Poedji Rochjati Score Card as Media for Preconception Counseling

Highlight:The PCC counseling effect using Poedji Rochjati Score Card (PRSC) on premarital knowledge about high-risk pregnancies was studied.PRSC for preconception counseling is effective for women to improve knowledge about high-isk pregnancy.Abstract:Preconception care (PCC) is a health approach that includes promotive and preventive activities to detect risk factors and interventions carried out to expectant mothers by considering biological, behavioral, and social aspects that affect their health. This study studied the effect of PCC counseling using Poedji Rochjati Score Card (PRSC) on premarital knowledge about high-risk pregnancies. This study was quasi-experimental with 52 respondents divided into 4 groups, namely intervention and control groups, 2 groups with partners, and 2 groups without partners that were chosen through total sampling by applying inclusion and exclusion criteria. Knowledge was measured using pretest and posttest questionnaires. The intervention given was in the form of counseling using PRSC for ± 20 minutes. There were differences in knowledge between the intervention and control group among respondents without partners. Preconception counseling using PRSC was effective for women attending premarital health checks. Applying PRSC as media for counseling could improve knowledge in high-risk pregnancy that could be avoided.

Planned Pregnancy in Kidney Transplantation. A Calculated Risk

Pregnancy is not contraindicated in kidney transplant women but entails risks of maternal and fetal complications. Three main conditions can influence the outcome of pregnancy in transplant women: preconception counseling, maternal medical management, and correct use of drugs to prevent fetal toxicity. Preconception counseling is needed to prevent the risks of an unplanned untimely pregnancy. Pregnancy should be planned ≥2 years after transplantation. The candidate for pregnancy should have normal blood pressure, stable serum creatinine <1.5 mg/dL, and proteinuria <500 mg/24 h. Maternal medical management is critical for early detection and treatment of complications such as hypertension, preeclampsia, thrombotic microangiopathy, graft dysfunction, gestational diabetes, and infection. These adverse outcomes are strongly related to the degree of kidney dysfunction. A major issue is represented by the potential fetotoxicity of drugs. Moderate doses of glucocorticoids, azathioprine, and mTOR inhibitors are relatively safe. Calcineurin inhibitors (CNIs) are not associated with teratogenicity but may increase the risk of low birth weight. Rituximab and eculizumab should be used in pregnancy only if the benefits outweigh the risk for the fetus. Renin–angiotensin system inhibitors, mycophenolate, bortezomib, and cyclophosphamide can lead to fetal toxicity and should not be prescribed to pregnant women.

Predictors of spontaneous abortion among reproductive-aged women at tertiary level hospital, Kathmandu

Introduction: Spontaneous abortion (SA) is one of the adverse outcomes during pregnancy, which is a challenge for maternal well-being. The present study aimed to analyze the predictors of SA among reproductive age women. Method: A hospital-based case-control study was conducted at Patan hospital, Nepal. The consecutive sampling technique was used to select the cases (84) and a purposive sampling technique was used for controls (168) in a 1:2 ratio. Ethical approval was obtained. Data were collected through face to face interviews using a structured questionnaire. Descriptive and inferential statistics (Chi-square, Fisher exact test, and logistic regression) were used for analyzing the data. Result: We found that previous history of abortion (OR=3.80, 95% CI=1.8-7.70), heavy lifting (OR=20.45, 95% CI =4.48-93.38), emotional disturbance (OR=10.06, 95% CI=1.06-96.96), health problems (fever of unknown cause and urinary tract infection) during pregnancy (OR=16.53, 95% CI=1.90-143.41), coffee intake (OR=0.36, 95% CI=0.20-0.63), unplanned pregnancy (OR=0.10,95% CI=0.04-0.22), preconception counseling/care not received (OR=6.48, 95% CI=2.18-19.21) were the significant predictors of SA among reproductive age women. Conclusion: Our findings show that the previous history of abortion, heavy lifting, emotional disturbances, health problems, and coffee intake during pregnancy are the significant cause of SA; and preconception counseling and planned pregnancy are protective factors.

Preconception Care to Reduce the Risks of Overweight and Obesity in Women of Reproductive Age: An Integrative Review

Despite adverse pregnancy outcomes for women with overweight or obesity, preconception guidelines for achieving optimal wellness for women contemplating pregnancy regarding the risks of overweight or obesity are varied based upon national affiliation. The aim of this study was to synthesize the best evidence related to preconception counseling and care focused on overweight or obesity provided to women of reproductive age. An integrative review of original studies was conducted. PubMed, Cumulative Index in Nursing and Allied Health Literature, Ovid, Scopus, Web of Science, and Embase were included. Full-text, data-based articles were searched from 2009 to 2018, with reviews and synthesis completed in 2019 and 2020. Of 8703 initial articles, 31 articles remained in the review. Quality assessment and level of evidence were evaluated based upon criteria from the Joanna Briggs Institute and the Johns Hopkins Nursing Evidence-Based Practice Quality Guide. The level of evidence for the majority of studies was non-experimental but they were of good quality with appropriate methods, samples and relevant results. Limited attention and interest in preconception counseling regarding risks of overweight or obesity by health care professionals were noted, which may contribute to women’s unawareness of these risks on preconception health.