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BMC Public Health Oct 2023Pelvic floor dysfunction in women encompasses a wide range of clinical disorders: urinary incontinence, pelvic organ prolapse, fecal incontinence, and pelvic-perineal... (Review)
Review
BACKGROUND
Pelvic floor dysfunction in women encompasses a wide range of clinical disorders: urinary incontinence, pelvic organ prolapse, fecal incontinence, and pelvic-perineal region pain syndrome. A literature review did not identify any articles addressing the prevalence of all pelvic floor dysfunctions.
OBJECTIVE
Determine the prevalence of the group of pelvic floor disorders and the factors associated with the development of these disorders in women.
MATERIAL AND METHODS
This observational study was conducted with women during 2021 and 2022 in Spain. Sociodemographic and employment data, previous medical history and health status, lifestyle and habits, obstetric history, and health problems were collected through a self-developed questionnaire. The Pelvic Floor Distress Inventory (PFDI-20) was used to assess the presence and impact of pelvic floor disorders. Pearson's Chi-Square, Odds Ratio (OR) and adjusted Odds Ratio (aOR) with their respective 95% confidence intervals (CI) were calculated.
RESULTS
One thousand four hundred forty-six women participated. Urinary incontinence occurred in 55.8% (807) of the women, fecal incontinence in 10.4% (150), symptomatic uterine prolapse in 14.0% (203), and 18.7% (271) reported pain in the pelvic area. The following were identified as factors that increase the probability of urinary incontinence: menopausal status. For fecal incontinence: having had instrumental births. Factors for pelvic organ prolapse: number of vaginal births, one, two or more. Factors for pelvic pain: the existence of fetal macrosomia.
CONCLUSIONS
The prevalence of pelvic floor dysfunction in women is high. Various sociodemographic factors such as age, having a gastrointestinal disease, having had vaginal births, and instrumental vaginal births are associated with a greater probability of having pelvic floor dysfunction. Health personnel must take these factors into account to prevent the appearance of these dysfunctions.
Topics: Pregnancy; Female; Humans; Pelvic Floor Disorders; Fecal Incontinence; Pelvic Floor; Prevalence; Urinary Incontinence; Pelvic Organ Prolapse; Surveys and Questionnaires; Pain; Observational Studies as Topic
PubMed: 37838661
DOI: 10.1186/s12889-023-16901-3 -
Cell Host & Microbe Jul 2023The microbiomes of cesarean-born infants differ from vaginally delivered infants and are associated with increased disease risks. Vaginal microbiota transfer (VMT) to... (Randomized Controlled Trial)
Randomized Controlled Trial
The microbiomes of cesarean-born infants differ from vaginally delivered infants and are associated with increased disease risks. Vaginal microbiota transfer (VMT) to newborns may reverse C-section-related microbiome disturbances. Here, we evaluated the effect of VMT by exposing newborns to maternal vaginal fluids and assessing neurodevelopment, as well as the fecal microbiota and metabolome. Sixty-eight cesarean-delivered infants were randomly assigned a VMT or saline gauze intervention immediately after delivery in a triple-blind manner (ChiCTR2000031326). Adverse events were not significantly different between the two groups. Infant neurodevelopment, as measured by the Ages and Stages Questionnaire (ASQ-3) score at 6 months, was significantly higher with VMT than saline. VMT significantly accelerated gut microbiota maturation and regulated levels of certain fecal metabolites and metabolic functions, including carbohydrate, energy, and amino acid metabolisms, within 42 days after birth. Overall, VMT is likely safe and may partially normalize neurodevelopment and the fecal microbiome in cesarean-delivered infants.
Topics: Female; Pregnancy; Humans; Infant; Infant, Newborn; Delivery, Obstetric; Microbiota; Cesarean Section; Gastrointestinal Microbiome; Feces
PubMed: 37327780
DOI: 10.1016/j.chom.2023.05.022 -
American Journal of Obstetrics and... Mar 2024Oxytocin is a peptide hormone that plays a key role in regulating the female reproductive system, including during labor and lactation. It is produced primarily in the... (Review)
Review
Oxytocin is a peptide hormone that plays a key role in regulating the female reproductive system, including during labor and lactation. It is produced primarily in the hypothalamus and secreted by the posterior pituitary gland. Oxytocin can also be administered as a medication to initiate or augment uterine contractions. To study the effectiveness and safety of oxytocin, previous studies have randomized patients to low- and high-dose oxytocin infusion protocols either alone or as part of an active management of labor strategy along with other interventions. These randomized trials demonstrated that active management of labor and high-dose oxytocin regimens can shorten the length of labor and reduce the incidence of clinical chorioamnionitis. The safety of high-dose oxytocin regimens is also supported by no associated differences in fetal heart rate abnormalities, postpartum hemorrhage, low Apgar scores, neonatal intensive care unit admissions, and umbilical artery acidemia. Most studies reported no differences in the cesarean delivery rates with active management of labor or high-dose oxytocin regimens, thereby further validating its safety. Oxytocin does not have a predictable dose response, thus the pharmacologic effects and the amplitude and frequency of uterine contractions are used as physiological parameters for oxytocin infusion titration to achieve adequate contractions at appropriate intervals. Used in error, oxytocin can cause patient harm, highlighting the importance of precise administration using infusion pumps, institutional safety checklists, and trained nursing staff to closely monitor uterine activity and fetal heart rate changes. In this review, we summarize the physiology, pharmacology, infusion regimens, and associated risks of oxytocin.
Topics: Pregnancy; Infant, Newborn; Humans; Female; Oxytocin; Oxytocics; Labor, Induced; Labor, Obstetric; Cesarean Section
PubMed: 37460365
DOI: 10.1016/j.ajog.2023.06.041 -
American Journal of Obstetrics and... Mar 2024The term "obstetric violence" has been used in the legislative language of several countries to protect mothers from abuse during pregnancy. Subsequently, it has been...
The term "obstetric violence" has been used in the legislative language of several countries to protect mothers from abuse during pregnancy. Subsequently, it has been expanded to include a spectrum of obstetric procedures, such as induction of labor, episiotomy, and cesarean delivery, and has surfaced in the peer-reviewed literature. The term "obstetric violence" can be seen as quite strong and emotionally charged, which may lead to misunderstandings or misconceptions. It might be interpreted as implying a deliberate act of violence by healthcare providers when mistreatment can sometimes result from systemic issues, lack of training, or misunderstandings rather than intentional violence. "Obstetric mistreatment" is a more comprehensive term that can encompass a broader range of behaviors and actions. "Violence" generally refers to the intentional use of physical force to cause harm, injury, or damage to another person (eg, physical assault, domestic violence, street fights, or acts of terrorism), whereas "mistreatment" is a more general term and refers to the abuse, harm, or control exerted over another person (such as nonconsensual medical procedures, verbal abuse, disrespect, discrimination and stigmatization, or neglect, to name a few examples). There may be cases where unprofessional personnel may commit mistreatment and violence against pregnant patients, but as obstetrics is dedicated to the health and well-being of pregnant and fetal patients, mistreatment of obstetric patients should never be an intended component of professional obstetric care. It is necessary to move beyond the term "obstetric violence" in discourse and acknowledge and address the structural dimensions of abusive reproductive practices. Similarly, we do not use the term "psychiatric violence" for appropriately used professional procedures in psychiatry, such as electroshock therapy, or use the term "neurosurgical violence" when drilling a burr hole. There is an ongoing need to raise awareness about the potential mistreatment of obstetric patients within the context of abuse against women in general. Using the term "mistreatment in healthcare" instead of the more limited term "obstetric violence" is more appropriate and applies to all specialties when there is unprofessional abuse and mistreatment, such as biased care, neglect, emotional abuse (verbal), or physical abuse, including performing procedures that are unnecessary, unindicated, or without informed patient consent. Healthcare providers must promote unbiased, respectful, and patient-centered professional care; provide an ethical framework for all healthcare personnel; and work toward systemic change to prevent any mistreatment or abuse in our specialty.
Topics: Pregnancy; Humans; Female; Parturition; Delivery, Obstetric; Maternal Health Services; Attitude of Health Personnel; Violence
PubMed: 37806611
DOI: 10.1016/j.ajog.2023.10.003 -
Journal of Obstetric, Gynecologic, and... Jul 2023
Topics: Humans; Nursing; Workforce; Education, Nursing, Baccalaureate
PubMed: 37204393
DOI: 10.1016/j.jogn.2023.04.004 -
Journal of Obstetric, Gynecologic, and... Jan 2024to follow.
to follow.
Topics: Infant, Newborn; Pregnancy; Female; Humans; Gynecology; Neonatal Nursing; Obstetric Nursing
PubMed: 37984492
DOI: 10.1016/j.jogn.2023.10.003 -
Nursing For Women's Health Aug 2023
Topics: Humans; Nursing; Nursing Staff; Workforce; Cultural Diversity; Education, Nursing, Baccalaureate
PubMed: 37204389
DOI: 10.1016/j.nwh.2023.04.002 -
Journal of Obstetric, Gynecologic, and... Nov 2023Transgender and gender-nonconforming people remain excluded from women's health spaces, and nurses with expertise in women's health best serve their needs when they seek... (Review)
Review
Transgender and gender-nonconforming people remain excluded from women's health spaces, and nurses with expertise in women's health best serve their needs when they seek sexual, reproductive, gynecologic, or obstetric care. However, commentary regarding the term "women" and exclusionary policies and behaviors in health care marginalize gender-nonconforming patients and contribute to health disparities. Therefore, the purpose of this article is twofold. First, we review terminology related to gender-nonconforming populations and their known health care needs; provide a brief historical overview of gender and health care; and describe the influence of White supremacist, misogynist, and heteronormative influences in women's health care. Second, we generate a call to action and specifically discuss the responsibilities of nurses and nursing organizations to ensure the provision of gender-equitable and respectful care and generate clinical recommendations for the specialty.
Topics: Pregnancy; Humans; Female; Women's Health; Gender Identity; Transgender Persons; Sexual Behavior; Delivery of Health Care
PubMed: 37699533
DOI: 10.1016/j.jogn.2023.08.007 -
Nursing For Women's Health Oct 2023The nursing shortage and the need to maintain appropriate staffing ratios have made contract nursing a growing health care business. Contract, or travel, nurses are...
The nursing shortage and the need to maintain appropriate staffing ratios have made contract nursing a growing health care business. Contract, or travel, nurses are often employed to meet staffing ratios, which are developed to promote positive patient outcomes. Health care facilities provide care at various levels of acuity, and nurses must be appropriately trained to deliver safe, competent care in the assigned facility. Levels of obstetric care are determined collaboratively between various professional organizations and include an assessment of acuity, service, and coordination of services. The purpose of this article is to offer recommendations for requirements for travel nurses working in obstetric and well neonatal care settings that are aligned with agency acuity and national guidelines. Shared responsibility between travel nurse agencies, hiring health care facilities, and individual nurses will lead to greater satisfaction and improved patient outcomes.
PubMed: 37567240
DOI: 10.1016/j.nwh.2023.05.003