Unintended pregnancies and related induced abortions are an important issue of women's health and are among the leading causes of death in women of reproductive age. It is estimated that about 25 million unsafe abortions are performed each year in developing countries. In addition, 4.7-13.2% of maternal causes of death are caused by unsafe abortions each year. According to the 2013 results Turkish Demographic and Health Survey. of all the births 13% are undesired, 11 % of pregnancies are unplanned, 23% of women had spontaneous abortion at least once, and 14% had an intentional abortion at least once. One of the aims of family planning is to prevent unintended pregnancies. Personal or religious beliefs, lack of knowledge about pregnancy risks, limitation of woman's right to decision, inadequacy in reaching contraceptive methods, failure to use contraceptive methods effectively and correctly cause unintended pregnancy. The midwife may play an important role in appropriate family planning methods to prevent unintended pregnancies and adolescent pregnancies and ensuring each individual achieves preventive methods for contro-ception. As a result of these measures, maternal deaths are thought to decrease significantly.
This study was conducted to analyse the anxiety and depression levels among parents whose newborns were staying at neonatal intensive care units. Material and Method: The sample of this crosssectional study was composed of 150 parents who had the infants hospitalized at the neonatal intensive care unit of a private hospital between January 1-March 31, 2017 and agreed to participate voluntarily in the research. The data were collected through face-to-face interviews using the Individual Identification Form, State-Trait Anxiety Scale and the Beck Depression Scale and were analysed using IBM Statistical Package for Social Sciences for Windows 20.0. Findings: The average age of the parents was 29,33 ± 5,990 years (min: 18, max: 52). 83,3% of the parents were mothers of the infants and 38,0% of the parents were high school graduates. 32,7% of newborns were premature babies, 33,3% of them were hospitalized due to respiratory distress and the duration of hospitalization was one week or more for 40,7% of the newborns. Total mean scores for the participants on State Anxiety Scale, Trait Anxiety Scale and Beck Depression Scale were found to be 45,13 ± 9,459, 44,66 ± 7,266 and 11,50 ± 10,626, respectively. A weak positive correlation was found between the anxiety levels and depression symptoms among the parents. Conclusion: Despite that the families were found to be moderately anxious in the study, most of them did not show signs of depression.
Background Oxytocin is widely used in perinatal medicine, but it can cause serious side effects. Health professionals should be familiar with the pharmacokinetics, dosing regimen, and fetal effects of oxytocin. This study aims to explore the use of oxytocin by healthcare professionals during labor. Methods This study was conducted in one medical faculty, one training and research hospital, one maternity hospital, and one private hospital in Adana, Turkey. The sample group included 107 participants. The data were gathered using a survey prepared in line with the literature. The survey was comprised of 30 questions. These questions concern the social demographic information of the participants, the knowledge and actual oxytocin use, and the views of the participants. The data were analyzed using descriptive statistics. Results The average age of the participants was 36.76 ± 8.70 years, the mean of working experience in the delivery room was 7.79 ± 7.73 years. 85.6% of the participants who answered the question of possible effects of oxytocin as contraction, 57.9% of the possible side effects as fetal distress. 69.2% of the participants stated that they applied oxytocin after dilution in a fluid while 47% stated that they applied it after dilution in fluid with 5% Dextrose. While 40% of the participants responded that they sometimes forgot to administer medication, 39.2% stated that they did not register medication in their survey responses. Conclusion It was determined that most of the participants answered the questions about the effect of oxytocin correctly, but they could not respond to all the side effects of oxytocin. It was found that most of the participants could not answer the storage conditions that are important for the effectiveness of the drug correctly. In addition, the importance level given to the principles of drug administration by the participants was generally found to be high.
Omuz distosisi, tüm doğumların yaklaşık %0,15-2,0'ında görülen, ciddi maternal ve neonatal komplikasyonlara neden olan tahmin edilemeyen ve önlenemeyen acil obstetrik bir durumdur. Omuz distosisinin saptanması ve yönetimi, ileri düzey ebelik ve obstetri bilgi ve becerisi gerektirdiği için ebelik eğitim ve uygulamalarında yer alan önemli bir konudur. Literatüre dayalı olarak hazırlanan bu çalışmanın amacı, omuz distosisi ve yönetimi ile ilgili güncel bilgilerin paylaşılmasını sağlamaktır. Omuz distosisi fetus başının doğumundan sonra, omuzların doğumunda başarısızlık olarak tanımlanmaktadır. Bu durum fetüsün omuz boyutu ile pelvis girişi arasındaki uyumsuzluk sonucu ortaya çıkabilir, ön ya da arka omuzun takılması şeklinde gelişebileceği gibi her iki omuzda da görülebilir. Fetal makrozomi, omuz distosisinin en önemli risk faktörü olarak gösterilmektedir. Omuz distosisi, yeterli teknik bilgi ve beceriye sahip ebe ve doktorlar tarafından uygun yaklaşımların seçimi ve kullanılması ile başarılı bir biçimde yönetilebilir. Literatürde omuz distosisinin yönetiminde kullanılan manevraların birincil, ikincil ve üçüncül olarak tanımlandığı, en yaygın olarak McRoberts, Rubin, Wood ve Gaskin manevralarının kullanıldığı bildirilmektedir. Ancak etkinlik ve güvenlik bakımından hiçbir manevranın tek başına bir diğerine göre üstünlüğü bulunmamaktadır. Hangi müdahalenin kullanılacağı, doğuma yardım eden sağlık çalışanının bilgi, tercih ve deneyimine bağlı olarak değişebilir. Ancak yapılan müdahalenin en az invazivden başlanarak daha invazive doğru olması gerekmektedir. Sonuç olarak, omuz distosinin öngörülemeyen ve önlenemeyen, çok ciddi maternal ve neonatal sonuçları olan önemli bir durum olduğu, önlenmesi, erken tanısı ve yönetiminde sistematik bir yaklaşımın kullanılması gerektiği anlaşılmaktadır. Ebelere simülasyon eğitimi yolu ile omuz distosisinin yönetimi konusundaki beceri kazandırılması ya da mevcut bilgi ve becerilerinin iyileştirilmesi ve sürecin yönetimine ilişkin kanıta dayalı bir standardizasyonun oluşturulması ile daha iyi sonuçlar elde edilebilir.
The aim of this study is to share the basic quality indicators of intrapartum midwifery care based on the current literature. To improve maternal and new-born outcomes, health care systems need to provide high quality care. Determining quality indicators is extremely important in terms of developing, planning and implementing health care services. Special attention should be paid to the determination of factors contributing to positive health outcomes when preparing indicators that measure the quality of intrapartum care. In this respect, instead of just monitoring maternal and neonatal morbidity and mortality rates, monitoring indicators that support normality may contribute to more maternal and neonatal health. As a result, it is thought that the use of quality indicators in the evaluation of intrapartum midwifery care will contribute to the improvement of the quality of care given in terms of maternal and neonatal health.
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