scholarly journals Exploring gender differences among couples with unexplained recurrent pregnancy loss regarding preferences for supportive care

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
N. A. du Fossé ◽  
E. E. L. O. Lashley ◽  
T. T. Treurniet ◽  
J. M. M. van Lith ◽  
S. le Cessie ◽  
...  
Keyword(s):  
Supportive Care ◽  
Health Care Professionals ◽  
Pregnancy Loss ◽  
Recurrent Pregnancy Loss ◽  
Male Partner ◽  
First Trimester ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Care Services ◽  
Men Health

Abstract Background International guidelines recommend to offer supportive care during a next pregnancy to couples affected by recurrent pregnancy loss (RPL). In previous research, several options for supportive care have been identified and women’s preferences have been quantified. Although it is known that RPL impacts the mental health of both partners, male preferences for supportive care have hardly been explored. Methods A cross-sectional study was conducted in couples who visited a specialized RPL clinic in the Netherlands between November 2018 and December 2019. Both members of the couples received a questionnaire that quantified their preferences for supportive care in a next pregnancy and they were asked to complete this independently from each other. Preferences for each supportive care option were analysed on a group level (by gender) and on a couple level, by comparing preferences of both partners. Results Ninety-two questionnaires (completed by 46 couples) were analysed. The overall need for supportive care indicated on a scale from 1 to 10 was 6.8 for men and 7.9 for women (P = 0.002). Both genders preferred to regularly see the same doctor with knowledge of their obstetric history, to make a plan for the first trimester and to have frequent ultrasound examinations. A lower proportion of men preferred a doctor that shows understanding (80% of men vs. 100% of women, P = 0.004) and a doctor that informs on wellbeing (72% vs. 100%, P = ≤0.000). Fewer men preferred support from friends (48% vs. 74%, P = 0.017). Thirty-seven percent of men requested more involvement of the male partner at the outpatient clinic, compared to 70% of women (P = 0.007). In 28% of couples, partners had opposing preferences regarding peer support. Conclusions While both women and men affected by RPL are in need of supportive care, their preferences may differ. Current supportive care services may not entirely address the needs of men. Health care professionals should focus on both partners and development of novel supportive care programs with specific attention for men should be considered.

scholarly journals What Do Men Want? Exploring Gender Differences in Supportive Care Preferences of Couples With Recurrent Pregnancy Loss

2021 ◽  
Author(s):  
NA du Fossé ◽  
EELO Lashley ◽  
TT Treurniet ◽  
JMM van Lith ◽  
S le Cessie ◽  
...  
Keyword(s):  
Supportive Care ◽  
Health Care Professionals ◽  
Pregnancy Loss ◽  
Recurrent Pregnancy Loss ◽  
Male Partner ◽  
First Trimester ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Care Services ◽  
Men Health

Abstract Background International guidelines recommend to offer supportive care during a next pregnancy to couples affected by recurrent pregnancy loss (RPL). In previous research, several options for supportive care have been identified and women’s preferences have been quantified. Although it is known that RPL impacts the mental health of both partners, male preferences for supportive care have hardly been explored. Methods A cross-sectional study was conducted in couples who visited a specialized RPL clinic in the Netherlands between November 2018 and December 2019. Both members of the couples received a questionnaire that quantified their preferences for supportive care in a next pregnancy and they were asked to complete this independently from each other. Preferences for each supportive care option were analyzed on a group level (by gender) and on a couple level, by comparing preferences of both partners. Results Ninety-two questionnaires (completed by 46 couples) were analyzed. The overall need for supportive care indicated on a scale from 1-10 was 6.8 for men and 7.9 for women (P = 0.002). Both genders preferred to regularly see the same doctor with knowledge of their obstetric history, to make a plan for the first trimester and to have frequent ultrasound examinations. A lower proportion of men preferred a doctor that shows understanding (80% of men vs. 100% of women, P = 0.004) and informs on wellbeing (72% vs. 100%, P = ≤0.000). Fewer men preferred support from friends (48% vs. 74%, P = 0.017). Thirty-seven percent of men requested more involvement of the male partner at the outpatient clinic, compared to 70% of women (P = 0.007). In 28% of couples, one partner desired peer support, while the other partner did not prefer this.Conclusions While both women and men affected by RPL are in need of supportive care, their preferences may differ. Current supportive care services may not entirely address the needs of men. Health care professionals should focus on both partners and development of novel supportive care programs with specific attention for men should be considered.

scholarly journals Prevalence and Determinants of Adequate Compliance with Antenatal Care in Peru

2021 ◽  
Vol 43 (06) ◽  
pp. 442-451
Author(s):  
Cesar Tello-Torres ◽  
Akram Hernández-Vásquez ◽  
Karla F. Dongo ◽  
Rodrigo Vargas-Fernández ◽  
Guido Bendezu-Quispe
Keyword(s):  
Antenatal Care ◽  
Health Care Professionals ◽  
Age Groups ◽  
Family Health ◽  
Wealth Quintile ◽  
First Trimester ◽  
Sociodemographic Factors ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
First Trimester Of Pregnancy

Abstract Objective To determine the adequacy of compliance with antenatal care (ANC) by pregnant women in Peru and to identify the associated factors. Methods An analytical cross-sectional study of data from the 2019 Peruvian Demographic and Family Health Survey (Encuesta Demográfica y de Salud Familiar, ENDES, in Spanish) was conducted. The dependent variable was adequate compliance with ANC (provided by skilled health care professionals; first ANC visit during the first trimester of pregnancy; six or more ANC visits during pregnancy; ANC visits with appropriate content) by women aged 15 to 49 years in their last delivery within the five years prior to the survey. Crude and adjusted prevalence ratios and their 95% confidence intervals were calculated using a log-binomial regression model. Results A total of 18,386 women were analyzed, 35.0% of whom adequately complied with ANC. The lowest proportion of compliance was found with the content of ANC (42.6%). Sociodemographic factors and those related to pregnancy, such as being in the age groups of 20 to 34 years and 35 to 49 years, having secondary or higher education, belonging to a wealth quintile of the population other than the poorest, being from the Amazon region, not being of native ethnicity, having a second or third pregnancy, and having a desired pregnancy, increased the probability of presenting adequate compliance with ANC. Conclusion Only 3 out of 10 women in Peru showed adequate compliance with ANC. Compliance with the content of ANC must be improved, and strategies must be developed to increase the proportion of adequate compliance with ANC.

scholarly journals Utilization of antenatal care services and factors affecting antenatal care visits in Pokhara sub-metropolitan city

2020 ◽  
Vol 3 (1) ◽  
Author(s):  
Sabita Paudel ◽  
Tarun Paudel ◽  
Seshananda Sanjel
Keyword(s):  
Antenatal Care ◽  
Rural Areas ◽  
Nuclear Family ◽  
First Trimester ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Factors Affecting ◽  
Face To Face ◽  
Metropolitan City ◽  
Care Services

Background: In context of Nepal, although pregnant women from city areas contribute to maternal mortality, evidence of the study of utilization of antenatal care services and factors affecting antenatal care visits (ANC) are focused in rural areas where health institutions are not easily available. The objective of this study was to identify ANC services utilization by eligible women in Pokhara sub-metropolitan city. Methods: This was a cross-sectional study conducted applying face to face interviews with 240 eligible women bearing at least one youngest child below the age of two years. A structured and semi-structured questionnaire was used after translating into the Nepali language and pretesting it in the field. Data entered in Microsoft excel were transferred in SPSS (Statistical package for social sciences) version 21 and analysis were carried out. Both descriptive and inferential statistics were computed. The significance was set at the 0.05 level. Results: Approximately 97.0% of women had visited ANC during their recent pregnancy and about 56.0% of women had ≥4 ANC visits. The majority (80.3%) of the women used to seek ANC checkups during their first trimester and nearly half (49.0%) of the respondents belonged to the younger age of 15-19 years. Women’s (99.0%) and her husbands’ (86.0%) educational level significantly impacted ANC visits. Women having fewer numbers of children (98.0%) and the nuclear family (99.0%) had significantly higher ANC visits. Husbands’and mother-in-laws’ encouragement to go for ANC visits was significantly higher. All of the above-mentioned parameters were statistically significant at p< 0.05 level. Conclusions: There was variation in ANC service taking as per the encouragement from the husband and mother-in-law of the woman. Hence, awareness programs targeting husband and mother-in-law regarding the importance of ANC services are suggested. Conduction of detailed study in the future to explore the quality of services is recommended.

Analysis of the cause of recurrent pregnancy loss in Vietnam: A cross-sectional study

2017 ◽  
Vol 39 (4) ◽  
pp. 463-471 ◽  
Author(s):  
Thi Anh Dao Le ◽  
Duy Anh Nguyen ◽  
Thanh Van Ta ◽  
Van Minh Hoang
Keyword(s):  
Pregnancy Loss ◽  
Recurrent Pregnancy Loss ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Cross Sectional

scholarly journals MEDICATIONS USED BY PREGNANT WOMEN: ANY SAFETY CONCERNS?

2017 ◽  
Vol 9 (5) ◽  
pp. 100
Author(s):  
Jey Vonn Kho ◽  
Siew Siang Chua ◽  
Rita Mohan Dallumal ◽  
Siti Zawiah Omar
Keyword(s):  
Pregnant Women ◽  
Health Care Professionals ◽  
First Trimester ◽  
Antenatal Clinic ◽  
The United States ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Face To Face ◽  
Major Teaching Hospital ◽  
Major Teaching

Objective: The use of medications during pregnancy may impose a potential risk to the fetus. Therefore, this study was conducted to determine the prevalence and safety of medications used by pregnant women.Methods: A cross-sectional study was conducted on pregnant women who attended the antenatal clinic of a major teaching hospital in Malaysia, from January to April 2013. Data was collected via face-to-face interviews using a structured questionnaire.Results: Of the 500 respondents in this study, 62% (95% confidence interval, CI: 57.7%, 66.3%) used at least one medication during their pregnancy and 30.8% (95% CI: 26.8%, 34.8%) took the medications during the first trimester. The classes of medications commonly used were analgesics (26.8%), followed by cough and cold medications (18.6%) and medications for gastrointestinal disorders (11.8%). Among the 697 medications used by the respondents during pregnancy, most of them were relatively safe, with approximately 50% being classified under the Food and Drug Administration of the United States (FDA, US)-assigned pregnancy category B. However, seven potentially teratogenic medications were identified, including four antiepileptic drugs and an antimigraine medication which contained ergotamine.Conclusion: This study found that a high proportion of pregnant woman consumed at least one medication during their pregnancy. The use of antimigraine medications containing ergotamine in pregnant women is of major concern as this medication could be obtained without a prescription in some countries, including in Malaysia. Therefore, it is essential for health care professionals to educate and counsel pregnant women on the safety of medications used.

scholarly journals Evaluation of the uterine cavity by office hysteroscopy in patients with infertility and recurrent pregnancy loss: a cross sectional study

2018 ◽  
Vol 8 (1) ◽  
pp. 200
Author(s):  
Abo Bakr A. Mitwally ◽  
Esraa Y. Badran ◽  
Tamer Arby ◽  
Ahmed M. Abbas ◽  
Ahmed Nasr ◽  
...  
Keyword(s):  
Pregnancy Loss ◽  
Recurrent Pregnancy Loss ◽  
Transvaginal Ultrasound ◽  
Uterine Cavity ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Office Hysteroscopy ◽  
Secondary Infertility ◽  
Cross Sectional ◽  
Endometrial Polyps

Background: The aim of the present study is to determine role of hysteroscopy in women presented with primary or secondary infertility and in women presented with recurrent pregnancy loss.Methods: This cross-sectional study was conducted at Obstetrics and Genecology Department, Women Health Hospital Assiut University, Egypt from October 2016 to February 2018. Reproductive aged women who are suspected as having intrauterine pathology, such as submucosal myoma, endometrial polyps or other endometrial pathological findings based on the transvaginal ultrasound were enrolled. All patients were scheduled for office hysteroscopy as an outpatient. An informed consent was obtained prior to participation in the study.Results: Hysteroscopy was performed in 139 infertile women and 41 cases of repeated pregnancy loss. With regard to infertile patients; 67.6% of the patients had normal findings, 10.1% of the patients had intrauterine adhesion, 8.6% of the patients had intrauterine polyp. 5.8% of the patients had septate uterus and 3.6% of the patients had depressed fundus. With regard to patients with recurrent pregnancy loss; 51.2% of the patients had normal findings, 21.9% of the patients had partial septum, 9.8% of patients had intrauterine adhesions, 7.3% of patients had intrauterine polyp and 4.9% of the patients had submucous myoma.Conclusions: It was concluded that hysteroscopy should be considered as routine investigation in evaluation of women with primary and secondary infertility.

scholarly journals Prevalence of Thyroid Autoimmunity in Women with Recurrent Pregnancy Loss

Medicina ◽  
2021 ◽  
Vol 57 (2) ◽  
pp. 96
Author(s):  
Myrna Souraye Godines-Enriquez ◽  
Silvia Miranda-Velásquez ◽  
María Magdalena Enríquez-Pérez ◽  
Lidia Arce-Sánchez ◽  
Nayeli Martínez-Cruz ◽  
...  
Keyword(s):  
Clinical Characteristics ◽  
Pregnancy Loss ◽  
Recurrent Pregnancy Loss ◽  
Thyroid Autoimmunity ◽  
Cross Sectional Study ◽  
Thyroid Peroxidase ◽  
Cross Sectional ◽  
Increased Risk ◽  
Significant Difference ◽  
Thyroid Profile

Background and objectives: Thyroid autoimmunity (TAI) has been associated with a significantly increased risk of miscarriage in women with recurrent pregnancy loss (RPL). The aim of this study was to determine the prevalence of TAI in women with RPL and compare the clinical characteristics of positive and negative TAI women. Materials and Methods: This is a retrospective cross-sectional study; 203 women with RPL were included. Thyroid profile, anti-thyroid peroxidase (TPO-Ab), and anti-thyroglobulin (TG-Ab) antibodies were measured in all participants. Clinical characteristics and causes of RPL were compared between positive and negative TAI. Results: Prevalence of TAI was 14.8%; prevalence of positive TPO-Ab and TG-Ab was 12.3% and 4.9%, respectively. Women with TAI had significantly higher concentrations of thyrotropin (TSH) compared to women without TAI (4.8 ± 3.8 versus 3.1 ± 1.1, p = 0.001). There was no significant difference in age, the number of gestations, miscarriages, state of antiphospholipid antibodies (aPL), or causes of RPL between women that were TAI-positive versus TAI-negative. Prevalence of positive TAI by cause of RPL was: endocrine 7/25 (28%), genetic 1/5 (20%), autoimmune 1/5 (20%), anatomic 8/55 (14.5%), and unexplained cause 13/112 (11.6%). Conclusions: The prevalence of TAI in women with RPL is 14.8%. Women with an endocrine cause have the highest prevalence of TAI.

scholarly journals The Rate of Pregnancy Loss in Von Willebrand Disease: A Cross-Sectional Study

Blood ◽  
2014 ◽  
Vol 124 (21) ◽  
pp. 2843-2843
Author(s):  
Leslie Skeith ◽  
Natalia Rydz ◽  
M. Dawn Goodyear ◽  
Man-Chiu Poon
Keyword(s):  
Pregnancy Loss ◽  
First Trimester ◽  
Cross Sectional Study ◽  
Von Willebrand Disease ◽  
Control Group ◽  
Cross Sectional ◽  
Postpartum Bleeding ◽  
Bleeding Score ◽  
Von Willebrand ◽  
And Control

Pregnancy and delivery represent a major hemostatic challenge in von Willebrand disease (VWD). In addition to maintaining adequate hemostasis, von Willebrand factor (VWF) is an important regulator of angiogenesis, with angiodysplasia contributing to morbidity in patients with VWD. Placental development is complex, with vascular development important for fetal growth and viability. It has been hypothesized that antepartum bleeding or abnormal placental angiogenesis may lead to pregnancy loss in women with VWD. Large studies have reported an increased risk of postpartum bleeding in patients with VWD, however, little information is available for rates of pregnancy loss. We conducted a cross-sectional study to determine the rate of pregnancy loss in women with VWD, when compared to a control population. We invited all women with VWD followed by the Southern Alberta Rare Blood and Bleeding Disorders Comprehensive Care Program to participate in an online or paper questionnaire, along with a control group of women without VWD identified through a low-risk obstetrical clinic in Calgary, Alberta. We included patients who were 18 years of age or older with a diagnosis of VWD, defined as VWF antigen and activity levels less than 50 percent or a historical diagnosis, in combination with a bleeding score of 4 or more (condensed MCMDM-1 bleeding questionnaire). Patients were excluded if they had no past pregnancies, no mailing address, or had an alternative bleeding disorder. Our 20-item questionnaire was reviewed and pre-tested by hematologists, obstetricians and laypeople. With patient consent, data was supplemented from clinical and hospital records to verify and expand on the information collected in the questionnaire. The primary outcome was the incidence of spontaneous abortion (fetal loss <20 weeks) or late pregnancy loss (≥20 weeks) in women with VWD. The secondary outcomes were antepartum and postpartum bleeding. Data on co-morbidities including placental abnormalities were also collected. Confidence intervals for proportions were calculated using the Wilson’s score method. Groups were compared using χ2 testing, with p values < 0.05 considered significant. Of the 98 women with VWD who met the study inclusion criteria, 31 (32%) completed the questionnaire. The mean bleeding score was 10.3 in VWD patients (SD 3.6). The majority (81%) of participants were diagnosed with Type 1 VWD, with 16% and 3% diagnosed as Type 2 and 3 VWD, respectively. Twenty-two women in the control group completed the questionnaire. The mean age at recruitment was 46.1 (SD 13.7) and 32.6 (SD 4.2) in the VWD and control group, respectively. There were 83 and 48 pregnancies in the VWD and control group, respectively. Two women in the VWD group and 1 woman in the control group had an elective pregnancy termination. In women with VWD, the rate of pregnancy loss was 24.7% out of 81 pregnancies (95% confidence interval 16.6-35.1), with 17 (85%) losses occurring less than 20 weeks, and 3 (15%) with unknown timing. In contrast, the rate of pregnancy loss in the control group was 12.8% (95% CI 5.96-25.17) (p=0.106), all occurring less than 20 weeks. In 83 pregnancies, the number of antepartum bleeding episodes in VWD women was 45 (29 first trimester, 9 second trimester, 7 third trimester), compared to the control group (9 first trimester, 3 second trimester, 1 third trimester) in 48 pregnancies. More women with VWD reported excessive postpartum bleeding compared to controls (56.7% versus 13.6%, p=0.002), with more delayed (>24 hour) bleeding post-delivery in women with VWD. In VWD women with and without pregnancy loss, there was no difference in mean bleeding score (9.7 vs. 10.9). There was also no difference in cases of pre-eclampsia, placental abruption or gestational hypertension in VWD women with and without pregnancy loss. Two VWD patients with previous pregnancy loss developed gastrointestinal angiodysplasia later in life. There was no significant increase in the rate of pregnancy loss in women with VWD, however, a larger cohort study is needed to confirm the rate of pregnancy loss before further conclusions can be made. Disclosures No relevant conflicts of interest to declare.

scholarly journals Association Between PON1 (L55M and Q192R) Genetic Polymorphism and Recurrent Pregnancy Loss in North Indian Women Exposed to Pesticides

2021 ◽  
Vol 43 (11) ◽  
pp. 805-810
Author(s):  
Shyam Pyari Jaiswar ◽  
Apala Priyadarshini ◽  
Apurva Singh ◽  
Mohd Kalim Ahmad ◽  
Sujata Deo ◽  
...  
Keyword(s):  
Genetic Polymorphism ◽  
Pregnancy Loss ◽  
Recurrent Pregnancy Loss ◽  
Pcr Amplification ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Indian Women ◽  
Increased Risk ◽  
Polymerase Chain ◽  
Pon1 Polymorphisms

Abstract Objective The aim of the present study was to examine the relation between the PON1 polymorphisms and recurrent pregnancy loss (RPL). Methods In a cross-sectional study, blood samples were collected from 100 females. DNA was extracted and PON1 genotypes were determined by polymerase chain reaction (PCR) amplification. Results Regarding PON1 L55M, the mutated allele (M) frequency was found in 70.5% in RPL and in 53.5% in controls; the M allele was significantly associated with an increased risk of RPL (adjusted odds ratio [ORadj] = 2.07; 95% confidence interval [CI]; p < 0.001). However, regarding PON1 Q192R, the R mutated allele frequency was found in 28.5% in RPL and in 33% in controls. The R allele did not show any risk for RPL (ORadj 0.81; 95%CI; p = 0.329). Conclusion The present study suggests that there is an effect of genetic polymorphism on RPL and provides additional evidence that combines with the growing information about the ways in which certain PON1 genotypes can affect the development of the fetus in the uterus.

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