Routine antenatal care for women and their babies: summary of NICE guidance

Current empirical evidence suggests that successful adoption of eHealth systems improves maternal health outcomes, yet there are still existing gaps in adopting such systems in Uganda. Service delivery in maternal health is operating in a spectrum of inadequacy, hence eHealth adoption cannot ensue. This study set out to explore the challenges that impede eHealth adoption in women's routine antenatal care practices in Uganda. A qualitative approach using semi-structured interviews was employed to document challenges. These challenges were classified based on a unified theory of acceptance and use of technology constructs. One hundred and fifteen expectant mothers, aged between 18 and 49 years, who spoke either English or Luganda were included in the study that took place between January to May 2019. Thematic analysis using template analysis was adopted to analyse qualitative responses. Challenges were categorised based on five principal unified theories of acceptance and use of technology constructs namely: performance expectancy, effort expectancy, social influence, facilitating conditions and behavioural intention. Facilitating conditions had more influence on technology acceptance and adoption than the other four constructs. Specifically, the lack of training prior to using the system, technical support, computers and smart phones had a downhill effect on adoption. Subsequently, the cost of data services, internet intermittency, and the lack of systems that bridge the gap between mothers and health providers further hindered technology uptake. In conclusion, strategies such as co-development, training end-users, garnering support at the national and hospital levels should be advocated to improve user acceptance of technology.

Download Full-text

Effect of utilizing developed gestational diabetes mellitus guideline on pregnancy and childbirth outcomes

Clinical Nursing Studies ◽

10.5430/cns.v9n1p15 ◽

2020 ◽

Vol 9 (1) ◽

pp. 15

Author(s):

Enas Sabry Fathy Elbeltagy ◽

Nahed Fikry Hassan Khedr ◽

Nadia Youssef Ahmed Abd-Ella

Keyword(s):

Diabetes Mellitus ◽

Gestational Diabetes ◽

Gestational Diabetes Mellitus ◽

Antenatal Care ◽

Pregnant Women ◽

Pregnancy Outcomes ◽

Lifestyle Changes ◽

Neonatal Complications ◽

Pregnancy And Childbirth ◽

Routine Antenatal Care

Background: Gestational Diabetes Mellitus (GDM) is one of the most common medical health problems that may happen during pregnancy and may lead to a range of short and long-term maternal, fetal as well as neonatal complications. However, effective management and education on GDM self-care measures improve pregnancy outcomes for both women and their neonates.Aim: The study was carried out to evaluate the effect of utilizing developed gestational diabetes mellitus guideline on pregnancy and childbirth outcomes.Methods: A quasi-experimental research design was used at Antenatal Clinic of Obstetric and Gynecological Specialty Center at Mansoura University Hospitals, Mansoura city. A purposive sample of 126 pregnant women diagnosed with GDM, assigned to the intervention group (n = 63) who utilized the Gestational Diabetes Mellitus Guideline (GDMG) of care in addition to routine antenatal care and control group (n = 63) who followed routine antenatal care only. Tools: Three tools were used to collect data from participants as A structured interview schedule, maternal assessment record and fetal & neonatal assessment record.Results: The current study findings indicated that, there was a highly statistical significant reduction of body mass index and the mean random blood glucose levels at 34 & 37 weeks’ of pregnancy after intervention in the GDMG group than control groups (p < .001). Also, there was a statistical significant reduction in the occurrence of maternal complications as gestational hypertension, preeclampsia, preterm labor and polyhydramnios in the GDMG group .Similarly, the neonates of the GDMG group had better Apgar scores after birth & lower incidence for developing neonatal complications as prematurity, respiratory distress syndrome and NICU admission.Conclusions and Recommendations: This study showed that, pregnant women with GDM who utilized the GDMG had better maternal & neonatal outcomes than those who did not utilize it. It is recommended to provide a manual GDMG to all pregnant women with GDM for better lifestyle changes & maintaining self-management regimen as well as better pregnancy outcomes.

Download Full-text

Current practice and attitudes towards vaccination during pregnancy: a survey of GPs across England

British Journal of General Practice ◽

10.3399/bjgp20x708113 ◽

2020 ◽

Vol 70 (692) ◽

pp. e179-e185

Author(s):

Christopher R Wilcox ◽

Paul Little ◽

Christine E Jones

Keyword(s):

Antenatal Care ◽

Influenza Vaccination ◽

Pregnant Women ◽

Odds Ratio ◽

Online Survey ◽

Current Practice ◽

Optimal Location ◽

Further Education ◽

Survey Questionnaire ◽

Routine Antenatal Care

BackgroundAntenatal vaccines are commonly delivered in primary care, yet the views of GPs regarding these programmes have been neglected in research to date.AimTo establish the attitudes and current practice of GPs towards antenatal vaccination and their views on the optimal location for delivery of this service.Design and settingA multicentre online survey questionnaire.MethodA questionnaire was sent to GPs across England between December 2018 and January 2019.ResultsThe majority of 1586 responders considered antenatal vaccination safe (96% for influenza, 89% pertussis). GPs were significantly less confident in their knowledge of pertussis compared with influenza vaccination (64% versus 80% were confident, P<0.001), and many desired further education (59% versus 48%, P<0.001). Few (37%) discussed vaccination with pregnant women regularly, but most (80%) felt their recommendation would influence decision making. Those with greater confidence in their knowledge of pertussis and influenza vaccination, and who were >2 years since qualifying, discussed vaccination significantly more often (odds ratio [OR] 3.52, P<0.001; OR 2.34, P = 0.001; OR 1.76, P = 0.003, respectively), regardless of whether they routinely saw pregnant women. Most (83%) reported that antenatal vaccination was GP led in their region, yet only 26% thought it should be primarily GP based. GPs expressed disconnect from antenatal care, and many suggested that midwives and/or secondary care should take greater responsibility for the delivery of antenatal vaccination.ConclusionThere is support among GPs to embed vaccination programmes within routine antenatal care. Further educational resources, specifically designed for the needs of GPs, are needed to facilitate opportunistic discussion with pregnant women about vaccination.

Download Full-text

Weighing as part of your care: a feasibility study exploring the re-introduction of weight measurements during pregnancy as part of routine antenatal care

BMC Pregnancy and Childbirth ◽

10.1186/s12884-020-03011-w ◽

2020 ◽

Vol 20 (1) ◽

Author(s):

V. Allen-Walker ◽

A. J. Hunter ◽

V. A. Holmes ◽

M. C. McKinley

Keyword(s):

Antenatal Care ◽

Feasibility Study ◽

Routine Antenatal Care

Download Full-text

Developing measures for WHO recommendations on antenatal care for a positive pregnancy experience: a conceptual framework and scoping review

BMJ Open ◽

10.1136/bmjopen-2018-024130 ◽

2019 ◽

Vol 9 (4) ◽

pp. e024130 ◽

Cited By ~ 3

Author(s):

Samantha R Lattof ◽

Özge Tunçalp ◽

Allisyn C Moran ◽

Maurice Bucagu ◽

Doris Chou ◽

...

Keyword(s):

Antenatal Care ◽

Conceptual Framework ◽

Scoping Review ◽

Clinical Practices ◽

Women's Voices ◽

Scoping Reviews ◽

Assess Quality ◽

Meta Analyses ◽

Routine Antenatal Care

ObjectivesIn response to the newest WHO recommendations on routine antenatal care (ANC) for pregnant women and adolescent girls, this paper identifies the literature on existing ANC measures, presents a conceptual framework for quality ANC, maps existing measures to specific WHO recommendations, identifies gaps where new measures are needed to monitor the implementation and impact of routine ANC and prioritises measures for capture.MethodsWe conducted searches in four databases and five websites. Searches and application of inclusion/exclusion criteria followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses flow approach for scoping reviews. Data were extracted on measure information, methodology, methodological work and implementation. We adapted and refined a conceptual framework for routine ANC based on these measures.ResultsThis scoping review uncovered 58 resources describing 46 existing measures that align with WHO recommendations and good clinical practices for ANC. Of the 42 WHO-recommended ANC interventions and four good clinical practices included in this scoping review, only 14 WHO-recommended interventions and three established good clinical practices could potentially be measured immediately using existing measures. Recommendations addressing the integration of ANC with allied fields are likelier to have existing measures than recommendations that focus on maternal health. When mapped to our conceptual framework, existing measures prioritise content of care and health systems; measures for girls’ and women’s experiences of care are notably lacking. Available data sources for non-existent measures are currently limited.ConclusionOur research updates prior efforts to develop comprehensive measures of quality ANC and raises awareness of the need to better assess experiences of ANC. Given the inadequate number and distribution of existing ANC measures across the quality of care conceptual framework domains, new standardised measures are required to assess quality of routine ANC. Girls’ and women’s voices deserve greater acknowledgement when measuring the quality and delivery of ANC.

Download Full-text