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Perinatal Care

Perinatal Care: The comprehensive medical and nursing care provided to mothers and their infants during the perinatal period, which encompasses the time period from the anticipation of pregnancy through the first year of a child's life.
This care includes preparation for pregnancy, prenatal care, delivery, postpartum care, and the care of the newborn, as well as family planning and genetic counseling, as needed.
Perinatal care aims to achieve healthy outcomes for both the mother and the infant.

Most cited protocols related to «Perinatal Care»

A qualitative, descriptive, multiple-case research design was used [21 ]. The cases comprised the health facilities providing perinatal services in four health regions in the province of Quebec: two urban regions, one mixed urban-rural region and one rural region [18 ]. The regions were selected because they present different models of continuity of care, depending on whether responsibility for postnatal follow-up had or had not been transferred to community partners. Each region has one or two hospitals offering perinatal care, an average of six community health centres, several private medical clinics, and voluntary organizations providing postnatal support. In addition, each region has a regional agency, whose mission includes ensuring the integration and consistency of services between the various healthcare facilities on its territory. These facilities were expected to implement collaboration following introduction of the early discharge of newborns, defined as a postpartum stay of approximately 48 hours (2 days) for an uncomplicated vaginal delivery and approximately 96 hours (4 days) for an uncomplicated caesarean [3 (link)-5 (link)]. This practice requires linking hospital care with primary-care services.
The data were collected through 33 semi-structured interviews with healthcare managers and professionals working in the four regions (Table 1). An analysis of written material (coordination agreements, protocols, etc.) was also conducted. The sampling was purposeful; respondents were selected to represent management and the different types of professionals. An interview plan based on D'Amour's model of collaboration was developed to guide the interviews. All interviews were recorded on audio tape and transcribed in full.
The data analysis combined two complementary strategies [22 ,23 ], deduction and induction. We thus based our analysis on the theoretical proposals of the analytical model of interprofessional collaboration but left room for new elements to emerge. Each stage in the analysis was conducted independently by three investigators who then compared their findings. The analysis comprised two main stages: an internal analysis of each case followed by a cross-sectional analysis of all the cases [24 ]. The first step involved three levels of analysis: condensation, organization and interpretation [23 ]. The units of meaning were thus coded in terms of the indicators of the model of collaboration or of the emerging themes. A history of collaboration and the factors influencing it was then written for each case and the cross-sectional analysis was then undertaken. The study was submitted for approval to the ethics committees of the University of Montreal and of the participating facilities, and all participants signed a consent form.
Publication 2008
Continuity of Patient Care Ethics Committees Infant, Newborn Obstetric Delivery Patient Discharge Perinatal Care Primary Health Care Vagina
The population for the present study was drawn from participants of the ongoing Pregnancy Outcomes, Maternal and Infant Study (PrOMIS) Cohort, designed to examine maternal social and behavioral risk factors of preterm birth and other adverse pregnancy outcomes among Peruvian women. The study population consists of women attending prenatal care clinics at the Instituto Nacional Materno Perinatal (INMP) in Lima, Peru. The INMP is the primary reference establishment for maternal and perinatal care operated by the Ministry of Health of the Peruvian government. Recruitment began in February 2012. Women eligible for inclusion were those who initiated prenatal care prior to 16 weeks gestation since, on average, less than 10% of women initiate prenatal care after 16 weeks of gestation at INMP. Women were ineligible if they were younger than 18 years of age, did not speak and read Spanish, or had completed more than 16 weeks gestation.The eligibility criteria threshold of initiating prenatal care prior to the completion of 16 weeks gestation was set so as to mitigate concerns about reverse causality and recall bias while enrolling a study population that is sufficiently generalizable to the source population of women seeking care at the study site. Before setting this threshold, we determined that over 90% of women delivering at INMP initiate prenatal care prior to 16 weeks gestation.
Enrolled participants were invited to take part in an interview where trained research personnel used a structured questionnaire to elicit information regarding maternal socio-demographic, lifestyle characteristics, medical and reproductive histories, and early life experiences of abuse and with symptoms of mood and anxiety disorders. All participants provided written informed consent. The institutional review boards of the INMP, Lima, Peru and the Harvard School of Public Health Office of Human Research Administration, Boston, MA approved all procedures used in this study.
Publication 2015
Anxiety Disorders Care, Prenatal Drug Abuse Eligibility Determination Ethics Committees, Research Hispanic or Latino Homo sapiens Infant Mental Recall Mood Mothers Perinatal Care Pregnancy Premature Birth Woman Youth
The trials used moderately different designs to arrive at one-to-one random allocation of intervention and control clusters. In the Perinatal Care Project (Bangladesh) and the Ekjut trial (rural India), districts were identified and clusters purposively sampled, then randomised within each district. In the Bangladesh Perinatal Care Project, clusters initially randomised to the women's group interventions were also re-randomised to receive training for Traditional Birth Attendants in a two-by-two factorial design. In the Mumbai City Initiative for Newborn Health trial, urban slum clusters were randomly sampled from a frame stratified by six purposively selected municipal wards, and then randomly allocated to the intervention. MaiKhanda and MaiMwana in Malawi used two-by-two factorial designs in which clusters were allocated randomly to a women's group intervention or no intervention, and each group was stratified by the presence or absence of another intervention - a breastfeeding counseling intervention in the case of MaiMwana, or a Quality Improvement of maternal and neonatal facility-based healthcare intervention in the case of MaiKhanda. For the Bangladesh Perinatal Care Project and the Malawi MaiKhanda and MaiMwana trials, we therefore only included in this study the clusters that were 'pure' controls. Details of stratification and number of clusters included are given in Table 1. Although all five trials included in the study had baseline data, we only included these for the 'pure' control clusters of the MaiKhanda study in Malawi because it started later than the other trials and had fewer cases to contribute to the analysis. One of the other trials (PCP) had retrospective baseline data, which we decided not to include in order to preserve data quality.
Publication 2011
Counseling Infant, Newborn Mothers Perinatal Care Reading Frames Traditional Birth Attendant Women's Groups
The NePeriQIP intervention will be implemented in 12 district level public hospitals in Nepal. Hospitals with >1000 deliveries per year were identified. The selected hospitals had an annual delivery rate ranging from approximately 1000 to 11 000, and an estimated intrapartum mortality rate of 20/1000 births (table 1). The geographical location of these hospitals are scattered all throughout the country, mostly in the flat lands. These hospitals are the referral hospitals for providing maternal and perinatal care. We selected these hospitals with the criteria of having government health facilities with deliveries >1000 per year.
Publication 2017
Hospital Referral Mothers Obstetric Delivery Perinatal Care
The training took place in two collaborating institutions: Tanzanian Training Centre for International Health (TTCIH) and Saint Francis Designated District Hospital (SFDDH). TTCIH is a non profit semi-autonomous institution that offers short international courses in health and a long course for AMOs. The two institutions (TTCIH and SFDDH) have had long experiences in health related training and health care service delivery. SFDDH, a hospital with a 372-bed capacity, receives referred patients from primary health facilities (dispensaries and health centres) in Ulanga and Kilombero districts. The mean annual delivery and caesarean section rates from 2005 to 2008 were 4,987 and 25% respectively. The key technical staff for the programmes included one medical curriculum expert, two obstetricians, one paediatrician, two generalist doctors and one senior AMO - all with vast experience in maternal and perinatal care. The training in anaesthesia was conducted by a consultant anaesthetist from Muhimbili National Hospital (MNH), one AMO specialized in anaesthesia and two senior anaesthetic nurses from SFDDH. The training programmes were built on the framework of human resources, pedagogical and technological materials available in the two institutions.
Publication 2011
Anesthesia Anesthetics Anesthetist Cesarean Section Consultant Delivery of Health Care General Practitioners Manpower Mothers Nurses Obstetric Delivery Obstetrician Patients Pediatricians Perinatal Care Physicians

Most recents protocols related to «Perinatal Care»

The basic feature of the PeriKIP social innovation was that trained facilitators supported local stakeholder groups at the commune level and at district and provincial hospital levels in their efforts to improve perinatal healthcare practices. Seven laywomen from the Women’s Union were recruited as facilitators on the commune level. Facilitator positions were advertised openly, and recruitment was based on applicants’ previous experience with community activities and communication skills. A retired director (physician) of the Reproductive Health Centre on the provincial level in Cao Bang was recruited and trained to take the role as facilitator in the participating four hospitals. The project was implemented within the existing healthcare system [37 (link)] to increase the local accountability and ownership of quality improvement among stakeholders responsible for health (see Table 1). The PeriKIP groups at the three different levels were expected to meet once a month for the project’s duration. Participating in meetings and actions within PeriKIP was expected to be part of the stakeholders’ duties. Therefore, none was paid for their engagement besides the village health worker and the Women’s Union worker from the village level, who were reimbursed for travel expenses enabling them to attend monthly meetings.

PeriKIP group stakeholders at three health system levels

Stakeholder groups at the commune level: Each commune has one Commune Health Centre providing primary healthcare. In each of the communes in the study area (n=48), one PeriKIP group was established with the following eight participants: three Commune Health Centre staff (head of Community Health Centre, midwife and nurse), one village health worker, one vice chairperson of the Peoples committee, one women union representative from community level, one women union representative from village level and one population officer
District and provincial hospital level: In each of the district hospitals in the study area (n=3) and in the provincial hospital (n=1), one PeriKIP group was established with the following eight participants: one midwife from the antenatal care clinic, one midwife from the labour ward, the head nurse of the paediatric department, the head of the obstetric department (physician), the head of the paediatric department (physician), the head of the general planning department, the leader of the hospital director board and one representative from Reproductive Health Centre at district or provincial level
During 2 weeks, the research group trained locally recruited facilitators with theoretical sessions, group discussions and role-play activities. Topics covered group dynamics and quality improvement methods (brainstorming and the PDSA cycle). To facilitate discussions about perinatal care, the facilitators were introduced to basic evidence-based neonatal care per recommendations in the Vietnamese National Guidelines in Reproductive Health Care [38 ]. Also, facilitators were briefed on the current health situation in their respective districts and the function of the healthcare system concerning reproductive health. Guides on facilitators’ roles, attitudes, responsibilities and how to handle challenging situations were based on the i-PARIHS framework [24 ] and modified materials from the NeoKIP project [39 (link)]. At the end of the training, facilitators practised their skills in rural communes and district hospitals outside the study area followed by feedback discussions on performance. One person with reproductive health responsibilities from each district was recruited as a mentor of the facilitators working in the communes of that district. These persons attended the facilitator training and participated in separate sessions focusing on how to mentor facilitators. A guide describing the role of the mentors was also developed and used to support the mentors in their roles. Members of the research group were not involved in delivering the intervention to the local stakeholder groups. Trained facilitators within PeriKIP received a monthly salary.
Publication 2023
Care, Prenatal Conditioning, Psychology Infant, Newborn Infantile Neuroaxonal Dystrophy Mentors Midwife Nurses Nurses, Head Pediatric Nurse Perinatal Care Physicians Primary Health Care Reproduction Vietnamese Village Health Workers Woman Workers
A process evaluation employing qualitative and quantitative methods prospectively tracked the implementation to describe how the social innovation was initiated, carried out and how participants responded to the innovation. The process evaluation was performed according to the UK Medical Research Council guidelines: implementation, mechanism of impact and context [41 (link)]. We developed a logic model, underpinning the assumptions on which the intervention was thought to function (see Additional file 1). For each of the three components, key questions needing an answer to understand the process were formulated, followed by identifying the target population, data sources, procedures, and tools (see Additional file 1). The implementation of the innovation: What was delivered and how it was delivered, including the procedures used to approach and attract facilitators, mentors, and group stakeholders (recruitment), the participation (reach), and the efforts of the facilitators (dose). Mechanism of impact: The participants’ responses to and interactions with the innovation. In this component, we explored why specific reactions to social innovation resulted in particular outcomes. Furthermore, we also explored the problems the groups addressed, the type and relevance of prioritised issues, actions taken, the interaction between group and facilitator and methods used. Context: What contextual aspects that influenced the innovation, the implementation and the mechanism of impact, leading to different outcomes. The outcomes of the social innovation included the relevance of identified problems and completion of PDSA cycles, knowledge of perinatal care, perspectives of gaining knowledge and performance of antenatal care. The following data collection modes and tools were used to monitor data of the three process evaluation components and the outcomes of the social innovation:
Publication 2023
Care, Prenatal Mentors Perinatal Care Process Assessment, Health Care Target Population
Dutch perinatal care is provided interdisciplinary from two healthcare tiers: primary care by community midwives and maternity care organizations; and secondary/tertiary care by hospital employed care professionals. Hospitals, regional community midwife practices and maternity care organizations increasingly cooperate in OCN to provide continuity of care across pregnancy, childbirth and puerperium. In 2019, PROM/PREM implementation was initiated from a regional collaborative between ten OCN in the middle of the Netherlands, of which three OCN participated. In each OCN, the hospital and 2–4 midwifery practices implemented individual-level PROM/PREM in clinic. All other professionals working in the OCN (e.g., from other midwifery practices, maternity care organizations, youth care) could join network-broad QI with group-level outcomes. Each OCN had an interdisciplinary team in charge of implementation (including, at least one obstetrician, clinical midwife, and community midwife from each participating midwifery practice), of which one was appointed project leader. In this study, participants were defined as (1) professionals directly involved in implementation: project team members (key participants) or obstetricians/midwives using individual-level PROM/PREM, and (2) indirectly involved professionals: from other OCN-organizations or discipline, such as nurses. Patients were involved in implementation as they completed PROM/PREM for routine care but did not actively participate in this evaluation study. As patients had participated in our pre-implementation analysis and feasibility pilot [8 (link), 28 (link)], their needs were incorporated in the initial implementation strategy.
Publication 2023
Continuity of Patient Care Midwife Nurses Obstetric Delivery Obstetrician Patients Perinatal Care Pregnancy Primary Health Care Youth
The PROM/PREM implemented in this project were those proposed in the PCB set: questionnaires at two moments during pregnancy (T1: first trimester, T2: early third trimester) and three postpartum (T3: maternity week, T4: 6 weeks postpartum, T5: 6 months postpartum). The PCB set was developed internationally and subsequently translated to the Dutch setting, both phases involving all stakeholders, including care professionals and patients [18 (link), 29 (link)]. An overview of the PCB set’s patient-reported domains and timeline for completion is provided in Additional file 1: Fig. S1. The set’s PROM/PREM were implemented for two purposes. First, individual-level PROM/PREM were implemented in clinic: reviewing N = 1 scores with patients during a regular care contact after completing a questionnaire. The timeline of collection, workflow, and follow-up services (including scoring and alert values) were organized as described in the national pilot project [30 (link)]. Second, the same PROM/PREM outcomes would be used at group-level in network-broad QI sessions. Despite the complexity of combining these purposes, findings in our pre-implementation research amongst care professionals, patients and other stakeholders in perinatal care suggested both goals could also reinforce each other [8 (link)]. Direct usability in clinical practice could, for instance, motivate care professionals and patients to comply, thereby generating data for group-level use (and vice-versa). Likewise, other previous findings from our pre-implementation analysis and feasibility pilot [8 (link), 28 (link)], were used to design the initial implementation strategy. Important elements for individual-level use included visual alerts to support care professionals in interpreting the answers and offering patients a choice whether their care professional had insight in their individual PREM answers. During the action research project, this initial implementation strategy (Fig. 1) was continuously refined guided by action research principles in iterative cycles of planning and executing implementation activities, data generation, and reflection on these data to refine subsequent activities. These cycles were conducted jointly by researchers and care professionals. The researchers developed the baseline strategy for project organization and education (e.g. identified possible IT-systems, developed an e-learning and kick-off meeting), provided materials and support for its execution (e.g. patient information folder, for working protocol for care professionals), and facilitated data generation for its refinement (e.g. organized focus groups, sent out the survey). The project teams designed and coordinated local implementation (e.g. adapt instruction material to local workflow, chose the IT system that best fitted local needs and resources) and participated in data generation and reflections (e.g. survey results were discussed in project team meetings, participation in focus groups). Three OCN started implementation sequentially to be able to learn from previous experiences, exchanged via the researchers and directly between care professionals from different OCN. After the one-year implementation period, project teams reported their experiences to their OCN and advised future steps in an end-evaluation.

Timeline of implementation and data generation activities. PROM, patient-reported outcome measure. PREM, patient-reported experience measure. QI, quality improvement. OCN, obstetric care network. CP, care professional. VHBC, value-based healthcare

Publication 2023
CARE protocol Patients Perinatal Care Pregnancy Reflex SET Domain TimeLine
The control group parents received the standard perinatal care offered by the hospitals they were recruited from, which consisted of antenatal checkups, optional antenatal classes, care during their stay in the ward, and a postnatal review scheduled 6 weeks post partum. Perinatal care was provided to the parents by obstetricians, nurses, neonatologists, and lactation consultants. The intervention group parents received the standard perinatal care as well, but they were also granted access to the mHealth intervention SPA upon recruitment into the study. In addition, they were matched with trained peer volunteers, who were experienced mothers trained by the research team to provide peer support for the parents in the RCT.
SPA included a variety of pregnancy-, childbirth-, postpartum-, and infant care–related information. This included articles, audio files, and videos about birth preparation, bonding and attachment across the perinatal period, breastfeeding, baby care–related tasks (from bathing to safe sleep habits), and involvement of both fathers and mothers in baby care tasks. The information was curated by the health care professionals involved in the study so that parents could conveniently access reliable and accurate information. Expert advice, discussion forums, and frequently asked questions were also features of the mobile app that aimed to resolve any pregnancy- or childcare-related queries that the parents might have. The parents were encouraged to interact with the peer volunteer with whom they were matched if they needed emotional or informational support from experienced mothers who had previously had and recovered from postnatal depression. Detailed features of the SPA mobile app and peer volunteer intervention can be found in the published development study [26 (link)]. The SPA intervention was made available to the intervention group parents from the point of recruitment until 6 months post partum.
Publication 2023
Childbirth Depression, Postpartum Emotions Fathers Health Care Professionals Mobile Health Mothers Neonatologists Nurses Obstetric Delivery Obstetrician Parent Perinatal Care Pregnancy Voluntary Workers

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More about "Perinatal Care"

Perinatal care is the comprehensive medical and nursing care provided to mothers and their infants during the perinatal period, which encompasses the time from pregnancy planning through the first year of a child's life.
This includes prenatal care, delivery, postpartum care, and newborn care, as well as family planning and genetic counseling as needed.
Perinatal care aims to achieve healthy outcomes for both the mother and the infant.
The perinatal period is a critical time for the development and well-being of both the mother and the child.
Proper perinatal care involves a range of services and interventions, including: - Preconception counseling and planning - Antenatal/prenatal care and monitoring - Labor and delivery management - Postpartum care and lactation support - Newborn care and pediatric follow-up - Family planning and contraception - Genetic counseling and testing Key aspects of perinatal care may involve the use of statistical software like Stata 13, SAS PROC LIFETEST, SAS PROC PHREG, SPSS Statistics version 23, and JMP to analyze data and inform clinical decision-making.
Diagnostic tests like the HBV DNA test kit may also be utilized to screen for and manage conditions during the perinatal period.
Optimizing perinatal care research is crucial for improving maternal and infant health outcomes.
Tools like PubCompare.ai can help researchers identify the best protocols and products for their perinatal care studies, leading to more accurate and reproducible results.
By leveraging the latest advancements in perinatal care, healthcare providers can ensure the best possible start for mothers and their children.