跳至主要内容

Incongruence between the Preferred Mode of Delivery and Risk of Childbirth Complications among Antepartum Women in Mulago Hospital, Uganda

Read full paper at:
http://www.scirp.org/journal/PaperInformation.aspx?PaperID=50671#.VEiRHFfHRK0

Objective: Women’s preferences for the mode of delivery provide clues on their knowledge and perceptions of anticipated risk of childbirth complications. The objective was toinvestigate incongruence between preferred mode of delivery and risk of adverse pregnancy outcomes. Methods: Through a cross-sectional study, data were collected from 327 women admitted to Mulago hospital. Data included socio-demographic characteristics, past medical, gynaecological and obstetric history, pregnancy complications, knowledge of pregnancy complications and preferred mode of delivery. The preferred mode of delivery and knowledge of related risks for adverse pregnancy outcomes were compared. Results: The mean age of participants was 24.7 years (±5.9), range 14 - 43 years, of whom 41.4% were nulliparous. The preferred mode of delivery was vaginal (84.1%). Incongruence (preference for a mode of delivery that did not correspond to expected or anticipated risks) occurred in 88 (26.9%) of the women, and was associated with having secondary school or higher level of education (OR 2.49, CI 1.52 - 4.08) and history of previous vaginal delivery (OR 3.82, CI 1.94 - 7.49). Conclusion: One in four women had incongruence between preferred mode of delivery and risks of adverse pregnancy outcomes, which called for urgent interventions to improve decision-making about intrapartum care.
Cite this paper
Kaye, D. , Nakimuli, A. , Kakaire, O. , Osinde, M. , Kakande, N. and Mbalinda, S. (2014) Incongruence between the Preferred Mode of Delivery and Risk of Childbirth Complications among Antepartum Women in Mulago Hospital, Uganda. Open Journal of Obstetrics and Gynecology, 4, 889-898. doi: 10.4236/ojog.2014.414125. 
 

[1] World Health Organization (1997) Care in Normal Birth: A Practical Guide. www.who.int/reproductive-health/publications/
[2] American College of Obstetricians and Gynecologists (2007) Caesarean Delivery on Maternal Request. ACOG Committee Opinion No. 394. Obstetrics and Gynecology, 110, 1501-1504.
[3] Schenker, J. and Cain, J. (1999) FIGO Committee Report: FIGO Committee for the Ethical Aspects of Human Reproduction and Women’s Health. International Journal of Gynecology and Obstetrics, 64, 317-322.
[4] Schindl, M., Birner, P., Reingrabner, M., Joura, E., Husslein, P. and Langer, M. (2003) Elective Caesarean Section vs. Spontaneous Delivery: A Comparative Study of Birth Experience. Acta Obstetriciaet Gynecologia Scandinavica, 82, 834-840.
[5] Villar, J., Carroli, G., Zavaleta, N., Donner, A., Wojdyla, D. and Faundes, A. (2007) Maternal and Neonatal Individual Risks and Benefits Associated with Caesarean Delivery: Multicentre Prospective Study. British Medical Journal, 335, 1025-1029. http://dx.doi.org/10.1136/bmj.39363.706956.55
[6] Zanardo, V., Simbi, A., Franzoi, M., Solda, G., Salvadori, A. and Trevisanuto, D. (2004) Neonatal Respiratory Morbidity Risk and Mode of Delivery at Term: Influence of Timing of Elective Caesarean Delivery. Acta Paediatricia, 93, 643-647.
[7] Weaver, J., Statham, H. and Richards, M. (2007) Are There “Unnecessary” Caesarean Sections? Perceptions of Women and Obstetricians about Caesarean Sections for Nonclinical Indications. Birth, 34, 32-41. http://dx.doi.org/10.1111/j.1523-536X.2006.00144.x
[8] Habiba, M., Kaminski, M., Da Frè, M., Marsal, K., Bleker, O., Librero, J., et al. (2006) Caesarean Section on Request: A Comparison of Obstetricians’ Attitudes in Eight European Countries. BJOG: An International Journal of Obstetrics & Gynaecology, 113, 647-665. http://dx.doi.org/10.1111/j.1471-0528.2006.00933.x
[9] Litorp, H., Kidanto, H., Nystrom, L., Darj, E. and Essén, B. (2013) Increasing Caesarean Section Rates among Low-Risk Groups: A Panel Study Classifying Deliveries According to Robson at a University Hospital in Tanzania. BMC Pregnancy Childbirth, 13, 107. http://dx.doi.org/10.1186/1471-2393-13-107
[10] Druzin, M.L. and El-Sayed, Y.Y. (2006) Cesarean Delivery on Maternal Request: Wise Use of Finite Resources? A View from the Trenches. Seminars in Perinatology, 30, 305-358.
http://dx.doi.org/10.1053/j.semperi.2006.07.012
[11] Hildingsson, I., R?destad, I., Rubertsson, C., Rubertsson, C. and Waldenstr?m, U. (2002) Few Women Wish to Be Delivered by Caesarean Section. BJOG: An International Journal of Obstetrics & Gynaecology, 109, 618-623. http://dx.doi.org/10.1111/j.1471-0528.2002.01393.x
[12] Angeja, A., Washington, A., Vargas, J., Gomez, R., Rojas, I. and Caughey, A. (2006) Chilean Women’s Preferences Regarding Mode of Delivery: Which Do They Prefer and Why? BJOG: An International Journal of Obstetrics & Gynaecology, 113, 1253-1258.
http://dx.doi.org/10.1111/j.1471-0528.2006.01069.x
[13] Aziken, M., Omo-Aghoja, L. and Okonofua, F. (2007) Perception and Attitude of Pregnant Women towards Caesarean Section in Urban Nigeria. Acta Obstetricia et Gynecologia Scandinavica, 86, 42-47. http://dx.doi.org/10.1080/00016340600994950
[14] Gamble, J. and Creedy, D. (2001) Women’s Preference for a Caesarean Section: Incidence and Associated Factors. Birth, 28, 101-110. http://dx.doi.org/10.1046/j.1523-536X.2001.00101.x
[15] Pang, M., Leung, T., Lau, T.K. and Chung, T.K.H. (2008) Impact of First Childbirth on Changes in Women’s Preference for Mode of Delivery: Follow-Up of a Longitudinal Observational Study. Birth, 35, 121-128. http://dx.doi.org/10.1111/j.1523-536X.2008.00225.x
[16] Waldenstrom, U., Hildingsson, I., and Ryding, E. (2006) Antenatal Fear of Childbirth and Its Association with Subsequent Caesarean section and Experience of Childbirth. BJOG: An International Journal of Obstetrics & Gynaecology, 113, 638-646.
http://dx.doi.org/10.1111/j.1471-0528.2006.00950.x
[17] Chigbu, C. and Iloabachie, G. (2007) The Burden of Caesarean Section Refusal in a Developing Country Setting. BJOG: An International Journal of Obstetrics & Gynaecology, 114, 1261-1265.
http://dx.doi.org/10.1111/j.1471-0528.2007.01440.x
[18] Lavender, T., Hofmeyr, G.J., Neilson, J.P., Kingdon, C. and Gyte, G.M.L. (2007) Caesarean Section for Non-Medical Reasons at Term. Cochrane Database of Systematic Reviews.
http://www.cochrane.org/reviews/en/ab004660.html
[19] Wax, J.R., Cartin, A., Michael, G. and Blackstone, J. (2004) Patient Choice Cesarean: An Evidence-Based Review. Obstetrical and Gynecological Survey, 59, 601-616.
http://dx.doi.org/10.1097/01.OGX.0000133942.76239.57
[20] D’Souza, R. and Arulkumaran, S. (2013) To “C” or not to “C”? Caesarean Delivery upon Maternal Request: A Review of Facts, Figures and Guidelines. Journal of Perinatal Medicine, 41, 5-15.
[21] Allen, V.M., O’Connell, C.M., Liston, R.M. and Baskett, T.F. (2003) Maternal Morbidity Associated with Cesarean Delivery without Labor Compared with Spontaneous Onset of Labor at Term. Obstetrics and Gynecology, 102, 477-482. http://dx.doi.org/10.1016/S0029-7844(03)00570-2
[22] Prior, E., Santhakumaran, S., Gale, C., Philipps, L.H., Modi, N. and Hyde, M.J. (2012) Breastfeeding after Cesarean Delivery: A Systematic Review and Meta-Analysis of World Literature. American Journal of Clinical Nutrition, 95, 1113-1135. http://dx.doi.org/10.3945/ajcn.111.030254
[23] Silver, R.M., Landon, M.B., Rouse, D.J., Leveno, K.J., Spong, C.Y., Thom, E.A., et al. (2006) Maternal Morbidity Associated with Multiple Repeat Cesarean Deliveries. Obstetrics and Gynecology, 107, 1226-1232. http://dx.doi.org/10.1097/01.AOG.0000219750.79480.84
[24] Walker, S.P., McCarthy, E.A., Ugoni, A., Lee, A., Lim, S. and Permezel, M. (2007) Cesarean Delivery or Vaginal Birth: A Survey of Patient and Clinician Thresholds. Obstetrics and Gynecology, 109, 67-72. http://dx.doi.org/10.1097/01.AOG.0000250902.67911.ce
[25] Smith, G.C., Pell, J.P., Cameron, A.D. and Dobbie, R. (2002) Risk of Perinatal Death Associated with Labor after Previous Caesarean Delivery in Uncomplicated Term Pregnancies. Journal of the American Medical Association, 287, 2684-2690. http://dx.doi.org/10.1001/jama.287.20.2684
[26] Gibbons, J.M.B., Lauer, J.A., Betrán, A.P. and Althabe, F. (2010) The Global Numbers and Costs of Additionally Needed and Unnecessary Caesarean Sections Performed per Year: Overuse as a Barrier to Universal Coverage. Background Paper 30. World Health Organization, Geneva.
[27] Mancuso, A., De Vivo, A., Fanara, G., Settineri, S., Triolo, O. and Giacobbe, A. (2006) Women’s Preference on Mode of Delivery in Southern Italy. Acta Obstetriciaet Gynecologia Scandinavica, 85, 694-699. http://dx.doi.org/10.1080/00016340600645255
[28] Dweik, D., Girasek, E., Toreki, A., Mészáros, G. and Pál, A. (2014) Women’s Antenatal Preferences for Delivery Route in a Setting with High Cesarean Section Rates and a Medically Dominated Maternity System. Acta Obstetricia et Gynecologica Scandinavica, 93, 408-415.
http://dx.doi.org/10.1111/aogs.12353
[29] Nerum, H., Halvorsen, L., Sorlie, T. and Oian, P. (2006) Maternal Request for Cesarean Section Due to Fear of Birth: Can It Be Changed through Crisis-Oriented Counseling? Birth, 33, 221-228.
http://dx.doi.org/10.1111/j.1523-536X.2006.00107.x
[30] Little, M.O., Lyerly, A.D., Mitchell, L.M., Armstrong, E.M., Harris, L.H., Kukla, R. and Kuppermann, M. (2008) Mode of Delivery: Toward Responsible Inclusion of Patient Preferences. Obstetrics and Gynecology, 112, 913-918. http://dx.doi.org/10.1097/AOG.0b013e3181888fd8
[31] Thompson, R. and Miller, Y.D. (2014) Birth Control: To What Extent Do Women Report Being Informed and Involved in Decisions about Pregnancy and Birth Procedures? BMC Pregnancy and Childbirth, 14, 62. http://dx.doi.org/10.1186/1471-2393-14-62
[32] Moffat, M.A., Bell, J.S., Porter, M.A., Lawton, S., Hundley, V., Danielian, P., et al. (2007) Decision Making about Mode of Delivery among Pregnant Women Who Have Previously Had a Caesarean Section: A Qualitative Study. BJOG: An International Journal of Obstetrics & Gynaecology, 114, 86-93.
http://dx.doi.org/10.1111/j.1471-0528.2006.01154.x
[33] Deng, W., Klemetti, R., Long, Q., Wu, Z., Duan, C., Zhang, W.H., et al. (2014) Cesarean Section in Shanghai: Women’s or Healthcare Provider’s Preferences? BMC Pregnancy Childbirth, 14, 285.
http://dx.doi.org/10.1186/1471-2393-14-285               eww141023lx
标签：

评论

发表评论

此博客中的热门博文

A Comparison of Methods Used to Determine the Oleic/Linoleic Acid Ratio in Cultivated Peanut (Arachis hypogaea L.)

Cultivated peanut ( Arachis hypogaea L.) is an important oil and food crop. It is also a cheap source of protein, a good source of essential vitamins and minerals, and a component of many food products. The fatty acid composition of peanuts has become increasingly important with the realization that oleic acid content significantly affects the development of rancidity. And oil content of peanuts significantly affects flavor and shelf-life. Early generation screening of breeding lines for high oleic acid content greatly increases the efficiency of developing new peanut varieties. The objective of this study was to compare the accuracy of methods used to classify individual peanut seed as high oleic or not high oleic. Three hundred and seventy-four (374) seeds, spanning twenty-three (23) genotypes varying in oil composition (i.e. high oleic (H) or normal/not high oleic (NH) inclusive of all four peanut market-types (runner, Spanish, Valencia and Virginia), were individually tested ...
发表评论
阅读全文

Location Optimization of a Coal Power Plant to Balance Costs against Plant’s Emission Exposure

Fuel and its delivery cost comprise the biggest expense in coal power plant operations. Delivery of electricity from generation to consumers requires investment in power lines and transmission grids. Placing a coal power plant or multiple power plants near dense population centers can lower transmission costs. If a coalmine is nearby, transportation costs can also be reduced. However, emissions from coal plants play a key role in worsening health crises in many countries. And coal upon combustion produces CO 2 , SO 2 , NO x , CO, Metallic and Particle Matter (PM10 & PM2.5). The presence of these chemical compounds in the atmosphere in close vicinity to humans, livestock, and agriculture carries detrimental health consequences. The goal of the research was to develop a methodology to minimize the public’s exposure to harmful emissions from coal power plants while maintaining minimal operational costs related to electric distribution losses and coal logistics. The objective was...
发表评论
阅读全文

Evaluation of the Safety and Efficacy of Continuous Use of a Home-Use High-Frequency Facial Treatment Appliance

At present, many home-use beauty devices are available in the market. In particular, many products developed for facial treatment use light, e.g., a flash lamp or a light-emitting diode (LED). In this study, the safety of 4 weeks’ continuous use of NEWA TM , a high-frequency facial treatment appliance, every alternate day at home was verified, and its efficacy was evaluated in Japanese individuals with healthy skin aged 30 years or older who complained of sagging of the facial skin.  Transepidermal water loss (TEWL), melanin levels, erythema levels, sebum secretion levels, skin color changes and wrinkle improvement in the facial skin were measured before the appliance began to be used (study baseline), at 2 and 4 weeks after it had begun to be used, and at 2 weeks after completion of the 4-week treatment period (6 weeks from the study baseline). In addition, data obtained by subjective evaluation by the subjects themselves on a visual analog scale (VAS) were also analyzed. Fur...
发表评论
阅读全文