ABSTRACT
BACKGROUND: This study aims to assess knowledge, attitude and acceptance of antenatal women for pain relief methods during labor and to know the effect of presumed availability of pain relief methods during labor on the attitude of women towards the mode of delivery. MATERIALS AND METHODS: A cross sectional study was conducted at a tertiary hospital between January and December 2016. A structured interview questionnaire had been administered including data related to current pregnancy, knowledge, attitude and previous experience of pain, labor analgesia, women's attitude toward the mode of delivery and its relation to the availability of adequate analgesia during labor. Visual analog scale (VAS) was used to assess pregnant women's attitude towards pain in general and that related to the process of labor (past and expected experience). RESULTS: Eight hundred and fourteen women were included in the study. The majority of our participants (82.9%) were unaware about the availability of labor analgesia. Sixty of the study participants preferred cesarean section (CS) to avoid labor pain. Availability of adequate pain relief during labor could decrease the women decision of CS by more than 50% in women expecting moderate and severe pain during labor compared to non-availability of pain relief (9.6% vs. 22.7% and 8.2% vs. 28.1% respectively). CONCLUSION: There is a great lack of knowledge regarding the availability of pain relief during labor. Lack of pain relief during labor can be responsible for more than half of women's intention to prefer CS as a mode of delivery.
ABSTRACT
BACKGROUND: Pregnancy during lactation is common in Egypt and is often unplanned. Overlap between pregnancy and lactation could be associated with an increased risk for the pregnant mother, her fetus as well as her nursing child. AIM OF THE STUDY: The current study aims to compare the maternal and perinatal outcome of pregnancies occurred during lactation with those occurred after weaning in women with substandard nutrition. MATERIALS AND METHODS: A prospective-cohort study was carried out in six Maternal and Child Health Centers in Assiut-Egypt. Estimated sample size was 540 women divided equally into two groups; the first included women who got pregnant during breastfeeding (PDBF), while the second included women who got pregnant after weaning (PAW). Tools were consisted of structured interview questionnaire including personal history, obstetrical data, breastfeeding, family planning histories and dietary intake during pregnancy. Pregnant women had been followed up to delivery to assess different maternal and fetal outcomes. RESULTS: Miscarriage rate was not statistically significant between both groups (2.2% in PDBF and 0.4% in PAW, p = 0.284). Women in PDBF group had higher prevalence of maternal anemia (54.1% versus 30.7%), intrauterine growth restriction (16.7% versus 4.8%), cesarean delivery (43.7% versus 31.5%), prolonged labor (13.3% versus 11.1%) and low birth weight infants (15.7% versus 8.8%) compared to women in PAW group. CONCLUSION: Pregnancy during breastfeeding is associated with an increase in the overall complications of pregnancy as compared to PAW. Although it does not increase the miscarriage rate, it increases the prevalence of maternal anemia, delayed fetal growth, prolonged labor, cesarean section delivery and the prevalence of low birth weight infants.
