Midwives' experience of delivery care in late foetal death: A qualitative study.

AIM: To explore the experiences of midwives regarding the attention given during labour in late foetal death. DESIGN: Qualitative research using a hermeneutic-interpretative phenomenological approach was carried out. Data were collected through focus groups, audio-recorded, transcribed verbatim, and analyzed using the van Manen approach. SETTING AND PARTICIPANTS: Three focus group with a purposive sample of 18 midwives from 10 public hospitals and 1 primary health centre in Madrid, Spain were conducted. FINDINGS: Two main themes were identified: Professionals for Life Not Death; and Organizing the Work Without Guidelines. Midwives felt there is a lack of social awareness related to the possibility of antepartum death that keeps the mourning hidden and affects the midwives´ practice during the late foetal death process. Midwives recognize difficulties in coping with a process that ends in death: organizations are not prepared for these events (not suitable rooms), there is lack of training to cope with them, and lack of continuity in the attention received by the parents when they are discharged. CONCLUSION: Midwives need to be trained in mourning and communication skills to guarantee good practice when attending late foetal death. Intervention guidelines and support mechanisms are required, not only for the parents, but also for the healthcare professionals.

Proceso de atención al parto en la muerte fetal tardía / Delivery care process in late fetal death

Objetivo: analizar la evidencia disponible acerca del proceso de atención al parto en la muerte fetal tardía, que permita conocer la experiencia y las necesidades de madres y padres, y la experiencia y dificultades de los profesionales que atienden estos casos. Método: revisión narrativa de estudios cualitativos publicados desde 2005 hasta agosto de 2017 en las bases de datos Pubmed, Cinahl, Embase, Scielo, Cuiden y Lilacs en el campo de la muerte fetal tardía, atendiendo a su definición en el contexto español (a partir de 28 semanas de gestación) y en el internacional (a partir de la semana 24 de gestación). Se llevó a cabo un análisis temático de los artículos seleccionados, identificándose cuatro áreas temáticas en función a la experiencia de las madres y padres, por un lado, y dos áreas temáticas según la experiencia de los profesionales. Resultados: se seleccionaron siete artículos cualitativos (cuatro análisis de contenido, dos análisis fenomenológicos y una teoría fundamentada). Los temas identificados respecto a la experiencia de madres y padres estuvieron relacionados con un diagnóstico devastador, comienzo de la despedida, construcción de la maternidad y la paternidad, e impacto de la actuación de los profesionales. Los temas identificados en relación a la experiencia de los profesionales fueron impacto personal y profesional, y manejo del caso. Conclusiones: esta revisión pone de manifiesto tanto lo traumático de la experiencia de las madres y padres que sufren una pérdida fetal tardía como la afectación personal de los profesionales que les atienden, que presentan dificultades para afrontar adecuadamente el caso, y demandan formación específica para ayudar de forma eficiente en el proceso de duelo

Objective: to analyze the evidence available about the delivery care process in late fetal death, allowing to learn about the experience and needs of mothers and fathers, and the challenges for the professionals managing these cases. Method: a narrative review of qualitative studies published from 2005 to August, 2017 in the following databases: Pubmed, Cinahl, Embase, Scielo, Cuiden and Llilacs, on the area of late fetal death, according to its definition in the Spanish setting (from 28 gestation weeks onwards), and in the international setting (from week 24 of gestation). A themed analysis was conducted on the articles selected, and four theme areas were identified, based on the experience of mothers and fathers on one hand, and two theme areas according to the experience of professionals. Results: seven qualitative articles were selected: four content analyses, two phenomenological analyses, and one grounded theory. The themes identified regarding the experience of mothers and fathers were associated with a devastating diagnosis, the initial goodbye, building maternity and paternity, and the impact of the action by professionals. The themes identified associated with the experience of professionals were: personal and professional impact, and case management. Conclusions: this review shows the traumatic experience of mothers and fathers suffering a late fetal loss, as well as the personal impact on those professionals managing them, who will be faced with difficulties for addressing the case adequately, and demand specific training to help in the mourning process in an efficient way

La matrona en el escenario de la gestación subrogada / No disponible

No disponible

Características del parto y resultados neonatales en mujeres inmigrantes / Characteristics of labour and neonatal outcomes in immigrant women

OBJETIVO: identificar las características específicas del parto y resultados neonatales según la nacionalidad de las mujeres en el Hospital Infanta Cristina de Parla (Madrid).MÉTODO: estudio observacional longitudinal con recogida retrospectiva de información, utilizando datos de 404 partos (202 de mujeres gestantes españolas y 202 de mujeres gestantes inmigrantes)asistidos en el Servicio de Ginecología y Obstetricia del Hospital Infanta Cristina de la localidad de Parla (Madrid) durante los años 2012 y 2013. RESULTADOS: la población inmigrante proviene de hasta 30 países diferentes. Las mujeres gestantes africanas son el grupo mayoritario(37%), seguidas por americanas (28%), resto de Europa (19%)y Asia (16%).Las mujeres gestantes inmigrantes del área de salud estudiada tienen menor edad (media 29 años (DE: 5,1)), menor duración de la gestación (media 39,2 semanas DE: 1,2), menor índice de utilización de analgesia epidural (71,8%) y neonatos con mayor peso(peso medio 3.352 g DE: 431) que las mujeres gestantes españolas, de manera estadísticamente significativa. Los resultados obstétricos y perinatales referentes al tipo de registro cardiotocográfico, tipo de parto, pinzamiento de cordón umbilical, test de Apgar, pH de arteria umbilical y tipo de reanimación neonatal no presentan diferencias significativas entre inmigrantes y españolas. CONCLUSIONES: las mujeres gestantes inmigrantes del área estudiada presentan características obstétricas similares a las españolas. A diferencia de las españolas son más jóvenes, utilizan menos la analgesia epidural y sus recién nacidos presentan mayor peso al nacimiento

OBJECTIVE: to identify the specific characteristics of labour and neonatal results according to the nationality of women in the Hospital Infanta Cristina in Parla (Madrid).METHOD: a longitudinal observational study with retrospective collection of information, using data from 404 labours (202 for Spanish pregnant women and 202 for immigrant pregnant women), managed at the Gynaecology and Obstetrics Unit of the Hospital Infanta Cristina located in Parla (Madrid) during the years2012 and 2013.RESULT: the immigrant population originates from up to 30different countries. African pregnant women form the majority group (37%), followed by American women (28%), women from the rest of Europe (19%) and Asian women (16%).The immigrant pregnant women in the healthcare area studied are younger (mean 29-year-old (SD: 5.1)), their pregnancy has as horter duration (mean 39.2 weeks, SD: 1.2), a lower rate of use of epidural analgesia (71.8%), and newborns with a higher weight(mean weight of 3,352 g SD: 431) than Spanish pregnant women, in a statistically significant way. There are no significant differences between immigrant and Spanish women regarding obstetric and perinatal outcomes about the type of cardiotocographic record, type of labour, umbilical cord clamping, Apgar Test, umbilical artery pH, and type of neonatal resuscitation. CONCLUSIONS: the immigrant pregnant women of the area studied present obstetric characteristics similar to Spanish women. Unlike Spanish women, they are younger, they use epidural anaesthesia to a lower extent, and their newborns have a higher weight at birth

Perception and satisfaction of cervical cancer screening by Visual Inspection with Acetic acid (VIA) at Meknes-Tafilalet Region, Morocco: a population-based cross-sectional study.

BACKGROUND: This study aims to explore the perception and satisfaction of cervical cancer screening by Visual Inspection with Acetic acid (VIA) in Meknes-Tafilalet Region among target women. METHODS: A cross-sectional study was conducted using face-to-face interviews with women, routinely attending health centers, who met the inclusion criteria. Descriptive analysis was undertaken to report data. RESULTS: A total of 324 women were included in the study. Results revealed low awareness about cervical cancer (19.6 %) and a very high acceptability of VIA screening (94.5 %). Of the 306 women screened, 99 % stated that they would recommend the VIA testing to their friends and female relatives. All those women who were screened negative expressed their intent to repeat the test every three years. Those found VIA positive affirmed they would perform confirmatory explorations. The majority (96.3 %) of the women believed that screening by VIA could save their lives; cervical cancer was a concern for 98.6 %; and only 11.6 % felt anxious about repeating the VIA test. The majority of women (98.6 %) were satisfied with the service received at the health center. CONCLUSIONS: This study showed that the participants had a strong perception about cervical cancer screening and were willing to have further confirmation or future retests.