Speaker: Melese Siyoum
Facilitator: Indri Astuti Purwanti
Back ground: Pelvic organ prolapse (POP) is a common condition that can significantly impact a woman’s quality of life. Pelvic floor muscle training (PFMT) is recommended as a first-line conservative treatment for prolapse, but evidence from low-resource settings is limited.
Objectives: This study aimed to assess midwife-led pelvic floor muscle training on prolapse symptoms and health-related quality of life (HRQoL) among women with mild to moderate prolapse in Ethiopia, 2024.
Methods: A community-based, parallel, two-arm cluster randomized controlled trial was conducted in Dale and Wonsho districts of Sidama Region, Ethiopia. Women with symptomatic POP stage I-III were randomized by cluster to receive either midwife-led PFMT plus lifestyle counseling (intervention group) or lifestyle counseling alone (control group). The primary outcomes were change in prolapse symptom score (POP-SS) and prolapse quality of life (P-QoL). Mixed-effects generalized linear model was used to determine the effect size at 99% confidence level.
Results: A total of 187 women were randomized (intervention = 89 and control = 98). At sixth month, the intervention group showed significantly greater improvements with a mean change difference of: -4.1 (99% CI: -5.38, -2.83) in prolapse symptoms; -11.48 (99% CI: -15.9, -7.1) in physical domain, -12.65 (99% CI: -19.3, -6.1) in psychological domain and -9.47 (99% CI: -15.5, -3.5) in personal relationship domain of P-QoL. A significantly higher number of women in the intervention group perceived their condition as ‘better’ after the intervention. Women with earlier stages of prolapse (stage I and II) experienced higher benefits compared to stage III.
Conclusions: A midwife-led PFMT combined with lifestyle counseling significantly improves prolapse symptoms and quality of life in mild to moderate POP. This strategy can be integrated into the existing maternal and reproductive health programs to address POP in low-income settings where access to trained specialist is limited.
Speaker: Judith Mercer
Facilitator: Ally Anderson
This presentation will explain how sustained umbilical cord circulation from placental transfusion after birth facilitates a large auto-transfusion from the placenta to the infant that holds potential for saving babies lives. This transfer of blood provides an innate force within the newborn’s body enhancing blood flow and perfusion, essential for normal growth, development, and regeneration. High progesterone levels, prime the body to receive blood at this time. Enhanced blood volume causes high pulmonary artery pressure for approximately the first 10 post-birth hours likely driving maximum perfusion throughout the whole body. The enhanced blood volume floods the newborn’s brainstem and other organs, prevents hypovolemia as well as subtle or overt ischemia, and helps the newborn regain homeostasis after the stress of birth.
This presentation provides evidence for each facet, explains how they work together to ensure newborn health, and will discuss the high cost of immediate (ICC) or early cord clamping (ECC).
