Bridging the Gaps Across the Continuum for Pregnant Women at Risk for Preterm Birth

Research objective: to study the use of uterine activity and variables of acceleration capacity (AC) and deceleration capacity (DC) in uterine contractile activity and fetal well-being monitoring in women at risk of preterm birth.Materials and methods. 292 pregnant women were included in the prospective study. All involved women underwent ultrasound cervicometry at 16 weeks. 124 pregnant women with a “short cervix” of the III (main) group were observed in the dynamics, as well as uterine activity and fetal AC/DC at 26, 32 and 38 weeks of gestation, and during labor were studied. In 112 women of group II the variables of fetal AC/DC were detected at these terms of pregnancy. They were monitored via conventional cardiotocography during labor. 56 pregnant women in group I with normal cervicometry were monitored.Results. Sensitivity and specificity of the diagnosis of the threatened preterm birth in the main group was 97.30% and 94.74% respectively. Diagnostic accuracy in the case of uterine activity according to fetal non-invasive electrocardiography was 96.18%. Sensitivity and specificity of the diagnosis of the threatened preterm birth in the comparison group were significantly lower: 89.29% and 87.80% respectively. The diagnostic accuracy was 88.41%.Patients in all clinical groups at 26 weeks had low AC/DC values. However, later in women of group I was found highest AC/DC level. AC/DC values in patients with risk of preterm birth were reduced compared with controls (p < 0.05). Sensitivity and specificity of the diagnosis of fetal distress if AC/DC was used were 91.67% and 99.12% respectively. Diagnostic accuracy of the test was 98.41%. In the comparison group the sensitivity was 77.78%, and the specificity was 89.22%. Diagnostic accuracy of intranatal cardiotocography was 86.82%.Conclusions. Uterine activity extracted from the maternal abdominal signal can significantly improve the diagnosis of the threatenedpreterm delivery. Patients at risk of preterm birth have a delayed fetal neurological, which leads to fetal distress. AC/DC variables obtained via fetal non-invasive electrocardiography allow increasing the accuracy of fetal distress diagnosis.

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Experiences of interactive ultrasound examination among women at risk of preterm birth: a qualitative study

BMC Pregnancy and Childbirth ◽

10.1186/s12884-019-2493-2 ◽

2019 ◽

Vol 19 (1) ◽

Cited By ~ 1

Author(s):

Henrika Pulliainen ◽

Hannakaisa Niela-Vilén ◽

Eeva Ekholm ◽

Sari Ahlqvist-Björkroth

Keyword(s):

At Risk ◽

Preterm Birth ◽

Qualitative Study ◽

Pregnant Women ◽

Ultrasound Examination ◽

Structured Interview ◽

Psychological Support ◽

University Hospital ◽

Singleton Pregnancy ◽

4D Ultrasound

Abstract Background Pregnant women who are at risk of preterm birth are often stressed, anxious and depressed because of worries and fears related to the health of the unborn baby, their own health and uncertainty about the future. Only a few studies have assessed the types of psychological support that would relieve these stress symptoms among women with high-risk pregnancies. The aim of this study was to describe 1) how women at risk of preterm birth experienced an interactive 3/4-dimensional (3/4D) ultrasound examination, and 2) their need for psychological support during the antenatal period. Methods This qualitative study was conducted at one university hospital in Finland in 2017. Women with a singleton pregnancy of 26–32 gestational weeks (gwks) were included in the study. The interactive 3/4D ultrasound included a joint observation of the baby, based on the mother’s wishes, with an obstetrician and psychologist. After the examination, the experiences were explored with a semi-structured interview. The data was analyzed using inductive thematic analysis. Results The women enjoyed the fact that the staff were focused on her fetus and genuinely present during the session and also enabled the women to actively participate. Watching the baby and her/his activities made the baby more concrete and relieved their concerns. The need for additional psychological support varied individually. Conclusions Interactive ultrasound examination is an interesting way to awaken mental images, increase attachment, and reduce stress. The results imply that an interactive way of jointly looking at the fetus supports pregnant women at risk of preterm birth and may be useful in clinical practice.

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Mobile applications for prematurity: a systematic review protocol

BMJ Paediatrics Open ◽

10.1136/bmjpo-2021-001183 ◽

2021 ◽

Vol 5 (1) ◽

pp. e001183

Author(s):

Malihe Sadeghi ◽

Mehdi Kahouei ◽

Shahrbanoo Pahlevanynejad ◽

Ali Valinejadi ◽

Marjan Momeni ◽

...

Keyword(s):

Systematic Review ◽

At Risk ◽

Preterm Birth ◽

Health Outcomes ◽

Pregnant Women ◽

Premature Infants ◽

Mobile Applications ◽

Mobile Application ◽

Health Concern ◽

Cochrane Library

BackgroundPremature birth is a global epidemic of significant public health concern. Counselling and education of pregnant women at risk of preterm birth or mothers with premature infants are essential to improve mother and infant health. Mobile applications are an increasingly popular tool among parents to receive health information and education. This study aims to evaluate the usages and the effects of a mobile application designed for premature births in order to improve health outcomes.MethodsThis review will include all studies of different designs which evaluated the use and impact of interventions provided via mobile applications on pregnant women at risk of preterm birth or mothers with premature infants in order to address all health outcomes. A combination of keywords and MeSH(Medical Subject Headings) terms is used in the search strategy. Literature databases including Scopus, PubMed, ISI Web of Science, ProQuest, CINAHL and Cochrane Library will be searched to May 2021. Furthermore, eligible studies will be chosen from the reference list of retrieved papers. Two researchers will independently review the retrieved citations to decide whether they meet the inclusion criteria. Mixed Methods Appraisal Tool (MMAT) V.2018 will be used to assess the quality of studies. Relevant data are collected in a data extraction form and analysed. Results are reported under the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines.DiscussionThis systematic review will recognize and combine evidence about the usages and impact of mobile application interventions on the health improvement of pregnant women at risk of preterm birth or mothers with premature infants.

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