scholarly journals A study on otorhinolaryngological manifestations in pregnant women

Author(s):  
Shallu Jamwal ◽  
Gopika Kalsotra ◽  
Monica Manhas ◽  
Apurva Raina ◽  
Parmod Kalsotra ◽  
...  

<p><strong>Background: </strong>Pregnancy is characterized by various endocrinological and physiological changes affecting different organs including ear, nose and throat. Otorhinolaryngological manifestations in pregnant women are mainly due to changes in levels of sex hormones such as estrogen and progesterone. While majority of these conditions are benign and reverse after parturition, some do not. The study was conducted with an objective to find the incidence of various otorhinolaryngological manifestations among pregnant women and to create awareness among the medical professionals to diagnose these conditions.<strong></strong></p><p><strong>Methods</strong>: This is a hospital based cross sectional study of 240 pregnant women who presented to the department of otorhinolaryngology with ENT symptoms. Detailed history, general physical examination and complete ENT examination was done on all subjects.</p><p><strong>Results</strong>: 47.9% of the study cases had otological manifestations among which otitis media was the main finding.</p><p>16.7 % of the cases had nasal symptoms among which rhinits was the main condition predominantly observed in the 3<sup>rd</sup> trimester. 19.6% of the cases had oral cavity lesions with stomatitis being the most commonly found cause. 15.8% of the cases had throat complaints, among which gastroesophageal reflux disease (GERD) was the most common cause found during 2<sup>nd</sup> and 3<sup>rd</sup> trimester.</p><p><strong>Conclusions: </strong>Recognition and understanding of pregnancy related ear, nose throat complaints will allow otolaryngologist to reassure and manage these patients, improving their experience of the gestational period.</p>

Author(s):  
Leimapokpam Roshan Singh ◽  
Kaushik Mahajan ◽  
Nandeibam Balchand Singh ◽  
Wairokpam Prabinkumar Singh ◽  
Kabita Athokpam ◽  
...  

Background: Fibromyoma (leiomyoma) is the most common benign tumour of the uterus. Approximately 10% to 30% of women with uterine fibroids developed complications during pregnancy. The aim of the study was planned to ascertain the fetomaternal outcome in pregnancies complicated by fibroid.Methods: A hospital based cross-sectional study was conducted among pregnant women with documented uterine fibroid who was admitted for any complication or delivered in the department of obstetrics and gynaecology, RIMS, Imphal from September 2017 to August, 2019 in the department of obstetrics and gynaecology in collaboration with department of paediatrics, Regional institute of Medical Sciences, Imphal. Detailed clinical history and socio-demographic profile were recorded in pre-designed proforma. General physical examination and systemic examination and obstetrical examination was carried out for the participants.Results: Major proportions was in the age group of 30-39 years (73.9%). Fibroids were more frequent in primigravida (76.1%) followed by P1 (15.2%) and ≥P2 (8.7%). Out of 46 patients 43 (93.5%) delivered by CS (69.76%), NVD (25.58%) and instrumental delivery (4.65%) while 3 patients (6.5%) undergo spontaneous abortions. Most common myoma found in this study was intramural (47.8%) followed by submucous (34.8%) and subserosal (17.4%). Out of 43 deliveries most common complications found was atonic PPH (6.97%) and placenta previa (6.97%) followed by degenerations (2.32%), abruptio placentae (2.32%), malpresentations (2.32%). Out of 43 deliveries 6.9% baby born with low birth weight, IUGR (6.9%), IUFD (4.6%), NICU admission (4.65%) and early neonatal death (2.32%).Conclusions: Pregnancies with fibroids are considered as high-risk pregnancy associated with complications during the antepartum, intrapartum, postpartum period. Pregnant women with myoma can be advised for regular ANC along with TAS for early diagnosis and management of complication.


2021 ◽  
Vol 8 (8) ◽  
pp. 445-449
Author(s):  
Melvin Dominic ◽  
Hari Hara C. Sudhan ◽  
Karthik Narayan ◽  
Ram Kirubakar Thangaraj ◽  
Abdussamad M ◽  
...  

BACKGROUND Fever is the commonest cause of thrombocytopenia that narrows the differential diagnosis and management of fever. The complexity of thrombocytopenia and its control can also be determined through fever. Lack of proper surveillance system and limited laboratory services pose a definite challenge for a perfect diagnosis leading to case management primarily based on clinical manifestations. METHODS A cross-sectional study was conducted on 90 patients attending outpatient department of Vinayaka Missions Kirupananda Variyar Medical College & Hospitals, during the period of April 2017 to September 2017 (6 months). In patients with fever with thrombocytopenia, a careful history was recorded, general physical examination, laboratory and technical investigation reports were noted down from regular investigations. Culture sensitivity and serology were considered as primary outcome variables. The continuous data was expressed as mean ± standard deviation (SD) and for independent sample “t” test was used to compare the data. A probability value (“P” value) of ≤ 0.05 at 95 % confidence interval was considered as statistically significant using Statistical Package for the Social Sciences (SPSS). RESULTS The mean age was 44.73 ± 21.18 years in the study population. 39 (43.33 %) were males and 51 (56.67 %) were females. The average period of stay in the hospital was 8.84 ± 5.73 days; the most common chief complaint was chills & rigors seen in 65 (72.22 %) patients. The most commonly observed comorbidity in the patients was diabetes mellitus. The mean and SD of platelet count was 91522.22 ± 32265.13 per µL. 21 (23.33 %) people had dengue. The mean platelet count at discharge was 192215.19 ± 49481.85 per µL. CONCLUSIONS The commonest cause is infection, for fever with decreased platelet count. A significant number of cases of febrile thrombocytopenia were diagnosed as sepsis in the present study. KEYWORDS Infection, Dengue, Septicaemia, Petechiae / Purpura, Spontaneous Bleeding, Fever


Author(s):  
Katarzyna Kwiatkowska ◽  
Katarzyna Kosińska-Kaczyńska ◽  
Izabela Walasik ◽  
Agnieszka Osińska ◽  
Iwona Szymusik

Background: No specific physical activity guidelines are available for women in multiple pregnancy. Aim of the study was to assess the knowledge and experience of women regarding physical activity during their latest twin pregnancy. Methods: A cross-sectional study including women after a twin delivery was conducted in Poland. A questionnaire was distributed in 2018 via web pages and Facebook groups designed for pregnant women. Results: 652 women filled out the questionnaire completely. Only 25% of women performed any physical exercises during twin gestation. The frequency of preterm delivery was similar in physically active and non-active participants. 35% of the respondents claimed to have gained information on proper activity from obstetricians during antenatal counselling while 11% claimed to be unable to identify the reliable sources of information. 7% of women admitted to feel discriminated by social opinion on exercising during a twin pregnancy. Conclusions: The population of women with a twin gestation is not sufficiently physically active and is often discouraged from performing exercises during gestation. Therefore, it is crucial to inform obstetricians to recommend active lifestyle during a twin gestation and to provide reliable information on physical activity to pregnant women. Further research on this topic is necessary in order for obstetric providers to counsel women on appropriate exercise with a twin pregnancy.


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Saran Tenzin Tamang ◽  
Thinley Dorji ◽  
Sonam Yoezer ◽  
Thinley Phuntsho ◽  
Phurb Dorji

Abstract Background The third Sustainable Development Goal for 2030 development agenda aims to reduce maternal and newborn deaths. Pregnant women’s understanding of danger signs is an important factor in seeking timely care during emergencies. We assessed knowledge of obstetric danger signs using both recall and understanding of appropriate action required during obstetric emergencies. Methods This was a cross-sectional study among pregnant women attending antenatal clinic at Bhutan’s largest hospital in Thimphu. Recall was assessed against seven obstetric danger signs outlined in the Mother and Child Health Handbook (7 points). Understanding of danger signs was tested using 13 multiple choice questions (13 points). Knowledge was scored out of 20 points and reported as ‘good’ (≥80%), ‘satisfactory’ (60–79%) and ‘poor’ (< 60%). Correlation between participant characteristics and knowledge score as well as number of danger signs recalled was tested using Pearson’s correlation coefficient. Association between knowledge score and participant characteristics was tested using t-tests (and Kruskal-Wallis test) for numeric variables. Socio-demographic and clinical characteristics associated with the level of knowledge ('good’ versus ‘satisfactory’ and ‘poor’ combined) were assessed with odds ratios using a log-binomial regression model. All results with p < 0.05 were considered significant. Results Four hundred and twenty-two women responded to the survey (response rate = 96.0%). Mean (±SD) knowledge score was 12 (±2.5). Twenty women (4.7%) had ‘good’ knowledge, 245 (58.1%) had ‘satisfactory’ knowledge and 157 (37.2%) had ‘poor’ knowledge. The median number of danger signs recalled was 2 (IQR 1, 3) while 68 women (20.3%) could not recall any danger signs. Most women were knowledgeable about pre-labour rupture of membranes (96.0%) while very few women were knowledgeable about spotting during pregnancy (19.9%). Both knowledge score and number of danger signs recalled had significant correlation with the period of gestation. Women with previous surgery on the reproductive tract had higher odds of having ‘good’ level of knowledge. Conclusions Most pregnant women had ‘satisfactory’ knowledge score with poor explicit recall of danger signs. However, women recognized obstetric emergencies and identified the appropriate action warranted.


2021 ◽  
Vol 6 (1) ◽  
pp. 29
Author(s):  
Cruz S. Sebastião ◽  
Joana Morais ◽  
Miguel Brito

The increase in HIV infection and drug-resistant strains is an important public health concern, especially in resource-limited settings. However, the identification of factors related to the propagation of infectious diseases represents a crucial target offering an opportunity to reduce health care costs as well as deepening the focus on preventing infection in high-risk groups. In this study, we investigate the factors related to drug resistance among HIV-infected pregnant women in Luanda, the capital city of Angola. This was a part of a cross-sectional study conducted with 42 HIV-positive pregnant women. A blood sample was collected, and HIV-1 genotyping was carried out using an in-house method. Multivariate analyses were performed to determine the interaction between sociodemographic characteristics and drug resistance. HIV drug resistance was detected in 44.1% of the studied population. High probabilities of drug resistance were observed for HIV-infected pregnant women living in rural areas (AOR: 2.73; 95% CI: 0.50–14.9) with high educational level (AOR: 6.27; 95% CI: 0.77–51.2) and comorbidities (AOR: 5.47; 95% CI: 0.28–106) and infected with a HIV-1 non-B subtype other than subtype C (AOR: 1.60; 95% CI: 0.25–10.3). The present study reports high HIV drug resistance. Furthermore, older-age, rural areas, high educational levels, unemployed status, having comorbidities, and HIV-1 subtypes were factors related to drug resistance. These factors impact on drug susceptibility and need to be urgently addressed in order to promote health education campaigns able to prevent the spread of drug-resistant HIV strains in Angola.


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Najmieh Saadati ◽  
Poorandokht Afshari ◽  
Hatam Boostani ◽  
Maryam Beheshtinasab ◽  
Parvin Abedi ◽  
...  

Abstract Background The COVID-19 pandemic has affected many countries around the world and Iran was no exception. The aim of this study was to evaluate health anxiety of Iranian pregnant women during the COVID-19 pandemic. Methods In this cross-sectional study, 300 pregnant women in different trimesters (n = 100 in each trimester) were recruited. A demographic questionnaire and the Health Anxiety Questionnaire were used to collect data. Scores of < 27, 27–34 and more than 35 were defined as low, moderate and high health anxiety, respectively. Due to nationwide restrictions, data were collected through social media groups. Chi-square tests, ANOVA and multiple linear regression were used to analyze the data. Results Mean (SD) total anxiety scores were 22.3 ± 9.5, 24.6 ± 9.3 and 25.4 ± 10.6 in the first, second and third trimesters of pregnancy, respectively. 9, 13 and 21% of women had severe anxiety in the first, second and third trimesters of pregnancy, respectively. Women in the third trimester had significantly higher health anxiety scores than those in the first trimester (p = 0.045). Conclusion At the time of the COVID-19 pandemic, women in the second and third trimesters of pregnancy were more worried about consequences of disease, but total health anxiety scores were significantly higher among women in the third trimester of pregnancy. Health care providers should pay more attention to the mental health of pregnant women in times of crises such as the COVID-19 pandemic.


2021 ◽  
Vol 8 ◽  
pp. 2333794X2199915
Author(s):  
Haymanot Mezmur ◽  
Nega Assefa ◽  
Tadesse Alemayehu

Background: According to the World Health Organization, teenage pregnancies are high-risk due to increased risks of fetal and infant morbidity and mortality. This study compares adverse fetal outcomes between teen and adult pregnant women from rural Eastern Ethiopia. Methods: Institutional-based cross-sectional study was conducted among women visiting maternity units from surrounding rural areas. A total of 481 teenagers (13-19 years old) and 481 adults (20-34 years old) women with a singleton pregnancy were included in the study. Two hospitals and 3 health centers were selected in Eastern Hararghe Zone, Eastern Ethiopia. Comparative analysis was carried out using the log-binomial regression model to identify factors associated with adverse fetal outcomes in both categories. The results are reported in adjusted prevalence ratios with 95% confidence intervals. Results: High proportion of adverse fetal outcome was observed among teenage women than adult (34.9% vs 21%). Statistically significant difference ( P < .05) in the proportion of low birth weight (21.1% vs 9.3%), preterm birth (18.7% vs 10.6%), APGAR score at 5th minute (9.3% vs 4%) were found in teenagers compared to adult women. Antenatal care attendance (APR = 0.44; 95% CI: 0.23, 0.86); eclampsia (APR = 1.96; 95% CI: 1.26, 3.06); pre-eclampsia (APR = 1.73; 95% CI: 1.12, 2.67); and wealth index (rich) (APR = 0.55; 95% CI: 0.32, 0.94) were significantly associated with adverse fetal outcomes among the teenage women. Whereas intimate partner violence (APR = 2.22; 95% CI: 1.26, 3.90); preeclampsia (APR = 3.05; 95% CI: 1.61, 5.69); antepartum hemorrhage (APR = 2.77; 95% CI: 1.73, 4.46); and hyperemesis gravderm (APR = 1.75; 95% CI: 1.09, 2.79) were significantly associated with adverse fatal outcomes among the adult women. Conclusion: teenage pregnancy is associated with a high rate of adverse fetal outcomes. Early identification and treatment of problems during antenatal follow-up should be the mainstay to avert the massive adverse fetal effects.


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