Pub Date : 2024-09-05eCollection Date: 2024-01-01DOI: 10.18332/ejm/191749
Kathryn E Taylor, Virginia Stulz
Introduction: Women experience medical interventions, episiotomy, and perineal lacerations during childbirth, impacting their physical, psychological, and sexual well-being. This study compares the perineal status of prospective women who had the midwifery intervention of perineal myofascial release during childbirth, to a matched retrospective control sample of women who received standard care during childbirth.
Methods: A non-randomized pilot study with prospective data collected for 50 women after informed verbal consent was obtained to having the midwifery intervention of perineal myofascial release during childbirth, and the matched retrospective data for the control group of 49 women were collected from a random sample generated from the medical records. Quantitative analyses included descriptive statistics, independent t-tests, regression, and chi-squared analyses. Retrospective trial registration was granted with The Australian New Zealand Clinical Trials Registry ANZTR.
Results: Women were six times (OR=0.15; 95% CI: 0.0-0.37) less likely to have a non-intact perineum and twice (OR=0.44; 95% CI: 0.35-0.56) less likely to have an episiotomy if they were in the intervention group. Chi-squared analysis found no statistically significant differences between groups for normal vaginal birth and instrumental births, excluding cesareans and waterbirth [χ2(1)= -0.37, p=0.542].
Conclusions: This study found perineal myofascial release benefits women by reducing perineal trauma and episiotomy. However, there were no significant differences in the duration of the active pushing stage of labor or mode of birth. This study has shown some promise in obtaining data for a larger, definitive, randomized controlled trial.
Clinical trial registration: The study was registered on the Australian New Zealand Clinical Trials Registry ANZTR.
Identifier: ID ACTRN12623000807651.
简介妇女在分娩过程中会经历医疗干预、外阴切开术和会阴撕裂伤,这些都会影响她们的生理、心理和性健康。本研究比较了在分娩过程中接受助产士会阴肌筋膜松解术干预的产妇与在分娩过程中接受标准护理的产妇的会阴状况:方法:这是一项非随机的试验性研究,收集了50名产妇的前瞻性数据,这些产妇在获得知情口头同意后,在分娩过程中接受了会阴肌筋膜松解术的助产干预,对照组49名产妇的匹配回顾性数据则是从医疗记录中随机抽样收集的。定量分析包括描述性统计、独立 t 检验、回归和卡方分析。澳大利亚-新西兰临床试验注册中心(ANZTR)对回顾性试验进行了注册:如果妇女属于干预组,其会阴不完整的可能性降低六倍(OR=0.15;95% CI:0.0-0.37),会阴切开术的可能性降低两倍(OR=0.44;95% CI:0.35-0.56)。卡方分析发现,正常阴道分娩和器械助产(不包括剖宫产和水中分娩)组间差异无统计学意义[χ2(1)=-0.37, p=0.542]:本研究发现,会阴肌筋膜松解术可减少会阴创伤和外阴切开术,从而使产妇受益。然而,在主动助产阶段的持续时间或分娩方式上没有明显差异。这项研究为更大规模的、明确的随机对照试验获取数据提供了一些希望:该研究已在澳大利亚-新西兰临床试验注册中心(ANZTR.Identifier)注册:id actrn12623000807651。
{"title":"Could a simple manual technique performed by a midwife reduce the incidence of episiotomy and perineal lacerations? A non-randomized pilot study.","authors":"Kathryn E Taylor, Virginia Stulz","doi":"10.18332/ejm/191749","DOIUrl":"10.18332/ejm/191749","url":null,"abstract":"<p><strong>Introduction: </strong>Women experience medical interventions, episiotomy, and perineal lacerations during childbirth, impacting their physical, psychological, and sexual well-being. This study compares the perineal status of prospective women who had the midwifery intervention of perineal myofascial release during childbirth, to a matched retrospective control sample of women who received standard care during childbirth.</p><p><strong>Methods: </strong>A non-randomized pilot study with prospective data collected for 50 women after informed verbal consent was obtained to having the midwifery intervention of perineal myofascial release during childbirth, and the matched retrospective data for the control group of 49 women were collected from a random sample generated from the medical records. Quantitative analyses included descriptive statistics, independent t-tests, regression, and chi-squared analyses. Retrospective trial registration was granted with The Australian New Zealand Clinical Trials Registry ANZTR.</p><p><strong>Results: </strong>Women were six times (OR=0.15; 95% CI: 0.0-0.37) less likely to have a non-intact perineum and twice (OR=0.44; 95% CI: 0.35-0.56) less likely to have an episiotomy if they were in the intervention group. Chi-squared analysis found no statistically significant differences between groups for normal vaginal birth and instrumental births, excluding cesareans and waterbirth [χ<sup>2</sup>(1)= -0.37, p=0.542].</p><p><strong>Conclusions: </strong>This study found perineal myofascial release benefits women by reducing perineal trauma and episiotomy. However, there were no significant differences in the duration of the active pushing stage of labor or mode of birth. This study has shown some promise in obtaining data for a larger, definitive, randomized controlled trial.</p><p><strong>Clinical trial registration: </strong>The study was registered on the Australian New Zealand Clinical Trials Registry ANZTR.</p><p><strong>Identifier: </strong>ID ACTRN12623000807651.</p>","PeriodicalId":32920,"journal":{"name":"European Journal of Midwifery","volume":null,"pages":null},"PeriodicalIF":1.5,"publicationDate":"2024-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11375755/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142141276","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-09-05eCollection Date: 2024-01-01DOI: 10.18332/ejm/191740
Anna Pilch, Małgorzata Jekiełek, Beata Stach, Joanna Zyznawska, Marek Klimek
Introduction: The study aimed to compare the impact of the physiotherapeutic method combined with TENS and physiotherapy alone on post-cesarean pain levels and the time required for intestinal peristalsis recovery. The study was conducted at the Specialist Hospital in Kraków, from January to March 2020.
Methods: The study was designed as a parallel randomized controlled trial (RCT). Participants were randomly assigned to one of three groups: TENS (n=52), nTENS (n=50) and control group (n=34), based on block randomization of 6. The allocation sequence was provided using a computer-generated random list. The participants were 136 postpartum primiparous women after cesarean birth, aged ≥18 years, having a healthy newborn, with no contradictions to TENS. The TENS group received a physiotherapeutic procedure involving a 20-minute exercise program plus a 40-minute session of TENS. The nTENS group received physiotherapeutic procedure alone, and the control group was under the routine care of midwives. The pain was assessed using the Numerical Rating Scale (NRS) at 6, 7, 12 and 24 hours after cesarean birth and twice during verticalization.
Results: TENS and nTENS groups had decreased pain intensity immediately after the intervention compared to the control group (p=0.002, p=0.027, respectively). During the first stage of the verticalization, the smallest increase in pain was observed in the TENS (p=0.044 compared to nTENS, p=0.000 compared to the control group). Within the increase in the pain score, the intestinal peristalsis recovery time was longer. In both groups undergoing physical therapy, a shortened recovery time of intestinal peristalsis was demonstrated (p=0.000).
Conclusions: The proposed physiotherapy program, combined with TENS and instruction, proved effective in relieving post-cesarean pain and accelerating the time to first defecation and should be considered part of the standard patient management program in maternity units.
{"title":"Impact of obstetric physiotherapy and transcutaneous electrical nerve stimulation (TENS) on pain management and gastrointestinal function following cesarean birth: A randomized controlled trial.","authors":"Anna Pilch, Małgorzata Jekiełek, Beata Stach, Joanna Zyznawska, Marek Klimek","doi":"10.18332/ejm/191740","DOIUrl":"10.18332/ejm/191740","url":null,"abstract":"<p><strong>Introduction: </strong>The study aimed to compare the impact of the physiotherapeutic method combined with TENS and physiotherapy alone on post-cesarean pain levels and the time required for intestinal peristalsis recovery. The study was conducted at the Specialist Hospital in Kraków, from January to March 2020.</p><p><strong>Methods: </strong>The study was designed as a parallel randomized controlled trial (RCT). Participants were randomly assigned to one of three groups: TENS (n=52), nTENS (n=50) and control group (n=34), based on block randomization of 6. The allocation sequence was provided using a computer-generated random list. The participants were 136 postpartum primiparous women after cesarean birth, aged ≥18 years, having a healthy newborn, with no contradictions to TENS. The TENS group received a physiotherapeutic procedure involving a 20-minute exercise program plus a 40-minute session of TENS. The nTENS group received physiotherapeutic procedure alone, and the control group was under the routine care of midwives. The pain was assessed using the Numerical Rating Scale (NRS) at 6, 7, 12 and 24 hours after cesarean birth and twice during verticalization.</p><p><strong>Results: </strong>TENS and nTENS groups had decreased pain intensity immediately after the intervention compared to the control group (p=0.002, p=0.027, respectively). During the first stage of the verticalization, the smallest increase in pain was observed in the TENS (p=0.044 compared to nTENS, p=0.000 compared to the control group). Within the increase in the pain score, the intestinal peristalsis recovery time was longer. In both groups undergoing physical therapy, a shortened recovery time of intestinal peristalsis was demonstrated (p=0.000).</p><p><strong>Conclusions: </strong>The proposed physiotherapy program, combined with TENS and instruction, proved effective in relieving post-cesarean pain and accelerating the time to first defecation and should be considered part of the standard patient management program in maternity units.</p>","PeriodicalId":32920,"journal":{"name":"European Journal of Midwifery","volume":null,"pages":null},"PeriodicalIF":1.5,"publicationDate":"2024-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11375754/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142141277","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-09-02eCollection Date: 2024-01-01DOI: 10.18332/ejm/191737
Nafila Abdul Rahman, Erinna Mohamad Zon, Engku Husna Engku Ismail, Nik Ahmad Nik Abdullah, Wan Mohd Zahiruddin Wan Mohammad, Rahimah Abdul Rahim, Nik Ahmad Zuky Nik Lah
Introduction: Maternal positioning during labor significantly influences maternal comfort. This study aims to identify the preferred maternal lateral position during the latent phase and examine the impact of alignment between maternal lateralization and fetal spine positioning during the active phase of the first stage of labor on maternal comfort.
Methods: Pregnant women in the first stage of labor beyond 37 weeks of gestation were recruited over six months from March to August 2020 for this prospective cohort study at Hospital Raja Perempuan Zainab II, Kota Bharu, Kelantan, Malaysia. Eligible individuals were randomly allocated to align with the fetal spine (n=180) or oppose it (n=180). Fetal spine positions were confirmed via transabdominal ultrasound. Maternal mean comfort scores were assessed using the established Maternal Comfort Assessment Tool. Statistical analysis was performed using IBM SPSS version 27, with a p<0.05 considered significant.
Results: There was a significant association between the preferred maternal position during the latent phase and concordance with the same maternal lateralization-fetal spine alignment (p<0.001). Higher mean comfort scores were observed when the maternal lateral position matched the fetal spine alignment during the active phase of labor. There was a significant association of normal CTG tracings when the maternal position was aligned with the fetal spine (p<0.001).
Conclusions: Parturients preferred lying in alignment with the fetal spine lateralization during the latent phase. This position also offers increased comfort during the active phase of labor. It highlights the importance of considering maternal-fetal alignment as a critical factor in intrapartum care.
导言分娩过程中产妇的体位对产妇的舒适度有很大影响。本研究旨在确定产妇在潜伏期的首选侧卧位,并研究第一产程活跃期产妇侧卧位与胎儿脊柱定位之间的一致性对产妇舒适度的影响:这项前瞻性队列研究于 2020 年 3 月至 8 月在马来西亚吉兰丹州哥打巴鲁的 Raja Perempuan Zainab II 医院进行,为期 6 个月。符合条件者被随机分配到与胎儿脊柱对齐(180 人)或对立(180 人)。胎儿脊柱位置通过经腹超声波检查确认。使用已建立的产妇舒适度评估工具对产妇的平均舒适度评分进行评估。统计分析使用 IBM SPSS 27 版进行,pResults:产妇在潜伏期的首选体位与相同的产妇侧位-胎儿脊柱对齐方式之间存在明显的关联(p结论:产妇在潜伏期的首选体位与相同的产妇侧位-胎儿脊柱对齐方式之间存在明显的关联:产妇在潜伏期更喜欢与胎儿脊柱侧位对齐的姿势。这种体位在活跃产程中也能提高舒适度。这凸显了将母胎侧位对齐作为产前护理关键因素的重要性。
{"title":"Impact of fetal spine alignment according to maternal lateralization during early labor on maternal comfort and birth outcomes: A prospective cohort study in Kelantan, Malaysia.","authors":"Nafila Abdul Rahman, Erinna Mohamad Zon, Engku Husna Engku Ismail, Nik Ahmad Nik Abdullah, Wan Mohd Zahiruddin Wan Mohammad, Rahimah Abdul Rahim, Nik Ahmad Zuky Nik Lah","doi":"10.18332/ejm/191737","DOIUrl":"10.18332/ejm/191737","url":null,"abstract":"<p><strong>Introduction: </strong>Maternal positioning during labor significantly influences maternal comfort. This study aims to identify the preferred maternal lateral position during the latent phase and examine the impact of alignment between maternal lateralization and fetal spine positioning during the active phase of the first stage of labor on maternal comfort.</p><p><strong>Methods: </strong>Pregnant women in the first stage of labor beyond 37 weeks of gestation were recruited over six months from March to August 2020 for this prospective cohort study at Hospital Raja Perempuan Zainab II, Kota Bharu, Kelantan, Malaysia. Eligible individuals were randomly allocated to align with the fetal spine (n=180) or oppose it (n=180). Fetal spine positions were confirmed via transabdominal ultrasound. Maternal mean comfort scores were assessed using the established Maternal Comfort Assessment Tool. Statistical analysis was performed using IBM SPSS version 27, with a p<0.05 considered significant.</p><p><strong>Results: </strong>There was a significant association between the preferred maternal position during the latent phase and concordance with the same maternal lateralization-fetal spine alignment (p<0.001). Higher mean comfort scores were observed when the maternal lateral position matched the fetal spine alignment during the active phase of labor. There was a significant association of normal CTG tracings when the maternal position was aligned with the fetal spine (p<0.001).</p><p><strong>Conclusions: </strong>Parturients preferred lying in alignment with the fetal spine lateralization during the latent phase. This position also offers increased comfort during the active phase of labor. It highlights the importance of considering maternal-fetal alignment as a critical factor in intrapartum care.</p>","PeriodicalId":32920,"journal":{"name":"European Journal of Midwifery","volume":null,"pages":null},"PeriodicalIF":1.5,"publicationDate":"2024-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11367680/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142120779","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-08-28eCollection Date: 2024-01-01DOI: 10.18332/ejm/191364
Katrine Aasekjær, Bente Bjørnås, Halldis K Skivenes, Eline S Vik
Introduction: The integration of technology within teaching offers efficient and diverse learning opportunities. Studies have shown that the use of virtual reality (VR), improves anatomical knowledge and spatial understanding. The aim of this pilot study was to examine whether the utilization of immersive virtual reality goggles as a learning tool for anatomy increase midwifery students' knowledge, and to explore the potential of replacing traditional classroom teaching with VR.
Methods: We conducted a pre-post pilot study using a questionnaire before and after the use of VR as a learning tool in two cohorts of midwifery students in higher education. Cohort one had completed eight hours of classroom teaching of anatomy before participating in the VR session.
Results: The study included 44 midwifery students from two different classes at the same Master's program in midwifery at a university college in Norway. Student in both cohorts were in their first semester of midwifery studies and possessed a Bachelor's degree in nursing. Both cohorts had an increased average mean score in anatomical knowledge immediate after and 14 days after attending the learning session in VR. Students from the cohort that did not participate in anatomy lectures scored high on knowledge, both before and after the session in VR compared to the cohort that had additional classroom teaching in anatomy.
Conclusions: Implementing VR as a learning tool, can contribute to increase spatial understanding and anatomical knowledge. By focusing on student learning in combination with learning activities and collaboration, the technology helps students gain understanding and knowledge.
{"title":"Immersive Virtual Reality (VR) when learning anatomy in midwifery education: A pre-post pilot study.","authors":"Katrine Aasekjær, Bente Bjørnås, Halldis K Skivenes, Eline S Vik","doi":"10.18332/ejm/191364","DOIUrl":"https://doi.org/10.18332/ejm/191364","url":null,"abstract":"<p><strong>Introduction: </strong>The integration of technology within teaching offers efficient and diverse learning opportunities. Studies have shown that the use of virtual reality (VR), improves anatomical knowledge and spatial understanding. The aim of this pilot study was to examine whether the utilization of immersive virtual reality goggles as a learning tool for anatomy increase midwifery students' knowledge, and to explore the potential of replacing traditional classroom teaching with VR.</p><p><strong>Methods: </strong>We conducted a pre-post pilot study using a questionnaire before and after the use of VR as a learning tool in two cohorts of midwifery students in higher education. Cohort one had completed eight hours of classroom teaching of anatomy before participating in the VR session.</p><p><strong>Results: </strong>The study included 44 midwifery students from two different classes at the same Master's program in midwifery at a university college in Norway. Student in both cohorts were in their first semester of midwifery studies and possessed a Bachelor's degree in nursing. Both cohorts had an increased average mean score in anatomical knowledge immediate after and 14 days after attending the learning session in VR. Students from the cohort that did not participate in anatomy lectures scored high on knowledge, both before and after the session in VR compared to the cohort that had additional classroom teaching in anatomy.</p><p><strong>Conclusions: </strong>Implementing VR as a learning tool, can contribute to increase spatial understanding and anatomical knowledge. By focusing on student learning in combination with learning activities and collaboration, the technology helps students gain understanding and knowledge.</p>","PeriodicalId":32920,"journal":{"name":"European Journal of Midwifery","volume":null,"pages":null},"PeriodicalIF":1.5,"publicationDate":"2024-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11350978/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142112750","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-08-28eCollection Date: 2024-01-01DOI: 10.18332/ejm/191295
Agnieszka Rey, Marta Chełmińska, Iwona Damps-Konstańska
Introduction: Numerous factors may influence the asthma course during pregnancy, potentially elevating the risk of specific pregnancy complications. This study aimed to evaluate non-allergic factors influencing asthma and to assess perinatal outcomes between asthmatic and non-asthmatic pregnancies in the population of the Pomeranian Voivodeship region of Poland.
Methods: The mixed cohort study was performed with 83 pregnant asthmatic patients aged 18-38 years. The control group consisted of 83 patients without asthma diagnosis or symptoms. A specially designed questionnaire was used to evaluate asthma course and perinatal outcomes. An Asthma Control Test (ACT) adapted for pregnancy was performed on enrollment. Asthma severity was assessed according to GINA guidelines.
Results: In 19 cases (22.80%), patients quit their regular treatment after pregnancy was confirmed. Respiratory tract infection occurred in 23 patients (27.71%) and had been statistically significantly more frequent among patients with partially and uncontrolled asthma (χ2=8.504, p<0.05). No statistically significant difference was found between infection episodes and perinatal complications. The incidence of cesarean section was significantly higher among patients with asthma (χ2=16.37, p<0.01), particularly in patients with severe asthma (χ2=7.07, p<0.05) and uncontrolled asthma (χ2=6.7, p<0.05). Apgar score was statistically significantly lower in patients with severe asthma (χ2=20.37, p<0.05).
Conclusions: Respiratory tract infections and adequate asthma treatment are the most important modifiable factors in preventing perinatal complications associated with asthma.
{"title":"Non-allergic factors that influence asthma control in pregnancy.","authors":"Agnieszka Rey, Marta Chełmińska, Iwona Damps-Konstańska","doi":"10.18332/ejm/191295","DOIUrl":"https://doi.org/10.18332/ejm/191295","url":null,"abstract":"<p><strong>Introduction: </strong>Numerous factors may influence the asthma course during pregnancy, potentially elevating the risk of specific pregnancy complications. This study aimed to evaluate non-allergic factors influencing asthma and to assess perinatal outcomes between asthmatic and non-asthmatic pregnancies in the population of the Pomeranian Voivodeship region of Poland.</p><p><strong>Methods: </strong>The mixed cohort study was performed with 83 pregnant asthmatic patients aged 18-38 years. The control group consisted of 83 patients without asthma diagnosis or symptoms. A specially designed questionnaire was used to evaluate asthma course and perinatal outcomes. An Asthma Control Test (ACT) adapted for pregnancy was performed on enrollment. Asthma severity was assessed according to GINA guidelines.</p><p><strong>Results: </strong>In 19 cases (22.80%), patients quit their regular treatment after pregnancy was confirmed. Respiratory tract infection occurred in 23 patients (27.71%) and had been statistically significantly more frequent among patients with partially and uncontrolled asthma (χ<sup>2</sup>=8.504, p<0.05). No statistically significant difference was found between infection episodes and perinatal complications. The incidence of cesarean section was significantly higher among patients with asthma (χ<sup>2</sup>=16.37, p<0.01), particularly in patients with severe asthma (χ<sup>2</sup>=7.07, p<0.05) and uncontrolled asthma (χ<sup>2</sup>=6.7, p<0.05). Apgar score was statistically significantly lower in patients with severe asthma (χ<sup>2</sup>=20.37, p<0.05).</p><p><strong>Conclusions: </strong>Respiratory tract infections and adequate asthma treatment are the most important modifiable factors in preventing perinatal complications associated with asthma.</p>","PeriodicalId":32920,"journal":{"name":"European Journal of Midwifery","volume":null,"pages":null},"PeriodicalIF":1.5,"publicationDate":"2024-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11350979/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142112751","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-08-23eCollection Date: 2024-01-01DOI: 10.18332/ejm/191248
Wesllanny S Brunelli, Adriana Caroci Becker, Marlise O P Lima, Sheyla G Oliveira, Angela M Ochiai, Lucca Caroci, Natalucia M D Araújo, Maria L Riesco
Introduction: The type of perineal repair can have significant long-term effects on various functions in a woman's postpartum life. The aim was to compare urinary incontinence (UI), women's satisfaction, pelvic floor muscle strength (PFMS), and sexual function according to the type of perineal repair (surgical glue or suture thread) during the first eight months after normal childbirth.
Methods: A controlled randomized clinical trial of 133 primiparous women undergoing perineal repair during birth with surgical glue or sutures, evaluated during labor and monitored up to 8 months postpartum, from March 2017 to September 2018, in the city in São Paulo, Bazil. Descriptive and inferential analyses were carried out.
Results: A total of 133 women were included in the study, 111 (83.5%) were assessed between 10 to 20 days postpartum, 121 (91.0%) between 50 to 70 days, and 54 (40.6%) between 6 to 8 months. There were no significant differences for UI concerning the type of repair; however, there was a significant difference concerning the postpartum period (p=0.031), with a higher prevalence at two months. Most women reported satisfaction, with the highest levels reported two months after birth (p=0.019). For PFMS, the mean of the glue and suture groups were 32.4 cmH2O and 27.4 cmH2O, but not significant. Women in the glue group showed higher mean values in all sexual function domains but without significance.
Conclusions: Surgical glue showed good aesthetic and functional results in the perineum at eight months postpartum.
{"title":"Repercussions of perineal repair using surgical glue or suture thread on postpartum outcomes: A controlled randomized clinical trial in São Paulo, Brazil.","authors":"Wesllanny S Brunelli, Adriana Caroci Becker, Marlise O P Lima, Sheyla G Oliveira, Angela M Ochiai, Lucca Caroci, Natalucia M D Araújo, Maria L Riesco","doi":"10.18332/ejm/191248","DOIUrl":"10.18332/ejm/191248","url":null,"abstract":"<p><strong>Introduction: </strong>The type of perineal repair can have significant long-term effects on various functions in a woman's postpartum life. The aim was to compare urinary incontinence (UI), women's satisfaction, pelvic floor muscle strength (PFMS), and sexual function according to the type of perineal repair (surgical glue or suture thread) during the first eight months after normal childbirth.</p><p><strong>Methods: </strong>A controlled randomized clinical trial of 133 primiparous women undergoing perineal repair during birth with surgical glue or sutures, evaluated during labor and monitored up to 8 months postpartum, from March 2017 to September 2018, in the city in São Paulo, Bazil. Descriptive and inferential analyses were carried out.</p><p><strong>Results: </strong>A total of 133 women were included in the study, 111 (83.5%) were assessed between 10 to 20 days postpartum, 121 (91.0%) between 50 to 70 days, and 54 (40.6%) between 6 to 8 months. There were no significant differences for UI concerning the type of repair; however, there was a significant difference concerning the postpartum period (p=0.031), with a higher prevalence at two months. Most women reported satisfaction, with the highest levels reported two months after birth (p=0.019). For PFMS, the mean of the glue and suture groups were 32.4 cmH<sub>2</sub>O and 27.4 cmH<sub>2</sub>O, but not significant. Women in the glue group showed higher mean values in all sexual function domains but without significance.</p><p><strong>Conclusions: </strong>Surgical glue showed good aesthetic and functional results in the perineum at eight months postpartum.</p>","PeriodicalId":32920,"journal":{"name":"European Journal of Midwifery","volume":null,"pages":null},"PeriodicalIF":1.5,"publicationDate":"2024-08-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11342807/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142056717","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-08-22eCollection Date: 2024-01-01DOI: 10.18332/ejm/188117
Marlene I Lopes, Margarida Vieira, Alexandrina Cardoso
Introduction: Recognizing the positive impact of movement and positions on labor progression and maternal and neonatal outcomes, there is a strong recommendation to empower women for active labor during antenatal education. This study investigates nurse-midwives' interventions in empowering women for active labor, during antenatal education within primary healthcare settings.
Methods: A qualitative descriptive study was conducted in Primary Healthcare Units that provide antenatal education for childbirth in Portugal. Semi-structured interviews were conducted with 10 nurse-midwives between August and October 2023. Content analysis, utilizing NVIVO software, was employed for data analysis, and the study adhered to the COREQ reporting guidelines.
Results: Six themes emerged: 1) Perspective of nurse-midwives and contextual influences; 2) Assessment of women's needs; 3) Enhancing women's knowledge; 4) Enhancing women's capabilities; 5) Supporting women in decision-making; and 6) Nurse-midwives' perspective on intervention outcomes. It is necessary to create environments conducive to knowledge and skill acquisition and invest in developing body awareness and its impact on labor progression. Encouraging women's involvement in decision-making is crucial, especially in less flexible hospital environments.
Conclusions: This study highlighted the value nurse-midwives place on empowering women for active labor. Interventions featured sharing evidence-based practices and birth stories to foster reflection, emphasizing pelvic mobility training and partner involvement. Reflective practices could enable women to explore options and communicate effectively with healthcare professionals during labor.
{"title":"Women's empowerment for active labor: A qualitative study with nurse-midwives in antenatal education for childbirth.","authors":"Marlene I Lopes, Margarida Vieira, Alexandrina Cardoso","doi":"10.18332/ejm/188117","DOIUrl":"10.18332/ejm/188117","url":null,"abstract":"<p><strong>Introduction: </strong>Recognizing the positive impact of movement and positions on labor progression and maternal and neonatal outcomes, there is a strong recommendation to empower women for active labor during antenatal education. This study investigates nurse-midwives' interventions in empowering women for active labor, during antenatal education within primary healthcare settings.</p><p><strong>Methods: </strong>A qualitative descriptive study was conducted in Primary Healthcare Units that provide antenatal education for childbirth in Portugal. Semi-structured interviews were conducted with 10 nurse-midwives between August and October 2023. Content analysis, utilizing NVIVO software, was employed for data analysis, and the study adhered to the COREQ reporting guidelines.</p><p><strong>Results: </strong>Six themes emerged: 1) Perspective of nurse-midwives and contextual influences; 2) Assessment of women's needs; 3) Enhancing women's knowledge; 4) Enhancing women's capabilities; 5) Supporting women in decision-making; and 6) Nurse-midwives' perspective on intervention outcomes. It is necessary to create environments conducive to knowledge and skill acquisition and invest in developing body awareness and its impact on labor progression. Encouraging women's involvement in decision-making is crucial, especially in less flexible hospital environments.</p><p><strong>Conclusions: </strong>This study highlighted the value nurse-midwives place on empowering women for active labor. Interventions featured sharing evidence-based practices and birth stories to foster reflection, emphasizing pelvic mobility training and partner involvement. Reflective practices could enable women to explore options and communicate effectively with healthcare professionals during labor.</p>","PeriodicalId":32920,"journal":{"name":"European Journal of Midwifery","volume":null,"pages":null},"PeriodicalIF":1.5,"publicationDate":"2024-08-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11339881/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142037241","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-08-22eCollection Date: 2024-01-01DOI: 10.18332/ejm/191162
Virginia Stulz, Dorothy Dunham, Tara Farrugia, Nicola Drayton
Introduction: Midwives in an Australian birth unit undertook a project to develop a resource for women and their support person. The aim of this study was to explore how the women, support persons and midwives viewed the introduction of this resource designed to guide and support women in their choice of support person.
Methods: A quantitative survey study was used to explore how three participant groups viewed the introduction of a support person information resource. A hospital designed survey was developed for women, support people and midwives. Data were analyzed using SPSS, version 26 and Braun and Clarke's guide for thematic analysis.
Results: More than half (55%) of the midwives believed that the information resource presented influenced women's choice of support people during labor. Almost three-quarters (72%) of the women did not change their choice of number of support people that they wanted during their labor. The majority (83%) of women would recommend the support person brochure to other women. The majority (83%) of support people stayed the entire duration of labor. Four themes were generated from open-ended questions: value of the information sheet, knowing how to be a support person, connecting midwives with being woman-centered, and choosing the support person.
Conclusions: The availability of an information resource was of benefit for women, support people and midwives, contributing to women feeling more informed in choosing their support person. Midwives felt they had evidence to support conversations with women, contributing to the feeling of being woman-centered. Support people had increased confidence.
{"title":"A survey on the perceptions of midwives, women, and support persons on the introduction of a support person information resource.","authors":"Virginia Stulz, Dorothy Dunham, Tara Farrugia, Nicola Drayton","doi":"10.18332/ejm/191162","DOIUrl":"10.18332/ejm/191162","url":null,"abstract":"<p><strong>Introduction: </strong>Midwives in an Australian birth unit undertook a project to develop a resource for women and their support person. The aim of this study was to explore how the women, support persons and midwives viewed the introduction of this resource designed to guide and support women in their choice of support person.</p><p><strong>Methods: </strong>A quantitative survey study was used to explore how three participant groups viewed the introduction of a support person information resource. A hospital designed survey was developed for women, support people and midwives. Data were analyzed using SPSS, version 26 and Braun and Clarke's guide for thematic analysis.</p><p><strong>Results: </strong>More than half (55%) of the midwives believed that the information resource presented influenced women's choice of support people during labor. Almost three-quarters (72%) of the women did not change their choice of number of support people that they wanted during their labor. The majority (83%) of women would recommend the support person brochure to other women. The majority (83%) of support people stayed the entire duration of labor. Four themes were generated from open-ended questions: value of the information sheet, knowing how to be a support person, connecting midwives with being woman-centered, and choosing the support person.</p><p><strong>Conclusions: </strong>The availability of an information resource was of benefit for women, support people and midwives, contributing to women feeling more informed in choosing their support person. Midwives felt they had evidence to support conversations with women, contributing to the feeling of being woman-centered. Support people had increased confidence.</p>","PeriodicalId":32920,"journal":{"name":"European Journal of Midwifery","volume":null,"pages":null},"PeriodicalIF":1.5,"publicationDate":"2024-08-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11339884/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142037240","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-08-02eCollection Date: 2024-01-01DOI: 10.18332/ejm/189955
Andrea Manzotti, Simona Fumagalli, Sonia Zanini, Veronica Brembilla, Adele Alberti, Ilaria Magli, Elis Buratti, Nicoletta Coraglia, Andrea De Fusco, Daniel Zambù, Valeria Zanotta, Antonella Nespoli
Introduction: This scoping review aims to comprehensively explore the existing research on the changes in pelvic floor function that occur throughout the childbirth pathway (antenatal, intrapartum, and postnatal period). Furthermore, it seeks to identify new opportunities and directions for future research in this field. In particular, this review focuses on investigating pelvic floor muscle strength and tone in women during the childbirth pathway.
Methods: The following databases were investigated from their inception: PubMed, OVID, Medline, ScienceDirect, The Cochrane Central Library, Scopus, Web of Science, PEDro, Scholar Google, Embase, and CINHAIL. Literature research was carried out from March to October 2022. Records identified through database searching were imported to Covidence. According to Arksey and O'Malley's five-stage scoping review framework, researchers screen titles and abstracts for eligibility and exclude records that do not meet the inclusion criteria.
Results: A total of 40 studies were included in the data extraction phase. These articles underwent a review, with a specific emphasis on examining the tone, strength, and distensibility of the pelvic floor throughout the childbirth pathway. Among the selected studies, 22 investigated pelvic floor strength, 7 the distensibility, and 3 articles the tone.
Conclusions: This review identified both areas of agreement and disagreement across all three themes examined, with a particular emphasis on labor and the postpartum period. Notably, the review unveiled a significant scarcity of data concerning the tone of pelvic floor muscles throughout the childbirth pathway. Further studies to investigate the relationship between midwifery care and pelvic floor outcomes are required to improve clinical practice.
{"title":"What is known about changes in pelvic floor muscle strength and tone in women during the childbirth pathway? A scoping review.","authors":"Andrea Manzotti, Simona Fumagalli, Sonia Zanini, Veronica Brembilla, Adele Alberti, Ilaria Magli, Elis Buratti, Nicoletta Coraglia, Andrea De Fusco, Daniel Zambù, Valeria Zanotta, Antonella Nespoli","doi":"10.18332/ejm/189955","DOIUrl":"10.18332/ejm/189955","url":null,"abstract":"<p><strong>Introduction: </strong>This scoping review aims to comprehensively explore the existing research on the changes in pelvic floor function that occur throughout the childbirth pathway (antenatal, intrapartum, and postnatal period). Furthermore, it seeks to identify new opportunities and directions for future research in this field. In particular, this review focuses on investigating pelvic floor muscle strength and tone in women during the childbirth pathway.</p><p><strong>Methods: </strong>The following databases were investigated from their inception: PubMed, OVID, Medline, ScienceDirect, The Cochrane Central Library, Scopus, Web of Science, PEDro, Scholar Google, Embase, and CINHAIL. Literature research was carried out from March to October 2022. Records identified through database searching were imported to Covidence. According to Arksey and O'Malley's five-stage scoping review framework, researchers screen titles and abstracts for eligibility and exclude records that do not meet the inclusion criteria.</p><p><strong>Results: </strong>A total of 40 studies were included in the data extraction phase. These articles underwent a review, with a specific emphasis on examining the tone, strength, and distensibility of the pelvic floor throughout the childbirth pathway. Among the selected studies, 22 investigated pelvic floor strength, 7 the distensibility, and 3 articles the tone.</p><p><strong>Conclusions: </strong>This review identified both areas of agreement and disagreement across all three themes examined, with a particular emphasis on labor and the postpartum period. Notably, the review unveiled a significant scarcity of data concerning the tone of pelvic floor muscles throughout the childbirth pathway. Further studies to investigate the relationship between midwifery care and pelvic floor outcomes are required to improve clinical practice.</p>","PeriodicalId":32920,"journal":{"name":"European Journal of Midwifery","volume":null,"pages":null},"PeriodicalIF":1.5,"publicationDate":"2024-08-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11295251/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141890267","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-08-02eCollection Date: 2024-01-01DOI: 10.18332/ejm/191253
Pornsri Disorntatiwat, Sudjit Liblub, Mary Steen
Introduction: In Thailand, the exclusive breastfeeding rate remains low at 14% in 2019, despite the World Health Organization's recommendation of exclusive breastfeeding for the first six months. Many mothers experience challenges such as lack of confidence, fatigue, and discomfort while breastfeeding. To address these issues, the novel arm sling innovation device was developed to provide support during breastfeeding. This study aimed to compare the effectiveness of breastfeeding using the arm sling versus the normal cross-cradle hold among first-time mothers and to evaluate their satisfaction with the breastfeeding arm sling.
Methods: A quasi-experimental crossover design was employed in the postpartum unit at Ramathibodi Hospital, Thailand, in 2022. Forty-six first-time mothers breastfed using both a breastfeeding arm sling and the normal cross-cradle hold, with a washout period in between. Breastfeeding effectiveness was measured by mothers and nurse-midwives using questionnaires, and mothers' satisfaction with the sling was assessed. Data were evaluated using descriptive statistics and t-tests.
Results: The breastfeeding arm sling innovation significantly improved breastfeeding effectiveness compared to the normal cross-cradle hold, reported by both mothers (t=4.32, p<0.001) and nurse-midwives (t=8.93, p<0.001). Most mothers expressed satisfaction with the arm sling, though some design aspects, such as ease of use, require improvement.
Conclusions: This study suggests that the breastfeeding arm sling can potentially improve breastfeeding experiences for first-time mothers. Further research is needed on a larger scale and in more diverse settings to confirm these findings and to improve the sling's design for user-friendliness.
导言:在泰国,尽管世界卫生组织建议在最初 6 个月进行纯母乳喂养,但 2019 年的纯母乳喂养率仍然很低,仅为 14%。许多母亲在母乳喂养时会遇到缺乏信心、疲劳和不适等挑战。为了解决这些问题,我们开发了新型臂式吊衣创新装置,为母乳喂养提供支持。本研究旨在比较初为人母者使用臂式吊衣和普通交叉抱枕进行母乳喂养的效果,并评估她们对母乳喂养臂式吊衣的满意度:方法:2022 年,在泰国拉玛提博迪医院产后病房采用了准实验交叉设计。46名初产妇同时使用母乳喂养臂吊衣和正常的交叉摇篮抱法进行母乳喂养,中间有一段冲洗期。母亲和助产士使用问卷对母乳喂养效果进行了测量,并评估了母亲对吊衣的满意度。数据采用描述性统计和 t 检验进行评估:结果:母乳喂养臂式吊衣创新与普通交叉摇篮抱法相比,明显提高了母乳喂养效果,两位母亲均有报告(t=4.32,p结论:母乳喂养臂式吊衣创新与普通交叉摇篮抱法相比,明显提高了母乳喂养效果,两位母亲均有报告(t=4.32,p结论):本研究表明,母乳喂养臂吊衣有可能改善初为人母者的母乳喂养体验。需要在更大范围和更多样化的环境中开展进一步研究,以证实这些发现,并改进吊衣的设计,使其更方便用户使用。
{"title":"Comparing the effectiveness of a breastfeeding arm sling with the normal cross-cradle hold position: A quasi-experimental study in Thailand.","authors":"Pornsri Disorntatiwat, Sudjit Liblub, Mary Steen","doi":"10.18332/ejm/191253","DOIUrl":"10.18332/ejm/191253","url":null,"abstract":"<p><strong>Introduction: </strong>In Thailand, the exclusive breastfeeding rate remains low at 14% in 2019, despite the World Health Organization's recommendation of exclusive breastfeeding for the first six months. Many mothers experience challenges such as lack of confidence, fatigue, and discomfort while breastfeeding. To address these issues, the novel arm sling innovation device was developed to provide support during breastfeeding. This study aimed to compare the effectiveness of breastfeeding using the arm sling versus the normal cross-cradle hold among first-time mothers and to evaluate their satisfaction with the breastfeeding arm sling.</p><p><strong>Methods: </strong>A quasi-experimental crossover design was employed in the postpartum unit at Ramathibodi Hospital, Thailand, in 2022. Forty-six first-time mothers breastfed using both a breastfeeding arm sling and the normal cross-cradle hold, with a washout period in between. Breastfeeding effectiveness was measured by mothers and nurse-midwives using questionnaires, and mothers' satisfaction with the sling was assessed. Data were evaluated using descriptive statistics and t-tests.</p><p><strong>Results: </strong>The breastfeeding arm sling innovation significantly improved breastfeeding effectiveness compared to the normal cross-cradle hold, reported by both mothers (t=4.32, p<0.001) and nurse-midwives (t=8.93, p<0.001). Most mothers expressed satisfaction with the arm sling, though some design aspects, such as ease of use, require improvement.</p><p><strong>Conclusions: </strong>This study suggests that the breastfeeding arm sling can potentially improve breastfeeding experiences for first-time mothers. Further research is needed on a larger scale and in more diverse settings to confirm these findings and to improve the sling's design for user-friendliness.</p>","PeriodicalId":32920,"journal":{"name":"European Journal of Midwifery","volume":null,"pages":null},"PeriodicalIF":1.5,"publicationDate":"2024-08-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11295250/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141890266","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}