Tolerance of uncertainty: a unifying theme in pregnancy care

BACKGROUND Mobile Health (mHealth) technologies, such as wearable devices and mobile applications have become popular for lifestyle and healthcare support. They have the potential to be beneficial for pregnancy monitoring, in the form of health and well-being tools to facilitate the tracking of health status changes, risks and complications of pregnant women. However, research on understanding clinicians’ and pregnant women’s interests, preferences and requirements for mHealth solutions tailored to pregnancy care is limited. OBJECTIVE This qualitative study aimed to understand clinicians’ and pregnant women’s perceptions on the potential use of mHealth to support the monitoring of health and well-being during pregnancy. METHODS Semi-structured interviews were conducted with four pregnant women, four postnatal women, and thirteen clinicians working in perinatal care. RESULTS Clinicians perceived the potential benefit of mHealth in supporting different levels of health and wellbeing monitoring, risk assessment and care provision in pregnancy care. The majority of women participants were open to the use of wearables and health monitoring devices and were more likely to use these technologies if they knew that clinicians can monitor the data. While some pregnancy-related medical conditions can be suitable for an mHealth model of remote monitoring, there are clinical and technical challenges for introducing mHealth in pregnancy care. Incorporating appropriate health and well-being measures, intelligent detection of abnormalities and tailored information for pregnant women were considered critical. Usability and data privacy were among the concerns of participants. The challenges of getting pregnant women engaged in longitudinal mHealth monitoring, the extra work required for clinicians in monitoring data, and the need for an evidence-based technical solution were highlighted. CONCLUSIONS mHealth technologies, such as wearable sensors, smart health devices and mobile applications capable of supporting the pregnancy journey are emerging. Clinical, technical and practical factors associated with the use of mHealth technologies to monitor health and well-being, as well as strategies for motivating pregnant women and clinicians’ in the use of the technologies need to be carefully considered before the introduction of mHealth pregnancy care routine and practices.

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Abstract P385: Pregnancy Care Must Do More to Meet Women's Social Needs: A Systematic Review of Interventions Addressing the Social Determinants of Health

Circulation ◽

10.1161/circ.141.suppl_1.p385 ◽

2020 ◽

Vol 141 (Suppl_1) ◽

Author(s):

Ana Reyes ◽

Rabih Dahdouh ◽

Precious Akanyirige ◽

Araceli Estrada ◽

Maria R Young ◽

...

Keyword(s):

Pregnant Women ◽

Social Determinants Of Health ◽

Social Determinants ◽

Social Needs ◽

Determinants Of Health ◽

Cochrane Library ◽

Risk Screening ◽

Pregnancy Care ◽

The Social ◽

In Pregnancy

Introduction: Consistent evidence has shown that the social determinants of health (SDoH) play an important role in shaping overall health. As health systems become more focused on improving the health of populations, there is an urgent need for interventions that address upstream factors such as the social determinants of health. Such interventions have not been widely studied and even less work exists in the realm of maternal health. But as maternal and infant mortality remain critical issues, there is great opportunity for the study and development of interventions to address social needs in pregnancy care. Hypothesis: We assessed the hypothesis that most existing interventions addressing the social needs of pregnant women would focus only on identifying social risks, while fewer would connect patients with resources in the community. We expected that most studies would not provide evaluations of effectiveness. Methods: We conducted a database search of MEDLINE, Embase, Cochrane Library, CINAHL, Scopus, and Web of Science to capture literature published between January 1970 and April 2019. A team of reviewers screened titles and abstracts for interventions that were issued in a clinical setting and addressed at least one SDoH as defined by the World Health Organization. Results: Preliminary results revealed 25 studies. All consisted of some form of risk screening and four included a referral process. Interventions addressing intimate partner violence were most numerous followed by psychosocial factors and cigarette smoking. Financial needs were assessed in one study. Eight studies included an evaluation process. Staff carrying out the interventions were primarily research staff, nurse practitioners or nurse midwives. Conclusions: In conclusion, more must be done to connect pregnant women with social resources. As unmet social needs put women at higher risk for poor outcomes in pregnancy, action should be taken to more seamlessly integrate social needs interventions into clinical workflows. Focus should expand beyond traditional social risk screening to capture a wider range of needs including financial stability, housing, and transportation. These are particularly important during pregnancy because adequate prenatal care requires women to be more engaged with the health care system than they would to maintain baseline health.

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Acknowledging and Addressing Allostatic Load in Pregnancy Care

Journal of Racial and Ethnic Health Disparities ◽

10.1007/s40615-020-00757-z ◽

2020 ◽

Author(s):

Kirsten A. Riggan ◽

Anna Gilbert ◽

Megan A. Allyse

Keyword(s):

Allostatic Load ◽

Pregnancy Care ◽

In Pregnancy

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Percutaneous Nephrostomy Tube Placement in Pregnancy: Care of the Mother and Unborn Child

Journal of Radiology Nursing ◽

10.1016/j.jradnu.2016.02.003 ◽

2016 ◽

Vol 35 (2) ◽

pp. 85-96

Author(s):

Ashwani Kumar Sharma ◽

Frederic J. Mis ◽

Thuong D. Vo ◽

Valerie G. Aarne Grossman

Keyword(s):

Percutaneous Nephrostomy ◽

Tube Placement ◽

Unborn Child ◽

Nephrostomy Tube ◽

Pregnancy Care ◽

In Pregnancy

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Chronic lymphocytic leukaemia in pregnancy: a case report and literature review

Obstetric Medicine ◽

10.1258/om.2009.090036 ◽

2009 ◽

Vol 2 (4) ◽

pp. 168-169 ◽

Cited By ~ 1

Author(s):

Cynthia Maxwell ◽

Rosheen Grady ◽

Michael Crump

Keyword(s):

Case Report ◽

Literature Review ◽

Chronic Lymphocytic Leukaemia ◽

Lymphocytic Leukaemia ◽

Rare Condition ◽

Multidisciplinary Care ◽

Pregnancy Care ◽

Active Disease ◽

In Pregnancy

Chronic lymphocytic leukaemia is a rare condition reported in pregnancy. We review a case of a woman presenting for pregnancy care with active disease and review the literature on this condition. This case raises several important issues with regard to managing complex medical diseases such as leukaemia in pregnant women, including the role of multidisciplinary care.

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