Abstract:
BACKGROUND:The UK National Institute for health and Care Excellence (NICE) publish guidance aimed at standardising practice. Evidence regarding how well recommendations are implemented and what clinicians think about guidance is limited. We aimed to establish the extent to which the NICE Hypertension in pregnancy (HIP) guidance has influenced care and assess clinician's attitudes to this guidance. METHODS:Five maternity units in the Midlands and North of England took part in the retrospective evaluation of 2490 birth records from randomly selected dates in 2008-2010 and 2013-2015. The proportion of women where care was adhered to before (2008-2010) and after (2013-2015) guidance publication was examined and differences estimated. Eleven midwives and obstetricians employed by Bradford Hospitals were interviewed. RESULTS:The proportion of high risk women prescribed Aspirin rose (before 14%, after 54%, p = < 0.01 (confidence interval of change (CI) 37, 43%) as well as for moderate risk women (before 3%, after 54%, p = < 0.01, CI 48, 54%) following guidance publication. Three quarters had blood pressure and a third proteinuria measured at every antenatal visit before and after guidance. Early birth < 37 weeks and ≥ 37 weeks gestation was more frequently offered after guidance publication than before (< 37 weeks: before 9%, after 18%, p = 0.01, CI 2, 16% and ≥ 37 weeks before 30%, after 52%, p = < 0.01, CI 9, 35%). Few were informed of future risk of developing a hypertensive disorder or had a documented postnatal review; however there was an increase in women advised to see their GP for this review (58% before and 90% after guidance p = < 0.01, CI 24, 39%). All clinicians said the NICE HIP guidance was informative and provided robust evidence, however they said length of the document made use in practice challenging. They did not always access NICE guidance, preferring to use local guidance at least initially; both obstetricians and midwives said they accessed NICE guidance for in-depth information. CONCLUSIONS:NICE HIP guidance is valued, used by clinicians and has influenced important aspects of care that may help improve outcomes for women who develop hypertension or pre-eclampsia, however some recommendations have had limited impact and therefore interventions are required to improve adherence.
journal_name
BMC Pregnancy Childbirthjournal_title
BMC pregnancy and childbirthauthors
Farrar D,Tuffnell D,Sheldon TAdoi
10.1186/s12884-020-2780-ysubject
Has Abstractpub_date
2020-02-12 00:00:00pages
101issue
1issn
1471-2393pii
10.1186/s12884-020-2780-yjournal_volume
20pub_type
杂志文章abstract:BACKGROUND:Childbirth confidence is an important marker of women's coping abilities during labour and birth. This study investigated socio-demographic, obstetric and psychological factors affecting self-efficacy in childbearing women. METHOD:This paper presents a secondary analysis of data collected as part of the BEL...
journal_title:BMC pregnancy and childbirth
pub_type: 杂志文章
doi:10.1186/s12884-015-0465-8
更新日期:2015-02-13 00:00:00
abstract:BACKGROUND:To evaluate the soluble fms-like tyrosine kinase-1 (sFlt-1), placental growth factor (PlGF), and sFlt-1/PlGF ratio for the prediction of early- and late-onset preeclampsia in a high-risk cohort. METHODS:We studied serial serum samples collected prospectively at 12+0-14+0, 18+0-20+0, and 26+0-28+0 weeks+days...
journal_title:BMC pregnancy and childbirth
pub_type: 杂志文章
doi:10.1186/1471-2393-13-110
更新日期:2013-05-12 00:00:00
abstract:BACKGROUND:In an era of worldwide population displacement, recent studies have identified strong associations between social situations and perinatal outcomes among immigrants. Little is known about the effect of maternal social background on pregnancy outcomes. The Human Development Index (HDI) assesses the following ...
journal_title:BMC pregnancy and childbirth
pub_type: 杂志文章
doi:10.1186/s12884-017-1515-1
更新日期:2017-09-21 00:00:00
abstract:BACKGROUND:Human papillomavirus (HPV) is known to be more prevalent in spontaneous abortions than in elective terminations of pregnancy. More recently, placental infection with HPV was shown to be associated with spontaneous preterm delivery. However, no study has evaluated the prevalence of HPV infection in pregnant K...
journal_title:BMC pregnancy and childbirth
pub_type: 杂志文章
doi:10.1186/1471-2393-13-173
更新日期:2013-09-06 00:00:00
abstract:BACKGROUND:Preeclampsia is a frequent syndrome and its cause has been linked to multiple factors, making prevention of the syndrome a continuous challenge. One of the suggested risk factors for preeclampsia is advanced maternal age. In the Western countries, maternal age at first delivery has been steadily increasing, ...
journal_title:BMC pregnancy and childbirth
pub_type: 杂志文章
doi:10.1186/1471-2393-12-47
更新日期:2012-06-11 00:00:00
abstract:BACKGROUND:Early antenatal care (ANC) initiation is a doorway to early detection and management of potential complications associated with pregnancy. Although the literature reports various factors associated with ANC initiation such as parity and age, pregnancy intentions is yet to be recognized as a possible predicto...
journal_title:BMC pregnancy and childbirth
pub_type: 杂志文章
doi:10.1186/1471-2393-13-35
更新日期:2013-02-06 00:00:00
abstract:BACKGROUND:Cultural practice have often overlooked when providing maternal and child health care services. Low birth weight is the second cause of neonatal mortality in the world but it is a major factor in a developing country such as Indonesia. The purpose of this study is to predict the neonatal mortality among low ...
journal_title:BMC pregnancy and childbirth
pub_type: 杂志文章
doi:10.1186/1471-2393-14-342
更新日期:2014-09-30 00:00:00
abstract:BACKGROUND:Gestational diabetes mellitus (GDM) is a growing global epidemic. Our study aims to confirm the association between circulatory coiled-coil domain-containing 80 (CCDC80) in pregnant women with GDM, to investigate the discriminatory power of CCDC80 on GDM, and to explore the relationships between this molecul...
journal_title:BMC pregnancy and childbirth
pub_type: 杂志文章
doi:10.1186/s12884-020-2743-3
更新日期:2020-01-28 00:00:00
abstract:BACKGROUND:Maternal smoking can cause health complications in pregnancy. Particulate matter (PM2.5) metrics applied to second hand smoke (SHS) concentrations provide indoor air quality (IAQ) measurements and have been used to promote smoking behaviour change among parents of young children. Here, we present the qualita...
journal_title:BMC pregnancy and childbirth
pub_type: 杂志文章
doi:10.1186/s12884-016-1062-1
更新日期:2016-10-12 00:00:00
abstract:BACKGROUND:Annually, around 44 million abortions are induced worldwide. Safe termination of pregnancy (TOP) services can reduce maternal mortality, but induced abortion is illegal or severely restricted in many countries. All abortions, particularly unsafe induced abortions, may require post-abortion care (PAC) service...
journal_title:BMC pregnancy and childbirth
pub_type: 杂志文章
doi:10.1186/s12884-016-0872-5
更新日期:2016-05-14 00:00:00
abstract:BACKGROUND:Gestational diabetes (GDM) has been associated with an elevated risk of type 2 diabetes in women after the pregnancy. Recognition of the factors differentiating the women at highest risk of progression to overt disease from those who remain normoglycemic after gestational diabetes is of key importance for ta...
journal_title:BMC pregnancy and childbirth
pub_type: 杂志文章
doi:10.1186/1471-2393-14-296
更新日期:2014-08-30 00:00:00
abstract:BACKGROUND AND AIM:Use of ultrasound scans early in pregnancy is increasing, but we have limited knowledge about the actual prevalence, associated decision-making and impact on expectant women/couples in a general population. The aim of this study was to document the use of, and experiences related to, foetal scanning ...
journal_title:BMC pregnancy and childbirth
pub_type: 杂志文章
doi:10.1186/s12884-018-2134-1
更新日期:2018-12-29 00:00:00
abstract:BACKGROUND:In population level studies, the conventional practice of categorizing women into low and high maternal risk samples relies upon ascertaining the presence of various comorbid conditions in administrative data. Two problems with the conventional method include variability in the recommended comorbidities to c...
journal_title:BMC pregnancy and childbirth
pub_type: 杂志文章,多中心研究
doi:10.1186/s12884-019-2500-7
更新日期:2019-10-21 00:00:00
abstract:BACKGROUND:Evidence has shown that there are several physical and mental advantages of exercise during pregnancy. Despite this, the recommendations for exercise during pregnancy are poorly fulfilled. The aim of this study was to illuminate non-exercising pregnant women's views and experiences concerning exercise before...
journal_title:BMC pregnancy and childbirth
pub_type: 杂志文章
doi:10.1186/s12884-018-2035-3
更新日期:2018-10-11 00:00:00
abstract:BACKGROUND:Postpartum depression explains various groups of depressive symptoms and syndromes that can take place during the first 6 weeks following birth. The postpartum period is a critical time where both mild and severe mood disorders can occur. The familiar forms are baby blues and postpartum depression. Understan...
journal_title:BMC pregnancy and childbirth
pub_type: 杂志文章
doi:10.1186/s12884-020-02873-4
更新日期:2020-03-30 00:00:00
abstract:BACKGROUND:Amniotic fluid embolism (AFE) is a rare, life threatening obstetric complication, often associated with severe coagulopathy. Induced abortions are extremely safe procedures however complications including AFE can occur. CASE PRESENTATION:A 29-year-old previously healthy woman, gravida 1 para 0, presented fo...
journal_title:BMC pregnancy and childbirth
pub_type: 杂志文章
doi:10.1186/s12884-019-2680-1
更新日期:2020-01-03 00:00:00
abstract:BACKGROUND:There is an increasing prevalence of women who tend to delay childbirth until a very advanced age. However, there is sparse data regarding very advanced maternal age (vAMA) and the interplay between vAMA and assisted reproductive technology (ART) on adverse perinatal outcomes. The study aimed to assess the r...
journal_title:BMC pregnancy and childbirth
pub_type: 杂志文章
doi:10.1186/s12884-018-2147-9
更新日期:2019-01-03 00:00:00
abstract:BACKGROUND:A risk prediction model of non-syndromic cleft lip with or without cleft palate (NSCL/P) was established by a discriminant analysis to predict the individual risk of NSCL/P in pregnant women. METHODS:A hospital-based case-control study was conducted with 113 cases of NSCL/P and 226 controls without NSCL/P. ...
journal_title:BMC pregnancy and childbirth
pub_type: 杂志文章
doi:10.1186/s12884-016-1116-4
更新日期:2016-11-23 00:00:00
abstract:BACKGROUND:Improving maternal health by reducing maternal mortality constitutes the fifth Millennium Development Goal and represents a key public health challenge in the United Republic of Tanzania. In response to the need to evaluate and monitor safe motherhood interventions, this study aims at assessing the coverage ...
journal_title:BMC pregnancy and childbirth
pub_type: 杂志文章
doi:10.1186/1471-2393-7-16
更新日期:2007-08-06 00:00:00
abstract:BACKGROUND:Unhealthy nutrition and lifestyle contribute to the worldwide rising prevalence of non-communicable diseases. This also accounts for the reproductive population, in which unhealthy behavior affects fertility and pregnancy outcome. Maternal smoking, alcohol consumption and inadequate folic acid supplement use...
journal_title:BMC pregnancy and childbirth
pub_type: 杂志文章,多中心研究
doi:10.1186/s12884-017-1228-5
更新日期:2017-01-26 00:00:00
abstract:BACKGROUND:Obstructed labour is still a major cause of maternal morbidity and mortality and of adverse outcome for newborns in low-income countries. The aim of this study was to investigate the role of individual and health facility factors and the risk for obstructed labour and its adverse outcomes in south-western Ug...
journal_title:BMC pregnancy and childbirth
pub_type: 杂志文章
doi:10.1186/1471-2393-11-73
更新日期:2011-10-14 00:00:00
abstract:BACKGROUND:Obstetric hemorrhage is the leading cause of maternal mortality globally. The Non-pneumatic Anti-Shock Garment (NASG) is a low-technology, first-aid compression device which, when added to standard hypovolemic shock protocols, may improve outcomes for women with hypovolemic shock secondary to obstetric hemor...
journal_title:BMC pregnancy and childbirth
pub_type: 临床试验,杂志文章,多中心研究
doi:10.1186/1471-2393-10-64
更新日期:2010-10-18 00:00:00
abstract:BACKGROUND:Pregnancy is a period in the life of women that is often associated with decreased daily physical activity and/or exercise. However, maintaining adequate levels of daily physical activity during pregnancy is important for mother and child. Studies suggest that moderate daily physical activity and exercise du...
journal_title:BMC pregnancy and childbirth
pub_type: 杂志文章,随机对照试验
doi:10.1186/1471-2393-9-1
更新日期:2009-01-05 00:00:00
abstract:BACKGROUND:Disrespect and abuse or mistreatment of women by health care providers in maternity settings has been identified as a key deterrent to women seeking delivery care. Mistreatment includes physical and verbal abuse, stigma and discrimination, a poor relationship between women and providers and policy and health...
journal_title:BMC pregnancy and childbirth
pub_type: 杂志文章
doi:10.1186/s12884-017-1288-6
更新日期:2017-03-28 00:00:00
abstract:BACKGROUND:Cardiotocography (CTG) has high sensitivity, but less specificity in detection of fetal hypoxia. There is need for adjunctive methods easy to apply during labor. Low fetal heart rate short term variation (STV) is predictive for hypoxia during the antenatal period. The objectives of our study were to methodol...
journal_title:BMC pregnancy and childbirth
pub_type: 杂志文章
doi:10.1186/s12884-016-0845-8
更新日期:2016-03-16 00:00:00
abstract:BACKGROUND:Medical screening detects risk factors for disease or presence of disease in otherwise well persons in order to intervene early and reduce morbidity and mortality. During antenatal care (ANC) it is important to detect conditions that complicate pregnancy, like gestational diabetes mellitus (GDM). Despite int...
journal_title:BMC pregnancy and childbirth
pub_type: 杂志文章
doi:10.1186/s12884-020-03115-3
更新日期:2020-07-23 00:00:00
abstract:BACKGROUND:HIV-positive mothers are likely to exclusively breastfeed if they perceive exclusive breastfeeding (EBF) beneficial to them and their infants. Nevertheless, very little is known in Malawi about HIV-positive mothers' perceptions regarding EBF. In order to effectively promote EBF among these mothers, it is imp...
journal_title:BMC pregnancy and childbirth
pub_type: 杂志文章
doi:10.1186/1471-2393-14-247
更新日期:2014-07-25 00:00:00
abstract:BACKGROUND:When faced with an unintended pregnancy, some women choose to undergo an unsafe abortion, while others do not. This choice may depend on long-term contraception that shapes the fertility goals of women, along with many other risk factors. We assessed the risk for unsafe abortion associated with contraceptive...
journal_title:BMC pregnancy and childbirth
pub_type: 杂志文章
doi:10.1186/s12884-017-1376-7
更新日期:2017-06-29 00:00:00
abstract:BACKGROUND:Prenatal risk stratification of women with previous cesarean section (CS) by ultrasound thickness measurement of the lower uterine segment (LUS) is challenging. There is a wide range of proposed cutoff values and a valuable algorithm for selection before birth is not available. Using 3 T magnetic resonance i...
journal_title:BMC pregnancy and childbirth
pub_type: 杂志文章
doi:10.1186/s12884-019-2314-7
更新日期:2019-05-08 00:00:00
abstract:BACKGROUND:Twin pregnancy is associated with increased perinatal mortality. Close foetal monitoring is therefore warranted. Doppler Ultrasound cardiotocography is currently the only available method to monitor both individual foetuses. Unfortunately, the performance measures of this method are poor and erroneous monito...
journal_title:BMC pregnancy and childbirth
pub_type: 杂志文章
doi:10.1186/s12884-020-02918-8
更新日期:2020-04-15 00:00:00