Composition of Vaginal Microflora in Relation to Vaginal pH and Wet Mount Diagnostic Tests in the First Trimester of Pregnancy

Abstract The aim of the study was to determine the relations between vaginal culture results, elevated vaginal pH and abnormal vaginal microflora observed in microscopy, during the first trimester of pregnancy. A cross-sectional, observational study of 100 women receiving antenatal care in five outpatient clinics was carried out in Rîga from March 2010 until April 2011. Pregnant women at the first antenatal visit were submitted to a vaginal specimen collection for pH measurement, wet mount and cultures. Fifty pregnant women with vaginal pH 4.5 and 50 subsequent pregnant women with vaginal pH less than 4.5 were included. 96% of women with increased pH and 86% of women with normal vaginal pH showed positive cultures. Increased vaginal pH was significantly associated with M. hominis (P < 0.001), U. urealyticum (P = 0.017) and E. coli (P = 0.018). Abnormal vaginal microflora patterns showed similar associations with culture findings. Multivariate logistic regression analysis showed the highest risk of abnormal vaginal microflora associated with M. hominis (OR 14.4, 95% CI 1.6–124.4, P = 0.015) and E. coli (OR 8.5, 95% CI 1.6–45.9, P = 0.013). Increased vaginal pH and abnormal vaginal microflora pattern in wet mounts was associated with M. hominis and E. coli in vaginal cultures.

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Antibiotic Prescriptions among China Ambulatory Care Visits of Pregnant Women: A Nationwide Cross-Sectional Study

Antibiotics ◽

10.3390/antibiotics10050601 ◽

2021 ◽

Vol 10 (5) ◽

pp. 601

Author(s):

Houyu Zhao ◽

Mei Zhang ◽

Jiaming Bian ◽

Siyan Zhan

Keyword(s):

Pregnant Women ◽

Ambulatory Care ◽

National Level ◽

Mainland China ◽

Antibiotic Use ◽

First Trimester ◽

Cross Sectional Study ◽

Cross Sectional ◽

Fetal Safety ◽

First Trimester Of Pregnancy

Background: Antibiotic use in pregnant women at the national level has rarely been reported in China. Objectives: We aimed to investigate antibiotic prescriptions during pregnancy in ambulatory care settings in China. Methods: Data of 4,574,961 ambulatory care visits of pregnant women from October 2014 to April 2018 were analyzed. Percentages of Antibiotic prescriptions by different subgroups and various diagnosis categories and proportions of inappropriate antibiotic prescriptions for different subgroups were estimated. Food and Drug Administration (FDA) pregnancy categories were used to describe the antibiotic prescription patterns. The 95% confidence intervals (CIs) were estimated using the Clopper––Pearson method or Goodman method. Results: Among the 4,574,961 outpatient visits during pregnancy, 2.0% (92,514 visits; 95% CI, 2.0–2.0%) were prescribed at least one antibiotic. The percentage of antibiotic prescriptions for pregnant women aged >40 years was 4.9% (95% CI, 4.7–5.0%), whereas that for pregnant women aged 26–30 years was 1.5% (95% CI, 1.4–1.5%). In addition, percentages of antibiotic prescriptions varied among different trimesters of pregnancy, which were 5.4% (95% CI, 5.3–5.4%) for the visits in the first trimester of pregnancy and 0.5% (95% CI, 0.4–0.5%) in the third trimester of pregnancy. Furthermore, the percentages of antibiotic prescriptions substantially varied among different diagnosis categories and nearly three-quarters of antibiotic prescriptions had no clear indications and thus might be inappropriate. In total, 130,308 individual antibiotics were prescribed; among these, 60.4% (95% CI, 60.0–60.8%) belonged to FDA category B, 2.7% (95% CI, 2.1–3.5%) were classified as FDA category D and 16.8% (95% CI, 16.2–17.4%) were not assigned any FDA pregnancy category. Conclusions: Antibiotic prescriptions in ambulatory care during pregnancy were not highly prevalent in mainland China. However, a substantial proportion of antibiotics might have been prescribed without adequate indications. Antibiotics whose fetal safety has not been sufficiently illustrated were widely used in pregnant women.

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Adverse pregnancy outcomes are associated with Plasmodium vivax malaria in a prospective cohort of women from the Brazilian Amazon

PLoS Neglected Tropical Diseases ◽

10.1371/journal.pntd.0009390 ◽

2021 ◽

Vol 15 (4) ◽

pp. e0009390

Author(s):

Jamille Gregório Dombrowski ◽

André Barateiro ◽

Erika Paula Machado Peixoto ◽

André Boler Cláudio da Silva Barros ◽

Rodrigo Medeiros de Souza ◽

...

Keyword(s):

Pregnant Women ◽

Pregnancy Outcomes ◽

Multivariate Logistic Regression Analysis ◽

Brazilian Amazon ◽

First Trimester ◽

Inflammatory Factors ◽

Anthropometric Measures ◽

First Trimester Of Pregnancy ◽

Adverse Pregnancy ◽

Angiopoietin 2

Background Malaria in Brazil represents one of the highest percentages of Latin America cases, where approximately 84% of infections are attributed to Plasmodium (P.) vivax. Despite the high incidence, many aspects of gestational malaria resulting from P. vivax infections remain poorly studied. As such, we aimed to evaluate the consequences of P. vivax infections during gestation on the health of mothers and their neonates in an endemic area of the Amazon. Methods and findings We have conducted an observational cohort study in Brazilian Amazon between January 2013 and April 2015. 600 pregnant women were enrolled and followed until delivery. After applying exclusion criteria, 329 mother-child pairs were included in the analysis. Clinical data regarding maternal infection, newborn’s anthropometric measures, placental histopathological characteristics, and angiogenic and inflammatory factors were evaluated. The presence of plasma IgG against the P. vivax (Pv) MSP119 protein was used as marker of exposure and possible associations with pregnancy outcomes were analyzed. Multivariate logistic regression analysis revealed that P. vivax infections during the first trimester of pregnancy are associated with adverse gestational outcomes such as premature birth (adjusted odds ratio [aOR] 8.12, 95% confidence interval [95%CI] 2.69–24.54, p < 0.0001) and reduced head circumference (aOR 3.58, 95%CI 1.29–9.97, p = 0.01). Histopathology analysis showed marked differences between placentas from P. vivax-infected and non-infected pregnant women, especially regarding placental monocytes infiltrate. Placental levels of vasomodulatory factors such as angiopoietin-2 (ANG-2) and complement proteins such as C5a were also altered at delivery. Plasma levels of anti-PvMSP119 IgG in infected pregnant women were shown to be a reliable exposure marker; yet, with no association with improved pregnancy outcomes. Conclusions This study indicates that P. vivax malaria during the first trimester of pregnancy represents a higher likelihood of subsequent poor pregnancy outcomes associated with marked placental histologic modification and angiogenic/inflammatory imbalance. Additionally, our findings support the idea that antibodies against PvMSP119 are not protective against poor pregnancy outcomes induced by P. vivax infections.

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Prevalence of Arbovirus Infections among Pregnant Women at a Maternity Hospital School

International Archives of Medicine ◽

10.3823/2412 ◽

2017 ◽

Vol 10 ◽

Author(s):

Maria das Neves Figueiroa ◽

Maria Lúcia Neto de Menezes ◽

Adrielly Martins Barbosa ◽

Ivanise Tibúrcio Cavalcanti Silva ◽

Estela Maria Leite Meirelles Monteiro ◽

...

Keyword(s):

Pregnant Women ◽

Low Income ◽

First Trimester ◽

Maternity Hospital ◽

Positive Serology ◽

Cross Sectional ◽

Mother And Child ◽

First Trimester Of Pregnancy ◽

Hospital School ◽

Zika Fever

Objective: Survey the prevalence of arbovirus infections among pregnant women provided with care at a maternity hospital school in Recife, Pernambuco, Brazil. Method: Descriptive, cross-sectional, retrospective, and quantitative study, carried out with data collected from the notification forms filled in during obstetric screening between August 2015 and July 2016. Results: Positive serology was found for arboviruses in 40.2% of the 103 suspected cases. Serology was not performed or it showed inconclusive results in 59.8% of the cases. Dengue fever occurred in 44% of the cases, chikungunya in 34%, and zika fever in 22%. Infections were more frequent among pregnant women over 20 years old, with low income and low schooling levels, living in Recife (48.5%) and Olinda, Pernambuco, Brazil (24.3%). The most frequently mentioned symptoms were arthralgia (94%), exanthema (82%), and fever (78%). Infections occurred within the first trimester of pregnancy (54.5%), 63.3% of the pregnant women had to be hospitalized, and 45.4% of them did not undergo morphological ultrasonography. Most babies were born full-term and they had adequate weight. The prevalence of microcephaly was 9.7% when considering cases of arbovirose and 62.5% when considering specific cases of zika fever. Conclusion: The prevalence and repercussions of arboviruses justify the consolidation of actions to fight Aedes aegypti, as well as the effective deployment of clinical protocols and recommendations aimed at the mother and child care.

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Subclinical Hypothyroidism (SCH) in the First Trimester of Pregnancy: A Cross-Sectional Study at a Tertiary Care Hospital

10.53350/pjmhs211581855 ◽

2021 ◽

Vol 15 (8) ◽

pp. 1855-1857

Author(s):

Israr-Ul- Haq ◽

Junaid Mushtaq ◽

Atiq Ahmad ◽

Waqas Mahmood ◽

Mujtaba Hasan Siddiqui ◽

...

Keyword(s):

Pregnant Women ◽

Subclinical Hypothyroidism ◽

Neonatal Death ◽

Tertiary Care ◽

First Trimester ◽

Cross Sectional Study ◽

Care Hospital ◽

Sectional Study ◽

Cross Sectional ◽

First Trimester Of Pregnancy

Aim: To evaluate and assess the prevalence along with its related complications of subclinical hypothyroidism in pregnant ladies during the 1st trimester of pregnancy in Pakistani population. Study design: Cross sectional study Place and duration of study: Department of Medicine, Unit-1 of Lahore General Hospital, Lahore, Pakistan from 11th February 2019 to 29th December 2019. Methodology: Four hundred and fifty seven pregnant women with a gestational age up to 12th week with an age group between 18-45 years were included in this study. Blood samples were collected for free triiodothyronine, free thyroxine and thyroid stimulating hormone levels. Patients were regularly followed at an interval of 4 weeks for their entire pregnancy period. Adverse events and complications were noted. Results: One hundred and sixty nine subjects had TSH levels above the normal range i.e., 4.6-10mIU/L. 288 subjects were having TSH below 4 mIU/L levels. The overall prevalence of subclinical hypothyroidism (SCH) was found to be 37% in pregnant women during their first trimester of pregnancy. Pregnant women having subclinical hypothyroidism (SCH) were having higher risks of loss of pregnancy, abruptio placentae and neonatal death rates as compared to euthyroid pregnant women. Conclusion: Higher prevalence of subclinical hypothyroidism (SCH) in the first trimester of pregnancy indicates that these women are at increased risks of loss of pregnancy, placental abruption and neonatal death as compared to euthyroid pregnant women. Keywords: First trimester; pregnancy; subclinical hypothyroidism

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Hypocalcaemia and its contributing factors among first trimester pregnant women in an urban area in Malaysia

Nutrition & Food Science ◽

10.1108/nfs-04-2017-0078 ◽

2018 ◽

Vol 48 (1) ◽

pp. 165-176

Author(s):

Noor Sharifatul Hana Yeop ◽

Zaleha Md Isa ◽

Khadijah Shamsuddin ◽

Khor Geok Lin ◽

Zaleha Abdullah Mahdy ◽

...

Keyword(s):

Pregnant Women ◽

Serum Calcium ◽

Calcium Level ◽

Serum Calcium Level ◽

First Trimester ◽

Cross Sectional Study ◽

Antenatal Visit ◽

Contributing Factors ◽

Cross Sectional ◽

Content Type

Purpose The aim of this study is to determine the prevalence of hypocalcaemia among first-trimester pregnant women and its contributing factors. Design/methodology/approach A cross-sectional study was carried out among first-trimester pregnant women who were recruited during their first antenatal visit. A total of 396 respondents of age 18-40 years completed the self-administered questionnaire (socio-demographic, socio-economic, obstetric information), validated semi-quantitative food frequency questionnaire for calcium (FFQ-calcium), anthropometric measurements (weight and height) and blood test for serum calcium during their first trimester. Findings The prevalence of hypocalcaemia based on serum calcium level of less than 2.11 mmol/L was 26.0 per cent (n = 103). The median serum calcium level was 2.2 mmol/L (IQR, 25th and 75th percentile – 2.1 and 2.3, respectively). Milk intake of less than two glasses per day during pregnancy showed a twofold increase in developing hypocalcaemia (OR, 2.231; 95 per cent CI, 1.399, 3.588). Other than that, underweight (aOR, 2.038; 95 per cent SK, 1.088, 3.820) and obese before pregnancy (aOR, 1.954; 95 per cent SK, 1.007, 3.790) are also predictors of hypocalcaemia. Originality/value The prevalence of hypocalcaemia among first-trimester pregnant women in this study was 26.0 per cent. Intake of two or more glasses of milk per day can help prevent hypocalcaemia at this stage of pregnancy.

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Antenatal care booking within the first trimester of pregnancy and its associated factors among pregnant women residing in an urban area: a cross-sectional study in Debre Berhan town, Ethiopia

BMJ Open ◽

10.1136/bmjopen-2019-032960 ◽

2020 ◽

Vol 10 (6) ◽

pp. e032960 ◽

Cited By ~ 1

Author(s):

Tufa Kolola ◽

Wogene Morka ◽

Bayisa Abdissa

Keyword(s):

Secondary School ◽

Antenatal Care ◽

Pregnant Women ◽

Associated Factors ◽

First Trimester ◽

School Level ◽

Cross Sectional ◽

Level Of Education ◽

Debre Berhan ◽

First Trimester Of Pregnancy

ObjectiveThis study aimed to assess antenatal care (ANC) booking within the first trimester of pregnancy and its associated factors among urban dwellers of pregnant women in Debre Berhan town, Ethiopia.DesignCross-sectional.SettingPublic and private health facilities that provide ANC services in Debre Berhan town.Outcome measureFirst ANC booking within the first trimester of pregnancy.ParticipantsUrban dwellers of pregnant women in Debre Berhan town (n=384).ResultsA total of 387 pregnant women in Debre Berhan town were selected for this study, of which 384 responded giving a response rate of 99.2%. The proportion of pregnant women who had ANC booking within the first trimester of pregnancy was 156 (40.6%; 95% CI: 35.8% to 45.6%). In the multivariable analysis, the odds of first ANC booking within the first trimester was higher among pregnant women who had secondary school (adjusted OR (AOR): 1.84; 95% CI: 1.10 to 3.19) and more than secondary level of education (AOR: 2.26; 95% CI: 1.27 to 4.03) compared with those who had less than a secondary school level of education. Pregnant women who have any ill health with their current pregnancy (AOR: 1.99; 95% CI: 1.21 to 3.27) were more likely to start booking within the first trimester than their counterparts. The odds of ANC booking within the first trimester was threefold higher among women with knowledge of ANC (AOR: 3.05; 95% CI: 1.52 to 6.11) compared with their counterparts.ConclusionFirst ANC booking within the first trimester was found to be low among urban dwellers of Debre Berhan town. Secondary school and more educational level, having ill health during early pregnancy and women’s knowledge about ANC services were statistically associated with ANC booking within the first trimester of pregnancy. Therefore, improving ANC booking according to the WHO recommendation requires due attention. Further qualitative research exploring why early ANC booking remains low among urban dwellers is important to design intervention modalities.

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Hubungan Pengetahuan Dan Sikap Ibu Hamil Dengan Kejadian Mual Muntah Pada Kehamilan Trimester Pertama Di Poskesdes Ampalu Kota Pariaman Bidan Helfiati, Amd. Keb.

Jurnal Surya Medika ◽

10.33084/jsm.v6i1.1620 ◽

2020 ◽

Vol 6 (1) ◽

pp. 70-76

Author(s):

Rika Armalini ◽

Prasetyaningsih Prasetyaningsih

Keyword(s):

Pregnant Women ◽

Significant Relationship ◽

Health Workers ◽

Statistical Tests ◽

Univariate Analysis ◽

First Trimester ◽

Nausea And Vomiting ◽

Cross Sectional ◽

Significance Level ◽

First Trimester Of Pregnancy

Nausea, vomiting in pregnancy is physiological that occurs in the first trimester, which starts 6 weeks after the first day of the last menstrual period, and disappears 6-12 weeks later. The report shows that almost 50-90% of pregnant women experience it. Nausea, vomiting if not treated can cause severe dehydration until poisoning occurs. The purpose of this study was to link the knowledge and attitudes of pregnant women with the occurrence of nausea and vomiting in the first trimester of pregnancy in the Poskesdes Ampalu Midwife Helfiati, Amd. Keb. The study was conducted in July 2019. This type of research is analytic survey research with a cross-sectional design. The population in this study were all pregnant women who visited Helfiati Amd.Keb polindes as many as 40 pregnant women with a total sampling technique. Data were analyzed by univariate and bivariate by computerized statistical tests using SPSS Ver. 17 with a significance level α = 0.05 and a degree of confidence of 95%. The results of the univariate analysis showed that 52.5% of mothers experienced nausea, vomiting, 62.5% of low-knowledge mothers and 42.5% of mothers were negative about how to deal with nausea and vomiting. there is a significant relationship between knowledge (p = 0,000) and attitude (p = 0,000) with the incidence of nausea and vomiting in the first trimester of pregnancy in the Poskesdes Ampalu Midwife Helfiati, Amd.Keb 2019. The results of this study can be concluded that there is a significant relationship between knowledge and attitude with the occurrence of nausea, vomiting. With this research it is expected that health workers provide IEC services and improve health care counseling in an effort to increase the knowledge of pregnant women about how to cope with nausea, and also expect mothers to be more active in seeking information about physiological complaints during pregnancy, especially how to deal with nausea vomiting by following counseling activities held by health workers so that in the future more knowledge from mothers.

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Subclinical hypothyroidism (SCH) in first trimester of pregnancy.

The Professional Medical Journal ◽

10.29309/tpmj/2020.27.11.4495 ◽

2020 ◽

Vol 27 (11) ◽

pp. 2474-2477

Author(s):

Kashif Ali Khan ◽

Muhammad Saleem Akhter ◽

Kehkashan Fatima ◽

Muhammad Waqar Saleem

Keyword(s):

Pregnant Women ◽

Subclinical Hypothyroidism ◽

Neonatal Death ◽

Placental Abruption ◽

First Trimester ◽

Free T4 ◽

Cross Sectional ◽

Death Rates ◽

First Trimester Of Pregnancy ◽

Tsh Levels

Objectives: The prime objective of this study was to evaluate and asses the prevalence and related complications of SCH in pregnant ladies in their 1st trimester of pregnancy in Pakistani population. Study Design: Cross Sectional study. Setting: Department of Medicine, Teaching Hospital, DG Khan, Pakistan. Period: 11th February 2017 to 29th December 2018. Material & Methods: We obtained informed consent from all patients. 457 pregnant ladies having last missed period till 12th week with age group between 18-45 years were included in this study. Samples were collected for T4 (Thyroxine), TSH (Thyroid Stimulating Hormone) and T3 (Triiodothyronine). Patients were followed for their entire pregnancy period. Adverse events and complications were noted. Results: Out of 457 patients who were included in our study, 169 subjects had TSH levels well above 4.6- 10 mIU/L. 288 subjects were having TSH levels below 4 mIU/L. The overall prevalence of subclinical hypothyroidism (SCH) was found to be 37% in pregnant women during their first trimester of pregnancy. Pregnant women having subclinical hypothyroidism (SCH) were having higher risks of loss of pregnancy, placental abruption and neonatal death rates as compared to euthyroid pregnant women. Conclusion: Our study concludes that overall prevalence of subclinical hypothyroidism (SCH) in Pakistani pregnant women during their first trimester of pregnancy was found to be 37%. Pregnant women having subclinical hypothyroidisms (SCH) were having higher risks of loss of pregnancy, placental abruption and neonatal death rates as compared to euthyroid pregnant women. In the light of these findings we recommend routine screening for TSH, free T3 and free T4 during pregnancy especially during 1st trimester of pregnancy.

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Perbedaan Kunjungan Pertama Ibu Hamil Berdasarkan Usia di Poskesdes Wilayah Kerja UPTD Puskesmas Gunungsari Kabupaten Lombok Barat

Indonesian Journal of Midwifery (IJM) ◽

10.35473/ijm.v2i2.288 ◽

2019 ◽

Vol 2 (2) ◽

Author(s):

Kusniyati Utami ◽

Irni Setyawati

Keyword(s):

Maternal Mortality ◽

Pregnant Women ◽

Health Workers ◽

Sampling Technique ◽

First Trimester ◽

P Value ◽

Antenatal Visit ◽

Chi Square ◽

Cross Sectional ◽

Significant Difference

The West Nusa Tenggara Provincial Health Office (2017) mentions the number of maternal mortality from 2015 to 2017 continues to decrease, from 95 cases to 85 cases. Maternal mortality during pregnancy can be prevented by antenatal care by health workers in accordance with the frequency of antenatal visits a minimum of four times. The first visit is carry out at a gestational age of the mother <16 weeks (Ministry of Health Republic of Indonesia, 2013), but still found pregnant women who made the first antenatal visit in the second trimester and even the third trimester.The purpose of this study was to determine the differences in first visit of pregnant women by age in the Poskesdes working area of the UPTD Puskesmas Gunungsari.This study used a cross-sectional analytic research design in eight Poskesdes in the working area of the UPTD Puskesmas Gunungsari, West Lombok district in November 2018 to January 2019. Samples were taken using a total sampling technique of 1042 people.Secondary data was collected from the maternal cohort register in eight Poskesdes in the UPTD Puskesmas Gunungsari working area in the form of the age of the mother at the first visit and the age of the mother's pregnancy at the first visit. Data were processed univariately and bivariately using the chi-square test.There was a significant difference in the first visit of pregnant women between mothers aged <20 years, 20-35 years, and> 35 years as indicated by the p value of 0.00001 (<0.05). It is expected that midwives in Poskesdes will further enhance the role of cadres in capturing first trimester pregnant women especially those aged <20 years and> 35 years.

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Knowledge about Anemia among Pregnant Women in Tertiary Hospital

Medicine Today ◽

10.3329/medtoday.v31i2.41962 ◽

2019 ◽

Vol 31 (2) ◽

pp. 105-110 ◽

Cited By ~ 1

Author(s):

Fahmida Sultana ◽

Gulshan Ara ◽

Tania Akbar ◽

Rayhana Sultana

Keyword(s):

Pregnant Women ◽

First Trimester ◽

Tertiary Hospital ◽

Cross Sectional Study ◽

Antenatal Visit ◽

Age Group ◽

Sectional Study ◽

Cross Sectional ◽

Gynecology And Obstetrics ◽

Medicine Today

Introduction: To evaluate knowledge about anemia among pregnant women visiting in OPD for antenatal care. Materials and Methods: A cross sectional study was conducted in tertiary hospital Dhaka, from outdoor patient department of gynecology and obstetrics, to assess the knowledge about anemia among pregnant women and also to find out the percentage and type of anemia. A total 396 pregnant women were interviewed and information were collected by pre designed data collection sheet using various parameters. Interviews conducted by direct questionnaire, blood samples were collected at same setting. Results: The mean age was 25.92±5.05, highest number 39.65% were age group 21-25 years, 28.79% were age group -30 years, 15.91% were age group 31-35 years, 11.36% were found age group <20 years. Regarding antenatal visit during pregnancy, 25.8% pregnant women visited in 1st trimester, 46.7% pregnant women visited in second trimester, and 27.5% in 3rd trimester. Also 11.11% patients had anemia in first trimester, 39.39% anemic in 2nd trimester, 14.39% pregnant women anemic in third trimester and 35.10% had normal findings. And 67% pregnant woman’s had knowledge about ANC 32% had no knowledge. Conclusion: In this cross sectional study it was found that poor knowledge about anemia and less iron intake is the main cause for anemia during pregnancy. Medicine Today 2019 Vol.31(2): 105-110

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