scholarly journals Nonproteinuric Preeclampsia among Women with Hypertensive Disorders of Pregnancy at a Referral Hospital in Southwestern Uganda

2021 ◽  
Vol 2021 ◽  
pp. 1-6
Author(s):  
Asiphas Owaraganise ◽  
Richard Migisha ◽  
Wasswa G. M. Ssalongo ◽  
Leevan Tibaijuka ◽  
Musa Kayondo ◽  
...  
Keyword(s):  
Pregnant Women ◽  
Cross Sectional Study ◽  
Referral Hospital ◽  
Chronic Hypertension ◽  
Care Providers ◽  
Hypertensive Disorders Of Pregnancy ◽  
Cross Sectional ◽  
Hypertensive Disorders ◽  
Liver Transaminases ◽  
Southwestern Uganda

Background. Preeclampsia is a priority obstetric emergency requiring urgent diagnosis and treatment to avert poor pregnancy outcomes. Nonproteinuric preeclampsia poses even greater diagnostic challenges due to contested diagnostic criteria by the clinical practice guidelines and variable clinical presentation. Previously, preeclampsia was only diagnosed if high blood pressure and proteinuria were present. This study determined the prevalence of nonproteinuric preeclampsia and associated factors among women admitted with hypertensive disorders of pregnancy at a referral hospital in southwestern Uganda. Methods. Women with hypertensive disorders of pregnancy were consecutively enrolled in a cross-sectional study at Mbarara Regional Referral Hospital between November 2019 and May 2020. We interviewed all pregnant women ≥20 gestation weeks presenting with hypertension and obtained their sociodemographic, medical, and obstetric characteristics. We excluded women with chronic hypertension. We measured bedside dipstick proteinuria in clean-catch urine. Preeclampsia was defined as hypertension plus any feature of severity including <100,000 platelets/ul, creatinine >1.1 g/dl, and liver transaminases ≥twice upper normal limit with or without proteinuria. We defined nonproteinuric preeclampsia in participants with <+2 urine dipstick cut-off and determined the factors associated with nonproteinuric preeclampsia using logistic regression. Results. We enrolled 134 participants. The mean age was 26.9 (SD ± 7.1) years and 51.5% were primigravid. The prevalence of nonproteinuric preeclampsia was 24.6% (95% CI: 17.9–32.7). Primigravidity (aOR 2.70 95% CI: 1.09–6.72, p  = 0.032) was the factor independently associated with nonproteinuric preeclampsia. Conclusion. Nonproteinuric preeclampsia was common, especially among primigravidae. We recommend increased surveillance for nonproteinuric preeclampsia, especially among first-time pregnant women, who may not be detected by the traditional criteria. Obstetrics care providers should emphasize laboratory testing beyond proteinuria, among all women with hypertensive disorders of pregnancy to optimally diagnose and manage nonproteinuric preeclampsia.

scholarly journals Competency of health workers in detecting and managing gestational hypertension, pre-eclampsia, severe pre-eclampsia and eclampsia during antenatal check-ups in primary care health facilities in Bangladesh: a cross-sectional study

BMJ Open ◽  
2021 ◽  
Vol 11 (7) ◽  
pp. e046638
Author(s):  
Sk Masum Billah ◽  
Abdullah Nurus Salam Khan ◽  
S M Rokonuzzaman ◽  
Nafisa Lira Huq ◽  
Marufa Aziz Khan ◽  
...  
Keyword(s):  
Primary Care ◽  
Health Workers ◽  
Gestational Hypertension ◽  
Cross Sectional Study ◽  
P Value ◽  
Sectional Study ◽  
Hypertensive Disorders Of Pregnancy ◽  
Cross Sectional ◽  
Hypertensive Disorders ◽  
Care Facilities

Study objectiveTo evaluate the competency of trained health workers in detecting and managing hypertensive disorders of pregnancy during routine antenatal check-ups (ANCs) at primary care facilities in Bangladesh.Study design and settingsCross-sectional study; conducted in 26 primary care facilities.Outcome measuresAccurate diagnosis of the hypertensive disorders of pregnancy.MethodIn total 1560 ANC consultations provided by primary health workers, known as Family Welfare Visitors (FWVs), were observed using a structured checklist between October 2017 and February 2018. All consultations were reassessed by study physicians for validation.ResultOf the ‘true’ cases of gestational hypertension (n=32), pre-eclampsia (n=29) and severe pre-eclampsia (n=16), only 3%, 7% and 25%, respectively, were correctly diagnosed by FWVs. Per cent agreement for the diagnosed cases of any hypertensive disorders of pregnancy was 9% and kappa statistics was 0.50 (p value 0.0125). For identification of any hypertensive disorders by FWVs, sensitivity and positive predictive values were 14% and 50%, respectively. There was a moderate positive correlation between the blood pressure measurements taken by FWVs and study physicians. Only 27% of those who had ‘some protein’ in urine were correctly identified by FWVs. Women diagnosed with any of the hypertensive disorders of pregnancy by FWVs were more likely to be counselled on at least one danger sign of pre-eclampsia (severe headache, blurring of vision and upper abdominal pain) than those without any such diagnosis (41% vs 19%, p value 0.008). All four cases of severe pre-eclampsia diagnosed by FWVs were given a loading dose of intramuscular magnesium sulphate and three among them were referred to a higher facility.ConclusionThe FWVs should be appropriately trained on risk assessment of pregnant women with particular emphasis on accurately assessing the diagnostic criteria of hypertensive disorders of pregnancy and its management.

scholarly journals Health anxiety and related factors among pregnant women during the COVID-19 pandemic: a cross-sectional study from Iran

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Najmieh Saadati ◽  
Poorandokht Afshari ◽  
Hatam Boostani ◽  
Maryam Beheshtinasab ◽  
Parvin Abedi ◽  
...  
Keyword(s):  
Pregnant Women ◽  
Health Care Providers ◽  
Health Anxiety ◽  
Cross Sectional Study ◽  
Care Providers ◽  
Sectional Study ◽  
Third Trimester ◽  
Related Factors ◽  
Cross Sectional ◽  
The Third

Abstract Background The COVID-19 pandemic has affected many countries around the world and Iran was no exception. The aim of this study was to evaluate health anxiety of Iranian pregnant women during the COVID-19 pandemic. Methods In this cross-sectional study, 300 pregnant women in different trimesters (n = 100 in each trimester) were recruited. A demographic questionnaire and the Health Anxiety Questionnaire were used to collect data. Scores of < 27, 27–34 and more than 35 were defined as low, moderate and high health anxiety, respectively. Due to nationwide restrictions, data were collected through social media groups. Chi-square tests, ANOVA and multiple linear regression were used to analyze the data. Results Mean (SD) total anxiety scores were 22.3 ± 9.5, 24.6 ± 9.3 and 25.4 ± 10.6 in the first, second and third trimesters of pregnancy, respectively. 9, 13 and 21% of women had severe anxiety in the first, second and third trimesters of pregnancy, respectively. Women in the third trimester had significantly higher health anxiety scores than those in the first trimester (p = 0.045). Conclusion At the time of the COVID-19 pandemic, women in the second and third trimesters of pregnancy were more worried about consequences of disease, but total health anxiety scores were significantly higher among women in the third trimester of pregnancy. Health care providers should pay more attention to the mental health of pregnant women in times of crises such as the COVID-19 pandemic.

scholarly journals Non-Proteinuric Preeclampsia: Prevalence, Factors Associated and End-Organ Dysfunction at Mbarara Regional Referral Hospital in Southwestern Uganda  

2021 ◽  
Author(s):  
Asiphas Owaraganise ◽  
Wasswa GM Ssalongo ◽  
Leevan Tibaijuka ◽  
Musa Kayondo ◽  
Godfrey Twesigomwe ◽  
...  
Keyword(s):  
Organ Dysfunction ◽  
Complete Blood Count ◽  
Referral Hospital ◽  
Chronic Hypertension ◽  
Care Providers ◽  
Cross Sectional ◽  
Regional Referral Hospital ◽  
Pregnancy Hypertension ◽  
Factors Associated ◽  
Significant Difference

Abstract Background: Formerly, preeclampsia was only diagnosed if high blood pressure and proteinuria were present in a gravid woman at or past 20 gestation weeks. Although it is possible to have preeclampsia yet never have proteinuria, the literature on how common and factors associated with non-proteinuric preeclampsia as well as whether the frequency of end-organ dysfunction among women with non-proteinuric differs from those with proteinuric pre-eclampsia is scant.Objectives: To determine the prevalence of, factors associated with non-proteinuric preeclampsia, and compare the frequency of end-organ dysfunction between women with non-proteinuric and proteinuric preeclampsia.Methods: Between November 2019 and May 2020, women with pre-eclampsia were consecutively enrolled in a cross-sectional study at Mbarara Regional Referral Hospital. We interviewed all pregnant women ≥20 gestation weeks presenting with hypertension ≥140/90mmHg and recorded their socio-demographic, medical, and obstetric characteristics. We excluded women with chronic hypertension and pregnancy hypertension. We measured bedside proteinuria on clean-catch urine, complete blood count, and renal function and liver enzyme tests. Pre-eclampsia was defined as hypertension plus any feature of severity including <100,000 platelets/ul, creatinine >1.1g/dl, and liver transaminases ≥ twice upper normal limit with or without proteinuria. We computed the proportion of total participants with non-proteinuric pre-eclampsia at ≤+2 urine dipstick cut-off, determined the factors associated with non-proteinuric preeclampsia using logistic regression; and used Chi-square test to compare the frequency of end-organ dysfunction between non-proteinuric preeclampsia and proteinuric groups.Results: We enrolled 134 of the screened 136 participants. Their mean age was 26.9 (SD±7.1) years and 51.5% were primigravid. The prevalence of non-proteinuric preeclampsia was 24.6% (95% CI: 17.9-32.7). Primigravidity (aOR 2.70 95%CI:1.09-6.72, p=0.032) was the factor independently associated with non-proteinuric pre-eclampsia. There was a non-significant difference in the frequency of end-organ dysfunction in women with non-proteinuric and proteinuric pre-eclampsia, p=0.309.Conclusion: Non-proteinuric preeclampsia is common, especially among primigravidae. End-organ dysfunction occurs similarly in women with non-proteinuric and proteinuric preeclampsia. Obstetrics care providers should emphasize laboratory testing, beyond proteinuria, among all women with hypertensive disorders of pregnancy to optimally diagnose and manage non-proteinuric preeclampsia.

scholarly journals Online Pregnancy-Related Information: Reliability and Worries Among Expectant Women In Qatar

2021 ◽  
Author(s):  
Ayman Al-Dahshan ◽  
Mohamad Chehab ◽  
Nagah Selim
Keyword(s):  
Antenatal Care ◽  
Pregnant Women ◽  
Sampling Technique ◽  
Cross Sectional Study ◽  
Care Providers ◽  
Cross Sectional ◽  
Web Based ◽  
Related Information ◽  
University Degree ◽  
Self Administered Questionnaire

Abstract Background: Although the internet can be a source of reassurance and clarification for expectant women, it ‎could cause concerns or feelings of worry when reading about pregnancy-related ‎information. The current research sought to assess the feelings of worry and perceived reliability towards online pregnancy-related information and the associated factors among expectant women attending antenatal clinics at primary healthcare centers in Qatar.Methods: A cross-sectional study design was employed. The participants were recruited through a systematic random sampling technique. ‎A self-administered questionnaire was used to collect data from the participants. Descriptive and analytic statistics were used when appropriate‎.Results: A total of 327 expecting women completed the questionnaire. Most participants were aged between 26-34 years (74.1%), held a college/university degree (76.4%), and multigravidas (73.1%). About one-third of the women ‎(31.2‎%) reported feeling worried due to something they read online. The participants coped with these feelings by consulting their antenatal care provider at the next appointment (51.0%) or by talking with relatives and friends (47.0%). Furthermore, most women (79.2%) considered online pregnancy-related information to be reliable or highly reliable. Holding a college/university degree, primigravidae, and having no children were factors significantly associated with a high perception of reliability of online health information.Conclusion: Although online pregnancy information caused feelings of worry for some pregnant ‎women, most women perceived such information to be reliable. Thus, antenatal care providers should be equipped to guide pregnant women on how to access high-quality web-based information.

Assessment of Prevalence of Hypertension in pregnant women with its Complications: A Cross Sectional Study

2021 ◽  
pp. 3805-3808
Author(s):  
Hemalatha S. ◽  
S. M. Shaheedha ◽  
Ramakrishna Borra
Keyword(s):  
Pregnant Women ◽  
Cross Sectional Study ◽  
World Health ◽  
Chronic Hypertension ◽  
Pregnancy Induced Hypertension ◽  
Cross Sectional ◽  
Mortality And Morbidity ◽  
Gynecology And Obstetrics ◽  
Induced Hypertension ◽  
History Of

Introduction: World Health Organization has reported that pregnancy induced hypertension is one of the main causes for mortality and morbidity in maternal and fetal deaths. About 60% of deaths accounted of eclampsia. Aims and Objectives: To diagnose for hypertension in pregnant women. To evaluate the knowledge of pregnancy induced hypertension among the pregnant women. To investigate the complications reported in Pregnancy induced hypertension (PIH) women, during and after labor. Study area and period: The present study was conducted in Chittoor government hospital, Chittoor, during the period of Jan 2016 and Dec 2017. The information and materials required for the study have been collected from the gynecology and obstetrics departments of the respective hospital. Results: During the study period of Jan 2016 and Dec 2017, about 2234 number of pregnant women have visited the obstetrics and gynecology department. All the 2234 pregnant women were tested for blood pressure. Among which 198 women were found to have hypertension, which may be of early onset PIH or chronic hypertension (HTN). Different variables of the study population like period of gestation [<20 weeks, ≥20 weeks], previous cesarean section if present, previous preterm delivery if present, hypertension in previous pregnancy, history of paternal hypertension, history of abortions if have been, history of any still births, family history of PIH have been noted and reported in table 2. More than 8% of women were found to been falling in <20 weeks of gestational age (GA). Conclusion: The study included 2234 pregnant women, in which 198 women were diagnosed with hypertension. Thus, prior investigation and identification hypertension in pregnant women helps in better management of PIH and to overcome the complications that are reported due to PIH during and after labor. Better knowledge and treatment is required for managing hypertension in maternal women in gynecology and obstetrics department for maternal and fetal care.

scholarly journals Disclosure of herbal medicine use to health care providers among pregnant women in Nepal: a cross-sectional study

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Mansoor Ahmed ◽  
Hyea Bin Im ◽  
Jung Hye Hwang ◽  
Dongwoon Han
Keyword(s):  
Health Care ◽  
Herbal Medicine ◽  
Pregnant Women ◽  
Health Care Providers ◽  
Healthcare Providers ◽  
Cross Sectional Study ◽  
Health Concern ◽  
Care Providers ◽  
Sectional Study ◽  
Cross Sectional

Abstract Background Pregnant women’s disclosure of herbal medicine (HM) use to their health care providers during pregnancy is crucial, as misuse of HM can have a detrimental effect on both pregnant woman and the fetus. However, the lack of disclosure of HM use to physicians remains a public health concern in developing countries such as Nepal. Methods A cross-sectional study was conducted among 400 postpartum women admitted at Maternity and Women’s Hospital located in Kathmandu, Nepal. The survey instrument included 30 questions on the use of HM during pregnancy, sociodemographic and health characteristics, and pregnancy outcomes. Chi-square test and logistic regression were conducted for data analysis using SPSS ver. 21.0., and a p-value of less than 0.05 was considered statistically significant for all analyses. Results 60.3% of respondents used at least one herbal remedy during their previous pregnancy, and the overall disclosure rate of HM use to healthcare providers was 54.6%. Women with secondary education level and four or more antenatal care visits were more likely to disclose their HM use to healthcare providers. Conclusions This study highlights that despite the popular use of HM among pregnant women in Nepal, most women obtained HM-related information from informal sources and did not disclose their HM use to physicians. To ensure the safe use of HM, physicians should integrate questions regarding patients’ HM use into their routine patient assessments to facilitate active communication and improve the quality of care.

scholarly journals Assessment of physical activity status among pregnant women in southwestern China

2019 ◽  
Vol 6 (2) ◽  
pp. 135-141 ◽  
Author(s):  
Ya-Nan Yin ◽  
Yan Huang ◽  
Xing-Hui Liu ◽  
Bi-Ru Luo
Keyword(s):  
Physical Activity ◽  
Pregnant Women ◽  
Health Care Providers ◽  
Chinese Women ◽  
First Trimester ◽  
Cross Sectional Study ◽  
Southwestern China ◽  
Care Providers ◽  
Cross Sectional ◽  
Exercise During Pregnancy

Abstract Objective To assess the patterns and intensities of physical activity among pregnant women in southwestern China, which help us create a fitness regimen based on the 2002 American College of Obstetricians and Gynecologists (ACOG) guidelines for exercise during pregnancy. Methods A cross-sectional study was performed to recruit pregnant women at a prenatal checking visit clinic with the self-administered Chinese version of Pregnancy Physical Activity Questionnaire (PPAQ). Results A total of 1179 Chinese pregnant women were enrolled, of whom 92.60% were classified as not meeting the ACOG guidelines. By intensity, 47.36% of the score was attributed to light-intensity activities (1.5 to <3.0 metabolic equivalent [MET]) in the first trimester; the other 2 trimesters were similar. By patterns, about 45.15% of the score was attributed to inactivity. More than 82.35% of enrolled pregnant women regarded slowly walking as the most common type of exercise during pregnancy. Conclusions This study represents a group of Chinese women who maintained an inactive lifestyle, including low-intensity activities and unitary type of exercises during their pregnancy. Health-care providers are advised to provide appropriate physical activity guidelines to pregnant women. Development of MET-hours/week recommendations is warranted to promote greater physical activity during pregnancy.

scholarly journals Pregnant women’s experiences with the management of hypertensive disorders of pregnancy: a qualitative study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Amyna Helou ◽  
Kay Stewart ◽  
Kath Ryan ◽  
Johnson George
Keyword(s):  
Blood Pressure ◽  
Qualitative Study ◽  
Pregnant Women ◽  
Clinical Management ◽  
Blood Pressure Monitoring ◽  
Chronic Hypertension ◽  
Hypertensive Disorders Of Pregnancy ◽  
Pressure Monitoring ◽  
Hypertensive Disorders ◽  
Management Of Complications

Abstract Background Hypertensive disorders are a leading cause of mortality and morbidity during pregnancy. Despite multiple national and international clinical guidelines and a plethora of research in the field of optimising management, there has been limited research describing the perspectives and experiences of pregnant women with the management of hypertensive disorders of pregnancy (HDP). Understanding these perceptions and experiences is imperative to the optimisation of HDP management. Methods A qualitative study involving face-to-face, in-depth interviews were undertaken with 27 pregnant women diagnosed with and being treated for HDP to explore their perspectives of and experiences with clinical management. Written consent was obtained individually from each participant, and the interviews ranged from 16 to 54 min. Inductive codes were generated systematically for the entire data set. Line-by-line analysis was then performed and nodes were created within NVivo, a qualitative data management software. Data collection was continued until thematic saturation was reached. Thematic analysis was employed to interpret the data. Results Three major descriptive themes were discerned regarding the women’s perspectives on and experiences with the management of HDP: attitudes towards monitoring of HDP, attitudes and perceptions towards development and management of complications, and perceptions of pregnant women with chronic hypertension. Trust in the hospital system, positive attitudes towards close blood pressure monitoring as well as self-monitoring of blood pressure, and a realistic approach to emergency antenatal hospital admissions contributed to a positive attitude towards monitoring of HDP. Women with prior experiences of HDP complications, including pre-eclampsia, were more confident in their clinical management and knew what to expect. Those without prior experience were often in shock when they developed pre-eclampsia. Some women with chronic hypertension displayed limited understanding of the potential risks that they may experience during pregnancy and thus lacked comprehension of the seriousness of the condition. Conclusions The clinical management experiences of pregnant women with HDP were varied. Many women did not feel that they were well informed of management decisions and had a desire to be more informed and involved in decision-making. Clear, concise information about various facets of HDP management including blood pressure monitoring, prescription of the appropriate antihypertensive agent, and planning for potential early delivery are required.

scholarly journals Kasus Hipertensi pada Kehamilan di Indonesia

2018 ◽  
Vol 32 (9) ◽  
pp. 295
Author(s):  
Novi Kartika Sari ◽  
Theodola Baning Rahayujati ◽  
Mohammad Hakimi
Keyword(s):  
Pregnant Women ◽  
Gestational Hypertension ◽  
Sampling Technique ◽  
Chronic Hypertension ◽  
Chi Square ◽  
Cross Sectional ◽  
Hypertensive Disorders ◽  
Hypertensive Disorders In Pregnancy ◽  
Cross Sectional Design ◽  
In Pregnancy

Determinants of pregnancy hypertensive disorders in Indonesia PurposeThis study aimed to assess the determinant factors of gestational hypertension (HDP) in Indonesia.MethodsThis research was an observational analytic study using a cross-sectional design. Sampling was calculated using consecutive sampling technique. The subjects were all pregnant women aged 15-54 years old in 33 provinces in Indonesia and 9024 women were selected as subjects. Chi-square and binomial regression tests were used to analyze the determinants of HDP to see the value of the Ratio Prevalence (RP). ResultsThe prevalence of hypertension among pregnant women was 6.18% (558 people) after being adjusted with external variables which were potentially confounders. The highest of hypertension was found in West Java with 59 pregnant women (10.57%). Overweight and chronic hypertension were related to hypertensive disorders in pregnancy with RP: 2.13 (95% CI: 1.80-2.51); and in overweight with RP: 4.36 (95% CI: 3.6-5.26) in hypertension assessments. The use of contraceptives was not a risk factor for hypertensive disorders in Indonesia with RP 0.92 (95% CI: 0.76-1.10). ConclusionOverweight and chronic hypertension are risk factors for the incidence of hypertensive disorders in pregnancy in Indonesia.

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