Abstract: Background: Antenatal care can be defined as the care provided by skilled healthcare professionals to pregnant women and adolescent girls to ensure the best health conditions for both mother and baby during pregnancy. The components of Antenatal Care (ANC) include risk identification; prevention and management of pregnancy-related or concurrent diseases; and health education and health promotion. The aim of this study: to assess the knowledge, attitude, and practice of pregnant women regarding ANC. Methodology: A descriptive knowledge, attitude, and practice (KAP) study was conducted in public hospitals in Sana'a City, Yemen. The study population included all pregnant women that intended to the prenatal department and clinical outpatient department; the final sample size was 371 pregnant women. A self-administered questionnaire was used to collect the data, statistical package for social sciences SPSS was used to data analysis. The results: Most (79%) of pregnant women had correct answers in total knowledge regarding ANC, and about two-thirds (67%) of pregnant women had performance practice regarding ANC and two-third (68%) of pregnant women had a positive attitude. Conclusions: More than three quarter of pregnant women had good knowledge level, most of pregnant women had moderate practice level, and more than two-thirds of pregnant women had a positive attitude regarding antenatal care. There was a statistically significant association between overall knowledge and practice level toward ANC and demographic characteristics of pregnant women, at P-value ≤ 0.05. Recommendations: we recommended more education and training courses, lecturers, and education sessions in clinical facilitators focused on ANC, which relies on evidence-based interventions provided to women during pregnancy by skilled healthcare providers such as midwives, doctors, and nurses.
Abstract: Substance use among pregnant women is a perennial problem in the Western Cape Province of South Africa. There are many influential elements related with substance use among women of childbearing-age. Factors associated with substance use during pregnancy were explored using qualitative research approach and bio-ecological theoretical framework was utilised to guide the study. Participants were selected using purposive sampling. Participants accessed from the Department of Social Development who met the inclusion criteria of the study were interviewed using semi structured interviews. Participants were referred for psychological intervention during the interview if deemed necessary. Braun and Clarke’s six phases of thematic analysis were used to analyse the data. The study adhered to ethical measures for the participants’ protection. Participants had been knowledgeable about the study earlier than the initiation of the interviews and the important points of their voluntary participation had been explained. The key findings from this study illustrate that social factors, individual area and romantic relationship are the major contributing factors to substance use among pregnant ladies in this sample. Recommendations arising from the study encompass that the stakeholders, rehabilitation centers, Department of Health and future researchers ought to act proactively against substance use all through pregnancy.
Abstract: The aim of this study is the review of the management practices of sickle cell disease patients during pregnancy, as well as the maternal and neonatal outcome at Ampang Hospital, Selangor. The study consisted of a review of pregnant patients with sickle cell disease under follow up at the Hematology Clinic, Ampang Hospital over the last seven years to assess their management and maternal-fetal outcome. The results of the review show that Ampang Hospital is considered the public hematology centre for sickle cell disease and had successfully managed three pregnancies throughout the last seven years. Patients’ presentations, managements and maternal-fetal outcome were compared and reviewed for academic improvements. All three patients were seen very early in their pregnancy and had been given a regime of folic acid, antibiotics and thrombo-prophylactic drugs. Close monitoring of maternal and fetal well being was done by the hematologists and obstetricians. Among the patients, there were multiple admissions during the pregnancy for either a painful sickle cell bone crisis, haemolysis following an infection and anemia requiring phenotype- matched blood and exchange transfusions. Broad spectrum antibiotics coverage during and infection, hydration, pain management and venous-thrombolism prophylaxis were mandatory. The pregnancies managed to reach near term in the third trimester but all required emergency caesarean section for obstetric indications. All pregnancies resulted in live births with good fetal outcome. During post partum all were nursed closely in the high dependency units for further complications and were discharged well. Post partum follow up and contraception counseling was comprehensively given for future pregnancies. Sickle cell disease is uncommonly seen in the East, especially in the South East Asian region, yet more cases are seen in the current decade due to improved medical expertise and advance medical laboratory technologies. Pregnancy itself is a risk factor for sickle cell patients as increased thrombosis event and risk of infections can lead to multiple crisis, haemolysis, anemia and vaso-occlusive complications including eclampsia, cerebrovasular accidents and acute bone pain. Patients mostly require multiple blood product transfusions thus phenotype-matched blood is required to reduce the risk of alloimmunozation. Emphasizing the risks and complications in preconception counseling and establishing an ultimate pregnancy plan would probably reduce the risk of morbidity and mortality to the mother and unborn child. Early management for risk of infection, thromboembolic events and adequate hydration is mandatory. A holistic approach involving multidisciplinary team care between the hematologist, obstetricians, anesthetist, neonatologist and close nursing care for both mother and baby would ensure the best outcome. In conclusion, sickle cell disease by itself is a high risk medical condition and pregnancy would further amplify the risk. Thus, close monitoring with combine multidisciplinary care, counseling and educating the patients are crucial in achieving the safe outcome.
Abstract: The goal of this work is to report the main dermatological alterations occurring during pregnancy and actual cosmetic protocols available and recommended for safe use. Throughout pregnancy, woman's body undergoes many transformations such as hormonal changes and weight gain. These alterations can result in undesirable skin aspects that end up affecting the future mother's life. The main complaints of pregnant women involve melasma advent, varicose veins, edema, and natural skin aging. Even if most of the time is recommended to wait for the birth to use cosmetics, there are some alternatives to prevent and to treat these alterations during pregnancy. For all these cases, there is a need to update information about safety and efficacy of new actives and technologies in cosmetic products. The purpose of this study was to conduct a literature review about the main skin alterations during pregnancy and actual recommended treatments, according to the current legislation.
Abstract: The quality of prenatal care is key to reduce maternal morbidity and mortality. Communication between the health service and users can stimulate prevention and care. M-health has been an important and low cost strategy to health education. The PRENACEL programme (prenatal in the cell phone) was developed. It consists of a programme of information via SMS from the 20th week of pregnancy up to 12th week after delivery. Messages were about prenatal care, birth, contraception and breastfeeding. Communication of the pregnant woman asking questions about their health was possible. The objective of this study was to evaluate the implementation of PRENACEL as a useful complement to the standard prenatal care. Twenty health clinics were selected and randomized by cluster, 10 as the intervention group and 10 as the control group. In the intervention group, women and their partner were invited to participate. The control group received the standard prenatal care. All women were interviewed in the immediate post-partum and in the 12th and 24th week post-partum. Most women were married, had more than 8 years of schooling and visit the clinic more than 6 times during prenatal care. The intervention group presented lowest percentage of higher economic participants (5.6%), less single mothers and no drug user. It also presented more prenatal care visits than the control group and it was less likely to present Severe Acute Maternal Mortality when compared to control group as well as higher percentage of partners (75.4%) was present at the birth compared to control group. Although the study is still being carried out, preliminary data are showing positive results of the compliance of women to prenatal care.
Abstract: This study aimed to analyse the pregnancy outcomes in patients with TPO positivity after appropriate L-Thyroxin supplementation with close surveillance. All pregnant women attending the antenatal clinic at Milann-The Fertility Center, Bangalore, India- from Aug 2013 to Oct 2014 whose booking TSH was more than 2.5 mIU/L were included along with those pregnant women with prior hypothyroidism who were TPO positive. Those with TPO positive status were vigorously managed with appropriate thyroxin supplementation and the doses were readjusted every 3 to 4 weeks until delivery. Women with recurrent pregnancy loss were also tested for TPO positivity and if tested positive, were monitored serially with TSH and fT4 levels every 3 to 4 weeks and appropriately supplemented with thyroxin when the levels fluctuated. The testing was done after an informed consent in all these women. The statistical software namely SAS 9.2, SPSS 15.0, Stata 10.1, MedCalc 9.0.1, Systat 12.0 and R environment ver.2.11.1 were used for the analysis of the data. 460 pregnant women were screened for thyroid dysfunction at booking of which 52% were hypothyroid. Majority of them (31.08%) were subclinically hypothyroid and the remaining were overt. 25% of the total no. of patients screened were TPO positive. The various pregnancy complications that were observed in the TPO positive women were gestational glucose intolerance [60%], threatened abortion [21%], midtrimester abortion [4.3%], premature rupture of membranes [4.3%], cervical funneling [4.3%] and fetal growth restriction [3.5%]. 95.6% of the patients who followed up till the end delivered beyond 30 weeks. 42.6% of these patients had previous history of recurrent abortions or adverse obstetric outcome and 21.7% of the delivered babies required NICU admission. Obstetric outcomes in our study in terms of midtrimester abortions, placental abruption, and preterm delivery improved for the better after close monitoring of the thyroid hormone [TSH and fT4] levels every 3 to 4 weeks with appropriate dose adjustment throughout pregnancy. Euthyroid women with TPO positive status enrolled in the study incidentally were those with recurrent abortions/infertility and required thyroxin supplements due to elevated Thyroid hormone (TSH, fT4) levels during the course of their pregnancy. Significant associations were found with age>30 years and Hyperhomocysteinemia [p=0.017], recurrent pregnancy loss or previous adverse obstetric outcomes [p=0.067] and APLA [p=0.029]. TPO antibody levels >600 I U/ml were significantly associated with development of gestational hypertension [p=0.041] and fetal growth restriction [p=0.082]. Euthyroid women with TPO positivity were also screened periodically to counter fluctuations of the thyroid hormone levels with appropriate thyroxin supplementation. Thus, early identification along with aggressive management of thyroid dysfunction and stratification of these patients based on their TPO status with appropriate thyroxin supplementation beginning in the first trimester will aid risk modulation and also help avert complications.
Abstract: To evaluate the effect of intramuscular administration
of vitamin A in pregnant dairy cows during late stages of pregnancy,
on vitamin A status of neonatal calves, a total of 30 cows were
randomly selected and divided into three groups; two treatment
groups and one control group. Single intramuscular injection of
2000000 IU vitamin A; was carried in 10 dairy cows at 7 months of
pregnancy (group 1). In second group of treated animals (10 cows)
the injection was performed in 8 months of pregnancy (group 2). Ten
pregnant dairy cows were received saline injection as placebo and
selected as control group. Blood samples were collected from
experimental dairy cows at 7 and 8 months of pregnancy as well as
their newborn calves’ pre and after colostrum intake. There was no
significant difference between vitamin A and β-carotene
concentration of dairy cows of three groups in two last months of
pregnancy (P> 0.05). Vitamin A concentration of calves of two
treatment groups before and after receiving of colostrum were
significantly higher than that in control group (P< 0.05). There was
no significant difference between serum concentrations of vitamin A
in calves of two treated groups (P> 0.05). β-Carotene concentration
of serum samples of dairy cows and neonatal calves of three groups
were not significantly different as compared with together. From
results of the present study it can be concluded that single injection of
vitamin A during at 7 or 8 month of pregnancy can significantly
increase level of vitamin A in their colostrum and neonatal calves.
Abstract: Effects of nicotine on pre-partum body weight and
preimplantation embryonic development has been reported
previously. Present study was conducted to determine the effects of
annatto (Bixa orellana)-derived delta-tocotrienol (TCT) (with
presence of 10% gamma-TCT isomer) on the nicotine-induced
reduction in body weight and 8-cell embryonic growth in mice.
Twenty-four 6-8 weeks old (23-25g) female balb/c mice were
randomly divided into four groups (G1-G4; n=6). Those groups were
subjected to the following treatments for 7 consecutive days: G1
(control) were gavaged with 0.1 ml tocopherol stripped corn oil. G2
was subcutaneously (s.c.) injected with 3 mg/kg/day of nicotine. G3
received concurrent treatment of nicotine (3 mg/kg/day) and 60
mg/kg/day of δ-TCT mixture (contains 90% delta & 10% gamma
isomers) and G4 was given 60 mg/kg/day of δ-TCT mixture alone.
Body weights were recorded daily during the treatment. On Day 8,
females were superovulated with 5 IU Pregnant Mare’s Serum
Gonadotropin (PMSG) for 48 hours followed with 5 IU human
Chorionic Gonadotropin (hCG) before mated with males at the ratio
of 1:1. Females were sacrificed by cervical dislocation for embryo
collection 48 hours post-coitum. Collected embryos were cultured in
vitro. Results showed that throughout Day 1 to Day 7, the body
weight of nicotine treated group (G2) was significantly lower
(p
Abstract: Several embryonic cellular mechanism including cell
cycle, growth and apoptosis are regulated by phosphatidylinositol-3-
kinase (PI3K)/Akt signaling pathway. The goal of present study is to
determine the effects of annatto (Bixa orellana)-derived δ-tocotrienol
(δ-TCT) on the regulations of PI3K/Akt genes in murine morula.
Twenty four 6-8 week old (23-25g) female balb/c mice were
randomly divided into four groups (G1-G4; n=6). Those groups were
subjected to the following treatments for 7 consecutive days: G1
(control) received tocopherol stripped corn oil, G2 was given 60
mg/kg/day of δ-TCT mixture (contains 90% delta & 10% gamma
isomers), G3 was given 60 mg/kg/day of pure δ-TCT (>98% purity)
and G4 received 60 mg/kg/day α-TOC. On Day 8, females were
superovulated with 5 IU Pregnant Mare’s Serum Gonadotropin
(PMSG) for 48 hours followed with 5 IU human Chorionic
Gonadotropin (hCG) before mated with males at the ratio of 1:1.
Females were sacrificed by cervical dislocation for embryo collection
48 hours post-coitum. About fifty morulas from each group were
used in the gene expression analyses using Affymetrix QuantiGene
Plex 2.0 Assay. Present data showed a significant increase (p
Abstract: Breast cancer is considered as a substantial health
concern and practicing mammography screening [MS] is important in
minimizing its related morbidity. So it is essential to have a better
understanding of breast cancer screening behaviors of women and
factors that influence utilization of them. The aim of this study is to
identify the factors that are linked to MS behaviors among the
Egyptian women. A cross-sectional descriptive design was carried
out to provide a snapshot of the factors that are linked to MS
behaviors. A convenience sample of 311 women was utilized and all
eligible participants admitted to the Women Imaging Unit who are 40
years of age or above, coming for mammography assessment, not
pregnant or breast feeding and who accepted to participate in the
study were included. A structured questionnaire was developed by
the researchers and contains three parts; Socio-demographic data;
Motivating factors associated with MS; and association between MS
and model of behavior change. The analyzed data indicated that most
of the participated women (66.6%) belonged to the age group of 40-
49.A high proportion of participants (58.1%) of group having
previous MS influenced by their neighbors to practice MS, whereas
32.7 % in group not having previous MS were influenced by family
members which indicated significant differences (P
Abstract: In this investigation, we have evaluated the effects of
arsenic trioxide on hepatic function in pregnant and lactating Swiss
albino mice and their suckling pups. Experiments were carried out on
female mice given 175 ppm As2O3 in their drinking water from the
14th day of pregnancy until day 14 after delivery. Our results showed
a significant decrease in plasma levels of total protein and albumin,
cholesterol and triglyceride in As2O3 treated mice and their pups. The
hyperbilirubinemia and the increased plasma total alkaline
phosphatase activity suggested the presence of cholestasis.
Transaminase activities as well as lactate deshydrogenase activity in
plasma, known as biomarkers of hepatocellular injury, were elevated
indicating hepatic cells’ damage after treatment with As2O3.
Exposure to arsenic led to an increase of liver thiobarbituric acid
reactive substances level along with a concomitant decrease in the
activities of superoxide dismutase, catalase and glutathione
peroxidase and in glutathione.
Abstract: In Brazil, neonatal mortality rate is considered
incompatible with the country development conditions, and has been
a Public Health concern. Reduction in infant mortality rates has also
been part of the Millennium Development Goals, a commitment
made by countries, members of the Organization of United Nations
(OUN), including Brazil. Fetal mortality rate is considered a highly
sensitive indicator of health care quality. Suitable actions, such as
good quality and access to health services may contribute positively
towards reduction in these fetal and neonatal rates. With appropriate
antenatal follow-up and health care during gestation and delivery,
some death causes could be reduced or even prevented by means of
early diagnosis and intervention, as well as changes in risk factors
and interventions. Objectives: To study the quality of maternal and
infant health care based on fetal and neonatal mortality, as well as the
possible actions to prevent those deaths in Botucatu (Brazil).
Methods: Classification of prevention according to the International
Classification of Diseases and the modified Wigglesworth´s
classification. In order to evaluate adequacy, indicators of quality of
antenatal and delivery care were established by the authors. Results:
Considering fetal deaths, 56.7% of them occurred before delivery,
which reveals possible shortcomings in antenatal care, and 38.2% of
them were a result of intra- labor changes, which could be prevented
or reduced by adequate obstetric management. These findings were
different from those in the group of early neonatal deaths which were
also studied. Adequacy of health services showed that antenatal and
childbirth care was appropriate for 24% and 33.3% of pregnant
women, respectively, which corroborates the results of prevention.
These results revealed that shortcomings in obstetric and antenatal
care could be the causes of deaths in the study. Early and late
neonatal deaths have similar characteristics: 76% could be prevented
or reduced mainly by adequate newborn care (52.9%) and adequate
health care for gestational women (11.7%). When adequacy of care
was evaluated, childbirth and newborn care was adequate in 25.8%
and antenatal care was adequate in 16.1%. In conclusion, direct
relationship was found between adequacy and quality of care
rendered to pregnant women and newborns, and fetal and infant
mortality. Moreover, our findings highlight that deaths could be
prevented by an adequate obstetric and neonatal management.
Abstract: The aim of this study is to determine the effect of age
and physiological status on progesterone and energy metabolism of
Ouled Djellal (O.D) breed ewes. 40 healthy ewes were divided into
two groups, primiparous and multiparous, with 20 ewes in each
group. The body weights (BW) (Kg) were 46.6 ± 4.20 and 59.2 ±
3.02, and consuming less 25 to 30% of their basal energetic
requirements. The values of serum glucose, triglycerides and
cholesterol were lower in pregnant than in non-pregnant ewes. The
high to very high significant differences were found during the 15th
week of pregnancy for glycaemia and triglyceridemia respectively.
Concerning serum progesterone, a very highly significant difference
(p
Abstract: The objective of this study is to analyze the
prophylactic usage of low molecular weight heparin (LMWH) along
pregnancy and the correlation between their usage and month/week
of pregnancy, in the Department of Gynecology and Obstetrics, at
Clinical Hospital in Tetovo. A retrospective study was undertaken
during 01 January – 31 December 2012. Over of one year, the total
number of patients was 4636. Among the 1447 (32.21%) pregnant
women, 298 (20.59%) of them were prescribed LMWH. The majority
of patients given LMWH, 119 (39.93%) were diagnosed
hypercoagulable. The age group with the highest attendance was 25-
35, 141 patients (47.32%). For 195 (65.44%) patients, this was their
first pregnancy. Earliest stage of using LMWH was the second month
of pregnancy 4 (1.34%) cases. The most common patients were 70
women along the seventh month (23.49%), followed by 68 in the
ninth month of pregnancy (22.81%). Women in the 28th gestational
week, were found to be the most affected, a total of 55 (78.57%) were
in that week. Clexane 2000 and Fraxiparine 0.3 were the most
common for which low molecular weight heparin was prescribed.
The number of patients which received Clexane 2000 was 84
(28.19%), followed by those with Fraxiparine 0.3 81 (27.18%). The
administration of LMWH is associated with long hospitalization
(median 14,6 days).
Abstract: Folic acid (FA) is known to be an important
supplement to prevent neural tube defect (NTD) in pregnant women.
Similar to some commercial formulations, sodium bicarbonate
solution is used as a solvent for FA. This work uses the antisolvent
vapour precipitation (AVP), incorporating ethanol vapour as the
convective drying medium in place of air to produce branch-like
micro-structure FA particles. Interestingly, the dissolution rate of the
resultant particle is 2-3 times better than the particle produce from
conventional air drying due to the higher surface area of particles
produced. The higher dissolution rate could possibly improve the
delivery and absorption of FA in human body. This application could
potentially be extended to other commercial products, particularly in
less soluble drugs to improve its solubility.
Abstract: This study was conducted to examine the possible role of serum Gamma-glutamyltransferase (GGT) and Lactate dehydrogenase (LDH) in the prediction of severity of preeclampsia. The study group comprised of 40 preeclamptic cases (22 with mild and 18 with severe) and 40 healthy normotensive pregnant controls. Serum samples of all the cases were assayed for GGT and LDH. Demographic, hemodynamic and laboratory data as well as serum GGT and LDH levels were compared among the three groups.
The results indicated that severe preeclamptic cases had significantly increased levels of serum GGT and LDH. The symptoms in severe preeclamptic women were significantly increased in patients with GGT > 70 IU/L and LDH >800 IU/L. Elevated levels of serum GGT and LDH can be used as biochemical markers which reflects the severity of preeclampsia and useful for the management of preeclampsia to decrease maternal and fetal morbidity and mortality.
Abstract: Our study was designed to determine the metabolic
changes of some biochemical parameters (cholesterol, triglyceride,
Iron, uric acid, Urea and folic acid) and highlight their changes in 57
women of the region Batna, during the first trimester of pregnancy.
This practical work was done with 27 women with missed
miscarriage, compared with 30 control subjects of normal pregnant
women. The assay results revealed a highly significant difference (P
= 0.0006) between the two groups in serum iron (64.00 vs 93.54) and
in the rate of folate (6.70 vs 9.22) (P
Abstract: Corpus luteum cross sectional (by ultrasonography) and plasma progesterone (by DELFIA) were estimated in early pregnant and non pregnant cows on days 14th and 20th to 23rd post insemination. On day 14th, corpus luteum sectional area was 348.43 mm2 in pregnant and 387.84mm2 in non pregnant cows. Within days 20th to 23rd, corpus luteum sectional area ranged between 342.06 and 367.90 mm2 in pregnant and between 193.85 and 270.69 mm2 in non pregnant cows. Plasma progesterone level was 2.43 ng/ml in pregnant and 2.46 ng/ml in non pregnant cows on day 14th, while during days 20th to 23rd the level ranged between 2.47 and 2.84 ng/ml in pregnant and between 0.53 and 1.17 ng/ml in non pregnant cows. Results of both luteal tissue areas as well as plasma progesterone levels were highly significantly deferent (P
Abstract: The importance of maternal nutritional practices during pregnancy cannot be overemphasized. This paper assessed the consumption pattern and dietary practices of 50 pregnant women selected using purposive sampling technique from three health care centres (Primary Health Care Centre, Obantoko; Primary Health Care Centre Alabata; and the General Hospital, Odeda) in Odeda Local Government Area of Ogun State, Nigeria. Structured questionnaire was used to elicit information on socioeconomic status, consumption pattern and dietary practices. Data were analyzed using the Statistical Package for Social Sciences (SPSS, 17). The results indicated that about 58% of the pregnant women were below the age of 30 while 42% were ages 28-40 years. Only 16% had tertiary education while (38%) had secondary education, 52% earn income through petty trading. On food intake, 52% got their energy source from rice on a daily basis, followed by pap (38%) and eko (34%). For protein intake, 36% consumed bean cake on a daily basis while 66% consumed moinmoin 2-3 times a week. Orange (48%) and Green Leafy vegetable (40%) accounted for the mostly consumed fruit and vegetable on daily basis. In terms of animal origin, fish (76%), meat (58%) and eggs (30%) were consumed daily, while chicken and snail were consumed occasionally by 54% and 42%, respectively. Forty-six percent (46%) of the pregnant women eat more than three times daily; while 60% of the women eat outside their homes with 42% respondents eat out lunch and only two percent least eaten out dinner. It is important to increase in awareness campaign to sensitize the pregnant women on the importance of good nutrition especially fruits, vegetables and dairy products.
Abstract: We used mathematical model to study the
transmission of dengue disease. The model is developed in which
the human population is separated into two populations, pregnant and
non-pregnant humans. The dynamical analysis method is used for
analyzing this modified model. Two equilibrium states are found and
the conditions for stability of theses two equilibrium states are
established. Numerical results are shown for each equilibrium state.
The basic reproduction numbers are found and they are compared by
using numerical simulations.