OBJECTIVE: This study aimed to evaluate immediate oral full feeding vs on-demand oral full feeding after unplanned cesarean delivery in labor on vomiting and maternal satisfaction.
STUDY DESIGN: A randomized controlled trial was conducted in a university hospital. The first participant was enrolled on October 20, 2021, the last participant was enrolled on January 14, 2023, and follow-up was completed on January 16, 2023. Women were assessed for full eligibility on arrival at the postnatal ward after their unplanned cesarean delivery. The primary outcomes were vomiting in the first 24 hours (noninferiority hypothesis and 5% noninferiority margin) and maternal satisfaction with their feeding regimen (superiority hypothesis). The secondary outcomes were time to first feed; food and beverage quantum consumed at first feed; nausea, vomiting, and bloating at 30 minutes after first feed, at 8, 16, and 24 hours after the operation, and at hospital discharge; parenteral antiemetic and opiate analgesia use; first breastfeeding and satisfactory breastfeeding, bowel sound, and flatus; second meal; cessation of intravenous fluid; removal of a urinary catheter; urination; ambulation; vomiting during the rest of hospital stay; and serious maternal complications. Data were analyzed using the t test, Mann-Whitney U test, chi-square test, Fisher exact test, and repeated measures analysis of variance as appropriate.
RESULTS: Overall, 501 participants were randomized into immediate or on-demand oral full feeding (sandwich and beverage). Vomiting in the first 24 hours were reported by 5 of 248 participants (2.0%) in the immediate feeding group and 3 of 249 participants (1.2%) in the on-demand feeding group (relative risk, 1.7; 95% confidence interval, 0.4-6.9 [0.48%-8.28%]; P=.50), and the maternal satisfaction scores from 0 to 10 were 8 (6-9) for the immediate feeding group and 8 (6-9) for the on-demand feeding groups (P=.97). The times from cesarean delivery to the first meal were 1.9 hours (1.4-2.7) vs 4.3 hours (2.8-5.6) (P
METHODOLOGY: Here, we further confirmed and characterized this bacterial species using PCR, histological staining, whole-genome sequencing, and bioinformatics approaches. PCR assays with in-house designed primer sets and 16S universal primers showed clear positive bands in the cerebrum, cerebellum, lung, and blood of UM3 suggesting that UM3 might have developed septicaemia. Histological staining showed the presence of Gram-negative rod-shaped bacteria in the pangolin brain and lungs, indicating the colonization of the bacteria in these two organs. In addition, PCR screening of UM3's fetal tissues revealed the presence of P. fungorum in the gastrocnemius muscle, but not in other tissues that we examined. We also sequenced and reconstructed the genome of pangolin P. fungorum, which has a genome size of 7.7 Mbps.
CONCLUSION: Our study is the first to present detailed evidence of the presence of P. fungorum in a pangolin and her fetus (although preliminary results were presented in our previous article). Here, we raise the concern that P. fungorum may potentially infect humans, especially YOPI (young, old, pregnant, and immunocompromised) people. Therefore, caution should be exercised when using this bacterial species as biodegradation or bioremediation agents in agriculture.
METHOD: Researchers conducted a meta-analysis of published data on the prevalence of constipation in pregnancy. The articles, which covered the period 1966 to 2024, were collected by searching Embase, PubMed, Scopus, Science Direct, Wos, and the Google Scholar search engine. The initial search was conducted on July 21, 2024, and the final update was made on August 10, 2024.
RESULTS: Thirteen studies were identified to determine the prevalence of constipation during pregnancy. The results show that the global prevalence of constipation throughout pregnancy is 32.4%, with the first trimester at 21.1%, the second trimester at 34%, and the third trimester at 30.3%.
CONCLUSION: According to a study, constipation is most common during the second trimester of pregnancy and the least common during the first trimester. Further research on the causes of constipation and prevention methods can help decrease its prevalence during pregnancy. Therefore, it is important to provide educational interventions on nutrition and encourage moderate physical activity during pregnancy to reduce the occurrence of constipation.
METHODS: A literature search was conducted across databases including PubMed, Embase, Web of Science, and Cochrane on October 20, 2023. The included studies reported the number of pregnant women and the count of those who were dual users. Quality assessment was undertaken using the JBI tool. The pooled prevalence of dual use was determined via a random-effects model. All statistical analyses were executed using R software, version 4.3.
PROSPERO: CRD42023486020.
RESULTS: Eighteen studies were analyzed, encompassing 5,983,363 pregnant women. The meta-analysis indicated an overall prevalence of 4.6% (95% CI: 2.0-10.3) for dual users with significant heterogeneity (I2 = 100%). Subgroup analysis based on the country showed a prevalence of 4.9% (95% CI: 2.0 to 11.6) for USA and 8.1% (95% CI: 0.00 to 1.00) for UK. Meta-regression revealed reduction of prevalence of dual use from 2019 to 2023. A potential publication bias was indicated by the LFK index and the Doi plot.
CONCLUSION: The dual consumption of e-cigarettes and traditional tobacco in pregnant women is a significant health concern, with a notable prevalence. Given the established risks of tobacco smoking during pregnancy and the uncertainties surrounding e-cigarettes, more comprehensive research and public health interventions are urgently needed to address this issue.
METHODS: PubMed, Web of Science and EBSCOHost was systematically searched for empirical studies between 2000 and 2023 that discussed on factors that influenced family planning usage among women with diabetes. This systematic literature review was conducted in accordance to Joanna Briggs Institute's approach for conducting systematic review of associations. Factors were categorised to either individual and non-individual factors. Narrative synthesis approach was adopted that appropriately accommodates the heterogeneity of the reviewed studies.
RESULTS: A total of 29 studies met the inclusion criteria. Studies included in this review mostly reported individual-level factors that influence family planning practice among women with diabetes mellitus which were mainly the presence of diseases and other sociodemographic characteristics. Only six studies reported factors beyond individual variables which include geographic region, access to care, opinion of significant others, healthcare providers' perception, role of doctors and types of service providers.
CONCLUSIONS: This systematic review provides evidences that highlighted the gap in knowledge on variables that were beyond individual-level factors which influence family planning practice among women with diabetes mellitus. Further studies that explored structural and systemic factors may benefit future program planning to identify and target modifiable factors.
OBJECTIVE: To identify the available assessment instruments for measuring the empowerment of pregnant women and to describe the appraisal content and their psychometric properties.
METHODS: We searched nine bibliographic databases for original studies that focus on the measurement of empowerment in pregnant women. Arksey and O'Malley's methodology and PRISMA-ScR were selected to guide the implementation of this scoping review. The COSMIN criteria was employed to assess the methodological quality and the quality of psychometric properties.
RESULTS: A total of 23 studies were included and 13 instruments were extracted. Given comprehensive considerations, Kameda's prenatal empowerment scale may be deemed suitable. The included instruments comprehensively measured the attributes of empowerment, with a particular focus on facilitating women's choice and decision-making. Except for the four most recent self-designed questionnaires, the remaining instruments had been tested for reliability and/or validity.
CONCLUSION: There were heterogeneous results regarding the included instruments' appraisal content and psychometric properties. Future studies focusing on the development or validation of measurement instruments should be guided by influential and identical standards.
DATA SOURCES: A scoping review using the Arksey and O'Malley's framework was conducted. A specific search strategy was developed with a research librarian across three databases: EMBASE, Medline, and the Maternity and Infant Care (MIC) database. Patient, Public Involvement, and Engagement (PPIE) members were consulted from the outset to co-design the research question and to provide feedback on the findings.
STUDY APPRAISAL AND SYNTHESIS METHODS: Out of 1958 articles, 19 were included in the study, with 47% from the US and 21% from Denmark. Articles were published from EMBASE. 47% of the articles measured health literacy, while 53% implemented health literacy interventions, such as digital or community-based approaches.
RESULTS: All 19 articles highlighted lower health literacy in BAME women compared to other groups. Ten proposed recommendations, while others emphasized the impact of social determinants of health, collectively underscoring the need for more research on BAME health.
CONCLUSIONS: The review underscores the inadequate health literacy and patient experience of BAME pregnant women. It also highlights the potential of digital health interventions to improve health literacy and health outcomes. The findings call for increased research into health literacy tools for BAME pregnant women. Healthcare systems, including the NHS, should allocate resources to enhance digital health interventions and address health inequalities in BAME groups during pregnancy.