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Predictores sociodemográficos y clínicos de la adherencia a los antidepresivos en los trastornos depresivos: una revisión sistemática con un metanálisis
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SESCS Publication: Effectiveness and Safety of the Double Intracervical Balloon vs Dinoprostone in Patients with Previous Cesarean Section

Alicia Rodríguez-Zurita, Sara Caamiña Álvarez, Carolina Caballero García, María Gallego Paniagua, Alba Rodríguez González, Miguel Ángel García Bello, Elena Díez González, José Luis Trabado Montesino

ABSTRACT

To compare effectiveness and safety of the Cook’s balloon with vaginal dinoprostone to induce labor in patients with previous cesarean section.

Observational, and retrospective study that included pregnant women at ≥ 37 weeks’ gestation, with unfavorable cervix, singleton pregnancy, intact membranes, and a previous cesarean section, who had undergone labor induction in the period 2014-2019. 170 patients (86 balloon-84 dinoprostone) were analyzed.

The proportion of women achieving vaginal delivery within 24 h was higher in the dinoprostone than in double-balloon group (RR, 3.24; 95% CI, 1.36-7.72).

No significant differences were detected in the first 48 h in vaginal deliveries (P = .749) or in cesarean section rates (P = .634).

Nor were there differences in maternal or fetal safety profiles.

A body mass index > 35 increased the risk of cesarean section by 1.53 times (P = .017) and a Bishop’s test score < 3 by 1.91 times (P = .009).

A vaginal delivery following a cesarean section decreased the probability of another cesarean section by 0.46 times (P = .039).

Labor induction with vaginal dinoprostone achieves better vaginal delivery rates in the first 24 h vs Cook’s balloon. While the difference in uterine rupture rate did not reach significance, this was higher in women receiving prostaglandin.

Keywords: Cervical ripening; Dinoprostone; Double balloon catheter; Trial of labor after cesarean section.

You can read the full article here.

Predictores sociodemográficos y clínicos de la adherencia a los antidepresivos en los trastornos depresivos: una revisión sistemática con un metanálisis
 Featured, News

SESCS PUBLICATION: Healthcare Professionals’ Perceptions about the Implementation of Shared Decision-Making in Primary Care: A Qualitative Study from a Virtual Community of Practice

Alezandra Torres-Castaño, Lilisbeth Perestelo-Pérez, Débora Koatz, Vanesa Ramos-García, Ana Isabel González-González, Ana Toledo-Chávarri, Carlos Jesús Bermejo-Caja, Himar Gonzalez-Pacheco, Analia Abt-Sack, Valeria Pacheco-Huergo, Carola Orrego

ABSTRACT

Background: The incorporation of shared decision making (SDM) is a central part of empowerment processes, as it facilitates greater activation on the part of patients, increasing the likelihood of them gaining control over their healthcare and developing skills to solve their health problems. Despite these benefits, there are still difficulties in the implementation of SDM among healthcare professionals due to internal and external factors related to the context and health systems.
Aim: To explore primary care professionals (PCPs)’ perceptions of the SDM model, based on their preconceptions and experience in clinical practice.
Methods: A framework analysis was conducted on qualitative data derived from a virtual community practice forum, within a cluster-randomized clinical trial developed in the e-MPODERA project.
Results: The most important points in the opinions of the PCPs were: exploring the patients’ values, preferences and expectations, providing them with and checking their understanding of up-to-date and evidence-based health information. The analysis revealed three themes: determinants of the implementation process of SDM, lack of consistency and dilemmas and benefits of PCP active listening, motivation and positive expectations of SDM.
Discussion: In our initial analysis, we examined the connections between the categories of the TDC model and its application in the primary care context. The categories related to the model reflect the theoretical understanding of professionals, while those related to perceptions of its application and use show certain discrepancies. These discrepancies could indicate a lack of understanding of the model and its real-world implications or insufficient commitment on the part of professionals or the organization to ensure its effective implementation.Conclusions: Specific targeted training that addresses knowledge, attitudes and practice may resolve the aforementioned findings.

You can read the full article (in English) here