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Clinical guidelines for postpartum women and infants in primary care–a systematic review

BACKGROUND: While many women and infants have an uneventful course during the postpartum period, others experience significant morbidity. Effective postpartum care in the community can prevent short, medium and long-term consequences of unrecognised and poorly managed problems. The use of rigorously...

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Autores principales: Haran, Crishan, van Driel, Mieke, Mitchell, Benjamin L, Brodribb, Wendy E
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2014
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3906750/
https://www.ncbi.nlm.nih.gov/pubmed/24475888
http://dx.doi.org/10.1186/1471-2393-14-51
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author Haran, Crishan
van Driel, Mieke
Mitchell, Benjamin L
Brodribb, Wendy E
author_facet Haran, Crishan
van Driel, Mieke
Mitchell, Benjamin L
Brodribb, Wendy E
author_sort Haran, Crishan
collection PubMed
description BACKGROUND: While many women and infants have an uneventful course during the postpartum period, others experience significant morbidity. Effective postpartum care in the community can prevent short, medium and long-term consequences of unrecognised and poorly managed problems. The use of rigorously developed, evidence-based guidelines has the potential to improve patient care, impact on policy and ensure consistency of care across health sectors. This study aims to compare the scope and content, and assess the quality of clinical guidelines about routine postpartum care in primary care. METHODS: PubMed, the National Guideline Clearing House, Google, Google Scholar and relevant college websites were searched for relevant guidelines. All guidelines regarding routine postpartum care published in English between 2002 and 2012 were considered and screened using explicit selection criteria. The scope and recommendations contained in the guidelines were compared and the quality of the guidelines was independently assessed by two authors using the AGREE II instrument. RESULTS: Six guidelines from Australia (2), the United Kingdom (UK) (3) and the United States of America (USA) (1), were included. The scope of the guidelines varied greatly. However, guideline recommendations were generally consistent except for the use of the Edinburgh Postnatal Depression Scale for mood disorder screening and the suggested time of routine visits. Some recommendations lacked evidence to support them, and levels or grades of evidence varied between guidelines. The quality of most guidelines was adequate. Of the six AGREE II domains, applicability and editorial independence scored the lowest, and scope, purpose and clarity of presentation scored the highest. CONCLUSIONS: Only one guideline provided comprehensive recommendations for the care of postpartum women and their infants. As well as considering the need for region specific guidelines, further research is needed to strengthen the evidence supporting recommendations made within guidelines. Further improvement in the editorial independence and applicability domains of the AGREE ll criteria would strengthen the quality of the guidelines.
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spelling pubmed-39067502014-01-31 Clinical guidelines for postpartum women and infants in primary care–a systematic review Haran, Crishan van Driel, Mieke Mitchell, Benjamin L Brodribb, Wendy E BMC Pregnancy Childbirth Research Article BACKGROUND: While many women and infants have an uneventful course during the postpartum period, others experience significant morbidity. Effective postpartum care in the community can prevent short, medium and long-term consequences of unrecognised and poorly managed problems. The use of rigorously developed, evidence-based guidelines has the potential to improve patient care, impact on policy and ensure consistency of care across health sectors. This study aims to compare the scope and content, and assess the quality of clinical guidelines about routine postpartum care in primary care. METHODS: PubMed, the National Guideline Clearing House, Google, Google Scholar and relevant college websites were searched for relevant guidelines. All guidelines regarding routine postpartum care published in English between 2002 and 2012 were considered and screened using explicit selection criteria. The scope and recommendations contained in the guidelines were compared and the quality of the guidelines was independently assessed by two authors using the AGREE II instrument. RESULTS: Six guidelines from Australia (2), the United Kingdom (UK) (3) and the United States of America (USA) (1), were included. The scope of the guidelines varied greatly. However, guideline recommendations were generally consistent except for the use of the Edinburgh Postnatal Depression Scale for mood disorder screening and the suggested time of routine visits. Some recommendations lacked evidence to support them, and levels or grades of evidence varied between guidelines. The quality of most guidelines was adequate. Of the six AGREE II domains, applicability and editorial independence scored the lowest, and scope, purpose and clarity of presentation scored the highest. CONCLUSIONS: Only one guideline provided comprehensive recommendations for the care of postpartum women and their infants. As well as considering the need for region specific guidelines, further research is needed to strengthen the evidence supporting recommendations made within guidelines. Further improvement in the editorial independence and applicability domains of the AGREE ll criteria would strengthen the quality of the guidelines. BioMed Central 2014-01-29 /pmc/articles/PMC3906750/ /pubmed/24475888 http://dx.doi.org/10.1186/1471-2393-14-51 Text en Copyright © 2014 Haran et al.; licensee BioMed Central Ltd. http://creativecommons.org/licenses/by/2.0 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
spellingShingle Research Article
Haran, Crishan
van Driel, Mieke
Mitchell, Benjamin L
Brodribb, Wendy E
Clinical guidelines for postpartum women and infants in primary care–a systematic review
title Clinical guidelines for postpartum women and infants in primary care–a systematic review
title_full Clinical guidelines for postpartum women and infants in primary care–a systematic review
title_fullStr Clinical guidelines for postpartum women and infants in primary care–a systematic review
title_full_unstemmed Clinical guidelines for postpartum women and infants in primary care–a systematic review
title_short Clinical guidelines for postpartum women and infants in primary care–a systematic review
title_sort clinical guidelines for postpartum women and infants in primary care–a systematic review
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3906750/
https://www.ncbi.nlm.nih.gov/pubmed/24475888
http://dx.doi.org/10.1186/1471-2393-14-51
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