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22. 122. Thacker 58, Banta HD (1982) Benefits and risk of episiotomy: An interpretive review of the English l angu age literature 1960-1980 . Obstet Gynaecol Surv 39; p 322-378. 123. Harris RE (1970) . An evaluation of median epsiotomy. Am J Obstet Gynecol; 106; p 660-665. 124 . Reading AE , Sledmere eM, Cox ON, Campbell 5 (1982). How women view epsiotomy pain . Br Ned J 1; p 243-246. 125. Abraham 5, Child A, Ferry J, Vizard J, Mira M (1990) . Recovery after childbirth: A preliminary prospective study. Med J Aust; 152; P 9-12 . 126 . Shy KK, Eschenbach DA ( 1979) . Fatal cellulitis from an episiotomy site. Obstet GynecoI; 54; (3); p 290-292 . 1 27 . Sutton GP, Smirz LR , Clark DH, Bennet JE (1985) . Group B necrotising f a s c iit i s arising from an episiotomy. Obstet Gynecoll 66; (5) I P 733-736. 128 . Soper DE (1986) Clostridial myonecrosis arising from an episiotomy . Obstet cyneccj 68 [ 3 Suppl ] ; p265-285 . 1 29 . Royal college of General Practitioners 1967: Oral contraceptives and thromboembolic disease. R Coll oen Pract; 13; P 267-279. 130. Howie PW (1977) . Thromboembolism. Clin Obstet Gynaecol : 4; p397-417. 131. Turnbull AC, Tindall VR, Robson G, Dawson MP, cfcake EP, Ashley JSA (1986) . Pulmonary embolism. A report on confidential enguiries into maternal deaths in England and Wales 1979-1981. H.M.S.O. London; p 30 -42 . 132 . Aaro LA, Juergens JL (1971) . Thrombophlebitis associated with pregnancy. Am J Obstet cynecca r 109; (8) I pl12B 1136 . 133 . Kierkegard A (1983) . Incidence and diagnosis of deep vein thrombosis associated with pregnancy. Acta Obstet cynecct scener 62 ; p 443-448 . 134. Bergqvist A, Bergqvist D, Hallbrook T (1983) . Deep v e i n thrombosis during pregnancy: A prospective study. Acta Obstet Gynecol Scand: 62: p 443 -448.
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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
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4' The incidence o f deep vein thro
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percent in Bali, Indonesia [37]. Th
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Pos t p a r t um Anaemia: Anaemia i
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study situat ions and ma y be up t
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wome n with caesarean deliveries (-
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deficien t , 50% f o l a t e defici
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days {178, 179] . In a study of pre
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22,774 births s t udied were 6 .1%,
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ca r d i a c failure, a ssoc iated
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of the disease in zaria has been at
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Africa. and the incidence is still
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i ncreased occu rrenC:2 of psychiat
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African studies respectively h a d
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about the i r mari t a l s tat us,
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CHAP TE R 4 M!ill!Q.!2S 4 .1 : THE
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Bearing in mind t he fact t ha t th
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- Fre e medical consultation for ..
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Examination : SUbjects wer e examin
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•• Lowe r genita l t ract i nte
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" c linica l assessment and lIlanaq
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sample cJ9scr ipt i on ; The charac
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Further mUltivariate logistic regre
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discharge s i n c e they were aa s
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104 ETHNIC ORIGINS: The majority of
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106 ap prenticeship- trained occupa
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YES 1l6'l\ FIG. 1.4 ANTENATAL CARE
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Labour e ve nts , c omplications a
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n . OTHER IMMEDI ATE COMPL.ICATIONS
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5 .2 : FOLLOW-UP AND MORBIDI'I'Y FI
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5 .2 . 1 Comparinq clinic a t t e n
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200 ,eo 100 FIG. 2.1 :HOW SUBJECTS
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FIG.2.3: THE DAY OF FEVER ONSET REP
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13 . I n a l l 21 2 ( 59 . 1\> s Ub
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133 sUbjects said they did. A wide
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136 Diastolic blood pressure readin
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141 OTHER PATHOLOGI CAL FI NDI NGS
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144 FOLLOW-UP OUTCOMES: At the end
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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
Page 192: 177 a bout half of t he women who h
Page 195 and 196: 180 ranked t he i r health as satis
Page 197: 1 8 2 I nformal i nf ormat ion obta
Page 201: 1 8 6 bact eriur ia r ates often r-
Page 205 and 206: 190 lacerations or i ncisions which
Page 207 and 208: The non-infectiolIs morbid!ties : P
Page 209 and 210: 194 About 60 % of the su b j ec t.s
Page 212 and 213: 197 for preventing postpartum infec
Page 214 and 215: '" comparable to t h e high 57% rep
Page 216 and 217: 201 p ostpartum pe r Lcd and also f
Page 218 and 219: 203 bcv ev e r , a bou t 3 to 10 t
Page 220: 205 The ve ry small number of patie
Page 225 and 226: 210 i n f orm ation on t he ea rly
Page 227 and 228: 212 depend o n the type of mo r b i
Page 229: one d id not fUlly escape t he l i
Page 232 and 233: 3 . What i s the ex tent o f pos t
Page 236: 2 21 38 . Kah n AR, Jahan FA ( 1 98
Page 240 and 241: 225 85 . Ph ill i p s I , ' Ba s s
Page 244: 2 29 13 5 . Skillman J J , Ke nt KC
Page 248 and 249: 2 33 18 4 . Van Don g en PWJ ( 1977
Page 250 and 251: 23 5 209. Oe rr.di:is J G, Ra himto
Page 253 and 254: 238 2 48. Marija Norusis. SPSS-X Ad
Page 256 and 257: APPENDIXC EARLY PUER PERAL MORBI DI
Page 258 and 259: APPENDIX 0 EARLY PUERPERAL MORBI DI
Page 261 and 262: STUDY FORM B: Page 4 Nipp le cracks
Page 264 and 265: Ceni tal I n f ecti o ns 249 It is
Page 266 and 267: Post p a r tum Hypertensio n 25 1 I
Page 268: h P PE NDI Z 0 SOCIO- DEMOGRAPHIC,
Page 272 and 273: APPENDI X K II THE PREDICTORS OF PO
Page 274: AP PENDI X H i THE PREDICTORS OF PO
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