scholarly journals Usefulness of Robson classification system to analyze caesarean section deliveries: a hospital based study

2020 ◽  
Vol 6 (1) ◽  
pp. 38-44
Author(s):  
Tshering Tamang ◽  
Jigme Dema ◽  
Sonam Pelden ◽  
Phuntsho Choden
Keyword(s):  
Caesarean Section ◽  
Classification System ◽  
Primary Objective ◽  
Referral Hospital ◽  
World Health ◽  
Delivery Methods ◽  
Robson Classification ◽  
Increased Risk ◽  
Tertiary Hospitals ◽  
Health Organization

Introduction: World Health Organization recommends using the Ten-group Robson classification as a standard for assessing and reducing caesarean section (CS) rates. Our study aimed at analyzing CS deliveries using this system with the primary objective of examining the driving factors of increased risk for caesarean delivery. Methods: A retrospective observational study was conducted in Mongar Regional Referral Hospital from 1st January 2016 to 31st December, 2018 recruiting all institutional deliveries and classifying each of them into 10 groups of Robson classification system based on six obstetric variables. Results: There were 2337 deliveries, of which 804 were CS, contributing to a rate of 34.4%. More than three fourth (78.9%) of caesarean deliveries occurred in Groups 5, 4, 2 and 1. Previous CS was the highest contributor of CS rate and the most common indication. Conclusion: Higher CS rate has been observed in our referral hospital, contributed largely by women with previous CS, induced labour and pre-labour CS. There is a need for implementation of Robson classification system in all tertiary hospitals.

scholarly journals The Ten-Group Robson Classification: A Single Centre Approach Identifying Strategies to Optimise Caesarean Section Rates

2017 ◽  
Vol 2017 ◽  
pp. 1-5 ◽  
Author(s):  
Keisuke Tanaka ◽  
Kassam Mahomed
Keyword(s):  
Caesarean Section ◽  
World Health Organization ◽  
World Health ◽  
Single Centre ◽  
Robson Classification ◽  
Nulliparous Women ◽  
Group 5 ◽  
Definition Of ◽  
Health Organization ◽  
Failure To Progress

Caesarean section (CS) rates have been increasing worldwide and have caused concerns. For meaningful comparisons to be made World Health Organization recommends the use of the Ten-Group Robson classification as the global standard for assessing CS rates. 2625 women who birthed over a 12-month period were analysed using this classification. Women with previous CS (group 5) comprised 10.9% of the overall 23.5% CS rate. Women with one previous CS who did not attempt VBAC contributed 5.3% of the overall 23.5% CS rate. Second largest contributor was singleton nulliparous women with cephalic presentation at term (5.1% of the total 23.5%). Induction of labour was associated with higher CS rate (groups 1 and 3) (24.5% versus 11.9% and 6.2% versus 2.6%, resp.). For postdates IOL we recommend a gatekeeper booking system to minimise these being performed <41 weeks. We suggest setting up dedicated VBAC clinic to support for women with one previous CS. Furthermore review of definition of failure to progress in labour not only may lower CS rates in groups 1 and 2a but also would reduce the size of group 5 in the future.

Antidiabetics: Structural Diversity of Molecules with a Common Aim

2018 ◽  
Vol 25 (18) ◽  
pp. 2140-2165 ◽  
Author(s):  
Jelena B. Popovic-Djordjevic ◽  
Ivana I. Jevtic ◽  
Tatjana P. Stanojkovic
Keyword(s):  
Structural Diversity ◽  
World Health ◽  
Common Disease ◽  
Peroxisome Proliferator ◽  
Epidemic Disease ◽  
Peroxisome Proliferator Activated Receptor ◽  
Increased Risk ◽  
Dipeptidyl Peptidase Iv Inhibitors ◽  
Glucagon Like Peptide 1 ◽  
Health Organization

Background: Diabetes mellitus type 2 (DMT2) is an endocrine disease of global proportions which is currently affecting 1 in 12 adults in the world, with still increasing prevalence. World Health Organization (WHO) declared this worldwide health problem, as an epidemic disease, to be the only non-infectious disease with such categorization. People with DMT2 are at increased risk of various complications and have shorter life expectancy. The main classes of oral antidiabetic drugs accessible today for DMT2 vary in their chemical composition, modes of action, safety profiles and tolerability. Methods: A systematic search of peer-reviewed scientific literature and public databases has been conducted. We included the most recent relevant research papers and data in respect to the focus of the present review. The quality of retrieved papers was assessed using standard tools. Results: The review highlights the chemical structural diversity of the molecules that have the common target-DMT2. So-called traditional antidiabetics as well as the newest and the least explored drugs include polypeptides and amino acid derivatives (insulin, glucagon-like peptide 1, dipeptidyl peptidase-IV inhibitors, amylin), sulfonylurea derivatives, benzylthiazolidine- 2,4-diones (peroxisome proliferator activated receptor-γ agonists/glitazones), condensed guanido core (metformin) and sugar-like molecules (α-glucosidase and sodium/ glucose co-transporter 2 inhibitors). Conclusion: As diabetes becomes a more common disease, interest in new pharmacological targets is on the rise.

scholarly journals Newborns at risk of Covid-19 ― lessons from the last year

2021 ◽  
Vol 0 (0) ◽  
Author(s):  
Malika D. Shah ◽  
Ola Didrik Saugstad
Keyword(s):  
Horizontal Transmission ◽  
Mode Of Delivery ◽  
Newborn Infants ◽  
World Health ◽  
Premature Delivery ◽  
Mortality And Morbidity ◽  
Skin Contact ◽  
Cord Clamping ◽  
Increased Risk ◽  
Health Organization

Abstract After more than 1 year of the SARS-CoV-2 pandemic, a great deal of knowledge on how this virus affects pregnant women, the fetus and the newborn has accumulated. The gap between different guidelines how to handle newborn infants during this pandemic has been minimized, and the American Academy of Pediatrics (AAP)’s recommendations are now more in accordance with those of the World Health Organization (WHO). In this article we summarize present knowledge regarding transmission from mother to the fetus/newborn. Although both vertical and horizontal transmission are rare, SARS-CoV-2 positivity is associated with an increased risk of premature delivery and higher neonatal mortality and morbidity. Mode of delivery and cord clamping routines should not be affected by the mother’s SARS-CoV-2 status. Skin to skin contact, rooming in and breastfeeding are recommended with necessary hygiene precautions. Antibodies of infected or vaccinated women seem to cross both the placenta and into breast milk and likely provide protection for the newborn.

Accounting for the Rising Caesarean Section Rate in Canada: What Are the Roles of Changing Needs, Practices, and Incentives?

2021 ◽  
Author(s):  
Michael Baker ◽  
Maripier Isabelle ◽  
Mark Stabile ◽  
Sara Allin
Keyword(s):  
Caesarean Section ◽  
Financial Incentives ◽  
Health Care Systems ◽  
Caesarean Section Rate ◽  
The United States ◽  
World Health ◽  
Strong Increase ◽  
Primary Determinant ◽  
Care Systems ◽  
Health Organization

In most high-income countries, including Canada, the share of births by Caesarean section (C‑section) has risen over the past decades to far exceed World Health Organization recommendations of the proportion justified on medical grounds (15 percent). Although unnecessary C-sections represent an important cost for health care systems, they are not associated with clear benefits for the mother and the child and can sometimes represent additional risks. Drawing on administrative records of nearly four million births in Canada, as well as macro data from the United States and Australia, we provide a comprehensive account of rising C-section rates. We explicitly consider the contributions of the main factors brought forward in the policy literature, including changing characteristics of mothers, births, and physicians as well as changing financial incentives for C-section deliveries. These factors account for at most one-half of the increase in C-section rates. The majority of the remaining increase in C-sections over the period 1994–2011 occurred in the early 2000s. We suggest that some event or shock in the early 2000s is likely the primary determinant of the recent strong increase in the C-section rate in Canada.

scholarly journals Covid-19 and Acute Kidney Injury: Recent Updates

2021 ◽  
Vol 4 (2) ◽  
Author(s):  
Salman Tahir Shafi
Keyword(s):  
Acute Kidney Injury ◽  
Severe Acute Respiratory Syndrome ◽  
World Health Organization ◽  
Recent Literature ◽  
Kidney Injury ◽  
World Health ◽  
Related Disease ◽  
Increased Risk ◽  
The World ◽  
Health Organization

In January 2020, the pathogen was identified and named by the World Health Organization as Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-COV-2). The consequent SARS-CoV-2-related disease was defined as coronavirus disease 2019 (COVID-19). As data emerged about characteristics of the disease, it was found to be associated with increased risk of acute kidney injury (AKI). We explore the recent literature and reports emerging from the epicenters of the pandemic to help our viewers understand the nature of AKI among these patients. 

Robson Classification and quality audit

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Gehanath Baral
Keyword(s):  
Cesarean Section ◽  
World Health Organization ◽  
Real Time ◽  
Perinatal Outcome ◽  
World Health ◽  
Related Factors ◽  
Quality Audit ◽  
Robson Classification ◽  
Health Organization

World Health Organization has recommended Robson Classification from baseline obstetric characters to assess, monitor and compare Cesarean Section rates by the quantity analysis. Incorporation of real time labor related factors requires quality audit for both maternal and perinatal outcome.

A global perspective on suicides and suicide attempts

2021 ◽  
pp. 93-98
Author(s):  
Elise Paul
Keyword(s):  
Suicide Attempt ◽  
Suicide Attempts ◽  
Global Perspective ◽  
World Health ◽  
Populations At Risk ◽  
Increased Risk ◽  
World Mental Health Survey ◽  
The World ◽  
Health Organization ◽  
Ongoing Monitoring

Specific populations at risk for suicide differ considerably according to region, country, sex, age, and the most common suicide methods used, highlighting the need for ongoing systematic surveillance to inform prevention efforts. The magnitude of the problem is not limited to suicide deaths. It is estimated that for every suicide, there are 20 more persons who have made an attempt. Individuals who have made a suicide attempt are at increased risk for dying by suicide. This chapter explores differences in the suicide and suicide attempt rates in the general population on different continents, by examining data from the World Health Organization (WHO) Global Health Estimates and the World Mental Health Survey Initiative. Differences across contexts in suicidal behaviours and the need for ongoing monitoring are emphasized.

Epidemiology and burden

Depression ◽  
2018 ◽  
pp. 3-10
Author(s):  
Raymond W. Lam
Keyword(s):  
Psychosocial Functioning ◽  
Indirect Costs ◽  
World Health ◽  
Medical Illness ◽  
Middle Income ◽  
Middle Income Countries ◽  
Increased Risk ◽  
Significant Impairment ◽  
Health Organization ◽  
Years Lived With Disability

Depression is a common condition with a lifetime prevalence of about 15%. People with depression experience significant impairment in psychosocial functioning, particularly in those with a recurrent or chronic course. Depression is now the leading cause of years lived with disability worldwide. Depression is also associated with increased risk of developing a medical illness and an increased risk of overall mortality, even when deaths from suicide are excluded. The economic costs of depression are staggering, largely owing to indirect costs associated with occupational impairment leading to work absence and reduced productivity. Depression remains undertreated, particularly in lower- and middle-income countries, but the World Health Organization has estimated that scaling up of depression treatment returns US$5 for every US$1 spent.

Evaluation of the use of a Healthy Weight Discussion Tool by a health visiting team

2019 ◽  
Vol 7 (6) ◽  
pp. 272-278
Author(s):  
Tess Hickson
Keyword(s):  
Focus Group ◽  
Universal Service ◽  
Excess Weight ◽  
World Health ◽  
Service Improvement ◽  
Healthy Weight ◽  
Group Evaluation ◽  
Increased Risk ◽  
Health Organization ◽  
The Uk

A quarter of children in the UK are entering primary school either overweight or obese ( NHS Digital, 2017 ). These children have an increased risk of serious health consequences during their childhood years, which often continues into adulthood ( World Health Organization (WHO, 2017 ). A Healthy Weight Discussion Tool was created and introduced into a health visiting service to assist staff to identify and manage children presenting with excess weight. Three teams trialled its use, but uptake of this tool was low. A focus group evaluation was therefore carried out to examine the experience of staff using the tool. Although the tool was effective when implemented as intended, certain factors prevented its use in practice. These findings need to be addressed and the use of the tool re-evaluated to ascertain whether this service improvement will enhance the management of children with excess weight within the Universal service.

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