Special footwear designed for pregnant women and its effect on kinematic gait parameters during pregnancy and postpartum period

Background D-dimer increases during pregnancy and is problematic to use in the diagnosis of venous thromboembolism. Fibrin monomer represents an alternative biomarker for venous thromboembolism. However, to be useful in pregnancy, the fibrin monomer concentration should be stable throughout pregnancy and during postpartum. Methods To describe the course of fibrin monomer concentration during pregnancy and the postpartum period in healthy pregnant women and to compare their within-subject biological variation (CVI) with non-pregnant women. Blood samples were obtained every fourth week during pregnancy and three samples after delivery in 20 healthy women and every fourth week during a 40-week period in 19 healthy non-pregnant women. Fibrin monomer (STA Liatest FM, Stago) was analysed in duplicates for all samples. Concentrations of fibrin monomer in pregnant and non-pregnant women were compared and the CVI for fibrin monomer was calculated. Results The median fibrin monomer concentration in pregnant women was 6.2 mg/L (2.5 and 97.5 percentiles 3.7–10.8 mg/L) and in non-pregnant women 4.8 mg/L (3.6–8.2) ( P < 0.01). The fibrin monomer concentration was relatively stable during pregnancy, although a few unexplained high fibrin monomer concentrations were found during pregnancy/postpartum. Fibrin monomer CVI in pregnancy and postpartum was 20.6% (95% CI 18.3, 23.5) and in non-pregnant 16.1% (13.7, 18.9). Conclusions For clinical purposes, fibrin monomer concentration can be considered stable during pregnancy, although it is slightly higher than in non-pregnant women. Pregnant and non-pregnant women have the same CVI. The suitability of fibrin monomer in venous thromboembolism diagnosis in pregnant women should be validated in further studies.

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Malaria and immunity during pregnancy and postpartum: a tale of two species

Parasitology ◽

10.1017/s0031182015000074 ◽

2015 ◽

Vol 142 (8) ◽

pp. 999-1015 ◽

Cited By ~ 23

Author(s):

A. R. D. McLEAN ◽

R. ATAIDE ◽

J. A. SIMPSON ◽

J. G. BEESON ◽

F. J. I. FOWKES

Keyword(s):

Plasmodium Falciparum ◽

Pregnant Women ◽

Postpartum Period ◽

Epidemiological Data ◽

Physiological Changes ◽

Risk Of Infection ◽

Increased Risk ◽

Pregnancy And Postpartum ◽

Compare And Contrast ◽

In Pregnancy

SUMMARYIt is well established that pregnant women are at an increased risk ofPlasmodium falciparuminfection when compared to non-pregnant individuals and limited epidemiological data suggestPlasmodium vivaxrisk also increases with pregnancy. The risk ofP. falciparumdeclines with successive pregnancies due to the acquisition of immunity to pregnancy-specificP. falciparumvariants. However, despite similar declines inP. vivaxrisk with successive pregnancies, there is a paucity of evidenceP. vivax-specific immunity. Cross-species immunity, as well as immunological and physiological changes that occur during pregnancy may influence the susceptibility to bothP. vivaxandP. falciparum. The period following delivery, the postpartum period, is relatively understudied and available epidemiological data suggests that it may also be a period of increased risk of infection toPlasmodiumspp. Here we review the literature and directly compare and contrast the epidemiology, clinical pathogenesis and immunological features ofP. vivaxandP. falciparumin pregnancy, with a particular focus on studies performed in areas co-endemic for both species. Furthermore, we review the intriguing epidemiology literature of bothP. falciparumandP. vivaxpostpartum and relate observations to the growing literature pertaining to malaria immunology in the postpartum period.

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Prophylaxis and management of venous thromboembolism during pregnancy and postpartum period

Obstetrics Gynecology and Reproduction ◽

10.17749/2313-7347/ob.gyn.rep.2021.222 ◽

2021 ◽

Vol 15 (5) ◽

pp. 599-616

Author(s):

V. Ya. Khryshchanovich ◽

N. Ya. Skobeleva

Keyword(s):

Risk Factors ◽

Venous Thromboembolism ◽

Pregnant Women ◽

Postpartum Period ◽

Anticoagulation Therapy ◽

Total Duration ◽

Factor Xa ◽

Pregnancy And Postpartum ◽

Routine Administration ◽

History Of

Introduction. Venous thromboembolism (VTE) is one of the lead causes for maternal mortality and morbidity during pregnancy in the majority of developed countries. The incidence rate of VTE per pregnancy-year increases during pregnancy and postpartum period about by 4-fold and at least 14-fold, respectively.Aim: to analyze and summarize current view on risk factors of thrombotic events during gestation and to discuss recent guidelines for the management of venous thromboembolic complications during pregnancy and postpartum, by taking into account a balance between risks and benefits of using anticoagulants.Materials and Methods. The literature search covering the last 10 years was carried out in the electronic scientific databases RSCI, PubMed/MEDLINE, and Embase. While formulating a search strategy for evidence-based information, the PICO method (P = Patient; I = Intervention; C = Comparison; O = Outcome) and the key terms “venous thromboembolism” and “pregnancy” were used.Results. Risk factors were found to include a personal history of VTE, verified inherited or acquired thrombophilia, a family history of VTE and general medical conditions, such as immobilization, overweight, varicose veins, some hematological diseases and autoimmune disorders. VTE is considered being potentially preventable upon prophylactic administration of anticoagulants, but no high confidence randomized clinical trials comparing diverse strategies of thromboprophylaxis in pregnant women have been proposed so far. Because heparins do not cross the placenta, weight-adjusted therapeutic-dose low molecular weight heparins (LMWH) represent the anticoagulant treatment of choice for VTE during pregnancy. Once- and twice-daily dosing regimens are acceptable. However, no evidence suggesting benefits for measurement of factor Xa activities and consecutive LMWH dose adjustments to improve clinical outcomes are available. In case of uncomplicated pregnancy-related VTE, no routine administration of vitamin K antagonists, direct thrombin or factor Xa inhibitors, fondaparinux, or danaparoid is recommended. Lactating women may switch from applying LMWH to warfarin. Anticoagulation therapy should be continued for 6 weeks postpartum with total duration lasting at least for 3 months.Conclusion. VTE is a challenging task in pregnant women expecting to apply a multi-faceted approach for its efficient solution by taking into account updated recommendations and personalized patient-oriented features.

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Effect of Gestational Diabetes on Serum Leptin during Pregnancy and Postpartum Period

The International Journal of Frontier Sciences ◽

10.37978/tijfs.v5i1.315 ◽

2020 ◽

Vol 5 (1) ◽

Author(s):

Jazib Andleeb ◽

Faiza Mehboob ◽

Sana Javaid ◽

Mudassar Ali ◽

Muhammad Imran Khan ◽

...

Keyword(s):

Insulin Resistance ◽

Gestational Diabetes ◽

Pregnant Women ◽

Postpartum Period ◽

Serum Insulin ◽

Homa Index ◽

Fasting Serum ◽

Serum Leptin ◽

Positive Correlation ◽

Pregnancy And Postpartum

Background: Gestational diabetes mellitus (GDM) is associated with marked increase in insulin resistance. The objective of study is to determine the relation of gestational diabetes with serum leptin and serum insulin levels during pregnancy and postpartum period. Methods: This case control study conducted on total ninety samples that include cases and controls taken after 24 weeks of gestation. The case sample included 40 pregnant women with GDM and 10 women with GDM at postpartum stage. The control sample included 30 normal pregnant women with no GDM and 10 normal women at postpartum. Fasting serum leptin and fasting serum insulin were measured by ELISA. HOMA index was calculated by fasting serum insulin and fasting blood glucose. Results: Serum leptin (30.89 ± 1.35), serum insulin (27.67 ± 1.32) and HOMA index (8.33 ± 0.53) significantly high in gestational diabetic women than normal pregnant (p<0.05) during pregnancy. However, after delivery of fetus, serum leptin, serum insulin and HOMA index in gestational diabetics significantly decreased compared to during gestation period. Hence a positive correlation of GDM was determined against serum leptin and HOMA index. Conclusion: Serum leptin level is raised in GDM which has a positive correlation with insulin resistance. This study finds that the serum leptin levels may use as a marker to early screen and diagnose Gestational diabetes.

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Epidemiology of Substance use in Pregnancy

European Psychiatry ◽

10.1016/s0924-9338(09)70541-3 ◽

2009 ◽

Vol 24 (S1) ◽

pp. 1-1

Author(s):

M.T. Kumar

Keyword(s):

Substance Use ◽

Pregnant Women ◽

Young Women ◽

Postpartum Period ◽

Substance Misuse ◽

Measurement Techniques ◽

Alcohol Exposure ◽

High Rate ◽

Pregnancy And Postpartum ◽

The Impact

An understanding of the epidemiology of alcohol and drug use in young women is important to appreciate the considerable morbidity and mortality associated with it and to understand the impact of such use on offspring. Although abstention rates are consistently higher among women than men in general substance misuse is increasing in young women. Differences in definitions, measurement techniques, availability, social acceptability and affordability partly explain the great variability in reported prevalence rates. Alcohol exposure among pregnant women varies from 0.2% to 14.8%. An Australian national survey revealed that nearly half of pregnant and or breast-feeding women up to 6 months postpartum were using alcohol. A Swedish study reported risky use of alcohol during the first 6 weeks of pregnancy, at 15%. Cannabis use among pregnant women varies from 1.8% to 15%. The reported prevalence of opiate use during pregnancy ranges from 1.65 to 8.5%. Cocaine use among pregnant women is reported to be between 0.3% and 9.5. Most pregnant women stop or reduce their substance use during pregnancy and this might be an opportune moment for detection and treatment. Substance use tends to increase sharply in the postpartum period with adverse consequences on mother and baby. Perinatal substance misuse interventions can reduce adverse neonatal outcomes. On the basis of relatively high rate of substance use disorders during pregnancy and postpartum period, effective screening and intervention strategies should be implemented.

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Epidemiology of Substance Use in Pregnancy

European Psychiatry ◽

10.1016/s0924-9338(09)70314-1 ◽

2009 ◽

Vol 24 (S1) ◽

pp. 1-1

Author(s):

M.T. Kumar

Keyword(s):

Substance Use ◽

Pregnant Women ◽

Young Women ◽

Postpartum Period ◽

Substance Misuse ◽

Measurement Techniques ◽

Alcohol Exposure ◽

High Rate ◽

Pregnancy And Postpartum ◽

The Impact

An understanding of the epidemiology of alcohol and drug use in young women is important to appreciate the considerable morbidity and mortality associated with it and to understand the impact of such use on offspring. Although abstention rates are consistently higher among women than men in general substance misuse is increasing in young women. Differences in definitions, measurement techniques, availability, social acceptability and affordability partly explain the great variability in reported prevalence rates. Alcohol exposure among pregnant women varies from 0.2% to 14.8%. An Australian national survey revealed that nearly half of pregnant and or breast-feeding women up to 6 months postpartum were using alcohol. A Swedish study reported risky use of alcohol during the first 6 weeks of pregnancy, at 15%. Cannabis use among pregnant women varies from 1.8% to 15%. The reported prevalence of opiate use during pregnancy ranges from 1.65 to 8.5%. Cocaine use among pregnant women is reported to be between 0.3% and 9.5. Most pregnant women stop or reduce their substance use during pregnancy and this might be an opportune moment for detection and treatment. Substance use tends to increase sharply in the postpartum period with adverse consequences on mother and baby. Perinatal substance misuse interventions can reduce adverse neonatal outcomes. On the basis of relatively high rate of substance use disorders during pregnancy and postpartum period, effective screening and intervention strategies should be implemented.

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Evaluation of the results of planned open surgical interventions in primary chronic vein disease in pregnant women

HEALTH OF WOMAN ◽

10.15574/hw.2020.149.51 ◽

2020 ◽

pp. 51-56

Author(s):

V.М. Аntonyuk-Kysil ◽

◽

І.Y. Dziubanovskyi ◽

V.М. Yenikeeva ◽

S.І. Lichner ◽

...

Keyword(s):

Pregnant Woman ◽

Pregnant Women ◽

Postoperative Period ◽

Postpartum Period ◽

Clinical Manifestations ◽

Lower Extremities ◽

Vascular Surgeon ◽

Surgical Interventions ◽

Perinatal Center ◽

Vein Disease

The objective: to evaluate the results of planned open surgical interventions (POSI) in pregnant women with primary symptomatic chronic vein disease (PSCVD). Materials and methods. The study included 457 pregnant women operated on a routine basis with PSCVD. The patients underwent ultrasound duplex angioscanning (USDA) of the veins of the lower extremities, inguinal canals, and iliac veins. The severity of the clinical manifestations of PSCVD was evaluated on a VCSS scale. With the help of the circadian visual-analog scale, the dynamics after the operative pain were studied. The effect of POSI on uterine tone and cardiac function of the fetus was investigated using cardiotocography. When forming the results for POSI, data from USDA, the severity of clinical and cosmetic manifestations of PCVD, the need for active prevention of thrombophlebetic, thromboembolic and hemorrhagic complications, minimization of surgical childbirth were taken into account. The results of treatment were studied in 2 groups of patients. Patients of the first group were treated with conservative therapy, the second group – POSI. Parametric indicators, which were presented as mean and standard error M(SD), were used for statistical data processing of the study, and their reliability was estimated using Student’s t-test. The species was determined to be significant at p<0.05. Results. 495 POSI were performed at 28-38 weeks gestation in an obstetric hospital (perinatal center), by a vascular surgeon from the staff of the center, who was familiarized with the peculiarities of working with this contingent of patients. Surgery was performed under local anesthesia in 346 (75.49%) pregnant women at one extremity, in 111 (24.51%) – at two in one session. According to the results of the study, it was noted that in the first group 33.7% of patients had a positive clinical result due to the reduction of pain syndrome, while 67.5% of patients had an increase and spread of varicose transformation in the area of saphenous and/or non-saphenous veins with spread of pathological venous reflux in the distal direction. 78% of patients had the need to administer prophylactic doses of low molecular weight heparins, both during pregnancy and in postpartum period. Out of 126 pregnant women with pronounced varicose veins of the external genital organs and perineum in 36 (28.6%) deliveries were performed by caesarean section. In 9 (3%) patients there was an acute thrombophlebitis of the subcutaneous veins of the lower extremities, which required 5 pregnant women to undergo urgent surgery when the inflammatory process had spread to the middle and above along the femoral vein of the large subcutaneous vein. Pregnant women of the second group with PSCVD on the basis of obstetric hospital (perinatal center) POSI were performed in the organization, which laid the ideology of the FTS program, strictly individual indications for intervention in the optimal terms of pregnancy, multidisciplinary management of patients, due to this in 93% of operated patients regression of clinical manifestations of the disease was noted, whch contributed to the correct and safe delivery of pregnancy with 100% absence of preterm birth, abnormalities in fetal development, pregnancy course, negative impact on obstetric and somatic condition of the pregnant woman. No hemorrhagic, thrombophlebic, thromboembolic complications were noted. Patients in the postoperative period did not require medical support, as during the period of pregnancy, during delivery and in the postpartum period. There were no indications for surgical delivery. 2.4% of patients experienced complications of post-operative wounds in the form of cheese, which had no effect on pregnancy and was eliminated before delivery. In the postoperative period, if necessary, it was recommended to use elastic compression class garments 1–2. Conclusion. POSI made at PSCVD in optimal terms of pregnancy in a specialized obstetric hospital by a vascular surgeon in strictly individual indications is safe, both for the fetus and the pregnant woman. It is promising to further study the results of POSI in pregnant women with PSCVD to introduce it into the arsenal of treatment of this pathology. Key words: FTS ideology, planned open surgical interventions in pregnant women.

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Promoting Healthy Weight Across the Pregnancy and Postpartum Period

Case Medical Research ◽

10.31525/ct1-nct04253977 ◽

2020 ◽

Author(s):

Keyword(s):

Postpartum Period ◽

Healthy Weight ◽

Pregnancy And Postpartum

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Clinical Pharmacokinetic Studies in Pregnant Women and the Relevance of Pharmacometric Tools

Current Pharmaceutical Design ◽

10.2174/1381612825666190320135137 ◽

2019 ◽

Vol 25 (5) ◽

pp. 483-495 ◽

Cited By ~ 7

Author(s):

André Dallmann ◽

Paola Mian ◽

Johannes Van den Anker ◽

Karel Allegaert

Keyword(s):

Pregnant Women ◽

Clinical Pharmacokinetic ◽

Individual Variability ◽

Current Status ◽

Pharmacokinetic Studies ◽

Full Potential ◽

Pbpk Models ◽

Pregnancy And Postpartum ◽

Population Pk ◽

The Impact

Background: In clinical pharmacokinetic (PK) studies, pregnant women are significantly underrepresented because of ethical and legal reasons which lead to a paucity of information on potential PK changes in this population. As a consequence, pharmacometric tools became instrumental to explore and quantify the impact of PK changes during pregnancy. Methods: We explore and discuss the typical characteristics of population PK and physiologically based pharmacokinetic (PBPK) models with a specific focus on pregnancy and postpartum. Results: Population PK models enable the analysis of dense, sparse or unbalanced data to explore covariates in order to (partly) explain inter-individual variability (including pregnancy) and to individualize dosing. For population PK models, we subsequently used an illustrative approach with ketorolac data to highlight the relevance of enantiomer specific modeling for racemic drugs during pregnancy, while data on antibiotic prophylaxis (cefazolin) during surgery illustrate the specific characteristics of the fetal compartments in the presence of timeconcentration profiles. For PBPK models, an overview on the current status of reports and papers during pregnancy is followed by a PBPK cefuroxime model to illustrate the added benefit of PBPK in evaluating dosing regimens in pregnant women. Conclusions: Pharmacometric tools became very instrumental to improve perinatal pharmacology. However, to reach their full potential, multidisciplinary collaboration and structured efforts are needed to generate more information from already available datasets, to share data and models, and to stimulate cross talk between clinicians and pharmacometricians to generate specific observations (pathophysiology during pregnancy, breastfeeding) needed to further develop the field.

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Long-Term IoT-Based Maternal Monitoring: System Design and Evaluation

Sensors ◽

10.3390/s21072281 ◽

2021 ◽

Vol 21 (7) ◽

pp. 2281

Author(s):

Fatemeh Sarhaddi ◽

Iman Azimi ◽

Sina Labbaf ◽

Hannakaisa Niela-Vilén ◽

Nikil Dutt ◽

...

Keyword(s):

Energy Efficiency ◽

Maternal Health ◽

Pregnant Women ◽

Health Monitoring ◽

Quality Care ◽

Well Being ◽

Pregnancy And Postpartum ◽

Comprehensive Framework ◽

Specific Health

Pregnancy is a unique time when many mothers gain awareness of their lifestyle and its impacts on the fetus. High-quality care during pregnancy is needed to identify possible complications early and ensure the mother’s and her unborn baby’s health and well-being. Different studies have thus far proposed maternal health monitoring systems. However, they are designed for a specific health problem or are limited to questionnaires and short-term data collection methods. Moreover, the requirements and challenges have not been evaluated in long-term studies. Maternal health necessitates a comprehensive framework enabling continuous monitoring of pregnant women. In this paper, we present an Internet-of-Things (IoT)-based system to provide ubiquitous maternal health monitoring during pregnancy and postpartum. The system consists of various data collectors to track the mother’s condition, including stress, sleep, and physical activity. We carried out the full system implementation and conducted a real human subject study on pregnant women in Southwestern Finland. We then evaluated the system’s feasibility, energy efficiency, and data reliability. Our results show that the implemented system is feasible in terms of system usage during nine months. We also indicate the smartwatch, used in our study, has acceptable energy efficiency in long-term monitoring and is able to collect reliable photoplethysmography data. Finally, we discuss the integration of the presented system with the current healthcare system.

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