A Prospective Study of the Relationship Between Sleep Quality and Depression in Pregnancy

Objective Poor sleep and depression are common problems during pregnancy, but there has been little investigation into the association between them. This prospective study aims to examine the relationship between sleep quality and depression during pregnancy. Methods Pregnant women under 14 weeks’ gestation attending routine outpatient antenatal care in Singapore’s largest maternity hospital were recruited between 2012 and 2014. Women with multiple pregnancies and deemed at high risk of miscarriage were excluded. Six hundred and forty participants completed the Pittsburgh Sleep Quality Index (PSQI) and Edinburgh Postnatal Depression Scale (EPDS) at the three trimesters during pregnancy. Results Mean PSQI score was highest in the third visit, suggesting poorer quality sleep in the late third trimester compared to other trimesters. 15.6% of participants at each time point fulfilled the criteria for antenatal depression according to the EPDS cut-off score > 14. PSQI scores were significantly correlated with EPDS scores, and also prospectively predicted EPDS scores in all three trimesters. Conclusion Sleep quality in Singaporean pregnant women was poorest in the third trimester, and was associated with the development of depressive symptoms. With more than 1 in 10 women having antenatal depression, interventions targeting sleep quality might be particularly beneficial.

Frequency and Determinants of Breastfeeding in Greece: A Prospective Cohort Study during the COVID-19 Pandemic

Breastfeeding is considered to be the cornerstone of child health. In Europe however, overall breastfeeding rates remain low. The present study aimed at estimating the frequency of breastfeeding in Greece during the COVID-19 pandemic period and comparing findings with the latest national study in order to identify a potential impact of the pandemic. Additionally, possible correlations of socio-cultural and demographic characteristics with breastfeeding indicators were investigated. This prospective cohort study included 847 women from five tertiary maternity hospitals, between January and December 2020. Data were collected by a structured questionnaire via interview during hospitalization and via telephone in the first, third and sixth month postpartum. Results showed that all breastfeeding indicators improved over the last three years. Full breastfeeding reached 7.2%, contrary to 0.78% of the latest national study at six months postpartum. Employment, marital status, educational level, mode of delivery, type of maternity hospital, body mass index before pregnancy, previous breastfeeding experience of the mother and infant’s birth weight correlated significantly with breastfeeding indicators at different time periods. The COVID-19 pandemic seems to have favorably influenced breastfeeding initiation and duration in Greece due to lockdowns, home confinement and teleworking.

Implementation of evidence-based practices in the perineal pain management in the postpartum period

ABSTRACT Objectives: To implement strategies for managing perineal pain in puerperal women admitted to a public maternity hospital in São Paulo state and to evaluate their compliance with evidence-based practices. Methods: Implementation study using the JBI model conducted with nursing professionals and puerperal women between September and December 2019. Interviews with puerperal women and medical record data were used to audit seven evidence-based criteria. The interventions adopted included a care protocol, professional training, and folder elaboration for puerperal women. Results: Prior to the intervention, deficits in audited practices and obstacles to pain management were identified, which were overcome by the strategies employed. The follow-up audit demonstrated improvements in compliance with best care practices. Conclusion: There was an increase in the criteria compliance evaluated after the implemented strategies, contributing to improving the nursing care results in the perineal pain management based on the best scientific evidence.

Death and dying of newborns and children: relationships between nursing and family according to Travelbee

ABSTRACT Objective: Identify the nursing staff's perception of their relationship with families of newborns and children who are in the process of death and dying. Methods: Qualitative research, carried out in the Neonatal and Pediatric Intensive Care Unit of a public maternity hospital in Rio Grande do Norte, with 17 nursing professionals, through a semi-structured interview. After being transcribed, the data were subjected to Bardin's content analysis and interpreted in the light of the theory of Interpersonal Relations proposed by Travelbee. Results: Four categories emerged from the analysis: "Caring and welcoming people, feelings and stories"; "Reactions in the midst of pain: moving between acceptance and suffering"; "Communication of bad news: challenges and strategies"; "The weight of caring and suffering". Final considerations: Family assistance can be established using Travelbee's principles, as they offer timely theoretical support for nursing actions in the context of the process of death and dying.

Role of Near-Infrared Spectroscopy in Monitoring the Clinical Course of Asphyxiated Neonates Treated with Hypothermia

Objective Hypoxic-ischemic encephalopathy (HIE) affects millions of newborns annually, especially in low-resource settings. Real-time monitoring of hypoxic-ischemic brain damage is urgently needed for assessment of severity and management of neonates with birth asphyxia. Aim of the work is monitoring of near-infrared spectroscopy (NIRS)-measured cerebral regional oxygen saturation (cRSO2) and cerebral fractional tissue oxygen extraction (FTOE) in neonates after birth asphyxia in relation to their clinical course. Study Design Forty asphyxiated-term and near-term neonates with mild to severe HIE admitted at neonatal intensive care unit of Alexandria University Maternity Hospital from March to October 2019, received therapeutic hypothermia (TH) and had continuous NIRS monitoring of cRSO2 for 72 hours. Infants were categorized into HIE with seizing and nonseizing groups, and abnormal and normal magnetic resonance imaging (MRI) groups. Results Clinical seizures (CS) occurred in 15 (37.5%) of HIE neonates and 13.3% of them died (n = 2). In the current study, significantly higher cRSO2 and lower FTOE values were found in the seizing infants as compared with nonseizing group (p < 0.001). NIRS-measured day 2-cRSO2 and day 1-FTOE were associated with CS in newborns with HIE and day 1-cRSO2 and FTOE were associated with abnormal MRI at 1 month of age. cRSO2 values were found to correlate positively with initial Thompson score especially in days 1 and 2. Further, neonates with CS were more likely to have MRI abnormalities at follow-up. Conclusion NIRS measures may highlight differences between asphyxiated neonates who develop CS or later MRI abnormalities and those who do not. Key Points

OVERVIEW OF IMMEDIATE NEW-BORN CHECK-UP

There's proof from maternity hospital-based settings in developing countries that newborn resuscitation education of the staff diminishes new-born deaths from inborn associated events, such as neonatal asphyxia (by 30%), with potential saving 93,700 neonates globally per year by investigating missed attendance of birth clinics or maternity hospitals, together with (up to 192,000) new-born at 90% scope, as it was considering the impact on intrapartum-related neonatal passings. In an arrangement to realize a higher reduction in intrapartum-related newborn passing's, preterm delivery and intrapartum death, a compelling obstetric plan is considered as the most vital intercession and this ought to be complemented with prompt infant care and resuscitation. There is expanding venture in obstetric care, yet to be coordinated by viable execution and supportability of quick infant care and essential newborn resuscitation. Within the private settings, prompt basic care at birth is essential and accessible, even though evaluated by specialists to be of low effects (10% on before delivery and on stillbirths associated with newborn passings). private hospital settingsbased newborn revival may minimise all the reasons of newborn and before delivery deaths, but available information is critical and controversial to directly gauge an effect size from the prove. Future researches ought to endeavour to address impediments distinguished here especially in terms of intercession definitions, plan, comparative control group, outcome identification and subdivision of reasons of stillbirths and neonatal passings. Whereas the available types of evidence for incitement at delivery and neonatal revival are low, mostly since they are regarded as a plan of care, there is adequate and consistent prove of effect. However, such fundamental care stays irregular particularly for the global 60 million home births. Disentangled preparing plan, and effective protocol, low price hardware are presently ac

Pregnancy-related health information behaviour of Estonian women

Purpose This study aims to increase the understanding of the pregnancy-related information behavior (IB) of pregnant women in Estonia. Design/methodology/approach The research involved a quantitative research methodology consisting of a semi-structured questionnaire. Data was collected from pregnant Estonian women through a self-administered Web-based questionnaire using a convenience sampling during the period from January to February 2019. A total of 300 pregnant women answered the questionnaire. The data were analysed using statistical analysis and the results of the study were compared with the results of previous studies. Findings The three topics on which information was most frequently sought were: fetal development, use of medicines during pregnancy and symptoms of pregnancy. The main sources of information were the internet and the midwife. The most reliable and valuable source of information was a midwife. Health-related information was sought mainly because it helped women make decisions related to pregnancy and childbirth. A number of factors facilitate the information seeking process. In addition, widespread access to the internet and technological skills facilitated IB. The following factors hindered the search for information: the controversy and/or ambiguity of information published on the internet and the time spent searching for information. Most women used wearable technologies during pregnancy. Research limitations/implications This study has several limitations. First, the weakness of online surveys is the potential lack of representativeness, as it excludes from the survey those who do not have access to or ability to use the internet for various reasons (Evans and Mathur, 2005; Limbu et al., 2021). Second, as most recruitment for the study took place online, there was a risk that those who did not use the internet could be excluded from the survey. Third, as the questionnaire was also shared in the Facebook news feed by the Women’s Clinic and Maternity Hospital of the East Tallinn Central Hospital, it may be that the respondents recruited through it more often used the support provided by medical professionals. Fourth, due to the volume limits of the study, it is not possible to present all the results of the study on the basis of socio-demographic characteristics and stage of pregnancy. Therefore, the findings cannot be generalized to the broader population and future studies should explore a larger and more representative populations. Practical implications This study will give some useful information to help to improve the services offered for pregnant women in Estonia. Social implications The findings of this study may inform how to better support this target group. Originality/value There is a lack of research in Estonia that focuses on the IB of pregnant women and this research fills this gap.

ANALYSIS OF THE ACTIVITIES OF "VORONEZH MATERNITY HOSPITAL №2" USING THE IDEF METHODOLOGY

Неудовлетворительное состояние здоровья населения страны в целом, ухудшающиеся показатели репродуктивного здоровья женщин лежат в основе тяжелой демографической ситуации. Такое положение в значительной мере обусловлено снижением доступности и качества медицинской помощи. В статье рассматривается деятельность родильного дома с помощью методологии IDEF0, IDEF3, дерева целей, а также проведена оценка его показателей и составлена таблица занятости медицинского персонала. Уровень оказываемой роддомом медицинской помощи напрямую влияет на здоровье рожениц и новорожденных, поэтому строгое наблюдение за его деятельностью и за соответствие всех показателей нормам необходимо. Репродуктивное здоровье женщин имеет высокую демографическую значимость, так как рождающееся потомство определяет здоровье популяции в целом, и социальную обусловленность - зависимость внутриутробного и раннего постнатального развития ребенка от качества жизни и состояния здоровья матери, обеспечивающей благополучие младенца после рождения. Для визуализации структуры организации и понятия целей ее деятельности использовались организационная структура и такой метод системного анализа как дерево целей. Для наглядного представления процессов, протекающих в роддоме, выявления взаимосвязей основных и вспомогательных элементов системы, управления и главных видов ресурсов использовалась общая модель IDEF0 и декомпозиция ее основных блоков. Диаграмма IDEF3 обеспечивает дискретность моделирования процесса, что позволяет контролировать ход выполнения работ. Основной целью моделирования деятельности родильного дома является анализ его показателей и выявление проблем, существующих в его процессах The unsatisfactory state of health of the population of the country as a whole, the deteriorating indicators of the reproductive health of women underlie the difficult demographic situation. This situation is largely due to the decline in the availability and quality of medical care. The article examines the activities of the maternity hospital using the methodology IDEF0, IDEF3, the tree of goals, as well as an assessment of its indicators and compiled a table of the employment of medical personnel. The level of medical care provided by the maternity hospital directly affects the health of women in labor and newborns, therefore, strict monitoring of its activities and the compliance of all indicators with standards is necessary. The reproductive health of women has a high demographic significance, since the offspring being born determines the health of the population as a whole, and social conditioning is the dependence of the intrauterine and early postnatal development of the child on the quality of life and the state of health of the mother, which ensures the well-being of the baby after birth. To visualize the structure of the organization and the concept of the goals of its activities, the organizational structure and such a method of system analysis as the tree of goals were used. To visualize the processes taking place in the maternity hospital, to identify the interrelationships of the main and auxiliary elements of the system, control and main types of resources, the general IDEF0 model and the decomposition of its main blocks were used. The IDEF3 diagram provides discrete process modeling, which allows you to monitor the progress of work. The main purpose of modeling the activities of a maternity hospital is to analyze its indicators and identify problems that exist in its processes. The article examines the activities of the maternity hospital using the methodology IDEF0, IDEF3, the goal tree, as well as an assessment of its indicators and compiled a table of employment of medical personnel. The level of medical care provided by the maternity hospital directly affects the health of women in labor and newborns, therefore, strict monitoring of its activities and compliance with all indicators with standards is necessary. The reproductive health of women has a high demographic significance, since the offspring born determines the health of the population as a whole, and social conditionality - the dependence of the intrauterine and early postnatal development of the child on the quality of life and the state of health of the mother, ensuring the well-being of the baby after birth. To visualize the structure of the organization and the concept of the goals of its activities, the organizational structure and such a method of system analysis as a tree of goals were used. For a visual representation of the processes taking place in the maternity hospital, to identify the interrelationships of the main and auxiliary elements of the system, management and the main types of resources, the general IDEF0 model and the decomposition of its main blocks were used. The main purpose of modeling the activities of a maternity hospital is to analyze its indicators and identify problems existing in its processes

Atrial flutter in newborns

Objective. To describe a case of atrial flutter in a newborn.Results. The child in the maternity hospital was found to have a heart rhythm disorder of the type: atrial flutter, constant form. Examination revealed an atrial septal defect and an increase in the level of natriuretic peptide. Subsequently, the child was diagnosed with atrial flutter, constant form. NK 0-1. Open oval window. Treatment with drugs from the group of antiarrhythmics, antioxidants and cardiac glycosides made it possible to avoid pronounced hemodynamic disorders.Conclusion. The presented case demonstrates that timely diagnosis and medical correction prevent possible complications.