Atenção primária a grávidas em relação ao consumo de mips na gravidez e os efeitos teratogênicos  / Primary care for pregnant women in relation to the consumption of mips in pregnancy and the teratogenic effects

Physiological changes in lipoprotein levels occur in normal pregnancy. Women with hyperlipoproteinemia are advised to discontinue statins, fibrates already when they consider pregnancy up to and including breast-feeding the newborn, because of the fear for teratogenic effects. Hypertriglyceridemia in pregnancy can rarely lead to acute pancreatitis. Management of acute pancreatitis in pregnant women is similar to that used in non-pregnant patients. Further large cohort studies are needed to estimate the consequence of supraphysiologic hyperlipoproteinemia or extreme hyperlipoproteinemia in pregnancy on the risk for cardiovascular disease later in life. Orv. Hetil., 2011, 152, 753–757.

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Hyperemesis gravidarum

InnovAiT Education and inspiration for general practice ◽

10.1177/1755738019850848 ◽

2019 ◽

Vol 12 (8) ◽

pp. 434-441

Author(s):

Yusra Khan

Keyword(s):

Primary Care ◽

Natural History ◽

Pregnant Women ◽

Early Treatment ◽

Hyperemesis Gravidarum ◽

Common Symptom ◽

Morning Sickness ◽

Extreme Form ◽

History Of ◽

In Pregnancy

Nausea and vomiting in pregnancy (NVP), or morning sickness, is the most common symptom experienced by pregnant women and affects 80% of pregnancies. NVP occurs across a spectrum, ranging from mild to severe, with hyperemesis gravidarum (HG) representing the most extreme form. HG is a complication of pregnancy affecting 1% of pregnancies, and if left untreated can cause maternal and fetal morbidity and mortality. Early treatment of NVP in primary care can prevent progression to HG. This article aims to help GP trainees understand the natural history of HG and provides a framework for its assessment and management.

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Conhecimento de Gestantes Sobre a Síndrome Hipertensiva Gestacional

Revista Enfermagem Atual In Derme ◽

10.31011/reaid-2018-v.86-n.24-art.88 ◽

2018 ◽

Vol 86 (24) ◽

Author(s):

Lia Maristela da Silva Jacob ◽

Daniela Gardano Bucharles Mont’Alverne ◽

Maura Cristiane e Silva Figueira ◽

Reginaldo Roque Mafetoni ◽

Cláudia Jeane Lopes Pimenta ◽

...

Keyword(s):

Primary Care ◽

Health Promotion ◽

High Pressure ◽

Focus Group ◽

Prenatal Care ◽

Pregnant Women ◽

Cultural Context ◽

Primary Care Professionals ◽

In Pregnancy

Este estudo objetiva analisar os saberes de gestantes sobre a síndrome hipertensiva da gestação para criar e validaruma cartilha sobre o tema de acordo com o contexto vivenciado. Trata-se de um estudo descritivo-exploratório,qualitativo, utilizando grupos focais com gestantes assistidas no pré-natal em Fortaleza, Ceará, Brasil. Participaram oitogestantes em acompanhamento do pré-natal de baixo risco. Durante o grupo focal emergiram duas categorias: (Des)saberes sobre a pressão alta na gravidez e Dificuldades no tratamento/acompanhamento. Os resultados apontaramsaberes insuficientes, ocasionando dúvidas sobre as causas, evolução e tratamento das síndromes hipertensivas.Percebe-se a necessidade dos profissionais da atenção básica adequarem estratégias de assistência mais voltadas aossaberes e ao contexto socioeconômico e cultural das gestantes realizando ações educativas que sejam compreendidase possíveis de implementação.Palavras-chave: Gestantes; Hipertensão Induzida pela Gravidez; Promoção à Saúde; Educação em Saúde. AbstractThis study aims to analyze the knowledge of pregnant women about gestational hypertensive syndrome to create andvalidate a booklet about the theme according to the experienced context. This is a descriptive-exploratory, qualitativestudy using focal groups with pregnant women assisted in prenatal care in Fortaleza, Ceará, Brazil. Participants wereeight pregnant women attending low-risk prenatal care. During the focus group two categories emerged: (Des)knowledge about high pressure in pregnancy and Difficulties in treatment/follow-up. The results indicated insufficientknowledge, causing doubts about the causes, evolution and treatment of hypertensive syndromes. It is noticed theneed of the primary care professionals to adapt assistance strategies more focused on the knowledge and thesocioeconomic and cultural context of the pregnant women, carrying out educational actions that are understood andpossible to implement.Keywords: Pregnant Women; Hypertension, Pregnancy-Induced; Health Promotion; Health Education.

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Determinants of influenza and pertussis vaccination uptake in pregnancy: a multi-centre questionnaire study of pregnant women and healthcare professionals

British Journal of General Practice ◽

10.3399/bjgp19x703301 ◽

2019 ◽

Vol 69 (suppl 1) ◽

pp. bjgp19X703301

Author(s):

Christopher Wilcox ◽

Anna Calvert ◽

Jane Metz ◽

Eliz Kilich ◽

Rachael Macleod ◽

...

Keyword(s):

Primary Care ◽

Pregnant Women ◽

Odds Ratio ◽

Healthcare Professionals ◽

Hospital Setting ◽

Uptake Rates ◽

Alternative Sites ◽

Routine Antenatal Care ◽

Logistical Barrier ◽

In Pregnancy

BackgroundUptake rates of influenza and pertussis vaccination in pregnancy remain suboptimal.AimTo determine the acceptability of routine vaccination among pregnant women; the confidence of maternity healthcare professionals (HCPs) discussing vaccination; and HCP opinion with regards to the optimum healthcare site for vaccine administration.MethodSeparate questionnaires for pregnant women and maternity HCPs were distributed within four NHS trusts in South England from July 2017–January 2018.ResultsResponses from 314 pregnant women and 204 HCPs (18% obstetricians, 75% midwives [both hospital and community], 7% unidentified) were analysed. Actual/intended uptake of influenza and pertussis vaccination was 78% and 92%, respectively. The commonest reason for declining vaccination was feared side effects for their child. White British women (79%) were significantly more accepting of influenza (odds ratio [OR] 3.25, 95% confidence interval [CI] = 1.67 to 6.32) and pertussis vaccination (OR 4.83, 95% CI = 1.77 to 13.19) compared with non-white British women. Among HCPs, 25% were not-at-all or slightly confident discussing vaccination. Obstetricians felt significantly more confident discussing pertussis vaccination than midwives (OR 2.05, 95% CI = 1.02 to 4.12). Among HCPs, 53%, 25%, and 16% thought vaccines should be administered in primary care (general practice), community midwifery, and the hospital setting, respectively.ConclusionMisconceptions exist regarding safety and efficacy of maternal vaccination, and framing information towards safety for the child may increase uptake. Education of HCPs is essential, and vaccine promotion should be incorporated into routine antenatal care, with an emphasis on women from ethnic minorities. Administration of vaccines in primary care may present a logistical barrier to women, however support for alternative sites appears low among HCPs.

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TO REVIEW THE TIMING OF INTERVENTION WHICH WILL PROVIDE THE BEST OUTCOME IN HYPOTHYROIDISM IN PREGNANCY

International Journal of Medical and Biomedical Studies ◽

10.32553/ijmbs.v3i4.209 ◽

2019 ◽

Vol 3 (4) ◽

Author(s):

Dr. Archana Mohana ◽

Dr. Sujata Badoniya

Keyword(s):

Pregnant Women ◽

Thyroid Disease ◽

Fetal Outcome ◽

Thyroxine Therapy ◽

In Pregnancy

The Aim of this study is to Review the timing of intervention which will provide the Best Outcome in Hypothyroidism in Pregnancy. Hypothyroid pregnant women are appropriately managed with regular antenatal checkup and thyroxine therapy during pregnancy, a good maternal and fetal outcome can be achieved and congenital cretinism and other neuro developmental sequele in the offspring can be averted. Keywords: Intervention, Hyperthyroidism, Pregnancy & Thyroid disease.

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A COMPARATIVE STUDY OF IODINE METABOLISM IN PREGNANCY, SPORADIC GOITRE AND THYROTOXICOSIS

Acta Endocrinologica ◽

10.1530/acta.0.0480014 ◽

1965 ◽

Vol 48 (1) ◽

pp. 14-22 ◽

Cited By ~ 3

Author(s):

S. A. Aboul-Khair ◽

J. Crooks

Keyword(s):

Comparative Study ◽

Pregnant Women ◽

Iodine Deficiency ◽

Physiological Responses ◽

Iodine Uptake ◽

Thyroid Activity ◽

Deficiency State ◽

Iodine Metabolism ◽

Inorganic Iodine ◽

In Pregnancy

ABSTRACT Studies of iodine metabolism have been carried out in 15 pregnant women, 33 cases with sporadic goitre and 11 with thyrotoxicosis. A low plasma inorganic iodine was common to the three groups. In pregnancy and sporadic goitre the thyroid clearance of iodine was elevated and the absolute iodine uptake normal. A high thyroid clearance of iodine in thyrotoxicosis was associated with a high absolute iodine uptake. The results suggest that both pregnancy and sporadic goitre are physiological responses to an iodine deficiency state while the iodine deficiency state of thyrotoxicosis is secondary to increased thyroid activity.

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LEUCOCYTE METABOLISM IN PREGNANCY

Acta Endocrinologica ◽

10.1530/acta.0.xxxv0575 ◽

1960 ◽

Vol XXXV (IV) ◽

pp. 575-584 ◽

Cited By ~ 2

Author(s):

C. Borel ◽

J. Frei ◽

A. Vannotti

Keyword(s):

Alkaline Phosphatase ◽

Oxygen Consumption ◽

Pregnant Women ◽

Phosphatase Activity ◽

Alkaline Phosphatase Activity ◽

Lactate Production ◽

Glucose Consumption ◽

In Pregnancy

ABSTRACT Enzymatic studies, on leucocytes of pregnant women, show an increase of the alkaline phosphatase activity and a decrease of the glucose consumption and lactate production, as well as of proteolysis. The oxygen consumption, with succinate as substrate, does not vary.

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Quantifying Pregnant Women’s Knowledge of Educational Components of Antenatal Care in Lesotho

Africa Journal of Nursing and Midwifery ◽

10.25159/2520-5293/4317 ◽

2019 ◽

Vol 21 (1) ◽

Author(s):

Tabeta Seeiso ◽

Mamutle M. Todd-Maja

Keyword(s):

Antenatal Care ◽

Maternal Mortality ◽

Pregnant Women ◽

Rural Areas ◽

Geographic Location ◽

Sub Saharan Africa ◽

World Health ◽

Cross Sectional ◽

Danger Signs ◽

In Pregnancy

Antenatal care (ANC) literacy is particularly important for pregnant women who need to make appropriate decisions for care during their pregnancy and childbirth. The link between inadequate health literacy on the educational components of ANC and maternal mortality in sub-Saharan Africa (SSA) is undisputable. Yet, little is known about the ANC literacy of pregnant women in SSA, with most studies inadequately assessing the four critical components of ANC literacy recommended by the World Health Organization, namely danger signs in pregnancy; true signs of labour; nutrition; and preparedness for childbirth. Lesotho, a country with one of the highest maternal mortality rates in SSA, is also underexplored in this research area. This cross-sectional study explored the levels of ANC literacy and the associated factors in 451 purposively sampled women in two districts in Lesotho using a structured questionnaire, making recourse to statistical principles. Overall, 16.4 per cent of the participants had grossly inadequate ANC literacy, while 79.8 per cent had marginal levels of such knowledge. The geographic location and level of education were the most significant predictors of ANC literacy, with the latter variable further subjected to post hoc margins test with the Bonferroni correction. The participants had the lowest scores on knowledge of danger signs in pregnancy and true signs of labour. Adequate ANC literacy is critical to reducing maternal mortality in Lesotho. Improving access to ANC education, particularly in rural areas, is recommended. This study also provides important recommendations critical to informing the national midwifery curriculum.

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Overt and subclinical hypothyroidism among Bangladeshi pregnant women and its effect on fetomaternal outcome

Bangladesh Medical Research Council Bulletin ◽

10.3329/bmrcb.v40i2.25183 ◽

2015 ◽

Vol 40 (2) ◽

pp. 52-57 ◽

Cited By ~ 5

Author(s):

M Sharmeen ◽

PA Shamsunnahar ◽

TR Laita ◽

SB Chowdhury

Keyword(s):

Adverse Effects ◽

Pregnant Women ◽

Subclinical Hypothyroidism ◽

Thyroid Dysfunction ◽

Perinatal Outcomes ◽

Fetal Outcome ◽

Thyroid Stimulating Hormone ◽

Overt Hypothyroidism ◽

Adequate Treatment ◽

In Pregnancy

Objectives: Thyroid disorders are among the common endocrine problems in pregnant women. It is now well established that not only overt but subclinical thyroid dysfunction also has adverse effects on maternal and fetal outcome. There are few data from Bangladesh about the prevalence of thyroid dysfunction in pregnancy. With this background, this study aims to find out thyroid dysfunction (both overt and subclinical hypothyroidism) in pregnancy and its impact on obstetrical outcome.Methods: We studied the evaluation of 50 admitted pregnancies corresponding to 29 women with subclinical hypothyroidism and rest 21 was overt hypothyroidism. Detailed history and examination were performed. Apart from routine obstetrical investigations, Thyroid Stimulating Hormone (TSH) estimation was done. Their obstetrical and perinatal outcomes were noted.Results: Overt hypothyroidism was significantly (p<0.05) higher in 25 to 44 years age group. However two and three abortions were significantly (p<0.05) higher in overt hypothyroidism patients. In sub clinical hypothyroidism 86.2% conceived firstly within 2 years and 66.7% in overt hypothyroidism patients conceived firstly in between 3 to 5 years after marriage. Overt hypothyroids were prone to have pregnancy-induced hypertension 42.9%, intrauterine growth restriction (P=0.001) and gestational diabetes (38.1%) as compared to subclinical cases. Neonatal complications were significantly more in overt hypothyroidism group. Mean TSH level was significantly (p<0.05) higher in overt hypothyroidism patients but mean FT4 level was almost similar in both groups. Majority of the patient underwent caesarean section in both groups due to associated medical and obstetrical complications. None of the babies showed hypothyroidism by cord blood tests. In this analysis our results showed that overt hypothyroidism among Bangladeshi pregnant women are associated with more maternal complication & adverse parental outcome than subclinical hypothyroidism. The adequate treatment of hypothyroidism during gestation minimizes risks and generally, makes it possible for pregnancies to be carried to term without complications. Significant adverse effects on maternal and fetal outcome were seen emphasizing the importance of routine antenatal thyroid screening.Bangladesh Med Res Counc Bull 2014; 40 (2): 52-57

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Acceptability of single screening and treatment policy for the control of malaria in pregnancy: perceptions of providers and pregnant women from selected health facilities in Lindi region, Tanzania

Malaria Journal ◽

10.1186/s12936-021-03782-3 ◽

2021 ◽

Vol 20 (1) ◽

Author(s):

Chonge Kitojo ◽

Frank Chacky ◽

Emmanuel S. Kigadye ◽

Joseph P. Mugasa ◽

Abdallah Lusasi ◽

...

Keyword(s):

Pregnant Women ◽

Health Facilities ◽

Malaria In Pregnancy ◽

National Guidelines ◽

Qualitative And Quantitative ◽

Main Challenge ◽

Malaria Rapid Diagnostic Tests ◽

Experienced Pain ◽

Care Workers ◽

In Pregnancy

Abstract Background Tanzania started implementing single screening and treatment (SST) for all pregnant women attending their first antenatal care (ANC) visits in 2014, using malaria rapid diagnostic tests (RDTs) and treating those who test positive according to the national guidelines. However, there is a paucity of data to show the acceptability of SST to both pregnant women and health care workers (HCWs), taking into consideration the shortage of workers and the added burden of this policy to the health system. This study assessed the perceptions and opinions of health service users and providers to determine the acceptability of SST policy. Methods Pregnant women and HCWs in eight health facilities in two districts of Lindi region (Kilwa and Lindi) were interviewed using semi-structured questionnaires with open and close-ended questions. Both qualitative and quantitative data were collected, including demographic characteristics, women’s experience, their perception on SST and challenges they face when receiving services for malaria offered at ANC. Experience of HCWs regarding the implementation of SST as part of routine services and the challenges encountered when providing ANC services for malaria in pregnancy (MIP) were also assessed. Results Of the 143 pregnant women interviewed, 97% viewed testing favourably and would wish to be tested for malaria again, while 95% were satisfied with services and reasons for testing during the first ANC visit. Nearly all (99%) would recommend their fellow pregnant women to be tested for malaria and all women recommended that the Ministry of Health should continue the SST strategy. This was despite the fact that 76% of the women experienced pain and 16% had anxiety as a result of finger prick. Sixteen HCWs (mostly nurses) were interviewed; they also viewed SST implementation favourably and reported feeling empowered to use RDTs for malaria screening. The main challenge identified by HCWs was that nurses are not allowed to prescribe anti-malarials to women who test positive and need to refer them to the outpatient department for treatment. Conclusion SST was considered an acceptable approach to control MIP by HCWs and pregnant women, and they recommended the continuation of the policy. In addition, consideration should be given to implementing a task-shifting policy to allow nurses to dispense anti-malarials to pregnant women.

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