Bacterial flora of the genital tract in pregnancy and early labour

Background: Bacterial infections of the reproductive tract are common during pregnancy and have been associated with some pregnancy-related morbidities. There is limited information on the prevalence of bacterial infection of the reproductive tract during labour. Objective: To compare the prevalence of bacterial colonisation of the reproductive tract of pregnant women in early third trimester and early labour, and determine the associated foetal outcome. Methods: High vaginal swabs were collected from 201 pregnant women with gestational age from 26 to 32 weeks at the antenatal clinic of a Nigerian teaching hospital. The samples were processed to isolate bacterial organisms. Repeat samples were collected in early labour. The foetal outcome was assessed and recorded. Results: The prevalence of bacterial colonisation was 31.3% in early third trimester and 21.9% in early labour (p = 0.032). Staphylococcus aureus was the most prevalent organism isolated. Cefoxitin and imipenem were the most sensitive antibiotics. Women who had positive bacterial cultures in pregnancy had a slightly higher risk of low birth weight babies (RR 1.9, CI 0.9-3.7) and neonatal hospitalization (RR 1.8, CI 0.9-3.4) but without statistical significance (p = 0.05, and p = 0.06 respectively). Conclusion: The prevalence of bacterial colonisation of the reproductive tract of pregnant women was significantly higher in early third trimester than in early labour. There was no significant difference in pregnancy outcome between women who had positive bacterial cultures and those with negative cultures.

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Bacterial vaginosis in pregnancy and early labour using Nugent scoring and the implication on foetal outcome

Ghana Medical Journal ◽

10.4314/gmj.v54i1.3 ◽

2020 ◽

Vol 54 (1) ◽

pp. 10-16

Author(s):

Adewale O. Sule-Odu ◽

Adedayo A. Oluwole ◽

Adebayo A. Akadri ◽

Babatunde A. Andu ◽

Adeniyi K. Akiseku ◽

...

Keyword(s):

Bacterial Vaginosis ◽

Pregnant Women ◽

Vaginal Flora ◽

Vaginal Microflora ◽

Early Labour ◽

Foetal Outcome ◽

Antenatal Clinics ◽

Prospective Longitudinal ◽

Abnormal Vaginal Flora ◽

In Pregnancy

Background: To compare the pattern of vaginal microflora during pregnancy with pattern in early labour using Nugent scoring and determine the effect of these changes on fetal outcome. Design: A prospective longitudinal study. Setting and Population: Pregnant women attending antenatal clinics of Olabisi Onabanjo University Teaching Hospital, Sagamu, Nigeria between June 2017 and May 2018. Methods: Consenting pregnant women who attended antenatal clinics were recruited. Vaginal secretions were obtained for Nugent scoring during pregnancy and at presentation in labour. Main Outcome Measures: Prevalence of abnormal vaginal flora in pregnancy and early labour, birth outcome, birth weight, gestational age at delivery, APGAR scores, need for neonatal ward admission. Results: Sixty-seven (33.3%) of pregnant women had abnormal flora which was consistent with bacterial vaginosis.At the presentation of these women in labour, 14.4% of them had bacterial vaginosis thus indicating a significant reduction in abnormal vaginal flora in labour compared to the proportion of abnormal flora in antenatal period(P<0.001). There were no significant differences in the fetal outcomes of mothers with bacterial vaginosis when compared with those with normal vaginal flora (P-value >0.05). Conclusions: Persistence of abnormal vaginal microflora from pregnancy till early labour did not seem to be associated with poorer foetal outcomes when compared with women with normal vaginal microflora in labour. The possibility of persistent infection or re-infection before labour may justify the need for re-evaluation of vaginal smears in the late third trimester to allow for prompt treatment before the onset of labour. Keywords: Bacterial vaginosis, foetal outcome, Lactobacillus, pregnancy, vaginal microflora. Funding: This research work was sponsored by the Tertiary Education Trust Fund, Nigeria (TETFund) with referencenumber OOU/IBR/010.

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Clinical significance of ultrasonic placental grading during third trimester in hypertensive disorders in pregnancy and its correlation with fetal outcome in tertiary care centre

International Journal of Reproduction Contraception Obstetrics and Gynecology ◽

10.18203/2320-1770.ijrcog20213443 ◽

2021 ◽

Vol 10 (9) ◽

pp. 3325

Author(s):

Aruna Naik ◽

Susheela Khoiwal ◽

Nisha Sharma ◽

Priya Aarthy

Keyword(s):

Pregnant Women ◽

Birth Asphyxia ◽

Morbidity And Mortality ◽

Study Group ◽

Perinatal Morbidity ◽

Foetal Distress ◽

Third Trimester ◽

Foetal Outcome ◽

Grade Iii ◽

In Pregnancy

Background: Hypertension is one of the common complications in pregnancy and contributes significantly to maternal and perinatal morbidity and mortality. The aim of the present study was to study placental grading by grading by ultrasonography in pregnancy complicated with hypertension and normotensive gravidas. To compare the foetal outcome regarding placental grading and its correlation pattern of placental grade distribution, type of delivery, foetal distress, birth asphyxia, foetal maturity, perinatal morbidity and mortality.Methods: The present study was conducted for a period of 12 months, which included 200 patients who attended OPD at PDRMC, Udaipur. Inclusion criteria was hypertensive pregnant women with BP >140/90 mmHg. Exclusion criteria was Pregnancy associated with other medical disorders, twin gestation, renal and cardiovascular disease and diabetes mellitus.Results: 100 pregnant women with preeclampsia as study group. The most common age group in study group is 22-23 Years. The grade III placenta was found early third trimester in study group. Caesarean delivery was more common mode of delivery in grade III placenta. In foetal outcome small for gestational age was more among the grade III placenta. Foetal distress, birth asphyxia, perinatal mortality, morbidity more among the grade III placenta among the study group.Conclusions: Foetal complications were significantly more in study group compared to control group. Ultrasound placental grade III was statistically significant in correlating with foetal complications like foetal distress, birth asphyxia, perinatal morbidity and mortality.

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Iron Physiological Requirements of Pregnant Women Assessed by the Stable Isotope Tracer Technique (P24-062-19)

Current Developments in Nutrition ◽

10.1093/cdn/nzz044.p24-062-19 ◽

2019 ◽

Vol 3 (Supplement_1) ◽

Author(s):

Lichen Yang ◽

Jiaxi Lu ◽

Min Li ◽

Jie Cai ◽

Yuxia Ma ◽

...

Keyword(s):

Stable Isotope ◽

Pregnant Women ◽

Measurement Data ◽

Reproductive Age ◽

Tracer Technique ◽

Third Trimester ◽

Stable Isotope Tracer ◽

Isotope Tracer ◽

Significant Difference ◽

In Pregnancy

Abstract Objectives Iron physiological requirement, the core index to formulate the dietary reference intakes (DRIs), is of great importance for the health of pregnant women and fetus and can help the mother to accurately plan iron supplement. While the direct measurement data of iron physiological requirements in pregnancy is still lacking worldwide, the objective of this study is to assess this value in Chinese pregnant women by stable isotope tracer technique. Methods 11 women of reproductive age who had been pregnant during the study from Hebei province in 2015 were included in the final analysis. Subjects were participated in a two-week metabolic test with oral intake of 50 mg 58Fe and followed up to about 2 years. The abundance of 58Fe and the total iron concentration was detected by MC-ICP-MS and AAS. The iron physiological requirements in pregnancy were calculated by the formula. Results The average iron physiological requirement of 11 subjects in the whole pregnancy was 3054.12 µg/d in total and 43.99 µg/(kg.d) after weight adjusted. The iron physiological requirement in the first, second and third trimester was 2039.07 µg/d, 3258.90 µg/d and 4134.47 µg/d, respectively. The iron physiological requirement adjusted by weight in the first, second and third trimester was 32.28 µg/(kg.d), 46.90 µg/(kg.d) and 55.74 µg/(kg.d), respectively. Comparing the results of each pregnancy period, there was no significant difference (P > 0.05). Conclusions The pregnant women need more than 2 times iron over that of the non-pregnant. The iron physiological requirements in different trimester showed no significant difference, while there was an increasing trend of requirements went with the pregnancy progress. Funding Sources National Natural Science Foundation of China (https://isisn.nsfc.gov.cn/egrantindex/funcindex/prjsearch-list, grant no.:81,330,066)

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Measurement of Barriers, Attitudes, and Expectations for Sitting Less in Pregnancy

American Journal of Health Behavior ◽

10.5993/ajhb.45.6.1 ◽

2021 ◽

Vol 45 (6) ◽

pp. 956-970

Author(s):

Bethany Barone Gibbs ◽

Melissa A. Jones ◽

Kara M. Whitaker ◽

Sharon Taverno Ross ◽

Kelliann K. Davis

Keyword(s):

Pregnant Women ◽

Sedentary Time ◽

Healthcare Providers ◽

Outcome Expectations ◽

Physical Symptoms ◽

Third Trimester ◽

Household Chores ◽

Prenatal Interventions ◽

Specific Barriers ◽

In Pregnancy

Objective: Our objective was to develop, validate, and describe findings from an instrument to measure barriers, attitudes, and outcome expectations of sitting less in pregnant women. Methods: This validation (sub-study 1) and descriptive study (sub-study 2) evaluated a new questionnaire measuring sedentary time in pregnant women (N=131) in each trimester. Results: In sub-study 1, construct validity was supported by associations between device-measured sedentary time and questionnaire scores. An optimized questionnaire removed infrequently reported and non-correlated items. The original and optimized questionnaires with scoring instructions are provided. In sub-study 2, physical symptoms and work were most commonly reported as major reasons for sitting in pregnancy, followed by leisure, family, and social activities. Some women reported limiting sitting due to boredom/restlessness, to improve energy or health, and to control weight. In the third trimester, some women reported sitting more/less due to pain and encouragement from family, friends, and co-workers. Few women reported household chores or pregnancy risks as reasons to sit, felt sitting was healthy or necessary during pregnancy, or were encouraged to sit by healthcare providers. Conclusions: The developed questionnaire demonstrated validity and identified barriers to and expectations of sitting less during pregnancy. Prenatal interventions to reduce sitting should address general and pregnancy-specific barriers.

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Gambaran Kadar Hemoglobin pada Ibu Hamil Trimester III di Rumah Sakit Robert Wolter Mongisidi Manado

Medical Scope Journal ◽

10.35790/msj.1.2.2020.28004 ◽

2020 ◽

Vol 1 (2) ◽

Author(s):

Selfesina Sikoway ◽

Yanti Mewo ◽

Youla Assa

Keyword(s):

Pregnant Women ◽

Descriptive Study ◽

Hemoglobin Level ◽

Inclusion Criteria ◽

Third Trimester ◽

Cross Sectional ◽

Abnormal Phenomenon ◽

Cross Sectional Design ◽

Obstetric Department ◽

In Pregnancy

Abstract: Hemoglobin (Hb) is a parameter used to determine anemia prevalence. The average level of normal Hb at the end of pregnancy is around 12.5 g/dL, meanwhile, aproximately 5% of pregnant women have Hb level less than 11.0 g/dL. To date, Hb level below 11.0 g/dL especially at the end of pregnancy should be considered as an abnormal phenomenon and is usually caused by iron deficiency and not by hypervolemia which is commonly found in pregnancy. This study was aimed to determine the hemoglobin level of third semester pregnant women in Robert Wolter Mongisidi Hospital Manado. This was a descriptive study with a cross sectional design. Subjects were 39 third semester pregnant women who visited the Obstetric Department of Robert Wolter Mongisidi Hospital and fulfilled the inclusion criteria. The results showed that 25 subjects (64.1%) had low hemoglobin levels and 14 subjects (35.9%) had normal level of hemoglobin. In conclusion, most third semester pregnant women had low hemoglobin levels.Keywords: hemoglobin rate, third trimester pregnant women, anemia Abstrak: Hemoglobin (Hb) darah merupakan parameter yang digunakan untuk menetapkan prevalensi anemia. Nilai normal Hb pada akhir kehamilan rata-rata 12,5 g/dL, dan sekitar 5% wanita hamil konsentrasinya kurang dari 11,0 g/dL. Nilai Hb dibawah 11,0 g/dL terutama pada akhir kehamilan perlu dianggap abnormal dan biasanya disebabkan oleh defisiensi besi dan bukan karena hipervolemia yang umumnya ditemukan pada kehamilan. Penelitian ini bertujuan untuk mengetahui kadar hemoglobin pada ibu hamil trimester III di Rumah Sakit Robert Wolter Mongisidi Manado. Jenis penelitian ialah deskriptif dengan menggunakan desain potong lintang. Subyek penelitian ialah 39 ibu hamil trimester III yang berkunjung di Poliklinik Kebidanan di Rumah Sakit Robert Wolter Mongisidi Manado yang memenuhi kriteria inklusi. Hasil penelitian menunjukkan 25 subyek (64,1%) memiliki kadar hemoglobin rendah dan 14 subyek (35,9%) memiliki kadar hemoglobin normal. Simpulan penelitian ini ialah sebagian besar ibu hamil trimester III memiliki kadar hemoglobin rendah.Kata kunci: kadar hemoglobin, ibu hamil trimester III, anemia

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Differences in pregnancy and perinatal outcomes among symptomatic versus asymptomatic COVID-19-infected pregnant women: a systematic review and meta-analysis

BMC Pregnancy and Childbirth ◽

10.1186/s12884-021-04250-1 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Durray Shahwar A. Khan ◽

La-Raib Hamid ◽

Anna Ali ◽

Rehana A. Salam ◽

Nadeem Zuberi ◽

...

Keyword(s):

Risk Factors ◽

Systematic Review ◽

Pregnant Women ◽

Low Birthweight ◽

Meta Analysis ◽

Perinatal Outcomes ◽

Respiratory Disorder ◽

Significant Difference ◽

The Mean ◽

In Pregnancy

Abstract Background There is dearth of information on COVID-19’s impact on pregnant women. However, literature reported trends of COVID-19 differ, depending on the presence of clinical features upon presentation. Objective This systematic review aimed to assess differences in risk factors, management, complications, and pregnancy and perinatal outcomes in symptomatic vs. asymptomatic pregnant women with confirmed SARS-CoV-2 infection. Methods A search was run on electronic databases to identify studies reporting COVID-19 in pregnancy. Meta-analysis was performed and odds ratios and mean difference with 95% confidence intervals were calculated using Review Manager 5.4. Review Prospero registration number CRD42020204662. Results We included ten articles reporting data from 3158 pregnancies; with 1900 symptomatic and 1258 asymptomatic pregnant women. There was no significant difference in the mean age, gestational age, and body mass index between the two groups. The meta-analysis suggested that pregnant women who were obese (OR:1.37;95%CI:1.15 to 1.62), hypertensive (OR:2.07;95%CI:1.38 to 3.10) or had a respiratory disorder (OR:1.64;95%CI:1.25 to 2.16), were more likely to be symptomatic when infected with SARS-CoV-2. Pregnant women with Black (OR:1.48;95%CI:1.19 to 1.85) or Asian (OR:1.64;95%CI:1.23 to 2.18) ethnicity were more likely to be symptomatic while those with White ethnicity (OR:0.63;95%CI:0.52 to 0.76) were more likely to be asymptomatic. Cesarean-section delivery (OR:1.40;95%CI:1.17 to 1.67) was more likely amongst symptomatic pregnant women. The mean birthweight(g) (MD:240.51;95%CI:188.42 to 293.51), was significantly lower, while the odds of low birthweight (OR:1.85;95%CI:1.06 to 3.24) and preterm birth (< 37 weeks) (OR:2.10;95%CI:1.04 to 4.23) was higher amongst symptomatic pregnant women. Symptomatic pregnant women had a greater requirement for maternal ICU admission (OR:13.25;95%CI:5.60 to 31.34) and mechanical ventilation (OR:15.56;95%CI:2.96 to 81.70) while their neonates had a higher likelihood for Neonatal Intensive Care Unit admission (OR:1.96;95%CI:1.59 to 2.43). The management strategies in the included studies were poorly discussed, hence could not be analyzed. Conclusion The evidence suggests that the presence of risk factors (co-morbidities and ethnicity) increased the likelihood of pregnant women being symptomatic. Higher odds of complications were also observed amongst symptomatic pregnant women. However, more adequately conducted studies with adjusted analysis and parallel comparison groups are required to reach conclusive findings.

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Competence of medical and obstetric registrars in the management of systemic lupus erythematosus in pregnancy

Obstetric Medicine ◽

10.1177/1753495x20964670 ◽

2020 ◽

pp. 1753495X2096467

Author(s):

Jarrod Zamparini ◽

Stuart Pattinson ◽

Kavita Makan

Keyword(s):

South Africa ◽

Systemic Lupus Erythematosus ◽

Pregnant Women ◽

Lupus Erythematosus ◽

Pass Rate ◽

Childbearing Age ◽

Systemic Lupus ◽

Significant Difference ◽

General Physicians ◽

In Pregnancy

Introduction Systemic lupus erythematosus has a predilection for women of childbearing age. Globally a shortage of rheumatologists exists resulting in general physicians and obstetricians treating systemic lupus erythematosus in pregnancy. Methods We conducted a survey amongst medical and obstetric registrars in South Africa to assess their subjective and objective competence in managing pregnant women with systemic lupus erythematosus. Results The pass rate for the objective section was 70.8% with no statistically significant difference in the pass rate between medical and obstetric registrars. Participants felt unprepared to manage pregnant women with systemic lupus erythematosus, with a mean overall score of 3.4 out of 7 for the subjective section, based on four Likert scale type questions. Conclusion Trainees are not able to accurately assess their own levels of competence in order to identify their learning needs. Due to the shortage of rheumatologists and lack of obstetric physicians in South Africa, general physicians and obstetricians must be equipped to provide adequate care to pregnant women with systemic lupus erythematosus.

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Thrombin Generation in Chinese Pregnant Women and the Effect of Insulin Use on Thrombin Generation in Patients with GDM

Clinical and Applied Thrombosis/Hemostasis ◽

10.1177/1076029619863492 ◽

2019 ◽

Vol 25 ◽

pp. 107602961986349

Author(s):

Feng Dong ◽

Longhao Wang ◽

Chengbin Wang

Keyword(s):

Blood Glucose ◽

Pregnant Women ◽

Thrombin Generation ◽

First Trimester ◽

Normal Pregnancy ◽

Third Trimester ◽

Control Blood Glucose ◽

Normal Ranges ◽

Increased Risk ◽

Significant Difference

Pregnancy is a hypercoagulable state associated with an increased risk of venous thrombosis. Calibrated automated thrombogram (CAT) is a test to monitor the thrombin generation (TG), a laboratory marker of thrombosis risk, and increases during normal pregnancy, but it is still unclear whether TG is related to the use of insulin in pregnant women with gestational diabetes mellitus (GDM). We performed thrombin generation by CAT on 135 normal pregnant women, including 43 in first trimester, 32 in second trimester, 60 in third trimester, respectively; 68 pregnant women with GDM were also enrolled, 19 patients with GDM using insulin to control blood glucose and 49 patients control their blood glucose through diet and exercise with noninsulin treatment. The overall CAT parameters were calculated using descriptive statistics method with mean ± standard deviation. Mean endogenous thrombin potential, peak thrombin generation, and StartTail time increased significantly with the pregnancy. There was no significant difference in TG test parameters except StartTail time( P = .003) in insulin-treated GDM group when compared to those without insulin in the GDM group. The normal ranges for CAT parameters in pregnant women were determined. Thrombin generation increased significantly in first trimester and remains stable in second and third trimester. The use of insulin in patient with GDM did not affect thrombin generation test. Our study helps to establish the reference range of thrombin generation in Chinese normal pregnant population and provide more basis to predict the risk of thrombus complicating during pregnancy.

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THE DIFFERENCE IN ADDITION OF BACK MASSAGE COMBINATION IN PREGNANCY EXERCISE IN IMPROVING QUALITY OF SLEEP IN THIRD TRIMESTER PREGNANT WOMEN

Majalah Ilmiah Fisioterapi Indonesia ◽

10.24843/mifi.2018.v06.i02.p03 ◽

2018 ◽

Vol 6 (2) ◽

pp. 16

Author(s):

Mezzi Wulandari Arenza ◽

Ni Wayan Tianing ◽

I Putu Adiartha Griadhi

Keyword(s):

Sleep Quality ◽

Pregnant Women ◽

Control Group ◽

Quality Of Sleep ◽

Third Trimester ◽

The Third ◽

The Difference ◽

In Pregnancy ◽

Back Massage

ABSTRACTSleep disturbance in the third trimester pregnant women is caused by discomfort, an increasingly largeabdominal condition, back pain, frequent urination, fetal movement, heartburn, cramps in the legs, tiredness, difficultygetting started, and physiological changes. Sleep disorders result in decreased quality of sleep. Pregnant women whohave poor sleep quality are at risk of longer labor, cesarean delivery, premature birth, and even infant mortality. The aimof this research is to know the difference of pregnant exercise combination and back massage in improving the sleepquality of third trimester pregnant women. This research use experiment method with quasi experiment approach andresearch design is pre and post test with control design. Sample are 18 people, divided into 2 groups, 9 people intreatment groups given pregnancy exercise and back massage and 9 people in control group is given only pregnantexercise. Intervention is given 8 times. Pittsburgh Sleep Quality Index (PSQI) questionnaire used for measured of sleepquality. The result of different test of unpaired group, in the treatment group got difference of average 4,556 and controlgroup got difference mean 2,333 with p=0,004 (p<0,05). These results showed that there was a significant differencebetween the treatment group and the control group in improving the sleep quality of the third trimester pregnant women.In conclusion, there are differences in the addition of back massage combination in pregnancy exercise intervention inimproving sleep quality of third trimester pregnant women.Keyword : Pregnancy Exercise, Back Massage, Sleep Quality, Third Trimester.

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Lactobacillus iners Is Associated with Vaginal Dysbiosis in Healthy Pregnant Women: A Preliminary Study

BioMed Research International ◽

10.1155/2019/6079734 ◽

2019 ◽

Vol 2019 ◽

pp. 1-9

Author(s):

Nengneng Zheng ◽

Renyong Guo ◽

Yinyu Yao ◽

Meiyuan Jin ◽

Yiwen Cheng ◽

...

Keyword(s):

Pregnant Women ◽

Vaginal Microbiota ◽

Second Trimester ◽

Premature Rupture Of Membranes ◽

Third Trimester ◽

Premature Rupture ◽

Significant Difference ◽

Bacterial Marker ◽

Preliminary Study ◽

Adverse Pregnancy

Vaginal dysbiosis has been identified to be associated with adverse pregnancy outcomes, such as preterm delivery and premature rupture of membranes. However, the overall structure and composition of vaginal microbiota in different trimesters of the pregnant women has not been fully elucidated. In this study, the physiological changes of the vaginal microbiota in healthy pregnant women were investigated. A total of 83 healthy pregnant participants were enrolled, who are in the first, second, or third pregnancy trimester. Quantitative real-time PCR was used to explore the abundant bacteria in the vaginal microbiota. No significant difference in the abundance of Gardnerella, Atopobium, Megasphaera, Eggerthella, Leptotrichia/Sneathia, or Prevotella was found among different trimesters, except Lactobacillus. Compared with the first pregnancy trimester, the abundance of L. iners decreased in the second and third trimester while the abundance of L. crispatus was increased in the second trimester. Moreover, we also found that vaginal cleanliness is correlated with the present of Lactobacillus, Atopobium, and Prevotella and leukocyte esterase is associated with Lactobacillus, Atopobium, Gardnerella, Eggerthella, Leptotrichia/Sneathia, and Prevotella. For those whose vaginal cleanliness raised or leukocyte esterase became positive, the richness of L. iners increased, while that of L. crispatus decreased significantly. Our present data indicated that the altered vaginal microbiota, mainly Lactobacillus, could be observed among different trimesters of pregnancy and L. iners could be considered as a potential bacterial marker for evaluating vaginal cleanliness and leukocyte esterase.

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