First Trimester Prenatal Care and Local Obstetrical Delivery Options for Women in Poverty in Rural Virginia

Abstract Objectives: to evaluate prenatal care provided to low-risk pregnant women users of the Sistema Único de Saúde (SUS) (Public Health System) in the city of Joinville, SC. Methods: this is a cross-sectional observational study carried out from March 2018 to February 2019, through interview and analysis of the Pregnant Card of puerperal over 18 years old, from Joinville, who underwent prenatal care at SUS, excluding recent given up puerperal. Prenatal care was evaluated according to the recommended criteria by the Prenatal and Birth Humanization Program. Results: 683 mothers were interviewed. The criteria with the highest levels of adequacy were accessibility (99.6%), early initiation on prenatal care (92.7%) and 6 or more consultations (87.1%) and the criteria with the lowest rates of adequacy were the set of guidelines (17.7%) and the third and first trimester exams (42.5% and 63.5% respectively). Conclusion: it is concluded that the prenatal care provided by SUS in the city of Joinville, despite the almost universal accessibility, the early onset and the prevalence of puerperal women with more than 6 consultations, showed a sharp decline in the analysis of the recommended indicators.

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Long-Run Effects of Temporary Incentives on Medical Care Productivity

American Economic Journal Applied Economics ◽

10.1257/app.20170128 ◽

2019 ◽

Vol 11 (3) ◽

pp. 92-127 ◽

Cited By ~ 2

Author(s):

Pablo A. Celhay ◽

Paul J. Gertler ◽

Paula Giovagnoli ◽

Christel Vermeersch

Keyword(s):

Prenatal Care ◽

Financial Incentives ◽

Quality Care ◽

First Trimester ◽

Early Initiation ◽

Health Clinics ◽

Randomized Field Experiment ◽

Long Run ◽

Care Processes ◽

New Strategies

We show that costs of adjustment as opposed to low perceived value may explain why improved quality care practices diffuse slowly in the medical industry. Using a randomized field experiment conducted in Argentina, we find that temporary financial incentives paid to health clinics for the early initiation of prenatal care motivated providers to test and develop new strategies to locate and encourage pregnant women to seek care in the first trimester of pregnancy. These innovations raised the rate of early initiation of prenatal care by 34 percent while the incentives were being paid in the treatment period. We also find that this increase persisted for at least 24 months after the incentives ended. We show that this is consistent with the presence of up-front costs from adjusting care processes that made it too expensive to develop and implement new strategies to increase early initiation of care in the absence of the incentives. Despite large increases in early initiation of prenatal care, we find no effects on health outcomes. (JEL C93, I11, I12, I13, I18, J16, O15)

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First Trimester Prenatal Care Initiation Among Hispanic Women Along the U.S.-Mexico Border

Maternal and Child Health Journal ◽

10.1007/s10995-017-2374-0 ◽

2017 ◽

Vol 21 (S1) ◽

pp. 11-18

Author(s):

Katherine Selchau ◽

Maricela Babuca ◽

Kara Bower ◽

Yara Castro ◽

Eugenie Coakley ◽

...

Keyword(s):

Prenatal Care ◽

Hispanic Women ◽

First Trimester ◽

Mexico Border ◽

The U.S

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First Trimester Ultrasound in Prenatal Diagnosis—Part of the Turning Pyramid of Prenatal Care

Journal of Clinical Medicine ◽

10.3390/jcm3030986 ◽

2014 ◽

Vol 3 (3) ◽

pp. 986-996 ◽

Cited By ~ 3

Author(s):

Ran Neiger

Keyword(s):

Prenatal Diagnosis ◽

Prenatal Care ◽

First Trimester ◽

First Trimester Ultrasound

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The Effectiveness of integrating spirituality into prenatal care on Improving Sleep Quality and Insomnia Severity among Pregnant Women: A Randomized Control Trial

10.21203/rs.3.rs-1025124/v1 ◽

2021 ◽

Author(s):

azam maleki ◽

Nahid Moradi ◽

Saeedeh Zenoozian

Keyword(s):

Prenatal Care ◽

Sleep Quality ◽

Pregnant Women ◽

Controlled Trial ◽

Intervention Group ◽

Severity Index ◽

First Trimester ◽

Routine Care ◽

Control Group ◽

Insomnia Severity

Abstract Background To determine the effectiveness of integrating spirituality into prenatal care on Improving Sleep Quality and Insomnia Severity among Pregnant Women. Methods This randomized controlled trial was carried out on 40 pregnant women recruited at five health centers of zanjan, Iran, 2020. The eligible women were allocated into two intervention and control groups according to the randomized design. Group counselling with spiritual content was carried out in eight sessions, two times a week at 16 to 20 weeks of gestation. The control group only received routine care. Data were collected using the Pittsburgh Sleep Quality Index (PSQI) and the Insomnia Severity Index (ISI) questionnaires in three stages, before the intervention, at 28 and 36 weeks of gestation. Statistical analysis was performed using the SPSS 16.0 software (SPSS Inc., Chicago, IL, USA). Results The results showed that comparing the mean score of insomnia severity, sleep quality and its components in the pre-intervention phase was not statistically significant between the two groups(p>0.05). Comparison of the insomnia severity, sleep quality, and its components scores decreased statistically in the second and third trimesters compared to the first trimester in the intervention group than the control group(p<0.05). The effect of the intervention (Eta score) was 64%. Conclusion The results showed that counselling with spiritual content could effectively ameliorate sleep quality and reduce insomnia severity in pregnant women. It seems that the approach is an acceptable basis to design intervention programs in this field that can be considered by midwives.

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Acute pulmonary edema as a complication of urinary infection in pregnant women: a case report

MedNEXT Journal of Medical and Health Sciences ◽

10.54448/mdnt21625 ◽

2021 ◽

Vol 2 (6) ◽

Author(s):

Lorena Silvestre Gabioli ◽

Katia Lara de Souza ◽

Tamara Veiga Faria

Keyword(s):

Case Report ◽

Prenatal Care ◽

Pulmonary Edema ◽

Pregnant Women ◽

Urinary Infection ◽

First Trimester ◽

Severe Form ◽

Acute Pulmonary Edema ◽

Fetal Mortality ◽

Pregnancy And Postpartum

Introduction: Urinary infection (UI) is the third most common pathology during pregnancy, affecting 10-12% of pregnant women in the first trimester. Thus, the prenatal care is important to reduce indicators of maternal-fetal mortality, promoting quality of life during pregnancy and postpartum. Objective: The aim of this study is to report the case of a pregnant woman with pyelonephritis, who evolved with acute pulmonary edema. Case report: The present study was elaborated according to the rules of CARE case report. This study was analyzed and approved by the Research Ethics Committee (CEP) according to a substantiated opinion number 4,375,418 and obtaining the patient's consent. The present study therefore highlights pyelonephritis as the most severe form of UI in pregnant women, associated with septic shock, with evolution to respiratory failure, resulting from acute pulmonary edema, and may be related to worse maternal-fetal prognoses. This clinical study contributes to the literature, emphasizing that, currently, all forms of UI during pregnancy should be considered as great potential for complications, and should be treated even in its asymptomatic form. Conclusion: It is evident the need for early intervention to minimize maternal-fetal losses, unnecessary interventions and to reduce costs in relation to additional treatments. The importance of rapid diagnosis and early treatment is emphasized in order to minimize or extinguish the damage. As well as promoting actions to encourage pregnant women to perform prenatal care.

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Prenatal Care: First Trimester Overview

Adult-Gerontology Practice Guidelines ◽

10.1891/9780826159311.0016c ◽

2019 ◽

Author(s):

Christina C. Reed

Keyword(s):

Prenatal Care ◽

First Trimester

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Family structure and use of prenatal care

Cadernos de Saúde Pública ◽

10.1590/0102-311x00052114 ◽

2015 ◽

Vol 31 (6) ◽

pp. 1298-1304

Author(s):

Elisabete Alves ◽

Susana Silva ◽

Simone Martins ◽

Henrique Barros

Keyword(s):

Prenatal Care ◽

Family Structure ◽

Single Mothers ◽

Unplanned Pregnancy ◽

Universal Access ◽

First Trimester ◽

Educational Interventions ◽

Cross Sectional Study ◽

Household Composition ◽

Cross Sectional

This cross-sectional study intended to assess the use of prenatal care according to the family structure in a population with free universal access to prenatal care. In 2005-2006, the Portuguese birth cohort was assembled by the recruitment of puerperae at public maternity wards in Porto, Portugal. In the current analysis, 7,211 were included. Data on socio-demographic characteristics, obstetric history, and prenatal care were self-reported. Single mothers were considered as those whose household composition did not include a partner at delivery. Approximately 6% of the puerperae were single mothers. These women were more likely to have an unplanned pregnancy (OR = 6.30; 95%CI: 4.94-8.04), an inadequate prenatal care (OR = 2.30; 95%CI: 1.32-4.02), and to miss the ultrasound and the intake of folic acid supplements during the first trimester of pregnancy (OR = 1.71; 95%CI: 1.30-2.27; and OR = 1.67; 95%CI: 1.32-2.13, respectively). The adequacy and use of prenatal care was less frequent in single mothers. Educational interventions should reinforce the use and early initiation of prenatal care.

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RISK FACTORS OF HIV-1 VERTICAL TRANSMISSION (VT) AND THE INFLUENCE OF ANTIRETROVIRAL THERAPY (ART) IN PREGNANCY OUTCOME

Revista do Instituto de Medicina Tropical de São Paulo ◽

10.1590/s0036-46652014000200008 ◽

2014 ◽

Vol 56 (2) ◽

pp. 133-138 ◽

Cited By ~ 12

Author(s):

Maria F.M. Barral ◽

Gisele R. de Oliveira ◽

Rubens C. Lobato ◽

Raul A. Mendoza-Sassi ◽

Ana M.b. Martínez ◽

...

Keyword(s):

Risk Factors ◽

Prenatal Care ◽

Pregnant Women ◽

Pregnancy Outcome ◽

Vertical Transmission ◽

First Trimester ◽

Antiretroviral Drugs ◽

Vertical Transmission Of Hiv ◽

Hiv 1 ◽

In Pregnancy

In the absence of intervention, the rate of vertical transmission of HIV can range from 15-45%. With the inclusion of antiretroviral drugs during pregnancy and the choice of delivery route this amounts to less than 2%. However ARV use during pregnancy has generated several questions regarding the adverse effects of the gestational and neonatal outcome. This study aims to analyze the risk factors for vertical transmission of HIV-1 seropositive pregnant women living in Rio Grande and the influence of the use of ARVs in pregnancy outcome. Among the 262 pregnant women studied the rate of vertical transmission of HIV was found to be 3.8%. Regarding the VT, there was a lower risk of transmission when antiretroviral drugs were used and prenatal care was conducted at the referral service. However, the use of ART did not influence the outcome of pregnancy. However, initiation of prenatal care after the first trimester had an influence on low birth weight, as well as performance of less than six visits increased the risk of prematurity. Therefore, the risk factors analyzed in this study appear to be related to the realization of inadequate pre-natal and maternal behavior.

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Adolescent childbearing in a Brazilian border municipality: the new mother’s profile

European Journal of Public Health ◽

10.1093/eurpub/ckaa166.974 ◽

2020 ◽

Vol 30 (Supplement_5) ◽

Author(s):

F K Nampo ◽

C M Fernandes ◽

S Souza

Keyword(s):

Prenatal Care ◽

Predominantly White ◽

Adolescent Mothers ◽

Descriptive Analysis ◽

Public Health Problem ◽

First Trimester ◽

Cross Sectional Study ◽

Cross Sectional ◽

Previous Pregnancy ◽

Adolescent Childbearing

Abstract Background Adolescent childbearing is considered a public health problem, due to the often associated social impacts. Understanding the phenomenon is necessary to support intervention proposals aimed at reducing its incidence. Methods In this cross-sectional study we investigated all adolescent mothers living in Foz do Iguassu that gave birth in the 2013-2017 period. Data from a governmental database were used and descriptive analysis was performed. Results Between 2013 and 2017, 3,207 adolescent mothers gave birth to a live child, of which 135 aged 10 to 14 years and 3,072 aged 15 to 19 years. 51.3% of the mothers were white, and 22.1% had previous pregnancy experience. 68.4% had a vaginal delivery, and 80.6% had full-term pregnancies. Among the women aged 10 to 14 years, 57.8% started prenatal care in the first trimester and 47.4% had 7 or more prenatal consultations. Among women aged between 15 and 19 years, 73.7% started prenatal care in the first trimester and 53.4% had 7 or more prenatal consultations. Additionally, at least 49% of the adolescents were delayed in school. Conclusions In Foz do Iguassu, adolescent mothers are predominantly white. At least half are delayed in school, and more than 1 in 5 already had previous pregnancy experience. Parturients between 15 and 19 years old start prenatal earlier and attend more prenatal consultations than parturients aged 10 to 14 years. Prematurity is more frequent among adolescents. Key messages Adolescents receive poor prenatal care, especially the younger ones. Adolescent pregnancy is not a synonym to unintended pregnancy, and its relationship should be further investigated.

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