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Purpose The aim of this study was to examine the characteristics of users of postpartum care services and compare the factors associated with utilization of these services for users and non-users. The focus was on postpartum physical and mental discomfort, childcare anxiety, qualities of partners regarded as the closest supporters, and the use of instruction in childcare techniques. Methods A longitudinal study using a web-based self-administered questionnaire was conducted from May 2019 to February 2020 with study participants at 35 weeks gestation and one month postpartum. Of the 2,402 women given the research information leaflet at the time of their antenatal checkup, 667 (27.8%) responded to the first self-administered webbased survey, and 448 (18.7%) responded to the second one. The 448 respondents who answered at both time points and indicated whether they used the postpartum care services were included in the analysis. The respondents were divided into two groups: those who answered that they had used the postpartum care services and those who responded that they had not. Chi-square tests, Mann-Whitney U tests, and student t-tests were performed on the investigation variables. Results Characteristics significantly associated with users of postpartum care services included the following: annual household income of at least 9 million yen, status as an employed woman, desiring to be pregnant, receiving a negative reaction from one's partner when becoming pregnant, first breastfeeding was the day following the birth, a strained relationship with one's partner at one month postpartum, and low scores on the Short Form-8 (SF-8) Japanese version of the Physical Component Summary (PCS) at one month postpartum. Conclusion In this study, the use of postpartum care services was associated with decreased physical quality of life (QoL) after childbirth. In addition to the need for rest, the relationship with one's partner might be related, suggesting the need to consider the relationship with the partner as a factor in deciding whether to use postpartum care services. In addition, financial difficulties associated with using the current postpartum care services also existed. Therefore, physical QoL, the relationship with one's partner, and financial support should be considered so that those needing postpartum care services can access them. [ABSTRACT FROM AUTHOR]

The purpose of this study was to reveal the characteristics of mothers who used stay-type postnatal care facilities, usage situation, reasons for use. In addition, to reveal the difficult situations that postpartum mothers experienced when they used stay-type postpartum care facilities. Methods This study surveyed users of stay-type postpartum care facilities in Tokyo who consented to the research. Data included mother's socio-demographics and responses to open-ended questions about situations that were difficult during their postpartum period. Data were analyzed using simple aggregation; open-ended responses were categorized using content analysis. Results From the 9 facilities queried, 111 questionnaires were returned during the one-month of data collection. Mother's ages ranged from 35 to 39 and the mode was 39 (35.1%), indicating that most were older mothers. The most common length of stay was less than one week after delivery by 39 (35.1%) of mothers. Mother's stay difficulties were sorted into 9 categories: (1) Situation of sleep deprivation due to frequent breastfeeding and baby crying; (2) Situation of caring for infant with physiological pain and distress after childbirth; (3) Breastfeeding situation that are not ideal; (4) Situation of dissonance with family due to changes in family roles; (5) Situation with vague anxiety and loneliness; (6) Situation of unclear judgment on the growth, development and physical condition of infant; (7) Situation that require self-judgment and response to childcare that goes against the image; (8) Situation of self-loathing by comparing self with others; (9) Situation of worries about returning to work and financial matters. Conclusions In recent years, the number of older women giving births, high-risk births, and painless births (epidural anesthesia) has increased, and it takes time to recover after delivery. Therefore, a postnatal care facility is necessary as a place for infant-care education according to the physical condition of the mother and the individuality of the baby. Postnatal care facilities that provide care mainly by midwives are expected. Because of necessary to adjust the child-care style according to the physical and mental conditions of the mother, breastfeeding conditions, and the individuality of the child. It is also expected to enhance self-efficacy to prevent mental health problems. [ABSTRACT FROM AUTHOR]

Purpose To describe midwives' perceptions of the continued existence of postpartum care services in midwifery homes, and to discuss the importance of midwifery homes in the community. Methods We conducted a qualitative study of 8 midwives who provided postpartum care services in midwifery homes in A prefecture. A semi-structured interview was administered where they described their perceptions of practicing at midwifery home. Data were descriptively analyzed. Results Regarding midwives' perceptions, the 1 core category [Practicing to support healthy life for mother-child dyads and their family] consisted of the 5 categories < Continued individual holistic supports>< Leading breastfeeding to pleasant of child-rearing > and . Midwives realized the existence of midwifery homes in the community as [Places of seamless child-rearing support in the community] and consisted 6 categories < Individual supports to mothers according to their background> and . Conclusion Midwives recognized that postpartum care services were essential practices in their profession that was different from ongoing project of postpartum care services. Moreover, the midwives continuously supported healthy lives for mother-child dyads and their families based on capturing mothers who are a series from pregnancy. Furthermore, the midwives considered the midwifery homes as places where they could perform professional roles in the community. [ABSTRACT FROM AUTHOR]

Purpose This study aimed to investigate the expectations of mothers regarding postpartum home visits less than 1 year after childbirth and to clarify the needs of mothers during postpartum home visits. Method This study was based on a survey conducted among 594 postpartum women in Tokyo, Chiba, and Saitama prefectures in Japan. All participants were surveyed within one year of delivery. A major part of the questionnaire concerned the requirements for postpartum home visits and included items on (1) basic attributes, (2) situation and method of delivery, (3) condition of the newborn baby, (4) postpartum support, (5) mothers' expectations regarding postpartum home visits (scheduling, number of visits, time, occupation of visitor, type of care), and (6) a free space for any additional comments. Results A total of 271 (45.6%) postpartum women returned the questionnaire. Their average age at delivery was 32.8 (± 5.0) years. Of the respondents, 176 (64.9%) were primipara, and 95 (35.1%) were multipara. The average pregnancy duration was 39.0 (±1.6) weeks, with 86.0% having a vaginal delivery and 14.0% opting for a Caesarean section. A total of 185 respondents (68.5%) had either "no reservations" or "few reservations" about home visits. Additionally, 174 respondents (64.4%) wanted home visits one to two months after delivery, and 114 (42.2%) wanted home visits immediately after leaving the hospital to one month after delivery; 180 respondents (67.7%) said they would like multiple home visits within one month of delivery, while 237 respondents (87.8%) wanted to be visited by a midwife, making this the most desired occupation, and 174 (72.2%) wanted to be visited by someone from a hospital or clinic. The most desired types of care included weighing the infant (228 respondents, 84.1%), breastfeeding-related concerns (198 respondents, 73.1%), and pelvic care (163 respondents, 60.1%). Conclusion Although the postpartum period includes mental stress, the most desired types of care involved breastfeeding, weighing the infant, and other direct physical approaches. Few mothers within the first year of delivery had strong reservations about home visits, and many wanted multiple visits within two months of delivery. Many respondents expressed a desire for both a midwife and someone affiliated with a hospital or clinic. Thus, in the future, it would be desirable for midwives from hospitals and clinics to provide outreach-style home visits for seamless care. [ABSTRACT FROM AUTHOR]

Copyright of Journal of Japan Academy of Midwifery is the property of Japan Academy of Midwifery and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Journal of Japan Academy of Midwifery is the property of Japan Academy of Midwifery and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Journal of Japan Academy of Midwifery is the property of Japan Academy of Midwifery and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Journal of Japan Academy of Midwifery is the property of Japan Academy of Midwifery and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Objectives To implement and evaluate the application of the Kemp Assessment, designed to screen for parental child abuse and neglect. Method The Kemp Assessment, translated from the Family Stress Checklist into Japanese for women at postnatal settings in Japan, was implemented by interview to access the risk for child abuse and neglect. The Kemp Assessment is comprises of ten items each weighted from 0 (no risk) to 10 points (highest risk) discriminating low-risk of child abuse and neglect from high-risk with a maximum score of 100. The cutoff point was a score of 25 (higher risk). Cronbach's α of the Kemp Assessment was 0.57. Utility of the Kemp Assessment Process was evaluated through screening method, scoring, and follow-up for high-risk women using an evaluation questionnaire. The Ethics Committee of St.Luke's College of Nursing approved the protocol. Results Participants were 88 (95.6%) of the 92 eligible women in the postnatal period at an urban hospital. The average total score was 9.8 (SD=9.8). Scoring 0 were 26.1% and eight women (10.0%) scored at high-risk for child abuse. According to the evaluation questionnaires the screening interviews were appropriate for timing and place. While interviews lasted 25-77 minutes; about half the participants required over 40 minutes, only 20.5% responded that the interview was slightly long. More than 60.0% responded that the interview was helpful in easing anxiety and for obtaining community resource information. For follow up of identified high-risk women, the researchers used participants' background information and details of the women's situation and of their families. Researchers and the midwives referred high-risk women to community health centers to continue support. Conclusion Participants' evaluation indicated positive reactions for the screening and follow-up methods. Researchers referred high-risk women to community health centers to continue support. The Kemp Assessment could be safely utilized in prenatal settings in Japan, when the psychometric properties of the instrument and study design are strengthened. [ABSTRACT FROM AUTHOR]

Medical treatment of epilepsy is quite different for women than for men. It is known that estrogen facilitates while progesterone inhibits the generation of epileptic seizures. Due to the direct neuronal effects of estrogen, progesterone, and their metabolites, as well as the cyclical nature of sex hormone release, women are particularly susceptible to the effects of these hormones on seizure frequency and severity. Antiepileptic drugs (AEDs) may result in reproductive endocrine disorders, decreased effects of oral contraceptives, or congenital malformations. On the other hand, if AED treatment is insufficient, seizures may influence reproductive endocrine disorders or cause fetal death. Physicians should minimize these risks through preconception counseling and appropriate treatment of women with epilepsy who are of reproductive age.

Depression is the most common complication in perinatal period, affecting approximately 10% of women. Studies were also examined for data related to the predictors/risk factors, effects on the fetus and newborn, and treatment of depression during these periods. Psychopharmacological treatment in pregnant or breastfeeding women with depression will result primarily from a careful evaluation of their psychopathological condition. Maternal depression is associated with adverse effects on fetal and infant development. Prevention and psychological intervention is also useful for detecting mother with postnatal depression, using the EPDS. Controlled psychological trials for postnatal depression have shown the benefit of involving health professionals. Multidisciplinary specialist teams in mother and baby units have been an important role in perinatal psychiatric care.

Recent studies suggest that early tracheal extubation after coronary artery bypass grafting (CABG) may reduce intensive care unit use and cost. During recent two years, 96 patients were underwent CABG under cardiopulmonary bypass by low-dose fentanyl and isoflurane anesthesia. We compared two groups of patients for evaluation of factors associated to early tracheal extubation. 47 cases (Group A) were extubated within six hours (average 4.4 hrs) following operation, and 26 cases (Group B) were extubated later than twelve hours (average 57.5 hrs). It is suggested that emergency cases, female, elderly patients, dysfunction of kidney and long operation time associated to late extubation. But early extubation after CABG does not increase perioperative morbidity except for the cases that fell in low cardiac output syndrome or postoperative respiratory complications.

Various diseases often occur after delivery but the systemic examinations have not been studied before. Thyroid dysfunction frequently (4.4%) occurs after delivery through an immune rebound mechanism. If postpartum women complain of the symptoms caused by thyrotoxicosis (palpitation, weight loss, increased sweating, finger tremor, fatigue) or hypothyroidism (edema, cold intolerance, hoarseness, sleepiness, fatigue), it is essential to examine thyroid hormones, thyroid stimulating hormone, anti-thyroid microsomal antibody (MCHA) and anti-TSH receptor antibody. To predict who will develop postpartum thyroid dysfunction, the measurement of MCHA during pregnancy is useful because 62% of the subjects with positive MCHA show thyroid dysfunction after delivery. The individuals at high risk of postpartum onset of Graves' thyrotoxicosis can be found early in their pregnancy by the detection of thyroid stimulating antibody (TSAb). Other autoimmune diseases, such as rheumatoid arthritis, systemic lupus erythematosus, autoimmune hypophysitis and so on, also could develop after delivery. These findings indicate that laboratory tests in the postpartum period are essential to diagnose postpartum onset of autoimmune diseases and the measurement of autoantibodies in early pregnancy is useful for prediction of their onset in the postpartum period.

The routine use of maternal ultrasonography has led to frequent discovery of fetal anatomical abnormalities of the urinary tract. Herein we report on 35 cases with congenital urogenital anomalies which were found during the last 5 years by the prenatal ultrasonography and referred to our clinic either for treatment or consultation. 1. Findings of prenatal ultrasonography There were 12 cases of hydronephrosis, 7 of multicystic dysplastic kidney, 4 of megaureter, 3 of posterior urethral valve, 2 of ureterocele, 2 of vesicoureteral reflux and 5 other cases. Fetal anomalies were diagnosed during routine maternal examination, as intrauterine growth retardation, oligohydramnios, or the recurrent risk secondary to genetic risk factor or previous abnormal pregnancies. Prenatal diagnosis was made as early as 20 weeks of gestation in a case of hypoplastic urethra with large bladder diverticula. In about 30% of cases, abnormalities were found before 30 weeks of gestation. Oligohydramnios was evident in 5 cases. Prenatal diagnosis was correct in about 60% of cases. In the remainder the diagnosis was either incomplete or incorrect. Errors in the diagnosis resulted from difficulties in the differentiation of dilated ureter, intestinal dilation or intraperitoneal cystic masses. 2. Management in newborn periods Of the patients, 12 were treated urologically in newborn periods. Although patients with distended bladder and dilatation of upper tracts first underwent therapeutic placement of the urethral catheter, upper tract diversion with nephrostomy or tubeless ureterocutaneostomy was required in 2 because of continued elevation of serum creatinine levels. In 2 neonates nephrectomy was indicated for unilateral multicystic kidney, because the large cystic mass might compress the intestine.(ABSTRACT TRUNCATED AT 250 WORDS)