RESUMO
BACKGROUND: The perinatal period is a crucial time for women, as they experience various biological, psychological, and social stressors. Due to the complexity of this vulnerable time, there is a high prevalence of depressive and anxiety disorders among pregnant women. In 2019, the Health Commission of Shenzhen initiated perinatal mental health screening programme in China. However, attitudes and perceptions of medical staff towards implementing mental health screening programme during pregnancy remain unclear. The aim of this study was to explore the perceptions and attitudes of obstetric staff and midwives towards screening for perinatal mental disorders in pregnant women, and identify their perceived needs and motivations for undertaking this task. METHODS: This is a qualitative exploratory study. Data were collected through in-depth, semi-structured, face-to-face interviews. The dataset was analysed using inductive content analysis. Purposive sampling method was used to recruit 13 participants at a tertiary maternal hospital in Shenzhen from September to November, 2019. RESULTS: A total of 13 obstetric staff was interviewed, including two obstetricians, three midwives, and eight nurses. Four themes were identified from this study: views on perinatal mental health disorders screening, competency in identifying and supporting high-risk groups, barriers to dealing with psychological problems during pregnancy, and the support needs of medical staff in undertaking the tasks of mental health disorders screening. CONCLUSION: Medical staff lacked sufficient knowledge and skills in perinatal psychological health and were not well prepared for the task of screening pregnant women for mental health disorders. To address this issue, medical organisations and relevant government sectors should provide training to medical staff on perinatal mental health disorders, enhance public awareness of perinatal mental health disorders, establish a model of multidisciplinary collaboration for the screening of women's perinatal mental disorders, and provide continuous and holistic care for pregnant women.
RESUMO
OBJECTIVES: This review aimed to explore the independent risk factors of postpartum urinary retention (PUR) after a vaginal delivery. METHODS: The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) was followed and relevant studies were retrieved from eleven databases. The quality of the included articles was assessed using Critical Appraisal Skills Programme tools or the Appraisal tool for Cross-Sectional Studies. The data analysis was performed using Review Manager version 5.3. RESULTS: A total of nine articles were included and five risk factors were identified, namely, episiotomy (OR = 2.99, 95%CI = 1.31-6.79, P = 0.009), epidural analgesia (OR = 2.48, 95%CI = 1.09-5.68, P = 0.03), primiparity (OR = 2.17, 95%CI = 1.06-4.46, P = 0.03), instrumental delivery (OR = 4.01, 95%CI = 1.97-8.18, P < 0.001), and the duration of the second stage of labor (MD = 15.24, 95%CI = 11.20-19.28, P < 0.001). However, fetal birth weights of more than 3800 g were not identified as an independent risk factor (MD = 64.41, 95%CI = -12.59 to 141.41, P = 0.10). CONCLUSION: This systematic review indicated that the independent risk factors for PUR were found to include episiotomy, epidural analgesia, instrumental delivery, primiparity, and a longer second stage of labor. In clinical practice, healthcare providers could pay more attention to women with these factors and prevent postpartum urinary retention.
