Blastocystosis And Iron Deficiency Anemia in Pregnant Women. A Call to Deep in A Little-Known Association

During the last twenty-five years, in parallel with the demonstration of a rapid increase of the global prevalence of blastocystosis, it has been documented the association between this parasitic infection and iron deficiency anemia in general population. More recently, it has been evidenced the high prevalence of blastocystosis in pregnant women and its association with iron deficiency anemia. Herein, we revise the most recent progress in the understanding of this association, the possible mechanisms that support it, including the Blastocystis subtypes involved, and its clinical consequences and public health significance. Taken in consideration the adverse impacts of anemia on the health of mothers and progeny, an adequate prevention and control of this parasitism during pregnancy may be mandatory. At the same time, and looking the problem from a more holistic multi-diseasebased perspective, the current initiatives to improve the prevention and control of intestinal parasitism in endemic areas may include in their communication strategies actions to inform, both at academic and community levels, about the possible adverse effects of blastocystosis on pregnancy evolution.

Cerclage for the Management of Cervical Insufficiency: A Review

Cervical insufficiency (CI) is classically characterized as painless dilation of the uterine cervix in the second trimester that results in delivery of the pregnancy, typically prior to 24 weeks’ gestation. Treatment of the condition has centered on prevention of recurrence in women with a history of CI or early preterm birth. Universal screening tools for CI in women without a history of prior PTB are lacking. Cervical change that is painless may occur with minimal symptoms such as increasing of vaginal discharge/mucous, vaginal pressure or fullness; many women and their providers can dismiss pathologic symptoms that would otherwise be benign in women without CI. The management of CI is categorized as surgical vs. nonsurgical. The cornerstone of surgical management is composed of cervical cerclage, and may be placed by a transvaginal or transabdominal approach depending on the obstetric history. Nonsurgical management includes pessary or activity restriction. For women who have experienced a midtrimester loss due to suspected cervical insufficiency, postnatal or preconception consultation is essential to identify modifiable risk factors, collect medical records of the delivery, and review pathology results if available.

Complications Associated With a Monocorial Twin Pregnancy Monoamniotic.

A case report of a monoamniotic monochorionic twin pregnancy is presented and a literature review of its associated complications is carried out. A literature search was carried out in databases such as Medline / Pubmed, selecting articles published in Spanish and English during the period from January 1990 to May 2013. The terms “twins”, “monozygotic twins”, “ multiple pregnancy”, “twin pregnancy”. Review articles and cross-sectional studies were included. Monoamniotic monochorial twin gestation is a rare event. This condition is associated with multiple obstetric complications including fetal death related to umbilical cord accidents (crossovers). The objective of prenatal care is the prevention of fetal mortality, so continuous testing of fetal well-being is suggested. Termination of pregnancy in the 34th week of gestation by caesarean section, after administration of steroids, has been proposed.

Impact of Preeclampsia onPlatelet Count and Platelet Indices among Sudanese Pregnant Women in Gezira State

Background: Preeclampsia is considered one of the major health problems is associated with pregnancy and one of the causes of maternal mortality. The pathogenesis of preeclampsia associated with platelets activation. Objectives: The aim of this study was to evaluate the platelets parameters (platelet count and platelet indices) in pregnant women with preeclampsia. Methodology: This is a case-control laboratory-basedstudy carried out in Wad Medani Obstetrics and Gynecology Teaching Hospital, Gezira State, Sudan from January to November 2020. A total of 50 pregnant women with preeclampsia as cases (32.20 ± 3.21 years) and 50 normotensive pregnant women as controls (30.68 ± 2.85 years)participated in this study. Three ml of venous blood samples were collected from all participants in K3 EDTA containers. platelets parameters (platelet count and platelet indices) were determined using Mindray BC 3000 Automated Hematology Analyzer. Data were analyzed usingthe SPSS computer program (version 22). Results: The study results showed that the thrombocytopenia account for 56 %, all cases with low PCT (100%). Furthermore, the means of PLTs count, PCT and PDW in cases were (144.40 ± 31.80 × 109/L, 0.13 ± 0.03 % and 15.80 ± 0.45 fl respectively) versus controls (269.40 ± 72.50 × 109/L, 0.22 ± 0.05 % and 15.50 ± 0.29 fl respectively), giving statistically significant differences (P value = 0.000, 0.003 and 0.022 respectively). The mean of PCT of mild cases was lower than severe cases (P value = 0.004); but there were no significant differences in PLTs count, MPV and PDW (P value = 0.379, 0.283 and 0.075 respectively). Conclusion: The study concluded that platelet count (PLTs count) and plateletcrit (PCT) were significantly decreased in pregnant women with preeclampsia especially, so, platelets parameters especially (PLTs count and PCT) should beincluded for assessing and predictingthe risk of severe preeclampsia.

Propofol as Inducing Agent of Elective Cesarean

Propofol as an inducing agent in selective caesarean section is considered one of the most effective methods to carry out the surgical procedure without any type of complication, however, studies have shown that anesthetics such as Thiopental produce similar effects, therefore A bibliographic review and a brief comparison with this drug are carried out in order to determine the effectiveness and efficacy of both, and their effects on the mother and the newborn.

Perception of Pain Management Among Nurses: A Study at Enchi Government Hospital

The subjective nature of pain makes it difficult to manage, especially when your healthcare personnel (mostly nurse) does not have requisite knowledge on pain management. Thus, the purpose of the study is to investigate the perception of pain management among nurses at Enchi Government Hospital. Descriptive cross-sectional study design with quantitative approach and convenient sampling method was used in conducting the study. Standard closed ended questionnaire was used to elicit responses from registered nurses at the Enchi Government Hospital. The study revealed that out of the total 150 respondents, 75.1% (112) of the total respondents’ responses depicted good perception on pain management, 76.7% (115) showed good knowledge on pain management and 51.4% (77) revealed good attitude towards pain management. In conclusion, majority of nurses at Enchi Government Hospital have good perception, good knowledge and good attitude towards pain management with others being at deficit. It is recommended that more studies are conducted on this subject concerning the topic of this study, other pertinent topics on pain management, in-service training conducted periodically and also implemented in curriculum for nursing education in Ghana.

Evaluation of Gynecologist’s and Patient’s Experience, Anxiety and Pain Perception During Intrauterine Device Insertion Containing Levonorgestrel ELA 52 Study

Objective: To characterize patient’s and obstetricians-gynecologist’s (ob-gyns) experience in insertion of a 52 mg levonorgestrel‐ releasing intrauterine device (LNG-IUD). Materials and Methods: A non-interventional, prospective and multicentric study was conducted in 583 patient of reproductive age who had insertion of Levosert® following routine clinical practice. Questionnaires were used to collect information on obgyns’ and patient’s experiences associated with IUD insertion. Pain and anxiety were rated, and possible predictors such as age, parity were evaluated. Results: Before IUD insertion, 50.8% of the participants felt minimal anxiousness and 44.9% predicted moderate pain. Twohundred and sixteen (37.0%) patient reported mild pain with insertion and 227 (38.9%) reported moderate pain. Ob-gyns were aware of the patient’s insertion pain experience and 84.2% considered LNG-IUD insertion “Easy” or “Very Easy”. The vast majority of patient (88.2%) were also “Satisfied” or “Very Satisfied” with LNG-IUD insertion, considering the procedure less or at least equally painful as they expected. Conclusions: Given the strong link between anxiety and expected pain and the lack pain management strategies effectiveness, the implementation of interventions that may mitigate both anxiety and pain during IUD insertion are crucial. LNG-IUD is associated with high satisfaction rates by patient and considered easy to apply by ob-gyns.

Health Dynamics Through Psychometric Networks in Gynecology, Obstetrics, Reproductive Health And COVID-19 Research

Network analysis offers a valuable methodological and practical contribution to research in gynecology, obstetrics and reproductive health. This analysis enables clinicians to interpret and translate the information derived from their research into better integrated care in the clinical population of interest, allowing them to focus a concrete intervention based on network results, from the perspective of complex model systems. The evaluation of the network reinforces a better explanation of the functioning of various reproductive and maternal health conditions to explain how their etiological mechanisms and concomitant variables interact with each other, of major clinical importance in the current COVID-19 pandemic context.

Acceptability of COVID-19 Vaccines in an International Sample of Pregnant Women

Background: There has been an unprecedented global effort to produce safe and effective vaccines for COVID-19. In less than a year, several pharmaceutical companies and research organizations have developed vaccines that effectively bring about an immune response. However, COVID-19 vaccines have not been accepted by a large percentage of the general population, especially among those excluded from the clinical trials of potential vaccines, such as pregnant women. The current study was aimed to identify predictors of vaccine acceptance in an international sample of pregnant women. Methods: In 2020, data were collected from pregnant women via an anonymous, online, cross-sectional survey. The survey was hosted on the Pregistry platform for COVID-19 studies and was advertised through a variety of social media platforms and parenting forums in 16 countries. Data related to demographics and likelihood of accepting a COVID-19 vaccine were collected. Results: In total, 5,356 women were included in the study. Vaccine acceptance increased as perceived vaccine efficacy increased. If the vaccine was found to be 90% effective, 30% of our sample indicated that they would be ‘very likely’ to get vaccinated, 11% ‘fairly likely’ and 12% ‘somewhat likely’. Ten percent of respondents felt that they were ‘very well informed’ about COVID-19 vaccines, while 8% were ‘very confident’ that these vaccines are safe and/or effective. Over 50% held the opinion that vaccination was ‘very important’ for their country and that the majority of the population should be vaccinated. In a multivariate model, being a college graduate (odds ratio [OR]: 1.20, 95% confidence interval [CI]: 1.07-1.35), >30 years of age (OR: 1.11, CI: 1.00-1.23), and residing in Africa (OR: 2.37, CI: 1.52-3.73), Asia (OR: 3.63, CI: 2.96-4.48), Europe (OR: 1.17, CI: 1.03-1.33), and South America (OR: 2.22, CI: 1.92-2.58) were associated with increased vaccine acceptance. White Hispanic, Asian, Black/ Black Hispanic, and Hispanic participants had increased odds of accepting the vaccine compared with those who self-identified as White; however, when stratified by region, this increase only held in North America for Hispanic participants. Conclusion: Only half of our international sample of pregnant women indicated that they would be ‘somewhat likely’, ‘fairly likely’, or ‘very likely’ to get vaccinated against COVID-19. Acceptance differed by region, race and ethnicity, age, and education. This fairly low acceptance suggests a need for public health campaigns that can increase confidence among pregnant women.

Impact of COVID-19 On the Development of Premature Labor

Background: According to the literature described, the perinatal results of maternal viral infections during pregnancy could lead to different obstetric complications; pregnant women have a higher risk of morbidity and mortality due to physiological changes in their immune system and cardiopulmonary system. has associated pneumonia in pregnant women with premature rupture of membranes before labor, preterm labor, fetal growth restriction, fetal death, and neonatal death. Methodology: A narrative review was carried out in which databases such as pubmed, science direct, scielo, academic google, among others, were used to search for articles, these were taken from indexed journals in first and second languages. The keywords DECS and MeSH, COVID-19, SARS-CoV-2, preterm birth and complications were used. Results: It’s no secret that women who are pregnant due to the same condition are at higher risk of severe illness and death from COVID-19 compared to non-pregnant women of reproductive age, and are at risk of adverse pregnancy outcomes, such as preterm delivery. Studies report that most cases of prematurity are secondary to respiratory complications and are done in order to preserve maternal health.