fbpx
Home Midwives Research Research abstracts

Research abstracts

Submissions 2

Research abstracts and items of interest selected for their relevance to midwifery in New Zealand

Adler, L., Rahkonen, L., & Kruit, H. (2020)

Maternal childbirth experience in induced and spontaneous labour measured in a visual analog scale and the factors influencing it; a two year cohort study.

BMC Pregnancy and Childbirth, 20:415: https://doi.org/10.1186/s12884-020-03106-4

Background

Poor maternal childbirth experience plays a role in family planning and subsequent pregnancies. The aim of this study was to compare childbirth experiences in induced and spontaneous labor and to investigate the factors influencing the childbirth experience.

Conclusions

Poor childbirth experience was associated with labor induction, primiparity, operative delivery, and labor complications, such as post-partum hemorrhage and maternal infections. These results highlight the aspects of care for which patient experience may be improved by additional support and counselling.

Full abstract and paper available here 

Daly, D., Minnie, K. C. S., Blignaut, A., Blix, E., Vika, Nilsen., A. B., Dencker, A., et al. (2020)

How much synthetic oxytocin is infused during labour? A review and analysis of regimens used in 12 countries.

PLoS ONE, 15(7): e0227941. https://doi.org/10.1371/journal.pone.0227941

Background

To compare synthetic oxytocin infusion regimens used during labour, calculate the International Units (IU) escalation rate and total amount of IU infused over eight hours.

Conclusion

Current variations in oxytocin regimens for induction and augmentation of labour are inexplicable. It is crucial that the appropriate minimum infusion regimen is administered because synthetic oxytocin is a potentially harmful medication with serious consequences for women and babies when inappropriately used. Estimating the total amount of oxytocin IU received by labouring women, alongside the institution’s mode of birth and neonatal outcomes, may deepen our understanding and be the way forward to identifying the optimal infusion regimen.

Full paper available here  

Olza, I., Uvnas-Moberg, K., Ekström-Bergström, A., Leahy-Warren, P., Karlsdottir, S. I., Nieuwenhuijze, M., et al. (2020)

Birth as a neuro-psycho-social event: An integrative model of maternal experiences and their relation to neurohormonal events during childbirth.

PLoS ONE, 15(7): e0230992. https://doi.org/10.1371/journal.pone.0230992

Background

Psychological aspects of labor and birth have received little attention within maternity care service planning or clinical practice. The aim of this paper is to propose a model demonstrating how neurohormonal processes, in particular oxytocinergic mechanisms, not only control the physiological aspects of labor and birth, but also contribute to the subjective psychological experiences of birth. In addition, sensory information from the uterus as well as the external environment might influence these neurohormonal processes thereby influencing the progress of labor and the experience of birth.

Conclusion

By listening to women’s experiences and by observing women during childbirth, factors that contribute to an optimized process of labor, such as the mothers’ wellbeing and feelings of safety, may be identified. These observations support the integrative role of endogenous oxytocin in coordinating the neuroendocrine, psychological and physiological aspects of labor and birth, including oxytocin mediated. decrease of pain, fear and stress, support the need for midwifery one-to-one support in labour as well as the need for maternity care that optimizes the function of these neuroendocrine processes even when birth interventions are used. Women and their partners would benefit from understanding the crucial role that endogenous oxytocin plays in the psychological and neuroendocrinological process of labor.

Full abstract and paper available here

 

Small, K. A., Sidebotham, M., Fenwick, J., & Gamble, J. (2020)

Intrapartum cardiotocograph monitoring and perinatal outcomes for women at risk: Literature review.

Women and Birth, 33(5):411-418

Problem

Caesarean section rates have risen in high-income countries. One of the potential drivers for this is the widespread use of CTG monitoring.

Findings

Nine randomised controlled trials and 26 non-experimental studies were included. Meta-analysis of pooled data from RCTs in mixed- and high-risk populations found no statistically significant differences in perinatal mortality rates. The majority of non-experimental research was at critical risk of bias and should not be relied on to inform practice. Cardiotocograph monitoring during preterm labour was associated with a higher incidence of cerebral palsy.

Discussion

Research evidence failed to demonstrate perinatal benefits from intrapartum cardiotocograph monitoring for women at risk for poor perinatal outcome.

Conclusion

There is an urgent need for well-designed research to consider whether intrapartum cardiotocograph monitoring provides benefits.

Full abstract and paper available here 

Association of Anaesthetists

Guideline on anaesthesia and sedation in breastfeeding women 2020

Summary

Breastfeeding has many health benefits for the mother and infant. Women who are breastfeeding may require anaesthesia or sedation. Concerns regarding the passage of drugs into breast milk may lead to inconsistent advice from professionals. This can sometimes result in the interruption of feeding for 24 hours or longer after anaesthesia, or expressing and discarding (‘pumping and dumping’) breast milk; this may contribute to early cessation of breastfeeding. However, there are data regarding the transfer of most anaesthetic drugs into breast milk. We advise that breastfeeding is acceptable to continue after anaesthesia and should be supported as soon as the woman is alert and able to feed, without the need to discard breast milk. We provide evidence-based information on the pharmacokinetics of drugs commonly used during anaesthesia so that professionals can undertake a risk-benefit discussion with the woman. We advise the development of local policies that aid logistical planning and guide staff to facilitate breastfeeding during the woman’s hospital stay.

Full guidelines available here