ABSTRACT
Prelabor rupture of membranes (PROM) occurs in approximately 8% to 10% of women with term pregnancies. The management of PROM continues to be controversial. Approaches include expectant management and immediate induction of labor. The use of orally administered misoprostol for the management of women with PROM may provide significant advantages when they choose immediate induction of labor. This literature review presents current evidence that supports the use of oral misoprostol for women with PROM, including the benefits of a decreased interval time from PROM to vaginal birth, good safety profile, and reductions in the use of oxytocin augmentation and epidural anesthesia. In addition to clinically proven benefits to women of oral misoprostol for PROM, it also has the potential to reduce chorioamnionitis by reducing the number of sterile vaginal examinations performed thereby reducing the risk of ascending bacteria. Women have also reported acceptability and satisfaction when using oral misoprostol for immediate induction of labor. This review of literature discusses what is known about the use of orally administered misoprostol for the management of term PROM and makes recommendations for clinical use.
Subject(s)
Fetal Membranes, Premature Rupture/drug therapy , Labor, Induced , Labor, Obstetric , Misoprostol/therapeutic use , Oxytocics/therapeutic use , Term Birth , Chorioamnionitis/prevention & control , Female , Humans , PregnancyABSTRACT
OBJECTIVE: To examine whether a radio-education intervention (REI) is associated with improved maternal knowledge of pregnancy danger signs (PDS) in Nicaragua. METHODS: This cross-sectional pilot study used pretests and posttests to evaluate whether an REI was associated with improved knowledge of PDS among 77 pregnant and postpartum women in Nicaragua. RESULTS: The total number of PDS identified by study participants increased from 130 before the intervention to 200 after the intervention, an increase of 53.8% (Wilcoxon signed-rank test (z) = -4.18; P < 0.00001). The three PDS for which participant knowledge increased significantly after the intervention were 1) swelling of the face and hands, 2) convulsions, and 3) vaginal bleeding. Participants who 1) reported having a sister who had experienced a pregnancy complication, 2) lived in an urban setting, and 3) had more than a sixth-grade education were significantly more likely to score higher on posttests related to knowledge of PDS than those without those attributes (90.9% versus 56.9% [Χ² (degrees of freedom) = 4.60 (1); P = 0.043; n = 76]; 75% versus 45.9% [Χ² = 6.8 (1); P = 0.009; n = 77]; and 62.5% (12+ years education) versus 79.3% (6-12 years) versus 50.0% (0-6 years education) versus 25.0% (no education) [Χ² = 8.11 (1); P = 0.044; n = 77] respectively). CONCLUSIONS: Exposure to the REI was associated with a significant increase in the ability to identify PDS. Further studies should establish whether this increase in knowledge of PDS is associated with increases in use of maternity care services and decreases in delays in seeking care.
Subject(s)
Health Education/methods , Health Knowledge, Attitudes, Practice , Pregnancy Complications , Radio , Cross-Sectional Studies , Female , Humans , Pilot Projects , Pregnancy , Pregnancy Complications/diagnosis , Young AdultABSTRACT
OBJECTIVE: To examine whether a radio-education intervention (REI) is associated with improved maternal knowledge of pregnancy danger signs (PDS) in Nicaragua. METHODS: This cross-sectional pilot study used pretests and posttests to evaluate whether an REI was associated with improved knowledge of PDS among 77 pregnant and postpartum women in Nicaragua. RESULTS: The total number of PDS identified by study participants increased from 130 before the intervention to 200 after the intervention, an increase of 53.8% (Wilcoxon signed-rank test (z) = -4.18; P < 0.00001). The three PDS for which participant knowledge increased significantly after the intervention were 1) swelling of the face and hands, 2) convulsions, and 3) vaginal bleeding. Participants who 1) reported having a sister who had experienced a pregnancy complication, 2) lived in an urban setting, and 3) had more than a sixth-grade education were significantly more likely to score higher on posttests related to knowledge of PDS than those without those attributes (90.9% versus 56.9% [Χ² (degrees of freedom) = 4.60 (1); P = 0.043; n = 76]; 75% versus 45.9% [Χ² = 6.8 (1); P = 0.009; n = 77]; and 62.5% (12+ years education) versus 79.3% (6-12 years) versus 50.0% (0-6 years education) versus 25.0% (no education) [Χ² = 8.11 (1); P = 0.044; n = 77] respectively). CONCLUSIONS: Exposure to the REI was associated with a significant increase in the ability to identify PDS. Further studies should establish whether this increase in knowledge of PDS is associated with increases in use of maternity care services and decreases in delays in seeking care.
OBJETIVO: Analizar si una intervención de educación por radio se asocia con un mejor conocimiento materno de los signos de peligro durante el embarazo (SPE) en Nicaragua. MÉTODOS: Este estudio piloto transversal evaluó si la intervención se asociaba con un mejor conocimiento de los SPE en 77 mujeres embarazadas o puérperas de Nicaragua mediante evaluaciones previas y posteriores a la intervención. RESULTADOS: El número total de SPE reconocidos por las participantes en el estudio aumentó de 130 antes de la intervención a 200 después de esta, un aumento de 53,8% (prueba de los rangos con signo de Wilcoxon (z) = -4,18; P < 0,00001). Los tres SPE cuyo conocimiento aumentó significativamente entre las participantes después de la intervención fueron 1) la hinchazón de la cara y las manos, 2) las convulsiones y 3) la hemorragia vaginal. Las participantes que 1) notificaron que tenían una hermana que había presentado una complicación del embarazo, 2) vivían en un entorno urbano y 3) tenían un nivel educativo superior al sexto grado tenían significativamente más probabilidades de obtener una mayor puntuación en las evaluaciones posteriores relacionadas con el conocimiento de los SPE que las que no cumplían esas condiciones (90,9 frente a 56,9% [Χ² (grados de libertad) = 4,6 (1); P = 0,043; n = 76]; 75 frente a 45,9% [Χ² = 6,8 (1); P = 0,009; n = 77]; y 62,5% (más de 12 años de formación) frente a 79,3% (6 a 12 años), frente a 50,0% (0 a 6 años), frente a 25,0% (sin formación) [Χ² = 8,1 (1); P = 0,044; n = 77], respectivamente). CONCLUSIONES: La exposición a la intervención de educación por radio se asoció con un aumento significativo de la capacidad de reconocer los SPE. Sería preciso llevar a cabo otros estudios para establecer si este aumento de conocimientos en materia de SPE se asocia con un incremento en el uso de los servicios de atención a la maternidad y una disminución de las demoras en la búsqueda de atención.
