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: Congenital Zika Virus Syndrome is an entity composed by a variety of birth defects presented in newborns that have been exposed to the Zika Virus during pregnancy. The syndrome characteristic features are severe microcephaly, cerebral tissue abnormalities, ophthalmological abnormalities such as uveitis and chorioretinitis, arthrogryposis, clubfoot deformity and muscular tone abnormalities. The confirmatory test is the Reverse transcription polymerase chain reaction (RT-PCR) associated to the physical findings. Here we present the case of a newborn with microcephaly whose mother presented a confirmed Zika Virus infection during the third trimester of pregnancy, despite of the evident findings and the history of Zika infection the RT-PCR in amniotic and cerebrospinal fluid of the newborn was negative. RT-PCR has demonstrated a low sensibility in samples with low viral loads, reason why, we propose a clinical diagnosis in patients with clinical history of Zika Virus infection during pregnancy accompanied by evident clinical manifestations of the child.
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: 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: The purposed of this research was to study the eating
habit of teenage pregnancy and its relationship to the knowledge of
nutrition during pregnancy. The 100 samples were derived from
simple random sampling technique of the teenage pregnancy in
Bangkae District. The questionnaire was used to collect data with the
reliability of 0.8. The data were analyzed by SPSS for Windows with
multiple regression technique. Percentage, mean and the relationship
of knowledge of eating and eating behavior were obtained. The
research results revealed that their knowledge in nutrition was at the
average of 4.07 and their eating habit that they mentioned most was
to refrain from alcohol and caffeine at 82% and the knowledge in
nutrition influenced their eating habits at 54% with the statistically
significant level of 0.001.
Abstract: VACTERL association is a rare disorder with various
congenital malformations. The aetiology remains unknown.
Combination of at least three congenital anomalies of the following
criteria is required for diagnosis: vertebral defects, anal atresia,
cardiac anomalies, tracheo-esophageal fistula, renal anomalies, and
limb defects. The first case was 1-day old male neonate with multiple
congenital anomalies was bore from 28 years old mother. The mother
had history of pregnancy with lymphocyte therapy. His anomalies
included: defects in thoracic and lumbar vertebral, anal atresia,
bilateral hydronephrosis, atrial septal defect, and lower limb
abnormality. Other anomalies were cryptorchidism and nasal canal
narrowing. The second case was born with 32 weeks gestational age
from mother with history of pregnancy with lymphocyte therapy. He
had thoracic vertebral defect, cardiac anomalies and renal defect.
diagnosis based on clinical finding is VACTERL association. Early
diagnosis is very important to investigation and treatment of other
coexistence anomalies. VACTERL association in mothers with
history of pregnancy with lymphocyte therapy has suggested possibly
of relationship between VACTERL association and this method of
pregnancy.
Abstract: Background: Bleeding during first half of pregnancy
mostly originates from placenta, some abort, others are at risk of
complications. Objective: Study was done to know perinatal outcome
with bleeding up to 20 weeks in singleton pregnancy. Material
Methods: Subjects were 1020, equal controls managed over 2 years,
435 had viable pregnancy at admission, 135 excluded, 300 followed
for perinatal outcome, 99 (19.52% up to 10 weeks), 201 (39.18% of
11-20 weeks). Results: Hypertensive disorders occurred in 24% cases
of bleeding within 10 weeks, 22% 11-20 weeks 14.79% controls,
placenta previa 4% in 10 weeks, 0.9% 11-20 weeks, 0.97% controls,
prelabor rupture of membranes in 16%, 7.45% controls. 20% up to 10
weeks, 35% 11-20 weeks, 18% controls had fetal growth restriction,
34.34% up to 10 weeks 30.35% of 11-20 weeks 17.17% controls had
preterm births, perinatal mortality rate in study was 118.62, in
controls 68.16 (Uneventful pregnancy in 13.52% study, 46.11%
controls). Conclusion: Once bleeding occurs, one third continue
pregnancy, maternal neonatal outcome gets affected with variations
in cases of bleeding within first 10 weeks & 11-20 weeks.
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: 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: 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.
Abstract: Various assisted reproductive techniques have been
developed and refined to obtain a large number of offspring from
genetically superior animals or obtain offspring from infertile (or
subfertile) animals. The embryo transfer is one assisted reproductive
technique developed well, aimed at increased productivity of selected
females, disease control, importation and exportation of livestock,
rapid screening of AI sires for genetically recessive characteristics,
treatment or circumvention of certain types of infertility. Embryo
transfer also is a useful research tool for evaluating fetal and maternal
interactions. This technique has been applied to nearly every species
of domestic animal and many species of wildlife and exotic animals,
including humans and non-human primates. The successful of
embryo transfers have been limited to within-animal, homologous
replacement of the embryos. There are several examples of
interspecific and intergeneric embryo transfers in which embryos
implanted but did not develop to term: sheep and goat, mouse and rat.
An immunological rejections and placental incompatibility between
the embryo and the surrogate mother appear to restrict interspecific
embryo transfer/interspecific pregnancy. Recently, preimplantation
embryo manipulation procedures have been applied, such as
technique of inner cell mass transfer. This technique will possible to
overcome the reproductive barrier interspecific embryo
transfer/interspecific pregnancy, if there is a protective mechanism
which prevents recognition of the foreign fetus by the mother of the
other species
Abstract: Dengue fever is an important human arboviral disease. Outbreaks are now reported quite often from many parts of the world. The number of cases involving pregnant women and infant cases are increasing every year. The illness is often severe and complications may occur. Deaths often occur because of the difficulties in early diagnosis and in the improper management of the diseases. Dengue antibodies from pregnant women are passed on to infants and this protects the infants from dengue infections. Antibodies from the mother are transferred to the fetus when it is still in the womb. In this study, we formulate a mathematical model to describe the transmission of this disease in pregnant women. The model is formulated by dividing the human population into pregnant women and non-pregnant human (men and non-pregnant women). Each class is subdivided into susceptible (S), infectious (I) and recovered (R) subclasses. We apply standard dynamical analysis to our model. Conditions for the local stability of the equilibrium points are given. The numerical simulations are shown. The bifurcation diagrams of our model are discussed. The control of this disease in pregnant women is discussed in terms of the threshold conditions.