scholarly journals Do we need to screen and treat pregnant women for subclinical hypothyroidism? A cross sectional study in a rural tertiary centre in Kerala, India

Author(s):  
Radha K. R. ◽  
Nishu Sugunan ◽  
Resmy C. R.

Background: Hypothyroidism (HT) is associated with maternal and perinatal morbidity. Subclinical HT rather than overt occur in pregnancy, because overt HT causes infertility. Treatment of overt HT was beneficial in reducing the fetal and maternal complications, Usefulness of correcting subclinical hypothyroidism was doubtful, hence Universal screening of pregnant women was not recommended.Methods: Cross sectional study, conducted in the department of obstetrics and gynecology, Government Medical College, Thrissur, Kerala, India. 50 consecutive cases of subclinical hypothyroidism in pregnancy were analyzed for Thyroid function, antenatal, natal, postnatal complications. Perinatal complications, including neonatal hypothyroidism also noted. Statistical analysis done using computer software Epi info3.4. Data expressed in its frequency and percentage, continuous data in mean.Results: All women in the study group received levothyroxine during pregnancy from time of diagnosis. At the time of delivery 84% women were euthyroid and 16% hypothyroid. Complications like anemia 36%, abruption 4%, and postpartum hemorrhage 6% showed a statistically significant association, while pre-eclampsia 20%, preterm labor 22% had no statistically significant association. Comparing the women who are euthyroid as a result of levothyroxine supplementation to women inadequately treated, complications like anemia (33% versus 50%, p value 0.042), abruption (0% versus 4%, p value0.023), PPH (2% versus 6%, p value 0.014) were significantly less in well controlled.Conclusions: Significant association was noted between inadequately treated hypothyroidism and maternal complications like anaemia, placental abruption, placenta previa, PPH, preterm delivery, and caesarean section rate for foetal distress. Universal screening of pregnant women for thyroid status is recommended.

F1000Research ◽  
2021 ◽  
Vol 10 ◽  
pp. 223
Author(s):  
Gayani Amarasinghe ◽  
Vasana Mendis ◽  
Thilini Agampodi

Background: Anaemia in pregnancy, which can lead to adverse maternal and fetal outcomes, is a significant global health problem. Despite Sri Lanka’s strong public health system and commitment towards prevention, maternal anaemia remains a major problem in the country. While prevention is focused on iron deficiency, detailed etiological studies on this topic are scarce. Moreover, estimates of socio demographic and economic factors associated with anaemia in pregnancy, which can provide important clues for anaemia control, are also lacking. This study aims to evaluate the hemoglobin distribution, spatial distribution, etiology and associated factors for anaemia in pregnant women in Anuradhapura, Sri Lanka. Methods: This is a cross sectional study of pregnant women in their first trimester registered for antenatal care from July to September 2019 in the Anuradhapura district. The minimal sample size was calculated to be 1866. Initial data collection has already been carried out in special field clinics for pregnant women between June to October 2019. An interviewer-administered questionnaire, a self-completed dietary questionnaire and an examination checklist were used for data collection. In addition, all participants underwent complete blood count testing. Further investigations are being conducted for predicting the etiology of anaemia based on a developed algorithm (such as high-performance liquid chromatography [HPLC] and peripheral blood film analysis). Discussion: Being the largest study on anaemia during pregnancy in a single geographical area in Sri Lanka, this study will provide important clues about geographical clustering of anaemia cases with similar etiology, associated factors and etiologies which would help to develop interventions to improve the health of pregnant women in the area. The possibility of selection bias is a potential limitation associated with the study design.


2013 ◽  
Vol 2 (2) ◽  
pp. 67
Author(s):  
Feby Andammori ◽  
Nur Indrawaty Lipoeto ◽  
Yusrawati Yusrawati

AbstrakTinggi rendahnya tekanan darah sistolik dan diastolik dalam kehamilan mempunyai pengaruh terhadap berat badan lahir. Penelitian ini bertujuan untuk mengidentifikasi hubungan tekanan darah ibu hamil aterm dengan berat badan lahir di RSUP dr M. Djamil Padang. Metode penelitian : Penelitian yang dilakukan merupakan survei analitik dengan menggunakan studi komparatif dengan design penelitian Cross Sectional Study. Penelitian menggunakan data sekunder yang diambil dari sub bagian Rekam Medik (Medical Record) RSUP dr. M. Djamil Padang bulan Januari 2010 – Desember 2012 dengan jumlah sampel 34 orang ibu hamil yang tidak hipertensi dan 34 orang ibu hamil yang mengalami hipertensi dalam kehamilannya. Hasil penelitian : Ditemukan rata-rata berat badan lahir bayi yang dilahirkan oleh kelompok ibu yang tidak mengalami hipertensi pada kehamilannya adalah 3.408 (SD 307) gram dan rata-rata berat badan lahir bayi yang dilahirkan oleh kelompok ibu yang mengalami hipertensi pada kehamilannya adalah 2.799 (SD 413) gram. Dari hasil uji analisis Independent Sample T-test diperoleh hasil ditemukan adanya hubungan tekanan darah ibu hamil dengan berat badan lahir di RSUP dr. M. Djamil Padang p = 0,00 (p < 0,05). Kesimpulan : Pemeriksaan kehamilan secara teratur penting untuk mengantisipasi adanya peningkatan tekanan darah ibu hamil yang dapat berpengaruh terhadap berat bayi lahir.Kata kunci: tekanan darah, berat badan lahir, ibu hamilAbstractHigh and low level of systolic and diastolic blood pressure in pregnancy has impact to birth weight. This research is purposed to identify the relation between aterm pregnant blood pressure and birth weight.Methods : This research is analytical survey which used comparative study with Cross Sectional Study design. This research used secondary data taken from Medical Record in RSUP dr. M. Djamil Padang since Januari 2010 until December 2012 with number of samples are 34 pregnant women who have not hypertension and 34 pregnant women who have hypertension in pregnancy.The results: Research found that average of birth weight from non-hypertension pregnant woman is about 3,408 (SD 307) gr and average of birth weight from hypertension pregnant woman is about 2,799 (SD 413) gr. The result from Independent sample T-test analysis found that there is a relation between blood pressure in pregnancy with birth weight at RSUP dr. M.Djamil Padang p = 0.00 (p<0.05).Conclusion: Regular antenatal care is important to anticipate an increase in maternal blood pressure can affect birth weight.Keywords: blood pressure, birth weight, pregnant women


2019 ◽  
Vol 2 (2) ◽  
pp. 162
Author(s):  
Moh. Rivandi Dengo ◽  
Idjrak Mohamad

The coverage of Antenatal Care (ANC) visits in Gorontalo District during the last three years is as follows: the first visit of the pregnant women in 2015 reached 90%, the visit in the following year in 2016 decreased to 76%, and the visit in 2017 reached 89,86%. This research aims to find out the factors related to the decrease of Antenatal Care in accordance with the decrease in the Antenatal Care visits in the first contact of pregnant women checking K-1 in the working area of Community Health Center Bongomeme Gorontalo District in 2018. The population of the current research was all pregnant women listed in Kohort pregnant women book in the Community Health Center Bogomeme in 2018 there were 163 pregnant women participated. The research design used was a cross sectional study approach. The obtained data were subsequently examined using chi-square test by referring to p value < 0,005. The research results shown that the parity variable of the pregnancy has p value of 0,038, pregnant women knowledge has p value of 0,012, and pregnant women job has p value of 0,000. Thus, this variable has a parity of pregnancy, knowledge of pregnant women and occupation of pregnant women has a relationship with antenatal visits (K-1), while family support variables with p value of 0.478 means that this variable has no relationship with antenatal visits (K-1). The conclusion was the parity, pregnant women knowledge, and pregnant women occupation have the significant relationship with the antenatal care visits (K-1), while the family support has no significant relationship with antenatal visits (K-1). The pregnant women should maintain the pregnancy spacing, maintain the pregnancy health, and increase their knowledge.Cakupan kunjungan Antenatal Care (ANC) di Kabupaten Gorontalo selama tiga tahun terakhir adalah cakupan kunjungan pertama ibu hamil (K-1) tahun 2015 mencapai 90%, pada tahun berikutnya tahun 2016 terjadi penurunan yaitu 76% dan pada tahun 2017 mencapai 89,86%. Penelitian ini bertujuan untuk mengetahui faktor-faktor yang berhubungan dengan rendahnya kunjungan Antenatal Care pada kontak pertama pemeriksaan ibu hamil K-1 pada Wilayah Kerja Puskesmas Bongomeme Kabupaten Gorontalo tahun 2018. Adapun populasi pada penelitian ini adalah seluruh ibu hamil tercatat di buku kohort ibu hamil Puskesmas Bongomeme tahun 2018 yaitu sebanyak 163 orang ibu hamil. Desain penelitian yang digunakan adalah pendekatan cross sectional study. Data yang diperoleh kemudian dilakukan uji statistic chi square dengan melihat nilai p value < 0,005. Hasil penelitian menunjukkan bahwa variable paritas kehamilan dengan nilai p value 0,038, pengetahuan ibu hamil nilai p value 0,012, dan pekerjaan ibu hamil nilai p value 0,000. Artinya variabel paritas kehamilan, pengetahuan ibu hamil dan pekerjaan ibu hamil memiliki hubungan dengan kunjungan antenatal (K-1). Sedangkan variabel dukungan keluarga nilai p value 0,478 ini berarti variabel dukungan keluarga tidak memiliki hubungan dengan kunjungan antenatal (K-1). Disimpulkan bahwa paritas, pengetahuan ibu, pekerjaan ibu ada hubungan yang signifikan dengan kunjungan antenatal K-I, sedangkan dukungan keluarga tidak memiliki hubungan yang signifikan dengan kunjungan antenatal (K-I). Ibu hamil agar lebih menjaga jarak kehamilan, menjaga kesehatan kehamilan, meningkatkan pengetahuan ibu hamil.


PLoS ONE ◽  
2020 ◽  
Vol 15 (12) ◽  
pp. e0238409
Author(s):  
Sheela Maru ◽  
Uday Patil ◽  
Rachel Carroll-Bennett ◽  
Aaron Baum ◽  
Tracy Bohn-Hemmerdinger ◽  
...  

Background Universal screening for SARS-CoV-2 infection on Labor and Delivery (L&D) units is a critical strategy to manage patient and health worker safety, especially in a vulnerable high-prevalence community. We describe the results of a SARS-CoV-2 universal screening program at the L&D Unit at Elmhurst Hospital in Queens, NY, a 545-bed public hospital serving a diverse, largely immigrant and low-income patient population and an epicenter of the global pandemic. Methods and findings We conducted a retrospective cross-sectional study. All pregnant women admitted to the L&D Unit of Elmhurst Hospital from March 29, 2020 to April 22, 2020 were included for analysis. The primary outcomes of the study were: (1) SARS-CoV-2 positivity among universally screened pregnant women, stratified by demographic characteristics, maternal comorbidities, and delivery outcomes; and (2) Symptomatic or asymptomatic presentation at the time of testing among SARS-CoV-2 positive women. A total of 126 obstetric patients were screened for SARS-CoV-2 between March 29 and April 22. Of these, 37% were positive. Of the women who tested positive, 72% were asymptomatic at the time of testing. Patients who tested positive for SARS-CoV-2 were more likely to be of Hispanic ethnicity (unadjusted difference 24.4 percentage points, CI 7.9, 41.0) and report their primary language as Spanish (unadjusted difference 32.9 percentage points, CI 15.8, 49.9) than patients who tested negative. Conclusions In this retrospective cross-sectional study of data from a universal SARS-Cov-2 screening program implemented in the L&D unit of a safety-net hospital in Queens, New York, we found over one-third of pregnant women testing positive, the majority of those asymptomatic. The rationale for universal screening at the L&D Unit at Elmhurst Hospital was to ensure safety of patients and staff during an acute surge in SARS-Cov-2 infections through appropriate identification and isolation of pregnant women with positive test results. Women were roomed by their SARS-CoV-2 status given increasing space limitations. In addition, postpartum counseling was tailored to infection status. We quickly established discharge counseling and follow-up protocols tailored to their specific social needs. The experience at Elmhurst Hospital is instructive for other L&D units serving vulnerable populations and for pandemic preparedness.


Author(s):  
Feri Yuda Anggara ◽  
◽  
Setyo Sri Rahardjo ◽  
Bhisma Murti ◽  
◽  
...  

ABSTRACT Background: Malaria infection in pregnancy contributes to low birth weight through preterm delivery and intrau-uterine growth restriction (IUGR). Maternal haemoglobin concentrations were found lower in malaria infected than non-infected women and reduced haemoglobin was the main determinant of preterm delivery. This study aimed to investigate the effect of malaria infection on premature birth delivery. Subjects and Method: Meta-analysis ad systematic review was conducted by collecting published articles from Google Scholar, PubMed, Springer Link, and Science Direct databases, from year 2010 to 2020. Keywords used “malaria in pregnancy”, “malaria during pregnant AND preterm”, malaria during pregnant AND preterm AND cross sectional study AND adjusted ratio”. The inclusion criteria were full text, using cross sectional study design, and reporting adjusted odds ratio. The articles were selected by PRISMA diagram. The quantitative data were analyzed by Review Manager 5.3 using random effect model. Results: 6 articles reported that malaria infection in pregnant women increased the risk of premature birth delivery (aOR= 1.72; 95% CI= 1.15 to 2.57; p= 0.009). Conclusion: Malaria infection in pregnant women increases the risk of premature birth delivery. Keywords: malaria infection, premature birth delivery Correspondence: Feri Yuda Anggara. Masters Program in Public Health, Universitas Sebelas Maret. Jl. Ir. Sutami 36A, Surakarta 57126, Central Java. Email: [email protected]. Mobile: 085220426805. DOI: https://doi.org/10.26911/the7thicph.03.119


2014 ◽  
Vol 6 (2) ◽  
pp. 130-137 ◽  
Author(s):  
Emmanuel O. Ugwu ◽  
Cyril C. Dim ◽  
Benjamin S. Uzochukwu ◽  
Emeka I. Iloghalu ◽  
Angela O. Ugwu

2016 ◽  
Vol 9 (4) ◽  
pp. 160-163 ◽  
Author(s):  
May C Soh ◽  
Srividhya Sankaran ◽  
Natali YA Chung ◽  
Catherine Nelson-Piercy ◽  
Jo Howard ◽  
...  

Pulmonary hypertension is associated with 36% mortality in pregnancy, and 6–10% of patients with sickle cell disease have pulmonary hypertension. Tricuspid regurgitant velocity ≥2.5 m/s on echocardiography is a well validated means of screening for pulmonary hypertension in the non-pregnant population. This is a pilot study to determine if this is a useful non-invasive screening test for pulmonary hypertension in pregnancy, and whether raised tricuspid regurgitant velocity ≥2.5 m/s was associated with poor outcomes. This is a cross-sectional study over a five-year period in a tertiary referral centre with a specialised multidisciplinary clinic for pregnant women with sickle cell disease. Women with sickle cell disease, no prior pulmonary hypertension and singleton pregnancies who had echocardiography with a measurable tricuspid regurgitant velocity in pregnancy were included. There were 34 pregnancies, of which eight had tricuspid regurgitant velocity ≥2.5 m/s. There were no significant differences in their characteristics, sickle cell-related complications or medical co-morbidities. The women with tricuspid regurgitant velocity ≥2.5 m/s had similar obstetric and perinatal outcomes as those with a tricuspid regurgitant velocity <2.5 m/s.


2016 ◽  
Vol 9 (2) ◽  
pp. 78-82
Author(s):  
NM Murphy ◽  
AS Khashan ◽  
DI Broadhurst ◽  
O Gilligan ◽  
K O’Donoghue ◽  
...  

Background To examine perinatal determinants of the antenatal levels of D-dimers. Methods Cross-sectional study of 760 low risk pregnant women recruited into five gestational groups. Variables examined in antenatal groups included maternal age, body mass index, parity, smoking, family history venous thromboembolism (VTE) and previous use of the oral contraceptive pill (OCP). Onset of labour and mode of delivery were also examined in the post-natal group. Results D-dimer levels in group 4 (38–40 + 6) were significantly lower in the women with a history of taking the OCP when compared to those that had not taken it in the past ( P = 0.027). In the day 2 post-natal group, the median level of D-dimer was significantly higher in primparous when compared to multiparous women ( P = 0.015). The median D-dimer levels were significantly lower in the elective Caesarean section group in comparison to spontaneous onset ( P = 0.003) and induction of labour ( P = 0.016). When the mode of delivery was examined, the median D-dimer levels were significantly lower in those that had an elective Caesarean section when compared to normal vaginal delivery ( P = 0.008) and instrumental vaginal delivery ( P = 0.007). Women post elective Caesarean section had a significantly lower D-dimer than those after emergency Caesarean section ( P = 0.008). Discussion There are some significant differences in D-dimer levels when certain perinatal determinants are examined. This work is potentially beneficial to the future diagnosis of VTE in pregnancy as it supports previously published recommended D-dimer levels for the diagnosis of VTE in pregnancy.


Nutrients ◽  
2021 ◽  
Vol 13 (7) ◽  
pp. 2394
Author(s):  
Deidre Meulenbroeks ◽  
Isabel Versmissen ◽  
Nanique Prins ◽  
Daisy Jonkers ◽  
Jessica Gubbels ◽  
...  

With an growing number of people on a strict plant-based diet, its potential effect on pregnancy and lactation becomes increasingly important. It is, however, unclear how obstetric caregivers currently handle and think about a strict plant-based diet in pregnancy. The aim of the study was therefore to evaluate the self-reported knowledge and advice given by Dutch obstetric caregivers and dietitians when treating pregnant women on a strict plant-based diet. A cross-sectional study was performed by sending an online survey to Dutch midwife practices, obstetricians, and dietitian practices. Descriptive statistics are reported. A total of 121 midwives, 179 obstetricians, and 111 dietitians participated in this study. The majority of midwives (80.2%) and obstetricians (93.9%) considered a strict plant-based diet to be a significant risk factor for nutrient deficiency during pregnancy. Maternal dietary preferences, including a potential strict plant-based diet, were discussed at the first prenatal appointment by 59.5% of midwives and 24.1% of obstetricians. A self-reported lack of knowledge concerning the strict plant-based diet was mentioned by 66.1% of midwives and 75.4% of obstetricians. Obstetric caregivers mostly considered the identification of this dietary habit and subsequent referral to a dietitian or a reliable website as optimal care for pregnant women on the strict plant-based diet. However, only 38.7% of dietitians indicated to have sufficient knowledge to counsel these women. Although obstetric caregivers thought that a strict plant-based diet in pregnancy may lead to increased risks of nutritional deficiencies, the majority report to have insufficient knowledge to provide adequate advice. Only a minority referred these women to dietitians, of whom a minority indicated to have adequate knowledge on this specific diet. These results suggest that current care is suboptimal for an increasing number of pregnant women. Women on a strict plant-based diet could benefit from increased knowledge about this topic among obstetric caregivers and dietitians, as well as from clear guidelines regarding this diet during pregnancy.


Author(s):  
Jeevankumar U. Yadav ◽  
Deepmala J. Yadav

Background: Globally there has been increased medicalization of pregnancy due to advances in technology. Ultrasonography examination during pregnancy has become an integral part of antenatal care throughout the world with advanced health care services.Methods: The cross-sectional study was conducted in pregnant women attending the ANC clinic of Obstetric department of D. Y. Patil Medical College Hospital, Kolhapur, Maharashtra, India for routine check up to know the awareness about ultrasonography among them. The study included 290 pregnant women. All were explained the purpose of study and assured confidentiality. Data has been collected from willing participants using pre-tested questionnaire in June-August 2015.Results: The study shows literacy was 87.6%, pregnancy above 20 years age 98.97% and most of them unskilled (83.4%), majority of middle social class (89%). Many (72.41%) pregnant women considered USG use to detect fetal anomalies while 27.93% considered for sex detection. Majority (93.1%) done USG in this pregnancy, of that more (43.45 %) in second trimester and mainly advised by doctors (91.03%). Nearly half of them (50.69%) considered its expensive procedure, 69.31% spent 200/- to 500/- rupees per USG, in spite 94.83% of them would recommend other pregnant women to undergo USG in pregnancy. 50.69%% of them opined it should be done twice in pregnancy. Almost 94.83% considered USG as safe and beneficial.Conclusions: Awareness regarding the uses of Ultrasonography during pregnancy and attitude towards it was found to be average. There is need to create more awareness in community about PCPNT act and its provisions. Also there is need of counselling about the safety, utility and frequency of USG during pregnancy to avoid misuse.


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