Journal of midwifery & women's health最新文献

{"title":"Clinical Applications of Fetal Cell-Free DNA: State of the Science","authors":"Julie Knutson CNM, DNP,&nbsp;Kathryn Anthony MD,&nbsp;Melissa L. Russo MD,&nbsp;Martha B. Kole-White MD","doi":"10.1111/jmwh.13674","DOIUrl":"10.1111/jmwh.13674","url":null,"abstract":"<p>Advances in technology have correlated with expanding prenatal genetic testing options for pregnant people. Leading medical organizations recommend cell-free DNA as the most sensitive screening test for trisomies 13, 18, and 21, as well as for fetal sex chromosome aneuploidies. The commercially available testing options go beyond these recommended tests, and prenatal care professionals should be familiar with the tests that their patients may choose despite being beyond the scope of current medical recommendations. This article explains updates in cell-free DNA technology and clinical considerations for prenatal care professionals, recognizing that this is a rapidly changing field of science and health care.</p>","PeriodicalId":16468,"journal":{"name":"Journal of midwifery & women's health","volume":"69 6","pages":"836-846"},"PeriodicalIF":2.1,"publicationDate":"2024-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141763618","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Disparities in Screening and Treatment Patterns for Depression and Anxiety During Pregnancy: An Integrative Review","authors":"Rachel Eakley PhD, RN, PMHNP-BC,&nbsp;Audrey Lyndon PhD, RNC","doi":"10.1111/jmwh.13679","DOIUrl":"10.1111/jmwh.13679","url":null,"abstract":"<div>\u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Symptoms of untreated depression and anxiety during pregnancy are associated with serious adverse effects for the pregnant person, birth outcomes, and child development. However, pregnant persons are less likely to be screened and treated compared with nonpregnant people. In this systematic review, we aimed to explore individual, provider, and systems factors that impact screening, identification, and treatment patterns for depression and anxiety during pregnancy.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Studies were eligible for inclusion if they were conducted within the United States and published in English between January 2012 and January 2023. Each study included analysis that compared rates of screening, identification, or treatment engagement and explicitly discussed disparities or health equity in marginalized groups. Fifteen articles met full inclusion criteria.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Results demonstrated variation in the screening, identification, and treatment of depression and anxiety during pregnancy among diverse groups of patients. Screening rates ranged from 51.3% in Puerto Rico to 90.7% in Alaska. Among specific clinical populations, rates were as low as 2.0%. Fewer than half of patients were referred to treatment when indicated by screening or diagnoses. Patient characteristics such as age, race, ethnicity, socioeconomic and health factors, mental health history, and obesity were associated with variation in the rates of screening, diagnoses, or treatment engagement. Language factors were the most common factor associated with lower rates of screening and treatment access.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Discussion</h3>\u0000 \u0000 <p>Results suggest that many pregnant people are being overlooked and lack appropriate referrals or resources to access treatment. Results are consistent with previous findings that role confusion and lack of time, provider training, and interest contribute to low rates of screening and treatment. Future research must focus on system level factors to address perceived barriers to screening and treating depression and anxiety during pregnancy in a systematic and equitable way.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16468,"journal":{"name":"Journal of midwifery & women's health","volume":"69 6","pages":"847-862"},"PeriodicalIF":2.1,"publicationDate":"2024-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11622364/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141763619","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Understanding Positionality and Reflexivity in Scholarly Writing","authors":"Lucinda Canty CNM, PhD,&nbsp;Ira Kantrowitz-Gordon CNM, PhD","doi":"10.1111/jmwh.13675","DOIUrl":"10.1111/jmwh.13675","url":null,"abstract":"&lt;p&gt;Midwifery, and by extension, midwifery research, exists within a complex social and political context. The ideation, construction, conduct, and presentation of midwifery scholarship are embedded in these structures, as well as the researchers and research participants who contribute, in varying ways, to the construction of the work. Positionality is understanding one's social identities and how these identities influence our interactions with others. Reflexivity can include examination of one's assumptions, biases, and blind spots.&lt;span&gt;&lt;sup&gt;1&lt;/sup&gt;&lt;/span&gt; Seeing things from multiple perspectives expands knowledge beyond the researcher's lived experience. Positionality and reflexivity are important in both qualitative and quantitative research.&lt;/p&gt;&lt;p&gt;Midwifery is built on the foundation of having the knowledge to address issues such as social determinants of health, racism, and other sources of inequity. Health care practitioners are increasingly aware of the societal structures that exist in our health care system and that influence health outcomes. Similarly, researchers need to be aware of the structures that exist within the research context to address health equity.&lt;/p&gt;&lt;p&gt;Our experiences shape who we are. Messages received since childhood shape our perception and understanding of the world. When generating knowledge to inform midwifery practice and education, it is important that we stay true to the realities of those we care for. The research findings should reflect their perceptions to inform how we understand the challenges and circumstances, and not be limited by our own perspectives.&lt;/p&gt;&lt;p&gt;Systems of power and oppression are built into the systems within which research is conducted. Underlying assumptions about value and importance that determine what is being studied (ie, what health conditions), who is being studied (what populations), and how it is studied (what methods) are determined by those who hold the most power (researchers, funders, authors, journals, and editors). These systems can be challenged only if we are aware and acknowledge that they exist. These include not just racism, but sexism, classism, and other forms of marginalization that can intersect within individuals. These oppressive structures are embedded so deep in our society that, as researchers, we may unknowingly become a part of these systemic issues and cause unintentional harm throughout the research process.&lt;/p&gt;&lt;p&gt;Qualitative research often involves direct contact between researchers and participants in dynamic data collection in the form of interviews. The researcher is the instrument of data collection when there is an interview. Similarly, the researcher is intricately part of the analysis and interpretation of findings. Interviews can be impacted by the lenses that interviewers and participants bring to the interaction from their social identities, past experiences with the topic of interest, and level of trust that the participant has in the research","PeriodicalId":16468,"journal":{"name":"Journal of midwifery & women's health","volume":"69 4","pages":"453-454"},"PeriodicalIF":2.1,"publicationDate":"2024-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jmwh.13675","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141753685","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Oral Health Care Among Women in Perimenopause or Menopause: An Integrative Review","authors":"Namitha Thomas MSc,&nbsp;Kath Peters PhD,&nbsp;Kate O’ Reilly PhD,&nbsp;Mariana S. Sousa PhD,&nbsp;Ajesh George PhD","doi":"10.1111/jmwh.13668","DOIUrl":"10.1111/jmwh.13668","url":null,"abstract":"<div>\u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Women in menopause are at a higher risk of developing oral health problems, affecting their overall quality of life. Several studies have identified the role of health care providers in addressing women's oral health needs across various phases of their lives, yet a review in the area of perimenopause and menopause has not been undertaken. Therefore, the aim of this review was to explore current evidence regarding the oral health knowledge, attitudes, and practices of women in perimenopause or menopause and their health care providers. Additionally, guidelines and recommendations to inform strategies for oral health promotion are included.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A systematic search was carried out across 5 databases. Inclusion criteria included articles published in English that examined at least one study outcome: oral health knowledge, attitudes, and practices of either women in perimenopause or menopause or of health care providers or guidelines around oral health care. Qualitative, quantitative, mixed-methods, and experimental studies with survey components were included with no restrictions on publication period, quality, or setting.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 12 articles met the inclusion criteria, with a majority being of poor quality and mostly from low-income and middle-income countries. Overall findings indicated that there was a lack of knowledge and limited practices in maintaining oral hygiene and visiting the dentist among women in perimenopause or menopause. Health care providers exhibited poor attitudes in advising the importance of periodic dental check-ups and informing oral health changes during this period. There were also insufficient guidelines to adopt care for women and guide health care providers in their practice.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Discussion</h3>\u0000 \u0000 <p>Women in perimenopause or menopause have limited oral health knowledge and unmet oral health needs. Appropriate guidelines and supportive strategies are required to assist health care providers in providing comprehensive care and encouragement to women in perimenopause or menopause to improve their oral health.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16468,"journal":{"name":"Journal of midwifery & women's health","volume":"70 1","pages":"17-31"},"PeriodicalIF":2.1,"publicationDate":"2024-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jmwh.13668","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141753683","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Altered Abdominal Muscle Recruitment and Declined Physical Function in Postpartum Individuals With Pregnancy-Related Pelvic Girdle Pain: A Matched Case-Control Study","authors":"Sze Chee Chua MS,&nbsp;Meng-Hsing Wu MD, PhD,&nbsp;Yi-Liang Kuo PT, PhD,&nbsp;Kuan-Yin Lin PT, PhD,&nbsp;Yi-Ju Tsai PT, PhD","doi":"10.1111/jmwh.13673","DOIUrl":"10.1111/jmwh.13673","url":null,"abstract":"<div>\u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>The influence of pregnancy-related pelvic girdle pain (PPGP) on lumbopelvic muscles has not been comprehensively examined in postpartum individuals. Previous research also presented self-reported activity limitations without objective measures.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Thirty postpartum individuals with PPGP (PPGP group) and 30 age-, parity-, and postpartum duration–matched asymptomatic individuals (healthy group) were recruited. Transabdominal ultrasonography was used to measure muscle thickness or activation changes of the external oblique (EO), internal oblique (IO), transverse abdominals, lumbar multifidus, and pelvic floor muscles (PFMs) during rest and while performing the active straight leg raise (ASLR). Muscle changes were compared separately in the painful and nonpainful sides between the PPGP and health control group. Physical function was assessed using the ASLR fatigue (ASLRF), timed up-and-go, and 6-m walking (6MW) tests.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The PPGP group had greater thickening changes in the bilateral IO during ASLR compared with the healthy group (nonpainful side, 16.34 vs 3.52 mm; <i>P</i> = .010; painful side, 18.83 vs 6.60 mm; <i>P</i> = .02) but became thinner in the EO (nonpainful side, −2.19 vs 19.97 mm; <i>P</i> &lt; .001; painful side, −5.97 vs 21.43 mm; <i>P</i> &lt; .001). Thicker IO and EO on the nonpainful side (IO, 6.60 vs 5.78 mm; <i>P</i> = .004; EO, 5.37 vs 4.54 mm; <i>P</i> = .011) and a lower bladder base (indication of PFMs) (91.87 vs 78.61 mm; <i>P</i> = .002) during rest were also observed in the PPGP group. Furthermore, the performance of the ASLRF and 6MW tests was poorer in the PPGP than in the healthy group (ASLRF nonpainful side, 82.36 vs 59.09 sec; <i>P</i> = .01; painful side, 75.73 vs 59.26 sec; <i>P</i> = .04; 6MW, 3.48 vs 3.17 sec; <i>P</i> = .02).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Discussion</h3>\u0000 \u0000 <p>Postpartum individuals with PPGP demonstrated altered abdominal muscle recruitment strategies during loading tasks, with objectively impaired physical functions. These findings are critical for developing effective muscle training interventions for PPGP.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16468,"journal":{"name":"Journal of midwifery & women's health","volume":"70 1","pages":"137-146"},"PeriodicalIF":2.1,"publicationDate":"2024-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jmwh.13673","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141753682","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Availability of Midwifery Care in Rural United States Communities","authors":"Emily C. Sheffield MPH,&nbsp;Alyssa H. Fritz MPH,&nbsp;Julia D. Interrante PhD, MPH,&nbsp;Katy Backes Kozhimannil PhD, MPA","doi":"10.1111/jmwh.13676","DOIUrl":"10.1111/jmwh.13676","url":null,"abstract":"<div>\u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Access to pregnancy-related and childbirth-related health care for rural residents is limited by health workforce shortages in the United States. Although midwives are key pregnancy and childbirth care providers, the current landscape of the rural midwifery workforce is not well understood. The goal of this analysis was to describe the availability of local midwifery care in rural US communities.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We developed and conducted a national survey of rural US hospitals with current or recently closed childbirth services. Maternity unit managers or administrators at 292 rural hospitals were surveyed from March to August 2021, with 133 hospitals responding (response rate 46%; 93 currently offering childbirth services, 40 recently closed childbirth services). This cross-sectional analysis describes whether rural hospitals with current or prior childbirth services had midwifery care with certified nurse-midwives available locally and whether rural communities with and without midwifery care differed by hospital-level and county-level characteristics.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Among hospitals surveyed, 55% of those with current and 75% of those with prior childbirth services reported no locally available midwifery care. Of the 93 rural communities with current hospital-based childbirth services, those without midwifery care were more likely to have lower populations (37% vs 33%); majority populations that were Black, Indigenous, and people of color (24% vs 10%); and hospitals where at least 50% of births were Medicaid funded (77% vs 64%), compared with communities with midwifery care. Conversely, communities with midwifery care more often had greater than 30% of patients traveling more than 30 miles for hospital-based childbirth services (38% vs 28%).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Discussion</h3>\u0000 \u0000 <p>More than half of rural hospitals surveyed reported no locally available midwifery care, and availability differed by hospital-level and county-level characteristics. Efforts to ensure pregnancy and childbirth care access for rural birthing people should include attention to the availability of local midwifery care.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16468,"journal":{"name":"Journal of midwifery & women's health","volume":"69 6","pages":"929-936"},"PeriodicalIF":2.1,"publicationDate":"2024-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11622357/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141753684","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"An Integrative Review Exploring Womens’ Experiences of Retraumatization Within Perinatal Services","authors":"Jennifer Gordon BSc,&nbsp;Andrew Hunter PhD, MSc, BSc, RMN,&nbsp;Fiona Callanan PGDip, BSc, RGN, RM,&nbsp;Clare Kiely MSc, BSc, RMN,&nbsp;Annmarie Grealish PhD, MSc, BSc, RNT, RMN, RGN","doi":"10.1111/jmwh.13662","DOIUrl":"10.1111/jmwh.13662","url":null,"abstract":"<div>\u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Evidence indicates that retraumatization has a detrimental effect for those women who are accessing perinatal services. One in five women worldwide has a history of childhood adversity. Between 18% and 34% of women experience trauma, which is a well-known risk factor for the onset of chronic mental health disorders. There is a lack of evidence on women's experiences on retraumatization in perinatal care settings and how to prevent retraumatization from occurring. The purpose of this study was to conduct an integrative review on women experiences of retraumatization to determine preventive measures within perinatal services.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This integrative review followed Whittemore and Knafl's 5-stage framework as it allows for the inclusion and integration of diverse research methodologies into an overall synthesis of the evidence. A systematic search of 5 databases was conducted (Web of Science, MEDLINE, CINAHL, ASSIA, and PsychINFO) with no date, language, or geographical limits set due to the paucity of research published in this subject area. This review was conducted and reported according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Fifteen studies met the inclusion criteria and were included in the thematic synthesis. The review identified that participants across the studies had a history of child sexual abuse, sexual abuse, and rape. Three main themes plus subthemes were identified: (1) activating (subthemes: positions in labor, intimate procedures, communications with health care professionals, loss of control); (2) outcomes (subtheme: emotional responses); and (3) interventions reducing or preventing retraumatization (subthemes: role of the health care professional, screening for abuse and history of trauma).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Discussion</h3>\u0000 \u0000 <p>Our findings demonstrate that women are experiencing retraumatization in perinatal services, and there is evidence of formalized approaches being applied in clinical settings to prevent retraumatization from occurring. This study is the first to examine the factors that contribute to retraumatization in perinatal services and make recommendations to reduce the harmful practices in place in perinatal care settings.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16468,"journal":{"name":"Journal of midwifery & women's health","volume":"70 1","pages":"32-49"},"PeriodicalIF":2.1,"publicationDate":"2024-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jmwh.13662","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141736197","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Presentation and Management of Postpartum Granulation Tissue: A Single-Institution Retrospective Study","authors":"Bethany Kette MD,&nbsp;Allison Kumnick MD, MPH,&nbsp;Serenity Budd MS,&nbsp;Neha Gaddam MD,&nbsp;Nicholas Hazen MD","doi":"10.1111/jmwh.13669","DOIUrl":"10.1111/jmwh.13669","url":null,"abstract":"<div>\u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Although the development of postpartum granulation tissue (PPGT) is an expected phase of healing of perineal and vaginal lacerations, the persistence of this tissue can result in delayed wound healing, pain, bleeding, and discharge. There is a paucity of information on the efficacy of the treatments used for pathologic PPGT. The objective of this study was to describe characteristics associated with the development of PPGT and the treatment methods currently used for management.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This was a retrospective cohort study of 140 patients diagnosed with PPGT within one year of birth from 2012 through 2022 within a single health care system. Patients were identified by <i>International Classification of Diseases</i> and Current Procedural Terminology codes. Demographics, birth characteristics, symptoms, and treatment information were obtained and assessed in frequencies and means. Treatments were compared with 95% CIs and <i>P</i> values. Time to resolution was assessed by the number of weeks and the number of visits.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>It was the first vaginal birth for 129 (92%) patients in the study cohort. The majority (84.3%) of patients presented with pain. Almost half of all patients (45%) were diagnosed after 6 weeks postpartum. 30.0% of patients were initially treated conservatively. 76.4% of patients were treated with silver nitrate, and 33.6% had an excisional procedure. Successful conservative management had the lowest average number of visits to resolution with 1.39 visits (95% CI, 1.15-1.69), followed by silver nitrate alone with 1.95 visits (95% CI, 1.73-2.19), and excision with or without silver nitrate with 2.40 visits (95% CI, 2.07-2.78). Conservative management was unsuccessful 45% of the time, requiring additional treatment with silver nitrate or excision. 30% of patients treated with silver nitrate or excision continued to report pain even after the resolution of granulation tissue upon examination.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>PPGT is commonly associated with first vaginal births, often presents beyond 6 weeks postpartum, and frequently requires treatment.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16468,"journal":{"name":"Journal of midwifery & women's health","volume":"70 1","pages":"104-110"},"PeriodicalIF":2.1,"publicationDate":"2024-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jmwh.13669","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141750136","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Miscarriage","authors":"","doi":"10.1111/jmwh.13670","DOIUrl":"10.1111/jmwh.13670","url":null,"abstract":"<p>A miscarriage is the early loss of a pregnancy. Miscarriage can happen any time between your last menstrual period and 20 weeks of pregnancy. After 20 weeks, a pregnancy loss is called a stillbirth. Most miscarriages happen before 14 weeks of pregnancy.</p><p>Miscarriage happens in about 15% to 20% of pregnancies. The true number is unknown because many happen before the person knows they are pregnant.</p><p>Usually there is no known cause. About half of all miscarriages are caused by genetic problems. Pregnancy loss is more common in older people and those who have had a miscarriage before. Medical problems like diabetes or thyroid disease, smoking, or alcohol use can increase the chance of miscarriage. A miscarriage can happen to anyone.</p><p>The most common signs of miscarriage are vaginal bleeding, cramping, or pain in your lower abdomen or back. These symptoms don't always mean a miscarriage will happen. Sometimes a miscarriage can occur without any warning.</p><p>A miscarriage is diagnosed by ultrasound. The ultrasound will show that the fetus does not have a heartbeat. Blood tests can also be done to check your levels of the pregnancy hormone (HCG). This can be helpful if your health care provider thinks you are having a miscarriage.</p><p>When someone is having a miscarriage before 20 weeks, nothing can be done to stop it. There are several options after you know you are miscarrying. The best option depends on how far along the pregnancy is, how healthy you are, and if other problems are happening. Your desires and your health care provider's advice are important too.</p><p>If your pregnancy is more than 16 weeks, your health care provider may admit you to the hospital to induce labor. This process can take some time and may involve the use of several medications. You will receive care during the process to support you and answer questions. You may be asked if you want to see the fetus.</p><p>When you become pregnant again, be sure to tell your health care provider that you have a history of pregnancy loss. They will check you out and tell you about your specific chance of having another miscarriage.</p><p>Flesch Kincaid score 7.1</p><p>Approved June 2024. This handout replaces “Miscarriage” published in Volume 58, Number 4, July/August 2013.</p><p>This page may be reproduced for noncommercial use by health care professionals to share with clients. Any other reproduction is subject to the Journal of Midwifery &amp; Women's Health's approval. The information and recommendations appearing on this page are appropriate in most instances, but they are not a substitute for medical diagnosis. For specific information concerning your personal medical condition, the Journal of Midwifery &amp; Women's Health suggests that you consult your health care provider.</p>","PeriodicalId":16468,"journal":{"name":"Journal of midwifery & women's health","volume":"69 4","pages":"621-622"},"PeriodicalIF":2.1,"publicationDate":"2024-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jmwh.13670","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141750135","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Research and Professional Literature to Inform Practice, July/August, 2024","authors":"Nancy A. Niemczyk CNM, PhD","doi":"10.1111/jmwh.13677","DOIUrl":"10.1111/jmwh.13677","url":null,"abstract":"","PeriodicalId":16468,"journal":{"name":"Journal of midwifery & women's health","volume":"69 4","pages":"615-618"},"PeriodicalIF":2.1,"publicationDate":"2024-07-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141731703","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}