Abdominal Packing for Obstetric Surgical Uncontrollable Hemorrhage

Postpartum hemorrhage (PPH), which makes up the bulk of the 14 million occurrences of obstetric hemorrhage that happen yearly, is the most prevalent type. Obstetric emergencies must be promptly identified and treated because most PPH-related deaths occur within four hours of delivery and even after hysterectomy. This literature study tries to elucidate abdominal packing in reducing obstetrical bleeding in greater detail. Pads or roller gauze (sterile pads bound by suture threads, wrapped in a sterile bag, or stacked gauze) and balloon pack (Foley catheter or Bakri balloon), and abdominal packs retrieved within 24-48 hours, are two categories of abdominal packing techniques for controlling bleeding after hysterectomy. Due to its ease of use, minimal risk of complications, and usefulness in environments with limited resources, abdominal packing continues to be a valuable technique in the arsenal of the modern obstetrician.

Not just numbers: beyond counting caesarean deliveries to understanding their determinants in Ghana using a population based cross-sectional study

The increasing rate of caesarean deliveries (CD) has become a serious concern for public health experts globally. Despite this health concern, research on factors associated CD in many low- and -middle countries like Ghana is sparse. This study, therefore, assessed the prevalence and determinants of CD among child-bearing women aged 15–49  in Ghana.

The study used data from the 2014 Ghana Demographic and Health Survey. The analysis was limited to mothers (n = 2742) aged 15–49 , who had given birth in health facilities 5 years preceding the survey. Association between CD and its determinants was assessed by calculating adjusted odds ratios (AOR) with their respective 95% confidence intervals using a binary logistic regression.

The percentage of mothers who delivered their babies through caesarean section (CS) was 18.5%. Using multivariable logistic regression, the results showed that women aged 45–49 (AOR = 10.5; 95% CI: 3.0–37.4), and women from a household that are headed by a female (AOR = 1.3; 95% CI = 1.1–1.7) had higher odds to deliver through CS. Women from the Upper East (AOR =0.4; 95% CI = 0.2–0.7) and Upper West (AOR = 0.4; 95% CI = 0.2–0.8) regions had lower odds to deliver their children through CS. Women with parity 4 or more (AOR = 0.3; 95% CI = 0.2–0.5) had lower odds of CD compared to those with parity 1. Women with female babies had lower odds (AOR = 0.8; CI = 0.7–0.9) of delivering them through CS compared to those with male children.

The percentage of women delivering babies through the CS in Ghana is high. The high rates of CD noted do not essentially indicate good quality care or services. Hence, health facilities offering this medical protocol need to adopt comprehensive and strict measures to ensure detailed medical justifications by doctors for performing these caesarean surgeries.