Anemia among Pregnant Women at Nepalgunj Medical College

Introduction: Anemia in pregnancy is major health issue of developing countries responsible for adverse maternal and fetal outcome. According to World health organization pregnant women with hemoglobin level less than 11 gm/dl in first trimester and less than 10.5gm/dl in second and third trimester are considered to be anemic. Iron deficiency anemia is common during pregnancy followed by megaloblastic anemia. Aims: To find out the prevalence of anemia during pregnancy. To correlate the maternal and fetal complications associated with anemia during pregnancy. Methods: This is a prospective hospital based study done at department of obstetrics and gynecology Nepalgunj Medical College from July 2020 to January 2021. All pregnant women with hemoglobin level <11 gm/dl were enrolled in the study. Data were collected from antenatal clinic and biochemistry laboratory. Results: In this study maximum participants were of age group 20-25 consisting of 38.5%. Anemia was more common in multiparous i.e. 60% as compared to primipara i.e. 40%. In this study maximum participant had vaginal delivery (57%) followed by LSCS (29%) then instrumental delivery (14%). These ladies had complications like postpartum hemorrhage (27.7%), preterm labor (16.9%), pregnancy induced hypertension (9.2%). similarly 10.8% had sepsis and 20% had no complications. About 23.1% babies delivered by anemic ladies required neonatal intensive care. Intrauterine growth restriction was seen in 12.3%, preterm birth in 10.3% and 53.8% babies had no complications. Conclusion: The prevalence of anemia during pregnancy is high leading to adverse maternal and fetal outcome.

Husband’s Perception on Anemia among Pregnant Women based on Cultural Perspective: A Qualitative Study

BACKGROUND: Anemia is one of the most common nutritional problems during pregnancy. Husbands have an important role in supporting their wives in pregnancy to prevent complications. Husband’s culture and beliefs will affect support for the health status of pregnant women. AIM: This study aims to explore husbands’ perceptions regarding anemia and cultural beliefs related to pregnancy. METHODS: This qualitative study was conducted using twelve in-depth interviews (IDIs) with husbands who have pregnant wives who were recruited through a purposive sampling method. Data were collected through IDIs using open-ended questions to gain insight about Husband’s Perception on Anemia among Pregnant Women based on Cultural Perspective. Data analysis was conducted by an inductive content analysis method to evaluate, encode, and analyze the interview’s result. RESULTS: Four themes emerged from interviews: (1) Husbands’ happiness and support to their wives during pregnancy; (2) Husbands’ perceptions and actions related to anemia symptoms; (3) Cultural beliefs during pregnancy believed by Acehnese people; and (4) the importance of local wisdom-based counseling. CONCLUSIONS: Our findings provide new insights into how husbands’ perceptions on anemia during pregnancy, how they support their pregnant wives, and what their believed in cultural views about pregnancy. These findings would assist in developing/adapting more strategic policies to prevent anemia in pregnancy.

Conditions that increase the risk of cesarean-related blood transfusions: a single-center cohort study

Objective This study aimed to define the conditions that increase the possibility of receiving a blood transfusion in patients who had a cesarean section. Methods This study was conducted between January 2016 – May 2020 in a university hospital located in Konya, Turkey. Pregnant women undergoing cesarean section were included. Of 4303 eligible patients, 188 women were the transfused group and 4115 women were the non-transfused group. Logistic regression analysis was performed for potential confounding factors. Results A total of 4303 eligible patients were evaluated in this study. There were 4115 patients (95.6%) in the non-transfused group. The transfused group consisted of 188 patients (4.4%). The probability of transfusion was higher in pregnant women with placenta previa, placenta accreta spectrum, thrombocytopenia, preoperative anemia, macrosomia above 4500 g, and multiple gestations [adjusted OR values (95% CI); 10.58 (range 4.75–23.57), 7.75 (range 3.22–18.61), 7.85 (range 3.46–17.79), 5.71 (range 4.21–7.74), 4.22 (range 1.21-14.67) and 2.10 (range 1.18-3.72), respectively]. There was no increase in the possibility of transfusion in 4000–4500 gram macrosomia, uterine fibroids, preeclampsia, premature rupture of membranes, previous cesarean sections and gestational diabetes mellitus. Conclusion Placenta previa, placenta accreta spectrum, thrombocytopenia, preoperative anemia, macrosomia above 4500 g and multiple gestations increase the possibility of transfusion. Perioperative blood preparation is vital in such patients. Prevention of anemia during pregnancy is critical in reducing transfusions.

Relationship between Anaemia during Pregnancy and Postpartum Haemorrhage: A Case from Saudi Arabia

Background: Anemia during pregnancy is an important cause of morbidity and mortality among postpartum women. The main reason for the condition is dietary Iron deficiency and the most common type of anemia found in women during pregnancy is iron deficiency anemia. Among many complications, postpartum hemorrhage is a problem linked with anemia during pregnancy. In Saudi Arabia, pregnancy and postpartum haemorrhage (PPH) is not common but still, cases are reported. The present study aimed to determine its prevalence in population and to see its relationship with anemia during pregnancy. Methods: It was an analytical cross-sectional study in which the data was collected from women using properly designed questionnaires. The study population was women who got pregnant and delivered in main hospitals of the kingdom of Saudi Arabia. The data of respondents for demographical and clinical variables were collected and analyzed using SPSS using appropriate statistical tests. Results: 600 participants responded to the questionnaire. The mean age was 26.32 years. The prevalence of PPH among studied population was 11.9%. Anemia during pregnancy was found to be positively associated with PPH with the p value of 0.0039. Smoking history was also correlated with PPH. There was no strong association between age and increase risk of PPH. Conclusion: This study concluded that PPH is not common in Saudi Arabia. There is a moderate association of anemia during pregnancy and PPH. Smoking is also a positive predictor for PPH. There are some limitations in the study so there is a need of large-scale study to confirm the findings in the population.

Ectopic Pregnancy in Tigray, Ethiopia: A Cross-Sectional Survey of Prevalence, Management Outcomes, and Associated Factors

Background. Ectopic pregnancy is a neglected and challenging gynecologic problem in developing countries including Ethiopia. Objective. The present study is aimed at assessing the prevalence of ectopic pregnancy, its management outcomes, and factors associated with management outcomes in Tigray, North Ethiopia. Methods. We employed a four-year retrospective cross-sectional study from September 2015 to August 2019. We extracted data about all pregnant mothers who were admitted and managed for EPs in Axum, Tigray. Ectopic pregnancy and its outcomes (favorable and unfavorable) were the dependent variables, and age, residence, ethnicity, religion, parity, history of abortion, history of EP, pelvic infections, history of surgical procedures, and use contraceptives were the independent variables. We employed descriptive statistics and bivariate and multivariate logistic regression analyses using SPSS. Ethical clearance was obtained from Axum University, Tigray, Ethiopia. Results. The overall prevalence of ectopic pregnancy was 0.52% of total deliveries, which equates to 1 : 193 deliveries. Surgery for ectopic pregnancy accounts for 7.6% of all gynecological surgeries. Most participants were in the age group 26–30 years and lived in rural areas. Among the different EP implantation sites, most cases (92.4%) occurred in the fallopian tube, followed by 5.1% in the ovary and 2.5% in abdominal EPs. Surgical management (laparotomy) was undertaken for all the 79 women diagnosed with EPs, including laparotomy (100%), salpingo-oophorectomy (17.7%), salpingectomy (73.9%), oophorectomy (3.4%), cornual resection (2.5%), and removal of concepts tissue 2.5. The record reports that intraoperative procedure was correctly managed for 47 (59.5%) women but the condition of EP procedure was ruptured for about two-thirds (63.3%) of the women. Thirty (38%) patients had developed some complications after surgery including anemia ( hemoglobin < 10.5 ) ( n = 12 ), fever ( n = 10 ), wound infection ( n = 2 ), and pneumonia ( n = 2 ). Women who were from urban ( AOR = 11.2 , 95% CI: 2.65-47.2) and who had normal hemoglobin at presentation ( AOR = 9.94 , 95% CI: 2.03-48.7) were associated with favorable maternal outcomes. Conclusions. More than one-third of women with ectopic pregnancies had an unfavorable maternal outcome, which was higher among rural residents and anemic mothers. Women living in rural areas and anemia during pregnancy should seek special attention in the management of EPs. We also recommend improving the data management of hospitals in Ethiopia.

Retrospective study on anemia prevalence of pregnant women during third trimester pregnancy in Yogyakarta 2019

Anemia during pregnancy can result in fetal death, abortion, congenital defects, low birth weight, reduced iron reserves in children or children born with malnutrition. This study aimed to describes the anemic incidence in the third trimester of pregnant women at Puskesmas Tegalrejo Yogyakarta. This research was a descriptive study that used a retrospective time approach. A total of 212 pregnant women in the third trimester met the inclusion criteria, which was pregnant women in the third trimester who had their pregnancy checked at the Puskesmas Tegalrejo Yogyakarta. The research tool used was a data collection sheet. Data was analyzed in proportion and percentage then using Chi Square analysis to get the correlational value (p0.05). Odds Ratio for Cohort value toward anemic status also was analyzed. The incidence rate of anemia (Hb 11gr%) occurred in 44 (20.8%) mothers aged 20 years and 35 years, 58 (27.4%) mothers with gestational age 37 weeks, 137 (64.6%) mothers with 4 parity, with a pregnancy interval of 24 months from the last child, as many as 141 (66.5%) mothers and 110 (51.9%) mothers with nutritional status based on upper arm circumference 23.5cm. These factors are considered risk factors for causing anemia in pregnant women. Correlation test using Chi Square is known to show p 0.05 for all variables. The highest risk for Anemic Incidence was known to be indicated by the Pregnancy Interval factor, 24 months (p 0.001; OR 9,512) followed by parity 4 (p 0.001; OR 6,679).

RISIKO FAKTOR IBU TERHADAP KEJADIAN STUNTING

Background: Stunting is one of the nutritional problems experienced by todders in the world today. According to RISKESDAS data in 2018, the incidence of stunting in indonesia wasa 29,9%. in west java 29,9%, in Sumedang regency 41,08%, and in the Jatinangor Puskesmas working area in 2019 there were 381 stunting children.Purpose: The purpose of this study is to analyze the relationship between maternal risk factors and the incidence of stunting in the working area of the Jatinangor Comunity Health Center. Methods: This research is a quantitative study with an analytical research design with a case control approach. The cases in this study werw children with stunting and control, namely children who were not stunting. Sampling was carried out by proportional stratified random sampling for stunting infants and for non-stunting samples according to stunting infants ( 1:1) with a samples size of 154 respondents. Data was collected by measuring the height of children under five, filling in the questionnare and looking at the history of anemia during pregnancy in the chi-square test. Results: The results showed that maternal factors such as: mother's age, mother's education, how many children, history of exclusive breastfeeding, history of anemia during pregnancy obtained p value> 0.05 which indicates there is no relationship and there is no significant risk and maternal factors such as work. obtained p value <0.05 which indicates there is a relationship and there is a large risk, namely 2.6 times compared to mothers who do not work.Conclusion: There is no significant relationship and risk between maternal age, mother’s education, how many children, history of exclusive breastfeeding, history of anemia in pregnant women, the incidence pf p>0,05 for each variable, and there is a relationship between maternal work and the incidence of stunting with p<0,05 (p=0,009<0,005) and there is a risk of stunting in working mothers with 2,6 times compared to mothers who do not work.Suggestion: Future researchers are expected to be able to further examine what types of mother's work can affect stunting and examine more deeply about who the child's parenting pattern is assigned to and the last education of the caregiver of the child, not only the last education of the mother. Keywords: risk factors, stunting, toddlers ABSTRAK Latar Belakang: Kejadian balita pendek atau sering disebut sebagai stunting merupakan salah satu masalah gizi yang dialami oleh balita di dunia saat ini. Menurut data Riset Kesehatan Dasar (Riskesdas) 2018 angka kejadian stunting di Indonesia terdapat 29,9%.1 Di Jawa Barat 29,9%, di Kabupaten Sumedang angkanya masih cukup tinggi yaitu sebesar 41,08%, dan berdasarkan data yang didapatkan di Kecamatan Jatinangor wilayah kerja Puskesmas pada tahun 2019 terdapat 381 balita stunting.Tujuan: Menganalisis hubungan antara faktor risiko ibu dengan kejadian stunting di wilayah kerja Puskesmas Jatinangor Kabupaten Sumedang.Metode: Penelitian ini merupakan penelitian kuantitatif dengan desain penelitian analitik dengan pendekatan kasus kontrol. Kasus dalam penelitian ini yaitu balita stunting dan kontrol yaitu balita non stunting. Sebanyak total 154 sampel yaitu 77 balita stunting dan 77 balita non stunting. Pengambilan sampel dilakukan dengan proportional stratified random sampling untuk balita stunting dan untuk sampel non stunting menyesuaikan dari balita stunting (1:1). Pengumpulan data dilakukan dengan melakukan pengukuran tinggi badan balita, mengisi lembar pertanyaan serta melihat riwayat anemia ibu saat hamil dibuku KIA. Analisis data bivariat menggunakan uji chi-square.Hasil: Hasil penelitian menunjukkan bahwa faktor ibu seperti: usia ibu, pendidikan ibu, anak keberapa, riwayat ASI ekslusif, riwayat anemia pada ibu saat hamil memperoleh nilai p > 0,05 yang menunjukkan tidak terdapat hubungan dan tidak terdapat risiko yang signifikan dan faktor ibu seperti pekerjaan didapatkan nilai p < 0,05 yang menunjukkan terdapat hubungan dan terdapat besar risiko yaitu 2,6 kali dibanding ibu yag tidak bekerja.Kesimpulan: Tidak terdapat hubungan dan risiko yang signifikan antara usia ibu, pendidikan ibu, anak keberapa, riwayat ASI eksklusif, riwayat anemia pada ibu hamil terhadap kejadian dengan diperoleh nilai p > 0,05 dari masing-masing varibel, dan terdapat hubungan antara pekerjaan ibu terhadap kejadian stunting dengan nilai p < 0,05 (p=0,009<0,05) serta terdapat risiko kejadian stunting pada ibu bekerja 2,6 kali dibanding ibu yang tidak bekerja.Saran: Peneliti selanjutnya diharapkan dapat meneliti lebih lanjut mengenai jenis pekerjaan ibu seperti apa yang dapat mempengaruhi stunting dan mengkaji lebih mendalam mengenai pola asuh anak diserahkan kepada siapa dan pendidikan terakhir pengasuh dari anak tersebut, bukan hanya pendidikan terakhir dari ibunya. Kata Kunci : faktor risiko, stunting, balita

“Anemia during Pregnancy and Its Prevalence”

Anemia is a serious health issue throughout the world affecting both sexes of any age group. This nutritional disease is more common among the pregnant women of developing countries, where it is a major cause of maternal death and negative outcome of pregnancy. Among all anemic types, IDA is most prevalent one and is comprises of about 95% of all anemic cases around the world. In many developing countries it is more common in women of low socio-economic background and with no record of antenatal checkup. There is need for further health educational programs to overcome anemia especially for pregnant females.