The Myometrium in Pregnant Women with Obesity

2020 ◽  
Vol 19 (2) ◽  
pp. 193-200
Author(s):  
Jorge A. Carvajal ◽  
Joaquín I. Oporto
Keyword(s):  
Pregnant Women ◽  
Public Health Problem ◽  
Oxytocin Receptor ◽  
High Rate ◽  
K Channel ◽  
Obese Women ◽  
Cesarean Sections ◽  
Cholesterol Levels ◽  
Myometrial Contractility ◽  
Lower Expression

: Obesity is a worldwide public health problem, affecting at least one-third of pregnant women. One of the main problems of obesity during pregnancy is the resulting high rate of cesarean section. The leading cause of this higher frequency of cesarean sections in obese women, compared with that in nonobese women, is an altered myometrial function that leads to lower frequency and potency of contractions. In this article, the disruptions of myometrial myocytes were reviewed in obese women during pregnancy that may explain the dysfunctional labor. The myometrium of obese women exhibited lower expression of connexin43, a lower function of the oxytocin receptor, and higher activity of the potassium channels. Adipokines, such as leptin, visfatin, and apelin, whose concentrations are higher in obese women, decreased myometrial contractility, perhaps by inhibiting the myometrial RhoA/ROCK pathway. The characteristically higher cholesterol levels of obese women alter myometrial myocyte cell membranes, especially the caveolae, inhibiting oxytocin receptor function, and increasing the K+ channel activity. All these changes in the myometrial cells or their environment decrease myometrial contractility, at least partially explaining the higher rate of cesarean of sections in obese women.

scholarly journals In the Crossing of Politics With Science: Medical Arguments on the High Rate of Cesarean Sections in Rio de Janeiro, Brazil

2021 ◽  
Author(s):  
Jaqueline Ferreira
Keyword(s):  
Social Movement ◽  
Pregnant Women ◽  
Rio De Janeiro ◽  
Participant Observation ◽  
Political Context ◽  
Point Of View ◽  
High Rate ◽  
Cesarean Sections ◽  
Medical Evidence ◽  
The World

Brazil is the second country with the highest rate of cesarean sections in the world. Most of these procedures are without medical reasons, representing risks for the mother and baby. Obstetric doctors are appointed as the main responsible for this index. The reasons given are for financial reasons or for the convenience of predictable and planned births, and in these cases, cesarean sections are performed without sufficient clarification to pregnant women about their risks and their real need. In this context, there is a constant conflict between doctors and social movement activists in favor of the humanization of childbirth. The purpose of this paper is to analyze from an anthropological point of view the arguments that doctors use to defend themselves against these accusations. Through participant observation at scientific events and meetings of representatives of medical entities, it was found that obstetricians argue that they are based on “medical evidence” and accuse humanized childbirth activists of being based on “ideology”. These arguments reflect the current political context in Brazil marked by intolerance and the advance of neoconservatism.

scholarly journals The Commonest Indications of Cesarean Sections at Ghalib Teaching Hospital in Year 2017; Cross-sectional Study

2021 ◽  
Author(s):  
Mohammad Rafi Fazli ◽  
Amena Mansouri ◽  
Hania Wahidi
Keyword(s):  
Cesarean Section ◽  
Pregnant Women ◽  
Vaginal Delivery ◽  
Teaching Hospital ◽  
Cross Sectional Study ◽  
High Rate ◽  
Cesarean Sections ◽  
Sectional Study ◽  
Cross Sectional ◽  
Previous Cesarean

Abstract Background: In the past few decades, the rate of cesarean section (CS) has increased worldwide which is common in high income countries. Although cesarean section has lots of socioeconomic impacts in the career of mothers and babies especially in LMICs like Afghanistan, it is also increasing in such countries. In compare to vaginal delivery the cesarean section has higher risks for maternal health. The most important aim of this study is to search the commonest indications of cesarean section at the only teaching hospital in west region of Afghanistan, Ghalib Teaching Hospital in 2017.Material and Method: This was a cross-sectional study. Among 456 pregnant women who came to Ghalib Teaching Hospital, 287(63%) had vaginal delivery and 169 (37%) had cesarean section delivery in 2017. Data was collected reviewing medical records; patients discharge certificate and a questionnaire which consisted of the data like; history of previous cesarean sections, age, and so on. Data was analyzed by epi info 7.Results: the prevalence of cesarean section in Ghalib Teaching Hospital was 37%, the median age was 28 years old, the mean age was 23.83 and the most ages were between 21-25 (42.5%). The commonest indications were severe oligohydramnios (29.5%) followed by previous cesarean section (12.4%) and elective cesarean section 10.9% (on maternal request). The least indication was cephalopelvic disproportion (3.09%). In our research we had more than one indication about 10.3%.Conclusion: according to the research the commonest indication of cesarean section was severe oligohydromnios which shows emergency indication among pregnant women. As the women in Afghanistan want many children so they usually do not consider having cesarean section deliveries. Cesarean section on maternal request also has high rate which needs appropriate guidelines and also policies to decrease this high rate of selective cesarean section. In our research 52.1% of indications of CS was fetal factors. This shows in LMICs many fathers have valued to the health of babies instead of mothers. It is highly needed to inform fathers to know about health of both babies and mothers.

scholarly journals Anti-Toxoplasma gondii Antibodies: Prevalence and Risk Factors among Pregnant Women Accessing Antenatal Care in Some Primary Health Centers in Jos Metropolis, Nigeria

2021 ◽  
pp. 9-17
Author(s):  
Ocheme Julius Okojokwu ◽  
Innocent Ajegba Onaji ◽  
Entonu Elijah Entonu ◽  
Bashiru Abubakar ◽  
Maryam Adebayo ◽  
...  
Keyword(s):  
Risk Factors ◽  
Toxoplasma Gondii ◽  
Antenatal Care ◽  
Pregnant Women ◽  
Public Health Problem ◽  
High Rate ◽  
Enzyme Linked Immunosorbent Assay ◽  
Blood Samples ◽  
Igm Antibody ◽  
Primary Health

Toxoplasma gondii infection causes high rate of gestational and congenital infection across the globe and is considered a both a public health problem and a neglected disease. The study was carried out to determine the prevalence of anti-Toxoplasma gondii antibodies and the associated risk factors among pregnant women attending antenatal care in some Primary Health Centres in Jos, Plateau State, Nigeria. In this cross-sectional study carried out within 5 months between Jan – May 2019, a total of 182 blood samples were collected from consenting pregnant women. Structured questionnaire was used to obtain data on socio-demography and risk factors. Three millilitres (3 ml) of blood samples were collected from the study participants. Sera were separated from the blood and evaluated for anti-Toxoplasma gondii antibodies (IgG and IgM) using enzyme-linked immunosorbent assay (ELISA). The data collected from the experiment were analysed using Statistical Package for the Social Sciences. Out of the 182 samples examined, 84 (46.2%) had anti-Toxoplasma gondii IgG antibody, 2 (1.1%) had IgM antibody while 98 (53.4%) were neither seropositive for IgG nor IgM. Trimester of pregnancy was significantly associated with prevalence of anti-Toxoplasma IgM antibody. In conclusion, Toxoplasmosis is prevalent in Jos. Eleven out of every 1000 women (i.e. 1.1%) had recent toxoplasmosis and 53.4% were not protected against primary infection thereby underscoring the need for prevention and control during pregnancy through enlightenment.

scholarly journals Study of the Prevalence of Obesity and Its Association with Maternal and Neonatal Characteristics and Morbidity Profile in a Population of Moroccan Pregnant Women

2021 ◽  
Vol 2021 ◽  
pp. 1-10
Author(s):  
Fatima Taoudi ◽  
Fatima Zahra Laamiri ◽  
Fatima Barich ◽  
Nadia Hasswane ◽  
Hassan Aguenaou ◽  
...  
Keyword(s):  
Pregnant Women ◽  
Age Groups ◽  
Public Health Problem ◽  
Normal Weight ◽  
Overweight And Obesity ◽  
Obese Group ◽  
Obese Women ◽  
Anthropometric Parameters ◽  
Cross Sectional ◽  
Prevalence Of Obesity

Obesity is a real public health problem whose prevalence continues to increase throughout the world. It affects all age groups and does not spare pregnant women. This work aims to determine the prevalence of obesity and to study its association with maternal and neonatal characteristics and the morbidity profile of pregnancy. This is a descriptive and cross-sectional study carried out in the maternity ward of the prefectural hospital center called “Sidi Lahcen” in Témara, Morocco, over a 12-month period. Maternal and neonatal data are collected through a preestablished questionnaire, and anthropometric parameters were recorded. 390 participants, aged between 18 and 43 years, were included in this study, with a prevalence of overweight and obesity of 34.9% and 41%, respectively. Correlation results revealed that the prevalence of overweight and obesity was significantly elevated in women over 25 years p < 0.001 . The rate of caesarean section was four times higher in obese women compared to women of normal weight (53.8% versus 12.8%; p = 0.018 ). The over-term was significantly high in the obese group compared to the nonobese group (33.8% versus 20.2%; p = 0.013 ). A statistically significant positive correlation was found between gestational body mass index and newborn birth weight (r = 0.29; p < 0.001 ) as well as a high prevalence of macrosomia in newborns of comparatively obese women compared to newborns of nonobese women (17.6% versus 9.6%; p = 0.041 ). The correlation analysis with the morbidity profile showed a significantly high preponderance of gestational diabetes, anemia, and toxemia of pregnancy in the obese group compared to the normal group p < 0.001 . This study clearly demonstrated that obesity during pregnancy is associated with higher risks of maternal and neonatal complications, the management of which places a burden on the health system as well as families. These data reinforce the need to improve antenatal care for the prevention of obesity and its preventable complications.

Crucial role of physiotherapy in treating COVID-19 patients

2020 ◽  
Vol 11 (SPL1) ◽  
pp. 967-971
Author(s):  
Poonam Thakre ◽  
Waqar M. Naqvi ◽  
Trupti Deshmukh ◽  
Nikhil Ingole ◽  
Sourabh Deshmukh
Keyword(s):  
Public Health ◽  
Distress Syndrome ◽  
Public Health Problem ◽  
Public Health Emergency ◽  
High Rate ◽  
Major Public Health Problem ◽  
Front Line ◽  
The Many ◽  
Sixth International

The emergence in China of 2019 of severe acute respiratory syndrome coronavirus2 (SARS-CoV-2) previously provisionally names 2019-nCoV disease (COVID19) caused major global outbreak and is a major public health problem. On 30 January 2020, the WHO declared COVID19 to be the sixth international public health emergency. This present pandemic has engrossed the globe with a high rate of mortality. As a front line practitioner, physiotherapists are expected to be getting in direct contact with patients infected with the virus. That’s why it is necessary for understanding the many aspects of their role in the identification, contains, reduces and treats the symptoms of this disease. The main presentation is the involvement of respiratory system with symptoms like fever, cough, sore throat, sneezing and characteristics of pneumonia leads to ARDS(Acute respiratory distress syndrome) also land up in multiorgan dysfunction syndrome. This text describes and suggests physiotherapy management of acute COVID-19 patients. It also includes recommendations and guidelines for physiotherapy planning and management. It also covers the guidelines regarding personal care and equipment used for treatment which can be used in the treatment of acute adult patients with suspected or confirmed COVID-19.

The Predictive Role of Biochemical Plasma Factors in Patients with Severe Traumatic Brain Injuries

2019 ◽  
Vol 70 (5) ◽  
pp. 1754-1757
Author(s):  
Marius Toma Papacocea ◽  
Ioana Anca Badarau ◽  
Mugurel Radoi ◽  
Ioana Raluca Papacocea
Keyword(s):  
Blood Pressure ◽  
Heart Rate ◽  
Blood Cell ◽  
Brain Injuries ◽  
Hematological Parameters ◽  
Group Versus ◽  
Public Health Problem ◽  
Traumatic Brain Injuries ◽  
High Rate ◽  
Control Group

Traumatic brain injuries (TBI) represent a high impact public health problem due to a high rate of death , long term disability and occurrence especially in young adults. Despite several promising animal studies, several parameters were proposed as biological markers and were assessed for this aim. Our study proposes the study of the early biochemical changes in association to hematological parameters for severe TBI patients prognosis. 43 patients with acute TBI were included in study based on clinical, laboratory and imagistic findings. The severity of the TBI was established by Glasgow Coma Scale GCS 3-8. In all patients were evaluated hematologic parameters (Red blood cell count - RBC, Hematocrit, blood Hemoglobin, White blood cell - WBC, Platelet count and biochemical parameters (glucose, urea, creatinine, electrolytes). Outcome was expressed as Glasgow Outcome Scale (GOS), between 1-5. Values were compared to control group -15 cases. Significant early differences in body temperature, heart rate, and systolic blood pressure were observed in TBI group versus control (p[0.05). After correlation, laboratory findings significantly associated to severe outcome - GOS = 1, 2 - (p[0.05) were plasma Na decrease and significant glucose increase. An early increase of temperature and decrease of Na may predict a severe outcome in patients with acute TBI; association with shifts in heart rate and blood pressure, imposes aggressive treatment measures.

Impact of obesity on female sexual dysfunction: A remiss

2020 ◽  
Vol 16 ◽  
Author(s):  
Asma Farooq Shah ◽  
Isha Chawla ◽  
Kirti Goel ◽  
Rakesh Gollen ◽  
Randhir Singh
Keyword(s):  
Sexual Dysfunction ◽  
Female Sexual Dysfunction ◽  
Kidney Diseases ◽  
Public Health Problem ◽  
Point Of View ◽  
Sexual Disorders ◽  
Sexual Dysfunctions ◽  
Obese Women ◽  
Prevalence Of Obesity ◽  
The Impact

: The prevalence of obesity around the globe is increasing at such an alarming rate that WHO consultation on obesity designated obesity as a major unattended public health problem worldwide. Obesity is associated with a greater risk of excessive fat related metabolic and endocrinal diseases associated with different set of illness and disabilities, including type 2 diabetes, cardiovascular diseases, kidney diseases, sleep apnea, arthritis, lung diseases and sexual disorders. Obesity is found to be associated with male and female sexual dysfunctions and several studies have indicated a positive correlation between obesity and sexual dysfunction among both males and females. The relationship between male obesity and sexual dysfunction has been widely discussed, whereas a very little emphasis is laid on relationship between obesity and female sexual dysfunctions. Sexual dysfunctions are common and affects 20-50% of obese women. Particularly, female sexual dysfunction is a multi-factorial problem, including organic and psychological aspects involved into it. These disorders not only affect physical health of women but to a greater extent mental health is also affected. Considering this point of view, present review is emphasized on the impact of obesity on female sexual dysfunctions.

scholarly journals ACE2, TMPRSS2 and L-SIGN expression in placentae from HIV-positive pregnancies exposed to antiretroviral therapy–implications for SARS-CoV-2 placental infection

2021 ◽  
Author(s):  
Smriti Kala ◽  
Ksenia Meteleva ◽  
Lena Serghides
Keyword(s):  
Antiretroviral Therapy ◽  
Pregnant Women ◽  
Viral Entry ◽  
Cell Entry ◽  
Hiv Positive ◽  
Mrna Levels ◽  
Black Race ◽  
Entry Receptor ◽  
Lower Expression ◽  
Human Placentae

Abstract Background SARS-CoV-2 binding receptor ACE2 and the spike protein priming protease TMPRSS2 are co-expressed in human placentae. It is unknown whether their expression is altered in the context of HIV infection and antiretroviral therapy (ART). Methods We compared mRNA levels of SARS-CoV-2 cell-entry mediators ACE2, TMPRSS2 and L-SIGN (an alternative entry receptor) by qPCR in 105 placentae: 45 from pregnant women with HIV (WHIV) exposed to protease inhibitor (PI)-based ART, 17 from WHIV on non-PI-based ART, and 43 from HIV-uninfected women. Results ACE2 levels were lower, while L-SIGN levels were higher in placentae from WHIV on PI-based ART as compared to those on non-PI-based ART and to HIV-uninfected women. TMPRSS2 levels were similar between groups. Black race was significantly associated with lower expression of ACE2 and higher expression of L-SIGN. ACE2 levels were significantly higher in placentae of female fetuses. Discussion We have identified pregnant women of Black race and WHIV who are on PI-based ART to have relatively lower expression of placental ACE2 than those of White race and HIV-uninfected women. This effect may potentially contribute to altered susceptibility to COVID-19 in these women, either favorably; by reduced viral entry, or detrimentally; by loss of ACE2 protection against hyperinflammation.

scholarly journals Advances in Hepatitis E Virus Biology and Pathogenesis

Viruses ◽  
2021 ◽  
Vol 13 (2) ◽  
pp. 267
Author(s):  
Shaoli Lin ◽  
Yan-Jin Zhang
Keyword(s):  
Pregnant Women ◽  
Hepatitis E Virus ◽  
Case Fatality ◽  
Hepatitis E ◽  
Host Cells ◽  
High Rate ◽  
Rapid Progression ◽  
Genotype 1 ◽  
Genotype 3 ◽  
Zoonotic Infections

Hepatitis E virus (HEV) is one of the causative agents for liver inflammation across the world. HEV is a positive-sense single-stranded RNA virus. Human HEV strains mainly belong to four major genotypes in the genus Orthohepevirus A, family Hepeviridae. Among the four genotypes, genotype 1 and 2 are obligate human pathogens, and genotype 3 and 4 cause zoonotic infections. HEV infection with genotype 1 and 2 mainly presents as acute and self-limiting hepatitis in young adults. However, HEV infection of pregnant women with genotype 1 strains can be exacerbated to fulminant hepatitis, resulting in a high rate of case fatality. As pregnant women maintain the balance of maternal-fetal tolerance and effective immunity against invading pathogens, HEV infection with genotype 1 might dysregulate the balance and cause the adverse outcome. Furthermore, HEV infection with genotype 3 can be chronic in immunocompromised patients, with rapid progression, which has been a challenge since it was reported years ago. The virus has a complex interaction with the host cells in downregulating antiviral factors and recruiting elements to generate a conducive environment of replication. The virus-cell interactions at an early stage might determine the consequence of the infection. In this review, advances in HEV virology, viral life cycle, viral interference with the immune response, and the pathogenesis in pregnant women are discussed, and perspectives on these aspects are presented.

scholarly journals Cesarean delivery on maternal request and its influencing factors in Chongqing, China

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Ruibin Deng ◽  
Xian Tang ◽  
Jiaxiu Liu ◽  
Yuwen Gao ◽  
Xiaoni Zhong
Keyword(s):  
Logistic Regression ◽  
Pregnant Women ◽  
Cesarean Delivery ◽  
High Rate ◽  
Primiparous Woman ◽  
Personal Factors ◽  
Maternal Request ◽  
Primary Indication ◽  
Vaginal Deliveries

Abstract Background A high rate of cesarean delivery has become a cause of global concern. Although the rate of cesarean delivery has declined over recent years, it remains at a high level largely because of cesarean delivery on maternal request (CDMR). Unnecessary cesarean delivery has limited significance in benefiting maternal and infant physical health; in some ways, it might pose potential risks instead. With the implementation of the “Two-child Policy” in China, an increasing number of women plan to have a second child. Accordingly, how to handle the CDMR rate in China remains an important issue. Methods Data were collected from a longitudinal follow-up study conducted in Chongqing, China, from 2018 to 2019. A structured questionnaire was administered to subjects for data collection. Basic information, including demographic characteristics, living habits, medical history, and follow-up data of pregnant women, as well as their families and society, was collected. Additionally, delivery outcomes were recorded. Logistic regression was performed to analyze the factors influencing CDMR. Results The rate of cesarean delivery in Chongqing, China was 36.01 %, and the CDMR rate was 8.42 %. Maternal request (23.38 %), fetal distress (22.73 %), and pregnancy complications (9.96 %) were the top three indications for cesarean delivery. Logistic regression analysis showed that older age (OR = 4.292, 95 % CI: 1.984–9.283) and being a primiparous woman (OR = 6.792, 95 % CI: 3.230-14.281) were risk factors for CDMR. In addition, CDMR was also associated with factors such as the tendency to choose cesarean delivery during late pregnancy (OR = 5.525, 95 % CI: 2.116–14.431), frequent contact with mothers who had undergone vaginal deliveries (OR = 0.547, 95 % CI: 0.311–0.961), and the recommendation of cesarean delivery by doctors (OR = 4.071, 95 % CI: 1.007–16.455). Conclusions “Maternal request” has become the primary indication for cesarean delivery. The occurrence of CDMR is related to both the personal factors of women during pregnancy and others. Medical institutions and obstetricians should continue popularizing delivery knowledge among pregnant women, enhancing their own professional knowledge about delivery, adhering to the standard indications for cesarean delivery, and providing pregnant women with adequate opportunities for attempting vaginal delivery.

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