Early- and Late-Onset Preeclampsia at a Tertiary Hospital in 2016

Introduction: Preeclampsia is still one of the major causes of maternal morbidity and mortality worldwide. Preeclampsia nowadays has another classification, early-onset preeclampsia and late-onset preeclampsia. This study aimed to evaluate the differences between early-onset and late-onset preeclampsia in Dr. Soetomo General Hospital, Surabaya in 2016.Methods: This was an analytic observational study, evaluating the difference between early- and late-onset preeclampsia in terms of maternal data, medical history, and obstetric history. The samples were taken from the medical record of Dr. Soetomo General Hospital, Surabaya from January until December 2016.Results: In maternal data, early- and late-onset preeclampsia mostly happened in productive age, consisted of 34 patients of early-onset preeclampsia (77.3%) and 31 patients of late-onset preeclampsia (73.8%). Early-onset preeclampsia tended to happen in nullipara (42.2%) and primigravida (35.6%) women, and late-onset preeclampsia usually happened in multipara (43.9%) and multigravida (85.4%) women. In medical and obstetric history, early-onset preeclampsia mostly had a history of hypertension (61.7%), rather than late-onset preeclampsia (32.7%). Moreover, there were no significant differences in other variables.Conclusion: Early-onset and late-onset preeclampsia had a significant difference in parity, gravidity, and hypertension disease.

Study to Evaluate Association of Torch Infection with Bad Obstetric History in Pregnant Women at Sms Medical College and Attached Group of Hospitals, Jaipur

Background: Congenital infections are transmissible in utero and it can lead to serious foetal outcomes. These infections can be early detected in pregnant women with bad obstetric history for better foetal outcomes. Aim of the Study was to evaluate the association of TORCH infection with bad obstetric history among pregnant women. Study Design: Observational and comparative study Place and Duration of Study: Central laboratory, Department of Microbiology, SMS Medical College, Jaipur between April 2020 and September 2021. Methodology: 260 blood samples of pregnant women (130 with bad obstetric history and 130 pregnant women without bad obstetric history) were collected. and tested for the presence of IgM and IgG antibodies against Toxoplasma gondii, Rubella virus, Cytomegalovirus by Chemiluminescence and Herpes simplex virus using ELISA kits. Results: Overall TORCH IgM seropositivity in high-risk pregnant women was 17.19%. In pregnant women with bad obstetric history, IgM Seropositivity for Toxoplasma gondii was 3.84% (P value .02), rubella 2.34% (P value .30), Cytomegalovirus 5.47% (P value .08), and 6.25% (P value .56) for Herpes-1 and 2 infections and IgG seropositivity for toxoplasma, rubella, cytomegalovirus and herpes virus was 16.41% (P value .001), 93.75% (P value .11), 98.44% (P value .55), 48.44% (P value .53) respectively. In pregnant women without bad obstetric history, IgM and IgG seropositivity for toxoplasma, rubella, cytomegalovirus and herpes virus was 0/0.77%, 0.76/97.69%, 1.53/99.23% and 4.61/44.62% respectively. The average age of the study population was 27.13 years. Conclusion: As TORCH infections are transmissible in-utero in all the stages of pregnancy and contributes in neonatal and infant deaths, so early diagnosis and appropriate interventions necessary which help in proper management of the pregnant women.

Prevalence of Cytomegalovirus, Rubella and Toxoplasma gondii among Internally Displaced Women of District North Waziristan, Pakistan with Home Obstetric History

The present study was conducted to estimate the prevalence rate and to identify risk factors of Cytomegalovirus, Rubella and Toxoplasma gondii among internally displaced women of District North Waziristan, Pakistan with home obstetric history. A total of 387 blood samples were collected from internally displaced infected women with the help of a comprehensive filled data form. To determine levels of Cytomegalovirus, Rubella and Toxoplasma gondii Infection, all blood samples were qualitative and quantitative analyzed using Immune chromatographic and Chemiluminescence Microparticle Immunoassay (CMIA) technique. Among 387 blood samples, the total numbers of reactive samples observed were 341 (88.11%) and non-reactive samples were 46 (11.88%). Of 341 (88.11%) reactive samples, the highest ratio 168 (49.26%) was reported for the co-infection of Cytomegalovirus and Rubella, followed by 76 (22.28%) for Cytomegalovirus, Rubella and Toxoplasma gondii combined. In reactive samples, the highest ratio of IgG was noted in order of CMV 22 (64.70%), Rubella 21 (67.74%) and Toxoplasma gondii 16 (72.72%), followed by IgG+IgM and IgM only. Regarding age-wise distribution, the highest ratio 144 (90.56%) of total reactive samples of Cytomegalovirus, Rubella and Toxoplasma gondii was reported in the 25-32 years old group of individuals. Similarly, the highest ratio 53 (48.18%) and 60 (41.66%) of co-infection among reactive samples for Cytomegalovirus, and Rubella was observed in 18-24 and 25-32 years old group. Further, the highest ratio of 100 (40.32%) of risk factors was observed in infected patients who were exposed to a poor hygienic environment and 57 (44.18%) of infected patients had complications of Severe UTI followed by others. Hence, it was revealed that Cytomegalovirus, Rubella and Toxoplasma gondii infection was most prevalent in internally displaced women of District North Waziristan, Pakistan. Therefore, an urgent base prophylactic approaches should need to be addressed to reduce the risk of the spread of disease in this locality.

Pregnancy Risk Perception and Associated Factors Among Pregnant Women Attending Antenatal Care at Health Centers in Jabitehnan District, Amhara, Northwest Ethiopia

Background: Pregnancy risk perception affects a pregnant woman’s decision about health care services use such as prenatal care, place of birth, choices about medical interventions, adherence to medical procedures, and recommendations. Methods: An institutional-based cross-sectional study was conducted among 424 mothers attending ANC at health centers in the Jabitenhan district from April 1 to 30, 2021. Data was collected through a face-to-face interview using a structured questionnaire which was developed according to the health belief model. The logistic regression model was used using adjusted odds ratio with 95% CI and p value <0.05Result: 424 pregnant women were interviewed of which nearly half of the respondents (48%) had good pregnancy risk perception. Women who had a history of obstetric complication (AOR:95%CI = 3.44:1.73,6.83), those who know at least one pregnancy danger sign (AOR:95%CI =5.22;2.46,11.07), pregnant women who had a bad obstetric history (AOR:95%CI = 2.23:1.13,4.41) and knowing women who died due to pregnancy-related complications (AOR:95%CI =2.85:1.45,5.60) were more likely to have good perception towards pregnancy risk as compared to their counterparts.Conclusion: Obstetric complications, awareness of pregnancy danger signs, bad obstetric history, and knowing women who died due to pregnancy-related complications were found to be significantly associated with pregnancy risk perception.

Study of bad obstetric history cases attending tertiary care centre, Tirupati

To assess the obstetric and medical risk factors in patients with bad obstetric history (BOH) and outcome of pregnancy in case of BOH. A prospective cross-sectional study was conducted in Government maternity hospital, Tirupati for a period of 1 year from December 2017 to November 2018. All pregnant women who were fulfilling inclusion criteria of BOH, as study group and all possible variable were compared with control group, who got selected randomly from the rest of deliveries. And analysed the results in terms of sociodemographic factors, risk factors, pregnancy complications, mode of delivery, maternal and foetal outcome. Of 102 pregnant women in BOH, 76.5% were in age group between 21-30yrs, and 14.7% in age group &#62;30yrs. Primary Recurrent pregnancy loss (RPL) was 51% and that of secondary recurrent pregnancy loss was 49%.History of hypertensive disorders including preeclampsia, eclampsia and chronic hypertension, noted in 11.8% cases, which was higher than previous studies, indicating changing trends in incidence.In foetal complications IUGR (0% vs 9.8%, p=0.026) and IUFD (0% Vs 7.8%, p=0.05) were more in BOH group and statistically significant also. Even though the maternal complications were more in BOH group, there was no statistical significance (P=0.075).Among the various causes of RPL found in the present study, endocrine causes were seen in 12.7%, Anatomical causes were found in 11.8% and in about 63.7% cases no definite cause was found and aetiology was unexplained. Present study, supporting the change in definition of recurrent pregnancy loss from 3 consecutive losses to 2. So early evaluation and with appropriate interventions in most of couples outcomes were fruitful.

Social support and subjective assessment of psychophysical condition, health, and satisfaction with quality of life among women after pregnancy loss

Background The task of modern medicine is not just to heal, but also to improve the patient’s well-being and achieve non-medical goals in the therapy process that enable effective physical, mental and social functioning of the patient. Social support in difficult situations mobilizes an individual’s strength and resources to cope with problems. Research on social support and women’s condition after pregnancy loss reflects a holistic approach to the patient and is important from the perspective of increasing the level of hospital care. Objective The aim of our study was to assess the impact of social support on the psychophysical condition, health, and satisfaction with quality of life among women after miscarriage and ectopic pregnancy. Methods The cross-sectional study was carried out in a group of 500 patients after miscarriage and 110 with ectopic pregnancy, hospitalized in hospitals in Lublin (Poland). The study was conducted with the use of a diagnostic survey, comprising the Berlin Social Support Scales (BSSS) and an original survey questionnaire (psychophysical condition, satisfaction with health and quality of life on a scale of 1–4, sources of support on a scale of 1–10, with 1 being the poorest rating). Results Respondents after miscarriage and those after ectopic pregnancy assigned the highest scores to the degree of perceived available instrumental support (respectively, miscarriage: M = 3.79, EP: M = 3.77). Women after pregnancy loss assigned the highest score to the support obtained from their partner (respectively, miscarriage: M = 9.26, EP: M = 9.23). Social support was significantly correlated with the condition of patients hospitalized as a result of pregnancy loss (p < 0.05). The assessment of psychophysical condition, health, and QoL of the respondents is determined by their education, financial standing, and obstetric history (p < 0.05). Conclusions Women hospitalized due to miscarriage and ectopic pregnancy assigned high scores to the level of perceived available instrumental, emotional, and actually received social support. There is a positive relationship between social support and subjective opinion about psychophysical condition, health and satisfaction with quality of life among women after pregnancy loss. The assessment is determined by sociodemographic factors and the respondents’ obstetric history.

Incidence and pattern of infections in pregnant women with bad obstetric history

Background: Adverse outcomes have been seen in pregnant women who had prior bad obstetric history along with infection with TORCH [toxoplasma, other infections (syphilis, varicella zoster, hepatitis B), rubella, cytomegalovirus, herpes simplex]complex and bacterial vaginosis. These infections are known to affect the health of the fetus. Objective was to study incidence and pattern of infections in pregnant women with bad obstetric history.Methods: A total of 190 patients with bad obstetric history fulfilling the methodology criteria were evaluated. Serological and molecular evaluations were carried out for TORCH complex and bacterial vaginosis was detected by both gram stain and gold standard clinical Amsel criteria and outcomes were followed.Results: Out of 190 pregnant women with bad obstetric history, a total of 36 (18.8%) were detected to have infections causing bad obstetric history. Toxoplasma was positive in 7 (20%) of the cases, 3 (51.92%) of them had abortions. Rubella in 12 (32%) of the cases, 7 (60%) cases had sensorineural deafness. Cytomegalovirus in 1 (2%) of the cases, 1 (100%) of the case had microcephaly. Herpes in 8 (22%) cases, 6 (71.1%) cases had abortions. Bacterial vaginosis in 8 (22%) of the cases, 4 (48.6%) cases had preterm delivery. The presence of infections with TORCH complex and bacterial vaginosis was related to adverse pregnancy outcomes.Conclusions: Women with bad obstetric history are prone to infections during pregnancy and have been found out to be associated with adverse pregnancy outcomes. Hence pregnant women should be screened so that early diagnosis and treatment of infections can be done to have better pregnancy outcomes.