Suture type used for perineal injury repair and sexual function: a randomised controlled trial.

The type of suture used to repair perineal injury may be associated with this healing process and subsequent sexual function. This study aims to assess whether the suture technique used (continuous or interrupted) has an impact on a woman's sexual function following childbirth. A single-blind randomised clinical trial was conducted with primiparous women who had experienced a perineal injury during childbirth. A computer-generated random number table was applied to allocate women to each group. Data were collected on sociodemographic variables, variables associated with childbirth, and outcomes during the 3 months after childbirth. Mean difference was used to assess the influence of the suture type on outcomes. Multivariate analyses were carried out to adjust for unbalanced variables after randomisation. Seventy women participated in the intervention group (continuous suture) and 64 women in the control group (interrupted suture). The women in the intervention group scored high for sexual desire, adjusted mean difference (aMD) = 1.8, 95% CI = 1.1-2.6 (p < 0.001); the same happened with arousal (aMD = 1.7, 95% CI = 0.8-2.5, p < 0.001). In the intervention group, orgasm was more easily reached, aMD = 0.8, 95% CI = 0.4-1.1 (p < 0.001). Women who received a continuous suture indicated they felt less discomfort (p < 0.001). Women who had a continuous suture reported better postpartum sexual function.Trial registration: ClinicalTrials.gov NCT03825211 posted 31/01/ 2019.

The Age at Which a Woman Becomes a Mother and Her Satisfaction with the Process of Pregnancy, Childbirth and the Puerperium.

This study assessed the effect of maternal age on satisfaction at each stage of pregnancy, childbirth and puerperium, and globally. An observational study was carried out in five hospitals of the Andalusian public health system with older primiparous women, from May 2016 to May 2018. Using a pre-piloted questionnaire, information was collected on pregnancy, childbirth, puerperium, newborn variables and degree of satisfaction with the care received. Crude and adjusted mean differences and the standard error of the mean were calculated. A total of 373 women participated. In total, 43.0% of the sample were very satisfied with the care received during pregnancy, and 74.2% with the care received during childbirth. During the puerperium, the highest percentage (60.4%) was found among the women who reported being quite satisfied, although the results were not significant in any of these stages (p > 0.05). No significant differences were established between women's different age strata and maternal satisfaction. However, the average given by women regarding their satisfaction with the process, on a scale from 0 to 4, was: 3.5 ± 0.5 in general, 3.2 ± 0.8 regarding pregnancy, 3.7 ± 0.5 in childbirth and 3.1 ± 0.6 in the postpartum period. The woman's satisfaction with the follow up and health care received during pregnancy, childbirth and puerperium is independent of the mother's age.

The delay of motherhood: Reasons, determinants, time used to achieve pregnancy, and maternal anxiety level.

BACKGROUND: Fertility in recent decades in European countries such as Norway, Spain or United Kingdom has declined, while in others such as Portugal, it has remained relatively constant, and in others such as Germany fertility rated have risen. The determinants of this change in reproductive pattern can be explained by the cultural, social, and economic changes that took place in our society. Objective: to identify the principal reasons and independent determinants associated with the postponement of motherhood and document any association between the time taken to achieve successful pregnancy and maternal age, as well as the level of anxiety of these women. METHODS: An observational study, including 326 women, was conducted in Spain with primiparous women, in which data was collected on sociodemographic, health, and pregnancy-related factors. Comparison of means (t-test or analysis of variance) and the analysis of covariance was used to estimate adjusted means for potential confounders. RESULTS: Women in stable relationships became mothers at older ages (31.83±0.29) than those who were not (28.75±0.78) (p<0.001). Women who delayed motherhood for medical reasons had a mean age of 34.15 ± 0.88 years, compared to a mean of 30.52±0.36 years for personal reasons, and 27.51±1.39 years for other reasons. Mothers with an older age had a higher level of anxiety (p<0.05). The average time required to achieve pregnancy increased as maternal age increased, with an average time of 24 months for women with a mean age of 35.23±0.71 years compared to <3 months for women with a mean age of 29.44±0.39 years. Women ≥ 35 years were more likely to need medical assistance to achieve pregnancy (aOR = 12.07, 95% CI: 1.50-97.05; p = 0.019). CONCLUSIONS: Medical reasons were among those cited for delaying motherhood. The postponement of motherhood was associated with difficulty to achieve a successful pregnancy and a higher level of anxiety.

Newborn Health Indicators Associated with Maternal Age during First Pregnancy.

Delaying motherhood is becoming increasingly common, raising questions of the possible influence that maternal age may have on newborn health. Therefore, the objective of this study was to determine the association between maternal age and different newborn health parameters. An observational study was conducted in Spain on primiparous women and their infants. Data were collected on newborn health variables, breastfeeding, and different clinical practices that are beneficial for child health and development. Crude and adjusted mean differences were calculated along with the standard error of the mean. A total of 373 women and their children participated. In terms of early commencement skin-to-skin contact, the mean age of women that did skin-to-skin contact was 29.95 ± 0.31 years compared to 31.49 ± 0.66 years in those that did not (p = 0.042). In terms of other newborn parameters, such as preterm birth, health problems or complications, or the need for hospital admission, these were more frequent in the oldest group of mothers, but the differences found were not significant (p > 0.05). Hence, indicators of newborn morbidity were not found to be significantly associated with maternal age; however, beneficial practices such as early commencement skin-to-skin contact were found to be significantly associated with maternal age.

Maternal Age and Pregnancy, Childbirth and the Puerperium: Obstetric Results.

Delaying maternity is becoming more common, resulting in questions regarding the influence age may have on obstetric results. Therefore, we proposed the objective to determine the association between maternal age and different health variables during pregnancy, childbirth and the puerperium. We conducted an observational study in Spain with primiparous women in which data was collected on sociodemographic, health and obstetric variables. Crude and adjusted mean differences were calculated with their corresponding 95% confidence intervals. The study included a final sample of 373 women. The mean age of women presenting with hypertension during pregnancy was 34.54 years (95% CI: 31.80-37.27) compared with a mean of 30.11 (95% CI: 29.56-30.66) in women that did not (p = 0.002). Women who had a eutocic delivery were also younger: 29.17 years (95% CI: 28.48-29.86) compared with 31.90 years (95% CI: 31.05-32.74; p < 0.001) for those that had a dystocic delivery. The duration of dilatation was longer in those ≥35 years (p = 0.001). In conclusion, an advanced maternal age is associated with a higher incidence of pathology during pregnancy and dystocic labor.

Inducción mecánica del parto: doble balón o sonda de Cook® / Mechanical induction of labour: double balloon or Cook® catheter

Los procedimientos mecánicos para la maduración de un cérvix desfavorable se están configurando como una alternativa eficaz frente a los farmacológicos, especialmente en los casos donde estos están contraindicados. En la actualidad se despierta el interés sobre el uso de estos métodos por tratarse en general de dispositivos que generan bajo coste, son seguros, simples, cómodos, reversibles, sin fármacos y, fundamentalmente, por sus pocos efectos adversos y repercusiones maternas y/o fetales. Con el objetivo de dar a conocer dicho método mecánico de inducción de parto, se realizó el seguimiento de una mujer gestante con patología asmática y con indicación de finalización del embarazo mediante doble balón de Cook®; este concluye con un parto eutócico y sin incidencias

Mechanical procedures for ripening an unfavourable cervix are positioning as an effective option vs. pharmacological methods, particularly in those cases where the latter are contraindicated. There is current interest about the use of these methods, as these are overall low-cost devices, simple, convenient, reversible, drug-free, and most of all, they cause few adverse effects and low impact on the mother and/or the foetus. With the objective to create awareness about said mechanical method for labour induction, follow-up was conducted for a pregnant woman with asthma and indication of end of pregnancy through Cook® double balloon, resulting in a normal delivery without incidences