scholarly journals Knowledge enhancement about pregnancy complications: Optimizing the role of high risk pregnancy prepared cadres

2020 ◽  
Vol 3 (1) ◽  
pp. 18
Author(s):  
Ika Parmawati ◽  
Ayyu Sandhi ◽  
Wenny Artanty Nisman ◽  
Wiwin Lismidiati ◽  
Anik Rustiyaningsih ◽  
...  
Keyword(s):  
High Risk ◽  
Early Detection ◽  
Community Health ◽  
Pregnancy Complications ◽  
High Risk Pregnancy ◽  
Control Group ◽  
Research Subjects ◽  
Development Indicators ◽  
Risk Pregnancy ◽  
Significant Difference

Maternal death rate is one of the important health development indicators. Indonesian maternal mortality is still high due to both direct and indirect causes that occur during pregnancy and childbirth. High-risk pregnancy can present complications for both the mother and fetus, and demands early detection. Early detection requires involvement of the community, health cadre, medical officers, and government. There is a need to increase the community health cadre competency in the detection of pregnancy complications, especially high-risk pregnancy knowledge. This study used a quasi-experimental design without control group to determine the effect of training regarding pregnancy complications on community health worker’s knowledge in Wijimulyo, Nanggulan, Kulon Progo, Yogyakarta in October 2018. The research subjects were community health cadre workers chosen by purposive random sampling. There were 43 research subjects who were given pretests, training about complications of pregnancy, and posttests. The instrument used was a knowledge questionnaire about complications during pregnancy that consisted of 23 items with reliability of 0.865. There was significant difference between community health cadre’s knowledge about complications of pregnancy at pretest and posttest. These results indicate that training about pregnancy complications increases the knowledge of community health cadre workers concerning complications of pregnancy. Further research is needed to assess community health cadre’s skills in making early detection of pregnancy complications.

scholarly journals Urinary Nephrin and Podocalyxin Levels as Predictors of Pre-eclampsia in High-Risk Pregnant Women

Folia Medica ◽  
2021 ◽  
Vol 63 (6) ◽  
pp. 948-957
Author(s):  
Irena Kostovska ◽  
Katerina Tosheska Trajkovska ◽  
Ognen Kostovski ◽  
Danica Labudovic
Keyword(s):  
High Risk ◽  
Pregnant Women ◽  
Gestational Age ◽  
High Risk Pregnancy ◽  
Renal Diseases ◽  
Control Group ◽  
Inclusion Criteria ◽  
Risk Pregnancy ◽  
Significant Difference ◽  
History Of

Introduction: Pre-eclampsia (PE) is characterized by new-onset hypertension and proteinuria. Damage of podocyte cells has been reported in pre-eclamptic women, thus podocyte specific proteins such as nephrin and podocalyxin could be useful biomarkers in PE. Aim: To investigate the role of urinary nephrin (u-nephrin) and urinary podocalyxin (u-PDX) levels in predicting PE in women with a high-risk pregnancy. Materials and methods: We included 101 pregnant women in this study and allocated them into three groups: group 1 included pregnant women at high risk of developing PE (n=41), group 2 - pregnant women with PE (n=30), and group 3 was the controls including healthy pregnant women (n=30). The inclusion criteria for women with PE were de novo hypertension >140/90 mm Hg, proteinuria >300 mg/24 hours, and presence of edema after 20 weeks of gestation, while the exclusion criteria were a history of renal diseases and pregnant women younger than 18. Inclusion criteria for the group of women with a high-risk pregnancy was gestational week >15, a history of PE in a previous pregnancy, pre-existing diabetes type 1 or 2, pre-existing hypertension, multiple gestations, prior placental abruption, obesity women, nulliparity, maternal age >35 years, and a family history of PE. The study was conducted from March 2016 to May 2017 in the Medical Faculty at the Institute of Medical and Experimental Biochemistry in Skopje. Urine samples were used to measure the nephrin and podocalyxin levels using immunoenzyme assay, creatinine and microalbumin. Blood samples were collected for biochemical analyses. Results: U-nephrin levels were elevated in 96.7% of women with PE, and 73% of women with a high-risk pregnancy. U-PDX levels were elevated in 63% of the women with PE and 100% of the women with a high-risk pregnancy. U-nephrin and u-PDX levels were significantly increased in women with a high-risk pregnancy and women with PE compared with a control group (p<0.001). A significant difference was found between the subgroups of pregnant women classified according to gestational age in their u-nephrin and u-PDX levels. There was a significant positive correlation between the levels of both markers and glomerular filtration rate, and significant negative correlation between the levels of both markers and gestational age. ROC analysis revealed that the cut-off value of 304.6 ng/ml of u-nephrin had a sensitivity (Se) of 96.7%, specificity (Sp) of 96.7% (for both Se and Sp 95% confidence interval (CI) 82.8-99.9), while the cut-off value of 59.5 ng/ml of u-PDX had a sensitivity of 100% and Sp of 93.3% (Se - 95% CI 88.4-100, Sp - 95% CI 77.9-99.2), in distinguishing women with PE and healthy pregnancies. Both markers showed excellent clinical utility (CUI&ge;0.81), for u-nephrin (CUI+ and CUI&minus; is 0.934), for u-PDX (CUI+ is 0.938; CUI&minus; is 0.933). Conclusions: U-nephrin and U-PDX levels could be useful as predictors of PE in women with a high-risk pregnancy.

scholarly journals Analysis of Factors Related to Midwife's Performance in Filling the "Poedji Rohyati" Score in Early Detection of High Risk Pregnancy atPublic Health Center of Lima Puluh Kota District

2018 ◽  
Vol 3 (1) ◽  
pp. 62
Author(s):  
Liza Andriani ◽  
Yuniar Lestari ◽  
Erwani Erwani
Keyword(s):  
High Risk ◽  
Early Detection ◽  
Community Health ◽  
Health Center ◽  
Quantitative Research ◽  
High Risk Pregnancy ◽  
District Health ◽  
Score Card ◽  
Risk Pregnancy ◽  
Level Of Knowledge

One indicator that determines community health status is mortality. Midwives as the spearhead of antenatal care must be able to prevent maternal mortality rates (AKI) by increasing their performance in providing antenatal services in accordance with standards. One attempt to prevent AKI is by early detection of high-risk pregnancy using the PoedjiRohyati score card (KSPR). Midwife's performance is influenced by several factors, namely individual, organizational and psychological factors. This study aims to analyze the factors related to the performance of midwives in filling the PoedjiRohyati score card on early detection of high-risk pregnancies in the Lima Puluh Kota District Health Center.       This study uses a combination of quantitative and qualitative methods. Quantitative research samples were 74 respondents, data collection was carried out from January to February 2018 with interview techniques using questionnaires and observation sheets. While the qualitative research informants were the Head of Community Health and Nutrition, the head of the puskesmas and the midwife coordinator of the Piladang, Taram, Koto BaruSimalanggang and TanjungPati health centers.       The results of the study prove that the factors associated with the performance of midwives in filling in the KSPR include the level of knowledge (p = 0.031), attitude (p = 0.004), motivation (p = 0.020) and supervision (p = 0.025). The factors that are most related to the performance of midwives in filling in KSPR are attitudes (p = 0.006).      Based on the research, it can be concluded that the midwife will have a good performance in filling in the KSPR if it is based on a high level of knowledge, a positive attitude, high motivation, periodic supervision and supported by complete facilities.

The Effect of Lullaby Intervention on Anxiety and Prenatal Attachment in Women with High-Risk Pregnancy: A Randomized Controlled Study

2021 ◽  
pp. 1-9
Author(s):  
Nazlı Baltacı ◽  
Mürüvvet Başer
Keyword(s):  
High Risk ◽  
Intervention Group ◽  
Group Versus ◽  
Mean Difference ◽  
High Risk Pregnancy ◽  
Controlled Study ◽  
Control Group ◽  
Prenatal Attachment ◽  
Randomized Controlled ◽  
Risk Pregnancy

<b><i>Background:</i></b> Women with high-risk pregnancy experience anxiety and low mother-fetal attachment when faced with signs of danger and health problems. This study aimed to investigate the effects of lullaby intervention on anxiety and prenatal attachment in women with high-risk pregnancy. <b><i>Materials and Methods:</i></b> This randomized controlled trial was conducted in the perinatology clinic of a state maternity hospital in Turkey. Seventy-six women with high-risk pregnancy were included. The intervention group listened to lullabies for 20 min once a day, and accompanied by lullabies touched their abdomen and thought about their babies, but the control group did not. Data were collected using the Pregnant Information Form, the State Anxiety Inventory, and the Prenatal Attachment Inventory. <b><i>Results:</i></b> Baseline anxiety did not differ in the intervention versus control group (47.83 ± 10.74 vs. 44.10 ± 8.08, mean difference 3.73 [95% Cl –1.18 to 8.64], <i>p</i> = 0.13), but after the 2nd day lullaby intervention anxiety was lower in the intervention group versus control group (33.66 ± 9.32 vs. 43.06 ± 8.10, mean difference –9.40 [95% Cl –13.91 to –4.88], <i>p</i> &#x3c; 0.01). Baseline prenatal attachment did not differ in the intervention versus control group (56.03 ± 10.71 vs. 53.86 ± 9.98, mean difference 2.16 [95% Cl –3.18 to 7.51], <i>p</i> = 0.42), but after the 2nd day lullaby intervention prenatal attachment was higher in the intervention group versus control group (66.70 ± 7.60 vs. 54.36 ± 9.52, mean difference 12.33 [95% Cl 7.87 to 16.78], <i>p</i> &#x3c; 0.01). In the within-group analysis the intervention group had lower anxiety and better prenatal attachment (<i>p</i> &#x3c; 0.01), but not in the control group (<i>p</i> &#x3e; 0.05). <b><i>Conclusion:</i></b> Lullaby intervention can play an effective role in reducing anxiety and improving prenatal attachment. The use of this integrative, noninvasive, non-pharmacologic, time-efficient, and natural intervention is suggested in the care of pregnant women.

Complex pharmaco-ozone therapy in the prevention of placental insufficiency in high-risk pregnancy

2020 ◽  
pp. 19-27
Author(s):  
L. V. Tsallagova ◽  
L. V. Maisuradze ◽  
S. V. Sagkaeva ◽  
T. I. Tsidaeva
Keyword(s):  
High Risk ◽  
Pregnant Women ◽  
The Body ◽  
High Risk Pregnancy ◽  
Placental Lactogen ◽  
Control Group ◽  
Ozone Therapy ◽  
Morphological Examination ◽  
Adaptive Capabilities ◽  
Risk Pregnancy

Summary. Purpose of research. Development of a method for prevention of placental insuffi ciency (PN) in high-risk pregnancy in women of the Republic of North Ossetia-Alania (RSO-A) with the complex use of antihypoxant limontar and ozone therapy (OT). Material and methods. Observations were made of 75 pregnant residents of RSO-A with diagnosed PN, whose average age was 32,6 ± 8,14 years. Using a simple randomization method, 3 groups were formed: in the main group (OG), patients received prevention of PN by using OT and antihypoxant limontar; in the comparison group (GS), only limontar; in the control group (KG), pregnant women did not receive prevention of PN. All patients observed before and after PN prevention were examined for placental lactogen and estriol, ultrasound of the fetoplacental complex (FPC), Doppler examination of the uterine blood fl ow and ultrasound examination of the placenta structure, and morphological examination of the placenta. Results. Based on identifi ed pathogenetic mechanisms of the disorders in the system “mother — placenta — fetus” are defined by a high clinical effi cacy of combined pharmaco-ozone therapy (CT) in the prevention of PN in pregnant women at risk, which was manifested by the lack of progression of PN, whereas in GS, where patients received only pharmacotherapy with limontar, progression was noted in 31,8 % of cases, in KG, where there was no prevention, is 56 %. Conclusion. In the present study, the positive effect of OT and antihypoxant limontar on the processes of microcirculation, metabolism, and adaptation of the body, which provides a signifi cant reduction in the frequency of pregnancy complications, increasing the adaptive capabilities of the fetus and improving perinatal outcomes.

scholarly journals Effects of Yoga on Utero-Fetal-Placental Circulation in High-Risk Pregnancy: A Randomized Controlled Trial

2015 ◽  
Vol 2015 ◽  
pp. 1-10 ◽  
Author(s):  
Abbas Rakhshani ◽  
Raghuram Nagarathna ◽  
Rita Mhaskar ◽  
Arun Mhaskar ◽  
Annamma Thomas ◽  
...  
Keyword(s):  
High Risk ◽  
Standard Care ◽  
Uterine Artery ◽  
Controlled Trial ◽  
Resistance Index ◽  
High Risk Pregnancy ◽  
Trophoblast Invasion ◽  
Control Group ◽  
Risk Pregnancy ◽  
Yoga Group

Introduction. Impaired placentation and inadequate trophoblast invasion have been associated with the etiology of many pregnancy complications and have been correlated with the first trimester uterine artery resistance. Previous studies have shown the benefits of yoga in improving pregnancy outcomes and those of yogic visualization in revitalizing the human tissues.Methods. 59 high-risk pregnant women were randomized into yoga (n= 27) and control (n= 32) groups. The yoga group received standard care plus yoga sessions (1 hour/day, 3 times/week), from 12th to 28th week of gestation. The control group received standard care plus conventional antenatal exercises (walking). Measurements were assessed at 12th, 20th, and 28th weeks of gestation.Results. RM-ANOVA showed significantly higher values in the yoga group (28th week) for biparietal diameter (P= 0.001), head circumference (P= 0.002), femur length (P= 0.005), and estimated fetal weight (P= 0.019). The resistance index in the right uterine artery (P= 0.01), umbilical artery (P= 0.011), and fetal middle cerebral artery (P= 0.048) showed significantly lower impedance in the yoga group.Conclusion. The results of this first randomized study of yoga in high-risk pregnancy suggest that guided yogic practices and visualization can improve the intrauterine fetal growth and the utero-fetal-placental circulation.

scholarly journals High risk scoring in pregnancy using modified Coopland’s scoring system and its association with perinatal outcome

2021 ◽  
Vol 10 (4) ◽  
pp. 1608
Author(s):  
Shobha S. Pillai ◽  
Swapna Mohan
Keyword(s):  
High Risk ◽  
Scoring System ◽  
Perinatal Outcome ◽  
Risk Group ◽  
Cost Effective ◽  
High Risk Group ◽  
High Risk Pregnancy ◽  
Risk Pregnancy ◽  
Significant Difference ◽  
Risk Scoring

Background: High-risk pregnancy is one in which the mother, foetus or the newborn has an elevated risk of experiencing an adverse outcome. These high-risk women form a special vulnerable cohort that can be identified in the antenatal period using a simple, easy to use, cost-effective tool- a maternal risk scoring system. Early identification of these high-risk mothers will facilitate effective intervention strategies to deal with the complications.Methods: This study was carried out on 300 pregnant women with gestational age more than 28 weeks. Detailed history, examination and necessary investigations were done and then using the Modified Coopland scoring system, each pregnant woman was assigned a risk score and stratified into 3 risk groups- low risk (0-3), moderate risk (4-6) and high risk (≥7) and followed up till delivery and 7 days postpartum. Subsequently, the maternal and perinatal outcomes were compared with their respective scores.Results: In this study, 14.66% patients belonged to the high-risk category. Statistically, a significant difference was noted in the number of low-birth-weight babies, in 5 minutes APGAR score <7 and in NICU admissions in the high-risk group compared to the low-risk group. Overall perinatal mortality was 13.33/1000 live births. In the high-risk group, a significant difference was seen in the occurrence of PPH and the need for operative delivery.Conclusions: Significant association between high-risk pregnancy and the poor maternal and perinatal outcome was noted. Therefore, a simple, cost-effective high-risk pregnancy scoring system such as the one proposed in this study can be used to identify potential high-risk pregnancies, provide them with tertiary care facilities and also corrective measures can be undertaken to prevent or minimize the complicating factors.

scholarly journals Dapatkah Kelas Ibu Hamil Model Virtual Meningkatkan Praktik Pencegahan Risiko Tinggi Kehamilan ?

2020 ◽  
Vol 30 (1) ◽  
pp. 1-14
Author(s):  
Ayun Sriatmi ◽  
Sri Suwitri ◽  
Zahroh Shaluhiyah ◽  
Sri Achadi Nugraheni
Keyword(s):  
High Risk ◽  
Pregnant Women ◽  
Mixed Model ◽  
Linear Mixed Model ◽  
Intervention Group ◽  
High Risk Pregnancy ◽  
Control Group ◽  
Control Approach ◽  
Risk Pregnancy ◽  
Quasi Experimental

Abstract The inability of pregnant women to identify and recognize danger signs of pregnancy indicates the lack of knowledge, attitudes and perceptions of mothers about healthy pregnancies which has an impact on the low practices of prevention of high risk of pregnancy. Pregnant Women Class Program (KIH) which is held is not optimal because of the low presence of pregnant women for various reasons. The aim of study to determine the effect of the KIH-Virtual model on the practice of preventing high risk of pregnancy. This is a quasi-experimental study with case-control approach. The population is pregnant women in Semarang City. The total sample was 60 mothers for the intervention group and 61 mothers for control group. The independent variable is KIH-Virtual intervention and dependent variable is the practice of preventing high risk pregnancy (covering 7 dimensions). Data collection through interviews and observations with four times measurements (pretest, posttest 1,2,3). Partial analysis using independent-T test and Paired test. Simultaneous analysis with Linear-Mixed-Model. Statistically, there were differences in the practice of preventing high risk pregnancy between intervention groups and control at the last measurement (p<0.05). Although both groups experienced an increase in scores at each measurement stage, it was evident in the intervention group that the increase was higher for all dimensions of practice. The highest increase in the effect of interventions on communication and collaboration practices was followed by health status monitoring practices. Daily self-care practices and lifestyle practices are the dimensions with the lowest intervention effect. Virtual-KIH influences the practice of pregnant women in the prevention of high risk of pregnancy and is able to improve the practice better than conventional models that have been underway. Abstrak  Ketidakmampuan ibu hamil mengidentifikasi dan mengenali tanda bahaya kehamilan mengindikasikan rendahnya pengetahuan, sikap dan persepsi ibu tentang kehamilan sehat, yang berdampak pada rendahnya praktik pencegahan risiko tinggi kehamilan. Program Kelas Ibu Hamil (KIH) yang diselenggarakan belum optimal karena terkendala rendahnya kehadiran ibu hamil dengan berbagai alasannya. Tujuan penelitian menganalisis pengaruh model KIH Virtual terhadap praktik pencegahan risiko tinggi kehamilan. Penelitian ini merupakan penelitian quasi experimental dengan pendekatan kasus-kontrol. Populasi adalah ibu hamil di Kota Semarang. Jumlah sampel 60 ibu untuk kelompok intervensi dan 61 ibu untuk kelompok kontrol. Variabel bebas yaitu intervensi KIH Virtual dan variabel terikatnya yaitu praktik pencegahan risiko tinggi kehamilan (meliputi 7 dimensi). Pengumpulan data melalui wawancara dan observasi dengan 4 kali pengukuran (pretest, posttest-1,2,3). Analisis parsial menggunakan uji beda independen dan berpasangan. Analisis simultan dengan Linear-Mixed-Model. Secara statistik ada perbedaan praktik pencegahan risiko tinggi kehamilan antara kelompok intervensi dengan kontrol pada pengukuran terakhir (p<0,05). Meski kedua kelompok mengalami peningkatan skor pada setiap tahap pengukuran, namun terbukti pada kelompok intervensi peningkatannya lebih tinggi untuk semua dimensi praktik. Peningkatan tertinggi efek intervensi pada praktik komunikasi dan kerjasama, diikuti praktik pemantauan status kesehatan. Praktik perawatan diri sehari-hari dan praktik gaya hidup merupakan dimensi praktik dengan efek intervensi terendah. KIH Virtual memengaruhi praktik ibu hamil dalam pencegahan risiko tinggi kehamilan dan mampu meningkatkan praktik tersebut dengan lebih baik dibandingkan model konvensional yang selama ini berlangsung.  

Hubungan Keteraturan Ibu Hamil Dalam Melaksanakan Kunjungan Antenatal Care (ANC) Terhadap Hasil Deteksi Dini Risiko Tinggi Ibu Hamil di Poli KIA RSUD Gambiran Kota Kediri

2017 ◽  
Vol 2 (2) ◽  
pp. 35
Author(s):  
Sumy Dwi Antono ◽  
Dwi Estuning Rahayu
Keyword(s):  
High Risk ◽  
Early Detection ◽  
Antenatal Care ◽  
Health Workers ◽  
Sampling Technique ◽  
Simple Random Sampling ◽  
High Risk Pregnancy ◽  
Measuring Instruments ◽  
Pregnant Mother ◽  
Risk Pregnancy

Each pregnancy can develop normally, but it is difficult to know before that the pregnancy would be a problem, Antenatal care is an important way to monitor and support the normal maternal health and to detect any abnormalities in normal pregnancy. This study aims to determine the correlation of Pregnant mother’s Regularity in visiting Antenatal Care (ANC) on the Results from Early Detection of High Risk Pregnancy in Poli KIA  RSUD Gambiran Kediri. This research is analytic correlation using a case-control study design. The populations in this study were all third trimester pregnant mother with high risk in Poli KIA RSUD Gambiran Kediri. The number of samples is 28 people who were taken with simple random sampling technique. Measuring instruments used KIA books and Antenatal care documentation. The results will be analyzed using Chi Square test with one sample with a standard error 5% (0,05). Based on the analysis results obtained values � = 14,28 ; 3,841 so it can be stated that there is the correlation of Pregnant mother’s Regularity in visiting Antenatal Care (ANC) on the Results from Early Detection of High Risk Pregnancy in Poli KIA RSUD Gambiran Kediri. The results are mostly high-risk pregnant mother are irregular in implementing Antenatal care. The recommendations of this research is needed to conduct counseling from a health counselor to all pregnant mother about the importance of prenatal care regularly to add the knowledge about pregnancy and also to allows health workers to detect early if there is a complication of pregnancy and as an effort to increase utilization of health services for mother pregnant.; Key words : regularity of ANC, Antenatal Care (ANC), Early Detection of High Risk

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