Qualitative analysis of mothers' perception related to the delivery of information regarding preterm births

BACKGROUND

Preterm birth is a major health issue due to its potential outcomes and socioeconomic impact. Prenatal counseling is of major importance for parents because it is believed that the risk of preterm birth is associated with a higher parental mental burden. Nowadays in France, the content and delivery of antenatal counseling is based on personal experience since there is a lack of official guidelines. The goal of the study was to evaluate maternal perception of antenatal information delivered in the setting of preterm births.

METHODS

A qualitative study was performed using semi-structured individual interviews of 15 mothers with a child born > 26-34 GW. Data analysis was based on a constant comparative method.

RESULTS

Concerning prenatal counseling content, parents wanted to be informed of their role in the care of their preterm child more so than statistics that were not always considered relevant. Parents' reactions to the announcement of the risk of a preterm birth was dominated by stupefaction, uncertainty and anxiety. When it comes to the setting of prenatal counseling, patients' room was deemed an appropriate setting by parents and ideally the presence of a coparent was appreciated as it increased patients' understanding. The physicians' attitude during the counseling was considered appropriate and described as empathic and optimistic. The importance of support throughout the hospitalization in the form of other parents' experiences, healthcare professionals and the possibility to preemptively visit the NICU was emphasized by participants. Delivery experience was dominated by a sense of uncertainty, and urgency. Some leads for improvement included additional support of information such as virtual NICU visit; participants also insisted on continuity of care and the multidisciplinary aspect of counseling (obstetrician, neonatologist, midwife, nurse, lactation consultant and psychologist).

CONCLUSION

Highlighting parents' expectations about prenatal counseling could lead to the establishment of overall general guidelines. However, some topics like the use of statistics and mentioning the risk of death underline the importance of a personalized information.

Impact of Physician Expertise on Probe Trajectory During Obstetric Ultrasound: A Quantitative Approach for Skill Assessment

INTRODUCTION

The objective of the study was to identify objective metrics to evaluate the significance of a sonographer's expertise on trajectories of ultrasound probe during obstetric ultrasound training procedures.

METHODS

This prospective observational study was conducted at Rennes University Hospital, Department of Obstetrics and Gynecology. We evaluated a panel of sonographers (expert, intermediate, and novice) in performing 3 tasks (brain, heart, and spine) with an obstetric ultrasound simulator (Scantrainer; Medaphor, Cardiff, UK). The trajectories of the probe were logged and recorded by a custom data acquisition software. We computed metrics on the trajectories (duration, path length, average velocity, average acceleration, jerk, working volume) to compare the 3 groups and identify discriminating metrics.

RESULTS

A total of 33 participants were enrolled: 5 experts, 12 intermediates, and 16 novices. Discriminatory metrics were observed among the 3 levels of expertise for duration, velocity, acceleration, and jerk for brain and spine tasks. Working volume was discriminatory for the brain and the heart task. Path length was discriminatory for the brain task.

CONCLUSIONS

Our results suggest a relationship between the sonographer's level of expertise and probe trajectory metrics. Such measurements could be used as an indicator of sonographer proficiency and contribute to automatic analysis of probe trajectory to evaluate the quality of sonography and the sonographer.

Lignin Degradation and Humus Formation in Alluvial Soils and Sediments

The contribution of lignin to the formation of humic compounds was examined in different environments of the terrestrial-aquatic interface in the Garonne River valley in southwestern France. Alluvial soils and submerged or nonsubmerged river and pond sediments containing alder, poplar, or willow [ 14 C-lignin]ligno-celluloses were incubated. After a 49-day incubation period, 10 to 15% of labeled lignins in alluvial soils was recovered as evolved 14 CO 2 . In nonsubmerged sediments, 10% of the applied activity was released as 14 CO 2 , and in submerged sediments, only 5% was released after 60 days of incubation. In the different alluvial soils and sediments, the bulk of residual activity (70 to 85%) remained in the two coarsest-grain fractions (2,000 to 100 and 100 to 50 μm). Only 2 to 6% of the residual activity of these two coarse fractions was recovered as humic and fulvic acids, except in the case of alder [ 14 C-lignin]lignocellulose, which had decomposed in a soil collected beneath alders. In this one 55% of the residual activity was extracted as humic substances from the 2,000- to 100-μm fraction. Humic and fulvic acids represented from 6 to 50% of the residual activity in the finest-grain fractions (50 to 20 and 20 to 0 μm). The highest percentages were obtained in soil collected beneath alders and in submerged pond sediment. The contribution of different groups of microorganisms, as well as nutrients and clay content, may influence humic-substance formation in such environments. Physical stability also may be an important factor for complex microbial activity involved in this process.