Informational needs related to aspirin prophylactic therapy amongst pregnant women at risk of preeclampsia – a qualitative study

Background: Preclampsia is a leading cause of maternal morbidity and mortality which accounts for 5%-10% of deaths worldwide. Several studies have attempted to effectively predict preclampsia early in pregnancy. The effective method of detection and treatment are yet to be determined. Early identification of women at risk would enhance prompt monitoring and treatment of both mother and fetus. International Federation of Gynaecology and obstetrics FIGO recommends that the use of risk factors along with biomarkers would be beneficial in predicting the disease among pregnant women. Thus, the discovery of a sensitive and specific biomarker would reduce the unwanted effect of preeclampsia. Several biomarkers have been studied but efforts to find an effective one for the prediction of preeclampsia is still elusive. The study evaluated the relationship between pregnancy-associated plasma protein-A (P PPA) and preeclampsia as a biomarker in predicting preeclampsia. Objectives: To determine the relationship between the levels of pregnancy-associated plasma protein-A and the onset of pre-eclampsia among pregnant women with risk factors for preeclampsia and those without known risk factors (control). Materials and Methods: A prospective cohort study of consenting patients who presented at the maternity unit of Ifako-Ijaiye Mother and Child Centre between 11-15 weeks gestation with risk factors for preeclampsia (cases) and those without known risk factors for preeclampsia (controls). Blood samples were obtained and sent to Lagos State University Teaching Hospital Medical Research Laboratory for analysis of Pregnancy Associated Plasma Protein-A (PAPP-A). Results: No significant correlation was found between the onset of preeclampsia and the levels of Pregnancy Associated Plasma Protein-A in pregnant women with risk as well as those without risk factors who later on developed the disease. p>0.05. Among women without identifiable risk of preeclampsia, median Pregnancy Associated Plasma Protein-A was significantly higher in pregnant women who did not develop Preeclampsia compared to those who subsequently developed preeclampsia (p=0.004). There was a statistically significant difference in the median PAPP-A levels between patients at risk of preeclampsia (cases) compared with those without risk (controls). p<0.05. Conclusion: There was a significantly lower median level of PAPP-A among patients with risk factors for preeclampsia when compared with low-risk patients. Meanwhile, there is no significant correlation between the levels of PAPP-A and onset of preeclampsia among those who subsequently developed the disease in those at risk and those without.

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Abstract 15048: Ischaemic Pre-conditioning: A Non-invasive Intervention That Improves Maternal Endothelial Function in Women With Preeclampsia And at Risk of Preeclampsia

Circulation ◽

10.1161/circ.142.suppl_3.15048 ◽

2020 ◽

Vol 142 (Suppl_3) ◽

Author(s):

Tamara Kubba ◽

Sean M Davidson ◽

David Williams

Keyword(s):

At Risk ◽

Endothelial Function ◽

Pregnant Women ◽

Brachial Artery ◽

Invasive Technique ◽

Baseline Measure ◽

Ischaemic Injury ◽

Non Invasive ◽

Flow Mediated Dilatation ◽

Risk Of Preeclampsia

Introduction: Preeclampsia is a pregnancy syndrome defined by the gestational onset of hypertension and proteinuria and characterised by maternal endothelial dysfunction with placental ischaemia. Preeclampsia affects approximately 4% of first-time pregnant mothers, but approximately 20% of women with pre-existing hypertension. Ischaemic pre-conditioning (IPC) is a phenomenon whereby transient episodes of ischaemia protect against future ischaemic injury. IPC has never previously been studied in pregnant women. We investigated whether IPC could improve maternal endothelial function in women at risk of preeclampsia and with preeclampsia. Hypothesis: We hypothesised that IPC would improve maternal endothelial function in women with preeclampsia and at risk of preeclampsia. Methods: We measured brachial artery flow mediated dilatation (FMD), before and after IPC in 3 groups of pregnant women between 24+0 and 36+6 weeks gestation: normotensive pregnancy (n=42), at risk of preeclampsia (n=20) and established preeclampsia (n=11). Following a baseline measure of brachial artery FMD, 3 cycles of 5-minutes of upper arm ischaemia were alternated with 5-minutes of reperfusion. Twenty-four hours later, maternal FMD was re-measured. Results: Women with preeclampsia had the lowest baseline FMD 4.09% +/- 0.73%: mean +/- SEM, which increased to 6.25% +/- 0.83% (p=0.0024) following IPC. Women at risk of pre-eclampsia had baseline FMD 7.57% +/- 0.82%, which increased to 8.93% +/- 0.73% (p=0.025) following IPC. Normotensive pregnant women had the highest baseline FMD (10.32% +/- 0.69%), which did not increase further following IPC (10.52% +/- 0.69%). However, normotensive pregnant women reached peak flow-mediated dilatation more quickly following IPC; 414 s +/- 2.94 s v 425 s +/- 4.22 s (p=0.0302). Conclusions: IPC is a non-invasive technique that we have shown improves local endothelial function in women with preeclampsia and at risk of preeclampsia. IPC merits further study as an intervention to improve systemic endothelial function and pregnancy outcomes for women with hypertensive pregnancies.

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Experiences of interactive ultrasound examination among women at risk of preterm birth: a qualitative study

BMC Pregnancy and Childbirth ◽

10.1186/s12884-019-2493-2 ◽

2019 ◽

Vol 19 (1) ◽

Cited By ~ 1

Author(s):

Henrika Pulliainen ◽

Hannakaisa Niela-Vilén ◽

Eeva Ekholm ◽

Sari Ahlqvist-Björkroth

Keyword(s):

At Risk ◽

Preterm Birth ◽

Qualitative Study ◽

Pregnant Women ◽

Ultrasound Examination ◽

Structured Interview ◽

Psychological Support ◽

University Hospital ◽

Singleton Pregnancy ◽

4D Ultrasound

Abstract Background Pregnant women who are at risk of preterm birth are often stressed, anxious and depressed because of worries and fears related to the health of the unborn baby, their own health and uncertainty about the future. Only a few studies have assessed the types of psychological support that would relieve these stress symptoms among women with high-risk pregnancies. The aim of this study was to describe 1) how women at risk of preterm birth experienced an interactive 3/4-dimensional (3/4D) ultrasound examination, and 2) their need for psychological support during the antenatal period. Methods This qualitative study was conducted at one university hospital in Finland in 2017. Women with a singleton pregnancy of 26–32 gestational weeks (gwks) were included in the study. The interactive 3/4D ultrasound included a joint observation of the baby, based on the mother’s wishes, with an obstetrician and psychologist. After the examination, the experiences were explored with a semi-structured interview. The data was analyzed using inductive thematic analysis. Results The women enjoyed the fact that the staff were focused on her fetus and genuinely present during the session and also enabled the women to actively participate. Watching the baby and her/his activities made the baby more concrete and relieved their concerns. The need for additional psychological support varied individually. Conclusions Interactive ultrasound examination is an interesting way to awaken mental images, increase attachment, and reduce stress. The results imply that an interactive way of jointly looking at the fetus supports pregnant women at risk of preterm birth and may be useful in clinical practice.

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Understanding Zika virus as an STI: findings from a qualitative study of pregnant women in the Bronx

Sexually Transmitted Infections ◽

10.1136/sextrans-2019-054093 ◽

2019 ◽

Vol 96 (2) ◽

pp. 80-84 ◽

Cited By ~ 2

Author(s):

Miguel Rodriguez ◽

Ayla Lord ◽

Carolina C Sanabia ◽

Abigail Silverio ◽

Meleen Chuang ◽

...

Keyword(s):

At Risk ◽

Qualitative Study ◽

Pregnant Women ◽

Zika Virus ◽

Sexual Transmission ◽

Coping Mechanism ◽

Theory Approach ◽

New Disease ◽

Prevention Measures ◽

Community Based

ObjectivesPregnant women in the Bronx were at risk for travel-related Zika exposure in the USA between 2016 and 2017. This qualitative study explored the experiences of 13 pregnant women to learn about their knowledge of Zika and prevention measures.MethodsIn the summer of 2017, pregnant women at risk of travel-related Zika exposure were interviewed in either Spanish or English to learn about their experiences and transcripts were analysed using a grounded theory approach.ResultsMost participants were Latinas living in the Bronx, median age of 29 years and median household income between $26 000 and $50 000. Participants displayed a strong understanding of Zika transmission via mosquito bites yet lacked knowledge about its sexual transmission. Interviews revealed three key themes: (1) Zika as a new disease, (2) denial as a coping mechanism and (3) the recommendation to treat Zika as an STI. Women observed Zika as a brand new disease with early messages emphasising mosquito-borne transmission. They lacked awareness of newer messaging about sexual transmission. Furthermore, if women did read about risk of sexual transmission, many stated being in denial and struggling with recommendations to prevent sexual transmission. Barriers included problems changing travel plans and rejection of condom use. Women unanimously suggested labelling Zika as an STI and adding it to existing lists of STIs for messaging and outreach in community-based and clinical prevention.ConclusionMany pregnant women were unaware that Zika virus can be sexually transmitted due to: (1) novelty of Zika, (2) denial as a coping mechanism and (3) Zika not being listed along with well-known STIs. Overcoming these barriers via community-based as well as clinical education for pregnant women in the Bronx would be helpful in 2019 and beyond when the risk of travel-related Zika exposure remains a public health threat to optimal pregnancy outcomes.

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Fuzzy Intelligent System for Patients with Preeclampsia in Wearable Devices

Mobile Information Systems ◽

10.1155/2017/7838464 ◽

2017 ◽

Vol 2017 ◽

pp. 1-10 ◽

Cited By ~ 9

Author(s):

Macarena Espinilla ◽

Javier Medina ◽

Ángel-Luis García-Fernández ◽

Sixto Campaña ◽

Jorge Londoño

Keyword(s):

At Risk ◽

Pregnant Women ◽

Intelligent System ◽

Analysis Tool ◽

Fuzzy Decision ◽

Maternal Deaths ◽

Linguistic Rules ◽

Linguistic Approach ◽

Fuzzy Linguistic ◽

Risk Of Preeclampsia

Preeclampsia affects from 5% to 14% of all pregnant women and is responsible for about 14% of maternal deaths per year in the world. This paper is focused on the use of a decision analysis tool for the early detection of preeclampsia in women at risk. This tool applies a fuzzy linguistic approach implemented in a wearable device. In order to develop this tool, a real dataset containing data of pregnant women with high risk of preeclampsia from a health center has been analyzed, and a fuzzy linguistic methodology with two main phases is used. Firstly, linguistic transformation is applied to the dataset to increase the interpretability and flexibility in the analysis of preeclampsia. Secondly, knowledge extraction is done by means of inferring rules using decision trees to classify the dataset. The obtained linguistic rules provide understandable monitoring of preeclampsia based on wearable applications and devices. Furthermore, this paper not only introduces the proposed methodology, but also presents a wearable application prototype which applies the rules inferred from the fuzzy decision tree to detect preeclampsia in women at risk. The proposed methodology and the developed wearable application can be easily adapted to other contexts such as diabetes or hypertension.

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GAMBARAN KARAKTERISTIK IBU HAMIL YANG MENGALAMI PREEKLAMPSIA

Media Ilmu Kesehatan ◽

10.30989/mik.v7i3.298 ◽

2019 ◽

Vol 7 (3) ◽

pp. 238-243

Author(s):

Yanita Trisetiyaningsih ◽

Annisa Smaradika

Keyword(s):

High School ◽

At Risk ◽

Nutritional Status ◽

Pregnant Women ◽

Quantitative Study ◽

Education History ◽

Minimal Level ◽

History Of ◽

Pregnant Mothers ◽

Risk Of Preeclampsia

Background : Preeclampsia is the escalting blood preasure as high as 140/90 mmHg at the minimal level, proteinuria, and oedema of pregnant mothers. Preeclampsia is a risk that may be harmful for mother and fetus. Up to date, the cause of preeclampsia remains unrevealed, but preeclampsia can effect certain grups like mother with predisposing factors such as age, education, job, parity, history of preeclampsia, history of hypertesion, nurtritional status , etc. Objective : to identify The Description of Characteristics of Pregnant Mothers with Pre Eclampsia in PKU Muhammadiyah Hospital of Bantul during 1st January 2015 - 29th June 2017. Method : This was a descriptive and quantitative study with total sampling data collecting method which was aimed to present a description about age, parity, job, education, history of hypertension, history of preeclampsia, and nutritional status with preeclampsia affection. Result : Since the beginning of 2015 until mid 2017, there had been 49 preeclampsia cases, mostly in the group of age 20-35 years old (69,4%), multigravid pregnant mothers (77,6%), last education of Senior High School (49,0%), IMT aspect with more nutrition (71,4%), had no history of preeclampsia (63,3%), had history of hypertension (59,2%), other jobs or house-wives (40,8%). Conclusions : It is expected that the hospital should always pay attention to pregnant women who are at risk of preeclampsia, in order to reduce the incidence of preeclampsia occurring in the area of the hospital and can cope with the incidence of preeclampsia earlier. Keywords : Preeclampsia, Pregnant Women

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GAMBARAN KARAKTERISTIK IBU HAMIL YANG MENGALAMI EKLAMPSIA

Media Ilmu Kesehatan ◽

10.30989/mik.v7i3.246 ◽

2019 ◽

Vol 7 (3) ◽

pp. 238-243

Author(s):

Yanita Trisetyaningsih ◽

Annisa Smaradika

Keyword(s):

High School ◽

At Risk ◽

Nutritional Status ◽

Pregnant Women ◽

Quantitative Study ◽

Education History ◽

Minimal Level ◽

History Of ◽

Pregnant Mothers ◽

Risk Of Preeclampsia

Background : Preeclampsia is the escalting blood preasure as high as 140/90 mmHg at the minimal level, proteinuria, and oedema of pregnant mothers. Preeclampsia is a risk that may be harmful for mother and fetus. Up to date, the cause of preeclampsia remains unrevealed, but preeclampsia can effect certain grups like mother with predisposing factors such as age, education, job, parity, history of preeclampsia, history of hypertesion, nurtritional status , etc. Objective : to identify The Description of Characteristics of Pregnant Mothers with Pre Eclampsia in PKU Muhammadiyah Hospital of Bantul during 1st January 2015 - 29th June 2017. Method : This was a descriptive and quantitative study with total sampling data collecting method which was aimed to present a description about age, parity, job, education, history of hypertension, history of preeclampsia, and nutritional status with preeclampsia affection. Result : Since the beginning of 2015 until mid 2017, there had been 49 preeclampsia cases, mostly in the group of age 20-35 years old (69,4%), multigravid pregnant mothers (77,6%), last education of Senior High School (49,0%), IMT aspect with more nutrition (71,4%), had no history of preeclampsia (63,3%), had history of hypertension (59,2%), other jobs or house-wives (40,8%). Conclusions : It is expected that the hospital should always pay attention to pregnant women who are at risk of preeclampsia, in order to reduce the incidence of preeclampsia occurring in the area of the hospital and can cope with the incidence of preeclampsia earlier. Keywords : Preeclampsia, Pregnant Women

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