health Transformation Plan on natural vaginal delivery and cesarean section frequency in Iran: an interrupted time series analysis. BMC Res Notes 2021; 14:257. [PMID: 34217368 PMCID: PMC8254991 DOI: 10.1186/s13104-021-05677-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2020] [Accepted: 06/29/2021] [Indexed: 11/15/2022] Open
Abstract
Objective This study was conducted to evaluate the effect of the Iran’s Health Transformation Plan on the frequency of natural vaginal deliveries (NVDs), cesarean sections (CSs), and total deliveries in the Fars province of Iran. Results Average number of total deliveries before and after the reform were 3946 and 3810, respectively (p = 0.164). The ratio of CS to total deliveries in the first study month was 54%. This rate reached 47% in the last month (p < 0.01). However, it had much fluctuation trend. The ITSA results showed that in the short-run, the NVD rate increased (β = 492.79, p < 0.01), the rate of CS decreased (β = − 407.09, p < 0.01), and total deliveries increased (β = 85.75, p < 0.724). However, in the long-run, the NVD (β = 5.74, p < 0.423), CS (β = 10.21, p < 0.189), and total deliveries (β = 15.96, p < 0.256) had no significant changes after the reform. Encouraging the NVD package was influential in the short-run but not in the longrun in Iran. Pricing and supply-side policies could not reduce the rate of non-clinical CS on their own. Therefore, paying attention to demand-side policies and changes in consumer behaviors, such as educating the women at the age of pregnancy about the advantages and disadvantages of CS and NVD and correcting misconceptions, could be helpful.
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Affiliation(s)
- Farhad Lotfi
- School of Health Management and Information Sciences, Health Human Resources Research Center, Shiraz University of Medical Sciences, Almas Building, Alley 29, Qasrodasht Ave, P.O. code: 71336-54361, Shiraz, Iran.,Department of Health Economics, School of Health Management and Information Sciences, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Saeed Lohivash
- School of Health Management and Information Sciences, Health Human Resources Research Center, Shiraz University of Medical Sciences, Almas Building, Alley 29, Qasrodasht Ave, P.O. code: 71336-54361, Shiraz, Iran.,Department of Health Economics, School of Health Management and Information Sciences, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Zahra Kavosi
- School of Health Management and Information Sciences, Health Human Resources Research Center, Shiraz University of Medical Sciences, Almas Building, Alley 29, Qasrodasht Ave, P.O. code: 71336-54361, Shiraz, Iran.,Department of Health Economics, School of Health Management and Information Sciences, Shiraz University of Medical Sciences, Shiraz, Iran
| | | | - Mohsen Bayati
- School of Health Management and Information Sciences, Health Human Resources Research Center, Shiraz University of Medical Sciences, Almas Building, Alley 29, Qasrodasht Ave, P.O. code: 71336-54361, Shiraz, Iran. .,Department of Health Economics, School of Health Management and Information Sciences, Shiraz University of Medical Sciences, Shiraz, Iran.
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Selection of Delivery Method and Its Related Factors in Pregnant Women of Shiraz in 2016. SHIRAZ E-MEDICAL JOURNAL 2019. [DOI: 10.5812/semj.81676] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
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Zhao J, Shan N, Yang X, Li Q, Xia Y, Zhang H, Qi H. Effect of second child intent on delivery mode after Chinese two child policy implementation: a cross sectional and prospective observational study of nulliparous women in Chongqing. BMJ Open 2017; 7:e018823. [PMID: 29282269 PMCID: PMC5770909 DOI: 10.1136/bmjopen-2017-018823] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
OBJECTIVES To assess the influence of second child intent on the delivery preferences and final delivery modes of nulliparous women, particularly caesarean delivery on maternal request (CDMR), after implementation of China's two child policy. DESIGN Cross sectional and prospective observational study. SETTING A tertiary teaching hospital in Chongqing, China. PARTICIPANTS 1000 low risk nulliparous women were initially involved, and were divided into two groups based on their intent on having a second child. 814 women who completed all interviews were analysed. MAIN OUTCOME MEASURES Preferred mode of delivery in second trimester and at admission; final delivery mode, CDMR. RESULTS 814 women who completed all interviews were analysed, in whom 51.2% intended to have a second child. The preference for caesarean delivery (CD) at the second trimester between the intent and no intent group was 6.2% versus 17.9% (adjusted RR 0.35, 95% CI 0.20 to 0.63) and increased to 24.2% versus 37.3% (adjusted RR 0.65, 95% CI 0.45 to 0.94) at admission, respectively. The overall CD rates between the two groups were 41.0% versus 50.4% (adjusted RR 0.84, 95% CI 0.60 to 1.18), and the CDMR rates were 16.7% versus 29.0% (adjusted RR 0.56, 95% CI 0.37 to 0.86), respectively. CONCLUSIONS Women who intend to have a second child are less likely to request a CD, and high rates of CD and CDMR in nulliparous women may have decreased after implementation of China's two child policy.
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Affiliation(s)
- Jianlin Zhao
- Department of Obstetrics and Gynaecology, First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Nan Shan
- Department of Obstetrics and Gynaecology, First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Xiaochang Yang
- Department of Obstetrics and Gynaecology, First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Qin Li
- Department of Obstetrics and Gynaecology, First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Yinyin Xia
- School of Public Health and Management, Research Center for Medicine and Social Development, Innovation Center for Social Risk Governance in Health, Chongqing Medical University, Chongqing, China
| | - Hua Zhang
- Department of Obstetrics and Gynaecology, First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Hongbo Qi
- Department of Obstetrics and Gynaecology, First Affiliated Hospital of Chongqing Medical University, Chongqing, China
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