International Journal of Obstetrics and Gynecology

International Journal of Obstetrics and Gynecology ISSN 2736-1594 Vol. 8 (10), pp. 001-008, October, 2020. © International Scholars Journals

Full Length Research paper

Pregnancy outcome and neonatal health by mothers aged 40 years and over

Lorenza Driul^1*, Ambrogio P Londero^1*, Serena Bertozzi^2*, Laura Peressini¹, Michele Vanin¹, Vito D’Aietti¹, Arrigo Fruscalzo³, Anna Biasioli¹, Stefania Salvador¹, Riccardo Furlan⁴, Maria Maddalena Petrovec¹, Diego Marchesoni¹

¹Clinic of Obstetrics and Gynecology, AOU "S M della Misericordia", 33100 Udine, Italy

²Clinic of Surgical Semeiotics, AOU "S M della Misericordia", 33100 Udine, Italy

³Department of Obstetrics and Gynecology, Gesundheitszentrum Rheine - Mathias-Spital, Rheine, Germany

⁴Neonatology Department, AOU "S M della Misericordia", 33100 Udine, Italy

Accepted 04 July, 2020

Abstract

This study was carried out to investigate obstetric outcomes in single pregnancies conceived by women older than 40 compared to those of their younger counterparts in a low natality setting with high mean age at first pregnancy. Data were collected about women who delivered in our Clinic between January and July 2005, excluding multiple pregnancies. Statistical analysis was performed using R (version 2.10.1), considering significant a p<0.05.We selected 688 women: 50 of them are 40 years or older and 638 are younger. Advanced age correlates with higher BMI (p=0.056) and seems to increase the risk of gestational hypertension (p<0.05) and gestational diabetes (p<0.05), cesarean sections (p<0.05) and vacuum extraction (p0.089), neonatal clavicle fracture (p<0.05) and perinatal mortality (p<0.05).Advanced age women have an increased risk of pregnancy complications, such as gestational hypertension and diabetes, neonatal clavicle fracture and perinatal death, and undergo more frequently cesarean sections.

Keywords: Advanced maternal age, pregnancy outcome, neonatal outcome, pregnancy related hypertensive disorders.

International Journal of Obstetrics and Gynecology ISSN 2736-1594 Vol. 8 (10), pp. 001-011, October, 2020. © International Scholars Journals

Full Length Research Paper

The comparison of low-risk women’s birth outcomes and experiences in different sized midwifery practices in The Netherlands

Yvonne Fontein

Midwifery, School of Health Studies, Glasgow Caledonian University, Govan Mbeki, room A306 Cowcaddens Road, Glasgow G4 0BA, Scotland, United Kingdom. E-mail: yvonne.fontein@gcal.ac.uk. Tel: +44 (0)141 331 8376.

Accepted 03 September, 2020

Abstract

To examine maternal birth outcomes and birth experiences of low-risk women in the Netherlands in different sized midwifery practices. Descriptive study was using postal questionnaires six weeks after the estimated due date. Women were recruited from urban, semi-rural and rural areas from small-sized practices (1-2 midwives), medium-sized practices (3-4 midwives) or large-sized practices (5 or more). 718 Dutch speaking women with uncomplicated pregnancies, a representative sample of women in 143 midwifery practices in the Netherlands who had given birth in the period between 20 April and 20 May 2007. Distribution of place of birth categories and intervention categories, birth experience, woman-midwife relationship and presence of own midwife after referral. Data were analyzed with Statistical Package for Social Sciences (SPSS). Women in practices with a maximum of two midwives were significantly more likely to experience lower rates of referral, interventions in general and specifically pain relief by means of pethidine, CTG registration and unplanned caesarean sections. Women with a maximum of two midwives were significantly more likely to know their midwife or midwives and were more frequently supported by their own midwife after referral in comparison to women in practices with more than two midwives. The presence of the woman’s own midwife added value to the birth experience. Women with a maximum of two midwives had higher levels of a positive birth experience than women in practices with more than two midwives. Midwifery practices with a maximum of two midwives contribute to non-interventionist birth and a positive birth experience. Awareness of the study results and further study is recommended to discuss re-organisation of care in order to achieve significant reductions on referral and interventions during childbirth and positive maternal birth experiences.

Key words: Midwifery, birth interventions, referral, practice size.

International Journal of Obstetrics and Gynecology ISSN 2736-1594 Vol. 8 (9), pp. 001-005, September, 2020. © International Scholars Journals

Full Length Research Paper

Maternal satisfaction with care during labour: A case study of the Mampong-Ashanti district hospital maternity unit in Ghana

Dzomeku, M. V.

Nursing/Midwifery Training School, P. O. Box 110, Kumasi, Ashanti Region, Ghana.

Accepted 11 April, 2020

Abstract

This study was conducted to assess the care and satisfaction of expectant mothers during labour, birth and lying-in period in Ghana. Purposive sampling was employed to recruit participants, based on the needs of the study and on predetermined variables. Participants were second or third time mothers, who were admitted in the first stage of labour with a cervical dilatation of not more than 5 cm. They were those who had returned there for their two weeks post natal visits, who had no history of neonatal loss and who had normal vaginal deliveries, excluding forceps deliveries and vacuum extractions. Eight individual interviews were conducted with volunteering respondents within 48 h after delivery. This was followed by two focus group discussions two weeks after delivery. The groups were made up of three and four volunteering respondents. Data were inductively examined using content analysis, the process of first level coding, pattern coding and memoing. The respondents were between the ages of 22 and 37; they had limited educational backgrounds with the exception of two who were graduates from the university and teachers training college, respectively. All participants had two or three previous pregnancies and for at least one of these pregnancies, they have had experiences in the Mampong maternity hospital. The majority (seven) of them gave birth within 2 h of coming to the hospital. Findings from this study have established that: (a) multiple factors influence mothers’ satisfaction with their care in labour, birth and the lying in period; (b) maternal satisfaction during this period is determined mostly by the attitude of care givers; (c) dissatisfaction with care leads to non-usage of the hospital in future or using the hospital only as a last resort. It is recommended that (1) staffs of the hospital have frequent continuing education on communication and interpersonal relationship, (2) The code of ethics of the nursing profession should be strictly enforced, (3) Care givers need to fully understand the expectations that patient have for their care, and provide care that is consistent with those expectations.

Key words: Maternal, mothers, satisfaction, care, labour.

International Journal of Obstetrics and Gynecology ISSN 2736-1594 Vol. 8 (9), pp. 001-007, September, 2020. © International Scholars Journals

Full Length Research Paper

The psychometric assessment of the Nottingham health profile for menopausal women in Turkish society

Mürüvvet Baser¹*, Lale Taskın and Bahar Güçiz Doğan³

¹Department of Gynecology and Obstetric Nursing, Health Science Faculty, University of Erciyes, 38039 Kayseri-Türkey.

²Department of Gynecology and Obstetrics Nursing, Health Science Faculty, University of Hacettepe, Ankara, Turkey.

³Department of Public Health, Faculty of Medicine, University of Hacettepe, Ankara, Turkey.

Accepted 16 April, 2020

Abstract

The Nottingham health profile (NHP) is a measurement of 38 items that was designed for measuring quality of life. The present study was conducted in order to determine evaluation of validity and reliability of the NHP for menopausal women. Ninety one (91) women who were menopausal were included in the sample of the study. The comparison of total scores of NHP and the (Medical Outcomes Study) MOS 36 item short form Health survey - SF 36 was made to determine the accuracy of the NHP. The evaluation was carried out using test-retest-reliability analysis, and correlation analysis. The correlation between NHP and SF- 36 was as follows: the sensitivity was 78% and selectivity was 76%. The coefficient of test-retest-correlation of the measurement was 0.97.The NHP was found to be an above-average measurement for menopausal women. Results of the study showed that all the statements, subcategories and total scores and the Pearson Moment Multiplication Correlation Coefficient were satisfying.

Key words: Menopause, quality of life, Nottingham health profile.

International Journal of Obstetrics and Gynecology ISSN 2736-1594 Vol. 8 (9), pp. 001-005, September, 2020. © International Scholars Journals

Full Length Research Paper

Effect of treatment for labor pain: Verbal reports versus visual analogue scale scores - A prospective randomized study

Lena Mårtensson¹* and Ingrid Bergh²

¹School of Life Sciences, University of Skövde, Box 408, SE-541 28 Skövde, Sweden.

²College of Nursing, University of Rhode Island, USA.

Accepted 21 March, 2020

Abstract

Assessing pain in relation to childbirth is one of the midwife’s more important tasks. However, pain research shows that health care professionals often assess patients’ pain inaccurately. The Visual Analogue Scale (VAS) is one of the most used instruments for assessing pain and pain relief both in research and clinical practice. On the other hand, a patient’s verbal report is considered to be the single most reliable indicator of how much pain the patient is experiencing. The aim of this study was to compare women’s verbally reported effect of treatment for labor pain with changes in VAS scores. This comparative prospective study was carrying out on a labor ward with approximately 2,500 deliveries annually in western part of Sweden. Women (n=122) at gestational week 37 to 42 with spontaneous onset of labor, requesting pain relief, were randomized to one of two treatments: acupuncture or sterile water injections. Pain was assessed on a VAS before as well as 30, 60, 90, 120, 150 and 180 min after treatment. Within two hours after delivery the women were asked to verbally report the effectiveness with the treatment. Main outcome measure was agreement between VAS scores and verbal reports. Non-parametric tests were used. All tests were two-tailed at the significance level p< 0.05. The distribution of the VAS scores 30 min after administration of pain relief showed that the women verbally responding that treatment was “very effective”, also rated their pain significantly lower (p< 0.001) on the VAS, compared to the women verbally reporting otherwise. A moderate correlation (r = 0.56; p< 0.001) was obtained between VAS-scored pain change after 30 min and verbally reported pain relief effect. The women who stated that treatment was “very effective” also rated their pain significantly lower at 30, 60 and 90 min on the VAS, compared to baseline. This study confirms that verbal reports and changes in VAS scores are reliable indicators of treatment effect for labor pain. It might, however, be valuable to combine VAS scores with verbal reports for a more extensive assessment of treatment effect.

Key word: Childbirth, pain, pain relief, verbal reports, visual analogue scale.

International Journal of Obstetrics and Gynecology ISSN 2326-7234 Vol. 8 (8), pp. 001-005, August, 2020. © International Scholars Journals

Full Length Research Papers

A randomized controlled trial comparing the physiological and directed pushing on the duration of the second stage of labor, the mode of delivery and Apgar score

Freshteh Jahdi¹, Maryam Shahnazari²*, Maryam Kashanian³, Mansoureh Ashghali Farahani⁴ and Hamid Haghani⁵

¹School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran.

²Islamic Azad University, Tehran Medical Branch, Tehran, Iran.

³Department of Obstetrics and Gynaecology, Tehran University of Medical Sciences, Akbarabadi Teaching hospital, Tehran, Iran.

⁴School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran.

⁵Tehran University of Medical Sciences, Tehran, Iran.

Accepted 21 March, 2020

Abstract

In recent year, there has been an increased trend to the physiological approach to labor. Physiological (spontaneous) pushing in upright position is one of the practices that promote the normal physiological process. Effect of physiological pushing versus directed pushing on the duration of the second stage of labor, mode of birth and Apgar. A randomized controlled trial was completed on 191 women who gave birth at a maternity unit in Iran between August and December 2009. Randomization occurred upon confirmation of full dilatation of the cervix with using block randomization. In the intervention group (n = 100), with full dilatation of the cervix and a fetal head plus 1, the midwives providing care suggested they commenced pushing in upright position only when they felt the urge to do so and gave no specific instructions about the timing and duration of pushing. In the control group (n = 91), women were coached by the midwife to use closed-glottis pushing three to four times in supine position during each contraction immediately as the same period. Mean duration of the second stage of labor in the primiparous women was 47.38±36.75 and 57.12±33.10 min in the intervention and control groups, respectively; the difference was significant (p < 0.0001). In the multiparous, women in the second stage of labor lasted for 26.12±23.43 and 33.20±22.76 min in the intervention and control groups, respectively, which was significantly different (p < 0.0001). One woman in the control group and 2 mother in the intervention group undertook cesarean surgery (p = 1). Apgar scores were similar in both groups. Physiological pushing was not associated with demonstrable adverse outcome. It seems that this technique can reduce the duration of the second stage of labor and it can be a safe method during the second stage of labor without any harm for mother and baby.

Key words: Spontaneous pushing, directed pushing, valsalva, second stage of labor.