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Antenatal consult

Carolyn F Weiniger, Sharon Einav, Uriel Elchalal, Vladislav Ozerski, Daniel Shatalin, Alexander Ioscovich, Yehuda Ginosar
BACKGROUND: Care of pregnant women with concurrent medical conditions can be optimized by multidisciplinary antenatal management. In the current study we describe women with concurrent medical conditions who attended our antenatal anesthesia clinic over a 14-year period, 2002-2015 and, based on the findings, we suggest new policies, strategies and practices to improve antenatal care. METHODS: In 2002, an antenatal anesthesia clinic was established in Hadassah Medical Center...
March 19, 2018: Israel Journal of Health Policy Research
Hellen Lívia Oliveira Catunda Ferreira, Mirna Fontenele de Oliveira, Elizian Braga Rodrigues Bernardo, Paulo César de Almeida, Priscila de Souza Aquino, Ana Karina Bezerra Pinheiro
This correlational study aimed to verify the association between maternal variables and exclusive breastfeeding in a specialized outpatient clinic in the state of Ceará, Brazil. The practice of exclusive breastfeeding was observed, showing a decrease during the first six months of a child's life. Most women were young, with partners, with a good level of schooling, multigravidas and had six or fewer antenatal consultations in health centers. There was a significant association between multiparity and exclusive breastfeeding variables, showing up as a protective variable for this practice...
March 2018: Ciência & Saúde Coletiva
Katherine E Gallagher, Tusajigwe Erio, Kathy Baisley, Shelley Lees, Deborah Watson-Jones
BACKGROUND: The burden of cervical cancer and shortage of screening services in Tanzania confers an urgent need for human papillomavirus (HPV) vaccination. However, the sustainability and impact of another new vaccine campaign in an under-resourced health system requires consideration. We aimed to determine the impact of the government's school-based HPV vaccine campaign in Kilimanjaro region on the provision of routine primary health services and staff workload. METHODS: Data on daily numbers of consultations were collected from health facility register books in 63 dispensaries and health centres in North-West Tanzania for 20 weeks in 2014...
March 12, 2018: BMC Health Services Research
Matthew J Drago, Ursula Guillén, Maria Schiaratura, Jennifer Batza, Annette Zygmunt, Anja Mowes, David Munson, John M Lorenz, Christiana Farkouh-Karoleski, Haresh Kirpalani
Objective How Latino parents perceive and understand antenatal counseling for extreme prematurity, < 26 weeks of gestational age (GA), is not clear. We aim to characterize Latino parental perceptions of antenatal counseling in order to construct and validate a Spanish decision-aid (SDA) to improve parental knowledge of prematurity after antenatal consults. Methods This is a three-phased, prospective, multicenter study. First, interviews of 22 Latino parents with a history of birth < 26 weeks GA were conducted...
March 8, 2018: Maternal and Child Health Journal
Holly E Reid, Anja Wittkowski, Sarah Vause, Alexander E P Heazell
OBJECTIVES: To explore the views of maternity service users and professionals towards obstetric consultant presence 24 hours a day, 7 days a week. DESIGN: Semistructured interviews conducted face to face with maternity service users and professionals in March and April 2016. All responses were analysed together (ie, both service users' and professionals' responses) using an inductive thematic analysis. SETTING: A large tertiary maternity unit in the North West of England that has implemented 24/7 obstetric consultant presence...
March 6, 2018: BMJ Open
Sophie Sarrassat, Nicolas Meda, Hermann Badolo, Moctar Ouedraogo, Henri Some, Robert Bambara, Joanna Murray, Pieter Remes, Matthiew Lavoie, Simon Cousens, Roy Head
BACKGROUND: Media campaigns can potentially reach a large audience at relatively low cost but, to our knowledge, no randomised controlled trials have assessed their effect on a health outcome in a low-income country. We aimed to assess the effect of a radio campaign addressing family behaviours on all-cause post-neonatal under-5 child mortality in rural Burkina Faso. METHODS: In this repeated cross-sectional, cluster randomised trial, clusters (distinct geographical areas in rural Burkina Faso with at least 40 000 inhabitants) were selected by Development Media International based on their high radio listenership (>60% of women listening to the radio in the past week) and minimum distances between radio stations to exclude population-level contamination...
March 2018: Lancet Global Health
Amala James Alenchery, Joanne Thoppil, Carl Denis Britto, Jimena Villar de Onis, Lavina Fernandez, P N Suman Rao
BACKGROUND: Skin to skin contact (SSC) at birth is the standard of care for newborns without risk factors. However, implementation of SSC at birth has been far from optimal. A qualitative study was undertaken to determine the barriers, enablers and potential solutions to implementation of SSC at birth in healthy newborn infants in a level III neonatal-care facility in Bangalore, India. METHODS: Consultants and residents/postgraduates (PG) from the departments of Obstetrics (n = 19) and Pediatrics (n = 14) and nurses (n = 8) in the labor room (LR) participated in the study...
February 9, 2018: BMC Pediatrics
Tadese Ejigu Tafere, Mesganaw Fanthahun Afework, Alemayehu Worku Yalew
BACKGROUND: In Ethiopia, more than 62% of pregnant women attend antenatal care at least once, yet only about one in four women give birth at health facility. This gap has fueled the need to investigate on the quality of ANC services at public health facilities and its link with the use of institutional delivery. OBJECTIVE: To assess the linkage between ANC quality and the use of institutional delivery among pregnant women attending ANC at public health facilities of BDR City Administration...
2018: PloS One
Sonya Nicholl, Holly Seale, Nathan Saul, Sue Campbell-Lloyd
PROBLEM: Typically there is limited opportunity for stakeholder engagement to determine service delivery gaps when implementing an outbreak or supplementary vaccination program. BACKGROUND: In response to increasing pertussis notifications in NSW, Australia, an antenatal pertussis vaccination program was introduced offering pertussis containing vaccine to all pregnant women in the third trimester. AIM: To explore the effectiveness of consulting with midwives prior to and during a new state-wide vaccination program...
February 1, 2018: Women and Birth: Journal of the Australian College of Midwives
Marjolein Poels, Henk F van Stel, Arie Franx, Maria P H Koster
PURPOSE: The objective of this study was to investigate the effect of a local promotional campaign on preconceptional lifestyle changes and the use of preconception care (PCC). MATERIAL AND METHODS: This quasi-comparative study was carried out between February 2015 and February 2016 at a community midwifery practice in the Netherlands. The intervention consisted of a dual track approach (i) a promotional campaign for couples who wish to conceive and (ii) a PCC pathway for health care providers...
January 29, 2018: European Journal of Contraception & Reproductive Health Care
Mechthild M Gross, Claire Michelsen, Bernhard Vaske, Sonja Helbig
INTRODUCTION: Midwifery models of care help to enhance perinatal health outcomes, women's satisfaction, and continuity of care. Despite the ubiquitous presence of certified midwives at births in Germany, no research has investigated the diversity of midwives' practice patterns. Describing the variety of working patterns through which midwives provide intrapartum care may contribute to improving the organisation of midwifery services. METHODS: This cross-sectional survey took place in the region of Hannover and Hildesheim, Germany...
January 16, 2018: Zeitschrift Für Geburtshilfe und Neonatologie
Goiuri Alberdi, Elizabeth J O'Sullivan, Helena Scully, Niamh Kelly, Regina Kincaid, Rosie Murtagh, Stephanie Murray, Denise McGuinness, Ashamole Clive, Mary Brosnan, Lucille Sheehy, Elizabeth Dunn, Fionnuala M McAuliffe
BACKGROUND: Breastfeeding is the optimum mode of infant feeding. Despite this, most global populations do not achieve the World Health Organisation's recommendation of exclusive breast milk for the first 6 months of life. Irish breastfeeding rates are among the lowest in Europe, necessitating a well-designed breastfeeding-support intervention. AIM: To evaluate the feasibility and acceptability of a multidimensional breastfeeding intervention in a rural and an urban maternity setting in Ireland...
December 24, 2017: Midwifery
Elena E Roik, Ekaterina E Sharashova, Evert Nieboer, Olga A Kharkova, Vitaly A Postoev, Jon Ø Odland
BACKGROUND: Knowledge about cervical cancer (CC) risk factors and benefits of CC prevention motivates women to participate in its screening. However, several studies show that there is a significant knowledge deficit worldwide about human papillomavirus (HPV). The current study explores the level of knowledge about HPV and CC prevention in the context of sociodemographic and behavioral characteristics of women who visited an antenatal clinic in Arkhangelsk, Russia. METHODS: This cross-sectional study was conducted in the city of Arkhangelsk, which seats the administrative center of Arkhangelsk County, Northwest Russia...
2017: PloS One
Ashraf Kharrat, Gregory P Moore, Stéphanie Beckett, Stuart G Nicholls, Margaret Sampson, Thierry Daboval
OBJECTIVE: To synthesize and describe parental expectations on how healthcare professionals should interact with them during a peripartum, antenatal consultation for extremely preterm infants. STUDY DESIGN: For this systematic literature review with textual narrative synthesis, we included studies that explored parental perspectives regarding the antenatal consultation for an extremely preterm infant. Electronic searches of Medline, CINAHL, PsycInfo, and Embase were conducted, along with a search of the grey literature...
December 6, 2017: Journal of Pediatrics
Des L McMahon, Marie Twomey, Maeve O'Reilly, Mary Devins
OBJECTIVE: To analyse the referral patterns of perinatal patients referred to a specialist palliative care service (SPCS), their demographics, diagnoses, duration of illness, place of death and symptom profile. DESIGN: A retrospective chart review of all perinatal referrals over a 4-year period to the end of 2015. SETTING: A consultant-led paediatric SPCS at Our Lady's Children's Hospital, Crumlin, Dublin, and the Coombe Women & Infants University Hospital, Dublin...
November 9, 2017: Archives of Disease in Childhood. Fetal and Neonatal Edition
Anam Feroz, Shagufta Perveen, Wafa Aftab
BACKGROUND: From 1990 to 2015, the number of maternal deaths globally has dropped by 43%. Despite this, progress in attaining MDG 5 is not remarkable in LMICs. Only 52% of pregnant women in LMICs obtain WHO recommended minimum of four antenatal consultations and the coverage of postnatal care is relatively poor. In recent years, the increased cellphone penetration has brought the potential for mHealth to improve preventive maternal healthcare services. The objective of this review is to assess the effectiveness of mHealth solutions on a range of maternal health outcomes by categorizing the interventions according to the types of mHealth applications...
November 7, 2017: BMC Health Services Research
Cynthia Gyamfi-Bannerman
Third-trimester bleeding is a common complication arising from a variety of etiologies, some of which may initially present in the late preterm period. Previous management recommendations have not been specific to this gestational age window, which carries a potentially lower threshold for delivery. The purpose of this document is to provide guidance on management of late preterm (34 0/7-36 6/7 weeks of gestation) vaginal bleeding. The following are Society for Maternal-Fetal Medicine recommendations: (1) we recommend delivery at 36-37 6/7 weeks of gestation for stable women with placenta previa without bleeding or other obstetric complications, such as preeclampsia or fetal growth restriction (Grade 1B); (2) we do not recommend routine cervical length screening for women with placenta previa in the late preterm period because of a lack of data on an appropriate management strategy (Grade 2C); (3) we recommend a planned delivery between 34 and 37 weeks of gestation for stable women with placenta accreta (Grade 1C); (4) we recommend delivery between 34 and 37 weeks of gestation for stable women with vasa previa (Grade 1C); (5) we recommend that in women with active hemorrhage in the late preterm period, delivery should not be delayed for the purpose of administering antenatal corticosteroids (Grade 1B); (6) we recommend that fetal lung maturity testing should not be used to guide management in the late preterm period when an indication for delivery is present (Grade 1B); and (7) we recommend that antenatal corticosteroids should be administered to women who are eligible and are managed expectantly if delivery is likely within 7 days, the gestational age is between 34 0/7 and 36 6/7 weeks of gestation, and antenatal corticosteroids has not previously been administered (Grade 1A)...
October 25, 2017: American Journal of Obstetrics and Gynecology
Marjon De Roose, Inge Tency, Dimitri Beeckman, Ann Van Hecke, Sofie Verhaeghe, Els Clays
OBJECTIVE: to examine the knowledge, attitude and practices (KAP) of Flemish midwives regarding miscarriage. DESIGN AND SETTING: a cross-sectional KAP study was conducted in 28 hospitals in Flanders (Northern region of Belgium) from September 2015 to January 2016. PARTICIPANTS: a total of 647 out of 1200 midwives (53.9%) working on maternity, labour and gynaecological wards, maternal and neonatal (intensive) care units, antenatal consultations, and reproductive medicine were recruited...
January 2018: Midwifery
P D Griffiths, C Mooney, M Bradburn, D Jarvis
There are a number of reasons why a pregnant woman might be considered to have an increased risk of carrying a fetus with a brain abnormality, but they fall broadly into two groups. First, there may be a relevant family history usually, but not always, when a fetus/child from a previous pregnancy has a developmental brain abnormality and a clinical geneticist judges that there is a risk of recurrence. Second, there may be findings in their current pregnancy that increases the risk of the fetus either having a developmental brain abnormality or accruing acquired brain pathology...
October 15, 2017: Clinical Radiology
Erica Phillips, Rebecca J Stoltzfus, Lesly Michaud, Gracia Lionel Fils Pierre, Francoise Vermeylen, David Pelletier
BACKGROUND: Antenatal care (ANC) is an important health service for women in developing countries, with numerous proven benefits. Global coverage of ANC has steadily increased over the past 30 years, in part due to increased community-based outreach. However, commensurate improvements in health outcomes such as reductions in the prevalence of maternal anemia and infants born small-for-gestational age have not been achieved, even with increased coverage, indicating that quality of care may be inadequate...
October 16, 2017: BMC Pregnancy and Childbirth
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