Obstetric Outcomes of SARS-CoV-2 Infection in Asymptomatic Pregnant Women.

Around two percent of asymptomatic women in labor test positive for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in Spain. Families and care providers face childbirth with uncertainty. We determined if SARS-CoV-2 infection at delivery among asymptomatic mothers had different obstetric outcomes compared to negative patients. This was a multicenter prospective study based on universal antenatal screening for SARS-CoV-2 infection. A total of 42 hospitals tested women admitted for delivery using polymerase chain reaction, from March to May 2020. We included positive mothers and a sample of negative mothers asymptomatic throughout the antenatal period, with 6-week postpartum follow-up. Association between SARS-CoV-2 and obstetric outcomes was evaluated by multivariate logistic regression analyses. In total, 174 asymptomatic SARS-CoV-2 positive pregnancies were compared with 430 asymptomatic negative pregnancies. No differences were observed between both groups in key maternal and neonatal outcomes at delivery and follow-up, with the exception of prelabor rupture of membranes at term (adjusted odds ratio 1.88, 95% confidence interval 1.13-3.11; p = 0.015). Asymptomatic SARS-CoV-2 positive mothers have higher odds of prelabor rupture of membranes at term, without an increase in perinatal complications, compared to negative mothers. Pregnant women testing positive for SARS-CoV-2 at admission for delivery should be reassured by their healthcare workers in the absence of symptoms.

Estudio prospectivo de la contribución de la matrona en la atención al parto normal / Prospective study of midwifery contribution to normal birth attention

Objetivo: Conocer las percepciones de las matronas barcelonesas, que trabajan tanto en atención primaria como en el ámbito hospitalario, acerca de la violencia obstétrica. Metodología: Se trata de un estudio cualitativo de corte etnográfico llevado a cabo en Barcelona en 2019. Se realizaron entrevistas a 8 matronas con un análisis del discurso posterior. Para la selección de la muestra se ha utilizado un muestreo intencional con informantes clave. El análisis cualitativo posterior ha sido triangulado con una extensa revisión teórica de textos que proceden tanto de las ciencias sociales como de la biomedicina. Resultados: La mayor parte de las matronas entrevistadas consideran que la violencia obstétrica existe, y que se produce y reproduce en su ámbito de trabajo a través de diversas prácticas. Otras matronas consideran que el concepto como tal es erróneo porque en ningún momento hay intención lesiva por parte de los profesionales de la salud implicados. Para muchas de las informantes, dicho fenómeno está relacionado con el enfoque de riesgo de la biomedicina, la patologización de los procesos reproductivos y las jerarquías hospitalarias. Conclusiones: La investigación invita a la reflexión acerca de las implicaciones que tiene la violencia obstétrica también para los profesionales de la salud. Además, sería conveniente iniciar un diálogo para definir qué prácticas son consideradas por profesionales y usuarias como violencia obstétrica, y cómo media la biomedicina en ellas. (AU)

Objective: To identify the proportion of single-child, full-term deliveries attended by midwives and/or student midwives, as well as to explore the outcomes associated with these deliveries in terms of both patient care and health, for both mothers and newborns. Methodology: Prospective observational study with a minimum sample size estimated of 352 births attended in the Health Area of Valladolid Oeste for the period between February 1st and June 1st, 2017. It was followed a consecutive data collection and we value 11 independent variables and 28 dependent variables. The variables were associated with the scale of Bologna Score which range of score is 0-5. Results: 368 cases were collected. Most women were attended by midwives/midwifery residents during the admission and during the second stage of labor. The Bologna Score obtained was 3,13. Discussion: The Bologna Score was lower than hospitals from the same stratum even though midwives care for a higher percentage. Conclusions: The III and IV variables of the Bologna Score (absence of labor augmentation and positions opposed to lithotomy position) are stablished as improvement areas. The relationship between prelabor duration and interventionism and maternal complications outstanding among maternal outcomes. The skin-to-skin contact and the early initiation of breastfeeding rates decrease in instrumental births and cesareans outstanding among neonatal outcomes. (AU)