An analysis of the pathological states of pregnant women in ante-intranatal fetal death in kharkov during 2016-2019

Background. In Ukraine among perinatal losses, a high proportion of stillbirth remains, the level of which depends on many factors, including the presence of somatic and genital pathology in a woman, pathological conditions during pregnancy, including eclampsia (PE), iron deficiency anemia of pregnant women (IDA), chorioamnionitis (CA). These conditions can be combined with each other, which increases the risk of fetal death during pregnancy or childbirth. Objective. To conduct a somatic and gynecological diseases, complications of pregnancy in pregnant women with preeclampsia (PE), iron deficiency anemia (IDA) and chorioamnionitis (CA), whose pregnancy ended in ante-intrapartum fetal death at 30-40 weeks of gestation. Methods. We investigated 58 cases of stillbirth at 30-40 weeks of gestation from pregnant women with PE (n = 16), IDA (n = 16), CA (n = 26) on the basis of the Communal non-profit enterprise "City Perinatal Center "Kharkov. The clinical data of the mothers, the protocols of the pathological examination of the placenta were studied. Results. Based on the study, it was found that in women whose pregnancy was complicated by PE and IDA, the most frequent types of somatic pathology were hypertensive disorders (32% and 12.5%, respectively) and chronic diseases of the digestive system. (25% and 12.5%, respectively), among gynecological diseases, uterine leiomyoma and endocervicosis were more common, among complications of pregnancy and childbirth - premature birth (50% each, respectively) pathology of the placenta (50% and 68.8%, respectively) and disorders of the content amniotic fluid (31.3% and 18.8%, respectively).The extragenital pathology in pregnant women with CA was presented with the infectious diseases (30.7%), an acute respiratory viral infections (19.2%), the cardiovascular pathology (11.5%), and the chronic inflammatory diseases of various localization (7.6%). The most frequency gynecological pathology were inflammatory genital diseases (23.21%). The pregnancy and labor were often complicated with the placental pathology (50%), premature birth (38.5%), preeclampsia (19.2%), and anemia (19.2%). During pregnancy, placental dysfunction diagnosed only in 31.3% of cases with PE, 25% with IDA and 3.8% with CA, but in pathological examination, morphological signs of placental insufficiency recorded in almost every case of all groups. Conclusion. In pregnancy, aggravated by PE, IDA or CA, the presence of extragenital pathology, gynecological diseases, and other complications of pregnancy were additional factors that increased the severity of placental insufficiency and fetal hypoxia, which was the cause of its death. Timely diagnosis of placental dysfunction and the implementation of therapeutic measures aimed at reducing the associated negative impact on the fetus can help reduce perinatal mortality.

Exudative otitis media in children: the role of prematurity and concomitant pathology in its formation. Part II

Despite the long-term study of exudative otitis media, the disease is not well understood. The wide prevalence of exudative otitis media in children and the increase in the incidence during recent decades explain the interest of specialists in the etiology of the disease. The article presents current views on the role of premature birth, gastroesophageal reflux, systemic and local immunodeficiency, disorders in the antioxidant defense system, mucopolysaccharidosis, genetic predisposition, and other factors in otitis media development. Unfortunately, the cause of exudative otitis media cannot always be established, and it requires further experimental and clinical studies in order to develop effective approaches to etiopathogenetically justified, timely and successful treatment of the disease and its implementation in clinical medicine.

Parents’ Perception of Family-Centered Music Therapy with Stable Preterm Infants

Premature birth places considerable demands on preterm infants and their families. Most of these infants are treated on a neonatal intensive care unit immediately after birth, leading to psychosocial stress for parents and making it more difficult to build a stable parent-child bond. We hypothesized that accompaniment with live music therapy by a music therapist supports the parents to get in contact with their child and to promote the parents’ wellbeing. Preterm infants born at less than 32 gestational weeks received creative music therapy twice a week until discharge. At the time of discharge, the parents were asked to complete a Likert-style questionnaire to evaluate the music therapy. Six items related to socio-demographic characteristics, 4 items to observations on the infant and 10 items to personal perception. Of 40 preterm infants receiving music therapy, 32 (80%) parents completed the questionnaires. Thirty (94%) of these parents were able to relax during the music therapy session. Relaxation in their infants was observed by 29 (91%) during and by 28 (88%) after music therapy. Parents perceived music therapy as a positive change and enrichment during their infant’s hospital stay. All parents were thankful for the music therapy they received. Music therapy supports the parents of preterm infants in the first time after birth until discharge from the hospital.

Increased Knowledge of Pregnant Women about the Importance of Micro Minerals (Fe) During Pregnancy

Micro minerals (Fe) are indispensable for every woman, especially during pregnancy. The need for micro minerals (Fe) increases with increasing gestational age. Micro minerals (Fe) are not only important for pregnant women, they are also important for babies in the womb. Deficiency of micro minerals (Fe) can increase the risk of giving birth to babies with low body weight or premature birth and even maternal and infant mortality. If the baby is born with a normal weight, but there is still the possibility of stunting (short children). The purpose of this community service is to increase the knowledge of pregnant women about the importance of consuming micro minerals (Fe) during pregnancy. Knowledge of pregnant women in Sungai Rengit Murni village about the consumption of micro minerals (Fe) can be said to be quite good, reaching 70% of the total number of pregnant women (statement of regional midwives). We hope that as a servant, with this community service program, it is hoped that the knowledge of pregnant women about the importance of consuming micro minerals (Fe) during pregnancy will increase. So that the risk that will occur to the mother and baby is reduced. In addition, the service also supports government programs in reducing maternal problems during pregnancy until delivery.

Hubungan Paritas dengan Kejadian Ketuban Pecah Dini

Premature rupture of membranes can cause various complications such as infection, prolonged parturition, postpartum hemorrhage, maternal morbidity and mortality, while in the fetus PROM can cause premature birth, decreased umbilical cord, hypoxia and secondary asphyxia. Based on the data taken at Batam city, the highest number of PROM cases from 3 hospitals was 546 cases, Harapan Bunda’s Hospital. This study aims to determine relationship Parity with premature rupture of membranes at Harapan Bunda Hospital Batam City. This research used method quantitative analitic survey with cross sectional design with 60 samples. The Conclusion the results obtained were there is relationship parity with premature rupture of membranes (p value = 0,001). Suggestions to clients and community to increase their knowledge about the cause PROM so that they can prevent or detect early complications that will occur in the future.

STUDI LITERATUR HUBUNGAN UMUR IBU DAN PARITAS DENGAN KEJADIAN PERSALINAN PREMATUR

Indonesia adalah negara pada urutan kelima dengan persalinan preterm tertinggi di dunia yaitu sebesar 675.700. Persalinan preterm dapat dipengaruhi oleh umur ibu dan paritas. Penelitian ini bertujuan untuk mengetahui hubungan antara umur ibu dan paritas dengan kejadian persalinan prematur. Metode yang digunakan adalah literature review dengan jenis literature review yang digunakan adalah tradisional literature review. Artikel didapatkan dari 4 database yaitu Pubmed, Google Scholar, Cochrane, dan DOAJ. Kata kunci yang digunakan dalam pencarian literatur: “Umur Ibu” , “Paritas” , “Persalinan Prematur” , “Maternal Age” , “Parity” , “Preterm Labor” , “Premature Birth”. Hasil penelitian menunjukkan dari 15 jurnal yang didapatkan, didapatkan hasil bahwa (92,3%) mengatakan ada hubungan antara umur ibu dan persalinan prematur dan (7,7%) mengatakan tidak ada hubungan antara umur ibu dan persalinan prematur, (85,7%) mengatakan ada hubungan antara paritas dengan persalinan prematur dan (14,3%) mengatakan tidak ada hubungan antara paritas dengan persalinan prematur. Terdapat hubungan antara umur ibu dan paritas dengan kejadian persalinan prematur sehingga diharapkan tenaga kesehatan mampu memberikan pendidikan kesehatan dan konseling perencanaan kehamilan, memberikan perawatan antenatal yang sesuai standar serta memberikan informasi dan akses kontrasepsi agar dapat mencegah terjadinya persalinan prematur.

Level of Anxiety among the Mothers of Preterm Newborn Admitted in Nicu Ward

Background: Premature birth has a great impact on the parents. In India, 27 million babies are born each year out of which 3.5 million babies are born premature. This study included premature infants <37 weeks of gestation. Preterm birth may have a negative impact on parents’ experience as well In fact, the premature birth of the baby suddenly interrupts the building of parents’ mental representations and expectations. Aim and Objective: The purpose of this study was to assess the level of anxiety among the mothers of preterm newborn admitted in NICU ward and to find out the association between the level of anxiety among the mothers of preterm newborn with their demographic variable. Design and Methods: A descriptive study was carried out on 50 mothers of premature newborn. Who were admitted to the neonatal intensive care unit of selected hospital, vadodara. Purposive sampling technique was used to collect the data. Descriptive and inferential statistics were applied to analyses the data by using SPSS-20 software. The samples in this study was selected by non randomised sampling technique. Mothers anxiety regarding the newborn were determined by Hamilton anxiety rating scale. Data was collected by applying Inclusion Criteria like Mothers of preterm who were willing to participate , who were admitted in the hospital. Results: The majority of mothers the study finding of qualitative data reveals that the mothers level of anxiety 10% mild, 10% moderate, 22% severe, 58% very severe. The linear regression analysis showed that anxiety level was at significance of 0.05 level. Association between age and birth weight in demographic variables. Conclusion: The present study concluded level of anxiety 10% mothers of having mild anxiety, 10% were having moderate anxiety, 22% were having severe anxiety, 58% were having very severe anxiety. The linear regression analysis showed that anxiety level was at significance of 0.05 level.

High-risk factors for adverse pregnancy outcomes in systemic lupus erythaematosus: a retrospective study of a Chinese population

ObjectiveTo clarify high-risk factors for adverse pregnancy outcomes (APOs) in systemic lupus erythaematosus (SLE).DesignA retrospective chart review study.SettingData were collected in a tertiary medical centre, Shanghai, China, from November 2010 to December 2018.ParticipantsA total of 513 pregnancies with SLE were retrospectively analysed. Twenty-seven patients who underwent artificial abortions due to personal reasons were excluded.Primary outcome measuresAPOs were primary outcomes, including foetal loss, premature birth, small for gestational age (SGA), asphyxia neonatorum, composite foetal APOs and hypertensive disorders of pregnancy (HDP). Multivariable logistic regression and Spearman correlation analysis were performed to determine the risk factors for APOs in SLE.ResultsRisk factors for foetal loss included prepregnancy hypertension, hypocomplementaemia-C3, anticardiolipin antibodies-IgM positivity and disease flares during pregnancy. Risk factors for premature birth included disease flares, use of immunosuppressive agents and HDP. Moreover, twin pregnancy, disease flares and HDP were risk factors for SGA, and prepregnancy hypertension was an independent risk factor for asphyxia neonatorum. Independent risk factors for composite foetal APOs included twin pregnancy, prepregnancy hypertension, disease flares during pregnancy, HDP, hypocomplementaemia-C3 and the use of immunosuppressive agents. Risk factors for SLE complicated with HDP included prepregnancy hypertension, renal disorders and thrombocytopaenia. Conversely, the use of aspirin was a protective factor against foetal loss and premature birth. The ds-DNA value had a low diagnostic value for APOs, whereas the extent of complement reduction may predict the incidence of composite foetal APOs and foetal loss. Proteinuria occurring in the first 20 gestational weeks may lead to APOs.ConclusionEstablished risk factors for each APO were identified in this study. Indicators with more predictive significance have been screened out from conventional indicators, which may help clinicians predict the pregnancy outcome of patients with SLE more accurately and minimise the incidence of APOs.

The Rare Case of a COVID-19 Pregnant Patient with Quadruplets and Postpartum Severe Pneumonia. Case Report and Review of the Literature

Background and Objectives: The multiple pregnancies associated with COVID-19 is a new and difficult condition to manage. The prognosis for rapid deterioration after the cesarean delivery is difficult to assess and needs close interdisciplinary follow-up due to pregnancy and postpartum-related changes. Materials and Methods: We report the case of a 37-year-old primigesta primipara patient who was admitted to “Elena Doamna” Clinical Hospital of Obstetrics and Gynecology at 33 weeks and 3 days of gestation with high-grade multiple pregnancies (triplets) for threatened premature birth associated with COVID-19. The patient had a history of surgically corrected atrial septal defect during childhood and currently is known to have paroxysmal supraventricular tachycardia. Tocolysis was ineffective and the decision to perform a cesarean operation was made. The diagnosis was established: primigesta, primipara, at 34 weeks of gestation, high-grade multiple pregnancy with triplets, intact membranes, threatened premature birth, surgically corrected atrial septal defect, paroxysmal supraventricular tachycardia, infection with COVID-19. The patient underwent a cesarean intervention and treatment for COVID-19 pneumonia. The intervention took place at 33 weeks and 4 days of gestation resulting in four newborns with weights between 1400 g and 1820 g and Apgar scores between 6–8. All newborns were transferred to a third-degree Neonatology ICU service due to their prematurity. The fourth newborn was not identified in any of the ultrasounds performed during pregnancy. During the postpartum period, the patient had a fulminant evolution of COVID-19 pneumonia, with rapid deterioration, needing respiratory support and antiviral treatment. Discussions: Managing high-risk obstetrical pregnancies associated with COVID-19 requires a multidisciplinary team consisting of obstetricians, anesthesiologists, neonatologists, and infectious disease doctors. Conclusion: Our case is the first to our knowledge in Romania to present an association of high-grade multiple pregancy with COVID19 moderate form, rapidly evolving postpartum, needing rapid intensive care admission, and specific treatment with Remdesivir, with good post-treatment evolution.