Speaker: Tsegaw Biyazin
Facilitator: Caroline Maringa and Meron Tessema Bekele
Antenatal fetal surveillance is a method of monitoring fetal welling during intrauterine life. Fetal movement counting is one parameter of antenatal fetal surveillance and it has a vital role to reduce stillbirth and prenatal mortality. This study aimed to assess maternal knowledge of fetal movement among pregnant women in Jimma Medical center, Jimma, Ethiopia.
Method: A facility-based cross-sectional study was conducted at Jimma Medical center from June 1 to July 30, 2022. A structured and pretest questionnaire was used to collect data. A systematic sampling technique was applied to collect data through a face-to-face interview. Binary and multivariate logistic regression was carryout to identify candidate predictors and significant variables respectively.
Result: A total of 422 respondents involved in the study. The majority of respondents 189(46.7%) were in the age group of 25-31 years. Regarding marital status, more than three-fourths of 323(79.8%) participants were engaged. Only one hundred twenty-two (30.1%) of respondents had good knowledge regards to their fetal movement count. predictors includes residence [AOR=.29, 95% CI (.16-.56), P value;.000], gestational age [AOR=.42, 95% CI (.24-.76);P-value;.004], high-risk pregnancy [AOR=5.34, 95% CI (2.46-11.60); P-value;.000] and health care provider [AOR=2.61,95% CI (1.49-4.56); P-value;.001) were among significant variables with knowledge of fetal movement counting.
Conclusion: the overall maternal knowledge regards fetal movement is unsatisfactory. Respondents’ residence, gestational age, pregnancy status, and source of information were significant predictors of maternal knowledge. Health care providers.
Recording: https://youtu.be/1P-fOkA9tPg
Speaker: Patricia Marianella
Facilitator: Paloma Terra
El objetivo fue comparar los resultados materno-neonatales y costos de la resolución de embarazos, en mujeres obesas y con peso normal pregestacional.
Métodos: Estudio transversal realizado en 60 gestantes con obesidad y 120 con peso normal pregestacional atendidas en un hospital público de Lima durante el 2018, seleccionadas aleatoriamente. Se recolectaron datos sociodemográficos, indicadores maternos (índice de masa corporal pregestacional, controles prenatales, edad gestacional, días de hospitalización), neonatales (Apgar, peso, morbilidad, edad gestacional por examen físico, días de hospitalización) y datos de los costos (medicamentos, procedimientos e insumos). Se utilizó la prueba estadística U de Mann Whitney.
Resultados: Se encontraron diferencias entre mujeres obesas y con peso normal pregestacional en los días de hospitalización materna (3 ±1,2 días vs 2,0 ±1,2 días; p=0,000); en el peso del recién nacido (3 615 ± 518,03 gr vs 3 245 ± 426,25 gr; p=0,000), en el costo de medicamentos ($ 19,78 ±16,47 vs $ 3,21 ±15,57; p=0,000), en el costo de procedimientos ($ 40,65 ±46,78 vs $ 27,67 ±49,47; p=0,001), y en el costo de insumos ($ 54,08 ±29,02 vs $ 9,32 ±28,26; p=0,000).
Conclusión: Las mujeres obesas presentaron recién nacidos con mayor peso, contaron con más días de hospitalización y los costos de medicamentos, procedimientos e insumos fueron superiores en comparación con las mujeres de peso normal.
English:
The objective was to compare maternal-neonatal outcomes and costs of pregnancy resolution in obese women and women with normal pregestational weight. Methods: Cross-sectional study conducted in 60 pregnant women, randomly selected, with obesity and 120 with normal pregestational weight attended in a public hospital in Lima during 2018. Sociodemographic data, maternal indicators (pregestational body mass index, prenatal controls, gestational age, days of hospitalization), neonatal (Apgar, weight, morbidity, gestational age by physical examination, days of hospitalization) and cost data (drugs, procedures and supplies) were collected. The Mann Whitney U statistical test was used. Results: Differences were found between obese and pregestational normal weight women in maternal hospitalization days (3 ±1.2 days vs. 2.0 ±1.2 days; p=0.000); in newborn weight (3 615 ± 518.03 gr vs. 3 245 ± 426.25 gr; p=0.000), in the cost of medications ($ 19.78 ±16.47 vs $ 3.21 ±15.57; p=0.000), in the cost of procedures ($ 40.65 ±46.78 vs $ 27.67 ±49.47; p=0.001), and in the cost of supplies ($ 54.08 ±29.02 vs $ 9.32 ±28.26; p=0.000).Conclusion: Obese women had heavier newborns, more days of hospitalization and the costs of medications, procedures and supplies were higher compared to women of normal weight.
Recording: https://youtu.be/McAV7M1Ub4M
Title: Considering evidence and wisdom in professional reality
Speaker: Céline Lemay
Facilitator: Elisa Segoni
With EBM we also see a proliferation of guidelines and recommendations directed targeting practitioners that are expected to “apply” them and valuing a standardised care. In their daily practice midwives are facing two different important professional orientations: following guidelines/protocols and also providing a woman centered individualized care. How to take the most appropriate decision for the patient then? The reality is complex and often hold ethical tensions. How can we demonstrate a good quality of care? In past years there was a number of publications promoting the importance of more practical wisdom or “phronesis” in health care professional practice. A review of literature on the subject was undertook and 37 papers were selected to answer the main question: how can we understand the meaning of practical wisdom and its place for a good quality of healthcare? Can practical wisdom be learned, taught, developed and cultivated? We will develop the mean findings of our review, highlighting the fundamental place of professional judgement in the profession. It is a question of using discernment and deliberation to decide the best action for the good of a unique person in a context of care. There is also the valorisation of a reflexive practice in clinical places as well as using narratives of experiences to learn discussion and reflection during undergraduate period. In all context of care practical wisdom can help midwives to use the strengths of EBM AND have a woman centered care. It is seen as a mean to flourish as a professional.
Recording: https://youtu.be/Ir1AJXKZVQs
Speaker: Betsy Arnold-Leahy
Facilitator: Ally Anderson
Abstract:
Occiput Posterior position is a variation of the normal birthing process, a complication of birth requiring patience, intervention, or something in between. Occiput Posterior Position of the fetus is often referred to as “the most common” fetal malposition or as a variation of normal. As many as 30% of fetuses spend some time in this position during labor only 5-12% will remain so for the actual birth. Persistent Occiput Posterior Position may account for up to 18% of cesarean births as well as increased operative births, along with maternal and neonatal morbidity and mortality. Anecdotally, many birthing people are increasingly worried if their fetuses are posterior even at early gestations because of the knowledge available in the media.
Midwives and accoucheurs have encountered this fetal position as documented into the Middle Ages (Louise Bouchard, Jane Sharp). Current data and research and strategies the management of Occiput Posterior position present the intersection of the ART and SCIENCE of midwifery. However most current data is based in Eurocentric literature. Only recently has there been literature from Spain, China, Japan, and Iran to name a few midwives from. Even these studies often reference the primarily English language literature aforementioned in their citations. Very rarely is there an article from a non-Eurocentric area where midwives and traditional birth attendants are prevalent.
This presentation will focus on other perspectives on midwifery management of Occiput Posterior the non-primarily English-speaking voices that are emerging in literature focusing on this topic. The purpose is to highlight what strategies and options are available to those midwives providing care for birthing people particularly in those areas prone to disruptions in care due to conflict and disaster. What can we learn and how can we further support one another?
Check the time in your location: https://bit.ly/VIDM24-session-14
Access: zoom link here: https://frontier.zoom.us/j/81953226873?pwd=tnaEumJ5LXfI521IKce2l9KyWkxieT.1
Recording: https://youtu.be/3PNmcSoyfHE
