scholarly journals High-risk pregnancy: effectiveness of personalized pregravid preparation and positive perinatal experience

2021 ◽  
pp. 34-41
Author(s):  
G.S. Manasova ◽  
N.V. Didenkul ◽  
N.V. Kuzmyn

Research objective: to study the possibilities of improving perinatal results by optimizing pergravid preparation in women with high perinatal risk.Materials and methods. The first stage – a cross-sectional study – consisted in determining the vitamin D (VD) status and assessing the course of pregnancy in 459 women in the II and III trimester; the second stage was a randomized controlled study of women with VD deficiency in group IIA (planning stage, 54 women) and IIB (I trimester, 60 women), who received the vitamin and mineral complex (VMC) Pregna-5 with a high calcitriol content and perinatal results were evaluated. VD in the blood was determined by the enzyme-linked immunosorbent assay.Results. VD level was optimal only in 30.7% of pregnant women (group ІА), in 69.3% of women its insufficiency or deficiency was found (group ІB). The frequency of threatened termination (9.9 vs. 45.6%; p < 0.01), preeclampsia (2.0 vs. 11%; p < 0.05), intrauterine growth retardation (7% only in group IIB, p < 0.01) was significantly higher against the background of BD deficiency. Normalization of the VD level (groups IIA and IIB) after VMC administration was observed within 1–3 months. Pregnancy complications value was higher in the group where the VMC was started in the first trimester: early gestosis (15 vs. 28.57%; p < 0.05), the threat of termination (22.2 vs. 36.7%; p < 0.05), bacterial vaginosis (7.4 vs. 31.7%; p < 0.05), placental dysfunction (18.5 vs. 40.0%; p <0.01), placental pathology in group IIB was detected 2–3 times more often. The differences between the preeclampsia (1.9 vs. 6.7%; p > 0.05) and anemia (16.6 vs. 28.3%; p > 0.05) were insignificant. Analysis of the childbirth results showed a significantly higher frequency of cesarean sections in group IIB (38.3 vs. 22.2%; p < 0.05), the average weight of newborns was less (3299.11 ± 128 g vs. 3643.24 ± 136 g; p < 0.01). The most effective was the VMC start at the stage of pregnancy planning (F = 13.35482; p = 0.000016); a significant difference was revealed in the course of pregnancy in the groups where VMC started in the first, second and third trimesters of pregnancy (Q = 4.67, p = 0.00458).Conclusions. Timely donation of VMC with a high content of cholecalciferol in women with high perinatal risk may lead to a positive course of pregnancy. Further research is required to obtain a convincing evidence base.

Author(s):  
Santhini Gopalakrishnan Sethulekshmi ◽  
S Sumathy ◽  
Banani Dutta

Introduction: Pregnancy is a period that is characterised by remarkable physiological changes which are needed to support the growing fetus. Micronutrients play a crucial role in the maintenance of pregnancy. Among the micronutrients, magnesium has got ample amount of clinical relevance to pregnancy. Magnesium deficiency has been associated with reproductive risk during pregnancy such as anaemia, pre-eclampsia, eclampsia, fetal growth retardation, preterm labour, low intrauterine growth rate and leg cramps. Aim: To find out whether there was significant difference in the magnesium levels among pregnant women with and without pregnancy related complications and also to find out whether the magnesium levels differed significantly among the three trimesters. Materials and Methods: This was a cross-sectional study done among 240 pregnant patients from different trimesters attending the Obstetrics and Gynaecology Outpatient Department. Out of them 164 women had complications like pre-eclampsia, Gestational Diabetes Mellitus, leg cramps and history of abortions. Demographic details were obtained from all the women. BMI was calculated for each subject using the formula BMI=weight(kg)/height(m2). Haemoglobin was assessed in all samples using cyanmethaemoglobin method. Magnesium levels were analysed in the all samples using automated analyser in the Biochemistry laboratory. Student’s t-test was used to compare the levels of magnesium among the groups with and without complications. ANOVA test was used to compare the three trimesters. Results: The pregnant women were divided into three groups based on the different trimesters in which the samples were taken. Magnesium levels among the women in the first trimester were (2.96±0.83) second trimester (2.99±1.48) and third trimester (3.05±1.48) respectively. Women with previous abortions were found to have less magnesium levels (2.71) compared to women without a history of abortion (3.11) and value was found to be statistically significant (p<0.007) and magnesium levels among vegetarians (2.45) were lower than non vegetarians (3.08) and it was found to be statistical significant (p<0.013). There was no significant difference in the magnesium levels among pregnant women with complications and those without complications. Conclusion: The study shows the importance of maintaining the magnesium levels among pregnant women. There was no difference in the magnesium levels among the three trimesters. Study also points out the influence of parity, diet and occupation of pregnant women on the levels of magnesium.


2011 ◽  
Vol 69 (4) ◽  
pp. 613-619 ◽  
Author(s):  
Waldmiro Antônio Diégues Serva ◽  
Vilneide Maria Santos Braga Diégues Serva ◽  
Maria de Fátima Costa Caminha ◽  
José Natal Figueiroa ◽  
Emídio Cavalcanti Albuquerque ◽  
...  

OBJECTIVE: To describe the course of migraine without aura and migraine with aura during pregnancy and factors that could influence its course, among migraine sufferers before pregnancy. METHOD: A cross sectional study undertaken at the IMIP, Brazil. Out of 686 consecutively assisted women, at the first postnatal week, 266 were identified as migraine sufferers before pregnancy. RESULTS: There was migraine remission in 35.4%, 76.8% and 79.3% among migraine without aura sufferers and 20.7%, 58.6% and 65.5% among those with migraine with aura, respectively in the first, second and third trimesters. Statistically significant difference was found when the first trimester was compared with the second and third trimesters. The factors associated with the presence of migraine during pregnancy were: multiparity, menstrually related migraine without aura prior to pregnancy and illness during pregnancy. CONCLUSION: The study contributed to elucidate the course of migraine during pregnancy in migraine sufferers prior to pregnancy.


2020 ◽  
Vol 4 ◽  
pp. 8-12
Author(s):  
Ekpereonne Babatunde Esu ◽  
Enobong Ime Okpon

Objectives: Ectopic pregnancy is a leading cause of maternal death during the first trimester of pregnancy, accounting for approximately one in ten pregnancy-related deaths. Knowledge of potential risk factors can improve early detection and avoid morbidity and complications. This cross-sectional study determined the knowledge level and prevalence of risk factors of ectopic pregnancy among female undergraduates. Material and Methods: Three hundred and ninety female students were randomly selected from the various hostels through multistage sampling. Results: The study found that 234 (60%) respondents were aware of ectopic pregnancy. The majority of the respondents (72.1%) had moderate to a good knowledge level of ectopic pregnancy and the risk factors. There was no significant difference in knowledge level based on marital status of the respondents (P = 0.642). Predominant risk factors for ectopic pregnancy identified among respondents were use of oral contraceptives – 151 (38.8%), frequent alcohol intake – 105 (26.9%), prior pelvic inflammatory disease 94 (24.1%), and induced abortion 52 (13.3%). Initiation of oral contraceptive use was between age 13 and 20 years for about 118 (77.7%) respondents. Conclusion: Health education interventions on the knowledge of symptoms and risk factors of ectopic pregnancy need to be targeted at women of reproductive age to reduce the associated morbidity and mortality.


2021 ◽  
Vol 12 (9) ◽  
pp. 26-30
Author(s):  
Pravin Shrestha ◽  
Vibha Mahato ◽  
Anil Subedi ◽  
Shipra Shrestha

Background: COVID-19 has become a global pandemic. It has affected the psychological condition of pregnant women. Aims and Objective: This study aims to assess prevalence of depression and anxiety in pregnancy during COVID-19 pandemic. Materials and Methods: The current study was an observational, cross sectional study conducted in the Department of Obstetrics and Gynecology, Manipal Teaching Hospital. Patients were assessed using Nepali version of Beck Anxiety Inventory (BAI) and Beck Depression Inventory (BDI) for anxiety and depression respectively. Result: There were total of 115 patients in this study. The prevalence of anxiety according to BAI was 39.1%. The prevalence of depression according to BDI was 19%. There was a statistically significant difference in rate of anxiety according to maternal age (p value 0.028). Anxiety was higher in women less than 20 years of age. Anxiety symptoms were more prevalent i.e., 44.6% in third trimester followed by 31.4% in second trimester and 29.4% in first trimester. Symptoms of depression was higher in women more than 35 years of age (27.2%) and in second trimester of pregnancy (27.2%). Conclusion: Antenatal anxiety and depression are important issues because it impacts both maternal wellbeing and fetal health. Prevalence of anxiety and depression among pregnant women during COVID 19 pandemic was studied. The prevalence of anxiety and depression was 39.1% and 19% respectively.


2017 ◽  
Vol 47 (1) ◽  
pp. 53-66
Author(s):  
Javeed A. Golandaj ◽  
Shrikanta R. Vatavati ◽  
Karabasappa Gadigeppa Kallihal

Purpose The purpose of this paper is twofold: first, to examine the effect of interventional measures on admitted children and, second, to estimate the level of utilization of nutrition rehabilitation centres (NRCs) through bed occupancy rate in India. Design/methodology/approach A cross-sectional study involving review of records of malnourished children admitted during 1st January to 31st December 2014 in four districts of Northern Karnataka, India. The data were collected during January 2015. Findings A statistically significant difference was obtained between the weight of children at admission and discharge (p < 0.001). The average weight gain during the stay at the centres was 6.1 ± 7.1 g/kg/day. The proportion of severely malnourished children decreased from 56 per cent at admission to 32 per cent at discharge. The children who stayed for a stipulated period of 14 days were fully recovered and discharged from the centre compared to those stayed for lesser period. Poor follow-up visits of discharged children are observed, and the average bed occupancy rate was only 40 per cent. Originality/value This study showed that, the NRCs were effective in improving the condition of admitted children, but the utilization of these NRCs was sub-optimal in Karnataka. This study pointed to a number of operational issues that need to be addressed if these NRCs are being used effectively.


2012 ◽  
Vol 4 (3) ◽  
pp. 29
Author(s):  
Olugbenga A. Mokuolu ◽  
Omotayo O. Adesiyun ◽  
Mohammed B. Suleiman ◽  
Mustapha Bello

The aim of the study was to define an intrauterine growth curve for a population of Nigerian newborn babies. A cross-sectional observational study design was adopted. Weight, length and head circumference were all measured in consecutive singleton deliveries at the University of Ilorin Teaching Hospital over a 3-year period. Gestational age (GA) of the babies was estimated from the last menstrual period or first trimester ultrasound. The estimates obtained were clinically validated using the Ballard score. Mean birth weights and percentiles of the weight, length and head circumferences for the respective GA were estimated using the SPSS 15 software package. A total of 5273 babies were recruited for the study with GA ranging from 25-44 weeks. Comparison of the mean birth weights of the various GA with the data from Denver, Colorado, showed that Nigerian babes tended to weigh less at the early GA, although these differences were not statistically significant. Between 26-36 weeks, the average weights of both sexes were similar; however, beyond this time point there was a consistent increase in the average weight of the males over the female babies. Growth curves for Nigerian newborn babies were generated and showed that the mean birth weight of Nigerian preterm babies was lighter than that of babies in Colorado. The impact of these differences on the classification of newborns will require further evaluation.


2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Chee Wai Ku ◽  
Xiaoxuan Zhang ◽  
Valencia Ru-Yan Zhang ◽  
John Carson Allen ◽  
Nguan Soon Tan ◽  
...  

AbstractProgesterone is a steroid hormone that is critical for implantation and maintenance of pregnancy, and low levels are associated with higher miscarriage risk. However, little is known about its trajectory during early pregnancy. We sought to determine the gestational age-specific normative values of serum progesterone on a week-by-week basis, and its associated maternal and fetal factors, during the first trimester of a viable low-risk pregnancy. A cross-sectional study was conducted at KK Women’s and Children’s Hospital from 2013 to 2018. 590 women with a single viable intrauterine low-risk pregnancy, between gestational weeks 5 and 12, were recruited. Serum progesterone showed an increasing trend during the first trimester, with a transient decline between gestational weeks 6–8, corresponding to the luteal–placental shift. Lowest levels were seen at week 7. Maternal age, BMI, parity, gestational age and outcome of pregnancy at 16 weeks’ gestation were found to be associated with progesterone levels. Normative values of serum progesterone for low-risk pregnancies would form the basis for future work on pathological levels of serum progesterone that may increase risk of miscarriage. Larger studies are required to validate these normative values, and personalize them to account for maternal age, BMI, parity and gestational age.


2020 ◽  
Vol 63 (6) ◽  
pp. 2016-2026
Author(s):  
Tamara R. Almeida ◽  
Clayton H. Rocha ◽  
Camila M. Rabelo ◽  
Raquel F. Gomes ◽  
Ivone F. Neves-Lobo ◽  
...  

Purpose The aims of this study were to characterize hearing symptoms, habits, and sound pressure levels (SPLs) of personal audio system (PAS) used by young adults; estimate the risk of developing hearing loss and assess whether instructions given to users led to behavioral changes; and propose recommendations for PAS users. Method A cross-sectional study was performed in 50 subjects with normal hearing. Procedures included questionnaire and measurement of PAS SPLs (real ear and manikin) through the users' own headphones and devices while they listened to four songs. After 1 year, 30 subjects answered questions about their usage habits. For the statistical analysis, one-way analysis of variance, Tukey's post hoc test, Lin and Spearman coefficients, the chi-square test, and logistic regression were used. Results Most subjects listened to music every day, usually in noisy environments. Sixty percent of the subjects reported hearing symptoms after using a PAS. Substantial variability in the equivalent music listening level (Leq) was noted ( M = 84.7 dBA; min = 65.1 dBA, max = 97.5 dBA). A significant difference was found only in the 4-kHz band when comparing the real-ear and manikin techniques. Based on the Leq, 38% of the individuals exceeded the maximum daily time allowance. Comparison of the subjects according to the maximum allowed daily exposure time revealed a higher number of hearing complaints from people with greater exposure. After 1 year, 43% of the subjects reduced their usage time, and 70% reduced the volume. A volume not exceeding 80% was recommended, and at this volume, the maximum usage time should be 160 min. Conclusions The habit of listening to music at high intensities on a daily basis seems to cause hearing symptoms, even in individuals with normal hearing. The real-ear and manikin techniques produced similar results. Providing instructions on this topic combined with measuring PAS SPLs may be an appropriate strategy for raising the awareness of people who are at risk. Supplemental Material https://doi.org/10.23641/asha.12431435


Author(s):  
Bhagavathami Meenaksh ◽  
Chitraa R. Chandran ◽  
Aravindhan Thathchari Ranganathan ◽  
Kavindapadi Venkateswaran Rama ◽  
Valarmathy Srinivasan

Background: This study aims to determine and compare the levels of trace elements copper, zinc, selenium and chromium in GCF and serum of patients with periodontitis and healthy individuals. Methods: This cross sectional study includes 24 study subjects recruited from the patients reporting to the Department of Periodontics , Tagore Dental College Chennai. All the selected patients were subjected to a clinical examination done by a single examiner. The estimation of trace elements Copper, Zinc, Selenium and Chromium in GCF and serum is performed using Perkin Elmer optima 5300 Inductively Coupled Plasma Emission Spectrometer (ICPOES). Results: GCF and serum copper levels showed no significant difference in both periodontitis and healthy groups . Selenium levels tend to be the same in both groups. Serum zinc levels are more in periodontitis patients than healthy subjects (p less than 0.01). GCF chromium levels are found to be more in patients with periodontitis than healthy. Conclusions : More research is therefore needed to monitor the role of these trace elements C with an increased sample size to ascertain whether they are associated with a reduced risk of periodontitis.


2018 ◽  
Vol 7 ◽  
Author(s):  
Arefeh Shahi

Background: Postpartum depression with a different incidence of 40- 45% in different societies, which it has adverse effects on the health of mothers and their child, given the negative effects of maternal depression and its harmful effects on the baby and the quality of family life. So, this study was performed with the aim to determine postpartum depression and its associated factors in Bandar Abbas city. Materials and Methods: A descriptive cross-sectional study was conducted in 2015 after obtaining consent from mothers by the census. A total of 343 mothers was examined for depression who referred to Bandar Abbas health centers in the 2nd and 4th months after childbirth. The data collection tools included demographic information and Postpartum Depression Edinburgh questionnaires. Finally, the statistical analyses were performed using SPSS (version 22.0) software and data were analyzed using the Independent t-test, Mann Whitney, Chi-square, and Fisher exact tests.Result: Totally, 68 (19.8%) of samples were in the second month and 54 (15.7%) in the fourth month after delivery had postpartum depression. The incidence of depression in the four months was 6.6%. There was a significant difference between depression and income, parental education, father’s use of cigarette and abnormalities of the infant (P <0.001). There was no significant difference between other factors such as gestational age, infant sex, birth weight, unwanted pregnancy, and type of delivery. Conclusion: Regarding the prevalence of this disorder, it seems that postpartum depression screening planning should be considered during child routine care as an essential component, especially for vulnerable groups.


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