Status of maternal and new born care at first referral units in the state of West Bengal.
A study was conducted in 12 First Referral Units (FRUs), selected through multistage sampling, from 6 districts of West Bengal. Infrastructure facilities, record keeping, referral system and MCH indicators related to newborn care were documented. Data was collected by review of records, interview and observation using a pre-designed proforma. Inadequate infrastructure facilities (e.g. no sanctioned posts of specialists, no blood bank at rural hospitals declared as First Referral Units etc.); poor utilization of equipment like neonatal resuscitation sets, radiant warmer etc, lack of training of the service providers were evident. Records/registers were available but incomplete. Referral system was found to be almost nonexistent. Most of the deliveries (86.1%) were normal delivery. Deliveries (87.71%) and immediate neonatal resuscitation (94.9%) were done mostly by nursing personnel. Institution based maternal, perinatal and early neonatal mortality rates were found to be 5.6, 62.4 and 25.2 per 1000 live births respectively. Eclampsia (48.9%), hemorrhage (17.7%), puerperal sepsis (7.1%) were reported to be major causes of maternal mortality. Common causes of early neonatal mortality were birth asphyxia (54.3%), sepsis (14.6%) and prematurity/LBW (12.4%).
Available from: John Akintunde Okeniyi
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ABSTRACT: Background. Appropriate resuscitation techniques are crucial the survival of newborn infants. Objective. To assess knowledge of nurses in western Nigeria about neonatal resuscitation. Method. A csoss-sectional survey of the nurses attached to secondary health facilities in western Nigeria was done using a closed-ended questionaire that tested evaluation and appropriate action aspects of neonatal resuscitation. Results. One hundred and seventy-nine nurses were interviewed. Of these, 72.6% had worked in the labour room and the special care baby unit within the last 5 years while only 14.0% had attended neonatal resuscitation training course within the last 5 years. Similarly 31.8%, 53.1%, 58.1%, and 35.2% had access to radiant warmers, ambu-bags, suction machine and oxygen delivery units respectively. The knowledge of the respondent was better for evaluation than for appropriate action (95.5% v.49.7%). Conclusion. The knowledge of the respondents about appropriate actions to be taken during neonatal resuscitation was poor. Frequent and intensive courses on neonatal resuscitation are highly desired.
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ABSTRACT: To study the impact of nonobstetric genital tract injury (NOGTI) in rural India.
A prospective observational study of 52 consecutive women admitted with NOGTIs caused by voluntary coitus or accidental injury. Details of the causes of trauma, clinical presentations, and management were recorded.
A total of 17 women (32.7%) presented with coital trauma, while 35 women (67.3%) sustained noncoital injuries: bicycle/automobile accidents (10); fall from height (7); cattle horn injury (7); straddle-type trauma (6); leech bites (3); and vaginal foreign bodies (2). Most women had multiple injuries; 15 women developed vulvar hematomas and 3 had anorectal lacerations. Management included immediate resuscitation along with primary repair of injuries, evacuation of vulvar hematomas, and removal of vaginal foreign bodies. Fifteen women (28.8%) required blood transfusions; none of the women died.
Severe hemorrhage caused by NOGTIs is potentially fatal in rural settings if treatment is delayed. Prompt resuscitation, early referral, and appropriate surgical intervention can avert both morbidity and mortality.
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