Methods of detection and isolation of trophoblast cells from trans-cervical specimens – a historical overview

Trophoblast cells can be detected and isolated from the cervical epithelial cells obtained via various techniques of trans-cervical samples collection such as a mucus aspiration, endocervical lavage, or standard cervical brushing in the early first trimester, even from the 5 weeks’ gestation. Isolated fetal cells can be used in the early prediction of fetal sex, prenatal diagnostics of the most common aneuploidies, and any other genetic abnormalities. Nevertheless, the collection of trophoblastic cells has limited efficacy compared to currently used methods of detection of free fetal DNA in maternal circulation or other protocols of invasive prenatal diagnostics available at later stages of pregnancy. In the past years, trans-cervical cell samples were collected mainly in women before planned pregnancy termination. The early trophoblastic cells isolation from women in ongoing pregnancies opens new perspectives for further studies focused on the elucidation of pathophysiology of numerous pregnancy-related complications.

Positive Negative Affect and Teen Pregnancy

Pregnancy is one of the important events in a woman’s life. Having a positive and planned pregnancy will impact the psychological well-being of both mother and baby. This study describes the relationship between the affect and demographics of pregnant adolescents. Respondents consisted of 92 pregnant adolescents (19.6% trimester 1, 41.3% trimester 2 and 39.1% trimester 3), with an age range of 16 to 35 years (M = 18.99, SD = 2.899). Pregnant adolescents were asked to fill in the positive and negative influence scale (PANAS). The correlation coefficient of Cronbach’s alpha for the positive influence scale is 0.845. The correlation coefficient of Cronbach’s alpha for the negative influence scale is 0.676. Researchers used Chi-Square to determine the relationship between positive and negative influences with the demographic characteristics of adolescent mothers. The results of the description of the Positive affect were related to age (Asymp. Sig. = 0.000) and gestational age (Asymp. Sig. = 0.009). In contrast, the Negative affect was related to adolescent education (Asymp. Sig. = 0.013). These results underlie the process of adaptation of adolescent mothers in undergoing a healthy and planned pregnancy.

Determinants of adherence to iron-folic acid supplementation among postnatal mothers in Addis Ababa referral hospitals, Ethiopia

Abstract: In Ethiopia, adherence to iron-folic acid supplementation is extremely low. There were only 5% who took more than 90 tablets during their pregnancy. However, only limited data is available on the determinant factors of non-adherence. Therefore, the aim of this study was to identify determinants of adherence to iron-folic acid supplementation among postnatal mothers in three referral hospitals of Addis Ababa, Ethiopia.Methods: An institutional based unmatched case-control study was conducted on 240 women who have been at postnatal care. Data were collected using interviewer administered questionnaire. Data were entered and analyzed using EpiData and SPSS version 20.0, respectively. Bivariate and multivariate logistic regressions were employed to identify the determinants at p-value < 0.25 and < 0.05, respectively.Results: The major determinant factors of adherence to iron-folic acid supplementation were, mothers age group 29-33 [AOR=1.66, 95% CI: 2.010-0.0492], ANC initiation time [AOR=4.21, 95% CI: 2.3-10.6], counseling on IFAS [AOR=3.89, 95% CI: 1.8-8.4], time taken to travel to health facility [AOR=3.17,95% CI:1.35-7.4], gravidity [AOR=2.08,95% CI:1.06-4.09], morning sickness [AOR 0.33, 95% CI: 0.15-0.69] and planned pregnancy [AOR=4.2, 95% CI: 1.6-10.9].Conclusion: This study highlighted age of participants, planned pregnancy, antenatal care initiation time, morning sickness, gravidity, counseling and distance to health facility are the key factors that have independently associate with adherence. Counseling should be given for clients on the correct dosage and duration of supplementation to prevent anemia and neural tube defects.

Pregnancy planning in women with diabetes mellitus type 2

BACKGROUND: The increase in the incidence of type 2 diabetes mellitus worldwide and the improvement in the quality of diabetic and obstetric care lead to an increase in the number of pregnant women with type 2 diabetes mellitus. The incidence of obstetric and perinatal adverse outcomes in women with type 2 diabetes mellitus is often higher than in women with type 1 diabetes. In the world literature, there are few works on the effect of pregnancy planning on the course and outcome of pregnancy in women with type 2 diabetes mellitus. AIM: The aim of this study was to evaluate the role of pregnancy planning in patients with type 2 diabetes mellitus in improvement of pregnancy and birth outcomes. MATERIALS AND METHODS: We retro- and prospectively analyzed the course and outcome of pregnancy in 124 women with type 2 diabetes mellitus, who were observed in the Diabetes Mellitus and Pregnancy Center of the Research Institute of Obstetrics, Gynecology and Reproductology named after D.O. Ott for the period from 2010 to 2019. The study included 34 women with type 2 diabetes mellitus at the stage of pregnancy planning and 90 women during pregnancy. All patients underwent a general clinical examination, carbohydrate metabolism correction, training at the School of Diabetes Mellitus in the principles of rational nutrition, self-control of glycemia and insulin therapy. Diabetes compensation was assessed by the level of glycated hemoglobin, determined using a method certified in accordance with the National Glycogemoglobin Standartization Program and standardized in accordance with the reference values adopted in the Diabetes Control and Complications Trial, as well as by the level of glycemia (self-control at least four times a day). We also assessed the severity of vascular complications of type 2 diabetes mellitus before and during pregnancy, and identified and treated comorbidities. To assess the degree of obesity, the criteria of the World Health Organization and the pregravid body mass index calculated by the Quetelet formula were used. The severity of preeclampsia was assessed in accordance with federal clinical guidelines. Ultrasound examination of the fetus with Doppler blood flow in the vessels of the fetoplacental complex was performed using a Voluson E6 ultrasound system (GE Healthcare, USA). For the timely diagnosis of diabetic fetopathy and fetal cardiomyopathy, dynamic fetometry and echocardiography were conducted. In addition, cardiotocography was performed for antenatal assessment of the fetus from the 30th week of pregnancy. After delivery, a neonatologist assessed the condition of the newborn using the Apgar scale at the first and fifth minutes of life, and then the assessment was carried out in the early neonatal period. RESULTS: In the group of women who received pregravid training, the course and outcomes of pregnancy were significantly better: the frequency of preeclampsia was lower (14.7%) compared to the group of women with an unplanned pregnancy (40.0%); there was no severe preeclampsia compared to the same women (13.3%). The number of preterm births was significantly lower (14.7%) in the group of women with planned pregnancy compared to the group of women without pregravid preparation (37.8%). In addition, in the group of women planning pregnancy, there were no fetal congenital malformations, neonatal hypoglycemic conditions, hypertrophic cardiomyopathy; in the group of women with an unplanned pregnancy, these parameters being found to amount to 6.7%, 24.4% and 6.7%, respectively. There was no perinatal mortality in the group of women with a planned pregnancy; however, this parameter was shown to be 3.3% in the group of women with an unplanned pregnancy. CONCLUSIONS: Pregnancy planning in patients with type 2 diabetes mellitus can significantly improve the course of pregnancy and childbirth outcomes.

Protective vaccinations during pregnancy - adult Poles knowledge in this area

Background The vaccine is a preparation of biological origin containing antigens that stimulate the body’s immune system to produce acquired immunity. Vaccines can contain killed or “live” (attenuated) microorganisms as well as fragments of these (antigens). Although many vaccines are used routinely in pregnancy to provide a seroprotective immune response for mother, fetus and neonate there is much controversy over their use during this unique time. The aim of the study was to find out about the knowledge of adult Poles on the use of preventive vaccinations during pregnancy. Methods The study involved 700 people (100%) aged 18 to 80 years ($$ \overline{x} $$ x ¯ = 32.16 ± 16.46). Most of the respondents were women (511; 73%). The study consisted of 9 questions about preventive vaccinations of pregnant women and 5 questions about members of the studied group. The aforementioned questions formed the basis of the preparation of the presented article. Results A significant part of respondents (322; 46%) did not have knowledge on the topic of safeness of using preventive vaccinations during pregnancy, 196 (28%) respondents believed that such procedure is not safe. Most of the respondents (371; 53%) did not know about the possibility of using “live” vaccines during pregnancy. 14 (2%) of respondents believed that pregnancy should be terminated in case of administration of a “live” vaccine to a pregnant woman. According to 294 (42%) respondents, vaccinations with “live” vaccines should be completed at least 3 months before the planned pregnancy. The subjects were not aware of the issue of post-exposure vaccination against tetanus and rabies among pregnant women. The respondents’ responses were divided on the issue of the safest trimester of pregnancy for vaccine administration. Almost 1/3 of the respondents (203; 29%) indicated the third trimester as the safest for their performance. Conclusion The knowledge of the surveyed group, the majority of whom were women, about the use of vaccinations before and during pregnancy was unsatisfactory. There is a need to educate the public about the benefits and risks of performing or avoiding preventive vaccinations during pregnancy.

IMPACT OF ULTRASOUND AND SOCIODEMOGRAPHIC VARIABLES ON MATERNAL FOETAL ATTACHMENT IN TARABA STATE, NIGERIA

Background: Maternal foetal attachment is manifested in behaviours that demonstrate care and commitment to the foetus. Ultrasound decreases maternal anxiety and confers psychological benefits following a reassuring sonogram. Maternal-foetal attachment is affected by many socio-demographic factors which include maternal age, occupation, educational level, race, marriage duration, ethnicity, Religion, income status, pregnancy planning, and identification of the foetal gender Aim: This study was aimed at assessing the effect of ultrasound and sociodemographic factors on maternal foetal attachment during pregnancy. Method: A prospective study was conducted from November 2019 to March 2020. A convenient sampling method was employed and included 404 pregnant women aged 18-45 years old in their 2nd and 3rd trimesters. The data were collected using a maternal foetal attachment scale questionnaire. Descriptive and inferential statistics were carried out at a p-value < 0.05. Result: The score of the maternal foetal attachment scale was greater with post ultrasound than the pre ultrasound. There was a statistically significant difference between the pre and post ultrasound maternal foetal attachment scale (p=0.000). A statistically significant difference was observed in the maternal foetal attachment across the different ethnic groups (p=0.000), planned and unplanned pregnancy (p=0.000). Conclusion: This study revealed that ultrasound scan has an influence on maternal foetal attachment, planned pregnancy. Hausa, Bandawa and Jenjo were found to be more attached to their foetuses.

A Unique case report of successful pregnancy and delivery after being treated with pioglitazone and glimepiride (in first three months)

A planned pregnancy (with IVF) in a patient with type 2 diabetes was treated with insulin along with glimepiride and pioglitazone (treated in first three months) from pre-conception stages until the postpartum is reported. She delivered a single viable male child at 33 weeks of gestation due to pregnancy induced hypertension and type 2 diabetes mellitus with no abnormalities. The newborn was healthy without any congenital and other abnormalities. To our belief, this is the first case reporting the use of pioglitazone as well as glimepiride in early pregnancy. It should be noted that both of the drugs are not recommended to be used in pregnancy but we may come across situations where the patient is already exposed to these drugs and not willing to abort pregnancy and this case adds value to the existing body of medical literature in such cases

Determinants of adherence to iron-folic acid supplementation among postnatal mothers in Addis Ababa referral hospitals, Ethiopia

Abstract: In Ethiopia, adherence to iron-folic acid supplementation is disappointingly low were only 5% took more than 90 tablets during their pregnancy; however, only limited data are available on the determinant factors of non-adherence. Therefore, the aim of this study was to identify determinants of adherence to iron-folic acid supplementation among postnatal mothers in three referral hospitals of Addis Ababa, Ethiopia.Purpose:Methods: An institutional based unmatched case-control study was conducted on 240 women who have been at postnatal care. Data were collected using interviewer administered questionnaire. Data were entered and analyzed using EpiData and SPSS version 20.0, respectively. Bivariate and multivariate logistic regressions were employed to identify the determinants at p-value < 0.25 and < 0.05 respectively.Results: The major determinant factors of adherence to iron-folic acid supplementation were, mothers age group 29-33 [AOR=1.66, 95% CI: 2.010-0.0492], ANC initiation time [AOR=4.21, 95% CI: 2.3-10.6], counseling on IFAS [AOR=3.89, 95% CI: 1.8-8.4], time taken to travel to health facility [AOR=3.17,95% CI:1.35-7.4], gravidity [AOR=2.08,95%CI:1.06-4.09], morning sickness [AOR 0.33, 95% CI: 0.15-0.69] and planned pregnancy [AOR=4.2, 95%CI: 1.6-10.9].Conclusion: This study highlighted age of participants, planned pregnancy, antenatal care initiation time, morning sickness, gravidity, counseling and distance to health facility are factors that have independently associate with adherence. Counseling should be given for clients on the correct dosage and duration of supplementation for prevention of anemia and neural tube defects.

Prevalence and factors associated with unplanned pregnancy in a Brazilian capital in the Northeast

Objectives: to analyze the prevalence and factors associated with unplanned pregnancy in a Brazilian capital in the Northeast. Methods: a cross-sectional study nested to a hospital birth cohort with a probable sample of 5,110 puerperal women. Associated factors were analyzed using a hierarchical theoretical model in three levels: distal (women’s socioeconomic and demographic characteristics), intermediate (reproductive characteristics, maternal habits and BMI), and proximal level (partner's characteristics). Multivariate Poisson regression analysis was performed. Results: the prevalence of unplanned pregnancy was 68.1% (CI95%=66.8-69.4). Multivariate analysis showed association with black skin color/race (PR=1.03; CI95%=1.01- 1.07), mother's age group up to 19 years old (PR=1.09; CI95%=1.06-1.12) and 20 to 24 years old (PR=1.04; CI95%=1.01-1.07), not living with partner (PR=1.09; CI95%=1.07- 1.11), highest number of people in the household: 5 people (PR= 1.10; CI95%=1.08-1.13) and 3 to 4 (PR=1.08; CI95%=1.05-1.10), number of ≥4 children (PR=1.09; CI95%=1.06- 1.13) and 2 or 3 children (PR=1.03; CI95%=1.02-1.05), alcohol consumption (PR=1.03; CI95%=1.01-1.05), malnourished pre-pregnancy BMI (PR=1.03; CI95%=1.01-1.06) and partner’s low schooling (5 to 8 years) (PR=1.03; CI95%=1.01-1.07). Prior abortion was inversely associated with planned pregnancy (PR=0.95; CI95%=0.93-0.97). Conclusions: the prevalence of unplanned pregnancy was high and was associated with socioeconomic and demographic characteristics that reflect on the combination of the complex inequalities that impact women and their partners