Enhancing the competencies of obstetrical nurses and midwives in high-risk pregnancy management through simulation-based training in Lao people's democratic republic: A pilot study.

BACKGROUND: Simulation-based training has been widely used as a valuable strategy for learning and evaluating clinical skills at different levels of nursing and midwifery education. The impact of simulation training on intensive management for high-risk pregnancy in a low-resource setting has been limited. AIM: To examine the effect of simulation-based training with low-fidelity mannequins on obstetrical nurses and midwives' knowledge, attitude, and skills for high-risk pregnancy management in a low-resource setting. METHOD: During September 2023, twenty-five obstetrical nurses or midwives who worked in five tertiary public hospitals in Vientiane Prefecture participated in the three-day training workshops for intensive management in high-risk pregnant women and newborns that used a simulation-based training approach integrating problem-based learning. The evaluated criteria of knowledge, attitudes, and skills pre- and post-test scores were statistically compared. FINDINGS: Workshop trainees demonstrated an increase significantly in knowledge for high-risk pregnancy management (p = 0.012), attitude toward high-risk pregnancy management (p = 0.000), and attitude toward simulation-based training design (p = 0.002). The clinical skills were used on the simulation performance checklist, and the pre-posttest gain in overall performance scores had a statistically significant difference (p = 0.000). The mean score of postpartum hemorrhage management skills was 11.48±2.23, which increased the highest score among all skills. CONCLUSIONS: The simulation-based training in high-risk pregnancy management improves the knowledge, attitude, and skills of nurses and midwives in low-resource settings. Next steps include direct observation of trainees in the clinical setting to assess their competence in ensuring patient safety, achieving positive pregnancy outcomes, and enhancing satisfaction.

Comparison of success rate of nifedipine, progesterone, and bed rest for inhibiting uterine contraction in threatened preterm labor.

AIM: To compare the success rates and gestational ages at delivery of nifedipine, proluton depot administration as a tocolytic agent and bed rest groups to pregnant women with threatened preterm labor. MATERIAL AND METHODS: A total of 150 pregnant women with threatened preterm labor between 28 and 35 weeks of gestation were enrolled in the study. All women underwent contraction inhibition randomly sorted into three groups. The first and second groups were inhibited with nifedipine and proluton depot, respectively. The third group was admitted for bed rest. RESULTS: Nifedipine, proluton depot and bed rest can be used to inhibit contraction in threatened preterm labor. However, when time-to-event test was used, nifedipine took the shortest time for contraction inhibition with statistical significance. CONCLUSION: Nifedipine, proluton depot and bed rest can be used successfully to inhibit contraction in threatened preterm labor. However, nifedipine took the shortest time to inhibit uterine contraction in threatened preterm labor.

Bacterial vaginosis in threatened preterm, preterm and term labour.

OBJECTIVE: To present the prevalence of bacterial vaginosis in threatened preterm, preterm, and term labor and results after treatment. MATERIAL AND METHOD: Forty-four, 50, and 56 pregnant women with threatened preterm, preterm, and term labor respectively were participated. Bacterial vaginosis was diagnosed by Amsel's criteria. Treatment by metronidazole or clindamycin was used. A case record form recorded maternal age, obstetric history, gestational age at admission and delivery, examination data, the route of delivery, and the newborn birth weight and conditions. RESULTS: The patients in threatened preterm labor group had significantly positive bacterial vaginosis when compared to those in the term labor group. CONCLUSION: Prevalence of bacterial vaginosis in threatened preterm, preterm, and term labor were presented The prevalence of bacterial vaginosis in both preterm labor groups was higher than in the term labor group.

Two different treatment regimens in women with preterm contractions who were admitted to a hospital due to a presumptive diagnosis of preterm labor: an observational study.

AIM: To determine the effect of adherence to a set of clinical practice guidelines (CPG) for the management of preterm contractions on health-care resource consumption and pregnancy outcomes. METHODS: This prospective observational study was conducted in a tertiary care university hospital from January 2003 to December 2004. Comparisons were made between the cases receiving treatment according to the CPG (CPG group) and those receiving treatment deviating from the CPG (non-CPG group). RESULTS: There were 203 patients with preterm contractions. Compared with the CPG group, the non-CPG group had a higher rate of both tocolytic and steroid use, a longer maternal hospital stay, and a lower neonatal birthweight. CONCLUSIONS: Adherence to CPG in patients with preterm contractions at 28(+0)-36(+6) weeks' gestation consumes fewer health-care resources without compromising pregnancy outcomes.

Prevalence of bacterial vaginosis in Thai pregnant women with preterm labor in Siriraj hospital.

OBJECTIVE: To study the prevalence of bacterial vaginosis (BV) in pregnant women with preterm labor in Siriraj hospital. MATERIAL AND METHOD: A cross-sectional study of 158 pregnant women with suspected preterm labor was performed between January and July 2005. The subjects enrolled in the present study were between 28+0 and 36+6 menstrual weeks. BV blue test was performed on the vaginal fluid collected from lower one- third of vagina. RESULTS: The prevalence of BV in women in the preterm labor group was 25.8% compared to 14.1% in the preterm contraction group (p = 0.07). CONCLUSION: Compared with preterm contractions a higher prevalence of BV was found in the pregnant women with preterm labor. Given that a quarter of pregnant women with preterm labor tested positive for BV, it might be appropriate to perform this test in the triage setting.