PubMed · 11246829
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S Jackson. 2001-02-15. Two's a crowd.. https://pubmed.ncbi.nlm.nih.gov/11246829/
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OBJECTIVE: To determine the incidence, causes, management, and the means of prevention of uterine rupture, as well as the characteristics of women with the condition, recorded in the Department of Obstetrics and Gynaecology at Korle-Bu Teaching Hospital in Accra, Ghana. DESIGN: A retrospective study between January 1, 1995, and December 31, 2001. RESULTS: During the study period, of 82061 deliveries at the Korle-Bu Teaching Hospital, 193 women developed uterine rupture, an incidence of 2.4 per 1000 deliveries. Of these 193 women, 24.6% had had a previous Caesarean section. The most frequent associated factor of uterine rupture was prolonged labour (33.6%). The perinatal mortality rate was 74.3%. Almost 70% (66.9%) of women underwent a total abdominal hysterectomy as management. The case fatality rate was 1.0%. CONCLUSION: A more vigilant approach to preventing prolonged and obstructed labour in delivery units within and around Accra, Ghana, is required to reduce the incidence of this condition.
A review of activity in a delivery suite in an acute hospital found that many women were there for reasons unconnected to labour, or because a bed could not be found in the hospital's maternity wards. Midwives have established a two-bed assessment room next to the suite and set up a 24-hour telephone helpline. Women are encouraged to telephone for advice rather than turn up at the unit when they have problems with their pregnancy. These innovations, which have been in operation for a year, are believed to have reduced pressure on the delivery unit.
AIM: To explore the meaning of caring in a fertility unit and to present the findings and discuss their implications for practice. BACKGROUND: Little research has been published internationally on the nature of nursing care in the fertility field. This study was intended to stimulate debate over the nature of care in fertility work. METHODOLOGY: An ethnographic approach, which included part-time participant observation and in-depth focused interviews with staff and patients. Data were also collected using a field and a research diary. Data were analysed using a modified thematic analysis. FINDINGS: The data suggest that caring is strongly linked with nurses and that patients' expectations of nurses may be more practically than emotionally focused. I argue that the organization of nursing work, which I call 'nursing the clinic and the doctor', facilitated this practical approach to caring. I discuss two features of nursing the clinic and the doctor: hovering and being there. CONCLUSIONS: While there may be other factors that influence the practice of this form of non-intimate caring, nursing in this way may be what patients desire and may be congruent with managing emotions. The findings have implications for the discourse on intimacy and caring within fertility nursing as well as in different outpatient settings.