scholarly journals Syphilis in Pregnancy and Congenital Syphilis: Reality in a Portuguese Central University Hospital

2017 ◽  
Vol 39 (06) ◽  
pp. 265-272 ◽  
Author(s):  
Magda Magalhães ◽  
Lígia Basto ◽  
Ana Areia ◽  
Sofia Franco ◽  
Maria Malheiro ◽  
...  
Keyword(s):  
At Risk ◽  
Pregnant Women ◽  
Congenital Syphilis ◽  
University Hospital ◽  
Tertiary Referral Hospital ◽  
Surveillance Network ◽  
Control And Prevention ◽  
Adverse Pregnancy ◽  
Syphilis Serology

Purpose To evaluate maternal-fetal surveillance and follow-up of infants at risk for congenital syphilis (CS). Methods Retrospective cohort study in a Portuguese Tertiary Referral Hospital. The main inclusion criterion was a positive syphilis serology. The study included all pregnant women that delivered in our hospital between January 2004 and December 2013. The neonates were classified according to their probability of infection based on the Centers for Disease Control and Prevention guidelines. Results Among the 27 pregnancies at risk for CS, 48.2% (n = 13) of the women had a diagnosis during the 1st trimester, and the median gestational age at the end of the treatment was 28 weeks. Inadequate treatment was noted in 44.4% (n = 12) of the women. Adverse pregnancy outcomes were observed in 30.8% of the cases (n = 8), 5 of which had been adequately treated. We found 2 (7.7%) cases with “proven or highly probable CS,” 10 (38.5%) with “possible CS,” 12 (46.1%) with “less likely CS,” and 2 (7.7%) with “unlikely CS.” Among the infants, the treatment was successful, except for 1 neurosyphilis case. Conclusion This study highlights many of the difficulties/concerns encountered in the maternal-neonatal management of syphilis. We highlight the importance of assuring the early detection of the infection as a way of guaranteeing the timely treatment, as well as a good compliance to the treatment and follow-up through a more efficient pregnant women surveillance network.

scholarly journals Prevalence, incidence and associated risk factors of STIs during pregnancy in South Africa

2020 ◽  
pp. sextrans-2020-054631
Author(s):  
Dorothy Chiwoniso Nyemba ◽  
Andrew Medina-Marino ◽  
Remco P H Peters ◽  
Jeffrey D Klausner ◽  
Phuti Ngwepe ◽  
...  
Keyword(s):  
Risk Factors ◽  
Pregnant Women ◽  
Birth Outcomes ◽  
Syndromic Management ◽  
Younger Age ◽  
Pregnancy And Birth Outcomes ◽  
Adverse Pregnancy ◽  
Associated Risk Factors ◽  
Pregnancy And Birth

ObjectiveSTIs during pregnancy increase adverse pregnancy and birth outcomes and may increase HIV risk. STI syndromic management is standard of care in South Africa. Our study evaluated the prevalence and incidence of STIs in pregnant women and the associated risk factors.MethodsWe combined data from two prospective observational studies of pregnant women enrolled while attending their first antenatal clinic (ANC) visit in Tshwane District and Cape Town. Women ≥18 years were tested at first ANC visit and at their first postpartum visit for Chlamydia trachomatis, Neisseria gonorrhoeae and Trichomonas vaginalis using Xpert assays (Cepheid, USA). We evaluated the prevalence and incidence of STI and the associated risk factors using multivariable regression models.ResultsWe enrolled 669 pregnant women, 64% (n=427) from Tshwane District and 36% (n=242) from Cape Town; 80% (n=534) were women living with HIV (WLHIV) and 20% (n=135) without HIV. At enrolment, 37% (n=250) were diagnosed with at least one STI, of which 76% (n=190) were asymptomatic. STI prevalence was 40% (n=213) in WLHIV and 27% (n=37) in women without HIV (p=0.01). Baseline STI infection was associated with younger age (OR=0.95 per year, 95% CI 0.92 to 0.98), higher gestational age (adjusted OR (aOR)=1.03 per week, 95% CI 1.00 to 1.05), single relationship status (aOR=1.53, 95% CI 1.09 to 2.15) and HIV status (aOR=1.86, 95% CI 1.17 to 2.95). Of 419 participants with no STI at baseline, 21 had an incident STI during follow-up, with a mean follow-up time of 140 days. The incidence rate of STI during pregnancy and early post partum was 15 infections per 100 women-years (95% CI 9 to 23). Younger age was associated with STI incidence.ConclusionOur study shows high prevalence and incidence of STIs in pregnancy, especially in WLHIV, demonstrating the need for STI screening in ANC to prevent adverse pregnancy and birth outcomes. Most STI cases were asymptomatic and would have gone untreated with syndromic management. Aetiological STI screening is urgently needed to reduce the burden of STIs in pregnancy.

scholarly journals Follow-up of Toxoplasmosis during Pregnancy: Ten-Year Experience in a University Hospital in Southern Brazil

2019 ◽  
Vol 41 (09) ◽  
pp. 539-547 ◽  
Author(s):  
Amanda Andrade Diesel ◽  
Suzana de Azevedo Zachia ◽  
Ana Lúcia Letti Müller ◽  
Amanda Vilaverde Perez ◽  
Flavio Antonio de Freitas Uberti ◽  
...  
Keyword(s):  
Amniotic Fluid ◽  
Pregnant Women ◽  
Triple Therapy ◽  
Gestational Age ◽  
Congenital Toxoplasmosis ◽  
Immunoglobulin M ◽  
University Hospital ◽  
Pcr Analysis ◽  
Ultrasound Findings

Abstract Objective To describe a population of pregnant women diagnosed with toxoplasmosis and their respective newborns, describing the hospital protocol for treatment and follow-up. Methods Retrospective cohort of pregnant women with acute toxoplasmosis infection and risk of transplacental transmission who were sent to the Fetal Medicine Group of Hospital de Clínicas de Porto Alegre (HCPA) between - January 1, 2006 and December 31, 2016. All patients with confirmed disease were included. The diagnostic protocol and treatment were applied; a polymerase chain reaction (PCR) analysis of the amniotic fluid was used to diagnose toxoplasmosis and determine the treatment. The newborns were followed up at the pediatric outpatient clinic specializing in congenital infection. The patients who were not followed up or were not born in the HCPA were excluded. Results A total of 65 patients were confirmed to have gestational toxoplasmosis; 40 performed amniocentesis, and 6 (15%) were identified as having positive PCR in the amniotic fluid. In five of those cases, this result associated with the gestational age defined the triple therapy during pregnancy, and in one case, it defined the monotherapy (advanced gestational age). A total of 4 of these newborns were treated from birth with triple therapy for 10 months, 1 was not treated (due to maternal refusal), and 1 progressed to death within the first 54 hours of life due to complications of congenital toxoplasmosis. Of the 34 remaining cases with a negative PCR, 33 were treated with monotherapy and 1 was treated with triple therapy (ultrasound findings); of these children, 9 (26.5%) presented negative immunoglobulin G (IgG), 24 (70.6%) presented positive IgG (but none presented positive immunoglobulin M [IgM]), and 1 (2,9%) presented alterations compatible with congenital disease and started treatment with the triple therapy soon after birth. Out of the total sample of 60 patients, among the 25 who did not perform amniotic fluid PCR, 5 were treated with triple therapy (ultrasound findings/prior treatment) and 20 patients were submitted to monotherapy; only two newborns underwent treatment for congenital toxoplasmosis. Among the 65 cases of gestational toxoplasmosis, 6 (9,2%) children had a diagnosis of congenital toxoplasmosis, and 2 patients with triple therapy felt severe adverse effects of the medications. Conclusions The present study suggests that research on PCR screening of the amniotic fluid may be useful to identify patients with a higher potential for fetal complications, who may benefit from the poly-antimicrobial treatment. Patients with negative PCR results must continue to prevent fetal infection with monotherapy, without risk of fetal or maternal impairment.

scholarly journals Cohort profile: targeted antenatal screening for haemoglobinopathies in Basel

BMJ Open ◽  
2020 ◽  
Vol 10 (7) ◽  
pp. e035735
Author(s):  
Gabriela Amstad Bencaiova ◽  
Franziska Geissler ◽  
Irene Hoesli
Keyword(s):  
High Risk ◽  
Pregnant Women ◽  
Risk Group ◽  
Iron Status ◽  
First Trimester ◽  
High Risk Group ◽  
University Hospital ◽  
Pregnancy Cohort ◽  
Haemoglobin Variant ◽  
Adverse Pregnancy

PurposeThe pregnancy cohort was established to examine the prevalence and variety of haemoglobinopathies in a high-risk group of pregnant women.ParticipantsThe pregnancy cohort is located in the Department of Obstetrics and Antenatal Care, University Hospital of Basel. The pregnant women were recruited in the first trimester between June 2015 and May 2019. Family origin questionnaires were used to screen pregnant women for the risk of a haemoglobin variant. Based on the questionnaire, pregnant women were divided into two groups: women with a high risk and women with a low risk of a haemoglobin variant. In women with a high risk, red blood cell indices, iron status and chromatography were conducted.Findings to date1785 pregnant women were recruited. Out of the 1785 women, 929 were identified as a part of the high-risk group. Due to the missing data of 74 pregnant women with a high risk, the final analysis was conducted in the remaining 855 women. The prevalence of haemoglobinopathies in the high-risk group was 14.5% (124/855).Future plansThis cohort will be used to: (1) implement the screening in prenatal care in Basel; (2) recommend the screening among pregnant women with a high risk of a haemoglobin variant in Switzerland; (3) improve prenatal and neonatal care in patients with a haemoglobin variant; (4) examine adverse pregnancy outcomes in women with a haemoglobin variant and (5) reduce maternal and neonatal morbidity and mortality in the future.Trial registration numberClinicalTrials.gov Registry (NCT04029142).

scholarly journals The Effect of Solution-Focused Counseling on Violence Rate and Quality of Life of Pregnant Women at Risk of Domestic Violence: A randomized Controlled Trial

2020 ◽  
Author(s):  
Sepideh Din Mohammadi ◽  
Mohsen Dadashi ◽  
Elahe Ahmadnia ◽  
leila Janani ◽  
Roghieh Kharaghani
Keyword(s):  
Quality Of Life ◽  
At Risk ◽  
Domestic Violence ◽  
Pregnant Women ◽  
Controlled Trial ◽  
Intervention Group ◽  
Control Group ◽  
Solution Focused

Abstract Background: Domestic violence is considered as one of the most common social problems, which can affect the quality of life of women. The problem of preventing and controlling this problem, especially during pregnancy, is one of the basic challenges of health systems. The aim of this study was to determine the effect of counseling based on conflict solution on the rate of violence and quality of life of pregnant women at risk of domestic violence. Methods: This study was a randomized controlled trial on 90 pregnant women, who were selected from maternity wards in health center number three in Zanjan city. Women who had inclusion criteria based on the domestic violence conflict tactics scale (CTS-2) selected with convenience sampling and randomly divided into two groups of intervention (45 people) and control (45 people) with a blocked randomization method. The intervention group received six counseling sessions with a solution-focused approach and the control group received no intervention. Study tool included demographic and reproductive questionnaires CTS- 2 and short form health survey (SF-36); which completed at baseline and six weeks follow-up in both groups. The results were analyzed by nonparametric ANCOVA using SPSS and R soft wares.Results: The results showed that there was a significant difference in the physical violence (P=0.001), psychological violence (P=0.001), and sexual violence (P=0.001) in the intervention group compared to the control group at six weeks follow- up. There were significant improvements in negotiation scores in the intervention group (P˂0.001). Moreover, there were significant differences in the quality of life scores (P=0.001), vitality (p=0.003), psychological health (p=0.004), bodily pain (p=0.014), physical functioning (p=0.023), and social functioning (p=0.019) between the two groups at the follow- up period.Conclusion: According to the result, individual counseling based on a solution-based approach reduces the amount of domestic violence and increases the quality of life of pregnant women at risk of violence.Trial registration: Iranian Registry of Clinical Trials IRCT2017040628352N4. Date of registration: August 20th 2017.

scholarly journals Study protocol: establishment of a multicentre pre-eclampsia database and biobank in Sweden: GO PROVE and UP MOST, a prospective cohort study

BMJ Open ◽  
2021 ◽  
Vol 11 (11) ◽  
pp. e049559
Author(s):  
Lilja Thorgeirsdottir ◽  
Malin Andersson ◽  
Ove Karlsson ◽  
Sven-Egron Thörn ◽  
Jonatan Oras ◽  
...  
Keyword(s):  
Cohort Study ◽  
Pregnant Women ◽  
Objective Assessment ◽  
Psychological Impact ◽  
Routine Data ◽  
Personal Identification ◽  
University Hospital ◽  
Ethical Review ◽  
Multisystem Disorder

IntroductionPre-eclampsia, a multisystem disorder in pregnancy, is one of the most common causes of maternal morbidity and mortality worldwide. However, we lack methods for objective assessment of organ function in pre-eclampsia and predictors of organ impairment during and after pre-eclampsia. The women’s and their partners’ experiences of pre-eclampsia have not been studied in detail. To phenotype different subtypes of the disorder is of importance for prediction, prevention, surveillance, treatment and follow-up of pre-eclampsia.The aim of this study is to set up a multicentre database and biobank for pre-eclampsia in order to contribute to a safer and more individualised treatment and care.Methods and analysisThis is a multicentre cohort study. Prospectively recruited pregnant women ≥18 years, diagnosed with pre-eclampsia presenting at Sahlgrenska University Hospital, Uppsala University Hospital and at Södra Älvsborgs Hospital, Sweden, as well as normotensive controls are eligible for participation. At inclusion and at 1-year follow-up, the participants donate biosamples that are stored in a biobank and they are also asked to participate in various organ-specific evaluations. In addition, questionnaires and interviews regarding the women’s and partner’s experiences are distributed at follow-up.Ethics and disseminationBy creating a database and biobank, we will provide the means to explore the disorder in a broader sense and allow clinical and laboratory discoveries that can be translated to clinical trials aiming at improved care of women with pre-eclampsia. Further, to evaluate experiences and the psychological impact of being affected by pre-eclampsia can improve the care of pregnant women and their partners. In case of incidental pathological findings during examinations performed, they will be handled in accordance with clinical routine. Data are stored in a secure online database. Biobank samples are identified through the women’s personal identification number and pseudonymised after identification in the biobank before analysis.This study was approved by the regional ethical review board in Gothenburg on 28 December 2018 (approval number 955-18) and by the Swedish Ethical Review Authority on 27 February 2019 (approval number 2019-00309).Results from the study will be published in international peer-reviewed journals.Trial registration numberISRCTN13060768

scholarly journals The Relationship Between Primary Health Care Services and Pregnancy Diagnosis and Follow-Up

2019 ◽  
Vol 8 (4) ◽  
pp. 175-181 ◽  
Author(s):  
Abdullah Kaan Kurt ◽  
Turan Set ◽  
Elif Ates
Keyword(s):  
Family Medicine ◽  
Prenatal Care ◽  
Pregnant Women ◽  
Health Care Services ◽  
Family Physicians ◽  
University Hospital ◽  
Cross Sectional ◽  
Pregnancy Diagnosis ◽  
The Family

Aim: The aim of this study was to determine the effectiveness of family medicine in the detection of pregnancies, the status of pregnant women being registered to family medicine, the time of first contact with the family physician, and the rate of monitoring by family physicians. Methods: This cross-sectional descriptive study was carried out at the pregnant follow-up polyclinic of a university hospital. The pilot study of the study was conducted with 15 participants. Data of 139 participants were analyzed. Results: The median of pregnancy detection week was 5.00 (IQR:4.00-6.00). For the first blood test 23.7% (n=33) of the pregnant women had applied to the family physicians. It was determined that all pregnant women received prenatal care from healthcare workers within the first 14 weeks. The rate of pregnant women who received prenatal care from family medicine at any time of pregnancy was 89.9% (n=125). Conclusion: It is seen that family medicine is not used effectively enough for pregnancy detection. The fact that knowing family medicine by almost all of the individuals, and informing the community will increase the rate and quality of application to family medicine. Improvement of family medicine pregnancy diagnosis and follow-up rates can be ensured by giving the necessary importance to the 15-49 age group follow-up and with the applicability of the referral chain. Keywords: primary care, family practice, pregnancy, pregnancy test

scholarly journals Pregnancy Complications in Venezuelan Women With Malaria

2020 ◽  
Author(s):  
Mariestefany Romero ◽  
Elizabeth Leiba ◽  
Fhabián Stevens Carrión-Nessi ◽  
Diana Carolina Freitas-DeNobrega ◽  
Ángel Gamardo ◽  
...  
Keyword(s):  
Pregnant Women ◽  
Clinical Laboratory ◽  
Negative Impact ◽  
Severe Anaemia ◽  
University Hospital ◽  
Third Trimester ◽  
Malaria Burden ◽  
High Prevalence ◽  
Symptoms And Signs

Abstract BackgroundPregnant women are particularly vulnerable to malaria infections, increasing the risk of maternal-foetal complications, mainly in areas of high endemicity. However, few studies of malaria in pregnancy (MiP) have been carried out in Latin America, a region with low endemicity and transmission of both, Plasmodium falciparum and P. vivax. Despite the high malaria burden in Venezuela in the last years, no recent studies of MiP have been conducted. Hence, epidemiological and clinical characteristics of pregnant women with malaria in Venezuela are described herein.MethodsA retrospective study in pregnant women attending to the “Ruíz y Páez” University Hospital Complex, Bolívar state, Venezuela between February and October, 2019 was carried out. Epidemiological, clinical, and laboratory information was analysed.ResultsThirty-seven out of 52 pregnant women analysed, were infected with P. vivax. Age ranged between 15 and 39 years, and adolescent pregnancies were common. Malaria infection was diagnosed mainly during the third trimester of pregnancy (63.4%). The distribution of symptoms and signs as well as clinical laboratory values was similar among Plasmodium spp. Although uncomplicated malaria was most frequent, 30% (13/52) had severe anaemia. A high proportion of studied women (44%) presented at least one complication during the pregnancy or delivery. Spontaneous abortion was recorded in four women, and three foetal deaths were observed. Six women had preterm delivery without any further complication.ConclusionsA high prevalence of maternal and foetal complications was found in the studied population, highlighting the requirement for a careful medical follow up during the prenatal check-ups, aimed to reduce the negative impact of malaria in the new-born and mother.

scholarly journals OBSTRUCTED LABOR

2015 ◽  
Vol 22 (05) ◽  
pp. 615-620
Author(s):  
Shazia Rahman Shaikh ◽  
Khalida Naz Memon ◽  
Gulzar Usman
Keyword(s):  
Risk Factors ◽  
Pregnant Women ◽  
Cross Sectional Study ◽  
Full Term ◽  
University Hospital ◽  
Public Health Issue ◽  
Obstructed Labor ◽  
Cross Sectional ◽  
Adverse Pregnancy ◽  
Demographic Risk

The women of developing countries are at risk of pregnancy-relatedcomplications including pre-eclampsia/ eclampsia, obstructed labor, sepsis etc. Obstructedlabor results due to three delays while woman is full term & is in labor. If detected and managedearly and correctly, the pregnancies can be made safe and may result in birth of healthybabies. Objectives: (1) To assess frequency of obstructed labor among pregnant women. (2)To determine socio-demographic risk factors associated with obstructed labor among studypopulation. (3)To determine outcomes of obstructed labor among pregnant women. StudyDesign: It was a hospital based descriptive cross sectional study. Period: Two months. Setting:Department of Gynaecology and Obstetrics units I, II and III of Liaquat University Hospital(LUH) Hyderabad. Methods: To estimate the frequency, risk factors & outcomes of obstructedlabor as of third trimester adverse pregnancy outcomes & to seek association of this adversepregnancy outcome with the socio-demographic characteristics of the pregnant women i.e.their age, residence, parity, level of education & socio economic class. Results: Out of total sixhundred & nine women enrolled in the study, only 22 (3.61%) were in obstructed labor. 63.64%of them were of age > 30 years. More than 60% women in obstructed labor had reported fromrural areas; and more than eighty percent of them were illiterate & belonged to lower socioeconomicclass. Only 4.55% of the women in obstructed labor were the booked cases. All thecases of obstructed labor were at full term. Cesarean section was done on 90.90% women. Nota single maternal mortality was reported among women enrolled in the study as obstructedlabor. Conclusion: Neglected obstructed labor is a major public health issue. It can be avoidedby addressing various socio-demographic determinants of pregnant women.

scholarly journals Epidemic Profile of Maternal Syphilis in China in 2013

2016 ◽  
Vol 2016 ◽  
pp. 1-8 ◽  
Author(s):  
Lixia Dou ◽  
Xiaoyan Wang ◽  
Fang Wang ◽  
Qian Wang ◽  
Yaping Qiao ◽  
...  
Keyword(s):  
Pregnant Women ◽  
Pregnancy Outcomes ◽  
Congenital Syphilis ◽  
Adverse Pregnancy Outcomes ◽  
Syphilis Infection ◽  
Increased Risk ◽  
Late Treatment ◽  
Adverse Pregnancy ◽  
Maternal Syphilis ◽  
Epidemiological Characteristics

Objective. The aim of this study was to investigate the epidemiological characteristics and adverse pregnancy outcomes of pregnant women with syphilis infection in China.Methods. Data were from China’s Information System of Prevention of Mother-to-Child Transmission of Syphilis Management. Women who were registered in the system and delivered in 2013 were included in the analysis.Results. A total of 15884 pregnant women with syphilis infection delivered in China in 2013. 79.1% of infected women attended antenatal care at or before 37 gestational weeks; however, 55.4% received no treatment or initiated the treatment after 37 gestational weeks. 14.0% of women suffered serious adverse pregnancy outcomes including stillbirth/neonatal death, preterm delivery/low birth weight, or congenital syphilis in newborns. High maternal titer (≥1 : 64) and late treatment (>37 gestational weeks)/nontreatment were significantly associated with increased risk of congenital syphilis and the adjusted ORs were 1.88 (95% CI 1.27 to 2.80) and 3.70 (95% CI 2.36 to 5.80), respectively.Conclusion. Syphilis affects a great number of pregnant women in China. Large proportions of women are not detected and treated at an early pregnancy stage. Burden of adverse pregnancy outcomes is high among infected women. Comprehensive interventions still need to be strengthened to improve uptake of screening and treatment for maternal syphilis.

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