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ALBA RICCHI

CULTORE DELLA MATERIA
Dipartimento di Scienze Mediche e Chirurgiche Materno-Infantili e dell'Adulto
Docente a contratto
Dipartimento di Scienze Biomediche, Metaboliche e Neuroscienze sede Policlinico

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Pubblicazioni

2021 - Estimation of fetal weight near term: comparison between ultrasound and symphysis-fundus evaluation by Johnson’s rule [Articolo su rivista]
Ricchi, A.; Pignatti, L.; Bufalo, E.; De Salvatore, C.; Banchelli, F.; Neri, I.
abstract

Introduction: The fetal weight estimation is commonly performed by ultrasound but the manual method is also applied in developing countries due to the lack of scan availability and in western countries for the management of low-risk pregnancy managed autonomously by the midwives. The most applied method to estimate fetal weight measures the longitudinal diameter of the symphysis-fundus according to Johnson’s rule. The aim of the present study is to evaluate the reliability of the symphysis-fundus method with respect to the ultrasound to estimate fetal weight in low risk pregnancies according to the classification of adequate, small and large for gestational age. Materials and methods: Two hundred twenty low-risk women referred to the clinic for the management of term pregnancy were enrolled for the study. The following data were collected: age, body mass index, parity, values of symphysis-fundus evaluation according to Johnson’s rule, ultrasound fetal weight estimation values, and birthweight. Results: Considering the whole sample, fetal weight was estimated similarly by the manual method and with the ultrasound (79.5 versus 85% of the cases; n.s.). However, in overweight women, the ultrasound better estimates fetal weight in respect to manual method (94.4 versus 80.3% of the cases; p <.02) and similarly in obese women also ultrasound performed better in comparison to manual method (91.8 versus 71.4% of the cases; p <.01). Conclusions: The manual evaluation could be considered a reliable method to assess fetal weight for the management of low-risk pregnancies near term to optimize the resources and also offer a safe nonmedical approach. Further studies should clarify the accuracy of the manual method to estimate fetal weight in overweight and obese women, also considering the great increase of the obesity incidence in the obstetric population.

2021 - The appropriate counseling on prenatal screening test for foreign women in Emilia-Romagna [Articolo su rivista]
Menichini, Daniela; Sciutti, Giovanna; Miano, Maria Vittoria; Ricchi, Alba; Infante, Ramona; Molinazzi, Maria Teresa; Bertucci, Emma; Facchinetti, Fabio; Neri, Isabella
abstract

Objective: The increase in the migratory phenomenon entails the need to adapt obstetric care to the population which includes foreign pregnant women. In this context, it emerged a little adherence to the prenatal screening test among foreign women compared to Italian women, which is assumed to be attributable to an inadequate counseling. This study aims to evaluate midwife's perception of the  counseling effectiveness in foreign women for the combined test and subsequently assess its adequacy through an external evaluation. Methods: this is a cross-sectional study conducted from September to November 2019. An ad hoc questionnaire was administered to midwives working in the territorial district of the Emilia-Romagna Region, investigating their counseling skills. Then an external evaluation of the counseling was conducted by observing the interview between the midwives and the patients (N = 10), to analyze its appropriateness. Results: Seventy-five midwives completed the questionnaire with a positive response rate of 57.2%. In general, 69.3% of midwives are satisfied with the training received from the regional course, but 85% found many difficulties in counseling foreign women. The 14% of midwives state that they always have the cultural and linguistic mediator available and 44% of them state that they use brochures translated into several foreign languages. In the interviews observed, the counseling to foreign women was found to be shorter and more limited than that provided to Italian women. Conclusions: Most of the consulting midwives declare that they feel prepared to perform a correct prenatal counseling also for foreign women, but the external evaluation of the interviews, and the regional data on adherence to the antenatal screening of foreign women, show many critical points. It becomes necessary to carry out further studies that investigate not only the counseling skills of midwives, but also the needs of assisted women about prenatal diagnosis.

2020 - Evaluation of midwifery students’ satisfaction with regards to clinical internship [Articolo su rivista]
Gemmellaro, G.; Ricchi, A.; Menichini, D.; Molinazzi, M. T.; Banchelli, F.; Infante, R.; Artioli, G.; Foa, C.; Neri, I.
abstract

Background and aim of the work. The clinical internship is fundamental for the training of the fu ture socio-health professional. Through the practical activity, the student develops professional skills, critical thinking and decision-making ability, internalizing the complexity of the professional role. While in the nursing field there are several tools for assessing the clinical experience of students, in the obstetric field there is a lack of validated tools. Therefore, the purpose of this work was to investigate the perception of the students of the Degree Course in Midwifery regarding the internship experience. Method. The study was conducted at the obstetric clinical internship where students carry out practical activities and involved all the students of the Degree Course in Midwifery at the University of Modena and Reggio Emilia. The data were collected through an anonymous online questionnaire (Google Model), which was inspired by the nursing CLES + T, simplified and adapted to the obstetric field. Results. In total, 54 students took part in the research (81.8% of all students enrolled in the degree program examined). They were mainly of Italian nationality (98.1%), women (94.4%), aged between 18-22 years (85.2%). In general, the third-year students were more satisfied with the internship experience than the second-and first-year students, most likely for having achieved a degree of autonomy of care, awareness and greater professional motivation. Conclusions. The results indicate the need to periodically investigate the quality and satisfaction of the clinical internships to ensure increasingly effective obstetric training. (www.actabiomedica.it).

2020 - Fetal alcohol spectrum disorders awareness in health professionals: Implications for psychiatry [Articolo su rivista]
Messina, M. P.; D'Angelo, A.; Battagliese, G.; Coriale, G.; Tarani, L.; Pichini, S.; Rasio, D.; Parlapiano, G.; Fiore, M.; Petrella, C.; Vitali, M.; Ferraguti, G.; Ceccanti, M.; Bertoli, D.; Canepa, M.; Cappadona, R.; D'Alessio, A.; Danza, M.; Morese, A.; Paolino, A.; Pileri, F.; Pinna, N.; Neri, I.; Razzano, R.; Ricchi, A.; Rizzi, M.
abstract

Fetal Alcohol Spectrum Disorders (FASD) are a plethora of malformative conditions leading to mental retardation that affect newborns and children who have been exposed to alcohol during pregnancy or breastfeeding. FASD is a relevant topic for public health in Europe: European area is first in ranking for alcohol use during pregnancy with a prevalence of 25.2%. Italy ranked third among European countries with higher prevalence of FASD (45.0 per 1000 population). Furthermore, FASD could still be underestimated because of numerous undiagnosed and misdiagnosed cases. Aims of the study were to briefly summarize existing evidences about FASD and its psychiatric aspects to assess knowledge, attitudes and practice towards alcohol drinking during pregnancy in an Italian sample of health care professionals in order to provide information about FASD prevention. An anonymous online questionnaire containing the AUDIT-C, T-ACE model and the Drinking Motive Questionnaire was sent to 400 Italian healthcare professionals and students. The survey included socio-demographic information, questions about drinking habits and about knowledge, attitude and practice towards alcohol assumption during pregnancy. Among 320 respondents, 96.3% were women. AUDIT-C revealed that 52.4% were low risk drinkers but 27.6% were hazardous drinkers. The 90.6% of participants denied to ever attended a course about the fetus damage induced by alcohol consumption during pregnancy but 91.3% were willing to participate to professional update initiatives on the topic. Only 19.1% of participants talk regularly about the deleterious effects for the fetus of prenatal alcohol drinking to women and only 51.1% advise the 'zero alcohol' policy. Around 41% of participants tolerates the assumption of low-alcohol beverages. No differences were found between no drinkers and low and hazardous drinkers. In conclusion, data show that only specific and continuing updating for health care professionals about drinking habits may have impactful actions to prevent gestational alcohol intake in order to prevent the main cause of mental retardation in western countries.

2020 - Physical activity in low risk pregnant women: a cross-sectional study [Articolo su rivista]
Menichini, D.; Fanetti, O.; Molinazzi, M. T.; Facchinetti, F.; Ricchi, A.; Neri, I.
abstract

OBJECTIVES: The aim of this study is to analyze the quality and quantity of physical activity (PA) practiced by low-risk pregnant women before and during pregnancy. DESIGN: This cross-sectional study assesses the dietary habits, exercise habits and body mass index. We used an ad hoc health lifestyle multiple choice questionnaire. The data collection lasted 7 months, from the beginning of September 2018 to the end of March 2019. POPULATION: We recruited 175 Italian women with a singleton, low-risk pregnancy at 32-36 weeks of gestational age. RESULTS: In the periconceptional period, 52.6 % of women do not perform any PA. For the other 47.4% of women, the most practiced activities, both before and during gestation, are walking and swimming. Data on the sedentariness showed that about a quarter of the population remains inactive watching TV for more than two hours a day. Interestingly, the most statistically significant risk factor for sedentariness is the BMI > 25 kg/m². Therefore, overweight or obese women are more likely to maintain a sedentary lifestyle during pregnancy. CONCLUSIONS AND IMPLICATION FOR THE PRACTICE: Our study highlighted a high rate of sedentariness in pregnancy, especially among overweight and obese women. Thus, it is important to undertake interventions aimed at informing pregnant women of various benefits that PA can bring. In particular, because of the significant association between sedentariness and BMI greater than 25 kg/m2, it results crucial to direct these recommendations particularly to overweight/obese pregnant women, addressing them to a healthy lifestyle.

2020 - Self-efficacy in breastfeeding support: A research on italian midwifery students [Articolo su rivista]
Prepelita, T; Ricchi, A; Messina, P; Molinazzi, Mt; Cappadona, R; Fieschi, L; Nespoli, A; Guana, M; Cervi, G; Parma, D; Mauri, Pa; Artioli, G; Banchelli, F; Foa, C; Neri, I.
abstract

2020 - Study of childbirth education classes and evaluation of their effectiveness [Articolo su rivista]
Ricchi, A.; La Corte, S.; Molinazzi, M. T.; Messina, M. P.; Banchelli, F.; Neri, I.
abstract

BACKGROUND: Childbirth education classes are antenatal support services offered to pregnant women or to the couple, aimed at increasing their knowledge regarding pregnancy, labour, delivery, breastfeeding, parenthood and newborn care. OBJECTIVE: The aim was to evaluate the effectiveness of Birthing Classes through the analysis of the occurrence of C-section, epidural analgesia, behavior during labor and delivery of the women who participated to the course as compared to those who did not attend it. Moreover, the level of satisfaction of pregnant women who attended the course was measured with a questionnaire of 20 items handed out after the delivery. METHODS: To measure the satisfaction level of pregnant women, in the period from February 2017 to October 2017, a questionnaire of 20 items was used. In order to analyze the results of the births the medical records were consulted. RESULTS: In the period of time going from February 2017 to October 2017 there were 147 women who have delivered and who have filled in the questionnaire. According to the multivariable analysis, there were no differences in the frequency of C-sections between the two groups (OR=0.8, 95%CI=0.3-1.7, p=0.503), whereas the frequency of epidural analgesia was lower in women who attended the Birthing Class (OR=0.3, 95%CI=0.1-0.9, p=0.036). We also observed that women who attended the Birthing Class: 1) had a higher likelihood of using breathing techniques during the labor (OR=5.5, 95%CI=1.5-20.0, p=0.009); 2) had a higher likelihood of taking advantage of the visualization exercises during the labor (OR=2.5, 95%CI=1.1-6.0, p=0.039). There was no other relevant difference between the two groups. DISCUSSION: The benefits of perinatal education are difficult to evaluate systematically, and further research would be required to determine real effects and agree upon reliable indicators of effectiveness. CONCLUSIONS: This study identified several positive factors that confirm the results of other studies indicating that antenatal classes are effective for women giving birth for the first time/nulliparous women, based on an analysis of childbirth outcomes, in order to improve maternal and neonatal health.

2019 - Breastfeeding pathologies: Analysis of prevalence, risk and protective factors [Articolo su rivista]
Govoni, L.; Ricchi, A.; Molinazzi, M. T.; Galli, M. C.; Putignano, A.; Artioli, G.; Foa, C.; Palmieri, E.; Neri, I.
abstract

Background and aim of the study: Breastfeeding is essential for the health of mothers and newborns, and it is recommended by WHO-UNICEF as the sole source of nutrition and protection for the first 6 months of life and beyond. In order to fully promote this practice, it is important to recognize early conditions that can lead to pathological breastfeeding. Aim: The study aims to analyze the prevalence and the possible risk or protective factors concerning the pathology of breastfeeding. Methods: For this observational study were consulted the medical records and the files of the Breastfeeding clinic of 1065 puerperal women, of the University Hospital of Modena, from January to August 2016. The data were processed with the SPSS Software. Results: In our study population, 532 (50%) puerperal women presented a breastfeeding-related disease, of which 330 (31%) had a disease affecting the mother (breast engorgement, fissures, a-/hypo-galactia, discontinuation of breastfeeding, galactocele, mastitis and candidiasis), 105 (9.9%) of the newborn (inadequate suction, neonatal jaundice, pathological weight loss, need for admission to NICU) and 97 (9.1%) of both the mother and the newborn. Discussions: It is evident from the results that the predicting factors of pathology in breastfeeding are present in pregnant women who give birth in an early gestational age and with high age, birth rate and nationality. Conclusions: Staff training courses are essential to respond to WHO-UNICEF recommendations and to improve the continuity of care for the mother-child dyad.

2019 - Midwives autonomy in discharge women after physiological childbirth [Articolo su rivista]
Ricchi, A.; Covezzi, I. P.; Di Biase, L.; Saccani, G.; Galli, C.; Molinazzi, M. T.; Putignano, A.; Neri, I.
abstract

BACKGROUND: International literature identifies the midwife as the professional figure deals with women and newborns in the context of childbirth; it is however found to be still difficult to ensure this continuity of care. In Italy both the national laws and the indications of Emilia Romagna region promote this practice, ensuring the midwives management of the low risk women immediately after childbirth. The aim of the study is to investigate and describe the midwives autonomy as regards the post-partum discharge. METHODS: The computerised medical records were consulted to identify the mothers after childbirth who can be discharged independently by the obstetrician following the guidelines of the Emilia-Romagna region. RESULT S: A retrospective analysis of 1371 medical records related to the period January-June 2017 showed that 41% of discharges were managed handled by the midwives, while the remaining 59% by obstetricians. Fifty-seven percent of the women followed by the family counselling service were discharged by the obstetricians and 43% independently by the midwives. Considering the women followed by a private physician 62% were discharged by the obstetricians and 38% by the midwives. CONCLUSIONS: The study shows that, in a short time from the beginning of the project, the results as regards midwives autonomy were excellent. Indeed the midwives discharges does not differed significantly from the medical ones, and care continuity between the hospital and territory is strengthened. Further studies must include questionnaires concerning satisfaction of the mother not administered in this sample of women.

2019 - The midwifery-led care model: A continuity of care model in the birth path [Articolo su rivista]
Ricchi, A.; Rossi, F.; Borgognoni, P.; Bassi, M. C.; Artioli, G.; Foa, C.; Neri, I.
abstract

Background and aim of the study: The birth path is affected by a fragmentation in the patient care process creating a discontinuity of this last one. The pregnant woman has to interface with many professionals both during the pregnancy the childbirth and the puerperium. However during the last ten years there has been an increasing of the pregnancy care operated by the midwife who is considered to be the operator with the right competences who can take care of every pregnancy and may avail herself of other professionals’ contributions in order to improve the outcomes of maternal and neonatal health. Aim: To verify whether there are proofs of effectiveness that support the caseload midwifery care model and if it is possible to apply this model in the birth path in Italy. Methods: A revision of literature has been done using some search engine (Google Bing) and specific databases (MEDLINE CINAHL Embase Home - ClinicalTrials.gov). There has also been a consultation of the Italian regulations the national guidelines and the recommendations of WHO. Results: The search string properly adapted to the three databases has given the following results: MEDLINE 64 articles CINAHL 94 articles Embase 88 articles. From this selection 14 articles have been extracted: 1 systematic review 3 controlled random trial 7 observational studies 3 qualitative studies. Conclusions: The caseload midwifery care seems to be an effective and reliable organisational/caring method. It responds to the criterions of quality and security to the needs of women not only during the pregnancy but also during the post-partum phase. For these reasons it seems very useful also for the birth path in the Italian reality. (www.actabiomedica.it).

2018 - Survey of students of the degree course in obstetrics, on learning using case based learning (cbl) method in the area of professional teachings [Articolo su rivista]
Ricchi, A.; Martelli, E.; Molinazzi, M. T.; Vaccari, S.; Messina, M. P.; Banchelli, F.; Neri, I.
abstract

Background. Case Based Learning (CBL) is a teaching methodology that, starting from a case associated with real life situations, is able to stimulate students to investigate, reflect and discuss to find the solution to the case. Objective. The aim of this study is to investigate the satisfaction and the educational impact on the students of the Obstetrics Degree Course on Learning Case Based Learning CBL (on real clinical cases) Methods. The observational study was carried out through the presentation of real clinical cases to a sample of 43 students of a degree course in Obstetrics and giving them questionnaires of evaluation regarding satisfaction and educational impact, using measurement scales which ranged from 1 (very bad) to 5 (excellent). Results. The higher satisfaction was towards the tutor’s exhibition capacity and the integration between participants, for 2 nd and 3 rd year students, respectively. Likewise, the highest educational impact was associated with the effectiveness of the tutor facilitator. Differences in the degree of satisfaction were observed between the two students cohorts, in particular regarding relevance of the topics, as satisfaction was higher in 2 nd year students (p=0.021), and regarding work times, as satisfaction was higher in 3 rd year students (p=0.042). No significant differences in the educational impact were observed between 2 nd and 3 rd year students. Discussions. Studies were examined to compare the effectiveness of Case Based Learning (CBL) to the use of other teaching methodologies. Conclusion. The results of the study highlight that the knowledge and skills acquired by Case Based Learning were useful and applicable in the workplace.