scholarly journals Recommendations of the AGG (Section Maternal Disease) for Myasthenia Gravis in Pregnancy

2021 ◽  
Vol 81 (12) ◽  
pp. 1301-1306
Author(s):  
Maritta Kühnert ◽  
Markus Schmidt ◽  
Bettina Kuschel ◽  
Ute Margaretha Schäfer-Graf

AbstractMyasthenia gravis is an autoimmune disease with a range of clinical presentations which manifest as combinations of weakness of the ocular, bulbar, and respiratory muscle groups and muscles of the extremities. Young women of reproductive age are most commonly affected. Preconception planning, the impact of pregnancy, prepartum management, drug therapy in pregnancy, myasthenic and cholinergic crises, fetal monitoring, peripartum management including analgesia and anesthesia during labor and cesarean section as well as neonatal management and neonatal myasthenia gravis are described here and the appropriate recommendations are given.

2021 ◽  
Vol 20 (1) ◽  
Author(s):  
Bruno F. Sunguya ◽  
Yue Ge ◽  
Linda Mlunde ◽  
Rose Mpembeni ◽  
Germana Leyna ◽  
...  

Abstract Background Anemia in pregnancy is behind a significant burden of maternal mortality and poor birth outcomes globally. Efforts to address it need evidence on trends and its pertinent factors as they vary from one area to another. Methods We pooled data of 23,203 women of reproductive age whose hemoglobin levels were measured from two Tanzania Demographic and Health Surveys (TDHS). Of them, 2,194 women were pregnant. Analyses employed descriptive analyses to determine the burden of anemia, its characteristics, and severity; GIS mapping to determine the regional changes of anemia between 2005 and 2015; and logistic regression to determine the remaining determinants of anemia among pregnant women using Stata 15. Results The burden of anemia among pregnant women in Tanzania has remained unprecedently high, and varies between regions. There was no significant decline of anemia in general between the two periods after adjusting for individual, households, reproductive, and child characteristics [AOR = 0.964, 95% CI = 0.774–1.202, p = 0.747). Anemia is currently prevalent in 57% of pregnant women in Tanzania. The prevalence is more likely to be higher among women aged 15–19 years than those aged between 20–34 years. It is more likely to be prevalent among those within large families, with no formal education, food insecurity, lack of health insurance, had no antimalaria during pregnancy, and had low frequency of ANC attendance. On the other hand, delivery in a health facility may be potentially protective against anemia. Conclusions Anemia in pregnancy remained persistently high and prevalent among 57% of pregnant women in Tanzania. Efforts to address anemia are crucial and need to be focused in regions with increasing burden of anemia among pregnant women. It is imperative to address important risk factors such as food insecurity, strengthening universal health coverage, empowering women of reproductive age with education and especially nutritional knowledge and advocating for early antenatal booking, attendance, and facility delivery.


2021 ◽  
pp. 141-146
Author(s):  
Reda Youssef ◽  
Gamal Sayed Ahmed ◽  
Samir Alhyassat ◽  
Sanaa Badr ◽  
Ahmed Sabry ◽  
...  

Dysgerminoma is an uncommon malignant tumor arising from the germ cells of the ovary. Its association with pregnancy is extremely rare, with a reported incidence of about 0.2–1 per 100,000 pregnancies. Women in the reproductive age group are more commonly affected. It can be extremely rare to conceive naturally, without assisted reproductive interventions, in cases with ovarian dysgerminoma. If a pregnancy does occur with a concurrent dysgerminoma, it is even more unusual to carry the pregnancy to viability or childbirth without fetal or maternal compromise. We report a case of right ovarian dysgerminoma in a young female with a viable intrauterine pregnancy at 10 weeks, which is rarely diagnosed and managed at this gestational age. Numerous factors played a role in her favorable outcome, including early suspicion by ultrasound and presenting history, surgery, histopathological assessment, imaging, and involvement of the multidisciplinary oncology team. Ovarian neoplasms may rapidly increase in size within a short period with little or no symptoms. This poses a diagnostic challenge for obstetricians and oncologists. Hence, we aimed to evaluate the role of imaging in pregnancy using ultrasound as an imaging modality for both early detection of ovarian neoplasms and for follow-up. In conclusion, patients with ovarian dysgerminoma in pregnancy can have favorable outcomes. Treatment should be individualized on a case-to-case basis, depending on many factors; cancer stage, previous reproductive history, the impact of imaging in staging or follow-up of tumor on the fetus, fetal gestational age, and whether termination of the pregnancy can improve survival or morbidity for the mother.


2008 ◽  
Vol 26 (2) ◽  
pp. 132-137
Author(s):  
P Madhivanan ◽  
K Krupp ◽  
V Chandrasekaran ◽  
C Karat ◽  
A Arun ◽  
...  

2018 ◽  
Vol 46 (1) ◽  
pp. 29-33 ◽  
Author(s):  
Vislava Globevnik Velikonja ◽  
Miha Lučovnik ◽  
Tanja Premru Sršen ◽  
Vesna Leskošek ◽  
Megie Krajnc ◽  
...  

AbstractObjective:To investigate the relationships among different forms of violence before and during pregnancy.Material and methods:An anonymous questionnaire (adapted NorAQ) was given to 1269 women after childbirth.Results:The response rate was 80% (n=1018). Different forms of violence were experienced by 46.9% of the women; 9.2% reported violence in pregnancy. Suffering from the consequences of violence was reported by 43.8% of the women; sexual (76.6%) and psychological (54.1%) ranked the highest. Past experience of any form of violence increased the risk of violence in pregnancy, violences experienced in adulthood even more than that in childhood [odds ratio (OR) 4.2, 95% confidence interval (CI) 2.7–6.5 vs. OR 1.9, 95% CI 1.2–2.9]. The onset of violence during pregnancy is rare. Violence was most frequently exerted by the intimate partner.Conclusion:Healthcare systems have access to most women of reproductive age, thus they have the unique opportunity to identify and adequately manage violence against women and its consequences.


2021 ◽  
Author(s):  
Mahshid Bokaie ◽  
Samaneh Hatefi ◽  
Shahnaz Mojahed ◽  
Nasibeh Roozbeh

Abstract Objectives: Female genital mutilation (FGM) is an important public health issue, especially in developing countries and it is still done in some parts of Iran. This study aimed to investigate the effect of FGM on the sexual function of women of reproductive age in Hormozgan province/IRAN.Study design: This study is a descriptive-analytical case-control study that was conducted in 2020 on 209 married women of reproductive age (15-49) in rural areas of Minab and Sirik counties in Hormozgan province/IRAN. Main outcome measures: The reliable and valid questionnaire FSFI for assessing female sexual function in the two groups was used after to obtain informed and voluntary consent from all participants and data with SPSS v: 16 software and with using descriptive/ Analytical statistics tests with a significant level of 0.05 were examined. Results: There is a significant difference between mutilated and non-mutilated women in the total score of sexual function(22.18±3.23 versus 23.41±2.52 respectively, p=0.023) and the domains of lubrication(3.04±0.62 versus 3.3±0.53 respectively, P=0.000), orgasm(3.81±0.63 versus 4.08±0.47 respectively, P=0.003), and sexual satisfaction(5.09±0.1 versus 5.37±0.87 respectively, P=0.017) But in the domains of desire, arousal, and pain in the two groups was no significant difference(P-value>0.05). Conclusion: FGM maybe leads to sexual dysfunction. Although most women were reluctant to perform mutilation on their daughters, more educational Actions are suggested to educate women about the impact of female mutilation on their sexual function. Counseling programs are also recommended to improve the sexual function of mutilated women.


2020 ◽  
Author(s):  
Li Yinglan ◽  
Vicent Bankanie ◽  
Fabiola Vincent Moshi

Abstract BackgroundUptake of deworming drugs is one of the important antenatal strategies in preventing anaemia in pregnancy. Little is known about the factors associated with uptake of the de-worming drugs. This study aimed at identifying the factors associated with the uptake of de-worming drugs during pregnancy among women of reproductive age.Method: The study used data from the 2015-16 Tanzania HIV Demographic and Health Survey and Malaria Indicators Survey (2015-16 TDHS-MIS). A total of 6924 women of active reproductive age from 15 to 49 were included in the analysis. Both univariate and multiple regression analyses were used to determine the factors associated with uptake of deworming drugs among women of reproductive age in Tanzania.Results: Majority of interviewed women 3864(60.1%) took deworming drug while a total of 2560(39.9%) did not take deworming drugs. After controlling for confounders, factors associated with uptake of deworming drugs were early antenatal booking, (AOR=1.404 at 95% CI=1.24-1.59,p<0.001); age group of a woman [20 to 34years (AOR=1.382 at 95% CI=1.125-1.696, p=0.002), more than 34years (AOR=1.287 at 95% CI=1.004-1.65, p=0.046)] age less than 20 years was a reference population; rural residence (AOR=1.53 at 95% CI=1.099-2.128,p=0.012); wealth index [middle (AOR=1.151 at 95% CI=1.003-1.32,p=0.044), rich (AOR=1.378 at 95% CI=1.185-1.602, p<0.001) poor was a reference population; level of education [higher level (AOR=2.455 at 95% CI=1.189-5.067,p=0.015)] no formal education was a reference population; parity [para 5 and above (AOR=0.993 at 95% CI=0.824-1.197,p<0.001)] para one was the reference population; zones [Mainland rural (AOR=0.439 at 95% CI=0.307-0.628,p<0.001), Zanzibar Island (AOR=0.22 at 95% CI=0.158-0.306, p<0.001) and Pemba Island AOR=0.493 at 95% CI=0.337-0.723, p<0.001.ConclusionFactors associated with uptake of deworming drugs were early antenatal booking, age group, rural residence, zonal residence, wealth index, level of education, and parity. Considering the outcomes of anaemia in pregnancy, clinicians should consider all the modifiable factors affecting the uptake of the deworming drugs during pregnancy to every woman of reproductive age before and after conception. Whenever possible, it should be done even beyond antenatal clinics.


2020 ◽  
Vol 11 (12) ◽  
pp. 10279-10289
Author(s):  
David F. Byrne ◽  
Aisling A. Geraghty ◽  
Cara A. Yelverton ◽  
Eileen F. Murphy ◽  
Douwe Van Sinderen ◽  
...  

Products containing probiotics are targeted at healthy or at-risk individuals as a preventative measure to minimise disease risk.


Nutrients ◽  
2020 ◽  
Vol 12 (10) ◽  
pp. 3102
Author(s):  
Jingqi Song ◽  
Ji Zhang ◽  
Wafaie Fawzi ◽  
Yangmu Huang

This study aimed to examine the impact of a wide range of demographic, socioeconomic, and community factors on the double burden of malnutrition among women of reproductive age using longitudinal data. We used data about 11,348 women of reproductive age who participated in the China Health and Nutrition Survey (CHNS), a longitudinal survey, between 1989 and 2015. Nutritional outcomes were categorized into four groups, namely underweight, normal weight, overweight, and obesity, with normal weight as reference. A multinomial logit model was fitted due to geographic clustering and repeated observations of individuals. The prevalence of underweight decreased over time from 1991 but has tended to rise again since 2004, while the prevalence of overweight/obesity continued to rise between 1991 and 2015. Improved individual factors, socioeconomic status, and community urbanization reduced the risk of underweight but elevated the risk of overweight and obesity. The medium levels, rather than the highest levels, of household income and community urbanization are associated with a higher risk of overweight and obesity. The notable increase in underweight prevalence is a cause for concern to be addressed along with efforts to curb the rising tide of overweight. In order to enhance the nutritional status of women of reproductive age, it is essential to improving the community environment, levels of education, and living environment from a wider context. Long-term and targeted plans are urgently needed for nutrition improvements among the different populations.


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