Chagas' disease: study of congenital transmission in cases of acute maternal infection

We studied three pregnant women with acute chagasic infection. Two patients, infected in the third trimester of pregnancy, had uninfected children. The third patient, infected earlier, had an infected newborn. These results encourage research on risk factors of transmission and on medical decisions concerning pregnant women with acute Chagas' disease.

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Prenatal Depression in Women in the Third Trimester: Prevalence, Predictive Factors, and Relationship With Maternal-Fetal Attachment

Frontiers in Public Health ◽

10.3389/fpubh.2020.602005 ◽

2021 ◽

Vol 8 ◽

Author(s):

Ling Zhang ◽

Lei Wang ◽

Shu Cui ◽

Qiuyu Yuan ◽

Cui Huang ◽

...

Keyword(s):

Risk Factors ◽

Correlation Analysis ◽

Pregnant Women ◽

Sleep Disorders ◽

Prenatal Depression ◽

Prenatal Education ◽

Third Trimester ◽

The Third ◽

Maternal Fetal Attachment ◽

Fetal Attachment

Objective: The prevalence of prenatal depression in pregnant women has found to be high, which may adversely affect the intimacy of a mother to her fetus. Few studies have investigated the relationship between prenatal depression and maternal-fetal attachment in pregnant Chinese women. This study is thus designed to evaluate the prevalence rate, predictive factors of prenatal depression in Chinese pregnant women in the third trimester of pregnancy, and the effect of prenatal depression on maternal-fetal attachment.Methods: A total of 340 pregnant women in the third trimester of pregnancy were recruited from a hospital in Anhui Province. The Edinburgh Postpartum Depression Scale (EPDS) was rated to assess the prenatal depression; the Pittsburgh Sleep Quality Index (PSQI) and Zung Self-Rating Anxiety Scale (SAS) were used to assess sleep quality and anxiety level for all participants. The Maternal Antenatal Attachment Scale (MAAS) was used to assess maternal-fetal attachment.Results: The prevalence of prenatal depression in the participants was high (19.1%) in our study. The scores of prenatal anxiety and sleep disorders were higher with prenatal depression than in those without prenatal depression (47.6 ± 9.5 vs. 38.9 ± 6.9; 8.3 ± 3.3 vs. 6.1 ± 2.7, all p < 0.01). MAAS quality was lower in prenatal depression women than those in non-prenatal depression women (43.8 ± 5.6 vs. 46.4 ± 4.5, p < 0.01). Correlation analysis showed that prenatal depression was associated with parity, prenatal education, education level, marital satisfaction, anxiety and sleep disorders (all p < 0.05). Furthermore, binary logistic regression results showed that anxiety and sleep disorders were risk factors for prenatal depression. Prenatal education, higher marriage satisfaction were protective factors for prenatal depression. In addition, correlation analysis also showed that prenatal depression was positively correlated with MAAS intensity, but negatively correlated with MAAS quality.Conclusions: Our results indicated a high prevalence of prenatal depression in women in the third trimester. Prenatal education and higher marital satisfaction were protective factors for prenatal depression; antenatal anxiety and sleep disorders during pregnancy were risk factors for prenatal depression. Prenatal depression was negatively correlated with MAAS quality, but positively correlated with MAAS intensity.

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Gambaran Faktor Risiko pada Wanita Hamil Trimester 3 yang Terkonfirmasi Positif SARS-CoV-2

Jurnal e-Biomedik ◽

10.35790/ebm.v9i2.31879 ◽

2021 ◽

Vol 9 (2) ◽

Author(s):

Aurelia S. Posumah ◽

Mayer F. Wowor ◽

Glady I. Rambert

Keyword(s):

Risk Factors ◽

Risk Factor ◽

Severe Acute Respiratory Syndrome ◽

Pregnant Women ◽

Close Contact ◽

Secondary Data ◽

Third Trimester ◽

Travel History ◽

The Third ◽

Diabetes Melitus

Abstract: Coronavirus Disease 2019 (COVID-19) a infectious disease caused by Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2). There are several groups that are susceptible to infection with SARS-CoV-2, one of which is pregnant women. This can be attributed to changes in the physiology and immune system that occur in pregnant women. This study aimed to determine the most risk factors that cause pregnant women in Prof. Dr. R. D. Kandou was infected with SARS-CoV-2. This type of research is descriptive with a retrospective approach, using secondary data in the form of data from the patient's medical record status. From 5 patients studied, there were 4 patients with risk factors for hypertension (80%) and 1 patient with close contact risk factors (20%), but other risk factors such as diabetes mellitus, travel history in transmission areas, obesity and smoking are not found. In conclusion, from 5 patients studied, the most risk factor that causes pregnant women in the third trimester to be infected with SARS-CoV-2 is hypertension (80%).Keywords: 3rd trimester pregnant women, SARS-CoV-2, risk factor Abstrak: Coronavirus Disease 2019 (COVID-19) penyakit menular yang disebabkan oleh Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2). Terdapat beberapa kelompok yang rentan terinfeksi SARS-CoV-2, salah satunya wanita hamil. Hal ini dapat dikaitkan dengan perubahan fisiologi dan sistem imunitas tubuh yang terjadi pada wanita hamil. Tujuan penelitian ini untuk mengetahui faktor risiko terbanyak yang menyebabkan wanita hamil di RSUP Prof. Dr. R. D. Kandou terinfeksi SARS-CoV-2. Jenis penelitian yang digunakan bersifat deskriptif dengan pendekatan retrospektif, yaitu menggunakan data sekunder berupa data dari status rekam medik pasien. Dari 5 pasien yang diteliti, didapatkan 4 pasien dengan faktor risiko hipertensi (80%) dan 1 pasien dengan faktor risiko kontak erat (20%), namun pada faktor risiko lain seperti diabetes melitus, riwayat perjalanan di daerah transmisi, obesitas dan merokok tidak ditemukan. Sebagai simpulan, dari 5 pasien yang diteliti, faktor risiko terbanyak yang menyebabkan wanita hamil trimester 3 terinfeksi SARS-CoV-2 adalah hipertensi (80%).Kata Kunci: wanita hamil trimester 3, SARS-CoV-2, faktor risiko

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Assessment of the severity of nausea and vomiting among women during pregnancy vs. selected risk factors

Polish Journal of Public Health ◽

10.1515/pjph-2015-0054 ◽

2015 ◽

Vol 125 (4) ◽

pp. 197-200

Author(s):

Anna Cisek ◽

Marzena Bucholc

Keyword(s):

Risk Factors ◽

Light Intensity ◽

Pregnant Women ◽

Statistical Tests ◽

Demographic Data ◽

First Trimester ◽

Nausea And Vomiting ◽

Average Intensity ◽

Third Trimester ◽

The Third

Abstract Introduction. It is estimated that 90% of pregnant women suffer from nausea and vomiting (NVP). The severity of NVP may vary and the first symptoms tend to appear between the 4th and 9th week of pregnancy, reaching their peak around 7th-12th week and disappear around 16th-20th week of pregnancy. The etiology of both nausea and vomiting is yet to be discovered, yet there is a number of factors that may contribute to it. These symptoms usually accompany the increase of human chorionic gonadotropin (hCG) and most intensive ailments associated to the highest rate of this hormone appear around the 10th week of pregnancy. Aim. Assessing the severity of nausea and vomiting in pregnant women and selected risk factors. Material and methods. The study group consisted of 150 women hospitalized in the Independent Public Teaching Hospital No 4 in Lublin. The head of the Department of Obstetrics and Perinatology Agreement has agreed for the studies to be conducted. The authors used a research tool named modified scale Pregnancy Unique Quantification of Emesis which allowed to investigate the incidence and severity of nausea and vomiting during pregnancy. Demographic data and information on the conditions of nausea and vomiting in pregnancy were collected using a questionnaire survey of the authors’ own making. Database and statistical tests were conducted using 10.0 STATISTICA software (StatSoft, Poland). Results. The analysis revealed that 108 women (72.00%) experienced nausea or vomitting during pregnancy. Taking into consideration the first trimester of pregnancy, a moderate severity of nausea and vomiting (NVP) occurred with an average of 6.51±3.17 pt. It was found that 82 respondents had light intensity of NVP, whereas 68 moderate. In the second trimester an average intensity of nausea and vomiting (NVP) came to 4.82±2.45 pt, i.e. 117 women had mild symptoms while 33 had moderate symptoms. During the third trimester NVP severity dropped to 3.88±1.67. The majority of respondents stated that nausea and vomiting was of light intensity (92.00%), while 8% declared that it was moderate. Conclusions. The severity of nausea and/or vomiting varies in the course of pregnancy, with significantly more moderate than mild symptoms occurring in the first compared to other trimesters of gestation. The degree of the severity of NVP in the third trimester of pregnancy is significantly affected by risk factors occurring before pregnancy (migraine headache, nausea or vomiting), and co-morbidities. However, the number of pregnancies, the fact whether the pregnancy was planned or not, motion sickness do not have major significance in this matter.

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D-dimer level significance for deep vein thrombosis screening in the third trimester: a retrospective study

BMC Pregnancy and Childbirth ◽

10.1186/s12884-021-04353-9 ◽

2022 ◽

Vol 22 (1) ◽

Author(s):

Keisuke Miyamoto ◽

Hiroaki Komatsu ◽

Masayo Okawa ◽

Yuki Iida ◽

Daiken Osaku ◽

...

Keyword(s):

Risk Factors ◽

Venous Thromboembolism ◽

Pregnant Women ◽

Lower Limb ◽

Third Trimester ◽

Vein Thrombosis ◽

The Third ◽

Deep Vein ◽

D Dimer ◽

Compression Ultrasonography

Abstract Background Venous thromboembolism often develops after surgery and childbirth, resulting in death in some cases. Although early deep vein thrombosis (DVT) detection can predict pulmonary thromboembolism, there is no early screening method for DVT in pregnant women. Lack of consensus regarding significance or setting and cut-off value interpretation of D-dimer levels further impedes venous thromboembolism screening in pregnant women. This study aimed to examine the utility of third-trimester serum D-dimer levels as a screening test for DVT during pregnancy and to determine the frequency of asymptomatic DVT using lower-limb compression ultrasonography. Methods This single-center retrospective study included 497 pregnant women who underwent elective cesarean section at term in our hospital between January 2013 and December 2019. Serum D-dimer levels were preoperatively measured at 32–37 weeks’ gestation. The presence or absence of DVT in patients with serum D-dimer levels ≥ 3.0 µg/ml, the cut-off value, was examined using compression ultrasonography. In all patients, the presence or absence of clinical venous thrombosis (symptoms such as lower-limb pain, swelling, and heat sensation) was examined within 4 postoperative weeks. The Royal College of Obstetricians and Gynecologists Guideline 2015 was referred to determine risk factors for the onset of venous thrombosis during pregnancy. Among those, we examined the risk factors for DVT that result in high D-dimer levels during pregnancy. Results The median age and body mass index were 35 (20–47) years and 21.2 (16.4–41.1) kg/m2, respectively. Further, the median gestational age and D-dimer levels were 37 weeks and 2.1 (0.2–16.0) µg/ml, respectively. Compression ultrasonography was performed on 135 (26.5%) patients with a D-dimer level ≥ 3.0 µg/ml, with none of the patients showing DVT. All patients were followed up for 4 postoperative weeks, with none presenting with venous thromboembolism. Multivariate analysis showed that hypertensive disorders of pregnancy are an independent risk factor for venous thromboembolism that causes high D-dimer levels (odds ratio: 2.48, 95% confidence interval: 1.05–6.50, P = 0.04). Conclusion There may be low utility in screening for DVT using D-dimer levels in the third trimester. Further, prepartum asymptomatic DVT has a low frequency, indicating the low utility of compression ultrasonography. Trial registration Institutional Review Board of Tottori University Hospital (IRB no. 20A149).

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COVID-19 in pregnant and non-pregnant women of early reproductive age

GYNECOLOGY ◽

10.26442/20795696.2021.3.200882 ◽

2021 ◽

Vol 23 (3) ◽

Author(s):

Tatiana E. Belokrinitskaya ◽

Nataly I. Frolova ◽

Konstantin G. Shapovalov ◽

Kristina A. Kolmakova ◽

Ludmila I. Anohova ◽

...

Keyword(s):

Risk Factors ◽

Computed Tomography ◽

Iron Deficiency ◽

Pregnant Women ◽

Iron Deficiency Anemia ◽

Clinical Manifestations ◽

Reproductive Age ◽

Deficiency Anemia ◽

Third Trimester ◽

The Third

Aim. To identify confounding factors, features of the clinical course and outcomes of COVID-19 in pregnant and non-pregnant patients of early reproductive age who have no known risk factors and premorbid background. Materials and methods. The study included 163 pregnant women in the third trimester of gestation, 100 non-pregnant women with laboratory-confirmed SARS-CoV-2 infection and 100 pregnant women who did not get sick. Patients of all groups were comparable in age (1835 years), social status, parity, body mass index, had no known risk factors for COVID-19; those who got sick were treated simultaneously. Results. Statistically significant associations were revealed between COVID-19 infection in the pregnant and iron deficiency anemia, vegetovascular dystonia, belonging to the Buryat ethnicity, and smoking. Pregnant women with COVID-19 were more likely to have no symptoms (23.3% vs 5%; p0.001) or had a mild course of the disease (58.9% vs 24%; p0.001). In non-pregnant patients, the course of infection was more often moderate (61% vs 14.7%; p0.001) or severe (10% vs 3.1%; p=0.038). Clinical manifestations of new coronavirus infection (NCV) in pregnant women were dominated by anosmia (87.7% vs 40%; p0.001), drowsiness (68.7% vs 17%; p0.001), dyspnea, even with a mild lung lesion (68.1% vs 19%; p0.001), headache (41.7% vs 24%; p=0.006), arthralgia (29.4% vs 16%; p=0.021), while fever above 38 C (7.4% vs 28%; p0.001) and cough (38.7% vs 61%; p0.001) were much less common. With computed tomography, pneumonia in pregnant women was diagnosed several times less often (21.4% vs 87.4%; p0.001). In the non-pregnant group, there was one death (1% vs 0%; p=0.201) associated with late hospitalization for severe NCI with grade 4 pulmonary involvement as shown on computed tomography. Conclusion. Confounders of COVID-19 in pregnant women who have no known risk factors in the third trimester of gestation are iron deficiency anemia, vegetovascular dystonia, belonging to the Buryat subpopulation, and smoking. In pregnant women, the main clinical symptoms of SARS-CoV-2 infection, with the exception of loss of smell, were nonspecific and characteristic of the physiological course of late gestation: drowsiness, dyspnea, joint pain. The predominance of mild or asymptomatic forms of infection, the lower incidence of pneumonia, and the absence of deaths in pregnant women suggests a more favorable course of COVID-19 NCI.

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Prevalence of anemia and factors associated with pregnant women in West Sumatra, Indonesia: Findings from VDPM Cohort Study

Jurnal Gizi dan Dietetik Indonesia (Indonesian Journal of Nutrition and Dietetics) ◽

10.21927/ijnd.2019.7(3).97-106 ◽

2020 ◽

Vol 7 (3) ◽

pp. 97

Author(s):

Arif Sabta Aji ◽

Yusrawati Yusrawati ◽

Safarina G Malik ◽

Nur Indrawaty Lipoeto

Keyword(s):

Public Health ◽

Risk Factors ◽

Vitamin D ◽

Cohort Study ◽

Pregnant Women ◽

Pregnant Mother ◽

Third Trimester ◽

The Third ◽

West Sumatra ◽

Prevalence Of Anemia

ABSTRAK Latar belakang: Anemia kehamilan masih menjadi masalah kesehatan masyarakat di negara berkembang yang berkontribusi terhadap risiko tinggi komplikasi kehamilan. Indonesia sebagai negara berkembang memiliki risiko anemia yang lebih tinggi yang bisa disebabkan oleh kekurangan asupan zat gizi mikro, infeksi, atau faktor sosial-demografis lainnya. Tujuan: Identifikasi prevalensi dan faktor risiko anemia pada ibu hamil yang tinggal di Sumatera Barat, Indonesia. Metode: Penelitian ini adalah analisis data sekunder dari studi kohort prospektif yaitu "“Vitamin D Pregnant Mother (VDPM) di Sumatera Barat". Subyek ibu hamil trimester diperoleh dari Puskesmas di Provinsi Sumatera Barat. Waktu penelitian dilakukan pada Januari-Maret 2017. Data demografi, sosial ekonomi, antropometri, dan Riwayat kesehatan ibu diteliti. Regresi logistik biner multivariatdigunakan untuk menentukan faktor-faktor terkait anemia. Dalam semua kasus, nilai p kurang dari 0,05 dianggap signifikan secara statistik. Hasil: 176 ibu hamil yang memenuhi kriteria inklusi diambil dalam penelitian ini. Prevalensi anemia ditemukan sebesar 61,90%. Rerata konsentrasi hemoglobin adalah 10,56 ± 1,41 g / dL. Prevalensi anemia sedang dan ringan masing-masing adalah 34% dan 27%. Status anemia ibu hamil trimester ketiga berhubungan dengan wanita yang memiliki <upah minimum/bulan (AOR: 5.15; 95% CI: 1.30-20.47), pengetahuan gizi ibu yang rendah (AOR: 15.88; 95% CI: 3.82- 66.02), IMT sebelum kehamilan <25 kg/m2 (AOR: 11.82; 95% CI: 2.70-51.69), dan tidak patuh konsumsi suplemen zat besi (AOR: 29.69; 95% CI: 6.58-133.91). Kesimpulan: Terdapat masih tingginya prevalensi anemia pada wanita hamil di Sumatera Barat. Oleh karena itu, meningkatkan kesadaran akan suplementasi zat besi dan kesehatan yang berkaitan dengan nutrisi selama kehamilan perlu dipertimbangkan untuk meningkatkan status kesehatan ibu untuk mengurangi anemia. Namun, penelitian lebih lanjut diperlukan dengan ukuran sampel yang besar untuk mengkonfirmasi temuan ini.KATA KUNCI: anemia; faktor risiko; kehamilan; trimester ketiga; Sumatra Barat ABSTRACT Background: Anemia during pregnancy remain to be a public health problem in developing countries which contributes to the high risk of adverse pregnancy outcomes. Indonesia as developing country has a higher risk of anemia that could be due to high of deficiencies of micronutrients intake, infection, or other socio-demographic factors. Objectives: The aim of this study was to determine the prevalence and risk factors anemia among pregnant women living in West Sumatra, Indonesia. Methods: The study is a secondary data analysis of prospective cohort study named “Vitamin D Pregnant Mother (VDPM) study in West Sumatra”. The third trimester pregnant women were enrolled from the public health centers in West Sumatra Province from January to March 2017. Structured questionnaires were used to collect data of demographic, socio-economic, anthropometry, and maternal health from all the study subjects. A multivariate binary logistic regression had been used to determine the associated factors of anemia. In all cases, P value less than 0.05 was considered statistically significant. Results: 176 pregnant women who fulfilled the inclusion criteria were enrolled this study. The prevalence of anemia was 61.90%. The mean of hemoglobin concentration was 10.56±1.41 g/dL. Moderate and mild anemia prevalence were 34% and 27%, respectively. The third trimester of pregnant women anemia status were associated with women who had <minimum wage/month (AOR: 5.15; 95%CI: 1.30-20.47), low-moderate maternal nutrition knowledge (AOR: 15.88; 95%CI: 3.82-66.02), pre-pregnancy BMI <25 kg/m2 (AOR: 11.82; 95%CI: 2.70-51.69), and no adherence iron supplement intake status (AOR: 29.69; 95%CI: 6.58-133.91). Conclusions: There was a high prevalence of anemia status in the third pregnant women in West Sumatra. Therefore, raise awareness of iron supplementation and health related to nutrition during pregnancy need to be considered to improve maternal health status to reduce anemia. However, further studies required with large sample size to confirm this finding.KEYWORDS: anemia; risk factors; third trimester; pregnancy; West Sumatra

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TOXOPLASMOSIS IN PREGNANT WOMEN IN YEMEN: THE IMMUNE STATUS AND POTENTIAL RISK FACTORS

Universal Journal of Pharmaceutical Research ◽

10.22270/ujpr.v6i2.570 ◽

2021 ◽

Author(s):

Nashwa Abdullah Naji Saeed Alqaisi ◽

Abdulsalam M. AL-Mekhlafi ◽

Hassan A. Al-Shamahy ◽

Abdullah AD Al-Rukeimi ◽

Kaima A. Foras ◽

...

Keyword(s):

Risk Factors ◽

Pregnant Woman ◽

Pregnant Women ◽

Peer Review ◽

Potential Risk ◽

Immune Status ◽

Age Group ◽

Third Trimester ◽

The Third ◽

Potential Risk Factors

Background and aims: Toxoplasmosis is caused as a result of intracellular protozoan organism, Toxoplasma gondii, and is a widespread disease. Toxoplasmosis can progress to a serious systemic disease (congenital form); once a mother becomes infected for the first time for the period of pregnancy, a transient haematopoietic parasite can appear with focal lesions produced within the placenta, thus infecting the fetus. Therefore, this cross-sectional study aimed at assessing the immune status of the pregnant woman towards toxoplasmosis, determining the prevalence of T. gondii in Amran city -Yemen, and identifying the potential risk factors that affect the pregnant woman towards toxoplasmosis. Material and methods: This study included 280 pregnant women who were admitted to maternity clinics at Amran General Hospital and Family Health Center in Amran City -Yemen during the period from December 2016 to June 2017. The questionnaire was used to obtain relevant demographic data and potential risk factors. Then, blood samples were collected from pregnant women and tested for identification of IgM and IgG antibodies against T. gondii using the ELISA technique. Results: The total positive rate for IgM antibodies was 3.6%, while for IgG was 27.9%. A high IgM rate equal to 5.3% was observed in the 31-35 age group, and a higher IgG rate (36.8%) was observed in the same age group. There were 69.3% of pregnant women susceptible to infection with toxoplasmosis, 2.9% recently infected, 27.1% protected, and 0.7% had secondary infection. The high rate of IgM positivity was observed in the second trimester of pregnancy (4.7%), while the lowest rate was in the third trimester of pregnancy (2%). A slight increase in the rate of IgG positivity was observed in the third trimester of pregnancy (32%). There was a significant association between contact with animals such as cats and infection with toxoplasmosis, where OR =5.4, CI =1.01-30.13, χ2 =4.59, p =0.04. While there was no significant association with the other studied factors. Conclusion: Yemen has less seropositivity than other Arab and African countries as a result of variation in risk factors. Data on T. gondii infection during pregnancy is scarce in numerous countries, in particular where there is a lack of political constancy such as Yemen. The risk factors identified included proximity to the cats and domistic animals, and increased maternal age. Toxoplasmosis in pregnancy in Yemen may be a really underestimated health problem. More research is needed. Peer Review History: Received 19 March 2021; Revised 12 April; Accepted 28 April, Available online 15 May 2021 UJPR follows the most transparent and toughest ‘Advanced OPEN peer review’ system. The identity of the authors and, reviewers will be known to each other. This transparent process will help to eradicate any possible malicious/purposeful interference by any person (publishing staff, reviewer, editor, author, etc) during peer review. As a result of this unique system, all reviewers will get their due recognition and respect, once their names are published in the papers. We expect that, by publishing peer review reports with published papers, will be helpful to many authors for drafting their article according to the specifications. Auhors will remove any error of their article and they will improve their article(s) according to the previous reports displayed with published article(s). The main purpose of it is ‘to improve the quality of a candidate manuscript’. Our reviewers check the ‘strength and weakness of a manuscript honestly’. There will increase in the perfection, and transparency. Received file: Reviewer's Comments: Average Peer review marks at initial stage: 6.5/10 Average Peer review marks at publication stage: 7.5/10 Reviewer(s) detail: Rola Jadallah, Arab American University, Palestine, [email protected] Prof. Dr. Gorkem Dulger, Duzce University, Turkey, [email protected] Similar Articles: PREVALENCE AND RISK FACTORS ASSOCIATED WITH VULVOVAGINAL CANDIDIASIS DURING PREGNANCY IN SANA'A, YEMEN VULVOVAGINAL CANDIDIASIS PREVALENCE AMONG PREGNANT WOMEN IN DIFFERENT HOSPITALS IN IBB, YEMEN

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Features of the course and treatment of glaucoma during pregnancy

Clinical Medicine (Russian Journal) ◽

10.30629/0023-2149-2020-98-3-178-184 ◽

2020 ◽

Vol 98 (3) ◽

pp. 178-184

Author(s):

T. V. Chernyakova ◽

A. Yu. Brezhnev ◽

I. R. Gazizova ◽

A. V. Kuroyedov ◽

A. V. Seleznev

Keyword(s):

Pregnant Women ◽

Laser Treatment ◽

Progressive Disease ◽

Clinical Course ◽

The Other ◽

Third Trimester ◽

The Third ◽

Chronic Progressive Disease ◽

Hypotensive Therapy ◽

Eye Pressure

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.

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A systematic review and meta-analysis of prevalence of insomnia in the third trimester of pregnancy

BMC Pregnancy and Childbirth ◽

10.1186/s12884-021-03755-z ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Nader Salari ◽

Niloofar Darvishi ◽

Behnam Khaledi-Paveh ◽

Aliakbar Vaisi-Raygani ◽

Rostam Jalali ◽

...

Keyword(s):

Pregnant Women ◽

Sleep Disorders ◽

Sleep Disturbances ◽

Meta Analysis ◽

Physical And Mental Health ◽

Third Trimester ◽

Cross Sectional ◽

The Third ◽

Physical Problems ◽

Meta Regression Analysis

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.

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The sFlt-1 to PlGF Ratio in Pregnant Women with Rheumatoid Arthritis: Impact of Disease Activity and Sulfasalazine Use

Rheumatology ◽

10.1093/rheumatology/keab372 ◽

2021 ◽

Author(s):

Rugina I Neuman ◽

Hieronymus T W Smeele ◽

A H Jan Danser ◽

Radboud J E M Dolhain ◽

Willy Visser

Keyword(s):

Rheumatoid Arthritis ◽

Cohort Study ◽

Disease Activity ◽

Pregnant Women ◽

Gestational Age ◽

Third Trimester ◽

Low Disease Activity ◽

The Third ◽

Observational Prospective Cohort Study ◽

Plgf Ratio

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 > 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.

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