Sexuality throughout all the stages of pregnancy: experiences of expectant mothers

Objective: To explore and understand the sexual experiences of expectant mothers during their pregnancy. Methods: The study was carried out in two healthcare centers in the Almería Health District, in southern Spain. The participants included pregnant women who received prenatal care and/or maternity education. The inclusion criteria were being pregnant, maintaining sexual activity and agreeing to participate in the study. The exclusion criteria were having limitations on sexual activity by medical prescription. The sample consisted of 15 expectant women selected using a convenience sample, of which 5 took part in a focus group (FG) and 10 in in-depth interviews (IDI). Data was collected between the months of June and December 2016. Participants were contacted by the main researcher and an appointment was made to carry out the FGs or the IDIs. Results: Three main categories emerged: False beliefs and a holistic approach to sexuality during pregnancy, which is related to the concept of sexuality, false beliefs, and limited sexual counseling during pregnancy. Limitations: From fear at the beginning to physical diffi culty at the end, referring to the fluctuations in sexual desire as well as the physical changes that limit sexual activity. Adapting to changes: safe practices and satisfaction with one’s body image, which encompasses concerns about the risks and the relationship between body image and self-esteem. Conclusion: A lack of sexual counseling during pregnancy leads to the creation of false beliefs, which, together with physical changes, concerns about the risk, and fl uctuations in sexual desire and interest, bring about a decrease in sexual activity. But sexuality remains an important aspect of pregnancy, toward which the participants must adopt a broader approach, not limited to intercourse, and adopt sexual practices that are adapted to the physical and emotional changes that happen during this time

Audit of epidural anaesthesia services at a district hospital in Nigeria

Background: Epidural anaesthesia and analgesia is considered the 'gold standard' analgesic technique for major surgery. However, its practice is limited in most hospitals in Nigeria. The objective of this review was to determine the rate of administration of epidural anaesthesia and to review the challenges affecting its routine use in a District Hospital. Methods: This was a retrospective study of all patients who received anaesthesia in the hospital between 2010 and 2011. Data extracted from the hospital record included the age and sex of the patients, type of surgery, types of anaesthesia used, outcomes of anaesthesia and the grade of anaesthetists involved.Results: A total of 2,828 anaesthetic procedures were carried out during the study period with 1,288 and 1,540 administered in 2010 and 2011 respectively. Three (0.2%) of the anaesthetic procedures were epidural in 2010 and 18 (1.2%) in 2011, giving a 500% increase in rate of its administration. Epidural anaesthesia constituted 0.74% (21/2,828) of all anaesthetic procedures. Of these, 16 (76%) were performed on females and 5 (24%) were males. Five Nurse Anaesthetists and one Consultant Anaesthetist provided anaesthesia services.There was no record of morbidity or mortality related to epidural anaesthesia.Conclusion: Epidural anaesthesia is safe but its utilization is very low at this clinical setting. More physician anaesthetists need to be trained in order to increase the practice of epidural anaesthesia.Keywords: Anaesthesia, Epidural, Maitama Hospital, Physician anaesthetis

Function and disability status among women with fistula using WHODAS2.0: A descriptive study from Rwanda and Democratic Republic of Congo

Objective: To assess function and disability among women in Rwanda and Democratic Republic of Congo living with fistula and identify characteristics associated with higher disability scores. Methods: Women presenting for fistula care were recruited. Eligible participants underwent a physical examination to classify fistula type and completed the WHO Disability Assessment Schedule 2.0 questionnaire to ascertain the impact of fistula on function across six domains: cognition, mobility, self-care, getting along, life activities, and participation. Disability scores were calculated (where 0 = no disability and 100 = complete disability). Participants were grouped according to no, low, or high disability status; results were examined to determine the domains most affected. Results: Among 69 participants, fistula type included: vesicovaginal (59.4%), ureterovaginal (14.5%), total absence of proximal urethra (11.6%), and rectovaginal (14.5%). Median disability score was 43.0/100 (interquartile range 26.0–67.0); 83% exhibited high disability status. Life activities and participation in society domains were most affected. Women with rectovaginal fistula reported the lowest scores, and those with total absence of proximal urethra reported the highest scores. Conclusion: WHO Disability Assessment Schedule 2.0 represents a simple, robust measure of global disability status, aligns with research efforts to estimate maternal disability, and may inform health needs and resource allocation for this population. In this study, disability was common, varied by fistula type, and affected physical, mental, and social domains