STRESS MOTHER EXPERIENCE FOR PREMATURE BIRTH

The main objective of this study is to approach the experience of these mothers in our Moroccan context by focusing on the analysis of the socio-cultural impact. The secondary objective is to determine the risk factors associated with feelings of psychological difficulties.&#x0D; This study was conducted at the Souissi Maternity Hospital in Rabat over the six months. We chose to conduct a survey of Moroccan women who gave birth to premature alive. Preterm birth was defined as any birth prior to 37 weeks of amenorrhea (SA). This is a prospective, descriptive and analytical study. 100 parturients were included in our study.&#x0D; The collection of information has been on the second day of delivery. Two groups of women were subsequently identified:&#x0D; &#x0D; group A with one or two light feelings (absent or mild psychological difficulty)&#x0D; group B with 3 or 4 medium or strong feelings (medium to strong psychological difficulty).&#x0D; &#x0D; We analyzed two groups to determine the risk factors associated with psychological difficulties.&#x0D; In univariate analysis, we examined the association of each of maternal and neonatal characteristics with both groups A and B.&#x0D; Nine factors were significantly associated with moderate or intense psychological difficulty.&#x0D; A high level of instruction, well-monitored pregnancy, presence of a pathological obstetrical history and cesarean delivery, all these factors accentuate the intensity of the feelings experienced.&#x0D; In parallel, a weight greater than or equal to 1500 g birth of the child, transfer the baby in neonatal medicine lessen these feelings.&#x0D; In multivariate analysis and after adjusting for factors studied, only the presence of pathological factors obstetrical history and the place of the child in the parental project are significant and therefore correlated with average or intense psychological difficulty.&#x0D; We have indeed found that prematurity inscribed the child and his mother in a difficult context. This would affect preterm rupture of the mother / child bond. After that other questions have emerged. Given that self-efficacy is rooted in the failures and successes encountered previously, it would have been interesting to consider primiparity of the mother, and the support of the father at birth and after, when returning home because it would play a leading role and would have a positive impact on the mother's psyche.</jats:p

Home care for antibiotic therapy in the management of maternal-fetal infection: Action research example

Introduction- Given the progress in medical care in neonatology, the development of neonatal medicine evaluation techniques and management of difficulties in our Moroccan context, the need to increase the alternative structures for complete hospitalization (CH) in this discipline, is clear. Purpose- Assess the economic and neonatal outcomes of neonatal infection in case of further outpatient care. Material and methods- This is a prospective, single-center including newborns hospitalized for infection between 1 January 2011 and 31 December 2013. Exclusion criteria were respiratory distress, birth defects, direct admission neonatal resuscitation. Results- 1060 neonates were included. The parturients had a preterm rupture of membranes PRM in 70% of cases. We had found a tinted amniotic fluid in 23% of cases. Mothers had chorioamnionitis in 20% of cases. We noted the presence of vaginal discharge with vaginal itching in 18% of cases. of mictional burns were found in 10% of cases. Breast laboratory tests (urinalysis, vaginal swabs, blood cultures, CRP) was positive in 3% of cases the mean birth weight was 3300.20 grams +/- 600. The average age was +/- 1.4 days 0.45. Thirty percent of the children were exclusively breastfed. 80% of patients were asymptomatic at admission. The clinical signs were found mainly respiratory distress. Mean CRP was 35,12mg / L +/- 3.5. The average duration of the PRM was 9.66 +/- 57.7 hours. The examination at the end of treatment was without abnormalities in 89.2% of cases. CRP control was below 6 mg / l in 48% of cases. The evolution of life on day 28 was favorable in 100% of cases. The average length of hospital treatment was 2.87 +/- 1.145 days; the average duration of treatment as outpatients was 2.74 +/- 1.31 days. 100% of newborns received treatment by parenteral perfusion according the protocol of the center. The average number of hospital days per patient spared protocol averaged 3.21 +/- 0.78 days. The average amount saved per patient was 82.65 +/- 5.51 Euros. Total amount saved over three years was 83,000 Euros. Conclusion- The partial hospitalization seems possible for infected newborns without aggravating their illness. It also contributes significantly to the health economy.</jats:p

A new strategy of management for newborns in a neonatal care unit: A succesful experience from Morocco

Aim of the study: To evaluate if the readmission rates of newborns treated in our unit has been affected by the introduction of new protocols. Materials and Methods: two groups were compared: Group A: newborns readmitted during the period from January 2010 to May 2011, Group B: newborns readmitted during the period from June 2011 until December 2012. Epidemiological data and settings of rehospitalization were collected on a standardized form, the reasons for rehospitalization, and evolution. Results: 105 were readmitted during the first four months of life , the rate of readmission was 1.8%. The difference is not significant between the two periods. The main reasons for readmission are nosocomial infection in 77% and 65% of premature groups A and B respectively, feeding difficulties with dehydration and weight loss, and viral infections in 31% and 21% of premature groups A and B respectively. The death rate was reduced in premature infants in group B (5.8%) compared to preterms of group A (23%). Conclusion: In our study the introduction of a new protocol support has a considerable gain in the number of patients treated, and the mortality reduction without affecting the rates of rehospitalisation.</jats:p