scholarly journals Predictors of Premature Rupture of Membranes among Pregnant Women in Rural Uganda: A Cross-Sectional Study at a Tertiary Teaching Hospital

2020 ◽  
Vol 2020 ◽  
pp. 1-6 ◽  
Author(s):  
Simon Byonanuwe ◽  
Emmanuel Nzabandora ◽  
Baltazar Nyongozi ◽  
Theophilus Pius ◽  
David Santson Ayebare ◽  
...  

Background. Premature rupture of membranes (PROM) is a common condition in developed and developing countries and poses a serious threat to the maternal and fetal well-being if not properly managed. This study delineated the prevalence and predictors of PROM in the western part of Uganda so as to guide specific preventive measures. Methods. A cross-sectional study design was conducted in the months of September 2019 to November 2019. A total of 334 pregnant women above 28 weeks of gestation admitted at the maternity ward of KIU-TH were consecutively enrolled. Interviewer-administered questionnaires were used to obtain the data. Descriptive statistics followed by binary logistic regression were conducted. All data analyses were conducted using STATA 14.2. Results. Of the 334 pregnant women enrolled, the prevalence of PROM was found to be 13.8%. The significant independent predictors associated with lower odds of PROM were no history of urinary tract infection (UTI) in the month preceding enrollment into the study (aOR=0.5, 95% CI: 0.22-0.69, p=0.038) and gestational age of 37 weeks or more (aOR=0.3, 95% CI: 0.14-0.71, p=0.01) while history of 3 or more abortions (aOR=13.1, 95% CI: 1.12-153.62, p=0.05) was associated with higher likelihood of PROM. Conclusions. Majorly urinary tract infections, low gestational age, and abortions influence premature rupture of membranes among women. There is a great need for continuous screening and prompt treatment of pregnant women for UTI especially those with history of 3 or more abortions at less than 34 weeks of gestation.

2021 ◽  
Vol 15 (10) ◽  
pp. 3520-3523
Author(s):  
Muneeba Sadaf ◽  
Afshan Zaman ◽  
Fatima Bibi ◽  
Maria Tariq ◽  
Uzma Nayyer ◽  
...  

Objectives: To determine the frequency of asymptomatic bacteriuria in pregnantwomen. Study design: Descriptive, Cross sectional study Place and Duration: Department of Obstetrics & Gynaecology, Benazir Bhutto Hospital, Rawalpindi. 26th December 2017 to 25th June 2018 Materials & Methods: A total of 151 pregnant women of gestational age ≥28 weeks, 18 to 40 years of age were included. Patients with genital tract trauma, history of UTI in the past one year and urinary tract stones were excluded. Then clean-catch midstream urine was collected from each woman into a sterile universal container and sample was sent to the institutional laboratory for presenceor absence of asymptomatic bacteriuria. Results: Age range in this study was from 18 to 40 years with mean age of 28.78 ± 3.90 years. Majority of the patients 84 (55.63%) were between 18 to 30 years of age. Mean gestational age was 31.06 ± 1.67 weeks. Mean parity was 3.17 ± 0.99. Mean BMI was 27.44 ± 3.02 kg/m2. In our study, frequency of asymptomatic bacteriuria in pregnant women was found in 25 (16.56%) patients. Conclusion: This study concluded that frequency of asymptomatic bacteriuria in pregnant women is quite high. Keywords: Asymptomatic Bacteriuria, Pregnancy, Urinary Tract Infection.


Author(s):  
John Musaba ◽  
Moses Mukosha ◽  
Lubinda Mukololo ◽  
Bellington Vwalika

Background: Micronutrient deficiency is one of the leading public health problems, particularly in lower-middle-income countries. The link between serum zinc (Zn) levels and urinary tract infections (UTIs) among pregnant women is still poorly understood. We investigated the association between maternal serum Zn levels and UTIs among pregnant women at women and newborn hospital in Lusaka, Zambia.Methods: We conducted an analytical cross-sectional study among 228 pregnant women aged 18 to 45 years between 1 September and 30 November 2019. Serum Zn levels were measured using atomic absorption spectrophotometry (AAS), whereas UTIs were determined based on the local hospital guidelines. We used the logistic regression model to determine the association between Zn levels and UTIs. The analysis was done at a significance level of 5% and 95% confidence interval.Results: Of the total participants, 118/228 (51.75%) tested positive for UTIs from urine culture. The mean serum Zn levels in the group diagnosed with UTIs were 53.95 ug/dl (SD=35.10), while in those who had no UTIs, it was 50.05 ug/dl (SD=35.10). In a multivariable logistic regression analysis, we found no evidence of an association between serum Zn levels and UTIs (p=0.435).Conclusions: From the study findings, there was no association between serum Zn levels and UTIs. This result suggests that Zn may not have any role in urinary tract infection. Nevertheless, more extensive studies are needed to confirm our findings.


Author(s):  
Surekha S. Mohan ◽  
Chamaraja Thippeveeranna ◽  
Naorem N. Singh ◽  
Laiphrakpam R. Singh

Background: Preterm premature rupture of membranes (PPROM) is one of the most common complications of pregnancy. It is an important cause of perinatal morbidity and mortality. Objective of present study was to determine incidence, risk factors, maternal, fetal outcome of PPROM occurring in patients attending a tertiary hospital in North Eastern India.Methods: This descriptive cross- sectional study was carried out in the department of Obstetrics and Gynecology, Regional Institute of Medical Sciences, Imphal, India. Out of 15,969 deliveries between July 2010 to December 2011, 358 pregnant patients with spontaneous preterm premature rupture of membranes from 28-0 to 36-6weeks gestation were reviewed. After excluding patients with uterine anomalies, intrauterine deaths and congenital anomalies 293 patients were included and evaluated in this study.Results: The incidence of PPROM was 2.2%. Out of 293 patients 86% were singleton pregnancies, 12.9% were twins and 1.02% were triplets. 48.4% had previous history of termination of pregnancy, 28.6% history of previous PPROM and 16.3% had urinary tract infection. The mean gestational age at the onset of membrane rupture was 34.1+2.4 weeks and the latency from the membrane rupture to delivery interval ranged from 0-72 days with a mean of 48.4 hours. There were 7stillbirths (2.38%) and 4 neonatal deaths (1.02%) resulting in perinatal deaths of 3.29% and perinatal mortality rate of 0.329 per 1000 births due to PPROM. Maternal morbidity was minimal with postpartum haemorrhage in 11 patients (4.1%), abruptio placentae in 7 patients (2.3%) and sepsis in 43patients (14.6%). 66 patients (22.5%) underwent caesarean section for which malpresentations were the major cause.Conclusions: Despite remarkable advances in perinatal care, preterm premature rupture of membranes continues to cause perinatal morbidity and mortality. Strategies should be developed for its prevention. Management protocol should be improved in regard to vaginal swab culture and use of specific antibiotics.


2020 ◽  
Vol 3 (9) ◽  
pp. 454-458
Author(s):  
Shikha Thakur ◽  
Dr. Komal Lata Nagpal

Background: Urinary tract infections “UTIs” are one of the frequently encountered problems during pregnancy. Untreated UTI can be associated with serious obstetric complications.  Hence the management and prevention of UTI in pregnancy is the crucial factor for the sustained pregnant period. Hence the present study was designed to identify the pathogenic agents of UTI and its associated risk factors in antenatal mothers in two private hospitals at Kathmandu city. Aim: The main objective of the study was to identify the etiological agent and associated risk factor in Urinary tract infection among pregnant women attending the antenatal care service visit in a selected hospital. Study Design: Cross-sectional descriptive study. Place and Time of Study: The study was carried out under the supervision of University and field study was carried out in Kathmandu, Nepal from March 2019 to October 2019. Methods: The cross-sectional study was performed at the Norvic Hospital and Baidya and Banskota hospital from March 2019 to October 2019. In this cross-sectional study, a total of 510, clean catch midstream urine (MSU) samples were collected aseptically and analyzed using standard microbiology methods. Data for the factors associated with UTI were obtained by use of questionnaires and standard laboratory tests for selected underlying conditions concerning associated risk factors were collected using structured questionnaires and the sample was also processed for antimicrobial drug susceptibility testing. Results: The study revealed 193/510(37.84%) UTI prevalence among patients attending two hospitals in Kathmandu valley. Escherichia coli was the most prevalent bacterial uropathogen with 119/193(61.6%) followed by Klebsiella pneumoniae 35/193(18.13%), Staphylococcus aureus 22/193 (11.39%), Proteus mirabilis 7/193 (3.6%), Enterococcus faecalis 2/193 (1.0%), Enterobacter aerogenes2/193(1.0%) Serratia odorifera 3/193(1.5%), Streptococcus species3/193(1.5%). Conclusions: The high prevalence of urinary tract infection in pregnant women warrant the need to screen all pregnant women and treat those infected with appropriate antimicrobial regimens in order to reduce its complications. Urinary Tract Infection screening is essential in pregnant women.


2020 ◽  
Author(s):  
Meixiang Guo ◽  
Jun Lu ◽  
Xiaowen Hu ◽  
Wenjing Hou ◽  
Xuemei Yu ◽  
...  

Abstract Background: Uric acid has strong antioxidant activity whereas its oxidative damage is closely related to many diseases. We assessed the association between serum uric acid (SUA) levels and premature rupture of membranes (PROM) in pregnant women with Gestational diabetes (GDM) in china. Method: In this cross-sectional study, a total of 456 pregnant women were enrolled. Anthropometric parameters for pregnant women were collected within 12 weeks of gestation. Weight gain during pregnancy was obtained from patients’ record. GDM was diagnosed according to 75-g oral glucose tolerance tests at 24-28th week’s gestation, and SUA was determined simultaneously. PROM was identified as the natural rupture of fetal membranes before the first stage of labor. Logistic models were fitted to identify the presence of PROM using clinical characteristics with (Model 1) or without serum uric acid (Model 2).Results: There exist differences in BMI, haemoglobin A1c, fasting blood glucose, 1-hour postprandial glucose, 2h PG, insulin levels, weight gain during pregnancy, the rate of macrosomia, PROM between women with and without GDM (all P<0.05). Furthermore, individuals with PROM had lower level of SUA than those without PROM in GDM women (P=0.030). The odds ratio of PROM decreases with the increase of SUA level. The area under the receiver operating characteristic curves for PROM based on Model 1 was larger than that in Model 2 (0.86 versus 0.71, p<0.05).Conclusion: Elevated relatively SUA levels at the 24-28th weeks of gestation were associated with a lower risk of PROM in women with GDM. SUA may be a protective factor for PROM in GDM patient. The optimal concentration of uric acid in different diseases and different populations needs to be further studied.


Author(s):  
Rian Lelie- van der Zande ◽  
Marcel Bouvy ◽  
Martina Teichert

Abstract Aim: To study whether changes in drug preferences in the Dutch guideline for the treatment of Urinary Tract Infection (UTI) for General Practitioners (GPs) in 2013, resulted in corresponding changes in antibiotic dispensing. Background: For the treatment of uncomplicated UTI, nitrofurantoin remained the first choice, while fosfomycin became the second choice and changed ranks with trimethoprim. For a subsequent febrile UTI, ciprofloxacin became the first choice and changed ranks with amoxicillin/clavulanic acid, co-trimoxazole remained the third choice. Methods: In this observational cross-sectional study, routinely collected dispensing data from the Dutch Foundation of Pharmaceutical Statistics from 2012 to 2017 were used. The number of women 18 years and older, treated with one of the guideline antibiotics for uncomplicated UTI and subsequent febrile UTI were analysed annually. Proportions were calculated. Data were stratified for age categories. Failure of uncomplicated UTI treatment was defined as the dispensing of an antibiotic for febrile UTI within 14 days after the dispensing of an antibiotic for uncomplicated UTI. Findings: Data were available from 81% of all pharmacies in 2012 to 89% in 2017. Percentages of women dispensed nitrofurantoin were relatively stable with 87.4% in 2012 and 84.4% in 2017. Percentages of women dispensed fosfomycin increased from 5.4% in 2012 to 21.8% in 2017, whereas percentages of women dispensed trimethoprim decreased from 17.8% to 8.0%. Within age categories, the percentage of women dispensed fosfomycin increased from 12.4% in women 18–30 years old to 36.7% in women above 80 years old. Percentages of women dispensed antibiotics for febrile UTI remained stable at 5% annually. Percentages of women receiving ciprofloxacin increased from 1.9% in 2012 to 3.3% in 2017, while those receiving amoxicillin/clavulanic acid decreased from 2.9% to 1.8%. New guideline recommendations resulted in corresponding changes in dispensed antibiotics for uncomplicated UTI and subsequent febrile UTI. Drug choices differed for age categories.


Author(s):  
Margit Steinholt ◽  
Shanshan Xu ◽  
Sam Ol Ha ◽  
Duong Trong Phi ◽  
Maria Lisa Odland ◽  
...  

We conducted a cross-sectional study among 194 pregnant women from two low-income settings in Cambodia. The inclusion period lasted from October 2015 through December 2017. Maternal serum samples were analyzed for persistent organic pollutants (POPs). The aim was to study potential effects on birth outcomes. We found low levels of polychlorinated biphenyls (PCBs) and organochlorine pesticides (OCP), except for heptachlors, β-hexachlorocyclohexane (HCH), heptachlor epoxide, and p,p’-DDE. There were few differences between the two study locations. However, the women from the poorest areas had significantly higher concentrations of p,p’-DDE (p < 0.001) and hexachlorobenzene (HCB) (p = 0.002). The maternal factors associated with exposure were parity, age, residential area, and educational level. Despite low maternal levels of polychlorinated biphenyls, we found significant negative associations between the PCB congeners 99 (95% CI: −2.51 to −0.07), 138 (95% CI: −1.28 to −0.32), and 153 (95% CI: −1.06 to −0.05) and gestational age. Further, there were significant negative associations between gestational age, birth length, and maternal levels of o,p’-DDE. Moreover, o,p’-DDD had positive associations with birth weight, and both p,p’-DDD and o,p’-DDE were positively associated with the baby’s ponderal index. The poorest population had higher exposure and less favorable outcomes.


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