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Background Simulation training is a powerful and evidence-based teaching method in healthcare. It allows students to develop essential competences that are often difficult to achieve during internships. High-Fidelity Perinatal Simulation exposes them to real-life scenarios in a safe environment. Although student midwives’ experiences need to be considered to make the simulation training work, these have been overlooked so far. Aim To explore the experiences of last-year student midwives with High-Fidelity Perinatal Simulation training. Methods A qualitative descriptive study, using three focus group conversations with last-year student midwives (n = 24). Audio tapes were transcribed and a thematic content analysis was performed. The entire data set was coded according to recurrent or common themes. To achieve investigator triangulation and confirm themes, discussions among the researchers was incorporated in the analysis. Findings Students found High-Fidelity Perinatal Simulation training to be a positive learning method that increased both their competence and confidence. Their experiences varied over the different phases of the High-Fidelity Perinatal Simulation training. Although uncertainty, tension, confusion and disappointment were experienced throughout the simulation trajectory, they reported that this did not affect their learning and confidence-building. Conclusion As High-Fidelity Perinatal Simulation training constitutes a helpful learning experience in midwifery education, it could have a positive influence on maternal and neonatal outcomes. In the long term, it could therefore enhance the midwifery profession in several ways. The present study is an important first step in opening up the debate about the pedagogical use of High-Fidelity Perinatal Simulation training within midwifery education. [ABSTRACT FROM AUTHOR]

Background Large congenital diaphragmatic hernia may require prosthetic correction. Acellular collagen matrices were introduced to avoid complications owing to the use of synthetic patches. We tested 3 different ACM for reconstruction of an abdominal wall defect in an animal model that mimics the fast growth during infancy. Methods Pelvisoft® (CR Bard, Covington, GA) and 2 investigational ACM were used for primary reconstruction of a full thickness abdominal wall defect. 3 months-old rats (n = 26) were allowed to survive for 90 days after implantation. Anatomical, tensiometric and histological analyses were performed. Based on good outcomes, we did the same with 1 month-old rats (n = 54). Unoperated rats were used for obtaining reference tensiometric values of selected native tissues. Results Major wound complications were exclusively observed in 1 month-old rats. All explants in both groups thinned significantly (p < 0.03) and had an elastic modulus increasing over time, far above that from native tissues at 90 days of life. Both investigational ACM induced a more vigorous foreign body reaction than Pelvisoft ® . Conclusions The shift from 3 to 1 month-old rats was associated with wound complications. Pelvisoft® showed a better biocompatibility than the 2 investigational ACM. Passive biomechanical properties of all explants were still not comparable to that of native tissues. [ABSTRACT FROM AUTHOR]

• Little is known about how Belgian women experienced the perinatal period during the pandemic. • It is confirmed that the quarantine affected pregnant women's mental health. • Women experienced a multiplicity of feelings in the perinatal period during the pandemic. • Some of the changes during the pandemic were experienced positively by many. • Our findings can support the maternity care organisation in the post pandemic era. During the COVID-19 pandemic a national quarantine was imposed in Belgium, which led to changes in the maternity care provision. Despite emerging literature, it remains unclear how pregnant women and women who have recently given birth experienced this period. With this study we aim to explore these women's experiences during the COVID-19 pandemic. This qualitative study is a part of a large longitudinal study on women's health-related quality of life (HRQoL), during the COVID-19 pandemic. An open-ended question, in an online survey, asking women about their experiences during the perinatal period was analysed using a thematic analysis. Of the 1007 women who participated in the HRQoL-study in June 2020, 556 (55%) women answered the open question. In general, we identified a multiplicity of mixed and interconnected feelings. Many women reported negative feelings; nevertheless, the pandemic also had some positive aspects for respondents. Six overreaching themes were identified: fear of contamination, feeling isolated and unsupported, not able to share experiences, disrupted care, feeling unprepared and experience a peaceful period. Although perinatal healthcare professionals did their utmost to provide the necessary care, being pregnant or being a new mother during this pandemic was challenging at times. However, this period was also experienced as a peaceful period with lot of opportunities to rest. Some of the changes such as telework and restricted visiting policies were experienced positively by many. Lessons learned can support perinatal healthcare professionals and policy makers in the organisation of maternity care in the post-pandemic era. [ABSTRACT FROM AUTHOR]

Simulation training is a powerful and evidence-based teaching method for students and healthcare professionals. The described educational model of Inter-professional Perinatal Simulation training is the result of a collaborative project with the Erasmus University College Brussels, the Medical School of the Vrije Universiteit Brussel (VUB) and the University Hospital Brussels. This model enhances student midwives to acquire competencies in all fields of midwifery according to national and European legislation and to the International Confederation of Midwives Global Standards for Midwifery Education. In our educational program, simulation training enhanced the achievement of decision-making and interprofessional communication competences. [ABSTRACT FROM AUTHOR]

Objective: The objective of the study was to determine whether cardiac troponin T (cTnT) and natriuretic peptides can be isolated from the amniotic fluid (AF) of pregnancies complicated by twin-to-twin transfusion syndrome (TTTS) and whether they correlate with fetal echocardiographic findings and recipient survival. Study Design: AF samples from the recipient sac were obtained in 52 TTTS cases and 16 controls. Samples were assayed for cTnT and natriuretic peptides. Prior to fetoscopic laser therapy, 34 recipient twins underwent assessment of atrioventricular flow patterns, myocardial performance index (MPI), and precordial venous Dopplers. Fetal survival was assessed 48 hours postoperatively. Results: AF B-type natriuretic peptide and cTnT levels were elevated in TTTS and correlated with functional echocardiographic findings. Postoperative recipient survival was 72% when both AF-cTnT and left ventricular MPI were increased. If 1 of both markers was normal, survival was 100% (P = .046). Conclusion: Combining ultrasound and AF-cTnT measurements allows the identification of fetuses at risk of postoperative demise. [Copyright &y& Elsevier]

Objective: We sought to assess fetal cardiac function in monochorionic twins before and after therapy for twin-to-twin transfusion syndrome (TTTS) and compare it with control subjects. Study Design: We conducted prospective longitudinal assessment of fetal cardiac function in cases undergoing curative fetal therapy for TTTS (n = 39) until 4 weeks postoperatively and in uncomplicated monochorionic twins (n = 23). Fetal cardiac function was assessed by the left and right ventricular myocardial performance index, atrioventricular valve flow pattern, ductus venosus a-wave, and umbilical vein pulsations. Results: Nomograms for the myocardial performance index were constructed. Fetal cardiac function was grossly abnormal in recipient twins of TTTS when compared with control subjects (P < .001 for all indices) but normalized by 4 weeks postoperatively. The donor developed abnormal ductus venosus flow and tricuspid regurgitation postoperatively that regressed within 4 weeks. Conclusion: The cardiac dysfunction in the recipient twin of TTTS normalizes within 1 month after laser. The donor develops a transient impairment of cardiac function postoperatively. [Copyright &y& Elsevier]