Bed Rest in Pregnancy and Its Related Complications: Is It Needed?

Reviews, 1996

Journal of Obstetric, Gynecologic, <html_ent glyph="@amp;" ascii="&amp;"/> Neonatal Nursing, 1997

= Objective: To describe the experience of prolonged bed rest from the perspective of women during high-risk pregnancies.

Journal of midwifery and reproductive health, 2018

Background & aim: pregnancy is a normal part of life, however, high-risk pregnancy that need bed rest can be stressful and affect woman and her family. Therefore, understanding the needs of women on bed rest seems to be necessary to enhance the quality of care services. The present study was conducted to investigate the women's needs on bed rest during high-risk pregnancy and postpartum period. Methods: This qualitative study was performed among women with high-risk pregnancy using purposeful sampling method. Data were collected by conducting 31 semi-structured interviews with 21 pregnant women, 10 spouses, and 7 medical staff involved in their healthcare. Data analysis was carried out using conventional content analysis developed by Hsieh and Shannon. Results: According to the results, there were four main categories of needs entailing the need for psychosocial support, support for family and personal affairs, support for looking after children, and the need for economic support. The final category was the need for comprehensive support. Conclusion: The personal and family life of pregnant women is affected during bed rest. Accordingly, comprehensive support is needed to enable women to cope with these problems. To reach this goal, the provision of family-centered support services based on coordination among health sections, supporting organizations, charities, social workers, and systems providing psychological and consultation services are recommended.

The Cochrane library, 2005

BackgroundBed rest or restriction of activity, with or without hospitalisation, have been advocated for women with hypertension during pregnancy to improve pregnancy outcome. However, benefits need to be demonstrated before such interventions can be recommended since restricted activity may be disruptive to women's lives, expensive, and increase the risk of thromboembolism.ObjectivesTo assess the effects on the mother and the baby of different degrees of bed rest, compared with each other, and with routine activity, in hospital or at home, for primary treatment of hypertension during pregnancy.Search methodsWe searched the Cochrane Pregnancy and Childbirth Group's Trials Register (January 2010).Selection criteriaRandomised trials evaluating bed rest for women with hypertension in pregnancy were selected.Data collection and analysisTwo review authors assessed trials for inclusion independently, and extracted data. Data were entered into RevMan software and double‐checked.Main resultsFour small trials (449 women) were included. Three were of good quality. Two trials (145 women) compared strict bed rest with some rest, in hospital, for women with proteinuric hypertension. There was insufficient evidence to demonstrate any differences between the groups for reported outcomes. Two trials (304 women) compared some bed rest in hospital with routine activity at home for non‐proteinuric hypertension. There was reduced risk of severe hypertension (one trial, 218 women; relative risk (RR) 0.58, 95% confidence interval (CI) 0.38 to 0.89) and a borderline reduction in risk of preterm birth (one trial, 218 women; RR 0.53, 95% CI 0.29 to 0.99) with some rest compared to normal activity. More women in the bed rest group opted not to have the same management in future pregnancies, if the choice were given (one trial, 86 women; RR 3.00, 95% CI 1.43 to 6.31). There were no significant differences for any other outcomes.Authors' conclusionsFew randomised trials have evaluated rest for women with hypertension during pregnancy, and important information on side‐effects and cost implication is missing from available trials. Although one small trial suggests that some bed rest may be associated with reduced risk of severe hypertension and preterm birth, these findings need to be confirmed in larger trials. At present, there is insufficient evidence to provide clear guidance for clinical practice. Therefore, bed rest should not be recommended routinely for hypertension in pregnancy, especially since more women appear to prefer unrestricted activity, if the choice were given.

Birth, 2007

Bedrest has long been recommended for high-risk pregnancies, but recent studies question its effectiveness in improving pregnancy outcomes. To be effective, the women for whom bedrest is recommended must practice it. This study examined degree of compliance and reason for noncompliance in women for whom bedrest was recommended, and outcomes of pregnancy among high-risk women who complied compared with those who did not. The subjects were 326 high-risk pregnant women who were prescribed bedrest for preterm labor, blood pressure problems, or bleeding problems. Of that group, one-third did not comply with the bedrest recommendation. These women had more children, were not currently married, had more stress, did not attend prenatal classes, continued drinking alcohol during pregnancy, and were not trying to get pregnant compared with women who complied. Reasons for noncompliance included the need to care for children, not feeling sick, household demands, lack of partner or family support, need to work, and discomfort. The pregnancy outcomes for the women who complied were similar to those of the women who did not comply. These findings support the importance of more research on the practice of prescribing bedrest to improve pregnancy outcomes.

Objective: To compare the effect of bed rest after intrauterine insemination for five, ten and twenty minutes on the pregnancy rate. Design: Randomized controlled trial. Setting: Integrated Fertility Center and Agial Fertility Center. Sample: Three hundred and ninety six couples with mild male factor, cervical factor, or unexplained infertility between the periods from 1/2012 to 12/2012. Methods: Intrauterine insemination with controlled ovarian hyper-stimulation. Main outcome measures: The chemical and clinical pregnancy rates. Results: The couples were randomly subdivided equally into three groups: A, B& C and they allocated for bed rest for five, 10& 20 minutes respectively after insemination, the chemical and clinical pregnancy rates in group A (6.1& 4.5% respectively) were significantly lower than in group B (18.2& 15.9% respectively), and also it were significantly lower than in group C (23.5& 19.7% respectively), but there was no statistically significant difference in the pregnancy rates between group B and C. Conclusions: Bed rest for 10 and 20 minutes after intrauterine insemination has a positive effect on the pregnancy rate, but there is no statistically significance difference between them. We recommend for at least 10 minutes after intrauterine insemination. Key words and Abbreviations Key words: Intrauterine insemination, infertility, bed rest.

Asian journal of pharmaceutical research and development, 2023

Background: Physical changes in the third trimester of pregnancy will appear due to physiological changes and psychological changes that cause discomfort. This uncomfortable condition causes sleep disturbances in the mother. Objective: To determine the relationship between discomfort in pregnancy and the quality of sleep of third trimester pregnant women at the Makasar Health Center. Method: This was a descriptive analytic study and a cross sectional study design. Determination of the number of samples using the sample size application resulted in 40 samples of pregnant women in the third trimester. The sampling technique used purposive sampling. When the study was conducted in September-November 2020. The research instrument used the Pittsburgh Sleep Quality (PSQI) questionnaire with cronbach alpha 0.83 and the cronbach alpha 0.86 physical discomfort disorder questionnaire was tested for validity with r-count> 0.367. Data were processed by crosstab and analyzed by Chi-square. Results: Most of the respondents experienced discomfort (66.7%) and experienced poor sleep quality (70.0%). The association between pregnancy discomfort and sleep quality of third trimester pregnant women with a p value of 0.030. Conclusion: There is a relationship between discomfort in pregnancy and the quality of sleep in the third trimester of pregnant women. Recommendation: From this research, it is hoped that it can be used as input for health workers, especially nursing, to provide education on how to reduce pregnancy discomfort and good sleep quality in third trimester pregnant women.

1991

https://ijshr.com/IJSHR_Vol.6_Issue.4_Oct2021/IJSHR-Abstract.028.html, 2021

Sleep disorder is one of the most common complaints experienced by pregnant women in the third trimester, sleep disorders have an impact on the condition of pregnant women and fetuses which cause a decrease in immunity that improves the risks of some diseases that will endanger the condition of the fetus and the risk of premature delivery and Caesar surgery. Pregnancy exercise is one of the basic needs in sport that is recommended during pregnancy. Pregnancy exercise is expected to reduce complications that occur during pregnancy, because it has the benefit in training breathing and strengthening the pelvic muscles. This study aims at determining the effect of pregnancy exercise on improving the sleep quality of pregnant women in the third trimester. This type of research is a pre-experimental one group pretest and posttest with a research design using a quantitative approach. Based on the results of statistical tests through the Wilcoxon signed ranks test that the exact sig value. (2-tailed) and asymp. sig. (2-tailed) or p = 0.03 <0.05 so it can be concluded that pregnancy exercise affects the sleep quality of pregnant women in the third trimester. It is recommended to health workers, especially midwives, to conduct more intensive counseling, especially counseling about the benefits of doing pregnancy exercises, especially in the third trimester of pregnancy to provide a sense of comfort to pregnant women and to prevent complications in pregnancy to reduce the cases of maternal and infant mortality rates during pregnancy at Bone District.

British Journal of Sports Medicine, 2018

Bone, 2007

Objective: The aims of our study were to evaluate the changes in bone turnover markers during pregnancy and puerperium as a longitudinal study and to elucidate the effect of bed rest during pregnancy on bone turnover markers in pregnant and postpartum women. Methods: The study population comprised 27 Japanese pregnant women aged 23-40 years. All women were recruited for the longitudinal study from the outpatients clinic of the Department of Obstetrics and Gynecology, Tokushima University Hospital. Concentrations of serum bonespecific alkaline phosphatase (BAP), urinary cross-linked type I collagen N-telopeptides (NTx), serum NTx and urinary C-terminal telopeptide of type I collagen (CTx) were measured at 10, 26, 30 and 36 weeks of pregnancy and at 4 days and 1 month postpartum. In addition, we recruited 15 pregnant women (aged 25-35 years) who were treated by bed rest before 30 weeks of pregnancy for threatened premature delivery and compared bone turnover markers in these women with those in 22 normal pregnant women (aged 22-39 years). Concentrations of serum BAP, serum NTx, urinary NTx and urinary CTx were measured at 30 and 34 weeks of pregnancy and at 4 days and 1 month postpartum. Results: In the longitudinal study, serum BAP concentration at 1 month postpartum was significantly higher than that at any stage of pregnancy and that at 4 days postpartum. Urinary concentration of NTx increased gradually during pregnancy and showed a peak at 36 weeks of pregnancy, followed by a decrease in the postpartum period. Serum NTx concentration and urinary CTx concentration showed the same patterns of change as that of urinary NTx concentration. In the comparison study, urinary concentrations of NTx and CTx at 30 and 34 weeks of pregnancy in women with bed rest were significantly (p < 0.0001 and p < 0.001, respectively) higher than those in normal pregnant women. Serum NTx concentration at 34 weeks of pregnancy in women with bed rest was also significantly (p = 0.0029) higher than that in normal pregnant women. Serum BAP concentration at 34 weeks of pregnancy in women with bed rest was significantly (p = 0.0038) higher than that in normal pregnant women, and these high levels were maintained during puerperium. Serum BAP concentration at 34 weeks of pregnancy was significantly correlated with duration of bed rest (r = 0.767, p = 0.0041). Conclusion: Immobilization due to bed rest during pregnancy is associated with increases in bone turnover markers in pregnant and postpartum women. Concentrations of bone resorption markers increased rapidly at the start of bed rest, while the concentration of a bone formation marker gradually increased toward puerperium.

Journal of Turkish Society of Obstetric and Gynecology, 2011

The data collected by face to face interview. "Patient Recognition Form" was used to collect information about individual socio-demographic characteristics and data about their pregnancy. Sleep quality was evaluated by using Pittsburgh Sleep Quality Index (PSQI), sleep apnea risk by Berlin Sleep Questionnaire and sleepiness by Epworth Sleepiness Scale. Observations: 86% of the pregnant women involved in our study were found to have bad sleep quality. It was determined that sleep quality in pregnant women is in relation with age, obesity, frequency of physician visits and presence of pregnancy affecting diseases (p<0.05). Results: It is recommended to raise awareness of pregnant women about sleep and its disorders, have them visit physician regularly and develop habits for sleep hygiene.

European Journal of Obstetrics & Gynecology and Reproductive Biology

BACKGROUND Preterm premature rupture of the membranes (PPROM) is defined as spontaneous rupture of the membranes before labor at less than 37 weeks of gestation. It complicates 3 percent of pregnancies but is responsible for one third of cases of preterm birth, which is the leading cause of perinatal morbidity and mortality in developed countries. PPROM etiology is still unclear but underlying infectious process, increased inflammatory pathway activation and genetic predisposition are probably involved. Latency time from PPROM to delivery is usually brief and inversely proportional to gestational age (GA) at rupture. During this time, intrauterine infection, placental abruption, umbilical cord compression or prolapse, and fetal compression and hypoxia are possible consequences. Chorioamnionitis is the major maternal consequence of PPROM. Neonatal morbidity is also higher when PPROM is complicated by chorioamnionitis but prematurity remains the major neonatal consequence after PPROM. Several studies support that prolonged latency improves fetal maturation and does not worsen neonatal prognosis, for a given GA at birth. In order to increase GA at birth, expectant management of viable pregnancies with prophylactic antibiotic administration is recommended. Antepartum bed rest is also widely prescribed, although its effectiveness to prevent preterm birth has not been demonstrated. OBJETIVE We aimed to access the impact of bed rest in latency time to delivery, chorioamnionitis incidence and other maternal and neonatal outcomes in pregnancies complicated by PPROM, thus enabling proper sample size calculation for future powered randomized controlled trial. STUDY DESIGN Pilot unblinded randomized controlled trial (1:1 allocation ratio). Simple random allocation sequence generated by the investigators and implemented by sequentially numbered sealed envelopes.

https://ijshr.com/IJSHR_Vol.6_Issue.1_Jan2021/IJSHR-Abstract.04.html, 2021

Background and Purpose: Pregnancy is accompanied by several psychological, emotional and physical changes that may predispose the woman to fatigue, which can range from mild tiredness to severe exhaustion. Sleep disorders are also especially prevalent in pregnancy due to a series of obvious reasons including pregnancy-associated hormonal, physical and behavioral changes. The purpose of our study was to find out rate of fatigue and quality of sleep in pregnant women and correlation between it. 0.05 level. Based on Statistical Analysis there is weak positive correlation between rate of fatigue and quality of sleep. So, that as rate of fatigue increases the quality of sleep decreases. Conclusion: The result of our study is that, as rate of fatigue increases, the quality of sleep decreases.

Indian Journal of Sleep Medicine