Search

INTRODUCTION: Assessment of mothers' breastfeeding attitudes during the COVID-19 pandemic can aid healthcare professionals in planning appropriate breastfeeding counseling. The aim of our study is to assess the breastfeeding attitudes of puerperal women during the COVID-19 pandemic and the related factors. METHODS: A cross-sectional study was conducted on 470 postpartum women who delivered in a state hospital in Turkey in 2022. Participants were selected through simple random sampling. RESULTS: The mean score on the Breastfeeding Attitude Evaluation Scale was 101.11 ± 19.79 (scores range from 0 to 184). Factors that positively influenced breastfeeding attitude included initiating breastfeeding in the first hour after birth (p = .043), planning exclusive breastfeeding for the first 6 months (p = .004), intending to breastfeed for 24 months or more (p = .008), giving breast milk as the baby's first food (p = .017), believing that a COVID-19-infected mother should breastfeed her baby (p = .000), and not separating a COVID-19-positive mother from her baby (p = .014). Conversely, being a primiparous mother (p = .011) and not believing that breast milk protects the baby from COVID-19 (p = .011) negatively impacted the breastfeeding attitude. CONCLUSION: This study found that postpartum women had positive breastfeeding attitudes during the COVID-19 pandemic, and certain factors influenced these attitudes. [ABSTRACT FROM AUTHOR]

Developmental coordination disorder (DCD) is one of the most frequently observed movement disorders in childhood, yet data on its prevalence are still unclear. This two-stage epidemiological study aims to determine the prevalence of DCD in children between 6 and 10 years of age according to the diagnostic criteria of the Diagnostic and Statistical Manual of Mental Disorders-5 (DSM-5). In the first stage, the Developmental Coordination Disorder Questionnaire (DCDQ’07) were given to primary school students. In the second stage, clinicians conducted psychiatric interviews with children who had an indication of DCD or were suspected of having DCD according to the DCDQ’07 and their parents. The interviews utilized the DSM-5 diagnostic criteria for DCD and applied the Schedule for Affective Disorders and Schizophrenia for School-Age Children-Present and Lifetime Version-Turkish Adaptation (K-SADS-PL) and Wechsler Intelligence Scale for Children (WISC-R) to identify co-occurring disorders. In the first stage, 2,306 children were evaluated, and 205 were invited for a clinical interview. Of the 198 children interviewed, 49 met the diagnostic criteria for DCD. The prevalence of DCD in Türkiye was found to be 2.1%. High parental education level, a previous psychiatric admission of the child, mother’s postpartum depressive symptoms, co-occurring disorders, and co-occurring attention deficit hyperactivity disorder (ADHD) were significantly more common among children with DCD. Potentially associated factors were evaluated by logistic regression analysis. The mother’s education level, the presence of postpartum depressive symptoms, and co-occurring disorders in the child were found to be associated factors. [ABSTRACT FROM AUTHOR]

Objective: The study was aimed at investigating the association between postpartum women's breastfeeding self-efficacy levels and their depression levels, social support levels, and breastfeeding attitudes in early postpartum period. Methods: The cross-sectional study was carried out in Kirklareli in Turkey. The population of the study consisted of 398 women aged 15–49 in the first 42 days of the postpartum period who presented to eight family health centers. The study data were collected face-to-face using the Personal Information Form, Breastfeeding Self-Efficacy Scale-Short Form (BSES-SF), Edinburgh Postnatal Depression Scale (EPDS), Multidimensional Scale of Perceived Social Support (MSPSS), and Breastfeeding Attitudes of the Evaluation Scale (BAES). Results: The mean age of the participants was 28.61±5.72 (Min:18, Max: 44), and the mean score they obtained from the BSES-SF was 55.13±8.39. Statistically significant differences were detected between the participants' BSES-SF scores and age groups, employment status, perceived income level, and the number of living children (p < 0.05). No statistically significant differences were detected between marital status, educational status and BSES-SF scores (p > 0.05). In the multivariate regression analysis adjusted according to the sociodemographic characteristics, BAES, EPDS and MSPSS accounted for 48.3% of the BSES-SF. A negative association was found between BSES-SF scores and EPDS scores (β = −0.178, 95% CI:−0.349, −0.006), and a positive relation between the BAES scores (β = 0.194, 95% CI: 0.163, 0.226) and the MSPSS scores (β = 0.114, 95% CI: 0.037, 0.191). Conclusion: As the level of depression of women increases in the postpartum period, the level of breastfeeding self-efficacy decreases. The breastfeeding self-efficacy increases as the level of social support increases and as the attitudes that drive breastfeeding behavior change positively. [ABSTRACT FROM AUTHOR]

Objective: The postpartum period is a process that affects mothers and fathers mentally. In this systematic review, we aimed to investigate the literature on postpartum depression and elucidate the factors associated with depression in fathers/men; and eventually to draw attention to the subject. Methods: A literature search was conducted between April-May 2019 including qualitative and quantitative research articles published between 2009-2019 in Pubmed, Science Direct, EBSCOhost, Turkish Psychiatric Index and Ulakbim Medical Databases. A total of 18 articles in English (n = 17) and Turkish (n = 1) were included. Results: The majority of studies were quantitative (n=17) and 1 had a qualitative design. 22.2% were carried out in the Americas, 61.1% in Europe and 16.7% in Asia. In 16 of the studies, Edinburgh Postpartum Depression Scale was used to diagnose postpartum depression in fathers, and 4 of them assessed psychometric properties. According to the results of the findings, unemployment, age, economic status and social support were among the factors affecting postpartum depression in fathers. Conclusion: Besides the factors affecting the mothers such as age, education, social support, whether the pregnancy was planned, parenting stress, parental stress/sense of competence, quality of the relationship with the spouse, history of depression, number of people living at home; factors such as housing status, economic situation and unemployment affect postnatal depression in fathers. Since there was only one research article from Turkey, we believe that there is a need for research on this subject in our country. [ABSTRACT FROM AUTHOR]

Background: Predictors of early or delayed recovery are unclear in peripartum cardiomyopathy (PPCM). Therefore, we aimed to assess the prognostic value of serial assessment of clinical, echocardiographic, and biochemical markers in patients with PPCM.Methods: Fifty-two consecutive women with PPCM were enrolled in this prospective study. Each patient underwent transthoracic echocardiography, B-type natriuretic peptide (BNP) and C-reactive protein (CRP) measurement at admission, and every 3 months. Early recovery was defined as resolution of heart failure at 6 months postdiagnosis, delayed recovery was defined if the length of time required for recovery of left ventricular function was longer than 6 months, and persistent left ventricular dysfunction (PLVD) was defined as an ejection fraction of less than 50% at the end of follow-up.Results: Thirty patients (57.7%) recovered completely, 10 died (19.2%), and 12 (23.1%) had PLVD. There were no significant differences in baseline BNP and CRP values between patients who recovered completely and who did not recover. However, patients with complete recovery were more likely to have a higher left ventricular ejection fraction, smaller left ventricle end-systolic dimensions at baseline, and lower CRP and BNP levels at follow-up. Elevated levels of BNP and CRP on follow up at 3 and 6 months were associated with nonrecovery. Third and sixth month BNP values were significantly lower in patients with rapid recovery, compared to patients with delayed recovery. Bromocriptine therapy was also associated with early recovery.Conclusions: Persistent elevation of plasma CRP and BNP levels at follow-up portend a slower response or nonrecovery in patients with PPCM. Bromocriptine therapy was an independent predictor of early recovery. [ABSTRACT FROM AUTHOR]

We examined the efficiency of different simulation methods for the improvement of knowledge and skills of nursing students in the management of postpartum hemorrhage. A total of 84 nursing students participated in the study. Data were obtained using a Semi-Structured Questionnaire Form, Student Satisfaction Evaluation Form, Effective Communication Skills Checklist, Spielberger's State-Trait Anxiety Inventory, and Skills Evaluation Form for Postpartum Bleeding Management. We suggest that the use of different simulation methods may be effective in improving the knowledge and skills of nursing students in the management of postpartum hemorrhage. [ABSTRACT FROM AUTHOR]

Objective: The diagnosis of disseminated intravascular coagulation (DIC) in obstetrics is complicated owing to physiological changes, particularly during late pregnancy and the postpartum period. Therefore, a pregnancy-modified DIC score that includes only three components of the International Society on Thrombosis and Hemostasis (ISTH) DIC score has been constructed. Our aim was to determine how many blood-transfused postpartum women actually had the diagnosis of overt DIC according to the modified ISTH score and had the correct indications for blood transfusion.Methods: We retrospectively analyzed 279 women who had received transfusion of at least two units of blood for postpartum hemorrhage. We used the modified ISTH score for DIC, which is based on platelet count, fibrinogen concentration, and prothrombin time (PT) differences. A total score of 26 points or higher indicated overt DIC, whereas a score lower than 26 points represented nonovert DIC.Results: According to the modified ISTH score, 100 of the 279 patients (35.8%) had overt DIC, with a median DIC score of 37.0. Thirty-five percent of patients in the overt DIC group and 25.7% in the nonovert DIC group had received more than four units of blood. The levels of PT and activated partial thromboplastin time were higher, and the fibrinogen level was lower in patients with overt DIC.Conclusions: According to the modified ISTH score, we found that blood transfusion was unnecessary in 179 of the 279 postpartum women (64.1%). If this scoring system is used to determine which patients should be transfused, unnecessary transfusions and their related risks and complications will be prevented. [ABSTRACT FROM AUTHOR]

Objective: Our aim is to evaluate trends in the direct and indirect causes' distribution using data from National Maternal Mortality Surveillance (2012-2015).Study Design: A population-based retrospective review was performed on all pregnancy-associated maternal deaths in Turkey from 2012 to 2015. Causes of death were grouped into direct and indirect maternal deaths and compared in the context of distribution. Maternal mortality rate was reported. Statistics included chi-square test or Fisher's exact test for categorical variables.Results: Between 2012 and 2015 there were 812 maternal deaths. The maternal mortality rate was 15.4 deaths per 100,000 live births in 2012 as compared to 13.7 in 2015. Direct maternal deaths in Turkey declined from 59.5% in 2012 to 45% in 2015 while indirect maternal deaths increased from 45% in 2012 to 55% in 2015 (p = 0.045). The leading direct causes of maternal deaths were postpartum hemorrhage. The major indirect causes of maternal deaths were circulatory system diseases.Conclusion: Direct maternal deaths in Turkey appear to be declining. This data will aid the management of maternal deaths. [ABSTRACT FROM AUTHOR]

Objective: To analyze the value of autopsy reports for determining the cause of maternal deaths in Turkey. Material and Methods: In this descriptive retrospective study, the case files of 992 maternal deaths, except for accidental causes, that occurred in Turkey between 2012 and 2016 were reviewed. An autopsy examination was performed in 177 (17.8%) of the cohort. When the files were reviewed, maternal descriptive data and the cause of maternal mortality according to the autopsy reports were recorded. Results: The mean age at death was 31.5±6.6 years. No exact cause of maternal death was identified after autopsy in 44 (24.9%) of the 177 cases. An exact cause of death could be determined in 133 (75.1%); 34.5% (n=61) were due to direct causes, and 40.7% (n=72) were due to indirect causes. The leading direct causes of maternal deaths were obstetric hemorrhage (13.0%) and obstetric (pulmonary and amniotic fluid) embolism (12.4%). The main cause among the indirect causes was ruptured aortic aneurysm and/or dissection of aorta (8.5%). Among the subjects with no clinical diagnosis based on the clinical course before death (n=96), the exact cause of death could not be determined at autopsy in 19 (19.8%) cases. The exact or possible cause of death was identified at autopsy in 80.3% (n=77) cases with no clinical diagnosis. Among the cases who had antemortem diagnoses based on the clinical course (n=81), the final diagnosis at autopsy was compatible with the clinical diagnosis in 48 (59.3%) subjects. Conclusion: Maternal autopsy examination provides an exact cause of death in most cases and is still a valuable tool for understanding the cause of maternal mortality. [ABSTRACT FROM AUTHOR]

Copyright of Turkish Journal of Obstetrics & Gynecology is the property of Galenos Yayinevi Tic. LTD. STI 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 African Journal of Reproductive Health is the property of Women's Health & Action Research Centre 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.)

Aim: Our aim was to assess the incidence and risk factors of the puerperal genital hematomas (PGH).Methods: We retrospectively reviewed recorded cases of PGH at Zekai Tahir Burak Research and Training Hospital, Ankara, Turkey, between January 2010 and 2014. Next three patients were chosen as control group.Results: There were 47 cases of PGH with an incidence of 1 in 762 deliveries. Patients with PGH were younger, more likely to be nulliparous and had a greater weight gain during pregnancy than the control group. Patients with PGH had a longer first and second stage of labor than the control group. Mediolateral episiotomy and operative delivery were more frequently performed in patients with PGH than the control group. Neonates born to mothers with PGH were heavier than the control group (3525 ± 428 versus 3325 ± 579; p = 0.031). In the logistic regression model, nulliparity (OR: 8.68, 95% CI = 2.96-25.3), instrumental delivery (OR: 7.96, 95% CI = 1.37-49.0) and mediolateral episiotomy (OR: 6.67, 95% CI = 2.61-17.1) were factors which had an independent impact on risk of PGH.Conclusions: Nulliparity, instrumental delivery and mediolateral episiotomy are the main risk factors for hematomas. [ABSTRACT FROM AUTHOR]

Purpose: The aim of this study was to evaluate risk factors, indications and materno-fetal outcomes for emergency peripartum hysterectomy.Methods: Retrospective evaluation was made of 23 cases. Maternal and neonatal outcomes, need for referral to the tertiary center and related complications were compared to those at the initial diagnosis for surgery, location of delivery, type of surgery and the admission diagnosis. The risk factors associated with emergency peripartum hysterectomy were also investigated. Significance was evaluated at p values of <0.01 and <0.05.Results: There was a correlation between peripartum hysterectomy and uterine atony or uterine rupture (p < 0.01). The referral rates of patients with home delivery were significantly higher than those of patients who delivered in hospital (p = 0.02) but no significant difference was observed in the neonatal outcomes (p = 0.38). There was no significant difference in the rates of maternal complications between home and hospital delivery (p = 0.068). According to the indication for surgery, no significant difference was observed between the rates of referral to the tertiary center, maternal outcomes, complications, or need for maternal intensive care (p > 0.05). However, a highly significant difference was observed between the neonatal outcomes (p = 0.001).Conclusion: The results of this study showed the most important risk factors associated with peripartum hysterectomy to be uterine atony, grand multiparity, and uterine rupture. Maternal intensive care, maternal death, neonatal death, or neonatal intensive care were associated with home delivery or delayed presentation at hospital. [ABSTRACT FROM AUTHOR]

Objective: Postpartum hemorrhage is the most important reason for maternal mortality. In developed countries, the reason of 13% of maternal deaths is postpartum hemorrhage while this percentage reaches more than 30% in other countries. In this study, the effect of oxytocin use in different times at the 3rd stage of delivery on changes in the postpartum hemoglobin levels was compared. Design and setting: In the study, 89 pregnant women to whom oxytocin was administered after placenta separation were studied in Group 1, 89 pregnant women were included in Group 2, and oxytocin was administered after delivery of the shoulder. The levels of hemoglobin and hematocrit before and after delivery were quantified. Results: The biochemical parameters were examined, there was no significant statistical differences in the levels of hemoglobin and hemotocrit before delivery between the two groups. When compared to Group 1, Δ-hemoglobin (P=>0.001), Δ-hematocrit (P=>0.001), the change between the prepartum and postpartum hemoglobin percentage (P<=0.001), and change between the prepartum and postpartum hemotocrit percentage (P<=0.001) were statistically lower in Group 2. Conclusions: It was determined that the use of oxytocin after shoulder delivery has more effects on decreasing the amount of postpartum hemorrhage. [ABSTRACT FROM AUTHOR]

Objective The aim of this study is to assess the effect of placental drainage during active management of the third stage of labor on reducing both blood loss and the length of the third stage. Study Design This prospective randomized controlled trial included 485 patients who underwent vaginal delivery in two tertiary hospital. Subjects were randomly allocated to the cord drainage group, in which the cord was unclamped after cutting (n ј 242), or the control group, in which the cord was left clamped (n = 243). The primary outcome was mean blood loss during the third and fourth stages of labor. Results The mean estimated blood loss was significantly lower in the cord drainage group than in the control group (207.04 _ 123.3 vs. 277.63 _ 246.9 mL, respectively; p 0.001). The third stage of labor was significantly shorter in the cord drainage group than in the control group (3.5 _ 1.9 vs. 7.7 _ 3.4 minutes, respectively; p 0.001). No adverse events occurred during the cord drainage period. Conclusion Active management of the third stage of labor with the cord drainage method significantly reduced postpartum blood loss and the duration of the third stage. [ABSTRACT FROM AUTHOR]

This descriptive study was conducted to determine the traditional practices used by 1410 mothers in the care of their babies in Eskisehir, Turkey. The results of the present study suggest that traditional practices, which sometimes may be hazardous or beneficial, are widely used by Turkish mothers. We recommend that families should be informed about the possible hazardous effects of some traditional practices, however the non-hazardous and beneficial practices providing spiritual well-being may be supported. The optimal strategy is to teach mothers this information during the pregnancy period. [ABSTRACT FROM AUTHOR]

Objective: To determine the effectiveness of oxygen inhalation after delivery in reducing vaginal blood loss during the third and fourth stages of labour. Methods: In this prospective randomised trial, 450 women undergoing vaginal delivery who did not have risk factors for post-partum haemorrhage were randomly assigned to receive either 8 L/min O2 via a face mask for 2 h ( n = 214) or normally breathe room air after the delivery ( n = 216). The oxygen was given to the women after delivering their babies. Active management of the third stage of labour was used in both groups. The primary outcome was mean blood loss during the third and fourth stages of labour. Results: No differences in demographic or clinical characteristics were observed between groups. The mean estimated blood loss at the third and fourth stages of labour did not significantly differ between the control and oxygen-inhalation groups (294.5 ± 179.7 vs 273.4 ± 146.6 mL, respectively; P = 0.18). In addition, there was no significant difference in the proportion of women who experienced an estimated blood loss >500 mL or the percentage of women who needed additional uterotonic agents (11 [5.1%] vs 9 [4.2%], respectively; RR 1.2 95% CI 0.5-2.8; P = 0.82 and 12 [5.6%] vs 8 [3.7%], respectively; RR 1.4 95% CI 0.6-3.5; P = 0.49). Conclusion: Post-partum oxygen inhalation is not beneficial for reducing vaginal blood loss during the third and fourth stages of labour. [ABSTRACT FROM AUTHOR]

Background: The aim of the study was to identify risk factors for depression and to estimate its prevalence in postnatal mothers.Methods: This cross-sectional and multi-centre study was carried out on 1,350 Turkish women in their first postnatal year. Measures included a structured questionnaire and the Turkish version of the Edinburgh Postnatal Depression Scale (EPDS).Results: Of the women, 31.1% had a score of 13 or higher on the EPDS. The mean score and standard deviation was 9.8+/-5.7. In the multivariate analysis, EPDS scores were significantly associated with economic status, access to support from family members and close friends, emotional distress at the pregnancy, whether the pregnancy was planned, health problems during pregnancy, the perceived standard of baby care after delivery, and mental disorder before and during pregnancy.Conclusion: The prevalence of EPDS-based depression among Turkish women in postnatal the period was high, and was associated with several social, economic and demographical factors. [ABSTRACT FROM AUTHOR]

Objectives: This study was conducted in order to produce translation, cultural adaptation, and validation of Assessment of Pelvic Floor Disorders and Their Risk Factors During Pregnancy and Postpartum Questionnaire (APFDQ) to Turkish in pregnant and postpartum population., Material and Methods: The study included 80 pregnant women. Internal consistency was tested using Cronbach's alpha. Questionnaires were applied three different times in order to assess for sensitivity. Patients were asked to complete the questionnaire first in the third trimester, secondly in postpartum 6th week and finally in postpartum 6th month after birth. For translation process content, face/content validity, reliability, construct validity and reactivity studies were done. All women had undergone pelvic examination and prolapse was assessed by using Pelvic organ Prolapse Quantification System (POP-Q). Urinary symptoms were also evaluated with Urinary Distress Inventory (UDI-6) questionnaire., Results: The mean age of patients was 27.7 ± 5.5 years. Forty-one (51.25%) of the patients had vaginal delivery and 39 (48.75%) had a cesarean section. Above 96% of the patients had completed the questionnaires. POP-Q assessments and UDI-6 results were used to evaluate construct validity. Cronbach's alpha results were found to be 0.7 for all the subscales of the questionnaire: bladder: 0.702, bowel: 0.744, prolapse: 0.701, sexual function: 0.706 respectively, indicating adequate reliability. The test/retest reliability was studied and Pabak values showed moderate reliability in the bowel, prolapse and sexuality, and good reliability for bladder subscale. The results of the patients were compared between pregnancy and postpartum to assess reactivity and shown to be reactive to changes. Also risk factors of the patients were assessed including, family predisposition, maternal age over 35 years, BMI > 25, nicotine use, subjective inability to contract pelvic floor and sense of postpartum wound pain., Conclusions: The Turkish version of APFDQ is a reliable and valid tool. It can be used for assessing the risk factors, incidence, assessing degree of PFDs and evaluating the impact on quality of life in pregnant and postpartum women.

Caesarean section as a contentious topic has attracted attention world-wide and different dimensions of the issue has been investigated. The primary reason behind these initiatives have been the upsurge of caesarean sections both in the developed and developing world and the realisation that the operation may not always contribute positively to the mother's and baby's health. By contrast, several studies have demonstrated both the short and long term negative effects. Research has also revealed that factors other than medical necessity play an important role in the decision to perform a caesarean section. Turkey, although reliable data does not exist, can be classified among the countries experiencing the caesarean epidemic, at least among highly educated and wealthy mothers. This research, exploring the perceptions of mothers in a teaching hospital with a high caesarean rate, is a rare example of its kind in Turkey. The main finding is the dissatisfaction of the mothers undergoing caesareans during their stay in the hospital.