Acute postpartum uterine inversion: a case report

No Abstrac

The prevalence, bacteriology and drug sensitivity of asymptomatic bacteriuria in antenatal women at Harare and Mbuya Nehanda maternity hospitals, in Zimbabwe

Objectives: To determine the prevalence of Asymptomatic Bacteriuria (AsB) and the drug sensitivities of the common causative organisms in antenatal women at Harare and Mbuya Nehanda Maternity Hospitals.Design: This was a descriptive cross sectional study.Setting: Harare and Mbuya Nehanda Maternity Hospital antenatal clinics.Subjects: One hundred and forty one (n=141) consenting women coming for routine antenatal care were recruited between the 15th of November and the 15th of December 2015.Intervention: The women were given health education sessions on AsB and urinary tract infection during pregnancy. A structured questionnaire was utilized to elicit demographic data, antenatal history, sexual hygiene and other risk factors for AsB. Mid stream urine was collected from each participant and dispatched to the laboratory for microscopy, culture and sensitivity. Patients whose culture results were positive were contacted by the researcher for appropriate treatment according to their drug sensitivities.Main Outcome Measures: The prevalence of AsB, the causative bacteria and their drug sensitivities.Results: Among the 141 antenatal women who participated in the study, 23% had positive urine cultures. The predominant bacteria was E. coli accounting for 18 (13%) participants followed by Streptococci in 7 (5%) and Staphylococcus in 5 (4%). Amoxycillin/Clavulinic acid, Nitrofurantoin and Ciprofloxacin were the effective antibiotics against the bacteria.Conclusion: The prevalence of AsB in this population of antenatal women was 23% and the common causative organisms were E. coli, Streptococci, Staphylococci and Klebsiella. The organisms were mostly sensitive to Amoxycillin/Clavulinic acid, Nitrofurantoin and Ciprofloxacin

An assessment of the maternal death notification system in Zimbabwe - 2006

No Abstract

A cluster randomized controlled trial of the non-pneumatic anti-shock garment for obstetric haemorrhage: sub-analysis of the Zimbabwean Arm

Objectives: To determine whether earlier application of the Non-pneumatic Anti-Shock Garment (NASG) at clinic level compared to the referral hospital level reduces maternal morbidity and mortality and recovery time from shock due to severe Obstetric Haemorrhage (OH) and to determine the safety of the NASG when applied at clinic level.Design:  A cluster Randomized Controlled Trial (RCT)Setting:  Harare and Parirenyatwa Referral Hospitals (RH) in Harare and the twelve Harare City Council clinics that offer maternity care.Subjects:  Women who had suffered severe OH at clinic level and were being transferred to a Referral Hospital (RH).Interventions:  The clinics were randomized into two groups. In the early NASG group eligible women were given the standard management for OH and had the NASG applied at the clinic level before transport to RH. In the control group, eligible women were given the standard management for OH at the clinic level, transferred to the RH, and received the NASG at the RH. All women received equivalent OH/hypovolemic shock management at the RH.Main Outcome Measures:  The main outcome measures were maternal mortality and morbidity, blood loss, recovery from shock and the occurrence of side effects whilst in the NASG.Results: There were few maternal deaths and morbidities, and no statistically significant differences between the two groups were noted. Women in the early NASG group spent a statistically significant shorter time in the NASG at referral hospital level (OR 0.64, 95% CI 0.52 - 0.79, p < 0.001) and had a non-significant 40% faster recovery from shock (HR 1.39; 95% CI 0.98-1.97, p=0.07). There were no differences in reported side effects.Conclusion:  Earlier NASG application at the clinic level was associated with faster recovery from shock in women who had suffered severe OH and appears safe to use

Clinical course of preterm prelabor rupture of membranes in the era of prophylactic antibiotics

<p>Abstract</p> <p>Background</p> <p>Preterm prelabor rupture of membrane (PPROM) causes maternal and neonatal complications. Prophylactic antiobiotics were used in the management of PPROM. The objectives of this retrospective study were to compare clinical course and outcome of PPROM managed expectantly with prophylactic antibiotics and antenatal corticosteroids with those without prophylactic antibiotics and antenatal corticosteroids.</p> <p>Results</p> <p>A total of 170 cases of singleton pregnant women with gestational age between 28–34 weeks suffering from PROM during January 1998 to December 2009 were included; 119 cases received prophylactic antibiotics and antenatal corticosteroids while 51 cases did not received prophylactic antibiotics and antenatal corticosteroids. Median latency period in the study group was significantly longer than in the control group (89.8 vs. 24.3 hours, P < 0.001). The percentage of patients who did not deliver within 48 hours and within 7 days in the study group were also significantly higher than in control group (64.7 vs. 31.4%, P < 0.001 and 29.4 vs. 7.8%, P = 0.002, respectively). Maternal infectious morbidity was comparable between groups (17.6% vs. 13.7%, P = 0.52). Neonatal infectious morbidity was significantly lesser in study group than control group (21% vs. 35.3%, p = 0.04).</p> <p>Conclusions</p> <p>Latency period of PPROM after using prophylactic antibiotics and antenatal corticosteroids increased while neonatal infectious morbidity was low. But maternal infectious morbidity was not increased. This retrospective study confirms the benefit of prophylactic antibiotics and antenatal corticosteroids in management of PPROM.</p