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 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: 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 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: 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: 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: 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.