scholarly journals Birth plan compliance and its relation to maternal and neonatal outcomes

2017 ◽  
Vol 25 (0) ◽  
Author(s):  
Pedro Hidalgo-Lopezosa ◽  
María Hidalgo-Maestre ◽  
Maria Aurora Rodríguez-Borrego
Keyword(s):  
Analytical Study ◽  
Neonatal Outcomes ◽  
Inclusion Criteria ◽  
High Compliance ◽  
Birth Plan ◽  
Low Degree ◽  
Maternal And Neonatal Outcomes ◽  
Inferential Analysis ◽  
Level Hospital ◽  
Umbilical Cord Ph

ABSTRACT Objective: to know the degree of fulfillment of the requests that women reflect in their birth plans and to determine their influence on the main obstetric and neonatal outcomes. Method: retrospective, descriptive and analytical study with 178 women with birth plans in third-level hospital. Inclusion criteria: low risk gestation, cephalic presentation, single childbirth, delivered at term. Scheduled and urgent cesareans without labor were excluded. A descriptive and inferential analysis of the variables was performed. Results: the birth plan was mostly fulfilled in only 37% of the women. The group of women whose compliance was low (less than or equal to 50%) had a cesarean section rate of 18.8% and their children had worse outcomes in the Apgar test and umbilical cord pH; while in women with high compliance (75% or more), the percentage of cesareans fell to 6.1% and their children had better outcomes. Conclusion: birth plans have a low degree of compliance. The higher the compliance, the better is the maternal and neonatal outcomes. The birth plan can be an effective tool to achieve better outcomes for the mother and her child. Measures are needed to improve its compliance.

Compliance with the principle of autonomy of pregnant women during their childbirth / Cumplimiento del principio de autonomía de las mujeres gestantes durante su parto

2019 ◽  
Vol 68 (1) ◽  
pp. 55-65
Author(s):  
María Dolores Hernández Benítez
Keyword(s):  
Analytical Study ◽  
Inclusion Criteria ◽  
High Compliance ◽  
Risk Pregnancy ◽  
Single Term ◽  
Low Degree ◽  
Term Delivery ◽  
Low Risk Pregnancy ◽  
Inferential Analysis ◽  
Las Mujeres

Objective: to determine the degree of compliance with the requests that women reflect in their birth plans and determine their influence on the main obstetric and neonatal outcomes. Method: retrospective, descriptive and analytical study with 178 women with a delivery plan in third level hospitals. Inclusion criteria: low risk pregnancy, cephalic presentation, single-term delivery. We excluded scheduled and urgent caesarean sections without labor. A descriptive and inferential analysis of the variables was carried out. Results: the delivery plan was fulfilled mostly in only 37% of the women. The group of women where compliance was low (less than or equal to 50%) had a percentage of caesarean sections of 18.8% and their children had worse results in Apgar test and cord pH; while in women with high compliance (75% or greater), the percentage of caesarean sections fell to 6.1% and their children obtained better results. Conclusion: the delivery plan has a low degree of compliance. The greater the compliance, the better the maternal and neonatal results. It can be an effective tool in achieving better results in the mother and her child. Measures are needed to improve the degree of compliance. ---------- Objetivo: conocer el grado de cumplimiento de las solicitudes que las mujeres reflejan en sus planes de parto y determinar su influencia en los principales resultados obstétricos y neonatales. Método: estudio retrospectivo, descriptivo y analítico con 178 mujeres con plan de parto en hospitales de tercer nivel. Criterios de inclusión: gestación bajo riesgo, presentación cefálica, parto único a término. Se excluyeron cesáreas programadas y urgentes sin trabajo de parto. Se realizó un análisis descriptivo e inferencial de las variables. Resultados: el plan de parto se cumplió mayoritariamente solo en el 37% de las mujeres. El grupo de mujeres donde el cumplimiento fue bajo (menor o igual al 50%) tuvo un porcentaje de cesáreas del 18,8% y sus hijos tuvieron peores resultados en test de Apgar y pH de cordón; mientras que en mujeres con cumplimiento alto (75% o mayor), el porcentaje de cesáreas cayó al 6,1% y sus hijos obtuvieron mejores resultados. Conclusión: el plan de parto tiene un grado de cumplimiento bajo. A mayor cumplimiento mejores son los resultados maternos y neonatales. Puede constituir una herramienta eficaz en la consecución de mejores resultados en la madre y su hijo. Son necesarias medidas que mejoren su grado de cumplimiento.

scholarly journals Resultados obstétricos e neonatais de partos assistidos

2018 ◽  
Vol 12 (4) ◽  
pp. 832 ◽  
Author(s):  
Régia Christina Moura Barbosa Castro ◽  
Clarice Mendes De Freitas ◽  
Ana Kelve De Castro Damasceno ◽  
Cinthia Maria Gomes Da Costa Escoto Esteche ◽  
Tatiane Da Silva Coelho ◽  
...  
Keyword(s):  
Retrospective Study ◽  
Pain Relief ◽  
Scientific Evidence ◽  
Neonatal Outcomes ◽  
Normal Birth ◽  
Skin Contact ◽  
Maternal And Neonatal Outcomes ◽  
Inferential Analysis ◽  
Quantitative Descriptive ◽  
Skin To Skin

RESUMOObjetivo: avaliar resultados obstétricos e neonatais de partos assistidos. Metodo: estudo quantitativo, descritivo, retrospectivo, com parturientes assistidas pelas enfermeiras residentes. Os dados foram coletados a partir das informações referentes aos partos, anotadas no livro de registro, analisados no SPSS, versão 20.0, agrupados em tabelas e submetidos à análise descritiva e numérica inferencial. Resultados: as enfermeiras residentes assistiram 147 partos de parturientes com faixa etária entre 20 e 24 anos e 44,9% eram nulíparas. Destas, 43 tiveram períneo íntegro após o parto; 61 apresentaram laceração de primeiro grau; 38, de segundo grau e cinco, de terceiro grau. O índice de episiotomia foi de 4,8%. Os métodos não farmacológicos de alívio da dor mais utilizados durante o trabalho de parto foram a respiração, o banho de aspersão e a massagem. Todos os recém-nascidos tiveram Apgar no quinto minuto igual ou maior que sete e 93,2% deles foram colocados em contato pele a pele com a mãe. Conclusão: os resultados maternos e neonatais foram favoráveis demonstrando que o programa de residência em Enfermagem Obstétrica se norteia nas evidências científicas e resulta em menos intervenções no processo de parturição. Descritores: Parto Normal; Enfermagem Obstétrica; Parto Humanizado; Enfermeiras; Recém-Nascido; Gestação. ABSTRACTObjective: to evaluate obstetric and neonatal outcomes of assisted births. Method: quantitative, descriptive, retrospective study with parturients assisted by resident nurses. The data were collected from the information about the births, recorded in the registry book, analyzed in SPSS, version 20.0, grouped in tables and submitted to descriptive and numerical inferential analysis. Results: resident nurses attended 147 births of parturients aged between 20 and 24 years and 44.9% were nulliparous. Of these, 43 had intact perineum after delivery; 61 presented first degree laceration; 38, of second degree and five, of third degree. The episiotomy index was 4.8%. The non-pharmacological methods of pain relief most used during labor were breathing, bathing, and massage. All newborns had Apgar in the fifth minute equal to or greater than seven and 93.2% of them were placed in skin-to-skin contact with the mother. Conclusion: maternal and neonatal outcomes were favorable, demonstrating that the Obstetric Nursing residency program is based on scientific evidence and results in fewer interventions in the parturition process. Descriptors: Normal Birth; Obstetric Nursing; Humanized Birth; Nurses; Newborn; Pregnancy.RESUMENObjetivo: evaluar resultados obstétricos y neonatales de partos asistidos. Método: estudio cuantitativo, descriptivo, retrospectivo, con parturientas asistidas por las enfermeras residentes. Los datos fueron recolectados a partir de las informaciones referentes a los partos, anotadas en el libro de registro, analizados en el SPSS, versión 20.0, agrupados en tablas y sometidos al análisis descriptivo y numérico inferencial. Resultados: las enfermeras residentes asisteron 147 partos por las enfermeras residentes, parturientas con grupo de edad entre 20 y 24 años y 44,9% eran nulíparas. De ellas, 43 tuvieron perineo íntegro después del parto; 61 presentaron laceración de primero grado; 38, de segundo grado y cinco de tercer grado. El índice de episiotomía fue del 4,8%. Los métodos no farmacológicos de alivio del dolor más utilizados durante el trabajo de parto fueron la respiración, el baño de aspersión y masaje. Todos los recién nacidos tuvieron Apgar en el quinto minuto igual o mayor que siete y el 93,2% de ellos fueron puestos en contacto piel a piel con la madre. Conclusión: los resultados maternos y neonatales fueron favorables, demostrando que el programa de residencia en Enfermería Obstétrica se basa en las evidencias científicas y resultando en menos intervenciones en el proceso de alumbramiento. Descriptores: Parto Normal; Obstétrica de Enfermería; Parto Humanizado; Enfermera; Recién Nacido; Embarazo.

scholarly journals Maternal and Neonatal Outcomes Associated with Amniotomy among Nulliparous Women Undergoing Labor Induction at Term

2020 ◽  
Author(s):  
Ashley N. Battarbee ◽  
Grecio Sandoval ◽  
William A. Grobman ◽  
Uma M. Reddy ◽  
Alan T.N. Tita ◽  
...  
Keyword(s):  
Cesarean Delivery ◽  
Labor Induction ◽  
Neonatal Outcomes ◽  
Inclusion Criteria ◽  
Time Intervals ◽  
Lower Odds ◽  
Neonatal Complications ◽  
Nulliparous Women ◽  
Maternal And Neonatal Outcomes ◽  
Term Labor

Abstract Objective The aim of the study is to evaluate the association between amniotomy at various time points during labor induction and maternal and neonatal outcomes among term, nulliparous women. Study Design Secondary analysis of a randomized trial of term labor induction versus expectant management in low-risk, nulliparous women (2014–2017) was conducted. Women met inclusion criteria if they underwent induction ≥38 weeks' gestation using oxytocin with documented time and type of membrane rupture. Women with antepartum stillbirth or fetal anomaly were excluded. The primary outcome was cesarean delivery. Secondary outcomes included maternal and neonatal complications. Maternal and neonatal outcomes were compared among women with amniotomy versus women with intact membranes and no amniotomy at six 2-hour time intervals: before oxytocin initiation, 0 to <2 hours after oxytocin, 2 to <4 hours after, 4 to <6 hours after, 6 to <8 hours after, and 8 to <10 hours after. Multivariable logistic regression adjusted for maternal age, body mass index, race/ethnicity, modified Bishop score on admission, treatment group, and hospital (as a random effect). Results Of 6,106 women in the parent trial, 2,854 (46.7%) women met inclusion criteria. Of these 2,340 (82.0%) underwent amniotomy, and majority of the women had amniotomy performed between 2 and <6 hours after oxytocin. Cesarean delivery was less frequent among women with amniotomy 6 to <8 hours after oxytocin compared with women without amniotomy (21.9 vs. 29.7%; adjusted odds ratio 0.61, 95% confidence interval 0.42–0.89). Amniotomy at time intervals ≥4 hours after oxytocin was associated with lower odds of labor duration >24 hours. Amniotomy at time intervals ≥2 hours and <8 hours after oxytocin was associated with lower odds of maternal hospitalization >3 days. Amniotomy was not associated with postpartum or neonatal complications. Conclusion Among a contemporary cohort of nulliparous women undergoing term labor induction, amniotomy was associated with either lower or similar odds of cesarean delivery and other adverse outcomes, compared with no amniotomy.

Advanced Maternal Age and Adverse Maternal and Neonatal Outcomes in Pregnant Women

2020 ◽  
Vol 16 ◽  
Author(s):  
Reza Omani-Samani ◽  
Saman Maroufizadeh ◽  
Nafise Saedi ◽  
Nasim Shokouhi ◽  
Arezoo Esmailzadeh ◽  
...  
Keyword(s):  
Birth Weight ◽  
Preterm Birth ◽  
Low Birth Weight ◽  
Cesarean Section ◽  
Pregnant Women ◽  
Maternal Age ◽  
Unwanted Pregnancy ◽  
Advanced Maternal Age ◽  
Neonatal Outcomes ◽  
Maternal And Neonatal Outcomes

Background: Advanced maternal age is an important predictor for maternal and neonatal outcomes such as maternal mortality, low birth weight, stillbirth, preterm birth, cesarean section and preeclampsia. Objective: To determine the association of advanced maternal age and adverse maternal and neonatal outcomes in Iranian pregnant women. Methods: In this hospital-based cross-sectional study, 5117 pregnant women from 103 hospitals in Tehran, Iran, were participated in the study in 2015. The required data were gathered from hospitals which equipped to the department of obstetrics and gynecology. Advanced maternal age was considered as an independent variable and unwanted pregnancy, preeclampsia, preterm birth, cesarean section and low birth weight were considered as interested outcomes. Results: In our study, the prevalence of advanced maternal age was 12.08%. Advanced maternal age was significantly associated with higher risk of unwanted pregnancy (OR: 1.39, 95% CI: 1.12-1.73), preterm birth (OR: 1.75, 95% CI: 1.28- 2.39) and cesarean section (OR: 1.34, 95% CI: 1.03-1.74). In our study, there was no significant relationship between advanced maternal age and preeclampsia but this relationship could be clinically important (OR: 1.48, 95% CI: 0.99-2.20, P=0.052), and there is no significant relationship between advanced maternal age and low birth weight (OR: 1.08, 95% CI: 0.67-1.74, P=0.736). Conclusion: Advanced maternal age is associated with higher risk of unintended pregnancy, preterm birth and cesarean section but our findings did not support advanced maternal age as a risk factor associated with low birth weight.

scholarly journals Characteristics of Pediatric Emergency and Risk Factors for Life-saving Interventions

2021 ◽  
Vol 8 ◽  
pp. 2333794X2199034
Author(s):  
Phatthranit Phattharapornjaroen ◽  
Yuwares Sittichanbuncha ◽  
Pongsakorn Atiksawedparit ◽  
Kittisak Sawanyawisuth
Keyword(s):  
Risk Factors ◽  
Analytical Study ◽  
Pediatric Patients ◽  
Pediatric Emergency ◽  
Limited Data ◽  
Inclusion Criteria ◽  
Resuscitation Room ◽  
Life Saving ◽  
Level 1 ◽  
Triage Level

Pediatric emergency patients are vulnerable population and require special care or interventions. Nevertheless, there is limited data on the prevalence and risk factors for life-saving interventions. This study is a retrospective analytical study. The inclusion criteria were children aged 15 years or under who were triaged as level 1 or 2 and treated at the resuscitation room. Factors associated with LSI were executed by logistic regression analysis. During the study period, there were 22 759 ER visits by 14 066 pediatric patients. Of those, 346 patients (2.46%) met the study criteria. Triage level 1 accounted for 16.18% (56 patients) with 29 patients (8.38%) with LSI. Trauma was an independent factor for LSI with adjusted odds ratio (95% CI) of 4.37 (1.49, 12.76). In conclusion, approximately 8.38% of these patients required LSI. Trauma cause was an independent predictor for LSI.

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