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BACKGROUND: Hydrotherapy is a technique used for pain management during labour, but its safety for both the mother and foetus remains uncertain. OBJECTIVE: The main aim of this study is to determine whether the use of hydrotherapy in the first stage of labour is safe for both the mother and newborn. METHODS: A retrospective observational study was conducted to collect data from the partogram, maternal and neonatal history. RESULTS: A total of 377 women who gave birth at the Costa del Sol Hospital in Malaga between January 2010 and December 2020 were randomly selected. They were divided into a control group (253 women) and an intervention group (124 women) that used hydrotherapy in the first stage of labour. There were no significant differences between the groups in terms of age, history of previous miscarriages, type of delivery, or newborn weight. The results showed that most women who opted for hydrotherapy were nulliparous, and the use of hydrotherapy during labour was safe for both the mother and foetus. There were no significant differences in the variables of maternal arterial hypotension, postpartum haemorrhage, postpartum maternal fever, foetal complications, neonatal admission, 1 and 5 min Apgar scores, umbilical arterial or venous pH, or foetal cardiotocographic recording. However, there was a significant difference (p = 0.005) in the rate of breastfeeding among mothers who opted for hydrotherapy (96% vs. 85.7%). CONCLUSIONS: The use of hydrotherapy during the first stage of labour is safe and is associated with increased breastfeeding rates compared to conventional delivery.
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Rapid advances and improved networking abilities have led to the widespread adoption of technology in healthcare, especially focused on diagnostics, documentation and evaluation, or mining of data to improve outcomes. Current technology allows for rapid and accurate decision-making in clinical care decisions for individual patients, collation and analysis at different levels for administrative and financial purposes, and the ability to visualise, analyse, and share data in real time for departmental needs. The adoption of technology may help to improve efficiency and efficacy of healthcare services. Obstetric anaesthesia is a specialised area that has to address the well-being of the pregnant woman and the unborn baby simultaneously. A shift toward caesarean sections as the major mode of childbirth has led to an increased involvement of anaesthesiologists with childbirth. Decisions are often made in high pressure, time intense situations to protect maternal and foetal health. Furthermore, labour analgesia using various neuraxial and non-neuraxial techniques is being demanded by parturients frequently, and for the materno-foetal safety, risk management is the core issue. Hence, it is essential that obstetric anaesthesia teams regularly audit their outcomes to improve services and to identify potential trouble spots earlier. It may be helpful to have audit parameters displayed as visual data, rather than complex tabular and numerical data, for ease of sharing, analysis, and redressal of problem areas. We describe the design and use of an obstetric anaesthesia dashboard that we have used in our department for the past 5 years.
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Managing symptoms of allergic rhinitis (AR) and urticaria in pregnant women is important to reduce complications and negative outcomes. The objective of this study was to provide information on the pregnancy outcomes of women exposed to the antihistamine cetirizine (CTZ). The UCB Pharma Patient Safety Database was searched for pregnancies up to 28 February 2015. Maternal CTZ exposure reports were extracted, and pregnancy outcomes were examined, including exposure, comorbidities and infant events. 228 of 522 pregnancies with maternal CTZ exposure had available outcomes; 49 were prospective. The majority (83.7%) resulted in live births; four spontaneous miscarriages, three induced abortions and one stillbirth were reported. Most pregnancies were exposed during the first trimester. Two congenital malformations were reported. The results suggest that CTZ exposure is not associated with adverse pregnancy outcomes above the background rates. While reassuring, the strengths and limitations of a safety database study need to be considered. Impact statement What is already known on this subject? AR and urticaria can substantially affect pregnant women, and adequately managing their symptoms is important to reduce maternal and foetal complications. Antihistamines are efficacious, however, there is still a lack of data regarding use during pregnancy. Although current evidence indicates that antihistamines are well-tolerated during pregnancy, data regarding foetal safety are inconclusive. What do the results of this study add? Our study suggests that CTZ exposure during pregnancy is not linked to an increase in adverse outcomes. CTZ exposure mainly happened during the first trimester only, when most organogenesis takes place. Most of the maternally exposed, prospective pregnancies resulted in live births (83.7%). Congenital malformations occurred in 2/41 live births from the CTZ-exposed pregnancies. What are the implications of these findings for clinical practice and/or further research? Our study presents a detailed data analysis from a large number of CTZ-exposed pregnancies, and its results are in line with those from previous reports. While the limitations of a safety database study need to be considered, the results shown here are reassuring. Further prospectively reported pregnancies are required, before definite conclusions on the risks of CTZ exposure during pregnancy can be drawn.