Introduction: Stillbirths are estimated at 2 million each year, of which more than 40% occur during labour. Our objective was to study the epidemiological aspects of stillbirth and neonatal deaths in the delivery room...Introduction: Stillbirths are estimated at 2 million each year, of which more than 40% occur during labour. Our objective was to study the epidemiological aspects of stillbirth and neonatal deaths in the delivery room in our health facility. Patients and methods: Prospective, descriptive and analytical study, conducted at the Jeanne Ebori Foundation Mother-Child University Hospital over 4 years (January 2019-December 2022). All neonatal deaths in the delivery room or foetal death in utero, were included. Results: Among the 18,346 deliveries performed, 512 newborns were declared dead in the delivery room (27.9‰ live births), divided into in utero foetal death (19.0‰) and immediate neonatal death (8.9‰). The mean age was 34.3 weeks of amenorrhea. The rate of preterm birth was 60.4%. The sex ratio was 1.1. The average weight was 2186.6. The main causes were vascular (46.1%), foetal (20.2%), adnexal (17.1%) and asphyxia per partum (16.6%). Foetal causes were more likely to result in IUFD than other causes (OR = 6.4 [2.4 - 15.7], p < 0.001). After birth, partum asphyxia was more likely to lead to death before 15 minutes of life than other causes (OR = 11 [6.1 - 18.9], p Conclusion: The causes of stillbirth and early neonatal mortality are dominated by maternal vascular pathologies. However, the proportion of childbirth-related causes remains worrying. Better monitoring of pregnancy and labour will minimize this prevalence in our hospital.展开更多
Effective communication and emotional support of parturient women improve the outcome of childbirth. Reduction in Duration of labor, cesarean rate, use of anesthesia, and 5 minute Apgar Score less than 7 can achieve. ...Effective communication and emotional support of parturient women improve the outcome of childbirth. Reduction in Duration of labor, cesarean rate, use of anesthesia, and 5 minute Apgar Score less than 7 can achieve. This study was a part of a large mixed method study during 2013-2014. In this qualitative study, in-depth interviews were conducted with 32 participants (16 mother and 16 midwife), using semi-structured interviews. Participants were recruited by pur-posive sampling with maximum diversity in terms of age, occupation, education and etc. Educational hospital of Arak University of Medical Sciences was considered as the setting. Each interview was conducted at a private and convenient location and took about 30 to 45 minutes. Interviews were audio taped and transcribed verbatim. Conventional content analysis was done for data analysis. Interviews continued until data saturation was obtained. Data were coded in MAXQDA software (version 11). The main category emerged as “outcome” of midwife-mother relationship. Facilitating childbirth, positive experience, mental health promotion and improvement in quality of life were derived as subcategories. Good midwife-mother relationship could promote positive outcome in labour. Results could assist midwives in providing holistic quality care to mothers during labour, thus providing positive consequence in child birth. Also, results could provide a framework and guidance for policymakers to create appropriate context for the midwife-mother relationship in maternity care.展开更多
When I interviewed Droma,she had already retired and was staying at home to look after her grandson.This was on June 3rd,2017.At the Apple Orchard in Lhoka City,Tibet Autonomous Region,the sun was hanging in sky with ...When I interviewed Droma,she had already retired and was staying at home to look after her grandson.This was on June 3rd,2017.At the Apple Orchard in Lhoka City,Tibet Autonomous Region,the sun was hanging in sky with sparkling light."I was born in the winter of 1956.展开更多
Background The aim of this study was to review current delivery room(DR)resuscitation intensity in Chinese tertiary neonatal intensive care units and to investigate the association between DR resuscitation intensity a...Background The aim of this study was to review current delivery room(DR)resuscitation intensity in Chinese tertiary neonatal intensive care units and to investigate the association between DR resuscitation intensity and short-term outcomes in preterm infants born at 24+0_31+6 weeks gestation age(GA).Methods This was a retrospective cross-sectional study.The source population was infants born at 24+0_31+6 weeks'GA who were enrolled in the Chinese Neonatal Network 2019 cohort.Eligible infants were categorized into five groups:(1)regular care;(2)oxygen supplementation and/or continuous positive airway pressure(O2/CPAP);(3)mask ventilation;(4)endotracheal intubation;and(5)cardiopulmonary resuscitation(CPR).The association between DR resuscitation and shortterm outcomes was evaluated by inverse propensity score-weighted logistic regression.Results Of 7939 infants included in this cohort,2419(30.5%)received regular care,1994(25.1%)received O,/CPAP,1436(18.1%)received mask ventilation,1769(22.3%)received endotracheal intubation,and 321(4.0%)received CPR in the DR.Advanced maternal age and maternal hypertension correlated with a higher need for resuscitation,and antenatal steroid use tended to be associated with a lower need for resuscitation(P<0.001).Severe brain impairment increased significantly with increasing amounts of resuscitation in DR after adjusting for perinatal factors.Resuscitation strategies vary widely between centers,with over 50%of preterm infants in eight centers requiring higher intensity resuscitation.Conclusions Increased intensity of DR interventions was associated with increased mortality and morbidities in very preterm infants in China.There is wide variation in resuscitative approaches across delivery centers,and ongoing quality improvement to standardize resuscitation practices is needed.展开更多
Background:Delivery room resuscitation assists preterm infants,especially extremely preterm infants(EPI)and extremely low birth weight infants(ELBWI),in breathing support,while it potentially exerts a negative impact ...Background:Delivery room resuscitation assists preterm infants,especially extremely preterm infants(EPI)and extremely low birth weight infants(ELBWI),in breathing support,while it potentially exerts a negative impact on the lungs and outcomes of preterm infants.This study aimed to assess delivery room resuscitation and discharge outcomes of EPI and ELBWI in China.Methods:The clinical data of EPI(gestational age[GA]<28 weeks)and ELBWI(birth weight[BW]<1000 g),admitted within 72 h of birth in 33 neonatal intensive care units from five provinces and cities in North China between 2017 and 2018,were analyzed.The primary outcomes were delivery room resuscitation and risk factors for delivery room intubation(DRI).The secondary outcomes were survival rates,incidence of bronchopulmonary dysplasia(BPD),and risk factors for BPD.Results:A cohort of 952 preterm infants were enrolled.The incidence of DRI,chest compressions,and administration of epinephrine was 55.9%(532/952),12.5%(119/952),and 7.0%(67/952),respectively.Multivariate analysis revealed that the risk factors for DRI were GA<28 weeks(odds ratio[OR],3.147;95%confidence interval[CI],2.082–4.755),BW<1000 g(OR,2.240;95%CI,1.606–3.125),and antepartum infection(OR,1.429;95%CI,1.044–1.956).The survival rate was 65.9%(627/952)and was dependent on GA.The rate of BPD was 29.3%(181/627).Multivariate analysis showed that the risk factors for BPD were male(OR,1.603;95% CI,1.061–2.424),DRI(OR,2.094;95% CI,1.328–3.303),respiratory distress syndrome exposed to≥2 doses of pulmonary surfactants(PS;OR,2.700;95%CI,1.679–4.343),and mechanical ventilation≥7 days(OR,4.358;95% CI,2.777–6.837).However,a larger BW(OR,0.998;95% CI,0.996–0.999),antenatal steroid(OR,0.577;95%CI,0.379–0.880),and PS use in the delivery room(OR,0.273;95%CI,0.160–0.467)were preventive factors for BPD(all P<0.05).Conclusion:Improving delivery room resuscitation and management of respiratory complications are imperative during early management of the health of EPI and ELBWI.展开更多
Introduction: In order to prevent the vertical transmission of the Human Immunodeficiency Virus (HIV), it is essential that pregnant women must know their HIV serological status. Objective: To determine the proportion...Introduction: In order to prevent the vertical transmission of the Human Immunodeficiency Virus (HIV), it is essential that pregnant women must know their HIV serological status. Objective: To determine the proportion of parturients with unknown Human Immunodeficiency Virus (HIV) status in the delivery room and to identify the associated factors. Methods: We conducted a prospective descriptive study carried out at the Reference Health Center of Commune IV in the district of Bamako from July 1, 2017 to July 1, 2018. The sample size was 267 parturients. The word processing was carried out on World software from the 2016 office suite at the end of the data entry and analysis was carried out on the IBM software, SPSS version 22.0. Results: A total of 267 women were eligible for our study, among which 14 parturients were seropositive, i.e., a proportion of 5.2% of cases. The knowledge of parturients on HIV was 95.5% of cases, but more than half did not know the mode of mother-child transmission. Unschooled parturients were the most represented with 41.2%. Conclusion: In view of the large proportion (5.2%) of HIV-positive parturients in our study, voluntary screening activities in the delivery room remain necessary for the future of children born to HIV-positive mothers.展开更多
<strong>Background:</strong> <span style="font-family:Verdana;">Sustained lung inflation (SLI) would permit lung recruitment immediately after birth, improving lung mechanics and reducing t...<strong>Background:</strong> <span style="font-family:Verdana;">Sustained lung inflation (SLI) would permit lung recruitment immediately after birth, improving lung mechanics and reducing the need for intubation and subsequent respiratory support in the neonatal intensive care unit among preterm infants.</span><span style="font-family:""> </span><b><span style="font-family:Verdana;">Aim of the Study:</span></b><span style="font-family:Verdana;"> To assess the ef</span><span style="font-family:Verdana;">fi</span><span style="font-family:Verdana;">cacy of initial sustained lung in</span><span style="font-family:Verdana;">fl</span><span style="font-family:Verdana;">ation compared to standard intermittent positive pressure ventilation</span><span style="font-family:""> </span><span style="font-family:""><span style="font-family:Verdana;">(IPPV) in preterm infants who need resuscitation in delivery room. </span><b><span style="font-family:Verdana;">Methods:</span></b></span><b><span style="font-family:""> </span></b><span style="font-family:Verdana;">This was prospective randomized observational study that was conducted in the delivery room and NICU of A</span><span style="font-family:""> </span><span style="font-family:Verdana;">in shames University hospital from February 2019 to September 2019. The study included 115 preterm infants between 26</span><span style="font-family:""> </span><span style="font-family:Verdana;">-</span><span style="font-family:""> </span><span style="font-family:""><span style="font-family:Verdana;">32 weeks of gestation who needed resuscitation at delivery room. The infants were randomly allocated into 2 groups;SLI group: included the preterm infants who received the SLI at initial inflation pressure of 25 cm H</span><sub><span style="font-family:Verdana;">2</span></sub><span style="font-family:Verdana;">O for 15 seconds using the Neopuff/T piece. IPPV group: preterm infants who received standard resuscitation;IPPV using the self-inflating bag. The heart rate (HR), oxygen saturation (SpO</span><sub><span style="font-family:Verdana;">2</span></sub><span style="font-family:Verdana;">), oxygen requirement, and intubation rate as well as need of surfactant in the delivery room were assessed. </span><span style="font-family:Verdana;">All cases were evaluated after admission to the NICU for the need of me</span><span style="font-family:Verdana;">chanical ventilation in the </span></span><span style="font-family:Verdana;">fi</span><span style="font-family:Verdana;">rst 72 hours of life, death in delivery room or NICU and for bronchopulmonary dysplasia or death at 36 weeks post menstrual age</span><span style="font-family:""> </span><span style="font-family:Verdana;">(PMA).</span><span style="font-family:""> </span><b><span style="font-family:Verdana;">Results:</span></b><span style="font-family:Verdana;"> The percentage of preterm infants who needed resuscitation was 25.5% from the total deliveries during the study period.</span><span style="font-family:""> </span><span style="font-family:Verdana;">56.5% of them received SLI and 43.4% received conventional IPPV. There were no significant differences between the studied groups regarding gestational age, birth weight.</span><span style="font-family:""> </span><span style="font-family:Verdana;">Apgar score, heart rate,</span><span style="font-family:""> </span><span style="font-family:""><span style="font-family:Verdana;">oxygen saturation was not significantly in</span><span style="font-family:Verdana;">creased in the SLI group at fifth minutes of age. The percentage of infants</span><span style="font-family:Verdana;"> who </span><span style="font-family:Verdana;">needed further resuscitation was 20% in SLI group and 12% in the IPPV </span><span style="font-family:Verdana;">group. There were no significant differences in need for surfactant, CPAP or ventilator among the studied groups.</span></span><span style="font-family:""> </span><span style="font-family:Verdana;">There were no</span><span style="font-family:""> </span><span style="font-family:Verdana;">significant differences in relation to complications as BPD, air leak or retinopathy and death between the two groups.</span><span style="font-family:""> </span><b><span style="font-family:Verdana;">Conclusion:</span></b><span style="font-family:Verdana;"> This study showed that there was no advantage from use of SLI in delivery room using T-piece upon the conventional IPPV using self-inflating bag.</span>展开更多
<strong>Purpose:</strong> <span><span><span style="font-family:""><span style="font-family:Verdana;">The purpose of this study was to determine HIV prevalen...<strong>Purpose:</strong> <span><span><span style="font-family:""><span style="font-family:Verdana;">The purpose of this study was to determine HIV prevalence among participants admitted to the delivery room and recent birth attendants. </span><b><span style="font-family:Verdana;">Materials and </span></b></span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><b><span style="font-family:Verdana;">M</span></b></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><b><span style="font-family:Verdana;">ethods: </span></b></span></span><span><span><span style="font-family:""><span style="font-family:Verdana;">This was a descriptive, cross-sectional, analytical study, with a prospective collection from February 1, 2018 to January 31, 2019 at fousseyni Daou Hospital in Kayes, Mali. </span><b><span style="font-family:Verdana;">Results: </span></b></span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">D</span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">uring our study period</span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">,</span></span></span><span><span><span style="font-family:""><span style="font-family:Verdana;"> we </span><span style="font-family:Verdana;">recorded 4269 deliveries. HIV-positive patients known before labour ac</span><span style="font-family:Verdana;">counted for 0.21%. Four hundred and six participants received counselling/testing in the delivery room;of which 36 refused the test: 8.87% and 370 accepted or 91.13%. Thirteen patients tested positive or 3.51%. The 20</span></span></span></span><span><span><span style="font-family:""> </span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">-</span></span></span><span><span><span style="font-family:""> </span></span></span><span><span><span style="font-family:""><span style="font-family:Verdana;">35 age group was the most represented at 76.92%. Positive patients tested received ARV treatment in the delivery room in 92.31% of cases;and 1 patient or 7.69% did not receive treatment for refusal. Vaginal delivery was the most common at 77%, </span><span style="font-family:Verdana;">with caesarean section 23%. Newborns had a good prognosis in their first </span><span style="font-family:Verdana;">weeks of life in 85%;fetal lethality was observed in 15% of newborns including 1 case of fresh stillbirth and 1 case of pediatric deaths for neonatal suffering. </span><b><span style="font-family:Verdana;">Conclusion:</span></b><span style="font-family:Verdana;"> Counselling and voluntary HIV/AIDS testing during labour </span><span style="font-family:Verdana;">and immediate postpartum can detect many pregnant women who escape</span><span style="font-family:Verdana;"> screening during antenatal consultations.</span></span></span></span>展开更多
文摘Introduction: Stillbirths are estimated at 2 million each year, of which more than 40% occur during labour. Our objective was to study the epidemiological aspects of stillbirth and neonatal deaths in the delivery room in our health facility. Patients and methods: Prospective, descriptive and analytical study, conducted at the Jeanne Ebori Foundation Mother-Child University Hospital over 4 years (January 2019-December 2022). All neonatal deaths in the delivery room or foetal death in utero, were included. Results: Among the 18,346 deliveries performed, 512 newborns were declared dead in the delivery room (27.9‰ live births), divided into in utero foetal death (19.0‰) and immediate neonatal death (8.9‰). The mean age was 34.3 weeks of amenorrhea. The rate of preterm birth was 60.4%. The sex ratio was 1.1. The average weight was 2186.6. The main causes were vascular (46.1%), foetal (20.2%), adnexal (17.1%) and asphyxia per partum (16.6%). Foetal causes were more likely to result in IUFD than other causes (OR = 6.4 [2.4 - 15.7], p < 0.001). After birth, partum asphyxia was more likely to lead to death before 15 minutes of life than other causes (OR = 11 [6.1 - 18.9], p Conclusion: The causes of stillbirth and early neonatal mortality are dominated by maternal vascular pathologies. However, the proportion of childbirth-related causes remains worrying. Better monitoring of pregnancy and labour will minimize this prevalence in our hospital.
文摘Effective communication and emotional support of parturient women improve the outcome of childbirth. Reduction in Duration of labor, cesarean rate, use of anesthesia, and 5 minute Apgar Score less than 7 can achieve. This study was a part of a large mixed method study during 2013-2014. In this qualitative study, in-depth interviews were conducted with 32 participants (16 mother and 16 midwife), using semi-structured interviews. Participants were recruited by pur-posive sampling with maximum diversity in terms of age, occupation, education and etc. Educational hospital of Arak University of Medical Sciences was considered as the setting. Each interview was conducted at a private and convenient location and took about 30 to 45 minutes. Interviews were audio taped and transcribed verbatim. Conventional content analysis was done for data analysis. Interviews continued until data saturation was obtained. Data were coded in MAXQDA software (version 11). The main category emerged as “outcome” of midwife-mother relationship. Facilitating childbirth, positive experience, mental health promotion and improvement in quality of life were derived as subcategories. Good midwife-mother relationship could promote positive outcome in labour. Results could assist midwives in providing holistic quality care to mothers during labour, thus providing positive consequence in child birth. Also, results could provide a framework and guidance for policymakers to create appropriate context for the midwife-mother relationship in maternity care.
文摘When I interviewed Droma,she had already retired and was staying at home to look after her grandson.This was on June 3rd,2017.At the Apple Orchard in Lhoka City,Tibet Autonomous Region,the sun was hanging in sky with sparkling light."I was born in the winter of 1956.
文摘Background The aim of this study was to review current delivery room(DR)resuscitation intensity in Chinese tertiary neonatal intensive care units and to investigate the association between DR resuscitation intensity and short-term outcomes in preterm infants born at 24+0_31+6 weeks gestation age(GA).Methods This was a retrospective cross-sectional study.The source population was infants born at 24+0_31+6 weeks'GA who were enrolled in the Chinese Neonatal Network 2019 cohort.Eligible infants were categorized into five groups:(1)regular care;(2)oxygen supplementation and/or continuous positive airway pressure(O2/CPAP);(3)mask ventilation;(4)endotracheal intubation;and(5)cardiopulmonary resuscitation(CPR).The association between DR resuscitation and shortterm outcomes was evaluated by inverse propensity score-weighted logistic regression.Results Of 7939 infants included in this cohort,2419(30.5%)received regular care,1994(25.1%)received O,/CPAP,1436(18.1%)received mask ventilation,1769(22.3%)received endotracheal intubation,and 321(4.0%)received CPR in the DR.Advanced maternal age and maternal hypertension correlated with a higher need for resuscitation,and antenatal steroid use tended to be associated with a lower need for resuscitation(P<0.001).Severe brain impairment increased significantly with increasing amounts of resuscitation in DR after adjusting for perinatal factors.Resuscitation strategies vary widely between centers,with over 50%of preterm infants in eight centers requiring higher intensity resuscitation.Conclusions Increased intensity of DR interventions was associated with increased mortality and morbidities in very preterm infants in China.There is wide variation in resuscitative approaches across delivery centers,and ongoing quality improvement to standardize resuscitation practices is needed.
文摘Background:Delivery room resuscitation assists preterm infants,especially extremely preterm infants(EPI)and extremely low birth weight infants(ELBWI),in breathing support,while it potentially exerts a negative impact on the lungs and outcomes of preterm infants.This study aimed to assess delivery room resuscitation and discharge outcomes of EPI and ELBWI in China.Methods:The clinical data of EPI(gestational age[GA]<28 weeks)and ELBWI(birth weight[BW]<1000 g),admitted within 72 h of birth in 33 neonatal intensive care units from five provinces and cities in North China between 2017 and 2018,were analyzed.The primary outcomes were delivery room resuscitation and risk factors for delivery room intubation(DRI).The secondary outcomes were survival rates,incidence of bronchopulmonary dysplasia(BPD),and risk factors for BPD.Results:A cohort of 952 preterm infants were enrolled.The incidence of DRI,chest compressions,and administration of epinephrine was 55.9%(532/952),12.5%(119/952),and 7.0%(67/952),respectively.Multivariate analysis revealed that the risk factors for DRI were GA<28 weeks(odds ratio[OR],3.147;95%confidence interval[CI],2.082–4.755),BW<1000 g(OR,2.240;95%CI,1.606–3.125),and antepartum infection(OR,1.429;95%CI,1.044–1.956).The survival rate was 65.9%(627/952)and was dependent on GA.The rate of BPD was 29.3%(181/627).Multivariate analysis showed that the risk factors for BPD were male(OR,1.603;95% CI,1.061–2.424),DRI(OR,2.094;95% CI,1.328–3.303),respiratory distress syndrome exposed to≥2 doses of pulmonary surfactants(PS;OR,2.700;95%CI,1.679–4.343),and mechanical ventilation≥7 days(OR,4.358;95% CI,2.777–6.837).However,a larger BW(OR,0.998;95% CI,0.996–0.999),antenatal steroid(OR,0.577;95%CI,0.379–0.880),and PS use in the delivery room(OR,0.273;95%CI,0.160–0.467)were preventive factors for BPD(all P<0.05).Conclusion:Improving delivery room resuscitation and management of respiratory complications are imperative during early management of the health of EPI and ELBWI.
文摘Introduction: In order to prevent the vertical transmission of the Human Immunodeficiency Virus (HIV), it is essential that pregnant women must know their HIV serological status. Objective: To determine the proportion of parturients with unknown Human Immunodeficiency Virus (HIV) status in the delivery room and to identify the associated factors. Methods: We conducted a prospective descriptive study carried out at the Reference Health Center of Commune IV in the district of Bamako from July 1, 2017 to July 1, 2018. The sample size was 267 parturients. The word processing was carried out on World software from the 2016 office suite at the end of the data entry and analysis was carried out on the IBM software, SPSS version 22.0. Results: A total of 267 women were eligible for our study, among which 14 parturients were seropositive, i.e., a proportion of 5.2% of cases. The knowledge of parturients on HIV was 95.5% of cases, but more than half did not know the mode of mother-child transmission. Unschooled parturients were the most represented with 41.2%. Conclusion: In view of the large proportion (5.2%) of HIV-positive parturients in our study, voluntary screening activities in the delivery room remain necessary for the future of children born to HIV-positive mothers.
文摘<strong>Background:</strong> <span style="font-family:Verdana;">Sustained lung inflation (SLI) would permit lung recruitment immediately after birth, improving lung mechanics and reducing the need for intubation and subsequent respiratory support in the neonatal intensive care unit among preterm infants.</span><span style="font-family:""> </span><b><span style="font-family:Verdana;">Aim of the Study:</span></b><span style="font-family:Verdana;"> To assess the ef</span><span style="font-family:Verdana;">fi</span><span style="font-family:Verdana;">cacy of initial sustained lung in</span><span style="font-family:Verdana;">fl</span><span style="font-family:Verdana;">ation compared to standard intermittent positive pressure ventilation</span><span style="font-family:""> </span><span style="font-family:""><span style="font-family:Verdana;">(IPPV) in preterm infants who need resuscitation in delivery room. </span><b><span style="font-family:Verdana;">Methods:</span></b></span><b><span style="font-family:""> </span></b><span style="font-family:Verdana;">This was prospective randomized observational study that was conducted in the delivery room and NICU of A</span><span style="font-family:""> </span><span style="font-family:Verdana;">in shames University hospital from February 2019 to September 2019. The study included 115 preterm infants between 26</span><span style="font-family:""> </span><span style="font-family:Verdana;">-</span><span style="font-family:""> </span><span style="font-family:""><span style="font-family:Verdana;">32 weeks of gestation who needed resuscitation at delivery room. The infants were randomly allocated into 2 groups;SLI group: included the preterm infants who received the SLI at initial inflation pressure of 25 cm H</span><sub><span style="font-family:Verdana;">2</span></sub><span style="font-family:Verdana;">O for 15 seconds using the Neopuff/T piece. IPPV group: preterm infants who received standard resuscitation;IPPV using the self-inflating bag. The heart rate (HR), oxygen saturation (SpO</span><sub><span style="font-family:Verdana;">2</span></sub><span style="font-family:Verdana;">), oxygen requirement, and intubation rate as well as need of surfactant in the delivery room were assessed. </span><span style="font-family:Verdana;">All cases were evaluated after admission to the NICU for the need of me</span><span style="font-family:Verdana;">chanical ventilation in the </span></span><span style="font-family:Verdana;">fi</span><span style="font-family:Verdana;">rst 72 hours of life, death in delivery room or NICU and for bronchopulmonary dysplasia or death at 36 weeks post menstrual age</span><span style="font-family:""> </span><span style="font-family:Verdana;">(PMA).</span><span style="font-family:""> </span><b><span style="font-family:Verdana;">Results:</span></b><span style="font-family:Verdana;"> The percentage of preterm infants who needed resuscitation was 25.5% from the total deliveries during the study period.</span><span style="font-family:""> </span><span style="font-family:Verdana;">56.5% of them received SLI and 43.4% received conventional IPPV. There were no significant differences between the studied groups regarding gestational age, birth weight.</span><span style="font-family:""> </span><span style="font-family:Verdana;">Apgar score, heart rate,</span><span style="font-family:""> </span><span style="font-family:""><span style="font-family:Verdana;">oxygen saturation was not significantly in</span><span style="font-family:Verdana;">creased in the SLI group at fifth minutes of age. The percentage of infants</span><span style="font-family:Verdana;"> who </span><span style="font-family:Verdana;">needed further resuscitation was 20% in SLI group and 12% in the IPPV </span><span style="font-family:Verdana;">group. There were no significant differences in need for surfactant, CPAP or ventilator among the studied groups.</span></span><span style="font-family:""> </span><span style="font-family:Verdana;">There were no</span><span style="font-family:""> </span><span style="font-family:Verdana;">significant differences in relation to complications as BPD, air leak or retinopathy and death between the two groups.</span><span style="font-family:""> </span><b><span style="font-family:Verdana;">Conclusion:</span></b><span style="font-family:Verdana;"> This study showed that there was no advantage from use of SLI in delivery room using T-piece upon the conventional IPPV using self-inflating bag.</span>
文摘<strong>Purpose:</strong> <span><span><span style="font-family:""><span style="font-family:Verdana;">The purpose of this study was to determine HIV prevalence among participants admitted to the delivery room and recent birth attendants. </span><b><span style="font-family:Verdana;">Materials and </span></b></span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><b><span style="font-family:Verdana;">M</span></b></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><b><span style="font-family:Verdana;">ethods: </span></b></span></span><span><span><span style="font-family:""><span style="font-family:Verdana;">This was a descriptive, cross-sectional, analytical study, with a prospective collection from February 1, 2018 to January 31, 2019 at fousseyni Daou Hospital in Kayes, Mali. </span><b><span style="font-family:Verdana;">Results: </span></b></span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">D</span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">uring our study period</span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">,</span></span></span><span><span><span style="font-family:""><span style="font-family:Verdana;"> we </span><span style="font-family:Verdana;">recorded 4269 deliveries. HIV-positive patients known before labour ac</span><span style="font-family:Verdana;">counted for 0.21%. Four hundred and six participants received counselling/testing in the delivery room;of which 36 refused the test: 8.87% and 370 accepted or 91.13%. Thirteen patients tested positive or 3.51%. The 20</span></span></span></span><span><span><span style="font-family:""> </span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">-</span></span></span><span><span><span style="font-family:""> </span></span></span><span><span><span style="font-family:""><span style="font-family:Verdana;">35 age group was the most represented at 76.92%. Positive patients tested received ARV treatment in the delivery room in 92.31% of cases;and 1 patient or 7.69% did not receive treatment for refusal. Vaginal delivery was the most common at 77%, </span><span style="font-family:Verdana;">with caesarean section 23%. Newborns had a good prognosis in their first </span><span style="font-family:Verdana;">weeks of life in 85%;fetal lethality was observed in 15% of newborns including 1 case of fresh stillbirth and 1 case of pediatric deaths for neonatal suffering. </span><b><span style="font-family:Verdana;">Conclusion:</span></b><span style="font-family:Verdana;"> Counselling and voluntary HIV/AIDS testing during labour </span><span style="font-family:Verdana;">and immediate postpartum can detect many pregnant women who escape</span><span style="font-family:Verdana;"> screening during antenatal consultations.</span></span></span></span>
