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Revista Matronas

Revista Matronas

DICIEMBRE 2019 N° 3 Volumen 7

The role of the midwife in preventing intrauterine deaths during the preconception and prenatal period

Section: Revisions

How to quote

Fernández-García E, Fernández-García A, Gutiérrez-Martín MJ, García-Calvo L, Varona-Iglesias S, Del Campo-Sanz Y. El papel de la matrona en la prevención de muertes intrauterinas durante el periodo de preconcepción y antenatal. Matronas hoy 2019; 7(3):29-40.

Authors

1 Elena Fernández-García, 2 Ana Fernández-García, 3 María Jesús Gutiérrez-Martín, 4 Laura García-Calvo, 5 Soraya Varona-Iglesias, 6 Yolanda Del Campo-Sanz

Position

1 Matrona. Hospital Universitario Ramón y Cajal. Madrid. 2 Médico Interno Residente Especialista en Medicina Familiar y Comunitaria. Hospital Clínico Universitario de Valladolid.3 Tutora Coordinadora de la Unidad Docente de Matronas de Valladolid-Segovia. Matrona. Hospital Universitario Río Hortega. Valladolid.4 Médico Interno Residente Especialista en Ginecología y Obstetricia. Hospital Universitario La Paz. Madrid.5 Matrona. Hospital de Laredo. Cantabria.6 Matrona. Hospital Universitario Río Hortega. Valladolid.

Contact email: elenafdezgarcia@hotmail.es

Abstract

Introduction: perinatal mortality rates are critical wellbeing indicators of the public health of a country, because they reveal the effectiveness of the healthcare strategies implemented. There are unjustified variation rates in fetal deaths for low-risk pregnancies throughout Europe, showing that it is possible to reduce the number of prenatal fetal deaths.  
Objectives: the objective of this systematic study is to review those interventions conducted solely and exclusively by midwives for the prevention of fetal deaths during the preconception and prenatal period of women.
Methods of Research: a traditional systematic review was conducted on the literature available, in order to analyze the most recent research about the role of the midwife in association with the prevention of fetal death during the preconception and prenatal periods of women. The PEO research strategy was used for this traditional review of literature, due to its qualitative nature.  
Results: the role of the midwife in public health, and their practice based on scientific evidence, is a key factor to reduce fatal deaths. Midwives must be aware, adapt and respond to the individual needs and wishes of the women and their families, because preconception and prenatal health are critical periods to ensure good health throughout their lives. The multifaceted approach of the interventions conducted by midwives based on scientific evidence is acknowledged by the main health organizations at world level. This evidence demonstrates that interventions conducted exclusively by nurses are cost-effective, and provide major benefits for the health of mother and fetus. They must be conducted before and during pregnancy, and include: personalized screening programs, reduction of obesity, tobacco and toxic substance cessation, education for acknowledging any reduction in fetal movement, encouraging women to sleep in lateral decubitus position from the 28th week onwards, and adequate detection of any restriction in fetal growth by measuring the uterine height in routine visits for pregnancy monitoring.
Conclusion and recommendations: after the literature review, the conclusion was that midwife care has a great impact on the prevention and reduction of fetal deaths. Midwives have a privileged position in order to educate, empower and support women to modify their health habits: applying the best evidence-based practice in care for women and newborns. However, some barriers have been identified in the United Kingdom and Spain, such as the national shortage of midwives and the lack of continuity in care for the woman by the same professional (“domino care”). Both are key characteristics in order to improve the health of women and babies, by offering personalized care and encouraging their ability to make informed decisions. From an international point of view, strong leadership is required in order to eradicate intrauterine deaths Midwives must conduct audits and design clear and specific guidelines/protocols for midwives based on scientific evidence in order to promote healthy and safe pregnancies.

Keywords:

intrauterine deaths; midwife; midwife interventionsthe role of the midwife.

Versión en Español

Título:

El papel de la matrona en la prevención de muertes intrauterinas durante el periodo de preconcepción y antenatal

Artículo completo no disponible en este idioma / Full article is not available in this language

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