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discharge s i n c e they were aa s c discharged unusually early . 101 A flow chart outli n ing aubjent; rec ruitment and fo llow- up is presented in Fig 1 .1 ; FIG.I.l FLOW CHART OF SUBJECT RECRUITMENT AND FOLLOW-UP
102 Twenty four (5 .1%) sUbj ects were admitted to the lying i n ward for various i ndications. The r emain i ng 448 were discharged routinely wi t hin 12 t o 24 ho ur s a f t e r de livery, a nd t he y wer e scheduled for follow-up morb idity assessment at the special s t ud y clinic. 5 .1: BASELINE CHARACTERISTICS OF RECRUITED SUBJECTS The baseline characteristics, i nc luding the 50 010 demographic features , pregnancy and risk factors, an tenatal ca re, and the l ab ou r outcomes of t he of the 47 2 recruited subj ects t o the study are presented in t his section . I: The socio-demographic characteristic s AGE: Th e a ges o f study ;u tlj e c t s ranged fro m 15 to 48 years wi th a mea n age of 25 .4 years (standard deviation (SO) :t 5 .9 yrs) . An obse rved feat u re in the age distributi o n, which is not evident i n FIG . 2 . 1 o f age distribution p resent ed below, was t he t enden cy f o r SUbjects t o r ou nd off the i r ages t o t he ne u r r.s t fifth year. Fo r e xample, person o f a g e s 23 a nd 2 4 rounded off to 25 ; the s e of 29 years r ou nd e d off t o 30 y e ars,
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A PROSPECTIVE STUDY OF EARLY PUERPE
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dysuria (26%). Nearly 60% of the st
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on l y greatl y enri ch ed the s ub
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5.4 De t e r mi na nt s o f morbidi
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Ta ble 2 .1 1 Di ag nos es in t rea
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CHAPTER 1 IN T RODU CTI ON As mor e
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impair mater nal health [ 13 ] . Th
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Many African countries l ike Ghan a
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Sex ratio (M/F) (1 989) 0 . 98 Rura
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growt h r ate of 2 .5% [ 21] . I t
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Sex ratio (M as a % o f F) Crude bi
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hours in t he h o s p i t ll;l. Nor
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irths ( 19 ) . Although no communit
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It i s ob vious froID. the above in
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The need for adequate puerperal car
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for )0% and 20% respectivel y (33]
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The Za r i a s t ud y ( a}, also re
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embolism coul d be classified a s a
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serious h e alth consequences becau
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o ne known pat hoge n [54] _ Candid
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a de qua t e trr ea tinerrc fo r th
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3 6 Three of the 31 bacteriuric cas
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sinc e direct bladd er s ampling h
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developing world countries have i n
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Unlike t he developed world, breast
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i n t h e puerper ium will occur i
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ED; siotomy wou nd inf ection: I n
Page 64 and 65: 4' The incidence o f deep vein thro
Page 66 and 67: percent in Bali, Indonesia [37]. Th
Page 68 and 69: Pos t p a r t um Anaemia: Anaemia i
Page 70 and 71: study situat ions and ma y be up t
Page 72 and 73: wome n with caesarean deliveries (-
Page 74: deficien t , 50% f o l a t e defici
Page 77 and 78: days {178, 179] . In a study of pre
Page 79 and 80: 22,774 births s t udied were 6 .1%,
Page 81 and 82: ca r d i a c failure, a ssoc iated
Page 84 and 85: of the disease in zaria has been at
Page 86 and 87: Africa. and the incidence is still
Page 88 and 89: i ncreased occu rrenC:2 of psychiat
Page 90 and 91: African studies respectively h a d
Page 92 and 93: about the i r mari t a l s tat us,
Page 94 and 95: CHAP TE R 4 M!ill!Q.!2S 4 .1 : THE
Page 97 and 98: Bearing in mind t he fact t ha t th
Page 99 and 100: - Fre e medical consultation for ..
Page 102 and 103: Examination : SUbjects wer e examin
Page 105: •• Lowe r genita l t ract i nte
Page 108 and 109: " c linica l assessment and lIlanaq
Page 110 and 111: sample cJ9scr ipt i on ; The charac
Page 112: Further mUltivariate logistic regre
Page 119 and 120: 104 ETHNIC ORIGINS: The majority of
Page 121: 106 ap prenticeship- trained occupa
Page 124: YES 1l6'l\ FIG. 1.4 ANTENATAL CARE
Page 129 and 130: Labour e ve nts , c omplications a
Page 131 and 132: n . OTHER IMMEDI ATE COMPL.ICATIONS
Page 133: 5 .2 : FOLLOW-UP AND MORBIDI'I'Y FI
Page 136: 5 .2 . 1 Comparinq clinic a t t e n
Page 140 and 141: 200 ,eo 100 FIG. 2.1 :HOW SUBJECTS
Page 142 and 143: FIG.2.3: THE DAY OF FEVER ONSET REP
Page 145: 13 . I n a l l 21 2 ( 59 . 1\> s Ub
Page 148 and 149: 133 sUbjects said they did. A wide
Page 151: 136 Diastolic blood pressure readin
Page 156 and 157: 141 OTHER PATHOLOGI CAL FI NDI NGS
Page 159 and 160: 144 FOLLOW-UP OUTCOMES: At the end
Page 161: 5. 3 : I NCI DENCE OF MORBI DITY 5
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150 LOWER GENITAL TRACT I NFECTIO N
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152 ACUTE URIN ARY TRACT I NFECTION
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154 !i\!m.!!!Ari. : The occurrence
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15 7 regr ession was performed, t o
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15. The s tat i stically significan
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161 s t atistically !li gnifica nt
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16 3 t.o de t ermi ne t hose wi th
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165 was 280 nr (SO ± 166 ml.) and
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1 6 7 The results o f multiva riate
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169 The s atur a t ed rnode I of th
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CHAPTER 6 !l!SQJ.SSI ON AND RECOMME
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175 higher ed ucation levels a nd l
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177 a bout half of t he women who h
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180 ranked t he i r health as satis
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1 8 2 I nformal i nf ormat ion obta
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1 8 6 bact eriur ia r ates often r-
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190 lacerations or i ncisions which
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The non-infectiolIs morbid!ties : P
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194 About 60 % of the su b j ec t.s
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197 for preventing postpartum infec
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'" comparable to t h e high 57% rep
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201 p ostpartum pe r Lcd and also f
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203 bcv ev e r , a bou t 3 to 10 t
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205 The ve ry small number of patie
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210 i n f orm ation on t he ea rly
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212 depend o n the type of mo r b i
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one d id not fUlly escape t he l i
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3 . What i s the ex tent o f pos t
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2 21 38 . Kah n AR, Jahan FA ( 1 98
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225 85 . Ph ill i p s I , ' Ba s s
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22. 122. Thacker 58, Banta HD (1982
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232 17 1. Hype r tensive di s o rde
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234 191. Cox ML ( J.963) . Incidenc
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'" 223 . Pugb TF , J erat h BK, Sch
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APPENDIZ A MAP OF GHANA AND STUDY "
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STUDY FORM A: Pa g e 2. PREGNANCY/l
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STUD Y FORM B : Page 2 IF YES, Did
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STUDY FORM B: Page 5 Bima nual Pa l
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3) Gaped wound/Delayed wound healin
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APPENDI X F R.ESULTS OF MUTI VARI A
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APPENDI X r II THE PREDICTORS OF PO
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APPENDIX L DETERMINANTS or POSTPART
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