Satisfaction with the Care Received and the Childbirth and Puerperium Experience in Christian and Muslim Pregnant Women

Over the last three decades, there has been an increase in the population as a result of the migratory flow due to the arrival of migrants to Spain, including young women of childbearing age and with reproductive capacity. This phenomenon has made childbirth assistance an extremely important priority in recent years. The aim of this study was to assess the satisfaction and experience during childbirth and the postpartum period in pregnant women according to their religion after assistance in a tertiary hospital. A descriptive cross-sectional study was conducted on a sample of 242 women using the validated Spanish version of the Mackey Childbirth Satisfaction Rating Scale (MCSRS) to measure satisfaction with the childbirth experience during the months of January to April 2021. Statistically significant differences were found in the domains of birth satisfaction (p < 0.01), satisfaction with the obstetrician (p < 0.01), and perception of pain during labour (p < 0.01). The Christian group of women scored higher in these three domains as compared to the Muslim group. The rate of breastfeeding at birth was 5.26 times higher among the Muslim group compared to the Christian group (p = 0.02). The experience of childbirth and the puerperium significantly influenced the levels of satisfaction of pregnant women with the process of childbirth in a different way according to the religious culture of the patient

Suicidal ideation and suicide attempts in healthcare professionals during the COVID-19 pandemic: A systematic review

Background: COVID-19 has caused a series of economic, social, personal, and occupational consequences that may affect the mental health of healthcare workers (HCWs), with the consequent risk of developing suicidal ideation and behaviors. Objectives: The aim of this study was to identify the main risk factors that may predispose HCWs to suicidal ideation and suicide attempts during the COVID-19 pandemic. Methods: A systematic review of studies published between January 2020 and August 2022 was conducted following the PRISMA guidelines in the following electronic databases: Pubmed, Scopus, Web of Science, CINAHL, and PsycINFO. Methodological quality was assessed using the critical appraisal tools for non-randomized studies of the Joanna Briggs Institute (JBI). The followed protocol is listed in the International Prospective Register of Systematic Reviews (PROSPERO) with code CRD42022340732.ResultsA total of 34 studies were included in this review. There are a number of underlying factors such as higher rates of depression, anxiety, pre-pandemic lifetime mental disorders or previous lifetime suicide attempt, living alone, having problems with alcohol and/or other drugs, etc. that favor the emergence of suicidal tendencies and ideation in times of COVID-19. Similarly, the pandemic may have precipitated a series of factors such as economic concerns, assessing one's working conditions as poor, having family members or friends infected, changes in services or functions, and feeling discriminated against or stigmatized by society. Other factors such as age, sex, or type of healthcare worker show differences between studies. Conclusion: Organizations should ensure the adoption of strategies and programmes for early detection of suicides as well as increased attention to the mental health of professions with a high workload.Universidad de Huelva/CBU

Maternal and fetal risks of planned vaginal breech delivery vs planned caesarean section for term breech birth: A systematic review and meta-analysis

Background Breech presentation delivery approach is a controversial issue in obstetrics. How to cope with breech delivery (vaginal or C-section) has been discussed to find the safest in terms of morbidity. The aim of this study was to assess the risks of foetal and maternal mortality and perinatal morbidity associated with vaginal delivery against elective caesarean in breech presentations, as reported in observational studies. Methods Studies assessing perinatal morbidity and mortality associated with breech presentations births. Cochrane, Medline, Scopus, Embase, Web of Science, and Cuiden databases were consulted. This protocol was registered in PROSPERO CRD42020197598. Selection criteria were: years between 2010 and 2020, in English language, and full-term gestation (37-42 weeks). The methodological quality of the eligible articles was assessed according to the Newcastle-Ottawa scale. Meta-analyses were performed to study each parameter related to neonatal mortality and maternal morbidity. Results The meta-analysis included 94 285 births with breech presentation. The relative risk of perinatal mortality was 5.48 (95% confidence interval (CI) = 2.61-11.51) times higher in the vaginal delivery group, 4.12 (95% CI = 2.46-6.89) for birth trauma and 3.33 (95% CI = 1.95-5.67) for Apgar results. Maternal morbidity showed a relative risk 0.30 (95% CI = 0.13-0.67) times higher in the planned caesarean group. Conclusions An increment in the risk of perinatal mortality, birth trauma, and Apgar lower than 7 was identified in planned vaginal delivery. However, the risk of severe maternal morbidity because of complications of a planned caesarean was slightly higher

Decision Support Tool for the Optimal Sizing of Solar Irrigation Systems

Solar photovoltaic (PV) irrigation is increasingly used in agriculture, driven by its low operation cost and virtually zero emissions, providing electricity access in rural areas. However, the high investment cost requires an optimal design. The objective of this work was to develop a user-friendly tool to optimally size a PV generator that satisfies crop irrigation needs under local constrictions. The ODSIS (Optimal Design of Solar Irrigation System) tool, was organized in three calculation modules, preceded by two complements, which determine the daily crop irrigation needs and power demand of the pumping system. Then, the first module sizes the PV plant, considering a multiplication factor, and provides the PV production potential throughout each day of the season. The second and third modules evaluate the total investment cost and equivalent greenhouse gas emissions avoided by comparison with traditional energy sources. This tool was applied to a case study in Senegal for which a multiplication factor of 1.4 was obtained for the optimal PV plant size. Between 22% to 64% of the investment cost corresponded to the PV pumping system, depending on the irrigation technique. The use of PV energy in the case study would represent an annual economic saving for the farmer after 5 to 8 years of payback period, avoiding the emission of between 29.8 and 37.9 tCO2eq/year for the case study area

Care in puerperium during health crisis due to COVID-19

Introducción: la infección por el nuevo coronavirus COVID-19, es actualmente una emergencia de salud pública internacional y ha sido declarada pandemia por la OMS. Aún se desconocen ciertos datos sobre su etiopatogenia, surgiendo la necesidad de analizar la influencia de la enfermedad por coronavirus durante la etapa puerperal y sus consecuencias. Objetivo: sintetizar el conocimiento y las últimas recomendaciones disponibles acerca de los cuidados específicos durante el periodo del puerperio, en relación con la crisis sanitaria por COVID-19. Metodología: se llevó a cabo una búsqueda sistemática en la literatura científica para localizar los documentos de evidencia científica disponibles en las principales bases de datos referenciales: Pubmed, Biblioteca Cochrane y Science Direct. Resultados: la lactancia materna aporta numerosos beneficios al recién nacido, entre ellos, la protección frente a infecciones respiratorias como el coronavirus. Si el estado materno y neonatal lo permite, se recomienda promover la lactancia materna durante el periodo de riesgo infeccioso. La SEGO y la SETH recomiendan la administración de heparina de bajo peso molecular a dosis profilácticas para evitar la enfermedad tromboembólica. La evidencia actual indica que el riesgo de transmisión a través de la lactancia materna al recién nacido es muy poco probable. Discusión/conclusiones: la limitación principal fue la escasez de literatura científica sobre el COVID-19 en relación con el periodo puerperal. Es fundamental que cualquier puérpera con una infección por COVID-19 y su recién nacido sean valorados de manera individualizada, precozmente y evaluada por un equipo multidisciplinar para prevenir resultados adversos.Introduction: the new coronavirus COVID-19 infection is currently an international public health emergency and it has been declared a pandemic by the WHO. Certain data about its etiopathogenesis is still unknown, arising the need to analyse the influence of coronavirus disease during the puerperal stage and its consequences. Objective: to synthesize the knowledge and the latest available recommendations about specific care during puerperium period, related to the health crisis due to COVID-19. Methodology: a systematic search was carried out in the scientific literature in order to locate the scientific evidence documents available in the main reference databases: PubMed, Cochrane Library and Science Direct. Results: breastfeeding brings many benefits to newborns, including protection against respiratory infections, such as coronavirus. If maternal and neonatal status allows it, it is recommended promoting breastfeeding during the infectious risk period. Both SEGO and SETH recommend the administration of low molecular weight heparin at prophylactic doses in order to avoid thromboembolic disease. Discussion/conclusions: the main limitation was the paucity of scientific literature about COVID-19 in relation to puerperal period. It is essential that any puerperal woman with COVID-19 infection and her newborn are assessed individually, early and evaluated by a multidisciplinary team to prevent adverse outcomes

Ensayo clínico aleatorizado y controlado para valorar una intervención por una unidad de hospitalización domiciliaria en la reducción de reingresos y muerte en pacientes dados de alta del hospital tras un ingreso por insuficiencia cardiaca

[Resumen] Introducción y objetivos. Evaluar la eficacia de una intervención de educación en pacientes con insuficiencia cardiaca (IC) realizada por hospitalización a domicilio. Métodos. Ensayo clínico aleatorizado y controlado. Se incluyó a 279 pacientes con diagnóstico clínico de IC dados de alta de un hospital terciario entre febrero de 2001 y junio de 2002. Se excluyó a los pacientes con demencias, enfermedad terminal no cardiológica o enfermedad pulmonar obstructiva crónica. La información recogida incluyó las causas de la descompensación. La intervención fue fundamentalmente de tipo educativo, en el domicilio del participante, y se extendió hasta 15 días después del alta. Se realizaron ajustes de tratamiento durante la primera semana cuando fue necesario. El objetivo principal fue determinar la incidencia acumulada de reingreso o muerte. Los objetivos secundarios fueron la incidencia de reingreso y la mortalidad, así como la utilización de los servicios de urgencia. Se llevó a cabo un seguimiento telefónico a los 3, 6 y 12 meses, y una revisión de las historias clínicas si era necesario. Asimismo, se valoró la utilización de servicios de urgencias los primeros 6 meses. Resultados. Al año, 62 pacientes de 137 (45,3%) ingresaron o murieron en el grupo de intervención, en comparación con 75 de 142 (52,8%) en el grupo control (p = 0,232; riesgo relativo [RR] = 0,86). En los pacientes que se descompensaron por incumplimiento terapéutico, 16 de 45 (35,6%) ingresaron o murieron en el grupo de intervención, en comparación con 34 de 56 (60,7%) en el grupo control (p = 0,016; RR = 0,59). Conclusiones. Esta intervención es factible pero, administrada de manera indiscriminada a todo paciente dado de alta por IC, en el mejor de los casos sólo podemos esperar un beneficio modesto, que en este estudio en particular no llegó a alcanzar significación estadística

Adaptation and psychometric study of the scale for the measurement of fear and anxiety of COVID-19 disease in pregnant women (AMICO_Pregnant)

https://www.frontiersin.org/articles/10.3389/fpubh.2023.1225822/full#supplementary-materialObjective: The aim of this research was to adapt and explore the psychometric properties of a specific scale to assess the levels of fear and anxiety of COVID-19 disease in pregnant women. Methods: An adaptation phase, by a panel of experts, and a psychometric descriptive cross-sectional study were carried out on the final version of the 16- item, self-administered AMICO_Pregnant scale. Univariate and bivariate analyses were carried out, followed by exploratory factor analysis (EFA) and confirmatory factor analysis (CFA). The consistency of the scale was assessed using the Omega coefficient and Cronbach’s Alpha. Results: With a sample of 1,013 pregnant women living in Spain and over 18 years of age, the mean age was 33 years. The scale showed a bifactor structure (anxiety and fear) that was confirmed with good fit parameters. Reliability was assessed in terms of internal consistency by calculating Cronbach’s Alpha coefficient (0.95) and McDonald’s Omega coefficient (0.94) as indicators of robustness of the scale’s reliability. Conclusion: The AMICO_Pregnant scale of 16 items with scores ranging from 1 to 10 is a valid and reliable tool to assess levels of anxiety and fear of COVID_19 in Spanish pregnant women. Pregnant women have shown moderate levels of anxiety and fear regarding the COVID_19 disease in the final phase of the pandemic

Antenatal Fear of Childbirth as a Risk Factor for a Bad Childbirth Experience

Giving birth is one of the most impressive experiences in life. However, many pregnant women suffer from fear of childbirth (FOC) and experience labour in very different ways, depending on their personality, previous life experiences, pregnancy, and birth circumstances. The aim of this study was to analyse how fear of childbirth affects the childbirth experience and to assess the related consequences. For this, a descriptive cross-sectional study was carried out in a sample of 414 women between 1 July 2021 and 30 June 2022. The Birth Anticipation Scale (BAS) was used to measure fear of childbirth and the Childbirth Experience Questionnaire (CEQ-E) was applied to measure satisfaction with the childbirth experience. Fear of childbirth negatively and significantly predicted the childbirth experience. In addition, women who were more fearful of childbirth were found to have worse obstetric outcomes and a higher likelihood of having a caesarean delivery (p = 0.008 C. I 95%). Fear behaved as a risk factor for the birth experience, so the greater the fear, the higher the risk of having a worse birth experience (OR 1.1). Encouraging active listening and support strategies may increase pregnant women's confidence, thus decreasing their fear of the process and improving their childbirth experience

Calidad de vida relacionada con la salud en una población de gestantes sanas tras un programa de actividad física en el medio acuático (PAFMAE)

Fundamentos: El ejercicio físico moderado aporta beneficios a la mujer gestante durante el embarazo. La finalidad de este trabajo fue evaluar el efecto sobre la calidad de vida de un programa de actividad física en el medio acuático, de seis semanas de duración, en mujeres gestantes sanas. Métodos: Se llevó a cabo un programa de actividad física en el medio acuático, desde mayo hasta julio de 2016 en un centro deportivo, de seis semanas de duración a un total de 46 mujeres embarazadas, que fueron distribuidas en grupo Experimental (n=18) y grupo Control (n=28), a las que se le aplicó el cuestionario de calidad de vida relacionada con la salud “SF- 36 v2” antes y después del programa. Estadísticamente se aplicó para medias intragrupo la prueba t-student para muestras pareadas, y para las diferencias entre grupos, la prueba t-student para muestras independientes. Resultados: Al finalizar el programa de actividad física se constató como el mismo actuó positivamente sobre las siguientes dimensiones, cuyos valores de la media fueron: percepción de Dolor Corporal (DC) antes 66,1 y después 68,4 percepción de Salud General (SG) antes 81,3 y después 83,6, Rol Emocional (RE) antes 89,0 y después 93,5 y Salud Mental (SM) 80,7 antes y 84,2 después. Conclusión: La práctica de un programa de actividad física en el medio acuático para embarazadas sanas brinda beneficios relacionados con la percepción de calidad de vida relacionada con la salud.Background: Moderate physical exercise brings benefits to pregnant women during pregnancy. The aim of this research is to evaluate the effect on the quality of life of a six-week aquatic physical activity program in healthy pregnant women Methods: A six-week physical activity program was conducted in the aquatic environment, from May to July 2016 in a sports center, to a total of 46 pregnant women, who were distributed in Experimental (n = 18) and Control (n = 28) groups, to which the health-related quality of life questionnaire “SF-36 v2” was applied before and after the program. The t-student test for paired samples was statistically applied for intragroup means, and for the differences between groups, the t-student test for independent samples. Results: At the end of the physical activity program, it was clearly established that it acted positively on the following dimensions whose mean values were: perception of Body Pain (BP) before 66.1 and after 68.4 perception of General Health (GH) before 81.3 and then 83.6, Emotional Role (ER) before 89.0 and Then 93.5 and Mental Health (MH) 80.7 before and 84.2 after. Conclusion: The practice of a program of physical activity in the aquatic environment for pregnant women provides benefits related to the perception of health-related quality of life

Pregnancy care during COVID-19 epidemic, a drive for change?

La atención prenatal, entendida como cuidados habituales brindados durante la gestación, debe estar basada en pilares básicos tales como tener en cuenta el contexto sociocultural en el que se ofrece dicha atención, garantizar que el servicio sea apropiado, accesible, y de alta calidad, y además permitir una atención personalizada. Según la Organización Mundial de la Salud el número mínimo de visitas recomendables durante el embarazo debe ser ocho, con los distintos profesionales implicados en el proceso, además de la preparación al nacimiento o educación maternal. Desde que estalló la pandemia provocada por el SARS-CoV-2, muchos de los servicios habituales sociosanitarios han tenido que adaptarse para proporcionar seguridad y evitar el contagio, algo prioritario en los grupos vulnerables en los que encontramos a las embarazadas. Los profesionales han tenido que acomodarse a una atención telemática, aunando consultas para una menor movilidad de la gestante a los centros sanitarios evitando así riesgos innecesarios. Por lo que toda esta situación ha abierto un campo de trabajo virtual que, si bien antes era llevado a cabo en diferentes ámbitos, ahora más que nunca cobra especial relevancia y requiere una formación profesional para que pueda llegar erigirse como complemento a las citas presenciales.Prenatal care, understood as routine care provided during pregnancy, should be based on basic pillars, such as taking into account the sociocultural context in which such care is offered, ensuring that the service is appropriate, accessible and of high quality, and also with care personalized. According to World Health Organization, the minimum number of recommended visits during pregnancy should be eight, with the different professionals involved in the process, in addition to preparing for childbirth or maternal education. Since the pandemic erupted due to SARS-CoV-2, many of the usual social health services have had to adapt to provide safety and prevent infection, a priority in vulnerable groups where pregnant women are found. Professionals have had to adapt to telematics care, thus attending consultations to reduce the mobility of pregnant women to health centers, thus avoiding unnecessary risks. Therefore, all this situation has opened a virtual field of work that, although previously carried out in different areas, now more than ever acquires special relevance and for which professional training is necessary, as a complement to face-to-face appointments