scholarly journals Burns in pregnancy: Five-year experience in a tertiary hospital in southeastern Nigeria

2021 ◽  
Vol 33 (3) ◽  
pp. 204-209
Author(s):  
Ugochukwu U. Nnadozie ◽  
Charles C Maduba ◽  
Gabriel M. Okorie ◽  
Lucky O. Lawani ◽  
Anikwe C Chidebe ◽  
...  
Keyword(s):  
Pregnant Women ◽  
Burn Injury ◽  
First Trimester ◽  
Tertiary Hospital ◽  
University Teaching ◽  
Management Approach ◽  
Southeastern Nigeria ◽  
Spontaneous Vaginal Delivery ◽  
Review Management ◽  
In Pregnancy

BackgroundBurns in pregnancy is often associated with high maternal and fetal morbidity and mortality especially when the total burn surface area (TBSA) involved is high. This study aims to review management outcome of cases of burns in pregnancy at Alex Ekwueme Federal University Teaching Hospital Abakaliki (AE-FUTHA).MethodsA five year retrospective study of all pregnant women that presented at AE-FUTHA with burn injury between April 2014 and March 2019. Information was collected from the medical records using a proforma and analyzed with IBM SPSS Statistics version 20.0 (IBM Corp., Armonk, NY, USA) using descriptive statistics.ResultsA total of 222 cases of burns were managed but only 8 were pregnant, giving an incidence of 3.6%. The commonest causes were flame (62.5%), scald (25%) and friction (12.5%) occurring mostly during the harmattan season. The median age of participants was 25-34 years. The burns affected 12.5% of the patients in the first trimester and 62.5% and 25% in the 2nd and 3rd trimesters respectively. Most patients (62.5%) had superficial burns while 25% had other associated injuries in addition to burns. About 87.5% had term spontaneous vaginal delivery. There was no maternal death but, there was an early neonatal death.ConclusionThe good outcome observed in this study with a 100% survival, could be explained by inter-disciplinary management approach given, even as most cases were minor degrees of burns. Early involvement of obstetricians in all burns affecting pregnant women is advised especially in burn centres where obstetricians are hardly in the employ.

scholarly journals Prevalence and aetiologies of anaemia among first trimester pregnant women in Sri Lanka; the need for revisiting the current control strategies

2022 ◽  
Vol 22 (1) ◽  
Author(s):  
Gayani Shashikala Amarasinghe ◽  
Thilini Chanchala Agampodi ◽  
Vasana Mendis ◽  
Krishanthi Malawanage ◽  
Chamila Kappagoda ◽  
...  
Keyword(s):  
Public Health ◽  
Iron Deficiency ◽  
Pregnant Women ◽  
Blood Count ◽  
First Trimester ◽  
Full Blood Count ◽  
Red Cell ◽  
Middle Income ◽  
Anaemia In Pregnancy ◽  
In Pregnancy

Abstract Background The Sustainable development goals, which focus strongly on equity, aim to end all forms of malnutrition by 2030. However, a significant cause of intergenerational transfer of malnutrition, anaemia in pregnancy, is still a challenge. It is especially so in the low- and middle-income settings where possible context-specific aetiologies leading to anaemia have been poorly explored. This study explores the prevalence of etiological factors significantly contributing to anaemia in pregnancy in Sri Lanka, a lower-middle-income country with a high prevalence of malnutrition albeit robust public health infrastructure. Methods All first-trimester pregnant women registered in the public maternal care programme in the Anuradhapura district from July to September 2019 were invited to participate in Rajarata Pregnancy Cohort (RaPCo). After a full blood count analysis, high-performance liquid chromatography, peripheral blood film examination, serum B12 and folate levels were performed in anaemic participants, guided by an algorithm based on the red cell indices in the full blood count. In addition, serum ferritin was tested in a random subsample of 213 participants. Anaemic women in this subsample underwent B12 and folate testing. Results Among 3127 participants, 14.4% (95%CI 13.2–15.7, n = 451) were anaemic. Haemoglobin ranged between 7.4 to 19.6 g/dl. 331(10.6%) had mild anaemia. Haemoglobin ≥13 g/dl was observed in 39(12.7%). Microcytic, normochromic-normocytic, hypochromic-normocytic and macrocytic anaemia was observed in 243(54%), 114(25.3%), 80(17.8%) and two (0.4%) of full blood counts in anaemic women, respectively. Microcytic anaemia with a red cell count ≥5 * 106 /μl demonstrated a 100% positive predictive value for minor haemoglobinopathies. Minor hemoglobinopathies were present in at least 23.3%(n = 105) of anaemic pregnant women. Prevalence of iron deficiency, B12 deficiency and Southeast Asian ovalocytosis among the anaemic was 41.9% (95%CI 26.4–59.2), 23.8% (95%CI 10.6–45.1) and 0.9% (95%CI 0.3–2.3%), respectively. Folate deficiency was not observed. Conclusion Even though iron deficiency remains the primary cause, minor hemoglobinopathies, B 12 deficiency and other aetiologies substantially contribute to anaemia in pregnancy in this study population. Public health interventions, including screening for minor hemoglobinopathies and multiple micronutrient supplementation in pregnancy, should be considered in the national programme for areas where these problems have been identified.

scholarly journals Cross-sectional study to assess etiology and associated factors for anaemia during first trimester of pregnancy in Anuradhapura District, Sri Lanka: a protocol

F1000Research ◽  
2021 ◽  
Vol 10 ◽  
pp. 223
Author(s):  
Gayani Amarasinghe ◽  
Vasana Mendis ◽  
Thilini Agampodi
Keyword(s):  
Sri Lanka ◽  
Data Collection ◽  
Pregnant Women ◽  
Associated Factors ◽  
First Trimester ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Cross Sectional ◽  
Anaemia In Pregnancy ◽  
In Pregnancy

Background: Anaemia in pregnancy, which can lead to adverse maternal and fetal outcomes, is a significant global health problem. Despite Sri Lanka’s strong public health system and commitment towards prevention, maternal anaemia remains a major problem in the country. While prevention is focused on iron deficiency, detailed etiological studies on this topic are scarce. Moreover, estimates of socio demographic and economic factors associated with anaemia in pregnancy, which can provide important clues for anaemia control, are also lacking. This study aims to evaluate the hemoglobin distribution, spatial distribution, etiology and associated factors for anaemia in pregnant women in Anuradhapura, Sri Lanka. Methods: This is a cross sectional study of pregnant women in their first trimester registered for antenatal care from July to September 2019 in the Anuradhapura district. The minimal sample size was calculated to be 1866. Initial data collection has already been carried out in special field clinics for pregnant women between June to October 2019. An interviewer-administered questionnaire, a self-completed dietary questionnaire and an examination checklist were used for data collection. In addition, all participants underwent complete blood count testing. Further investigations are being conducted for predicting the etiology of anaemia based on a developed algorithm (such as high-performance liquid chromatography [HPLC] and peripheral blood film analysis). Discussion: Being the largest study on anaemia during pregnancy in a single geographical area in Sri Lanka, this study will provide important clues about geographical clustering of anaemia cases with similar etiology, associated factors and etiologies which would help to develop interventions to improve the health of pregnant women in the area. The possibility of selection bias is a potential limitation associated with the study design.

scholarly journals Intermittent preventive treatment for malaria in pregnancy: Is directly observed therapy still necessary? A prospective cohort study in a tertiary hospital, Southern Nigeria

2020 ◽  
Vol 4 ◽  
pp. 34-39
Author(s):  
Ubong Akpan ◽  
Udeme Asibong ◽  
Zibrin Okhormbe ◽  
Mabel Ekott ◽  
Saturday Etuk
Keyword(s):  
Cohort Study ◽  
Pregnant Women ◽  
Rural Areas ◽  
Venous Blood ◽  
Intermittent Preventive Treatment ◽  
Preventive Treatment ◽  
Tertiary Hospital ◽  
Control Group ◽  
Directly Observed Therapy ◽  
In Pregnancy

Objective: Malaria is a major cause of indirect maternal death. In the last two decades several efforts have been made to combat the menace of this disease especially among pregnant women and children in developing countries. Directly observed therapy (DOT) was recommended to enhance the uptake of intermittent preventive treatment (IPT) of malaria with sulfadoxine – pyrimethamine among pregnant women. Due to challenges involved in the practice of DOT especially with regards to shortage of man power and clean water in rural areas, there is need to evaluate impact of DOT on the effectiveness of treatment. Material and Methods: A cohort study was carried out among 320 healthy pregnant women receiving ante natal care with equal assignment of subjects. The study group (160) received two doses of IPT by DOT while 160 matched controls were given prescription for self- drug administration at home. Malaria tests were done using microscopy method and the hemoglobin values determined using centrifuge one month after the second dose of IPT. Umbilical cord blood samples were obtained for a repeat microscopy at delivery. Results: The results showed that there were no statistical significant differences in the venous blood parasitemia, placental parasitemia and anaemia between the DOT group and the control group (P = 0.215; P = 0.100; P = 0.966) respectively. Lower social class was the main predictor of anaemia in pregnancy (P = 0.032). Conclusion: The delivery of IPT through DOT may not influence uptake in some settings. Effort may need to be channeled into ante natal education and women empowerment.

scholarly journals Gestation at completion of prenatal questionnaires in ALSPAC

2020 ◽  
Vol 5 ◽  
pp. 100
Author(s):  
Yasmin Iles-Caven ◽  
Kate Northstone ◽  
Jean Golding
Keyword(s):  
Data Collection ◽  
Pregnant Women ◽  
First Trimester ◽  
Environmental Data ◽  
Parents And Children ◽  
Using Data ◽  
Time Critical ◽  
Avon Longitudinal Study ◽  
In Pregnancy ◽  
Made In

Enrolling a cohort in pregnancy can be methodologically difficult in terms of structuring data collection. For example, some exposures of interest may be time-critical while other (often retrospective) data can be collected at any point during pregnancy.  The Avon Longitudinal Study of Parents and Children (ALSPAC) is a prime example of a cohort where certain data were collected at specific time points and others at variable times depending on the gestation at contact.  ALSPAC aimed to enrol as many pregnant women as possible in a geographically defined area with an expected date of delivery between April 1991 and December 1992. The ideal was to enrol women as early in pregnancy as possible, and to collect information, when possible, at two fixed gestational periods (18 and 32 weeks). A variety of methods were used to enrol participants.   Approximately 80% of eligible women resident in the study area were enrolled. Gestation at enrolment ranged from 4-41 (median = 14) weeks of pregnancy. Given this variation in gestation we describe the various decisions that were made in regard to the timing of questionnaires to ensure that appropriate data were obtained from the pregnant women.  45% of women provided data during the first trimester, this is less than ideal but reflects the fact that many women do not acknowledge their pregnancy until the first trimester is safely completed. Data collection from women at specific gestations (18 and 32 weeks) was much more successful (80-85%). Unfortunately, it was difficult to obtain environmental data during the first trimester. Given the time critical nature of exposures during this trimester, researchers must take the gestational age at which environmental data was collected into account. This is particularly important for data collected using the questionnaire named ‘Your Environment’ (using data known as the A files).

Hazards of vaccination in pregnancy

1973 ◽  
Vol 11 (4) ◽  
pp. 13-15
Keyword(s):  
Pregnant Women ◽  
Yellow Fever ◽  
Early Pregnancy ◽  
First Trimester ◽  
Childbearing Age ◽  
Department Of Health ◽  
Chemical Agents ◽  
Women And Girls ◽  
Yellow Fever Vaccination ◽  
In Pregnancy

With the effects of certain chemical agents and rubella in mind, most authorities advise caution in the use of all vaccines during pregnancy and especially during the first trimester. The booklet issued by the Department of Health and Social Security1 lists pregnancy as a contra-indication to rubella, smallpox and polio vaccinations, with certain provisions, and the manufacturers’ literature adds yellow fever vaccination. Pregnant women wishing to travel obviously pose a problem. Neither the doctor nor the patient may be aware of an early pregnancy and this is always a hazard when vaccinating women and girls of childbearing age. However, apart from rubella and smallpox vaccinations, the risks are hypothetical.

scholarly journals Prevalence of thyroid disorders in pregnancy

2018 ◽  
Vol 7 (9) ◽  
pp. 3493
Author(s):  
Sangeeta Pahwa ◽  
Sabia Mangat
Keyword(s):  
Pregnant Women ◽  
Subclinical Hypothyroidism ◽  
First Trimester ◽  
Antenatal Clinic ◽  
Fetal Outcome ◽  
Overt Hypothyroidism ◽  
Thyroid Disorders ◽  
Subclinical Hyperthyroidism ◽  
Thyroid Screening ◽  
In Pregnancy

Background: Thyroid disorders are among the common endocrine problems in pregnant women. Often overlooked in pregnancy due to nonspecific symptoms and hyper-metabolic state of pregnancy. Western literature shows prevalence of hypothyroidism in pregnancy as 2.5% and hypothyroidism as 0.1-0.4%. There is paucity of data on prevalence of thyroid disorders in India pregnant population. This study was carried out to know prevalence of thyroid disorders in pregnant women in Indian population.Methods: One hundred pregnant women attending antenatal clinic in first trimester were registered. Detailed history and examination was done. Apart from routine basic and obstetrical investigations, TSH, FT3 and FT4 level estimation was done.Results: Prevalence of thyroid dysfunction was high in this study in first trimester pregnant women, with subclinical hypothyroidism in 6%, overt hypothyroidism in 2%, subclinical hyperthyroidism 2 % and overt hyperthyroidism 0%.Conclusions: Prevalence of thyroid disorders, especially subclinical hypothyroidism (6%), overt hypothyroidism (2%) and subclinical hyperthyroidism (2%) was high. To prevent adverse effects on maternal and fetal outcome, we are emphasizing the importance of routine antenatal thyroid screening.

scholarly journals Gastrointestinal symptoms in pregnancy among antenatal clinic attendees in Abubakar Tafawa Balewa University Teaching Hospital Bauchi, Northeast Nigeria

2020 ◽  
Vol 9 (3) ◽  
pp. 1029
Author(s):  
Muhammad Baffah Aminu ◽  
Mohammed Alkali ◽  
Bala M. Audu ◽  
Toyin Abdulrazak
Keyword(s):  
Pregnant Women ◽  
Gastrointestinal Symptoms ◽  
Antenatal Clinic ◽  
University Teaching ◽  
P Value ◽  
Cross Sectional ◽  
Significance Level ◽  
Gi Symptoms ◽  
Physical Changes ◽  
In Pregnancy

Background: Pregnant women are at increasing risk of GI symptoms such as nausea, vomiting and heartburns, most of these symptoms are as a result of the hormonal and physical changes associated with pregnancy. This study aimed to determine prevalence of gastrointestinal symptoms (GI) among pregnant women attending booking clinic at a Northeastern Nigerian Teaching Hospital.Methods: The study was a cross-sectional, questionnaire-based survey of four hundred and fifty-two pregnant women booking for antenatal care. Their sociodemographic variables as well as the presence or absence of gastrointestinal symptoms in index pregnancy were obtained at by the use of researcher-administered questionnaire. Data were analyzed and presented as frequencies and percentages. A 5% significance level (p <0.05) to test associations.Results: Two fifty-five women had heart burns (56.4%) while 235 (52.0%) had nausea in pregnancy, these were observed to be the most prevalent GI symptoms among the women. Diarrhea and hemorrhoids were the uncommon GI symptoms in the study population constituting 406 (89.5%), and 360 (79.6%) respectively. Easy fullness was noted in 39.8% of the women while vomiting was in 41.8% and constipation in 29% of the respondents. A significant association was observed (p value <0.05) between parity and development of anorexia and hemorrhoids in pregnancy (p values of 0.049 and 0.051 respectively) but not for the other symptoms.Conclusions: GI symptoms are common in pregnancy, the most prevalent symptoms are that of heart burns and nausea, while diarrhea is relatively uncommon.

scholarly journals Assessment of Thyroid Function in Early Pregnancy

2018 ◽  
Vol 19 (2) ◽  
pp. 98
Author(s):  
Mohammad Saifur Rahman ◽  
Sadia Sultana ◽  
Ayesha Nazneen
Keyword(s):  
Pregnant Women ◽  
Thyroid Function ◽  
Early Pregnancy ◽  
Correct Diagnosis ◽  
First Trimester ◽  
Military Hospital ◽  
Thyroid Disorders ◽  
Thyroid Disorder ◽  
Cross Sectional ◽  
In Pregnancy

<p><strong>Objectives:  </strong>Thyroid disorders are commonly observed in pregnancy. Thyroid hormones play an important role in embryogenesis and fetal development. The fetus is completely dependent on the mother for thyroid hormone in first trimester. About 10% of all pregnant women can be affected by thyroid disorders during pregnancy. Thyroid function abnormalities in pregnancy are a challenge for the concerned physicians.  The objective of this study was to assess the maternal thyroid function in first trimester of pregnancy.</p><p><strong>Patients and Methods: </strong>A descriptive cross sectional study was carried out at the Combined Military Hospital (CMH), Dhaka over a period of one year from January 2013 to December 2013 to see the serum FT<sub>3</sub>, FT<sub>4</sub>, TSH, thyroid antibodies level and common thyroid disorders in pregnancy. A total of 138 pregnant women in their first trimester (up to 12 weeks) of pregnancy with an age range of 18-35 years were enrolled in this study. Pregnant women with known thyroid disorder and on treatment and pregnancy more than three months were excluded. Measurement of serum FT<sub>3</sub>, FT<sub>4</sub>, TSH, Anti TPO-Ab and Anti TG-Ab were done in each patient at the time of enrolment. Ultrasonography of each patient was done for confirmation of pregnancy and correlation of gestational age.</p><p><strong>Results:  </strong>Among 138 pregnant women, subclinical hypothyroidism was detected in 10 (7.2%) patients and subclinical hyperthyroidism was detected in 3 (2.2%) patients. Mean difference of the investigation findings were not statistically significant among primi and multi gravida. TPO-Ab and TG-Ab difference were statistically significant between two age groups.</p><p><strong>Conclusion: </strong>Subclinical thyroid disorders are fairly high among pregnant women. Correct diagnosis in early pregnancy and prompt treatment will bring an excellent prognosis for both mother and offspring.</p><p>Bangladesh J. Nuclear Med. 19(2): 98-102, July 2016</p>

scholarly journals Moderate Iodine Deficiency Is Common in Pregnancy but Does Not Alter Maternal and Neonatal Thyroid Function Tests

2020 ◽  
Vol 11 ◽  
Author(s):  
Tal Schiller ◽  
Arnon Agmon ◽  
Viviana Ostrovsky ◽  
Gabi Shefer ◽  
Hilla Knobler ◽  
...  
Keyword(s):  
Pregnant Women ◽  
Thyroid Function ◽  
Iodine Deficiency ◽  
Urinary Iodine ◽  
Iodine Content ◽  
First Trimester ◽  
Thyroid Function Tests ◽  
Neonatal Thyroid Function ◽  
Iodine Deficiency In Pregnancy ◽  
In Pregnancy

IntroductionAn Israeli national survey found that 85% of pregnant women had urinary iodine content (UIC) levels below the adequacy range (&lt;150 µg/L). Widespread desalinated water usage and no national fortification plan are possible causes. Studies assessing relationships between iodine status and maternal and neonatal thyroid function provided varying results. Our aims were to determine whether iodine deficiency was associated with altered maternal or neonatal thyroid function and the factors leading to iodine deficiency.MethodsA cross-sectional study including 100 healthy women without prior thyroid disease, in their first trimester of a singleton pregnancy were recruited from an HMO clinic in central Israel. The women were followed from their first trimester. All women completed a 24-h dietary recall and life habits questionnaires. We tested for UIC, maternal and neonatal thyroid function, maternal autoantibodies, and neonatal outcomes.ResultsMedian UIC in our cohort was 49 µg/L [25%–75% interquartile range (IQR) 16-91.5 µg/L], with 84% below adequacy range. No correlation was found between iodine deficiency and maternal or neonatal thyroid function which remained within normal ranges. Antibody status did not differ, but thyroglobulin levels were significantly higher in iodine insufficient subjects. UIC was higher in women consuming an iodine containing supplement. There was no association between UIC and dietary iodine content or water source.ConclusionsModerate iodine deficiency is common in our healthy pregnant women population. Our data imply that moderate iodine deficiency in pregnancy seem sufficient to maintain normal maternal and neonatal thyroid function.

scholarly journals Retrospective Case Reports of Anemic Pregnant Women Receiving Intravenous Ferric Carboxymaltose: Experience from a Tertiary Hospital in Spain

2016 ◽  
Vol 2016 ◽  
pp. 1-5 ◽  
Author(s):  
Rafael Aporta Rodriguez ◽  
Mariola García Montero ◽  
Jose Pablo Lorente Aporta ◽  
Carolina Gallego Luque ◽  
Alfonso Chacón Mayor ◽  
...  
Keyword(s):  
Iron Deficiency ◽  
Pregnant Women ◽  
Case Reports ◽  
First Trimester ◽  
Tertiary Hospital ◽  
Adverse Outcomes ◽  
Deficiency Anemia ◽  
Ferric Carboxymaltose ◽  
Retrospective Case ◽  
Apgar Scores

Iron deficiency and iron deficiency anemia during pregnancy call for safe treatment options that raise maternal hemoglobin levels and counterbalance iron demand and blood volume expansion while minimizing risks for the growing fetus. This retrospective study describes experience with intravenous ferric carboxymaltose given to pregnant women in a tertiary hospital in Spain. In a 5-year period, 95 pregnant women who had pretreatment hemoglobin <10 g/dL and at least one time of ferric carboxymaltose administration during pregnancy were included. Main outcome measures were week of pregnancy at iron administration, Hb levels before and after treatment, neonatal 5-minute Apgar scores, and birth weight. The majority received one dose of ferric carboxymaltose (1000 mg iron) during advanced pregnancy (median 31 weeks; interquartile range [IQR]: 27; 37 weeks) with minor to no adverse outcomes. Overall, median Hb increased from 8.5 g/dL (8.1; 8.9 g/dL) before treatment to 11.0 g/dL (9.9; 11.7 g/dL) after treatment. Normal Apgar scores were observed in all 97 infants (median birth weights 3560 g, 3270, and 3798 g). Four women received ferric carboxymaltose in the first trimester and twenty-eight during the second trimester without adverse outcomes for mother or child. These cases add to the evidence that ferric carboxymaltose administration during pregnancy is effective and safe.

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