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Eligible aubj eot.s who were admitted (Le , detained for more than 24 hours) or who later died from some complications of labou r were monitored by the research assistant responsible for sUbject enrolment, and details of reasons for admission and other outcomes were recorded . Since pre-delivery haemoglobin level was not routinely measured in the h o s p i t a l because of l imited l a b o r a t o r y service, the study undertook this investigation on all the i ntended study eubj ec'ts coming t o the ward from houe , Dlood samples were col lected by the admitting nu r s e s . " .5 : ENHANCING PARTICIPAT I ON Recognising t hat the success of t he study de pended l a r g e l y on successful SUbject participation , strategies for enhancing participat ion were deemed necessary and pre-planned. At t ractive incentives offered t o sUbjects i n the stUdy included the following: - The provision of fre e treatment drugs for common puer pe re t disorders , - A month's supply of haematinics, (ferrous sulphate and fol ic acid), 83
- Fre e medical consultation for .. tudy sUbjects an d the i r new i n fant s outs ide s c heduled vlsltt'l and du r inq the en tir e pe riod. of t he study , - Facilitated refe r ral t o othe r specia lists, ....hen t h i s wa o r equi r ed, and - a n oppor t uni t y f or t he m to d i s c us s pe r t ine nt issues such as c ontrac e ption , i nf an t f eed i ng a nd Immun isations. SUb j e c t s who were co ns i de r ed as like l y t o be l es s i nt erested i n the e eudy , f o1." e x amp l e , i nd i v i dua ls wi th stillb i r t hs , or who l i ved very f ar a way f rom t he s tUdy ce nt er wer e t a r ge ted a nd received Qxt ra at. t.ent. Lc n and encourageme nt during r ecruitm ent . 4 . lS: BAS ELI NE DATA Baseline data on socia- demog raph ic status, a ntenata l history a nd d elivery details wer e obt a i ne d by ( 1) i nt e rview f r om the eligi b l e sUb ject s (2 ) f rom hos pi t a l l a bour char t s and P ) f r ol ante natal r ec ord c ha r ts . They i nc luded the followi ng info rma t ion: Socio- de mographic: Ag e Et hnic gr ou p o cc up a t i on Educati onal l ev e l Name / r e sidential ad dres s Nex t o f k in
Page 5:
A PROSPECTIVE STUDY OF EARLY PUERPE
Page 8 and 9:
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
Page 16 and 17:
CHAPTER 1 IN T RODU CTI ON As mor e
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impair mater nal health [ 13 ] . Th
Page 20 and 21:
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
Page 47 and 48: o ne known pat hoge n [54] _ Candid
Page 49 and 50: a de qua t e trr ea tinerrc fo r th
Page 51 and 52: 3 6 Three of the 31 bacteriuric cas
Page 53 and 54: sinc e direct bladd er s ampling h
Page 56 and 57: developing world countries have i n
Page 58 and 59: Unlike t he developed world, breast
Page 60 and 61: i n t h e puerper ium will occur i
Page 62 and 63: 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: Bearing in mind t he fact t ha t th
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 116 and 117: discharge s i n c e they were aa s
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
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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
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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
Page 240 and 241:
225 85 . Ph ill i p s I , ' Ba s s
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22. 122. Thacker 58, Banta HD (1982
Page 247 and 248:
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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