Understanding barriers preventing pregnant women from starting antenatal clinic in the first trimester of pregnancy in Ntcheu District-Malawi

Introduction: In the early stages of pregnancy, ultrasound is an extremely specific method for examination. This article reviews how the normal development of a baby in the first trimester of pregnancy relates to ultrasound findings. Aim: To highlight the importance of routine ultrasonography in the first trimester of pregnancy in detecting and dating gestation, its viability and early detection of anomalies and complications Methods: This descriptive study involved 100 pregnant women within 12 weeks of gestation attending antenatal clinic at Saveetha Medical college, during the study period Inclusion Criteria: Pregnant women with history of amenorrhea <12 weeks of gestation. Exclusion criteria: Individuals with history of pain abdomen and bleeding per vaginum Results: A total of 99 pregnancies were intrauterine of which 1 was anembryonic and 2 had early pregnancy failure, 15 pregnancies were redated. One ectopic and one fibroid complicating pregnancy were aslo found. Conclusion: Ultrasonography is an effective method to detect and date pregnancy, identify nonviable pregnancies, fetal abnormalities and early trimester complications. Hence it is ideal to use it routinely as screening tool during the first trimester of pregnancy.

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Factors associated with the delay in seeking first antenatal care service among pregnant women at Katutura state hospital, Khomas region

International Journal of Medicine ◽

10.14419/ijm.v5i1.7152 ◽

2017 ◽

Vol 5 (1) ◽

pp. 37 ◽

Cited By ~ 1

Author(s):

Nghitanwa Emma Maano ◽

Shanyengange Tuwilika. N.

Keyword(s):

Antenatal Care ◽

Pregnant Women ◽

State Hospital ◽

Care Service ◽

First Trimester ◽

Antenatal Clinic ◽

Long Distance ◽

Factors Associated ◽

Care Services ◽

First Trimester Of Pregnancy

The purpose of this study was to identify the factors associated with the delay in seeking first antenatal care (ANC) service among pregnant women at Katutura state hospital, Khomas region. A qualitative, explorative and descriptive design was used to gain the data from pregnant women started first antenatal care later than twelve weeks of gestation.Data was collected through in-depth interview among pregnant women during their first visit at Katutura state hospital antenatal clinic, Khomas region. The data analysis was done in line with thematic analysis and themes and sub-themes were identified.The study findings concluded that most pregnant women attend their first ANC later than twelve weeks gestation because of work commitment, long distance to health facilities, and lack of knowledge about the important of starting ANC in first trimester of pregnancy.The study recommends the establishment and implementation of a community based health education programs about the antenatal care services in order to create awareness and knowledge in the community about the importance of starting antenatal care services during the first trimester of pregnancy.

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Antibiotic Prescriptions among China Ambulatory Care Visits of Pregnant Women: A Nationwide Cross-Sectional Study

Antibiotics ◽

10.3390/antibiotics10050601 ◽

2021 ◽

Vol 10 (5) ◽

pp. 601

Author(s):

Houyu Zhao ◽

Mei Zhang ◽

Jiaming Bian ◽

Siyan Zhan

Keyword(s):

Pregnant Women ◽

Ambulatory Care ◽

National Level ◽

Mainland China ◽

Antibiotic Use ◽

First Trimester ◽

Cross Sectional Study ◽

Cross Sectional ◽

Fetal Safety ◽

First Trimester Of Pregnancy

Background: Antibiotic use in pregnant women at the national level has rarely been reported in China. Objectives: We aimed to investigate antibiotic prescriptions during pregnancy in ambulatory care settings in China. Methods: Data of 4,574,961 ambulatory care visits of pregnant women from October 2014 to April 2018 were analyzed. Percentages of Antibiotic prescriptions by different subgroups and various diagnosis categories and proportions of inappropriate antibiotic prescriptions for different subgroups were estimated. Food and Drug Administration (FDA) pregnancy categories were used to describe the antibiotic prescription patterns. The 95% confidence intervals (CIs) were estimated using the Clopper––Pearson method or Goodman method. Results: Among the 4,574,961 outpatient visits during pregnancy, 2.0% (92,514 visits; 95% CI, 2.0–2.0%) were prescribed at least one antibiotic. The percentage of antibiotic prescriptions for pregnant women aged >40 years was 4.9% (95% CI, 4.7–5.0%), whereas that for pregnant women aged 26–30 years was 1.5% (95% CI, 1.4–1.5%). In addition, percentages of antibiotic prescriptions varied among different trimesters of pregnancy, which were 5.4% (95% CI, 5.3–5.4%) for the visits in the first trimester of pregnancy and 0.5% (95% CI, 0.4–0.5%) in the third trimester of pregnancy. Furthermore, the percentages of antibiotic prescriptions substantially varied among different diagnosis categories and nearly three-quarters of antibiotic prescriptions had no clear indications and thus might be inappropriate. In total, 130,308 individual antibiotics were prescribed; among these, 60.4% (95% CI, 60.0–60.8%) belonged to FDA category B, 2.7% (95% CI, 2.1–3.5%) were classified as FDA category D and 16.8% (95% CI, 16.2–17.4%) were not assigned any FDA pregnancy category. Conclusions: Antibiotic prescriptions in ambulatory care during pregnancy were not highly prevalent in mainland China. However, a substantial proportion of antibiotics might have been prescribed without adequate indications. Antibiotics whose fetal safety has not been sufficiently illustrated were widely used in pregnant women.

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Malarial Infection in HIV Infected Pregnant Women Attending a Rural Antenatal Clinic in Nigeria

Advances in Epidemiology ◽

10.1155/2014/694213 ◽

2014 ◽

Vol 2014 ◽

pp. 1-6 ◽

Cited By ~ 1

Author(s):

R. S. Houmsou ◽

B. E. Wama ◽

S. O. Elkanah ◽

L. C. Garba ◽

T. D. Hile ◽

...

Keyword(s):

Risk Factors ◽

Haemoglobin Level ◽

Pregnant Women ◽

Rural Areas ◽

First Trimester ◽

Antenatal Clinic ◽

Severe Anaemia ◽

Sub Saharan Africa ◽

Malarial Infection ◽

Sub Saharan

Malaria still remains a challenging infection affecting the lives of several HIV infected pregnant women in sub-Saharan Africa. This study was undertaken to determine malarial infection in HIV infected pregnant women in relation to sociodemographic and obstetrical factors. The study also assessed relationship between malarial infection and haemoglobin level, CD4+ counts, and ART regimen, as well as predisposing risk factors that influenced occurrence of malarial infection in the women. Thick and thin blood smears were prepared and stained with Giemsa. Haemoglobin level was determined using a hematology analyzer, while the flow cytometry was used to measure CD4+ counts. Sociodemographic and obstetrical parameters were obtained through the administration of questionnaires. Of the 159 HIV infected pregnant women examined, 33.3% (59/159) had malarial infection. Malarial infection was significantly higher in pregnant women who were divorced, 40.24% (33/82) (χ2=5.72; P=0.05), were at their first trimester (4–12 weeks), 54.8% (17/31) (χ2=14.85; P=0.01), had CD4+ = [201–500 cells/μL], 42.42% (42/99) (χ2=10.13; P=0.00), and those that had severe anaemia (<8 dg/L), 100.00% (χ2= 45.75; P=0.00). However, risk factors that influenced the occurrence of malarial infection in the pregnant women were occupation (farming) (AOR=0.226; P=0.03), marital status (divorced) (AOR=2.80; P=0.02), gestation (first trimester) (AOR=0.33; P=0.00), haemoglobin level (Hb < 8 dg/L) (AOR=0.02; P=0.00), and CD4+ counts (low CD4+) (OR=0.40; P=0.05). The study reported endemicity of malaria in HIV infected pregnant women living in rural areas of Benue State, Nigeria. Malarial infection was higher in women that were divorced, and at their first trimester, had low CD4+ count, and had severe anaemia. Farming, divorce, gestation, severe anaemia, and low CD4+ counts were predisposing risk factors that influenced malaria occurrence in the HIV infected pregnant women. It is advocated that HIV infected pregnant women should be properly and thoroughly educated on malaria preventive measures in rural areas so as to avoid unpleasant effect of malaria during their pregnancies.

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Adequacy and Sources of Protein Intake among Pregnant Women in the United States, NHANES 2003–2012

Nutrients ◽

10.3390/nu13030795 ◽

2021 ◽

Vol 13 (3) ◽

pp. 795

Author(s):

Mary M. Murphy ◽

Kelly A. Higgins ◽

Xiaoyu Bi ◽

Leila M. Barraj

Keyword(s):

Pregnant Women ◽

Protein Intake ◽

First Trimester ◽

The United States ◽

Limited Information ◽

Health And Nutrition ◽

Animal Source ◽

Usual Intake ◽

First Trimester Of Pregnancy ◽

Using Data

Limited information is available on protein intake and adequacy of protein intake among pregnant women. Using data from a sample of 528 pregnant women in the National Health and Nutrition Examination Surveys (NHANES) 2003–2012, usual intake of protein (g/day and g/kg body weight (bw)/day) and prevalence of intake below the Estimated Average Requirement (EAR) by trimester of pregnancy were calculated using the National Cancer Institute method. Percent contributions to protein intake by source (i.e., plant and animal, including type of animal source) were also calculated. Mean usual intake of protein was 88 ± 4.3, 82 ± 3.1, and 82 ± 2.9 g/day among women in trimester 1, 2, and 3 of pregnancy, respectively, or 1.30 ± 0.10, 1.35 ± 0.06, and 1.35 ± 0.05 g/kg bw/day, respectively. An estimated 4.5% of women in the first trimester of pregnancy consumed less protein than the EAR of 0.66 g/kg bw/day; among women in the second and third trimesters of pregnancy, 12.1% and 12.8% of women, respectively, consumed less protein than the EAR of 0.88 g/kg bw/day. Animal sources of protein accounted for approximately 66% of total protein. Findings from this study show that one in eight women in the second and third trimesters of pregnancy have inadequate intake of protein. Pregnant women should be encouraged to consume sufficient levels of protein from a variety of sources.

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AYURVEDIC MANAGEMENT OF GARBHINI CHARDI (Emesis Gravidarum) WITH CHATURJATA CHOORNA (CHATURJATA POWDER) - A PILOT STUDY

November 2020 - International Ayurvedic Medical Journal ◽

10.46607/iamj0308072020 ◽

2020 ◽

Vol 8 (9) ◽

pp. 4317-4323

Author(s):

Priyanka 1 ◽

Shreyes. S ◽

Yogitha Bali M.R

Keyword(s):

Pilot Study ◽

Pregnant Women ◽

First Trimester ◽

Nausea And Vomiting ◽

Morning Sickness ◽

Excessive Salivation ◽

First Trimester Of Pregnancy ◽

Rice Water ◽

Single Blind

Background: During pregnancy many demands are made by growing fetus, to meet these requirements maternal system has to undergo certain changes. Garbhinichardi (Emesis Gravidarum) is one among them and this has been termed as Gruhita Garbha Lakshanas (Immediate signs of conception) in Ayurvedic clas-sics. Approximately 80 % of pregnant women experience excessive salivation, nausea and vomiting during pregnancy, commonly known as “morning sickness”, which is seen frequently throughout the day. Design: This is single blind pilot study. 30 patients with complaints of Garbhinichardi (Emesis Gravidarum) in first trimester were included in this study. Patients were given Chaturjatachurna (Chatutjata powder)for a peri-od of 2 weeks in dose of 3gms thrice a day after meal with Anupana (Adjuvant) as Madhu (honey) of 5ml mixed with Tandulodaka (Raw rice water) Results: This pilot study showed statistically significant changes with Chaturjatachurna in reducing the complaints of pregnant women such as nausea (p<0.001), vomiting (p<0.001) and Aruchi (Anorexia) (p<0.001) in their first trimester of pregnancy. Conclusion: Chaturjata-churna was effective in the management of Garbhini Chardi (Emesis Gravidarum) and other symptoms in the first trimester of pregnancy.

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Obstetrical and Neonatal Outcomes in Pregnant Women with Serum Thyroid-Stimulating Hormone (TSH) Levels >2.0 mU/Lvs.Those with TSH <2.0 in the First Trimester of Pregnancy

10.1210/endo-meetings.2011.part2.or6.or15-4 ◽

2011 ◽

pp. OR15-4-OR15-4

Author(s):

Shweta Achit ◽

Tapasya Dhar ◽

Kumkum Awasthi ◽

Bharti Uppal ◽

Jubbin Jagan Jacob

Keyword(s):

Pregnant Women ◽

First Trimester ◽

Thyroid Stimulating Hormone ◽

Neonatal Outcomes ◽

First Trimester Of Pregnancy ◽

Tsh Levels ◽

Stimulating Hormone

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Adverse pregnancy outcomes are associated with Plasmodium vivax malaria in a prospective cohort of women from the Brazilian Amazon

PLoS Neglected Tropical Diseases ◽

10.1371/journal.pntd.0009390 ◽

2021 ◽

Vol 15 (4) ◽

pp. e0009390

Author(s):

Jamille Gregório Dombrowski ◽

André Barateiro ◽

Erika Paula Machado Peixoto ◽

André Boler Cláudio da Silva Barros ◽

Rodrigo Medeiros de Souza ◽

...

Keyword(s):

Pregnant Women ◽

Pregnancy Outcomes ◽

Multivariate Logistic Regression Analysis ◽

Brazilian Amazon ◽

First Trimester ◽

Inflammatory Factors ◽

Anthropometric Measures ◽

First Trimester Of Pregnancy ◽

Adverse Pregnancy ◽

Angiopoietin 2

Background Malaria in Brazil represents one of the highest percentages of Latin America cases, where approximately 84% of infections are attributed to Plasmodium (P.) vivax. Despite the high incidence, many aspects of gestational malaria resulting from P. vivax infections remain poorly studied. As such, we aimed to evaluate the consequences of P. vivax infections during gestation on the health of mothers and their neonates in an endemic area of the Amazon. Methods and findings We have conducted an observational cohort study in Brazilian Amazon between January 2013 and April 2015. 600 pregnant women were enrolled and followed until delivery. After applying exclusion criteria, 329 mother-child pairs were included in the analysis. Clinical data regarding maternal infection, newborn’s anthropometric measures, placental histopathological characteristics, and angiogenic and inflammatory factors were evaluated. The presence of plasma IgG against the P. vivax (Pv) MSP119 protein was used as marker of exposure and possible associations with pregnancy outcomes were analyzed. Multivariate logistic regression analysis revealed that P. vivax infections during the first trimester of pregnancy are associated with adverse gestational outcomes such as premature birth (adjusted odds ratio [aOR] 8.12, 95% confidence interval [95%CI] 2.69–24.54, p < 0.0001) and reduced head circumference (aOR 3.58, 95%CI 1.29–9.97, p = 0.01). Histopathology analysis showed marked differences between placentas from P. vivax-infected and non-infected pregnant women, especially regarding placental monocytes infiltrate. Placental levels of vasomodulatory factors such as angiopoietin-2 (ANG-2) and complement proteins such as C5a were also altered at delivery. Plasma levels of anti-PvMSP119 IgG in infected pregnant women were shown to be a reliable exposure marker; yet, with no association with improved pregnancy outcomes. Conclusions This study indicates that P. vivax malaria during the first trimester of pregnancy represents a higher likelihood of subsequent poor pregnancy outcomes associated with marked placental histologic modification and angiogenic/inflammatory imbalance. Additionally, our findings support the idea that antibodies against PvMSP119 are not protective against poor pregnancy outcomes induced by P. vivax infections.

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Prevalence of thyroid disorders in pregnancy

International Journal of Reproduction Contraception Obstetrics and Gynecology ◽

10.18203/2320-1770.ijrcog20183401 ◽

2018 ◽

Vol 7 (9) ◽

pp. 3493

Author(s):

Sangeeta Pahwa ◽

Sabia Mangat

Keyword(s):

Pregnant Women ◽

Subclinical Hypothyroidism ◽

First Trimester ◽

Antenatal Clinic ◽

Fetal Outcome ◽

Overt Hypothyroidism ◽

Thyroid Disorders ◽

Subclinical Hyperthyroidism ◽

Thyroid Screening ◽

In Pregnancy

Background: Thyroid disorders are among the common endocrine problems in pregnant women. Often overlooked in pregnancy due to nonspecific symptoms and hyper-metabolic state of pregnancy. Western literature shows prevalence of hypothyroidism in pregnancy as 2.5% and hypothyroidism as 0.1-0.4%. There is paucity of data on prevalence of thyroid disorders in India pregnant population. This study was carried out to know prevalence of thyroid disorders in pregnant women in Indian population.Methods: One hundred pregnant women attending antenatal clinic in first trimester were registered. Detailed history and examination was done. Apart from routine basic and obstetrical investigations, TSH, FT3 and FT4 level estimation was done.Results: Prevalence of thyroid dysfunction was high in this study in first trimester pregnant women, with subclinical hypothyroidism in 6%, overt hypothyroidism in 2%, subclinical hyperthyroidism 2 % and overt hyperthyroidism 0%.Conclusions: Prevalence of thyroid disorders, especially subclinical hypothyroidism (6%), overt hypothyroidism (2%) and subclinical hyperthyroidism (2%) was high. To prevent adverse effects on maternal and fetal outcome, we are emphasizing the importance of routine antenatal thyroid screening.

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