Comparison of Conservative and Surgical Treatments in Symptomatic Pregnancy Hydronephrosis

2021 ◽  
pp. 1-7
Author(s):  
Mehmet Demir ◽  
İsmail Yağmur ◽  
Eyyup Sabri Pelit ◽  
Bülent Katı ◽  
Adem Tunçekin ◽  
...  

<b><i>Objectives:</i></b> This study aimed to evaluate the factors affecting the treatment choice in pregnant women with symptomatic hydronephrosis. <b><i>Methods:</i></b> Hospital records of pregnant women who visited our clinic due to symptomatic hydronephrosis between December 2010 and December 2020 were analysed retrospectively. Patients were divided into 2 groups: conservative and surgical (JJ stent) treatment groups. Age, gestational week, primipara, trimester, visual analogue scale (VAS), and preterm birth rates as well as clinical, laboratory, and ultrasonography findings were compared between the groups. <b><i>Results:</i></b> The study included 227 pregnant women (conservative treatment group, 133; JJ stent group, 94). Age, gestational week, primipara, trimester, hydronephrosis side, fever, pyelonephritis, pyuria, preterm labour and abortion, as well as blood urea nitrogen, creatinine, C-reactive protein, and white blood cell levels did not differ significantly between the groups (<i>p</i> &#x3e; 0.05). In the JJ stent group, VAS, creatinine value, culture positivity rate, degree of hydronephrosis, and renal pelvis anterior-posterior (AP) diameter were significantly higher than those in the conservative treatment group (<i>p</i> &#x3c; 0.05). The cut-off value for renal pelvis AP diameter was 16.5 mm in the first 2 trimesters and 27.5 mm in the third trimester. <b><i>Conclusions:</i></b> Surgical treatment should not be delayed in pregnant women who do not respond to conservative treatment and have impaired renal function and grade 3–4 hydronephrosis. Early surgical intervention is necessary in patients with a renal pelvis AP diameter of &#x3e;16.5 mm in the first 2 trimesters and &#x3e;27.5 in the third trimester.

2021 ◽  
Vol 7 (2) ◽  
pp. 287-294
Author(s):  
Noviyanti Noviyanti ◽  
Rahmi Rahmi ◽  
Ratna Dewi ◽  
Nurdahliana Nurdahliana

GIVING MURATTAL AL-QURAN THERAPY ON QUALITY TRIMESTER PRIMARY PREGNANT MOTHER'S SLEEP III Background : Expecting mothers experienced different discomforts which were frequently felt in the third trimester, a waiting period in which the pregnant mothers started to be alert of delivering a baby. These discomforts resulted in disturbance of activities of the expectants. Sleep problem was mostly occured during this trimester which might decrease sleep quality. To overcome the complaint, there should be a way to increase sleep quality of the pregnant women. One of them is Murattal Qur'an.Purpose : This study was aimed at finding out the effect of Murattal Qur'an on third semester toward sleep quality of the pregnants.Methods : This research belonged to a quasi-experimental with a pretest-posttest control group design. The population in this study were all pregnant women in the third trimester primigravida in the working area of the Kuta Baro Health Center, Aceh Besar. The sample was 40 pregnant women who were divided into the control group and the treatment group. The treatment group listened to the Murattal Quran chapter Ar-Rahman on Android for 7 nights before going to bed. Data was  analysed by using the Wilcoxon test because the data were not normally distributed.Results : The obtained significant value (p) of  the treatment group of before and after  therapy was  0.000 lower than 0.05 (p=0.000 <0.05)Conclusion : There is an effect of giving Murattal Al-Quran therapy in the third trimester primigravida on the quality of mother's sleep.Suggestion : It hoped that it increased the active role of Midwives to provide information to pregnant women about the way to overcome the sleep disorders of   the third trimester pregnant women was by by listening to the murattal Quran. Keywords: Murattal Al-Quran, Sleep Quality, Primigravida, Third Trimester.ABSTRAK Latar Belakang :  Ketidaknyamanan yang dirasakan oleh ibu hamil paling sering dirasakan saat trimester III. Trimester III merupakan masa menunggu kelahiran bayinya. Ketidaknyamanan yang dirasakan ibu mengakibatkan aktivitas sehari-hari ibu hamil menjadi terganggu. Gangguan tidur merupakan Keluhan yang paling sering terjadi pada ibu hamil trimester III. Gangguan ini menyebabkan kualitas tidur ibu menurun. Salah satu cara pendekatan untuk meningkatkan kualitas tidur ibu hamil adalah mendengarkan lantunan ayat Al-Quran.Tujuan : Mengetahui pengaruh pemberian terapi murattal Al-Quran pada primigravida trimester III terhadap kualitas tidur ibu.Metode : Jenis penelitian adalah quasi-eksperimen dengan pendekatan pretest-posttest control group design. Populasi adalah primigravida trimester III di wilayah kerja Puskesmas Kuta Baro Kabupaten Aceh Besar. Jumlah sampel 40 ibu hamil yang dibagi menjadi kelompok kontrol dan kelompok perlakuan. Kelompok perlakuan mendengarkan murattal Al-Quran surah Ar-Rahman dengan menggunakan HP Android selama 7 malam sebelum tidur. Analisa data menggunakan Uji Wilcoxon karena data berdistribusi tidak normal.Hasil :  Nilai signifikan pada kelompok perlakuan terhadap kualitas tidur ibu sebelum dan sesudah diberikan terapi adalah p = 0,000 lebih kecil dari nilai 0,05.Kesimpulan : Terdapat pengaruh pemberian terapi murattal Al-Quran pada primigravida trimester III terhadap kualitas tidur ibu.Saran : Meningkatkan peran aktif bidan dalam memberikan informasi kepada ibu hamil tentang asuhan ketidaknyaman ibu hamil trimester III yaitu masalah gangguan tidur dengan mendengarkan murattal Al-Quran.  Kata Kunci: Murattal Al-Quran, Kualitas tidur, Primigravida, Trimester III. 


2015 ◽  
Vol 59 (9) ◽  
pp. 5727-5735 ◽  
Author(s):  
Floris Fauchet ◽  
Jean-Marc Treluyer ◽  
Silvia M. Illamola ◽  
Claire Pressiat ◽  
Gabrielle Lui ◽  
...  

ABSTRACTThe aims of this study were to describe the unbound and total lopinavir (LPV) pharmacokinetics in pregnant women in order to evaluate if a dosing adjustment is necessary during pregnancy. Lopinavir placental transfer is described, and several genetic covariates were tested to explain its variability. A total of 400 maternal, 79 cord blood, and 48 amniotic fluid samples were collected from 208 women for LPV concentration determinations and pharmacokinetics analysis. Among the maternal LPV concentrations, 79 samples were also used to measure the unbound LPV concentrations. Population pharmacokinetics models were developed by using NONMEM software. Two models were developed to describe (i) unbound and total LPV pharmacokinetics and (ii) LPV placental transfer. The pharmacokinetics was best described by a one-compartment model with first-order absorption and elimination. A pregnancy effect was found on maternal clearance (39% increase), whereas the treatment group (monotherapy versus triple therapy) or the genetic polymorphisms did not explain the pharmacokinetics or placental transfer of LPV. Efficient unbound LPV concentrations in nonpregnant women were similar to those measured during the third trimester of pregnancy. Our study showed a 39% increase of maternal total LPV clearance during pregnancy, whereas unbound LPV concentrations were similar to those simulated in nonpregnant women. The genetic polymorphisms selected did not influence the LPV pharmacokinetics or placental transfer. Thus, we suggest that the LPV dosage should not be increased during pregnancy.


2014 ◽  
Vol 11 (2) ◽  
pp. 61
Author(s):  
Hana Shafiyyah Zulaidah ◽  
Istiti Kandarina ◽  
Mohammad Hakimi

Background: Anemia causes fetal growth disorders that affect birth weight. Antenatal care (ANC) coverage and provision of high Fe if not followed by a decrease in the incidence of anemia can result indirectly in the risk of low birth weight. Supplementary feeding is expected to resolve the issue.Objective: To assess the effect of supplementary feeding on the third trimester of pregnancy on birth weight.Method: This was a quantitative study with a study design of quasi-experiment and non-equivalent control group. The given intervention was fish-processed feeding for 30 days. The study population was pregnant women in the third trimester in all health centers in the City of Yogyakarta and the samples were 104 pregnant women in some health centers with convenience sampling technique. The subjects were divided into two, namely the treatment group (PMT) and the comparison group (non-PMT). Birth weight was weighed immediately after the baby was born. Statistical analysis used t-test and logistic regression. Results: The mean birth weight of infants in the treatment group and the comparison group was 3248 g and 2974 g, respectively, so that the difference in the mean birth weight of both groups was 274 g (p=0.0002; 95%C:131-416). Thus, supplementary feeding was shown significantly affect the birth weight. The extraneous variables that significantly influenced birth weight were pregnancy interval. Other extraneous variables were age, mid-upper-arm circumference (MUAC), education, occupation, economic status, parity, protein intake, compliance of Fe tablet intake, antenatal care, gestational age at delivery and anemia status were not proven statistically significant to affect birth weight. Conclusion: Supplementary feeding effect on birth weight.


2014 ◽  
Vol 60 (3) ◽  
pp. 270-275
Author(s):  
Ana Luisa Fernandes Lauletta ◽  
Roseli Mieko Yamamoto Nomura ◽  
Seizo Miyadahira ◽  
Rossana Pulcineli Vieira Francisco ◽  
Marcelo Zugaib

Objective: the aim of this study was to investigate the patterns of transient FHR accelerations (10 bpm and 15 bpm) in the third trimester of pregnancy, comparing the occurrence of this event before and after the 32nd gestational week. Methods: This is a prospective study comparing the results of the computerized cardiotocography of 46 low-risk women with singleton pregnancies, maternal age between 18 and 40 years, gestational age between 28 and 40 weeks, absence of maternal morbidity and adequate fetal growth according to ultrasound. Computed Cardiotocography (8002 Sonicaid System and Fetal Care System) was performed for 30 minutes to analyze the variables of FHR. Results: twenty-three pregnant women underwent cardiotocography before 32 weeks (mean = 29.9 weeks, SD = 1.4 weeks) and were compared with 23 pregnant women who were examined after 32 weeks (mean = 36.3 weeks, SD = 2.5 weeks). Regarding the characteristics of FHR, fetuses evaluated between 32 1/7 weeks and 40 weeks showed a significantly greater number of accelerations above 15 bpm (median = 5, variation 0-18) than the group of pregnant women from 28 to 32 weeks (median = 4, variation 0 to 10; P = 0.048). There was a significant positive correlation between the number of accelerations above 15 bpm and the gestational age at examination (rho = 0.33; P = 0.026). Conclusion: computerized cardiotocography showed an association regarding the number of transient accelerations greater than 15 bpm in the assessment of both periods before and after 32 weeks of gestational age, suggesting the influence of the maturation of the fetal autonomic nervous system with pregnancy progression.


2020 ◽  
Vol 98 (3) ◽  
pp. 178-184
Author(s):  
T. V. Chernyakova ◽  
A. Yu. Brezhnev ◽  
I. R. Gazizova ◽  
A. V. Kuroyedov ◽  
A. V. Seleznev

In the review we have integrated all up-to-date knowledge concerning clinical course and treatment of glaucoma among pregnant women to help specialists choose a proper policy of treatment for such a complicated group of patients. Glaucoma is a chronic progressive disease. It rarely occurs among childbearing aged women. Nevertheless the probability to manage pregnant patients having glaucoma has been recently increasing. The situation is complicated by the fact that there are no recommendations on how to treat glaucoma among pregnant women. As we know, eye pressure is progressively going down from the first to the third trimester, so we often have to correct hypotensive therapy. Besides, it is necessary to take into account the effect of applied medicines on mother health and evaluate possible teratogenic complications for a fetus. The only medicine against glaucoma which belongs to category B according to FDA classification is brimonidine. Medicines of the other groups should be prescribed with care. Laser treatment or surgery may also be a relevant decision when monitoring patients who are planning pregnancy or just bearing a child. Such treatment should be also accompanied by medicines.


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Nader Salari ◽  
Niloofar Darvishi ◽  
Behnam Khaledi-Paveh ◽  
Aliakbar Vaisi-Raygani ◽  
Rostam Jalali ◽  
...  

Abstract Background Sleep disorders, which are among the foremost important medical care issues, are prevalent in pregnancy. The present study is a meta-analysis of the prevalence of insomnia in the third trimester of pregnancy. This study aims to systematically review the overall prevalence of insomnia in the third trimester of pregnancy through conducting a meta-analysis. Method The literature used in this meta-analysis for the topic discussed above were obtained through searching several databases, including SID, MagIran, IranDoc, Scopus, Embase, Web of Science (WoS), PubMed Science Direct and Google Scholar databases without time limitation until December 2020. Articles developed based on cross-sectional studies were included in the study. The heterogeneity of studies was investigated using the I2 index. Also, the possible effects of heterogeneity in the studied studies are investigated using meta-regression analysis. Result In 10 articles and 8798 participants aged between11–40, the overall prevalence of insomnia in the third trimester of pregnancy based on meta-analysis was 42.4% (95% CI: 32.9–52.5%). It was reported that as the sample size increases, the prevalence of insomnia in the third trimester of pregnancy increases. Conversely, as the year of research increases, the prevalence of insomnia in the third trimester of pregnancy decreases. Both of these differences were statistically significant (P < 0.05). Conclusion Insomnia was highly prevalent in the last trimester of pregnancy. Sleep disorders are neglected among pregnant women, and they are considered natural. While sleep disturbances can cause mental and physical problems in pregnant women, they can consequently cause problems for the fetus. As a result, maintaining the physical and mental health of pregnant mothers is very important. It is thus recommended that in addition to having regular visits during pregnancy, pregnant women should also be continuously monitored for sleep-related disorders.


Rheumatology ◽  
2021 ◽  
Author(s):  
Rugina I Neuman ◽  
Hieronymus T W Smeele ◽  
A H Jan Danser ◽  
Radboud J E M Dolhain ◽  
Willy Visser

Abstract Objectives An elevated sFlt-1/PlGF-ratio has been validated as a significant predictor of preeclampsia, but has not been established in women with rheumatoid arthritis (RA). We explored whether the sFlt-1/PlGF-ratio could be altered due to disease activity in RA, and could be applied in this population to predict preeclampsia. Since sulfasalazine has been suggested to improve the angiogenic imbalance in preeclampsia, we also aimed to examine whether sulfasalazine could affect sFlt-1 or PlGF levels. Methods Making use of a nationwide, observational, prospective cohort study on pregnant women with RA, sFlt-1 and PlGF were measured in the third trimester. A total of 221 women, aged 21–42 years, were included, with a median gestational age of 30 + 3 weeks. Results No differences in sFlt-1 or PlGF were observed between women with high, intermediate or low disease activity (p= 0.07 and p= 0.41), whereas sFlt-1 and PlGF did not correlate with DAS28-CRP score (r=-0.01 and r=-0.05, respectively). Four (2%) women with a sFlt-1/PlGF-ratio ≤38 developed preeclampsia in comparison to three (43%) women with a ratio &gt; 38, corresponding to a negative predictive value of 98.1%. Sulfasalazine users (n = 57) did not show altered levels of sFlt-1 or PlGF in comparison to non-sulfasalazine users (n = 164, p= 0.91 and p= 0.11). Conclusion Our study shows that in pregnant women with RA, the sFlt-1/PlGF-ratio is not altered due to disease activity and a cut-off ≤38 can be used to exclude preeclampsia. Additionally, sulfasalazine use did not affect sFlt-1 or PlGF levels in this population.


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Najmieh Saadati ◽  
Poorandokht Afshari ◽  
Hatam Boostani ◽  
Maryam Beheshtinasab ◽  
Parvin Abedi ◽  
...  

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.


2021 ◽  
Vol 10 (2) ◽  
pp. 304-312
Author(s):  
Nurfadillah S ◽  
Wardihan Sinrang ◽  
Suryani As'ad ◽  
Muh. Nasrum Massi ◽  
Mardiana Ahmad ◽  
...  

Background: According to 2018 World Health Organization (WHO) data globally, an estimated 17.3% of the population has inadequate zinc intake, with estimates ranging from 5.7% in Oceania to 7.6% in Europe, 9.6% in America and the Caribbean, highest in Africa (23.9%) and Asia (19.6%). Zinc is important for the function of a number of enzymes and growth hormones during pregnancy. In pregnant women, the relative zinc concentration decreases up to 35% due to the influence of hormonal changes and the transport of nutrients from mother to baby. Objectives: The purpose of this study was to identify the effect of giving zinc tablets to pregnant women with zinc deficiency in the third trimester on body weight and length of babies born at the Makassar City Health Center. Methods: This type of research is True Experimental with a pretest-posttest design with a control group. The sample in this study was 62 samples of third trimester pregnant women, and the sampling technique used was purposive sampling. Measurement of zinc levels in third trimester pregnant women using the Elisa reader kit at the Research Laboratory of the Hasanuddin University Teaching Hospital. The research instruments were in the form of a research explanation sheet, respondent's consent sheet, respondent's checklist sheet, and the mother's zinc tablet consumption control sheet for 14 days. Results: Judging from the average value of newborns in pregnant women who did not have zinc deficiency, the average value of birth weight in pregnant women with zinc deficiency was 15.70 g/dL and 18.95 g/dL. zinc deficiency with a value (p < 0.05), while pregnant women with zinc deficiency have an average birth length of 10.00 g/dL and mothers who do not have a deficiency of 19.87 g/dL with a value (p < 0.05). So, it can be concluded that giving zinc tablets to pregnant women in the third trimester has an effect on Birth Weight (BBL) and Birth Length (PBL). Conclusion: Giving zinc tablets has an effect on increasing zinc levels in third trimester zinc deficiency pregnant women and increasing birth weight and length of the baby.  


2021 ◽  
Vol 13 (02) ◽  
pp. 172
Author(s):  
Dyah Ayu Wulandari ◽  
Meika Jaya Rockhmana ◽  
Adelina Cahyaningrum

ABSTRAKAdaptasi fisik dan psikis kehamilan trimester III secara fisiologis dapat menimbulkan kecemasan ibu hamil. Adanya kecemasan pada ibu hamil trimester III dapat menyebabkan komplikasi ibu dan janin saat kehamilan, persalinan bahkan nifas. Terapi acupressure merupakan natural terapi dengan cara menekan acupoint  untuk merelaksasi tubuh, melancarkan sirkulasi darah serta memberikan rasa tenang dan nyaman. Acupoint KID 27 dan CV 17 adalah titik yang berhubungan dengan kecemasan, agitasi, penyimpangan kelenjar tiroid, keseimbangan tubuh dan pusat jantung. Penekanan pada titik ini menyeimbangkan kadar hormon tiroid dan mengatasi gangguan kecemasan. Tujuan penelitian mengetahui pengaruh acupressure depression points terhadap kecemasan ibu hamil trimester III. Metode: Jenis penelitian kuantitatif dengan metode penelitian pre-experimental One Group Pretest-Posttest Design. Penelitian dilakukan Bulan Februari-Agustus 2021. Populasi penelitian ibu hamil trimester III yang melakukan ANC bulan Juni 2021 dengan keluhan kecemasan. Sampel penelitian 22 ibu hamil trimester III dengan teknik purposive sampling. Instrumen penelitian menggunakan kuesioner PRAQ-R2. Analisa data univariat dan bivariat (Uji Wilcoxon) Hasil: Hasil analisa statistik dengan uji Wilcoxon diperoleh nilai P-value 0,000 pada tingkat kecemasan. Kesimpulan: Acupressure depression points berpengaruh terhadap tingkat kecemasan ibu hamil trimester III di Semarang.Kata kunci: kecemasan, ibu hamil trimester IIIREDUCE ANXIETY IN PREGNANT MOTHER TRIMESTER III WITH ACCUPRESSURE DEPRESSION POINTS METHODABSTRACTPhysical and psychological adaptation of the third trimester of pregnancy can physiologically cause anxiety for pregnant women. The existence of anxiety in third trimester pregnant women can affect the quality of sleep which causes maternal and fetal complications during pregnancy, delivery and even postpartum. Acupressure therapy is a natural therapy by pressing the acupoints to relax the body, improve blood circulation and provide a sense of calm and comfort. Acupoints KID 27 and CV 17 are points associated with anxiety, agitation, thyroid disorders, body balance and heart centers. Emphasis on this point balances thyroid hormone levels and treats anxiety disorders thereby improving sleep quality. Objective: to determine the effect of acupressure depression points on the level of anxiety and sleep quality of pregnant women in the third trimester. Methods: This type of research is quantitative with pre-experimental research method One Group Pretest-Posttest Design. The study was conducted in February-August 2021. The study population was pregnant women in the third trimester who performed ANC in June 2021 with complaints of anxiety. The study sample was 22 pregnant women in the third trimester with purposive sampling technique. The research instrument used the PRAQ-R2. Analysis of univariate and bivariate data (Wilcoxon test) Results: The results of statistical analysis using the Wilcoxon test obtained a P-value of 0.000 on anxiety levels. Conclusion: Acupressure depression points have an effect on the level of anxiety of pregnant women in the third trimester at Semarang.Keyword: Anxiety, Pregnant Women In The Third Trimester


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