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MCN. the American Journal of Maternal... 2020When caring for women experiencing preterm labor and birth, nurses play a significant role as bedside experts, advocates, patient educators, and key members of the... (Review)
Review
When caring for women experiencing preterm labor and birth, nurses play a significant role as bedside experts, advocates, patient educators, and key members of the maternity care team. Enhanced expertise on clinical and professional knowledge of preterm labor and birth is crucial in prevention and treatment. As preterm birth rates continue to rise, perinatal nurses as well-informed clinical experts have the opportunity to offer innovative education, holistic assessments, and communication through shared decision-making models. Educating pregnant women about early recognition of preterm labor warning signs and symptoms allows for timely diagnosis, interventions, and treatment. Informed and collaborative nursing practice improves quality of clinical care based on individualized interactions. A clinical review of preterm labor and preterm birth is presented for perinatal nurses.
Topics: Adult; Female; Humans; Infant, Newborn; Mass Screening; Maternal Health Services; Obstetric Labor, Premature; Pregnancy; Premature Birth
PubMed: 33074911
DOI: 10.1097/NMC.0000000000000656 -
Ethiopian Journal of Health Sciences May 2020Aromatherapy as an alternative and complementary medicine is a well-known method for reducing the symptoms of various physiological processes such as labor experience....
BACKGROUND
Aromatherapy as an alternative and complementary medicine is a well-known method for reducing the symptoms of various physiological processes such as labor experience. The aim of this study was to systematically review the currently available evidences evaluating the use of aromatherapy for management of labor pain and anxiety.
METHODS
In a systematic review, 5 databases (PubMed, SCOPUS, Web of Science, Google Scholar and Scientific Information Database [SID]) were searched, from database inception up to December 2019. Keywords used included (aromatherapy OR ""essential oil" OR "aroma*") AND (pain OR anxiety) AND (labor OR delivery). Using the Cochrane Collaboration's 'Risk of bias' method; the risk of bias in the included studies was evaluated.
RESULTS
A total of 33 studies were verified to meet our inclusion criteria. Most of the included studies were conducted in Iran. Aromatherapy was applied using inhalation, massage, footbath, birthing pool, acupressure, and compress. The most popularly used essential oil in the studies was lavender (13 studies), either as a single essential oil or in a combination with other essential oils. Most of included studies confirmed the positive effect of aromatherapy in reducing labor pain and anxiety.
CONCLUSION
The evidences from this study suggest that aromatherapy, as a complementary and alternative modality, can help in relieving maternal anxiety and pain during labor.
Topics: Anxiety; Aromatherapy; Female; Humans; Labor Pain; Obstetric Labor Complications; Pain Management; Pregnancy; Treatment Outcome
PubMed: 32874088
DOI: 10.4314/ejhs.v30i3.16 -
International Journal of Environmental... Oct 2020The decentralization of health systems can have direct repercussions on maternity care. Some inequalities can be noted in outcomes, like neonatal and child mortality in...
The decentralization of health systems can have direct repercussions on maternity care. Some inequalities can be noted in outcomes, like neonatal and child mortality in Spain. This study aimed to make the presence of obstetric violence in Spain visible as an interterritorial equity criterion. A descriptive, restrospective and cross-sectional study was conducted between January 2018 and June 2019. The sample comprised 17,541 questionnaires, which represented all Spanish Autonomous Communities. Of our sample, 38.3% perceived having suffered obstetric violence; 44.4% perceived that they had undergone unnecessary and/or painful procedures, of whom 83.4% were not requested to provide informed consent. The mean satisfaction with the attention women received obtained 6.94 points in the general sample and 4.85 points for those women who viewed themselves as victims of obstetric violence. Spain seems to have a serious problem with public health and respecting human rights in obstetric violence. Offering information to women and requesting their informed consent are barely practiced in the healthcare system, so it is necessary to profoundly reflect on obstetric practices with, and request informed consent from, women in Spain.
Topics: Cross-Sectional Studies; Delivery, Obstetric; Female; Humans; Informed Consent; Maternal Health Services; Perception; Pregnancy; Spain; Violence
PubMed: 33105788
DOI: 10.3390/ijerph17217726 -
Seminars in Perinatology Jun 2020Triage in healthcare is sorting patients by acuity to prioritize them for full evaluation. Standardizing this process with the use of triage acuity classification tools... (Review)
Review
Triage in healthcare is sorting patients by acuity to prioritize them for full evaluation. Standardizing this process with the use of triage acuity classification tools has been shown to improve patient flow and quality of care in the emergency department. The American College of Obstetricians and Gynecologists recommends that pregnant women be triaged based on acuity, rather than time of arrival, and that obstetric triage acuity scales can serve as templates for use at the facility level. Three obstetric triage acuity scales developed in North America are reviewed and the implementation of one in a system with 40 birth hospitals is described. Use of obstetric triage acuity scales resulted in timelier initial assessment and decreased wait times. Acuity, volume, and trends data helped improve nurse and provider staffing in triage units. These findings support the promise of obstetric triage acuity scales to promote efficient care.
Topics: Advanced Practice Nursing; Algorithms; Female; Humans; Implementation Science; Multi-Institutional Systems; Nurses; Obstetric Labor Complications; Obstetric Nursing; Obstetrics; Patient Acuity; Patient Transfer; Pregnancy; Pregnancy Complications; Quality Improvement; Time Factors; Triage; Vital Signs
PubMed: 32279833
DOI: 10.1016/j.semperi.2020.151240 -
International Journal of Nursing Studies Feb 2023Perineal massage during childbirth has been recommended as an effective measure to prevent perineal injury. However, the overall effects of perineal massage during... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
Perineal massage during childbirth has been recommended as an effective measure to prevent perineal injury. However, the overall effects of perineal massage during childbirth on maternal and neonatal outcomes in primiparous women remain inconclusive. Particularly, the effects of perineal massage begun during different stages of labor need to be further investigated.
OBJECTIVES
To comprehensively review the effects of perineal massage during childbirth on primiparous health outcomes, including perineal-related outcomes, duration of labor, hemorrhage and postpartum perineal pain, and neonatal outcomes, including Apgar scores and neonatal complications, and to further explore the effects of perineal massage begun during different stages of labor.
DESIGN
A systematic review and meta-analysis following the Cochrane Handbook guidelines and PRISMA2020.
METHODS
A systematic search strategy was developed following the three-phase search approach, and the literature search was conducted in electronic databases and clinical trial registers from inception to 7th January 2022. Study selection and data extraction were completed independently by two researchers. The updated Cochrane risk of bias 2.0 tool for randomized trials was chosen to evaluate the quality of included studies. Data analyses were conducted using the Revman5.4 software, and subgroup analyses were performed based on the different start times of perineal massage. Furthermore, the certainty of body of evidence for each outcome was assessed utilizing the GRADEpro online tool.
RESULTS
Seventeen randomized controlled trials involving 3248 primiparous women were included in the review. The pooled results of meta-analyses indicated that perineal massage begun during the second stage of labor significantly increased the occurrence of intact perineum (RR = 2.78, 95 % CI: [1.52, 5.05], P < 0.001), reduced the rate of second- and third-degree perineal lacerations (P < 0.05), and decreased the incidence of episiotomy (RR = 0.63, 95 % CI: [0.50, 0.79], P < 0.001), while perineal massage during the first stage of labor effectively shortened the duration of the first and second stages of labor (P < 0.05). The available evidence also suggests the potential role of perineal massage on hemorrhage and long-term postpartum perineal pain (P < 0.05). However, the aggregated results failed to demonstrate the beneficial effects of perineal massage on neonatal outcomes (P > 0.05).
CONCLUSIONS
Perineal massage begun during the second stage of labor effectively improves the perineal-related outcomes in primiparous women, while perineal massage during the first stage of labor significantly shortens the duration of labor. High-quality studies exploring the standardized procedure for perineal massage and the short- and long-term effects of perineal massage are warranted.
REGISTRATION NUMBER
CRD42022302336 (PROSPERO).
Topics: Pregnancy; Infant, Newborn; Female; Humans; Perineum; Obstetric Labor Complications; Delivery, Obstetric; Massage; Pain; Randomized Controlled Trials as Topic
PubMed: 36442355
DOI: 10.1016/j.ijnurstu.2022.104390 -
BMC Pregnancy and Childbirth Feb 2021Labor pain during childbirth can have devastating effects on the progress of labor, mother, and fetus. Consequently, the management of labor pain is crucial for the... (Randomized Controlled Trial)
Randomized Controlled Trial
BACKGROUND
Labor pain during childbirth can have devastating effects on the progress of labor, mother, and fetus. Consequently, the management of labor pain is crucial for the well-being of the mother and fetus. Transcutaneous electrical nerve stimulation (TENS) is a non -pharmacological analgesic technique. It uses a low-voltage electrical current to activate descending inhibitory systems in the central nervous system to relieve pain. This study aimed to determine the effects of TENS therapy in the first stage of labor.
METHODS
In this single-blind randomized controlled trial, we screened low-risk pregnant women who anticipated spontaneous vaginal delivery. Women were assigned (1:1) to either the experimental group (received TENS therapy in the first stage of labor) or the control group (received routine obstetric care). The women, midwives, and researchers working in the gynecology and obstetric department were aware of the treatment group, but statisticians analysis the data were blinded. The primary outcome was labor pain intensity, assessed by visual analog scale (VAS) immediately after the randomization, at 30, 60, and 120 min after TENS therapy, and 2-24 h post-delivery. We used SPSS 21.0 software in data analysis. An independent sample t-test compared the mean VAS scores and labor duration between groups. A Chi-square test was employed to compare categorical variables between the groups. A significant level of ≤0.05 was statistically significant.
RESULTS
A total of 326 pregnant women were eligible: experimental group (n = 161) and control group (n = 165). The experimental group had statistically significantly lower mean VAS scores at a different time (30, 60, and 120 min post-intervention and 2-24 h post-delivery) than the control group (p < 0.001). The experimental group demonstrated a statistically significant shorter duration of the active labor phase than the control group (p < 0.001).
CONCLUSION
This study indicates that TENS can be used as a non-pharmacological therapy to reduce pain and shorten the active labor phase.
TRIAL REGISTRATION
ISRCTN registry, ISRCTN23857995 . Registered on 11/12/2020, 'retrospectively registered.
Topics: Adult; Analgesia, Obstetrical; Delivery, Obstetric; Female; Humans; Labor Pain; Labor, Obstetric; Pain Management; Pain Measurement; Pregnancy; Single-Blind Method; Transcutaneous Electric Nerve Stimulation
PubMed: 33627077
DOI: 10.1186/s12884-021-03625-8 -
The Journal of Perinatal & Neonatal... 2020Preterm birth occurs with 10% of deliveries and yet accounts for more than 85% of perinatal morbidity and mortality. Management of preterm labor prior to delivery... (Review)
Review
Preterm birth occurs with 10% of deliveries and yet accounts for more than 85% of perinatal morbidity and mortality. Management of preterm labor prior to delivery includes a multipronged pharmacologic approach targeting utilization of reproductive hormones for continuation of pregnancy, advancement of fetal lung maturity, and the decrease of uterine contractility (tocolysis). This article will review and compare guidelines on pharmacologic management of preterm labor as recommended by the American College of Obstetricians and Gynecologists and the European Association of Perinatal Medicine. The classifications of drugs discussed include exogenous progesterone, corticosteroids, and tocolytics (β-adrenergic agonists, magnesium sulfate, calcium channel blockers, prostaglandin inhibitors, nitrates, and oxytocin receptor blockers). For each of these drug classes, the following information will be presented: mechanism of action, maternal/fetal side effects, and nursing implications.
Topics: Female; Humans; Infant, Newborn; Medication Therapy Management; Obstetric Labor, Premature; Pharmaceutical Preparations; Pregnancy; Prenatal Care
PubMed: 32332445
DOI: 10.1097/JPN.0000000000000474 -
MCN. the American Journal of Maternal... 2021
Topics: Female; Humans; Obstetric Nursing; Patient Acuity; Patient Transfer; Pregnancy
PubMed: 33284248
DOI: 10.1097/NMC.0000000000000682 -
Journal of Midwifery & Women's Health Mar 2020Although the safety of water immersion during labor is largely supported by evidence from research, the risks to women and neonates during waterbirth are not well...
INTRODUCTION
Although the safety of water immersion during labor is largely supported by evidence from research, the risks to women and neonates during waterbirth are not well established. The purpose of this study was to generate evidence regarding maternal and neonatal outcomes related to water immersion in labor and during birth.
METHODS
A retrospective cohort study included a convenience sample of women receiving prenatal care at a nurse-midwifery practice. Participants were categorized into 3 groups: 1) waterbirth, 2) water labor, or 3) neither. Participant characteristics, maternal outcomes, and newborn outcomes were collected at time of birth and health record abstraction. At the 6-week postpartum visit, another maternal outcome, satisfaction with birth, was measured using the Care in Obstetrics: Measure for Testing Satisfaction (COMFORTS) scale. Analysis included effect size, descriptive statistics (sample characteristics), and maternal and neonatal group differences (analysis of variance and chi-square) with a significance level of P < .05.
RESULTS
Women in the waterbirth (n = 58), water labor (n = 61), and neither (n = 111) groups were primarily white, married, and college educated and did not differ by age or education. Women in the waterbirth group were more likely to be multiparous. Nulliparous women who had a waterbirth had a significantly shorter second stage of labor than nulliparous women who did not have a waterbirth (P = .03). The most commonly cited reasons for discontinuation of hydrotherapy were maternal choice (42.6%) and need for pain medication (29.5%). Significantly more women in the waterbirth group experienced a postpartum hemorrhage, compared with water labor or neither (n = 5, n = 3, n = 1, respectively; P = .045); there was no difference in related clinical measures. Neonatal outcomes were not significantly different. Maternal satisfaction was high across all groups.
DISCUSSION
The results of this study suggest that waterbirth, attended by qualified intrapartum care providers in hospital settings in the United States, is a reasonable option for low-risk women and their neonates.
Topics: Adult; Choice Behavior; Decision Making; Delivery, Obstetric; Female; Humans; Immersion; Infant, Newborn; Midwifery; Natural Childbirth; Pregnancy; Prenatal Care; Retrospective Studies
PubMed: 31489975
DOI: 10.1111/jmwh.13033 -
Journal of Obstetric, Gynecologic, and... Jul 2023
Topics: Humans; Nursing; Workforce; Education, Nursing, Baccalaureate
PubMed: 37204393
DOI: 10.1016/j.jogn.2023.04.004