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Heim MA, Makuch MY. Evaluation of a short in-person and online antenatal educational intervention for high-risk pregnant women linked to antenatal consultation. Eur J Midwifery 2024; 8:EJM-8-03. [PMID: 38239277 PMCID: PMC10795506 DOI: 10.18332/ejm/175927] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2022] [Revised: 03/20/2023] [Accepted: 12/27/2023] [Indexed: 01/22/2024] Open
Abstract
INTRODUCTION The aim of this study was to evaluate a short educational intervention that focused on labor pain (through visual analogue scale, VAS), postpartum anxiety, and birthing experience before and during the SARS-CoV-2 (COVID-19) pandemic. METHODS This was a quasi-experimental study conducted between November 2019 and May 2021 in Brazil in 100 women with a high-risk pregnancy in the third trimester of pregnancy with an intervention group with in-person or virtual sessions (during the COVID-19 pandemic) and a non-intervention group. The antenatal intervention included breathing and relaxation techniques, upright positions, and information about labor. For evaluation, an antenatal questionnaire, State-Trait Anxiety Inventory (STAI) and a postpartum questionnaire were used. For data analysis, Student's t-test, chi-squared and Fisher's exact tests, ANOVA, bivariate, and multivariate regression analysis, were used. RESULTS When comparing the women in the intervention group to the non-intervention group, it was observed that the latter group reported higher fear of pain at labor during antenatal consultations (p<0.013); more women needed analgesia at 0-4 cm dilation (17/40) (p<0.018); the duration of labor was ≥12 hours (37/50) (p<0.037); while the intervention reported having a regular, good or excellent labor period (36/50) (p=0.014). The multiple regression analysis for labor pain showed a significant relationship between mode of delivery (cesarean delivery: RR; SE -21.43; 5.32, p<0.001) and labor pain, and good satisfaction with labor (RR; SE -13.86; 6.40, p=0.033). CONCLUSIONS Women from the intervention group had more satisfaction and less pain during labor than women from the non-intervention group.
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Affiliation(s)
- Maria A. Heim
- Department of Obstetrics and Gynecology, University of Campinas Faculty of Medical Sciences, Sao Paulo, Brazil
| | - Maria Y. Makuch
- Department of Obstetrics and Gynecology, University of Campinas Faculty of Medical Sciences, Sao Paulo, Brazil
- Campinas Reproductive Health Research Center, Sao Paulo, Brazil
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Keten Edis E, Kurtgöz A. Care experiences and care expectations of hospitalized high-risk pregnant women: a qualitative study. Women Health 2023; 63:704-712. [PMID: 37758687 DOI: 10.1080/03630242.2023.2262614] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2022] [Accepted: 09/19/2023] [Indexed: 09/29/2023]
Abstract
Gaining insight into the prenatal care experiences and expectations of high-risk pregnant women is crucial for offering holistic care that aligns with their individualized needs. This study aimed at determining the care experiences and expectations of women with high-risk pregnancies. We adopted a descriptive qualitative approach in the research. The data were collected through in-depth interviews between March and June 2022. The participants included 27 high-risk pregnant women selected by purposive sampling. We analyzed the data using inductive content analysis. We utilized the Consolidated Criteria for Reporting Qualitative Research (COREQ) checklist to report data. The participants' ages ranged from 22 to 40 years. The participants' gestational ages ranged from 29 to 38 weeks. We identified three themes, namely "Emotions felt in the course of pregnancy", "Care experiences; satisfaction and dissatisfaction", and "Expectations for ideal care". The findings showed that women experienced fear, stress, and anxiety while expecting supportive, attentive, and understanding care during the course of pregnancy. Our results revealed that high-risk pregnant women have some unmet care needs. Healthcare professionals should strive to provide individualized and holistic care for high-risk pregnant women.
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Affiliation(s)
- Elif Keten Edis
- Department of Nursing, Faculty of Health Sciences, Amasya University, Amasya, Turkey
| | - Aslı Kurtgöz
- Sabuncuoglu Serefeddin Health Services Vocational School, Amasya University, Amasya, Turkey
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Keten Edis E, Bal S. The effect of prenatal anxiety on prenatal attachment in high-risk pregnant women and related factors: a cross-sectional study. Women Health 2023; 63:696-703. [PMID: 37743542 DOI: 10.1080/03630242.2023.2262609] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2022] [Accepted: 09/19/2023] [Indexed: 09/26/2023]
Abstract
High-risk pregnant women experience stress and anxiety. Anxiety may affect prenatal attachment. This study aimed to examine the effect of anxiety on prenatal attachment in high-risk pregnant women. The study was cross-sectional and conducted on 290 high-risk pregnant women who applied to the perinatology outpatient clinic of a university hospital between February and July 2022. The data were collected with the descriptive information sheet, Prenatal Attachment Inventory (PAI), and Perinatal Anxiety Screening Scale (PASS). Mann-Whitney U, Kruskal Wallis-H, and Spearman's Correlation tests were used to analyze the data. The mean age of the examined pregnant women was 28.12 ± 5.36, and most of them were multigravida (65.5 percent) and in the third trimester (80.7 percent). The PAI and PASS mean scores were 64.09 ± 11.31 and 27.98 ± 16.52, respectively. There was a weak positive correlation between anxiety and prenatal attachment (r = .227, p < .001). The levels of prenatal attachment were higher in primigravidas and women with no children. Also, the anxiety levels of pregnant women in the third trimester were lower. Health professionals should evaluate the prenatal attachment and anxiety levels of high-risk pregnant women, and consider obstetrical factors that may influence both prenatal attachment and anxiety levels.
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Affiliation(s)
- Elif Keten Edis
- Department of Nursing Faculty of Health Sciences, Amasya University, Amasya, Turkey
| | - Sümeyye Bal
- Department of Midwifery Faculty of Health Sciences, Ondokuz Mayıs University, Samsun, Turkey
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Pereira AA, Rodrigues ILA, Nogueira LMV, Palmeira IP, Nunes HHDM, de Andrade EGR, da Silva FO. Social representations of pregnant women about high-risk pregnancy: repercussions for prenatal care. Rev Esc Enferm USP 2023; 57:e20220463. [PMID: 37844202 PMCID: PMC10578866 DOI: 10.1590/1980-220x-reeusp-2022-0463en] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2023] [Accepted: 07/20/2023] [Indexed: 10/18/2023] Open
Abstract
OBJECTIVE To analyze the Social Representations of pregnant women about high-risk pregnancy and its repercussions for prenatal care. METHOD Qualitative study, based on the procedural aspect of the Theory of Social Representations, carried out with 62 high-risk prenatal pregnant women at a High Complexity Maternity, in Belém, PA, Brazil. Data from semi-structured interviews were processed by the software Interface de R pour les Analyzes Multidimensionnelles de Textes et de Questionnaires. RESULTS Four categories emerged, in which three dimensions of the Theory composing the genesis of Social Representations are considered: the affective dimension, the biological dimension and the sociocultural dimension. CONCLUSION Affects, negative feelings, and adaptations were revealed, with high-risk pregnancy being represented as an unusual and uncomfortable event, influenced by common sense and science, communication means, and dialogues with health professionals, with family support being considered of paramount importance. and prenatal care a propitious moment for establishing bonds with the health professional, seen as essential for their adherence to the care offered.
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Affiliation(s)
- Alexandre Aguiar Pereira
- Universidade do Estado do Pará, Escola de Enfermagem Magalhães Barata, Programa de Pós-Graduação em Enfermagem, Belém, PA, Brazil
| | - Ivaneide Leal Ataíde Rodrigues
- Universidade do Estado do Pará, Escola de Enfermagem Magalhães Barata, Departamento de Enfermagem Comunitária, Belém, PA, Brazil
| | - Laura Maria Vidal Nogueira
- Universidade do Estado do Pará, Escola de Enfermagem Magalhães Barata, Departamento de Enfermagem Comunitária, Belém, PA, Brazil
| | - Iací Proença Palmeira
- Universidade do Estado do Pará, Escola de Enfermagem Magalhães Barata, Departamento de Enfermagem Comunitária, Belém, PA, Brazil
| | - Heliana Helena de Moura Nunes
- Fundação Santa Casa de Misericórdia do Pará, Programa de Pós-Graduação em Gestão e Saúde na Amazônia, Belém, PA, Brazil
| | - Erlon Gabriel Rego de Andrade
- Universidade do Estado do Pará, Escola de Enfermagem Magalhães Barata, Programa de Pós-Graduação em Enfermagem, Belém, PA, Brazil
| | - Fabiane Oliveira da Silva
- Universidade do Estado do Pará, Escola de Enfermagem Magalhães Barata, Programa de Pós-Graduação em Enfermagem, Belém, PA, Brazil
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Holness N, Barfield L. Mental state, well-being and coping are affected by a high-risk pregnancy. Evid Based Nurs 2023; 26:136. [PMID: 37248028 DOI: 10.1136/ebnurs-2022-103687] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/15/2023] [Indexed: 05/31/2023]
Affiliation(s)
- Nola Holness
- Undergraduate Nursing, Florida International University, Miami, Florida, USA
| | - Latisha Barfield
- Undergraduate Nursing, Florida International University, Miami, Florida, USA
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Javadifar N, Tadayon M, Dastoorpoor M, Shahbazian N. "Living in a vacuum": Lived experiences of maternal near-miss among women with placenta accreta spectrum. J Reprod Infant Psychol 2023:1-14. [PMID: 37158037 DOI: 10.1080/02646838.2023.2211595] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/10/2023]
Abstract
BACKGROUND Placenta accreta spectrum (PAS) is one of the life-threatening complications of pregnancy, the prevalence of which has increased in parallel with the caesarean section rate. OBJECTIVE The purpose of this study was to investigate the experiences of mothers with PAS who have also experienced maternal near miss. METHODS The participants of this study included 8 mothers who had experienced near miss due to placenta accreta during the past year, as well as two husbands and two health care professionals. Data collection was done using face-to-face, in-depth virtual and in-person interviews. In this qualitative study, the interpretive phenomenological analysis approach was used to analyse the data. RESULTS The superordinate theme that emerged from the lived experiences of the studied mothers is 'Living in a vacuum', which was derived from 3 main themes. The theme of 'distorted identity' is related to the mothers' experience of losing the uterus as a symbol of femininity and nostalgia for the former self. The theme of 'exacerbated exhaustion' indicates the burnout and fatigue perceived by these mothers and has dimensions far beyond the exhaustion caused by performing parenting duties. The third theme, 'a threatened future', reflects these mothers' vague image of the future in terms of health, preservation of life, and the continuation of living together with the husband. CONCLUSIONS It seems that mothers with PAS need to be covered by integrated and well-organised psycho-social support from the time they are diagnosed with the complication until long after delivery due to the high potentiality of maternal near miss.
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Affiliation(s)
- Nahid Javadifar
- Reproductive Health Promotion Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Mitra Tadayon
- Reproductive Health Promotion Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Maryam Dastoorpoor
- Department of Epidemiology, Menopause- Andropause Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Nahid Shahbazian
- Fertility, Infertility and Perinatology Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
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Jackson K, Erasmus E, Mabanga N. Fatherhood and high-risk pregnancy: a scoping review. BMC Pregnancy Childbirth 2023; 23:168. [PMID: 36922778 PMCID: PMC10018843 DOI: 10.1186/s12884-023-05422-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2022] [Accepted: 02/02/2023] [Indexed: 03/18/2023] Open
Abstract
BACKGROUND The experience of expectant parenthood is commensurate of relative angst and nervousness albeit one of overall excitement and joy. However, when the pregnancy is regarded as high-risk, this experience changes dramatically for both parents. While literature on high-risk pregnancies is gaining traction, the focus is predominantly on the mother's experiences and therefore, a paucity exists in exploring the father's experiences of a high-risk pregnancy. This study aimed to determine the current extent of literature focusing on father's experiences of a high-risk pregnancy using a scoping review methodology. METHOD Nine databases were reviewed using the EBSCOHost metadatabase: Academic Search Complete; APA PsychArticles; CINAHL Plus with full-text; Health Source: Nursing/Academic Edition; MasterFILE Premier; MasterFILE Reference eBook Collection; MEDLINE; SocINDEX with full-text; and eBook Collection. Data was extracted according to the following headings: Authors (including the year of publication); aim of the study; research context; research design; sample characteristics; and key findings. RESULTS Fifteen studies were included in this review. A narrative synthesis was applied within which 4 key themes emerged from the data: (1) The father versus the healthcare professional and the hospital environment; (2) The impact of high-risk pregnancies on fathers; (3) Redefining the role of 'father' after experiencing high-risk pregnancy and (4) Focus on fathers: Recommendations for support during high-risk pregnancies. CONCLUSION The findings of this study highlights the importance of the inclusion of men and fathers in supporting both his partner and (un)born child. The findings further illustrated the long-lasting impact of trauma felt by men which constrained his ability to support his family. A family-centred approach is needed to further support the family and the impact of a high-risk pregnancy on all members within the family unit.
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Affiliation(s)
- Kyle Jackson
- Department of Psychology, University of the Western Cape, Robert Sobukwe Rd, Cape Town, 7535, South Africa.
| | - Erika Erasmus
- Department of Psychology, University of the Western Cape, Robert Sobukwe Rd, Cape Town, 7535, South Africa
| | - Ntobizodwa Mabanga
- Department of Psychology, University of the Western Cape, Robert Sobukwe Rd, Cape Town, 7535, South Africa
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Kittleson MM, DeFilippis EM, Bhagra CJ, Casale JP, Cauldwell M, Coscia LA, D'Souza R, Gaffney N, Gerovasili V, Ging P, Horsley K, Macera F, Mastrobattista JM, Paraskeva MA, Punnoose LR, Rasmusson KD, Reynaud Q, Ross HJ, Thakrar MV, Walsh MN. Reproductive health after thoracic transplantation: An ISHLT expert consensus statement. J Heart Lung Transplant 2023; 42:e1-e42. [PMID: 36528467 DOI: 10.1016/j.healun.2022.10.009] [Citation(s) in RCA: 10] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2022] [Accepted: 10/10/2022] [Indexed: 11/16/2022] Open
Abstract
Pregnancy after thoracic organ transplantation is feasible for select individuals but requires multidisciplinary subspecialty care. Key components for a successful pregnancy after lung or heart transplantation include preconception and contraceptive planning, thorough risk stratification, optimization of maternal comorbidities and fetal health through careful monitoring, and open communication with shared decision-making. The goal of this consensus statement is to summarize the current evidence and provide guidance surrounding preconception counseling, patient risk assessment, medical management, maternal and fetal outcomes, obstetric management, and pharmacologic considerations.
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Affiliation(s)
- Michelle M Kittleson
- Department of Cardiology, Smidt Heart Institute, Cedars-Sinai Medical Center, Los Angeles, California.
| | - Ersilia M DeFilippis
- Division of Cardiology, New York Presbyterian-Columbia University Irving Medical Center, New York, New York
| | - Catriona J Bhagra
- Department of Cardiology, Cambridge University and Royal Papworth NHS Foundation Trusts, Cambridge, UK
| | - Jillian P Casale
- Department of Pharmacy Services, University of Maryland Medical Center, Baltimore, Maryland
| | - Matthew Cauldwell
- Department of Obstetrics, Maternal Medicine Service, St George's Hospital, London, UK
| | - Lisa A Coscia
- Transplant Pregnancy Registry International, Gift of Life Institute, Philadelphia, Pennsylvania
| | - Rohan D'Souza
- Division of Maternal and Fetal Medicine, Department of Obstetrics and Gynecology, McMaster University, Hamilton, Ontario, Canada
| | - Nicole Gaffney
- Lung Transplant Service, Alfred Hospital, Melbourne, Australia; Department of Medicine, Central Clinical School, Monash University, Melbourne, Australia
| | | | - Patricia Ging
- Department of Pharmacy, Mater Misericordiae University Hospital, Dublin, Ireland
| | - Kristin Horsley
- Department of Obstetrics and Gynecology, McMaster University, Hamilton, Ontario, Canada
| | - Francesca Macera
- De Gasperis Cardio Center and Transplant Center, Niguarda Hospital, Milan, Italy; Dept of Cardiology, Cliniques Universitaires de Bruxelles - Hôpital Erasme, Brussels, Belgium
| | - Joan M Mastrobattista
- Department of Obstetrics & Gynecology, Division of Maternal-Fetal Medicine, Baylor College of Medicine Houston, Texas
| | - Miranda A Paraskeva
- Lung Transplant Service, Alfred Hospital, Melbourne, Australia; Department of Medicine, Central Clinical School, Monash University, Melbourne, Australia
| | - Lynn R Punnoose
- Vanderbilt Heart and Vascular Institute, Vanderbilt University Medical Center, Nashville, Tennessee
| | | | - Quitterie Reynaud
- Cystic Fibrosis Adult Referral Care Centre, Department of Internal Medicine, Hospices civils de Lyon, Pierre Bénite, France
| | - Heather J Ross
- Peter Munk Cardiac Centre of the University Health Network, Toronto, Ontario, Canada; Ted Rogers Centre for Heart Research, Toronto, Ontario, Canada; University of Toronto, Toronto, Ontario, Canada
| | - Mitesh V Thakrar
- Department of Medicine, Division of Respirology, University of Calgary, Calgary, Alberta, Canada
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Tetruashvili N, Domar A, Bashiri A. Prevention of Pregnancy Loss: Combining Progestogen Treatment and Psychological Support. J Clin Med 2023; 12:jcm12051827. [PMID: 36902614 PMCID: PMC10003391 DOI: 10.3390/jcm12051827] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2022] [Revised: 01/26/2023] [Accepted: 02/19/2023] [Indexed: 03/03/2023] Open
Abstract
Pregnancy loss can be defined as a loss before either 20 or 24 weeks of gestation (based on the first day of the last menstrual period) or the loss of an embryo or fetus less than 400 g in weight if the gestation age is unknown. Approximately 23 million pregnancy losses occur worldwide every year, equating to 15-20% of all clinically recognized pregnancies. A pregnancy loss is usually associated with physical consequences, such as early pregnancy bleeding ranging in severity from spotting to hemorrhage. However, it can also be associated with profound psychological distress, which can be felt by both partners and may include feelings of denial, shock, anxiety, depression, post-traumatic stress disorder, and suicide. Progesterone plays a key part in the maintenance of a pregnancy, and progesterone supplementation has been assessed as a preventative measure in patients at increased risk of experiencing a pregnancy loss. The primary objective of this piece is to assess the evidence for various progestogen formulations in the treatment of threatened and recurrent pregnancy loss, postulating that an optimal treatment plan would preferably include a validated psychological support tool as an adjunct to appropriate pharmacological treatment.
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Affiliation(s)
- Nana Tetruashvili
- V.I. Kulakov Obstetrics, National Medical Research Center for Obstetrics, Gynecology and Perinatology, Ministry of Healthcare of the Russian Federation, 117977 Moscow, Russia
| | - Alice Domar
- Inception Fertility, Houston, TX 77081, USA
- Obstetrics, Gynecology and Reproductive Biology, Harvard Medical School, Boston, MA 02115, USA
| | - Asher Bashiri
- Faculty of Health Science, Ben-Gurion University of the Negev, Be’er-Sheva 84101, Israel
- Maternity C Ward & Recurrent Pregnancy Loss Prevention Clinic, Maternal Fetal Medicine and Ultrasound, Soroka University Medical Center, Be’er-Sheva 84101, Israel
- Correspondence: ; Tel.: +972-08-6400842
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Ayalde J, Epee-Bekima M, Jansen B. A review of placenta accreta spectrum and its outcomes for perinatal mental health. Australas Psychiatry 2023; 31:73-75. [PMID: 36375814 DOI: 10.1177/10398562221139130] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVES Placenta accreta spectrum conditions are rare, life-threatening disorders of placentation encountered in the perinatal period, with lasting impacts on maternal quality of life and psychological wellbeing. Although the obstetric outcomes are well-known, further review is warranted to explore the psychological sequelae that may accompany these conditions. CONCLUSIONS The occurrence of placenta accreta spectrum during pregnancy is a major life stressor that can contribute to the development of psychiatric co-morbidity including posttraumatic stress disorder, depression and anxiety disorders. Early recognition of psychological distress and symptomatic profile is recommended at all stages of perinatal care complicated by this rare spectrum of conditions.
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Affiliation(s)
- Jeremiah Ayalde
- Medical School, 172098The University of Western Australia, Crawley, WA, Australia
| | - Mathias Epee-Bekima
- Obstetrics and Gynaecology, 60082King Edward Memorial Hospital for Women Perth, Subiaco, WA, Australia
| | - Brendan Jansen
- Department of Psychological Medicine, Mother and Baby Unit, 60082King Edward Memorial Hospital for Women Perth, Subiaco, WA, Australia
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Chen Y, Dai J, Wang Y, Guo L, Huang Q. Postpartum post-traumatic stress disorder symptoms in high-risk pregnancies: Associated resilience and social support. J Psychosom Res 2023; 165:111098. [PMID: 36470754 DOI: 10.1016/j.jpsychores.2022.111098] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/17/2022] [Revised: 11/14/2022] [Accepted: 11/17/2022] [Indexed: 11/20/2022]
Affiliation(s)
- Ying Chen
- Nanjing Stomatological Hospital, Medicine School of Nanjing University, China.
| | - Jiayang Dai
- Yangzhou University, School of Nursing, School of Public Health, China
| | - Yuanyuan Wang
- Yangzhou University, School of Nursing, School of Public Health, China
| | - Lu Guo
- Yangzhou University, School of Nursing, School of Public Health, China
| | - Qian Huang
- Nanjing Stomatological Hospital, Medicine School of Nanjing University, China
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Khadivzadeh T, Shojaeian Z, Sahebi A. High Risk-pregnant Women's Experiences of Risk Management: A Qualitative Study. INTERNATIONAL JOURNAL OF COMMUNITY BASED NURSING AND MIDWIFERY 2023; 11:57-66. [PMID: 36650847 PMCID: PMC9839972 DOI: 10.30476/ijcbnm.2022.96781.2148] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/18/2022] [Revised: 12/06/2022] [Accepted: 12/10/2022] [Indexed: 01/19/2023]
Abstract
Background Maternal and fetal morbidity and mortality depend on identifying of pregnancy risks and risk management. There is a dearth of information about the experiences of high-risk pregnant mothers in self-mitigation of the risk in the socio-cultural setting of Iran. This research was conducted to explore the risk management experiences of high-risk pregnant mothers. Methods This Qualitative study was conducted in educational hospitals in Mashhad, Iran, from July 2018 to December 2020. The purposive sampling method was used to recruit the participants based on medical or obstetric high-risk conditions in pregnancy. Qualitative data were obtained from in-depth and semi-structured 29 interviews. Mothers' experiences of pregnancy in a risky condition were asked, and the interview continued until data saturation. Data were analyzed using the MAXQDA 10 software and the Elo and Kyngäs method. Results Maternal experiences for risk management in pregnancy were formed by nine sub-categories and three categories: the excitement of emotion including: "feeling worry and despair", "gladness in the shadow of hope and optimism", "momentary shocking and excitement", and "inactivity and helplessness"; self-contemplation including: "active analysis of the ways of moderating the risk", "cognitive denial", and "ignoring the risk"; and witnessed action including: "problem-focused and rational actions", and "avoidance and inefficient engagements". Conclusion Risk management experiences of pregnant women with high-risk pregnancies include a wide range of positive and negative feelings, effective and ineffective thoughts, and behaviors. Mutual collaboration between mothers and midwives/obstetricians by providing high-quality risk management counseling can lead to choosing effective risk management strategies.
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Affiliation(s)
- Talat Khadivzadeh
- Nursing and Midwifery Care Research Center, Mashhad University of Medical Sciences, Mashhad, Iran,
Department of Midwifery, School of Nursing and Midwifery, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Zahra Shojaeian
- Department of Midwifery, Quchan Branch, Islamic Azad University, Quchan, Iran
| | - Ali Sahebi
- Senior Faculty of the William Glaser institute, Sydney, Australia
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Williamson SP, Moffitt RL, Broadbent J, Neumann DL, Hamblin PS. Coping, wellbeing, and psychopathology during high-risk pregnancy: A systematic review. Midwifery 2023; 116:103556. [PMID: 36427386 DOI: 10.1016/j.midw.2022.103556] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2022] [Revised: 11/10/2022] [Accepted: 11/12/2022] [Indexed: 11/16/2022]
Abstract
OBJECTIVE Complications during pregnancy can negatively impact the physical and psychological wellbeing of mothers. This systematic review aimed to synthesise evidence which has examined the impact of high-risk conditions developed during pregnancy on women's coping, wellbeing, and symptoms of psychopathology. DATA SOURCES Medline (Ovid), PsycINFO (ProQuest), Scopus, Web of science, AMED (Ebsco), CINAHL (Ebsco) and ProQuest databases were searched in May 2021 with no restrictions on publication date. STUDY SELECTION English-language literature was reviewed to identify 31 articles. DATA EXTRACTION Fifteen articles examined Gestational Diabetes Mellitus (GDM: 48%), nine examined multiple high-risk pregnancy conditions (29%), four examined Hypertensive disorders of pregnancy, Preeclampsia (PE: 13%), two did not specify the condition examined (7%), and one examined Pregnancy-Related Acute Kidney Injury (PR-AKI: 3%). The most common study design was quantitative, non-randomised, and survey-based. DATA SYNTHESIS Twenty-seven articles (87%) reported a high-risk pregnancy resulted in decreased wellbeing and ability to cope, and increased symptoms of psychopathology. The remaining four articles (13%) reported no difference in wellbeing or psychopathology outcomes for women experiencing high-risk compared to healthy pregnancies. Moreover, hypertensive disorders and GDM were associated with ineffective submissive or avoidant coping, reduced wellbeing, and quality-of-life, and exacerbated symptoms of anxiety and depression. CONCLUSION High-risk pregnancy negatively impacts coping, wellbeing, and psychopathology, and preventive and supportive interventions to mitigate this should focus on empowering women to feel optimistic and in control of their pregnancy. A holistic and culturally sensitive approach is recommended, where pregnant women (and their partners or support people) are involved in healthcare decisions, thus promoting wellbeing, coping, satisfaction, and improved treatment outcome.
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Affiliation(s)
| | - Robyn L Moffitt
- School of Psychology, Deakin University, Melbourne, Australia
| | | | - David L Neumann
- School of Applied Psychology, Griffith University, Gold Coast, Australia
| | - Peter S Hamblin
- Department of Endocrinology and Diabetes, Western Health, Melbourne, Australia; Institute for Health Transformation, Faculty of Health, Deakin University, Melbourne, Australia; Department of Medicine, Western Health, University of Melbourne, Melbourne, Australia
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14
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Reviewing birth experience following a high-risk pregnancy: A feasibility study. Midwifery 2023; 116:103508. [PMID: 36223663 DOI: 10.1016/j.midw.2022.103508] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2020] [Revised: 04/07/2022] [Accepted: 09/30/2022] [Indexed: 11/06/2022]
Abstract
BACKGROUND Complications during pregnancy and birth are known risk factors for negative birth experience. Women value the opportunity to review their birth experiences, but limited knowledge exists about appropriate interventions and the feasibility of providing this care for women following high-risk pregnancies. OBJECTIVE To describe the construction and evaluate the feasibility and acceptability of a postpartum midwifery counselling intervention for women following high-risk pregnancies. DESIGN A mixed-method study. SETTING A high-risk antenatal outpatient clinic at Landspítali University Hospital in Reykjavík, Iceland. SAMPLE, RECRUITMENT AND DATA COLLECTION Thirty women who experienced high-risk pregnancies were invited to write about and review their birth experience with a known midwife 4-6 weeks postpartum. Eight midwives working in a high-risk antenatal clinic provided the intervention after a special training. Data including birth outcomes, birth experience and experience of the intervention were collected by questionnaires from women at two time points before and after the counselling intervention. Midwives providing the intervention completed diaries and participated in focus group interview to explore their experiences of the process. DATA ANALYSIS Descriptive and content analysis. FINDINGS Women and midwives perceived the intervention positively and feasible in this context. Midwives evaluated the pre-training program as helpful. Most women would like to review their birth experience with a midwife they know, 4-6 weeks postpartum. Almost half of the women wrote about their birth experiences. KEY CONCLUSIONS The findings indicate that women experiencing high-risk pregnancies might benefit from a follow up by a midwife they know. Women and midwives perceived the counselling intervention as an acceptable and feasible option in maternity care. The training program sufficiently prepared the midwives to provide the counselling intervention. IMPLICATIONS FOR PRACTICE The findings provide an opportunity to offer the intervention on a larger scale to explore the effects further and subsequently implement into routine care after birth for high-risk women.
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Mohammadi S, Shojaei K, Maraghi E, Motaghi Z. Quality of perinatal care for women with high-risk pregnancies during the COVID-19 pandemic in Iran. J Int Med Res 2022; 50:3000605221106723. [PMID: 35850546 PMCID: PMC9309783 DOI: 10.1177/03000605221106723] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Background COVID-19 has had a catastrophic effect on the healthcare system. Healthcare
quality assessment measures the difference between expected and actual
performances to identify gaps in the healthcare system. This study aimed to
evaluate the quality of perinatal care for women with high-risk pregnancies
(HPR) during the COVID-19 pandemic. Materials and Methods This cross-sectional study enrolled 450 women with HPR from health centers in
Ahvaz, Iran, from December 2020 to May 2021, using a multi-stage sampling
method. Quality of care was assessed using an observational checklist
adapted from Ministry of Health guidelines. Data were analyzed using
descriptive and statistical methods. Results The quality of the assessed aspect in comprehensive health centers and in
peripartum, perinatal, and postpartum wards was moderate. The overall score
for peripartum care was significantly positively correlated with the length
of the retraining period, and the quality of perinatal care was
significantly related to the proportion of elective cesarean sections and
preterm delivery. Conclusion The development of care practices in health centers in Iran should focus on
education and counseling. Practices in peripartum wards should emphasize the
use of partographs, physical/mental support, and privacy for mothers, while
perinatal wards should focus on timely counseling.
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Affiliation(s)
- Solmaz Mohammadi
- Student Research Committee, School of Nursing and Midwifery, Shahroud University of Medical Sciences, Shahroud, Iran
| | - Kobra Shojaei
- Fertility, Infertility and Perinatology Research Center, Department of Obstetrics and Gynecology, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Elham Maraghi
- Department of Biostatistics and Epidemiology, Faculty of Public Health, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Zahra Motaghi
- Reproductive Health Department, School of Nursing and Midwifery, Shahroud University of Medical Sciences, Shahroud, Iran
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McKinlay AR, Fancourt D, Burton A. Factors affecting the mental health of pregnant women using UK maternity services during the COVID-19 pandemic: a qualitative interview study. BMC Pregnancy Childbirth 2022; 22:313. [PMID: 35413807 PMCID: PMC9005019 DOI: 10.1186/s12884-022-04602-5] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2021] [Accepted: 03/22/2022] [Indexed: 01/16/2023] Open
Abstract
Background People using maternity services in the United Kingdom (UK) have faced significant changes brought on by the COVID-19 pandemic and social distancing regulations. We focused on the experiences of pregnant women using UK maternity services during the pandemic and the impact of social distancing rules on their mental health and wellbeing. Methods We conducted 23 qualitative semi-structured interviews from June 2020 to August 2021, with women from across the UK who experienced a pregnancy during the pandemic. Nineteen participants in the study carried their pregnancy to term and four had experienced a miscarriage during the pandemic. Interviews took place remotely over video or telephone call, discussing topics such as mental health during pregnancy and use of UK maternity services. We used reflexive thematic analysis to analyse interview transcripts. Results We generated six higher order themes: [1] Some pregnancy discomforts alleviated by social distancing measures, [2] The importance of relationships that support coping and adjustment, [3] Missed pregnancy and parenthood experiences, [4] The mental health consequences of birth partner and visitor restrictions, [5] Maternity services under pressure, and [6] Lack of connection with staff. Many participants felt a sense of loss over a pregnancy experience that differed so remarkably to what they had expected because of the pandemic. Supportive relationships were important to help cope with pregnancy and pandemic-related changes; but feelings of isolation were compounded for some participants because opportunities to build social connections through face-to-face parent groups were unavailable. Participants also described feeling alone due to restrictions on their partners being present when accessing UK maternity services. Conclusions Our findings highlight some of the changes that may have affected pregnant women’s mental health during the COVID-19 pandemic. Reduced social support and being unable to have a partner or support person present during maternity service use were the greatest concerns reported by participants in this study. Absence of birth partners removed a protective buffer in times of uncertainty and distress. This suggests that the availability of a birth partner or support person must be prioritised wherever possible in times of pandemics to protect the mental health of people experiencing pregnancy and miscarriage. Supplementary Information The online version contains supplementary material available at 10.1186/s12884-022-04602-5.
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Affiliation(s)
- A R McKinlay
- Research Department of Behavioural Science and Health, Institute of Epidemiology & Health Care, University College London, 1-19 Torrington Place, London, WC1E 7HB, UK.
| | - D Fancourt
- Research Department of Behavioural Science and Health, Institute of Epidemiology & Health Care, University College London, 1-19 Torrington Place, London, WC1E 7HB, UK
| | - A Burton
- Research Department of Behavioural Science and Health, Institute of Epidemiology & Health Care, University College London, 1-19 Torrington Place, London, WC1E 7HB, UK
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Yu X, Liu Y, Huang Y, Zeng T. The effect of nonpharmacological interventions on the mental health of high-risk pregnant women: A systematic review. Complement Ther Med 2022; 64:102799. [PMID: 34995769 DOI: 10.1016/j.ctim.2022.102799] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2021] [Revised: 12/31/2021] [Accepted: 01/03/2022] [Indexed: 11/19/2022] Open
Abstract
OBJECTIVES To evaluate the effect of nonpharmacological interventions on the mental health of high-risk pregnant women. METHODS This review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses 2020 (PRISMA) statement. The Cochrane Library, Embase, CINAHL, PubMed and Web of Science databases were systematically searched for randomized controlled trials and quasi-randomized controlled trials from inception to April 2021. The quality of the studies was assessed using the Cochrane Risk of Bias Tool 2.0. Data were independently extracted and narratively synthesized. RESULTS Fifteen studies involving 1723 pregnant women were selected. Nonpharmacological interventions included cognitive behavioral interventions, yoga, relaxation interventions, psychological and educational support interventions, and acupressure. Cognitive behavioral interventions and yoga for high-risk pregnant women had potential benefits on the symptoms of anxiety, stress and depression. There was insufficient evidence that relaxation interventions, psychological and educational support interventions and acupressure had positive effects on these women's mental health. CONCLUSIONS This review showed that cognitive behavioral interventions and yoga during pregnancy may benefit women with high-risk pregnancies. However, due to methodological limitations of this review, further studies with robust methodological designs are needed to verify the efficacy.
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Affiliation(s)
- Xiaoyan Yu
- Department of Nursing, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, No. 1095 Jiefang Avenue, Wuhan 430030, China
| | - Yu Liu
- Department of Nursing, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, No. 1095 Jiefang Avenue, Wuhan 430030, China.
| | - Yi Huang
- Department of Nursing, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, No. 1095 Jiefang Avenue, Wuhan 430030, China
| | - Tieying Zeng
- Department of Nursing, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, No. 1095 Jiefang Avenue, Wuhan 430030, China
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Yoo H, Ahn S. Effects of nonpharmacological interventions on the psychological health of high-risk pregnant women: a systematic review and meta-analysis. KOREAN JOURNAL OF WOMEN HEALTH NURSING 2021; 27:180-195. [PMID: 36311977 PMCID: PMC9328588 DOI: 10.4069/kjwhn.2021.09.17] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2021] [Revised: 09/17/2021] [Accepted: 09/17/2021] [Indexed: 11/24/2022] Open
Abstract
Purpose This study aimed to summarize the current evidence on the effects of nonpharmacological interventions on psychological health outcomes for women with high-risk pregnancies due to conditions such as preeclampsia, gestational diabetes, or preterm labor. Methods The following databases were searched from January 2000 to December 2020: PubMed, Ovid Embase, CINAHL, Web of Science, DBpia, RISS, and KISS. Two investigators independently reviewed and selected articles according to the inclusion/exclusion criteria. RoB 2 and the ROBINS-I checklist were used to evaluate study quality. Results Twenty-nine studies with a combined total of 1,806 pregnant women were included in the systematic review and meta-analysis. Psychological health improvements were found in women with preeclampsia (Hedges’ g=–0.67; 95% confidence interval [CI], –0.91 to –0.44), gestational diabetes (Hedges’ g=–0.38; 95% CI, –0.54 to –0.12), and preterm labor (Hedges’ g=–0.73; 95% CI, –1.00 to –0.46). The funnel plot was slightly asymmetrical, but the fail-safe N value and the trim-and-fill method showed no publication bias. Conclusion Nonpharmacological interventions for women with high-risk pregnancies due to conditions such as preeclampsia, gestational diabetes, and preterm labor can improve psychological parameters such as anxiety, stress, and depression. Nurses can play a pivotal role in the nursing management of pregnant women with high-risk conditions and apply various types of nonpharmacological interventions to meet their needs in uncertain and anxious times during pregnancy.
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Affiliation(s)
- Hyeji Yoo
- College of Nursing, Chungnam National University, Daejeon, Korea
| | - Sukhee Ahn
- College of Nursing, Chungnam National University, Daejeon, Korea
- Corresponding author: Sukhee Ahn College of Nursing, Chungnam National University, 266 Munhwa-ro, Jung-gu, Daejeon 35015, Korea Tel: +82-42-580-8324 E-mail:
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