scholarly journals The Danish implementation study on response to pregnancy complications, MAMAACT

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
S Villadsen ◽  
H Johnsen ◽  
T D Rasmussen ◽  
J Sørensen ◽  
U Christensen ◽  
...  
Keyword(s):  
Pregnant Women ◽  
Pregnancy Complications ◽  
Smart Phone ◽  
Target Group ◽  
Warning Signs ◽  
Perinatal Health ◽  
Vulnerable Groups ◽  
Contributing Factors ◽  
Increased Risk ◽  
Ward Level

Abstract Differential incidence and severity of pregnancy complications are likely important contributing factors to the increased risk of poor pregnancy outcomes among ethnic minority women in Europe. To address this issue, the MAMAACT trial has been developed based on a thorough mixed methods needs assessment and co-creation process, feasibility tested, now implemented in a nationwide complex intervention. The overall aim of the Danish MAMAACT trial is to reduce ethnic and social disparity in stillbirth and newborns' health by improved management of pregnancy complications. The overall target group is all pregnant women, and the specific target group is women of non-Western origin. The hypothesis of MAMAACT is that improved communication between pregnant women and midwives regarding body symptoms that need prompt reaction will improve perinatal health among these vulnerable groups. The intervention consists of postgraduate training of midwives in intercultural communication and a smart phone application and a leaflet, both in six different languages. The app and leaflet target the women and explain the most serious warning signs of pregnancy complications and how to respond to them. MAMAACT is implemented and evaluated in a randomized controlled cluster trial and 10 maternity wards consist the intervention groups, while nine maternity wards are the control groups. The evaluation is a mixed method evaluation focusing on understanding the mechanisms of change, how context at both maternity ward level as well as in the everyday life of women affects the implementation, and finally if effects on health literacy of the women and perinatal health of the children can be documented.

scholarly journals Contextual Factors Influencing the MAMAACT Intervention: A Qualitative Study of Non-Western Immigrant Women’s Response to Potential Pregnancy Complications in Everyday Life

2020 ◽  
Vol 17 (3) ◽  
pp. 1040
Author(s):  
Helle Johnsen ◽  
Ulla Christensen ◽  
Mette Juhl ◽  
Sarah Fredsted Villadsen
Keyword(s):  
Everyday Life ◽  
Maternity Care ◽  
Pregnancy Complications ◽  
Immigrant Women ◽  
Warning Signs ◽  
Delayed Response ◽  
Full Potential ◽  
Care Providers ◽  
Sources Of Knowledge ◽  
Increased Risk

In western countries, immigrant women have an increased risk of negative birth outcomes. Immigrant women’s and maternity care system’s delayed response to pregnancy complications contribute to ethnic inequities in reproductive health. The MAMAACT intervention was developed to improve midwives’ and women’s response to pregnancy complications in Denmark. The study examines the context of the implementation of the MAMAACT intervention and investigates how the intended intervention mechanisms regarding response to pregnancy complications were affected by barriers in non-Western immigrant women’s everyday life situations. Twenty-one interviews with non-Western immigrant women were undertaken. Systematic text condensation and the situational-adaptation framework by Alonzo were used to analyze data. Four main categories were identified: ‘Sources of knowledge during pregnancy’, ‘Containment of pregnancy warning signs’, ‘Barriers during the onset of acute illness’ and ‘Previous situations with maternity care providers’. Attention to potential pregnancy complications may conflict with immigrant women’s everyday life situations and result in the containment of symptoms as well as causing delays in seeking medical assistance. It is probable that barriers in women’s everyday life will impact the intended intervention mechanisms and thus the full potential of the intervention may not be reached.

scholarly journals Evaluation of clinico-epidemiological factors and outcome of COVID-19 disease in perinatal period

2021 ◽  
Vol 10 (4) ◽  
pp. 1515
Author(s):  
Suchita V. Dabhadkar ◽  
Vaishali S. Taralekar ◽  
Mahima R. A. ◽  
Salil D. Barsode ◽  
Pooja S. Kale
Keyword(s):  
Pregnant Women ◽  
Health Care Workers ◽  
Perinatal Period ◽  
Vulnerable Groups ◽  
Substantial Impact ◽  
Care Workers ◽  
Increased Risk ◽  
Study Participants ◽  
Infective Etiology ◽  
Disease Community

Background: The coronavirus disease 2019 (COVID-19) is caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). It is well accepted that pregnant women are at increased risk of infections, morbidity from known respiratory viruses like H1N1, varicella, influenza. COVID-19, a virus from the same family poses a greater and influential risk to the health of our mothers and their babies. Raised concerns of pregnant women, being physiologically immunocompromised with associated comorbidities like hypertension, diabetes, heart disease, anemia is very challenging for the obstetrician to conquer.Methods: We tested 405 pregnant women for PCR SARS CoV-2 during the pandemic out of which 59 pregnant women turned out to be positive, and were included in the study analysis. These women had singleton live pregnancy beyond 37 weeks and opted for in patient management. Study participants did not have any known obstetric complications.Results: 81% of women were delivered by cesearean section, indication being premature rupture of membranes and anhydramnios in 45 % of women reflecting the infective etiology of the disease. 60% women were asymptomatic, yet positive for the disease. Community spread was seen in 75% of the women. No ICU admissions were recorded.Conclusions: The substantial impact on the vulnerable groups like pregnancy has necessitated need for further studies and research and to build more service models as frontline obstetric COVID health care workers. 

scholarly journals  Risk Factors associated with Fetal and Pregnancy Complications in Palestine

2021 ◽  
Author(s):  
Sana ’ Al-Aqqad ◽  
Nihal Al-Natour ◽  
Mariam Al-Tell
Keyword(s):  
Risk Factors ◽  
Health Care ◽  
Primary Health Care ◽  
Pregnant Women ◽  
Gestational Age ◽  
Pregnancy Complications ◽  
Health Care Clinics ◽  
Primary Health ◽  
Increased Risk ◽  
Fetal Complications

Abstract Background: Complications observed during pregnancy affect both mother and fetus, and are more commonly observed among pregnant women from developing countries. The study aims to identify the most common pregnancy and fetal complications during pregnancy, and associated risk factors with these complications. Methods: A longitudinal study was conducted from September 2017 to July 2018 among pregnant women attending and registering in primary health care clinics of the Palestinian Ministry of Health in Nablus city. Data were collected through interviews and by reviewing medical records. Women were followed up during their regular visits to the primary health care clinics. Any complication affecting either the fetus or the mother during the pregnancy period was recorded. Binary logistic regression was used to identify independent risk factors for pregnancy and fetal complications. Results: A total of 380 pregnant women were included in the study. The most common complications seen among women during pregnancy were preterm labor (PTL) (11.3%), followed by an equal number of gestational diabetes (GDM) and pregnancies induce hypertension (PIH), i.e. (7.9%). Large for gestational age (LGA) (11.6 %) and small for gestational age (SGA) (10.5%) were the most commonly observed fetal complications. Pregnant women living in camps (O.R 2.35, 95% [CI] 1.02- 5.45), nulliparity (O.R 14.9, 95% [CI] 1.09-202.5) and low parity women (O.R 16.8, 95% [CI] 1.47- 192.5) were at higher risk of having pregnancy complications. However, lower risk was noticed between women with gravida 4 (O.R 0.11, 95% [CI] 0.03-0.47) compared to women having more than 6 pregnancies. Age younger than 41 years was a protective factor against fetal complications, while parity (≤ 6 parities) especially 4 to 6 parities (OR 36.17; 95% CI 4.88-268) and active smoking mothers (OR 1.25; 95% CI 1.0-3.07) were identified as risk factors that are associated with an increased risk of fetal complications. Conclusions: Fetal and pregnancy-related complications are prevalent among Palestinian pregnant women. Increasing the awareness and improving the understanding of the identified risk factors related to these complications among the public, and specifically, females may help to reduce the prevalence of these conditions and the associated risk of these complications.

scholarly journals Implementation, Mechanisms and Context of the MAMAACT Intervention to Reduce Ethnic and Social Disparity in Stillbirth and Infant Health

2021 ◽  
Vol 18 (16) ◽  
pp. 8583
Author(s):  
Trine Damsted Rasmussen ◽  
Helle Johnsen ◽  
Signe Smith Jervelund ◽  
Ulla Christensen ◽  
Anne-Marie Nybo Andersen ◽  
...  
Keyword(s):  
Pregnant Women ◽  
Pregnancy Complications ◽  
Infant Health ◽  
Training Session ◽  
Organizational Factors ◽  
Warning Signs ◽  
Interaction Patterns ◽  
Cross Sectional Survey ◽  
Social Disparity ◽  
Contextual Barriers

The MAMAACT intervention aimed to address ethnic and social disparity in stillbirth and infant health by improving management of pregnancy complications. This process evaluation of the intervention was guided by the British Medical Research Council’s framework. We examined implementation through dose, reach, and fidelity, important mechanisms and the influence of contextual factors. The intervention included a six-hour training session for antenatal care (ANC) midwives in intercultural communication and cultural competence, two follow-up dialogue meetings, and health education materials (leaflet and app) on warning signs of severe pregnancy complications and how to respond for pregnant women. A mixed-methods approach was applied. Cross-sectional survey data and administrative data were used to assess intervention reach and dose. Qualitative data (records from dialogue meetings with midwives, participant observations and field notes from ANC visits, focus group interviews with midwives, and individual interviews with non-Western immigrant women) evaluated intervention fidelity, mechanisms, and contextual barriers. More than 80% of women received the MAMAACT leaflet and many found the content useful. The app was used more selectively. Midwives described being more aware and reflective in their communication with women from various cultural backgrounds. Organizational factors in ANC (time pressure, lack of flexibility in visits, poor interpreter services), barriers in women’s everyday life (lack of social network, previous negative experiences/lack of trust and domestic responsibilities), and habitual interaction patterns among midwives served as contextual barriers. The reach of the intervention was high and it was evaluated positively by both pregnant women and midwives. Organizational factors hindered changes towards more needs-based communication in ANC potentially hindering the intended mechanisms of the intervention. When interpreting the intervention effects, attention should be drawn to both organizational and interpersonal factors in the clinic as well as the pregnant women’s life situations.

scholarly journals Circulating Anti-PLAC1 Antibodies during Pregnancy and in Women with Reproductive Failure: A Preliminary Analysis

2011 ◽  
Vol 2011 ◽  
pp. 1-5 ◽  
Author(s):  
Anne C. Kotto-Kome ◽  
Celso Silva ◽  
Valerie Whiteman ◽  
Xiaoyuan Kong ◽  
Michael E. Fant
Keyword(s):  
Pregnant Women ◽  
Sample Size ◽  
Pregnancy Complications ◽  
Preliminary Analysis ◽  
Pregnancy Loss ◽  
Recurrent Pregnancy Loss ◽  
Unexplained Infertility ◽  
Reproductive Failure ◽  
Increased Risk ◽  
Secondary Outcomes

The aims of this study were to determine the prevalence of anti-PLAC1 antibodies in normal pregnant women and in women with infertility or recurrent pregnancy loss (RPL). Secondary outcomes were the development of complications associated with anti-PLAC1 seropositivity and the rate of seroconversion during pregnancy. Sera from 103 healthy pregnant women and 45 women with unexplained infertility or RPL were analyzed by ELISA. The prevalence of anti-PLAC1 antibodies was 2% in healthy pregnant women and 4.5% in women with unexplained infertility or RPL (P=0.355). There was no detectable association of seropositivity with increased risk of pregnancy complications. Finally, 2% of women seroconverted during pregnancy. The prevalence of anti-PLAC1 antibodies in women with unexplained infertility or RPL is not significantly higher than the prevalence in normal pregnant women. However, the sample size in this study was too small. The exposure to the PLAC1 antigen during pregnancy can lead to the spontaneous development of antibodies.

scholarly journals Influence of Maternal Infection and Pregnancy Complications on Cord Blood Telomere Length

2021 ◽  
Vol 2021 ◽  
pp. 1-9
Author(s):  
Keith T. S. Tung ◽  
Catherine M. W. Hung ◽  
Ko Ling Chan ◽  
Rosa S. Wong ◽  
Hing Wai Tsang ◽  
...  
Keyword(s):  
Cord Blood ◽  
Pregnant Women ◽  
Telomere Length ◽  
Pregnancy Complications ◽  
Maternal Infection ◽  
Intrauterine Environment ◽  
Important Indicator ◽  
Functional Changes ◽  
Increased Risk ◽  
The Impact

Background. Exposure to suboptimal intrauterine environment might induce structural and functional changes that can affect neonatal health. Telomere length as an important indicator of cellular health has been associated with increased risk for disease development. Objectives. This study was aimed to examine the independent and combined effects of maternal, obstetric, and foetal factors on cord blood telomere length (TL). Methods. Pregnant women at the gestational age of 20th to 24th week who attended the antenatal clinic of a major local hospital in Hong Kong were recruited. Participants were asked to complete a questionnaire on demographics, health-related quality of life, and history of risk behaviors. Medical history including pregnancy complications and neonatal outcomes was obtained from electronic medical records of both mother and neonate. Umbilical cord blood was collected at delivery for TL determination. Results. A total of 753 pregnant women (average age: 32.18 ± 4.51 years) were recruited. The prevalence of maternal infection, anaemia, and hypertension during pregnancy was 30.8%, 30.0%, and 6.0%, respectively. The adjusted regression model displayed that maternal infection was negatively associated with cord blood TL ( β = − 0.18 , p = 0.026 ). This association became even stronger in the presence of antenatal anaemia, hypertension, delivery complications, or neonatal jaundice ( β = − 0.25 to −0.45). Conclusions. This study consolidates evidence on the impact of adverse intrauterine environment at the cellular level. Maternal infection was significantly associated with shorter cord blood TL in a unique manner such that its presence may critically determine the susceptibility of telomere to other factors.

ASSESSMENT OF THE PLATELET COUNT IN THE PREGNANT WOMEN IN IGIMS, PATNA, BIHAR

2020 ◽  
Vol 4 (2) ◽  
Author(s):  
Tanwi Singh ◽  
Anshuman Sinha
Keyword(s):  
Platelet Count ◽  
Pregnant Women ◽  
Screening Test ◽  
Low Cost ◽  
Medical Science ◽  
Cost Effective ◽  
Platelet Indices ◽  
Increased Risk ◽  
Low Platelet Count ◽  
Severity Of The Disease

The major risk associated with low platelet count in pregnancy is the increased risk of bleeding during the childbirth or post that. There is an increased blood supply to the uterus during pregnancy and the surgical procedure requires cutting of major blood vessels. Women with thrombocytopenia are at increased risk of losing excessive blood. The risk is more in case of caesarean delivery as compared to vaginal delivery. Hence based on above findings the present study was planned for Assessment of the Platelet Count in the Pregnant Women in IGIMS, Patna, Bihar. The present study was planned in Department of Pathology, Indira Gandhi Institute of Medical Science, Patna, Bihar, India. The present study was planned from duration of January 2019 to June 2019. In the present study 200 pregnant females samples received for the platelet estimation were enrolled in the present study. Clinically platelet indices can be a useful screening test for early identification of preeclampsia and eclampsia. Also platelet indices can assess the prognosis of this disease in pregnant women and can be used as an effective prognostic marker because it correlates with severity of the disease. Platelet count is a simple, low cost, and rapid routine screening test. Hence the data generated from the present study concludes that platelet count can be used as a simple and cost effective tool to monitor the progression of preeclampsia, thereby preventing complications to develop during the gestational period. Keywords: Platelet Count, Pregnant Women, IGIMS, Patna, Bihar, etc.

Pathological features of the sequence in pregnant women with delayed fetal growth

2019 ◽  
pp. 50-54
Author(s):  
V.O. Golyanovskiy ◽  
◽  
Ye.O. Didyk ◽  
Keyword(s):  
Pregnant Women ◽  
Intrauterine Growth Restriction ◽  
Normal Development ◽  
Intrauterine Infection ◽  
Normal Pregnancy ◽  
Growth Restriction ◽  
Control Group ◽  
Intrauterine Growth ◽  
Increased Risk ◽  
Infection And Inflammation

Pregnant women with intrauterine growth restriction (IUGR) have an increased risk of adverse perinatal and long-term complications compared with the birth of children with normal body weight. Thus, IUGR is one of the main challenges for the global health system, especially in poor and developing countries. Morpho-functional studies of the placentas help in determining the causes of IUGR, and therefore, timely prevent complications in pregnant women with IUGR. The objective: The purpose of this study is to investigate various morphometric and pathomorphological changes in the placenta, including inflammatory, in cases of IUGR, and to establish a correlation of these results with the etiology and complications for the fetus. Materials and methods. In the current study, 54 placentas of the fetuses with IUGR (the main group) were compared with 50 placentas of the fetuses with normal development (control group). The criteria for the inclusion of IUGR were gestational age more than 30 weeks and all fetuses with a weight less than 10th percentile for this period of pregnancy. The placenta material was studied pathomorphologically with laboratory screening for infection and inflammation. Similarly, the results were determined for placentas of the fetuses with normal development compared to placentas with IUGR. Results. The placenta study showed the presence of calcification in the case of IUGR, as well as in the case of prolonged pregnancy. However, calcification of the placenta in the case of IUGR was more progressive compared with placenta in the normal pregnancy. In addition, the presence of intrauterine infection and inflammation was observed, which could also lead to an adverse outcome for the further progression of pregnancy with IUGR. Conclusion. A comparative macro- and microscopic pathomorphological study of the placentas in the two groups has shown a significant increase in the pathological changes in all the anatomical structures of the fetuses with IUGR. Key words: Intrauterine growth restriction (IUGR), fetal weight, pathomorphological changes of the placenta.

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