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[PMID]: 28376565 [Au] Autor: Batten M; Stevenson E; Zimmermann D; Isaacs C [Ti] Título: Implementation of a Hydrotherapy Protocol to Improve Postpartum Pain Management. [So] Source: J Midwifery Womens Health;62(2):210-214, 2017 Mar. [Is] ISSN: 1542-2011 [Cp] País de publicação: United States [La] Idioma: eng [Ab] Resumo: INTRODUCTION: A growing number of women are seeking alternatives to traditional pharmacologic pain management during birth. While there has been an extensive array of nonpharmacologic options developed for labor, there are limited offerings in the postpartum period. The purpose of this quality improvement project was to implement a hydrotherapy protocol in the early postpartum period to improve pain management for women choosing a nonmedicated birth. PROCESS: The postpartum hydrotherapy protocol was initiated in a certified nurse-midwife (CNM) practice in an urban academic medical center. All women who met criteria were offered a 30-minute warm water immersion bath at one hour postpartum. Pain scores were assessed prior to the bath, at 15 minutes after onset, and again at the conclusion (30 minutes). Women who completed the bath were also asked to complete a brief survey on their experience with postpartum hydrotherapy. OUTCOMES: In women who used the bath (N = 45), there was a significant reduction in pain scores (P < .001) between the onset of the bath and scores at both 15 minutes and 30 minutes. There was no significant difference between pain scores at 15 minutes and 30 minutes (P = .97). Of those women who completed a survey (n = 43), 97.7% reported both that the bath reduced their pain and improved their birth experience. One hundred percent reported they would use it again in another birth. DISCUSSION: This project demonstrated successful implementation of a hydrotherapy protocol as an alternative or adjunct to medication for early postpartum pain management that significantly reduced pain and improved the birth experience for those who used it. It offers a nonpharmacologic alternative where there have traditionally been limited options. [Mh] Termos MeSH primário: Hidroterapia Parto Normal Complicações do Trabalho de Parto Manejo da Dor Dor/etiologia Período Pós-Parto [Mh] Termos MeSH secundário: Protocolos Clínicos Feminino Seres Humanos Imersão Enfermeiras Obstétricas Medição da Dor Satisfação do Paciente Gravidez Água [Pt] Tipo de publicação: JOURNAL ARTICLE [Nm] Nome de substância: 059QF0KO0R (Water) [Em] Mês de entrada: 1709 [Cu] Atualização por classe: 170913 [Lr] Data última revisão: 170913 [Sb] Subgrupo de revista: IM; N [Da] Data de entrada para processamento: 170405 [St] Status: MEDLINE [do] DOI: 10.1111/jmwh.12580

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[PMID]: 28316039 [Au] Autor: Danilack VA; Gee RE; Berthelot DP; Gurvich R; Muri JH [Ad] Endereço: National Perinatal Information Center, Inc., Providence, RI, USA. [Ti] Título: Public Health Data in Action: An Analysis of Using Louisiana Vital Statistics for Quality Improvement and Payment Reform. [So] Source: Matern Child Health J;21(5):988-994, 2017 May. [Is] ISSN: 1573-6628 [Cp] País de publicação: United States [La] Idioma: eng [Ab] Resumo: Introduction In 2012, the Louisiana (LA) Department of Health and Hospitals revised the LA birth certificate to include medical reasons for births before 39 completed weeks' gestation. We compared the completeness and validity of these data with hospital discharge records. Methods For births occurring 4/1/2012-9/30/2012 at Woman's Hospital of Baton Rouge, we linked maternal delivery and newborn birth data collected through the National Perinatal Information Center with LA birth certificates. Among early term births (37-38 completed weeks' gestation), we quantified the reasons for early delivery listed on the birth certificate and compared them with ICD-9-CM codes from Woman's discharge data. Results Among 4353 birth certificates indicating delivery at Woman's Hospital, we matched 99.8% to corresponding Woman's administrative data. Among 1293 early term singleton births, the most common reasons for early delivery listed on the birth certificate were spontaneous active labor (57.5%), gestational hypertensive disorders (15.3%), gestational diabetes (8.7%), and premature rupture of membranes (8.1%). Only 2.7% of births indicated "other reason" as the only reason for early delivery. Most reasons for early delivery had >80% correspondence with ICD-9-CM codes. Lower correspondence (35 and 72%, respectively) was observed for premature rupture of membranes and abnormal heart rate or fetal distress. Discussion There was near-perfect ability to match LA birth certificates with Woman's Hospital records, and the agreement between reasons for early delivery on the birth certificate and ICD-9-CM codes was high. A benchmark of 2.7% can be used as an attainable frequency of "other reason" for early delivery reported by hospitals. Louisiana implemented an effective mechanism to identify and explain early deliveries using vital records. [Mh] Termos MeSH primário: Efeitos Psicossociais da Doença Reforma dos Serviços de Saúde/métodos Saúde Pública/economia Melhoria de Qualidade/estatística & dados numéricos Estatísticas Vitais [Mh] Termos MeSH secundário: Feminino Reforma dos Serviços de Saúde/economia Registros Hospitalares/estatística & dados numéricos Seres Humanos Classificação Internacional de Doenças/estatística & dados numéricos Louisiana/epidemiologia Parto Normal/economia Parto Normal/estatística & dados numéricos Vigilância da População/métodos Gravidez Nascimento Prematuro/epidemiologia Saúde Pública/métodos Saúde Pública/estatística & dados numéricos Estatística como Assunto/métodos [Pt] Tipo de publicação: JOURNAL ARTICLE [Em] Mês de entrada: 1708 [Cu] Atualização por classe: 171030 [Lr] Data última revisão: 171030 [Sb] Subgrupo de revista: IM [Da] Data de entrada para processamento: 170320 [St] Status: MEDLINE [do] DOI: 10.1007/s10995-016-2254-z

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[PMID]: 28159127 [Au] Autor: Swift EM; Gottfredsdottir H; Zoega H; Gross MM; Stoll K [Ad] Endereço: Department of Nursing, University of Iceland, Eirberg vid Eiriksgotu, 101 Reykjavik, Iceland. Electronic address: ems23@hi.is. [Ti] Título: Opting for natural birth: A survey of birth intentions among young Icelandic women. [So] Source: Sex Reprod Healthc;11:41-46, 2017 Mar. [Is] ISSN: 1877-5764 [Cp] País de publicação: Netherlands [La] Idioma: eng [Ab] Resumo: OBJECTIVE: To describe and analyse factors associated with natural birth intentions in a sample of pre-pregnant Icelandic women. METHODS: An internationally validated tool was used to survey pre-pregnant women about their attitudes towards birth. The online survey was sent to all students at the University of Iceland in November 2014. Log binomial regression was used to calculate crude and adjusted relative risks (RR ), and corresponding 95% confidence intervals (CI), for intentions of natural birth (defined as vaginal birth without epidural analgesia) by high, moderate and low childbirth fear and by high, moderate and low confidence in birth knowledge. Models were adjusted for socio-demographic and psychological factors. RESULTS: 410 eligible women completed the cross-sectional survey. Women with low fear of birth were more likely to have natural birth intentions when compared to women with moderate (RR = 2.83; 95% CI; 1.48-5.41) and high (RR = 4.86; 95% CI; 1.37-17.27) fear. Women with high confidence in their birth knowledge were more likely to have natural birth intentions compared to women with moderate (RR = 2.81; 95% CI; 1.51-5.22) and low (RR = 3.42; 95% CI; 1.43-8.18) confidence in their birth knowledge. CONCLUSION: Pre-pregnant women with low fear of birth and high confidence in their birth knowledge are more likely to have natural birth intentions. Addressing concerns about pain, safety, the perceived unpredictability of birth and worries about the physical impact of childbirth may strengthen natural birth intentions. [Mh] Termos MeSH primário: Parto Obstétrico Medo Conhecimentos, Atitudes e Prática em Saúde Intenção Parto Normal [Mh] Termos MeSH secundário: Adulto Estudos Transversais Tomada de Decisões Parto Obstétrico/psicologia Feminino Seres Humanos Islândia Parto Normal/psicologia Gravidez Estudantes Inquéritos e Questionários Universidades Adulto Jovem [Pt] Tipo de publicação: JOURNAL ARTICLE [Em] Mês de entrada: 1706 [Cu] Atualização por classe: 170621 [Lr] Data última revisão: 170621 [Sb] Subgrupo de revista: IM [Da] Data de entrada para processamento: 170205 [St] Status: MEDLINE

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[PMID]: 28072700 [Au] Autor: Li C; Gong Y; Dong L; Xie B; Dai Z [Ad] Endereço: aDepartment of Obstetrics and Gynaecology, Shanghai First Maternity and Infant Hospital, Tongji University School of Medicine bDepartment of Nursing, Zhongshan Hospital of Fudan University cDepartment of Gynaecology and Obstetrics, Gynaecology and Obstetrics Hospital of Fudan University, Shanghai, China. [Ti] Título: Is prophylactic tranexamic acid administration effective and safe for postpartum hemorrhage prevention?: A systematic review and meta-analysis. [So] Source: Medicine (Baltimore);96(1):e5653, 2017 Jan. [Is] ISSN: 1536-5964 [Cp] País de publicação: United States [La] Idioma: eng [Ab] Resumo: BACKGROUND: To assess the efficacy and safety of tranexamic acid (TA) in reducing blood loss and lowering transfusion needs for patients undergoing caesarean section (CS) or vaginal delivery (VD). METHODS: An electronic literature search of PubMed, EMBASE, OVID, Cochrane library, Scopus, Central, and Clinical trials.gov was performed to identify studies that evaluating the usage of TA in CS or VD. The methodological quality of included trials was assessed and data extraction was performed. RESULTS: Finally, 25 articles with 4747 participants were included. Our findings indicated TA resulted in a reduced intra-, postoperative, and total blood loss by a mean volume of 141.25 mL (95% confidence interval [CI] -186.72 to -95.79, P < 0.00001), 36.42 mL (95% CI -46.50 to -26.34, P < 0.00001), and 154.25 mL (95% CI -182.04 to -126.47, P < 0.00001) in CS. TA administration in VD was associated with a reduced intra-, postoperative, and total blood loss by a mean volume of 22.88 mL (95% CI -50.54 to 4.77, P = 0.10), 41.24 mL (95% CI -55.50 to -26.98, P < 0.00001), and 84.79 mL (95% CI -109.93 to -59.65, P < 0.00001). In addition, TA could lower the occurrence rate of postpartum hemorrhage (PPH) and severe PPH, and reduce the risk of blood transfusions. No increased risk of deep vein thrombosis (DVT) after CS or VD was associated with TA usage, while the minor side effects were more common. CONCLUSIONS: Our findings indicated that intravenous TA for patients undergoing CS was effective and safe. Although prophylactic TA administration is associated with reduced PPH, current existing data are insufficient to draw definitive recommendations about its clinical significance due to the poor to moderate quality of the included literatures. Thus, high-quality randomized controlled trials with larger samples are needed to validate our findings. [Mh] Termos MeSH primário: Cesárea/efeitos adversos Parto Normal/efeitos adversos Hemorragia Pós-Parto/prevenção & controle [Mh] Termos MeSH secundário: Antifibrinolíticos/farmacologia Quimioprevenção/métodos Feminino Seres Humanos Hemorragia Pós-Parto/etiologia Gravidez Ácido Tranexâmico/farmacologia Resultado do Tratamento [Pt] Tipo de publicação: JOURNAL ARTICLE; META-ANALYSIS; REVIEW [Nm] Nome de substância: 0 (Antifibrinolytic Agents); 6T84R30KC1 (Tranexamic Acid) [Em] Mês de entrada: 1702 [Cu] Atualização por classe: 170224 [Lr] Data última revisão: 170224 [Sb] Subgrupo de revista: AIM; IM [Da] Data de entrada para processamento: 170111 [St] Status: MEDLINE [do] DOI: 10.1097/MD.0000000000005653

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[PMID]: 28072678 [Au] Autor: Tzeng YL; Yang YL; Kuo PC; Lin YC; Chen SL [Ad] Endereço: 1PhD, RN, Professor, School of Nursing, China Medical University, and Adjunct Advisor, Department of Nursing, China Medical University Hospital 2PhD, RN, Assistant Professor, School of Nursing, College of Medicine, National Taiwan University, and Adjunct Supervisor, Department of Nursing, National Taiwan University Hospital 3PhD, RN, Professor, School of Nursing, Chung Shan Medical University 4MSN, RN, Instructor, School of Nursing, China Medical University 5PhD, RN, Professor, Director of Department of Nursing, Hungkuang University. [Ti] Título: Pain, Anxiety, and Fatigue During Labor: A Prospective, Repeated Measures Study. [So] Source: J Nurs Res;25(1):59-67, 2017 Feb. [Is] ISSN: 1948-965X [Cp] País de publicação: China (Republic : 1949- ) [La] Idioma: eng [Ab] Resumo: BACKGROUND: Pain, anxiety, and fatigue are known to significantly influence labor; however, the interacting relationships among the three symptoms have not been empirically shown. PURPOSE: The aim of this study was to investigate the interrelationships among intrapartum pain, anxiety, and fatigue relative to the mode of delivery, with or without epidural analgesia (EDA). METHODS: A prospective, repeated measures design was adopted, and women with uncomplicated pregnancies at term (N = 186) were enrolled. Self-reported visual analog scales were used to assess pain, anxiety, and fatigue during the four phases of labor, as determined by cervical dilation (e.g., Phase 1 = 2-4 cm, Phase 2 = 4-6 cm, Phase 3 =10 cm, and Phase 4 = immediately after delivery of the placenta). Of the 186 participants, 48 received EDA when their cervical dilation was 3-4 cm. RESULTS: Throughout the process of labor, pain, anxiety, and fatigue were significantly correlated, no matter whether participants had received EDA, especially during Phases 1 and 3. For the participants undergoing EDA, the level of fatigue decreased more slowly than the levels of pain and anxiety. The participants who received EDA had significantly greater pain and fatigue in Phase 1 of labor than those who did not receive EDA. Mode of delivery was correlated with age, parity, and pain level in Phase 2 of labor and anxiety level in Phase 2 of labor. CONCLUSIONS/IMPLICATIONS FOR PRACTICE: Intrapartum pain, anxiety, and fatigue were strongly interrelated. Intrapartum pain management (EDA) led to a significant decline in anxiety and fatigue. Furthermore, fatigue accumulated during the course of labor and was not easily diminished. These findings provide a reference for maternity nurses to develop strategies for managing multiple symptoms. [Mh] Termos MeSH primário: Ansiedade/etiologia Ansiedade/psicologia Fadiga/etiologia Fadiga/psicologia Início do Trabalho de Parto/psicologia Dor do Parto/complicações Dor do Parto/psicologia [Mh] Termos MeSH secundário: Adulto Analgesia Epidural/psicologia Feminino Seres Humanos Meia-Idade Parto Normal/psicologia Gravidez Estudos Prospectivos Adulto Jovem [Pt] Tipo de publicação: COMPARATIVE STUDY; JOURNAL ARTICLE [Em] Mês de entrada: 1708 [Cu] Atualização por classe: 170809 [Lr] Data última revisão: 170809 [Sb] Subgrupo de revista: IM; N [Da] Data de entrada para processamento: 170111 [St] Status: MEDLINE [do] DOI: 10.1097/jnr.0000000000000165

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[PMID]: 27914111 [Au] Autor: Ellwood D; Oats J [Ad] Endereço: Griffith University School of Medicine, Gold Coast, Queensland, Australia. [Ti] Título: Response to 'Natural childbirth ideology is endangering women and babies'. [So] Source: Aust N Z J Obstet Gynaecol;56(6):557, 2016 12. [Is] ISSN: 1479-828X [Cp] País de publicação: Australia [La] Idioma: eng [Mh] Termos MeSH primário: Parto Normal [Mh] Termos MeSH secundário: Feminino Seres Humanos Lactente Gravidez [Pt] Tipo de publicação: JOURNAL ARTICLE; COMMENT [Em] Mês de entrada: 1707 [Cu] Atualização por classe: 170817 [Lr] Data última revisão: 170817 [Sb] Subgrupo de revista: IM [Da] Data de entrada para processamento: 161204 [St] Status: MEDLINE [do] DOI: 10.1111/ajo.12566

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[PMID]: 27769011 [Au] Autor: Thompson SM; Nieuwenhuijze MJ; Low LK; de Vries R [Ad] Endereço: Research Centre for Midwifery Science, Maastricht, Zuyd University, PO Box 1256, 6201 BG Maastricht, The Netherlands; CAPHRI, School of Public Health and Primary Care Maastricht, PO Box 616, 6200 MD Maastricht, The Netherlands. Electronic address: s.thompson@av-m.nl. [Ti] Título: Exploring Dutch midwives' attitudes to promoting physiological childbirth: A qualitative study. [So] Source: Midwifery;42:67-73, 2016 Nov. [Is] ISSN: 1532-3099 [Cp] País de publicação: Scotland [La] Idioma: eng [Ab] Resumo: OBJECTIVE: to describe Dutch midwives' attitudes toward, and motivations for, the promotion of physiological childbirth and to identify factors associated with those attitudes and motivations. DESIGN: exploratory, qualitative design using focus groups. SETTING: The Netherlands. PARTICIPANTS: hospital- and community-based midwives. FINDINGS: four themes emerged: physiological birth as a continuum, navigating the settings, woman-centeredness and competence and confidence. Midwives view the safeguarding and promotion of physiological childbirth as central to their role. They define physiological childbirth along a continuum that is related to the context of their practice. Hospital culture is seen as an inhibitor of practices that promote physiological birth. Midwives believe that woman-centred ways of working and challenging practices that are not evidence-based will promote physiological childbirth. KEY CONCLUSIONS: in order to become competent and confident practitioners of physiological childbirth midwives need to be aware of the factors that inhibit and encourage practices that support this way of giving birth. IMPLICATIONS FOR PRACTICE: midwives should consciously employ strategies that promote physiological birth in both home and hospital settings. Midwifery education and midwifery science research should focus on developing strategies that support midwives in this endeavor. [Mh] Termos MeSH primário: Atitude do Pessoal de Saúde Serviços de Saúde Materna/organização & administração Tocologia/métodos Parto Normal/métodos [Mh] Termos MeSH secundário: Adulto Competência Clínica Parto Obstétrico/métodos Feminino Grupos Focais Seres Humanos Meia-Idade Tocologia/educação Países Baixos Gravidez Relações Profissional-Paciente Pesquisa Qualitativa [Pt] Tipo de publicação: JOURNAL ARTICLE [Em] Mês de entrada: 1705 [Cu] Atualização por classe: 170503 [Lr] Data última revisão: 170503 [Sb] Subgrupo de revista: N [Da] Data de entrada para processamento: 161022 [St] Status: MEDLINE

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[PMID]: 27677435 [Au] Autor: Dietz HP; Exton L [Ad] Endereço: Department of Obstetrics and Gynaecology, Sydney Medical School Nepean, University of Sydney, Sydney, New South Wales, Australia. hpdietz@bigpond.com. [Ti] Título: Natural childbirth ideology is endangering women and babies. [So] Source: Aust N Z J Obstet Gynaecol;56(5):447-449, 2016 Oct. [Is] ISSN: 1479-828X [Cp] País de publicação: Australia [La] Idioma: eng [Ab] Resumo: Natural childbirth ideology has become dominant across much of the developed world. This ideology increasingly clashes with the reality of modern obstetrics, which is dealing with a demographic that is getting older and more obese, hence more complicated, and it has become a danger to the health of women and babies. The most visible expression of these trends is the focus on caesarean section rates which have become a key performance indicator of obstetric services. This trend is resulting in increasingly obvious negative consequences for morbidity and mortality, as chronicled in the Morecambe Bay Report, published in the UK last year. At the same time, there is mounting emphasis on patient autonomy in obstetric decision-making, which mandates informed consent. A 2015 Supreme Court decision in the UK (Montgomery vs Lanarkshire) is likely to impact on obstetric management in Australia and New Zealand. The 'paternalism in a skirt' of natural childbirth ideology is already exposing obstetricians and services to an ever-increasing degree of medicolegal risk. [Mh] Termos MeSH primário: Parto Obstétrico Parto Normal Preferência do Paciente [Mh] Termos MeSH secundário: Austrália Parto Obstétrico/tendências Feminino Seres Humanos Idade Materna Nova Zelândia Obesidade/complicações Autonomia Pessoal Gravidez [Pt] Tipo de publicação: JOURNAL ARTICLE [Em] Mês de entrada: 1703 [Cu] Atualização por classe: 170817 [Lr] Data última revisão: 170817 [Sb] Subgrupo de revista: IM [Da] Data de entrada para processamento: 160929 [St] Status: MEDLINE [do] DOI: 10.1111/ajo.12524

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[PMID]: 27628861 [Au] Autor: Hresanová E [Ti] Título: The Psychoprophylactic Method of Painless Childbirth in Socialist Czechoslovakia: from State Propaganda to Activism of Enthusiasts. [So] Source: Med Hist;60(4):534-56, 2016 Oct. [Is] ISSN: 2048-8343 [Cp] País de publicação: England [La] Idioma: eng [Ab] Resumo: This paper explores the history of the 'psychoprophylactic method of painless childbirth' in socialist Czechoslovakia, in particular, in the Czech and Moravian regions of the country, showing that it substantially differs from the course that the method took in other countries. This non-pharmacological method of pain relief originated in the USSR and became well known as the Lamaze method in western English-speaking countries. Use of the method in Czechoslovakia, however, followed a very different path from both the West, where its use was refined mainly outside the biomedical frame, and the USSR, where it ceased to be pursued as a scientific method in the 1950s after Stalin's death. The method was imported to Czechoslovakia in the early 1950s and it was politically promoted as Soviet science's gift to women. In the 1960s the method became widespread in practice but research on it diminished and, in the 1970s, its use declined too. However, in the 1980s, in the last decade of the Communist regime, the method resurfaced in the pages of Czechoslovak medical journals and underwent an exciting renaissance, having been reintroduced by a few enthusiastic individuals, most of them women. This article explores the background to the renewed interest in the method while providing insight into the wider social and political context that shaped socialist maternity and birth care in different periods. [Mh] Termos MeSH primário: Dor do Parto/história Parto Normal/história [Mh] Termos MeSH secundário: Comunismo/história Tchecoslováquia Parto Obstétrico/história Parto Obstétrico/métodos Feminino História do Século XX Seres Humanos Dor do Parto/psicologia Dor do Parto/terapia Parto Normal/psicologia Gravidez Propaganda Socialismo/história [Pt] Tipo de publicação: HISTORICAL ARTICLE; JOURNAL ARTICLE [Em] Mês de entrada: 1701 [Cu] Atualização por classe: 170220 [Lr] Data última revisão: 170220 [Sb] Subgrupo de revista: IM; QIS [Da] Data de entrada para processamento: 160916 [St] Status: MEDLINE [do] DOI: 10.1017/mdh.2016.59

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[PMID]: 27498475 [Au] Autor: Cheyne H; Bowers J [Ti] Título: Reducing the length of postnatal hospital stay. [So] Source: Midwives;19:34, 2016. [Is] ISSN: 1479-2915 [Cp] País de publicação: England [La] Idioma: eng [Mh] Termos MeSH primário: Parto Obstétrico/estatística & dados numéricos Tempo de Internação/estatística & dados numéricos Alta do Paciente/estatística & dados numéricos Cuidado Pós-Natal/organização & administração [Mh] Termos MeSH secundário: Feminino Seres Humanos Parto Normal/estatística & dados numéricos Fatores Socioeconômicos [Pt] Tipo de publicação: JOURNAL ARTICLE [Em] Mês de entrada: 1609 [Cu] Atualização por classe: 160808 [Lr] Data última revisão: 160808 [Sb] Subgrupo de revista: N [Da] Data de entrada para processamento: 160809 [St] Status: MEDLINE

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