Bmc Pregnancy Childb
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Bmc Pregnancy Childb · Jan 2014
Randomized Controlled Trial Multicenter StudyAdapting iron dose supplementation in pregnancy for greater effectiveness on mother and child health: protocol of the ECLIPSES randomized clinical trial.
Currently, there is no consensus regarding iron supplementation dose that is most beneficial for maternal and offspring health during gestation. Recommended iron supplementation dose does not preempt anemia in around 20% of the pregnancies, nor the risk of hemoconcentration in 15%. This deficit, or excess, of iron prejudices the mother-child wellbeing. Therefore the aims of the study are to determine the highest level of effectiveness of iron supplementation adapted to hemoglobin (Hb) levels in early pregnancy, which would be optimum for mother-child health. ⋯ Should conclusive outcomes be reached, the study would indicate the optimal iron supplementation dose required to promote maternal and infant health. These results would contribute towards developing guidelines for good clinical practice.
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Bmc Pregnancy Childb · Jan 2014
ReviewEffects of demand-side financing on utilisation, experiences and outcomes of maternity care in low- and middle-income countries: a systematic review.
Demand-side financing, where funds for specific services are channelled through, or to, prospective users, is now employed in health and education sectors in many low- and middle-income countries. This systematic review aimed to critically examine the evidence on application of this approach to promote maternal health in these settings. Five modes were considered: unconditional cash transfers, conditional cash transfers, short-term payments to offset costs of accessing maternity services, vouchers for maternity services, and vouchers for merit goods. We sought to assess the effects of these interventions on utilisation of maternity services and on maternal health outcomes and infant health, the situation of underprivileged women and the healthcare system. ⋯ Demand-side financing schemes can increase utilisation of maternity services, but attention must be paid to supply-side conditions, the fine-grain of implementation and sustainability. Comparative studies and research on health impact and cost-effectiveness are required.
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Bmc Pregnancy Childb · Jan 2014
Randomized Controlled Trial Multicenter StudyA randomized controlled trial to assess the clinical and cost effectiveness of a nurse-led Antenatal Asthma Management Service in South Australia (AAMS study).
Pregnancy presents a unique situation for the management of asthma as it can alter the course of asthma severity and its treatment, which in turn can affect pregnancy outcomes. Despite awareness of the substantial adverse effects associated with asthma during pregnancy, little has been done to improve its management and reduce associated perinatal morbidity and mortality. The aim of this randomized controlled trial is to evaluate the clinical and cost effectiveness of an Antenatal Asthma Management Service. ⋯ The integration of an asthma education program within the antenatal clinic setting has the significant potential to improve the participation of pregnant women in the self-management of their asthma, reduce asthma exacerbations and improve perinatal health outcomes.
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Bmc Pregnancy Childb · Jan 2014
Multicenter StudyCesarean section in a high-parity community in Saudi Arabia: clinical indications and obstetric outcomes.
The study of the indications for cesarean section (CS) and its outcomes are useful for hospitals, clinicians, and researchers in determining strategies to lower the primary and repeat CS rate. The aim of this study was to identify the indications for CS and the incidence of adverse maternal/fetal outcomes in a tertiary care setting. ⋯ Difficult labor and previous CS were the main indications for CS in Saudi Arabia. High gravidity was a significant predictor of adverse maternal outcomes. Encouraging Saudi women to consider embarking on fewer pregnancies could act as a safeguard against mandatory CSs for subsequent births in multigravida and grand-multigravida Saudi females. Future prospective study that addresses women with repeat CSs and their association with adverse maternal and fetal outcomes is recommended.
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Bmc Pregnancy Childb · Jan 2014
ReviewIn a maternity shared-care environment, what do we know about the paper hand-held and electronic health record: a systematic literature review.
The paper hand-held record (PHR) has been widely used as a tool to facilitate communication between health care providers and a pregnant woman. Since its inception in the 1950s, it has been described as a successful initiative, evolving to meet the needs of communities and their providers. Increasingly, the electronic health record (EHR) has dominated the healthcare arena and the maternity general practice shared-care arrangement seems to have adopted this initiative. A systematic review was conducted to determine perspectives of the PHR and the EHR with regards to data completeness; experiences of users and integration of care between women and health care providers. ⋯ There was a surprising gap in knowledge surrounding data completeness on maternity PHRs or EHRs. There is also a paucity of available impressions from community clinicians using both forms of the records.