RESUMO
Objective: Vulnerability relates to fragile physical, psychological, and socio-environmental circumstances. Pregnant women's social vulnerability can lead to disruptions in their medical follow-ups, prematurity, and increased infant mortality rates, such that their special needs must be considered. Yet, despite different governments' 'perinatality' plans, international literature suggests their care can be improved. Although quantitative studies regularly evaluate these plans, few studies have assessed vulnerable pregnant women's views. This study explores the needs and expectations of vulnerable women regarding their follow-ups during pregnancy and identified strategies to improve their circumstances. Methods: The study was a phenomenological qualitative study involving semi-structured interviews with women who gave birth in the past six months (December 2017 to June 2018) and who fulfilled at least one vulnerability criterion. The women were recruited by French midwives and general practitioners (GPs). Findings: Concerning these vulnerable pregnant women, three phenomenological categories emerged: 1) they need to be monitored by a single trusted contact; 2) they seek medical and social support adapted to their situations that addresses their needs; and 3) they expect kind and person-centred communication skills from professionals who provide them appropriate information. Conclusion: We identified various international recommendations to screen and care for vulnerable pregnant women, but still these women often experience numerous challenges. Finally, the implementation of recommendations for healthcare professionals based on women's real-life experiences could help optimise the identification of vulnerable pregnant women as well as their follow-up care.
RESUMO
BACKGROUND: An increasing prevalence of sexually transmitted infections (STI) has been noted in France over the past decade. Asymptomatic carriage may be high in patients infected with Chlamydia trachomatis attending free and anonymous screening centres (CDAG) and information, diagnosis and screening centres for STI (CIDDIST). In these centres, systematic C. trachomatis detection is recommended in women ≤25 years and in men ≤30 years. OBJECTIVES: This study aimed at estimating the prevalence of C. trachomatis, Neisseria gonorrhoeae and Mycoplasma genitalium in asymptomatic patients younger than 30 years attending a CDAG-CIDDIST. MATERIAL AND METHODS: A free systematic screening for C. trachomatis, N. gonorrhoeae and M. genitalium was offered to asymptomatic subjects under 30 years attending the Montpellier CDAG-CIDDIST from April to August 2009. Pathogens were identified by PCR in first void urine samples. RESULTS: Of the 1381 subjects included (53.8% women and 46.2% men), 105 (42.9% men and 57.1% women) tested positive for C. trachomatis (7.6%, 95% CI [6.3;9.13]); eight (seven men and one woman) tested positive for M. genitalium (0.58% [0.2;1]) of whom two were infected with C. trachomatis ; five (two men and three women) tested positive for N. gonorrhoeae (0.36% [0.1;0.8]) of whom three were infected with C. trachomatis. CONCLUSION: This study confirmed the need for C. trachomatis screening in all patients under 30 years. Our results did not support a systematic screening for N. gonorrhoeae and M. genitalium in urine samples in this kind of facility.