The comparison of dinoprostone and vagiprost for induction of lobar in post t...iosrphr_editor
The IOSR Journal of Pharmacy (IOSRPHR) is an open access online & offline peer reviewed international journal, which publishes innovative research papers, reviews, mini-reviews, short communications and notes dealing with Pharmaceutical Sciences( Pharmaceutical Technology, Pharmaceutics, Biopharmaceutics, Pharmacokinetics, Pharmaceutical/Medicinal Chemistry, Computational Chemistry and Molecular Drug Design, Pharmacognosy & Phytochemistry, Pharmacology, Pharmaceutical Analysis, Pharmacy Practice, Clinical and Hospital Pharmacy, Cell Biology, Genomics and Proteomics, Pharmacogenomics, Bioinformatics and Biotechnology of Pharmaceutical Interest........more details on Aim & Scope).
Course Director, Elizabeth A. Stewart, MD, prepared useful Practice Aids pertaining to uterine fibroids and endometriosis for this CME activity titled "Advances in Medical Options for Uterine Fibroids and Endometriosis: Clinical Highlights From Montreal." For the full presentation, monograph, complete CME information, and to apply for credit, please visit us at http://bit.ly/2HY3HDz. CME credit will be available until June 24, 2020.
AN ANALYSIS OF OUTCOMES IN TWIN PREGNANCIES WITH ACTIVE FETAL SURVEILLANCE AN...Apollo Hospitals
The incidence of multiple gestations is increasing with
increasing maternal age and use of assisted reproduction
techniques. Selective fetal reduction of multifetal pregnancies is now widely practiced to reduce the higher order multiples to twins based on evidence from nonrandomised studies which suggests that this will improve the perinatal outcome. The proportion of twin pregnancies with unique fetal and maternal problems is therefore increasing. Optimising maternal, fetal and perinatal outcomes in twin pregnancies continues to be a formidable challenge in the present day clinical practice.
The comparison of dinoprostone and vagiprost for induction of lobar in post t...iosrphr_editor
The IOSR Journal of Pharmacy (IOSRPHR) is an open access online & offline peer reviewed international journal, which publishes innovative research papers, reviews, mini-reviews, short communications and notes dealing with Pharmaceutical Sciences( Pharmaceutical Technology, Pharmaceutics, Biopharmaceutics, Pharmacokinetics, Pharmaceutical/Medicinal Chemistry, Computational Chemistry and Molecular Drug Design, Pharmacognosy & Phytochemistry, Pharmacology, Pharmaceutical Analysis, Pharmacy Practice, Clinical and Hospital Pharmacy, Cell Biology, Genomics and Proteomics, Pharmacogenomics, Bioinformatics and Biotechnology of Pharmaceutical Interest........more details on Aim & Scope).
Course Director, Elizabeth A. Stewart, MD, prepared useful Practice Aids pertaining to uterine fibroids and endometriosis for this CME activity titled "Advances in Medical Options for Uterine Fibroids and Endometriosis: Clinical Highlights From Montreal." For the full presentation, monograph, complete CME information, and to apply for credit, please visit us at http://bit.ly/2HY3HDz. CME credit will be available until June 24, 2020.
AN ANALYSIS OF OUTCOMES IN TWIN PREGNANCIES WITH ACTIVE FETAL SURVEILLANCE AN...Apollo Hospitals
The incidence of multiple gestations is increasing with
increasing maternal age and use of assisted reproduction
techniques. Selective fetal reduction of multifetal pregnancies is now widely practiced to reduce the higher order multiples to twins based on evidence from nonrandomised studies which suggests that this will improve the perinatal outcome. The proportion of twin pregnancies with unique fetal and maternal problems is therefore increasing. Optimising maternal, fetal and perinatal outcomes in twin pregnancies continues to be a formidable challenge in the present day clinical practice.
Role of Dydrogesterone in Threatened Abortion Dr Sharda Jain Lifecare Centre
*EXPERINCE SHARING By EXPERTS*
Dr Uma Rai(DGF *E*)
Dr Sangeetaa Gupta(DGF *E*)
Dr Neerja Varshney(DGF *E*)
Dr Surjeet Kapoor(DGF *E*)
Dr Rupam arora(DGF *E*)
Dr Meenakshi Ahuja(DGF *S* )
Dr.Harsha khullar(DGF *C* )
Dr Mamta mittal(DGF *N*)
Dr Leena Sreedhar(DGF *D*)
Dr.Dipti Nabh(DGF *E*)
Dr. Shama Batra(DGF *E*)
Dr Poonam Paul(DGF *SW*)
PAN DGF ( DELHI GYNAECOLOGIST FORUM) CME ON DYDROGESTERONE ON 3/2 /22
Antiretroviral intensification to prevent intrapartum HIV transmission in lat...Илья Антипин
Lallemant M. и др. «Antiretroviral intensification to prevent intrapartum HIV transmission in late comers» 8th IAS Conference on HIV Pathogenesis, Treatment, and Prevention (IAS 2015), Vancouver, 2015. MOAC0204.
Longitudinal hemodynamics in acute phase of treatment with labetalol in hypertensive pregnant women to predict need for vasodilatory therapy
D. Stott, M. Bolten, D. Paraschiv, I. Papastefanou, J.B. Chambers and N.A. Kametas
Volume 49, Issue 1, Date: January (pages 85–94)
Read the free-access article here: http://onlinelibrary.wiley.com/doi/10.1002/uog.17335/full
Serial hemodynamic monitoring to guide treatment of maternal hypertension leads to reduction in severe hypertension
D. Stott, I. Papastefanou, D. Paraschiv, K. Clark and N.A. Kametas
Volume 49, Issue 1, Date: January (pages 95–103)
Read the free-access article here: http://onlinelibrary.wiley.com/doi/10.1002/uog.17341/full
Slides prepared by Dr Katherine Goetzinger (UOG Editor for Trainees)
Effects of intrauterine retention and postmortem interval on body weight following intrauterine death: implications for assessment of fetal growth restriction at autopsy
J Man, JC Hutchinson, M Ashworth, AE Heazell, S Levine and NJ Sebire
Volume 47, Issue 11; Date: November, pages 574–578
Read the free-access article here: http://onlinelibrary.wiley.com/doi/10.1002/uog.16018/full
Organ weights and ratios for postmortem identification of fetal growth restriction: utility and confounding factors
J Man, JC Hutchinson, M Ashworth, I Jeffrey, AE Heazell, and NJ Sebire
Volume 48, Issue 5; Date: November, pages 585–590
Read the free-access article here: http://onlinelibrary.wiley.com/doi/10.1002/uog.16017/full
Poor neonatal acid–base status in term fetuses with low cerebroplacental ratio
J. Morales-Roselló, A. Khalil, M. Morlando, A. Bhide, A. Papageorghiou and B. Thilaganathan
Volume 45, Issue 2, Date: February (pages 156–161)
http://onlinelibrary.wiley.com/doi/10.1002/uog.14647/abstract
Human fetal growth is constrained below optimal for perinatal survival
B. Vasak, S.V. Koenen, M.P.H. Koster, C.W.P.M. Hukkelhoven, A. Franx, M.A. Hanson and G.H.A. Visser
Volume 45, Issue 2, Date: February (pages 162–167)
http://onlinelibrary.wiley.com/doi/10.1002/uog.14644/abstract
Cervical length screening for prevention of preterm birth in singleton pregnancy with threatened preterm labor: systematic review and meta-analysis of randomized controlled trials using individual patient-level data
V. Berghella, M. Palacio, A. Ness, Z. Alfirevic, K. H. Nicolaides and G. Saccone
Volume 49, Issue 3, Date: March (pages 322–329)
Slides prepared by Dr Shireen Meher (UOG Editors-for-Trainees)
Link to free-access article: http://onlinelibrary.wiley.com/doi/10.1002/uog.17388/full
Single deepest vertical pocket or amniotic fluid index as evaluation test for predicting adverse pregnancy outcome (SAFE trial): a multicenter, open‐label, randomized controlled trial
S Kehl, A Schelkle, A Thomas, A Puhl, K Meqdad, B Tuschy, S Berlit, C Weiss, C Bayer, J Heimrich, U Dammer, E Raabe, M Winkler, F Faschingbauer, MW Beckmann, M Sutterlin
Volume 47, Issue 6, Date: June (pages 674–679)
Link to free-access article: http://onlinelibrary.wiley.com/doi/10.1002/uog.14924/full
Surgical treatment for hydrosalpinx prior to in‐vitro fertilization embryo transfer: a network meta‐analysis
A. Tsiami, A. Chaimani, D. Mavridis, M. Siskou, E. Assimakopoulos, A. Sotiriadis
Volume 48, Issue 4, Pages 434–445
Slides prepared by Dr Shireen Meher (UOG Editor for Trainees)
Link to free-access article: http://onlinelibrary.wiley.com/doi/10.1002/uog.15900/full
Professor Soo Downe presenting at the Doctoral Midwifery Research Society Alcohol & Medication in Pregnancy Conferene about 'Which horse for which courses? The EBM Problem in studies of pharmacological substances in maternity care'.
Role of Dydrogesterone in Threatened Abortion Dr Sharda Jain Lifecare Centre
*EXPERINCE SHARING By EXPERTS*
Dr Uma Rai(DGF *E*)
Dr Sangeetaa Gupta(DGF *E*)
Dr Neerja Varshney(DGF *E*)
Dr Surjeet Kapoor(DGF *E*)
Dr Rupam arora(DGF *E*)
Dr Meenakshi Ahuja(DGF *S* )
Dr.Harsha khullar(DGF *C* )
Dr Mamta mittal(DGF *N*)
Dr Leena Sreedhar(DGF *D*)
Dr.Dipti Nabh(DGF *E*)
Dr. Shama Batra(DGF *E*)
Dr Poonam Paul(DGF *SW*)
PAN DGF ( DELHI GYNAECOLOGIST FORUM) CME ON DYDROGESTERONE ON 3/2 /22
Antiretroviral intensification to prevent intrapartum HIV transmission in lat...Илья Антипин
Lallemant M. и др. «Antiretroviral intensification to prevent intrapartum HIV transmission in late comers» 8th IAS Conference on HIV Pathogenesis, Treatment, and Prevention (IAS 2015), Vancouver, 2015. MOAC0204.
Longitudinal hemodynamics in acute phase of treatment with labetalol in hypertensive pregnant women to predict need for vasodilatory therapy
D. Stott, M. Bolten, D. Paraschiv, I. Papastefanou, J.B. Chambers and N.A. Kametas
Volume 49, Issue 1, Date: January (pages 85–94)
Read the free-access article here: http://onlinelibrary.wiley.com/doi/10.1002/uog.17335/full
Serial hemodynamic monitoring to guide treatment of maternal hypertension leads to reduction in severe hypertension
D. Stott, I. Papastefanou, D. Paraschiv, K. Clark and N.A. Kametas
Volume 49, Issue 1, Date: January (pages 95–103)
Read the free-access article here: http://onlinelibrary.wiley.com/doi/10.1002/uog.17341/full
Slides prepared by Dr Katherine Goetzinger (UOG Editor for Trainees)
Effects of intrauterine retention and postmortem interval on body weight following intrauterine death: implications for assessment of fetal growth restriction at autopsy
J Man, JC Hutchinson, M Ashworth, AE Heazell, S Levine and NJ Sebire
Volume 47, Issue 11; Date: November, pages 574–578
Read the free-access article here: http://onlinelibrary.wiley.com/doi/10.1002/uog.16018/full
Organ weights and ratios for postmortem identification of fetal growth restriction: utility and confounding factors
J Man, JC Hutchinson, M Ashworth, I Jeffrey, AE Heazell, and NJ Sebire
Volume 48, Issue 5; Date: November, pages 585–590
Read the free-access article here: http://onlinelibrary.wiley.com/doi/10.1002/uog.16017/full
Poor neonatal acid–base status in term fetuses with low cerebroplacental ratio
J. Morales-Roselló, A. Khalil, M. Morlando, A. Bhide, A. Papageorghiou and B. Thilaganathan
Volume 45, Issue 2, Date: February (pages 156–161)
http://onlinelibrary.wiley.com/doi/10.1002/uog.14647/abstract
Human fetal growth is constrained below optimal for perinatal survival
B. Vasak, S.V. Koenen, M.P.H. Koster, C.W.P.M. Hukkelhoven, A. Franx, M.A. Hanson and G.H.A. Visser
Volume 45, Issue 2, Date: February (pages 162–167)
http://onlinelibrary.wiley.com/doi/10.1002/uog.14644/abstract
Cervical length screening for prevention of preterm birth in singleton pregnancy with threatened preterm labor: systematic review and meta-analysis of randomized controlled trials using individual patient-level data
V. Berghella, M. Palacio, A. Ness, Z. Alfirevic, K. H. Nicolaides and G. Saccone
Volume 49, Issue 3, Date: March (pages 322–329)
Slides prepared by Dr Shireen Meher (UOG Editors-for-Trainees)
Link to free-access article: http://onlinelibrary.wiley.com/doi/10.1002/uog.17388/full
Single deepest vertical pocket or amniotic fluid index as evaluation test for predicting adverse pregnancy outcome (SAFE trial): a multicenter, open‐label, randomized controlled trial
S Kehl, A Schelkle, A Thomas, A Puhl, K Meqdad, B Tuschy, S Berlit, C Weiss, C Bayer, J Heimrich, U Dammer, E Raabe, M Winkler, F Faschingbauer, MW Beckmann, M Sutterlin
Volume 47, Issue 6, Date: June (pages 674–679)
Link to free-access article: http://onlinelibrary.wiley.com/doi/10.1002/uog.14924/full
Surgical treatment for hydrosalpinx prior to in‐vitro fertilization embryo transfer: a network meta‐analysis
A. Tsiami, A. Chaimani, D. Mavridis, M. Siskou, E. Assimakopoulos, A. Sotiriadis
Volume 48, Issue 4, Pages 434–445
Slides prepared by Dr Shireen Meher (UOG Editor for Trainees)
Link to free-access article: http://onlinelibrary.wiley.com/doi/10.1002/uog.15900/full
Professor Soo Downe presenting at the Doctoral Midwifery Research Society Alcohol & Medication in Pregnancy Conferene about 'Which horse for which courses? The EBM Problem in studies of pharmacological substances in maternity care'.
This power point was created based in a case study from HBR. This is a response to improve the efficiency in recruitment by the Israeli Special Forces.
Explains about the importance of diet in Ayurveda and in special the postnatal herbal diet which makes the women to slim down after parturition and prevent the common puerperal
complaints.
Invited lecture by Dr Sujoy dasgupta in the Annual Conference of the "Academy of Clinical Embryologists" (ACE) held in October 2021 in "Hybrid mode" (Kolkata and Webinar)
Invited lecture by Dr Sujoy Dasgupta in the Scientific Session on "Embryo Transfer and Beyond " in the AICOG (All India Congress of Obstetrics and Gynaecology) at Kolkata, 2023
Newborn survival and perinatal health in resource-constrained settings in Asia and the Pacific: Applying Global Evidence to Priorities Beyond 2015
12 April 2013
Intrauterine insemination (IUI) is procedure which involves placing sperm inside a woman's uterus to facilitate fertilization. The ovaries are stimulated with tablets and injections and then monitored for the probable time of ovulation. For more info visit :-//www.newhopeivf.com/intrauterine-insemination-iui.html
Similar to Quality of care in obstetric services in rural south India evidence from two studies in a 10 year period-Asha Kilaru (20)
Exploring perceptions and functioning of Rogi Kalyan Samiti in selected distr...
Quality of care in obstetric services in rural south India evidence from two studies in a 10 year period-Asha Kilaru
1. QUALITY OF CARE IN OBSTETRIC
SERVICES IN RURAL SOUTH INDIA:
EVIDENCE FROM TWO STUDIES IN A
10 YR PERIOD
BELAKU TRUST
Asha Kilaru, BaneenKarachiwala,
SaraswathyGanapathy
2. Objectives
• Compare changes in pregnancy and delivery
services over a decade in a taluka of
Ramnagaram District (1996-98 and 2007-09)
• Identify gaps in the quality of services currently
being delivered to women during pregnancy,
delivery and postpartum.
• Make suggestions for how the observed gaps
can be addressed.
3. Methods
Study 1 - 1996-98 Study 2 – 2007-2009
Village selection 11 villages randomly 39 villages across 13
selected (population PHCs randomly selected,
approximately 25,000). 41 adjacent villages
purposively selected
(population approximately
150,000.)
All pregnant women All women who planned to
Study sample between 1996-98 (520 deliver in study area and
women), followed 3 were in 3rd trimester (642)
months postpartum between April 2007 – Jan
2009.
2 antenatal, 1 immediately 1 antenatal (3rd trimester),
post-delivery and 1 three 1 within one month
Questionnaires
months into post-partum postpartum
4. Findings
Antenatal Study 1 Study 2
1996-98 2007 - 09
Contact in 1st 56% 83%
trimester
> 4 antenatal visits 6% 64%
Quality of care at BP measured 57% At most recent visit -
antenatal visit Abdomen palpated: 88%
BP: 66%
IFA: 64%
Blood test: 13%
urine test: 8%
advice on signs or problems:
23%
breastfeeding advice: 5%
postnatal visit advice: 2%
Planned to deliver 87% 10%
5. Findings (2)
Study 1 Study 2
1996-98 2007 - 09
Planning for problems, Not available, but low Not available, but low
and response during according to our according to our
onset of labour observation observation
Switching place of del 30% 33%
(planned/anticipated to Switched for reasons
actual) other than referral by
provider
6. Findings (3)
Study 1 Study 2
1996-98 2007 - 09
Institutional deliveries 35% 82% (35% at Taluk
hosp)
ANM in attendance at 34% 17%
home delivery
Oxytocin administered 53% 17%
at home delivery
Oxytocin administered Not available 23%
intramuscular at inst
delivery
Birth weight recorded <25% 76%
7. Findings (4)
Study 1 Study 2
1996-98 2007 - 09
Length of stay Usually few hours 62% <6hrs
(even with LBW infants)
Postpartum/ Rarely given 56-62%
newborn advice given (62% of women w/o
LBW infant and 56% of
those w/ LBW received
advice)
Perinatal deaths 11 stillbirths 13 stillbirths
15 nn deaths 14 nn deaths
(26/355 live births) (27/581 live births)
8. Findings (5)
Study 1 Study 2
1996-98 2007 - 09
Postpartum visits 58% with some 93%( 565) at least 1
postpartum contact, contact with HCP
most with only 1
Of these, 94% said it
was only for baby
Most of the visits
(68%) reported
routine visits for
immunization
9. Findings (6)
Cost of care (Study 2 data)
• Costs high, much exceeding JSY payments.
• Much of it under-the-table
• Antenatal - highest expenditure for medicines
• Intrapartum - highest expenditure for provider payments
• Normal delivery median costs
Rs 1000-1300 in PHCs and Taluk hosp
Rs 4000 in tertiary govinst and pvt institutions
• C-sections median costs
Rs 8000 at tertiary govinst, Rs 20,000 at pvt inst
10. Women’s perceptions cont’d
Aspect of PHC % Taluk hosp % Private % Other Govt%
quality
Little or no 26 45 17 23
help from
health staff
companion 51 87 87 96
not allowed
Provider did 4 13 21 37
not speak
with respect
Not 36 38 22 44
comfortable
to ask ques
not clean 41 49 19 53
11. Socio-culturally linked factors
• Family members key
• Local ideas about interpretation of symptoms, causes of
illness were a significant factor in care-seeking
▫ Especially true in post-partum e.g., PPH, breast abscess
▫ Little recognition or acknowledgement of this by providers
• Attitudes that affect planning for emergencies or at onset of
labour
• Use of political connections for preferential work by
providers
12. Summary
• Improved ANC coverage, content inconsistent
• Drop in ANMs attending home births
• Little change in ‘switching’ – indicates lack of
change in problem planning
• Increase in IDs, cost
• Persistent oxytocinuse in contravention of
guidelines
• Duration of stay very short
• Little change in provider communication and advice
on warning symptoms, special care, risk
assessment
• Increase in PN contact, but little change in attention
to woman’s health
13. Conclusions and Recommendations
1. Improve the availability of 24x7 PHCs
2. Checklists for health providers on specific components
of recommended care
3. Emphasize communication - informing women and
families about what is being done and why, asking
about concerns and confusions
4. Create and mainstream specific protocols for women
with LBW newborns, use of oxytocin for labour
augmentation and AMSTL
5. Increase length of stay after delivery in institutions, esp
for women and newborns at risk
14. Conclusions and Recommendations (2)
6. Allow women to have a companion of choice
present during delivery
7. Identify and address inequities in health care
services and advice, content, & quality of care
provided by health professionals.
8. Improve safe birth attendance at home births
9. Prioritize routine postpartum care for women, not
only for vaccination of the newborn
10. Universal perinatal death review
15. Goal
Institutional deliveries
or
Safe and supported birth?