"Excuse me ma'am, but do you know how I can find a methadone clinic where I can get care around here? I recently moved here from another state and I haven't had my methadone in 4 days." The past two days had been consumed by trying to coordinate care for the pregnant patient we discharged from labor and delivery. She presented to labor and delivery in a northeast state to rule out preterm labor, with a history of six previous preterm deliveries. We learned that she was on methadone maintenance and had not had her dose for 4 days. We gave her methadone, her contractions stopped and she was ruled out for labor. The problem of access to methadone as an outpatient became apparent. Since she was new to the state she had no established care (prenatal or substance use) here and none of the Obstetrician and Gynecologist (OBGYN) staff had experience managing pregnant patients in recovery from opioid use disorder.
Preeclampsia, which afflicts 3-5% of pregnancies worldwide, has recently being recognized to be a cardio-renal syndrome, in which neurologic complications contribute to the morbidity and mortality of this syndrome. The precise pathogenesis of preeclampsia, itself, is not definitely elucidated, but an imbalance of angiogenic & anti-angiogenic factors appear at play. The acute neurologic complications of preeclampsia such as seizures, cerebral edema, stroke, and posterior reversible leukoencephalopathy syndrome (PRES) are the leading contributors to obstetric mortality and morbidity in many low to middle and some high income countries. In addition to these acute devastating complications, registry and other long-term data, over recent decades now reveal that chronic neurologic & cardiovascular complications in the mothers as well as the offspring of preeclamptic pregnancies also contribute to future morbidity. In this review, we evaluate putative biophysical mechanisms of these cardio-renal and neurologic complications in both mother & child, as well as clinical implications of these new findings. We outline a rational monitoring strategy for these late complications in preeclamptic mothers & children born from preeclamptic pregnancies. Preventive strategies, encompassing aspirin, calcium-vitamin D supplementation, exercise, pravastatin, and metformin, offer insights into mitigating preeclampsia risks. Active management, balancing antihypertensives and planned delivery, appears to yield positive outcomes. Future pathways emphasize advancements in pathogenesis research, early predictive biomarkers, personalized therapeutic approaches, and global health initiatives. The role of wearable devices, telemedicine, and continuous monitoring in maternal-fetal health surveillance is paramount. Specific attention to unraveling neurological complications and establishing long-term follow-up programs is crucial for comprehensive care.
Preeclampsia (PE) is a common pregnancy-related hypertensive disorder and is a leading cause of maternal and perinatal morbidity and mortality. The incidence of PE and its associated health care costs have been increasing in the United States over the past three decades. Pregnancies complicated by PE put both the mother and child at increased risk for chronic illnesses such as cardiovascular disease, cerebrovascular disease, and cognitive impairment later in life. To date, there is no effective treatment for PE and the etiology of PE is largely unknown. While human epidemiological studies have established an association between various genetic factors and PE, a causative link between genes associated with PE and PE development has been difficult to establish. Human studies have shown that variants in eNOS (endothelial nitric oxide synthase, also known as NOS3) gene are associated with PE, and animal experimental studies have provided evidence to show the potential functional connection between the eNOS gene and PE. Here we review several studies that investigated the role of eNOS in PE, as well as studies that described how manipulating the eNOS/NO pathway could aid in disease intervention.
Background: Self-medication with conventional and/or herbal medicines is an important public health concern, especially to a delicate group of pregnant women due to its harmful and potential risks to mother and foetus. Awareness to its detrimental effects is influenced by social demographic factors and is highly related to its practice. This study determined the general knowledge, practice and common factors for self-medication among pregnant women attending antenatal clinic at Sengerema designated district hospital. Method: A hospital based descriptive cross-sectional study was conducted using a semi structured questionnaire in which a sample of 381 pregnant women on their first trimester of pregnancy was enrolled through convenient sampling. Data were analysed using STATA version 13 (TX: StataCorp LLC). Continuous variables were presented as frequencies, percentages and proportions while categorical variables were presented in charts, graphs and figures. Logistic regression analysis was performed to determine the factors associated with self medications. Results: The overall proportion of self-medication practice was found to be 289(75.9%) whereby 146(38.3%) and 143(37.5%) did self-medication with conventional and herbal medicines respectively. Prior experience with the medicine and better knowledge on disease and treatment were common reasons for self medication reported by 178(61.6%) and 152(52.6%) pregnant women respectively. On the other hand, Malaria, headache and morning sickness (nausea and vomiting) were the leading ailments treated by self-medication as reported by 93(32.2%), 72(24.9%) and 68(23.5%) proportions of women respectively. Marital status, occupation, Level of education, parity was significantly associated with self-medication with conventional medicines (p-value < 0.01) while residence, occupation and level of education were associated with self-medication with herbal medicines Journal of Pregnancy and Child Health Katabalo DM, et al. J Preg Child Health 5: 119. www.doi.org/10.29011/JPCH-119.100019 www.gavinpublishers.com Citation: Katabalo DM, Robert DN, Mwita S, Minja WV, Abbas S, et al. (2022) Self-Medication during First Trimester Among Pregnant Women Attending Antenatal Care Clinic at a District Hospital in Mwanza, North-western Tanzania. J Preg Child Health 5: 119. DOI: 10.29011/JPCH-119.100019 2 Volume 05; Issue 01 (p-value <0.01). Furthermore this study found that participants had no adequate knowledge on the medication they were using as well as harmful effects of self-medication during first trimester of pregnancy. Conclusion: The practice of self-medication during first trimester was highly common among women attending district hospital. Majority of them had no adequate knowledge on the detrimental effects of this practice posing a potential risk to them and to the foetus they are carrying.
The diagnostic criteria of GDM used in the province of Trento are those of the International Association of Diabetes and Pregnancy Study Group (IADPSG). The pregnancy monitoring data are recorded in the Childbirth Assistance Certificate (CedAP), a mandatory document in Italy for monitoring pregnancy, childbirth and the health of the newborn and to be completed by the midwife who assisted the birth. Based on the data recorded in the CedAP, the trend in the prevalence of GDM over time was retrospectively analyzed, on all pregnant women, on pregnant women of Italian and foreign citizenship. The prevalence of GDM was also analyzed in relation to the age group and educational level of pregnant women.
Objective: To evaluate the effect of abnormal Umbilical artery Doppler and Cerebro-placental ratio on perinatal outcome in pregnant women between 28-40 weeks of gestation. Methods: It’s a prospective observational study of 139 pregnant women with abnormal umbilical artery Doppler and cerebroplacental ratio from 28-40wks excluding all medical diseases. Doppler was considered abnormal when pulsatality Index (PI) > 95th percentile for gestational age and when Cerebro-placental Ratio is less than 1.08. Results: Abnormal Doppler results are grouped into 3 groups, AEDF (absent end diastolic factor), REDF (reverse end diastolic factor), CPR (cerebro-placental ratio) <1. In AEDF, REDF, CPR groups, respiratory distress syndrome (RDS) was noted in73%, 95%, 37%. Low Apgar (score less than 7), was 4.5%, 35%, 3.1%.FGR was noted in 37%, 81%, 15%. Birth weight < 2.5kg as seen in 32%, 45% whereas in REDF group 95% of babies were <2kg.Sepsis were noted more in REDF 70% whereas none in CPR group. Meconium stained amniotic fluid seen in 13%, 10% and none in CPR group. All babies required NICU stay more than 7 days in REDFcompared to other groups. Perinatal mortality was highest in the REDF (15 %) compared to AEDF (2.29 %) and CPR <1.08 (Zero) [p <0.001]. Conclusion: Abnormal umbilical artery Doppler along with CPR <1 is associated with substantial risk of adverse perinatal outcomes. Abnormal CPR and AEDF are not the indications for immediate delivery. Using Dopplers of other vessels like ductus venosus with UAAEDF could help in deciding the time of delivery and reduce the adverse perinatal outcome.
Introduction: Pre-Pregnancy Diabetes (PPD) affects 03-05/100 and Gestational Diabetes (GDM) affects 7/100 pregnancies. The prevalence estimates show, for both conditions, a wide range of variability in relation to the characteristics of the populations and the diagnostic criteria used. In recent years there has been a significant increase in pregnancies in women with both type 1 and type 2 PPD. Similar increases are also reported for the GDM. The study reports the trend of the prevalence of PPD and GDM in pregnant women assisted at the maternity units of the province of Trento (North East Italy) from 2012 to 2019. Material and Methods: The criteria for monitoring blood glucose during pregnancy are based on the recommendations by the International Association of Diabetes and Pregnancy Study Groups. The glycemic monitoring data are recorded in the province of Trento, on the personal obstetric guide of each pregnant woman, which is updated on the occasion of periodic checks and therefore in all pregnant women on the occasion of registration of data in the Birth Attendance Certificate (BAC) on a specific computer support operating at each maternity unit. The cases recorded in the BAC were compared with those collected by the provincial register of type 1 diabetes mellitus and with the hospital discharge archive. Based on the integrated data, the birth cohorts 2012-2019 were retrospectively analyzed. The temporal trend of the prevalence of PPD and GDM was calculated, considering the citizenship, the age group and the educational qualification of the pregnant women. Prevalence estimates are provided by 95% confidence intervals Results: Between 01.01.2012 and 12.31.2019, 33,577 pregnant women received care at hospital maternity units of the province of Trento. 158 cases of PPD (20 cases per year) and 1,950 cases of GDM (244 cases per year) were recorded. 1 case of GDM and one case of PDD had escaped the BAC. The mean period prevalence for PPD in all pregnant women is 0.44/100 (95% CI 0.37-0.50), in Italian women is 0.39/100 (95% CI 0, 31-0.46) while in foreign women it is 0.57/100 (95% CI 0.42-0.72). The average period prevalence of GDM for all pregnant women is 5.5/100 (95% CI 5.27-7.73), in Italian women is 4.3/100 (95% CI 4.064.54), while in foreign women it is 8.8/100 (95% CI 8.23-9.37). The prevalence of PPD overall shows a slight increase over time, this appears substantially stable in the Italians and increasing in the foreigners. In the case of the GDM, there is an increase over time in both population groups, greater in foreigners than in Italians. The prevalence of PPD and GDM in foreign women is higher than in Italian women. Women coming from African and Asian countries show the highest values. The prevalence of PPD and GDM grows linearly with age and with the reduction in the level of education of women. Discussion: The information flow of the BAC, as organized in the province of Trento, can be considered a reliable source in the recovery and registration of the frequency of PPD and GDM. The prevalence estimates of PPD and GDM reported in the present study increase over the course of subsequent birth cohorts, in agreement with what is reported in the international literature. Overall, for both forms of diabetes, we report in the period under study a prevalence of about 6/100 pregnancies. The increase of prevalence according to the birth cohorts is evident above all in foreigners. Foreign women, especially from Asia and Africa and women with childbirth age over 35, and with low educational qualifications represent a significant share of PPD and GDM cases and therefore of subpopulations at greater risk to be considered as a priority in public health action. Citation: Piffer S, Rizzello R, Massimo O, Francesca Z (2021) Prevalence of Pre-Pregnancy and Gestational Diabetes in the Province of Trento-North Italy: Trend 20122019. J Preg Child Health 04: 117. DOI: 10.29011/JPCH-117.100017 2 Volume 04; Issue 01
Background: Unintended pregnancy is a potential hazard for every sexually active woman as it poses a serious threat to the health and well-being of families globally. Information on Tanzanian women who conceive unintentionally is rarely documented. Understanding the extent of unintended pregnancy and the factors associated is crucial to devise evidence-based interventions. This study aimed to determine prevalence of and factors associated with unintended pregnancy Methods: This was a hospital-based cross-sectional study. A total of 300 pregnant women were recruited through random sampling and questionnaires were pre-tested and administered. Multiple logistic regression analysis was performed using SPSS version 20 software to identify the factors associated with an unintended pregnancy. Results: The overall prevalence of unintended pregnancy was found to be 73 (24.3%) and those who wanted it at a later time and not at all accounted for 143 (47.7%) and 227 (75.7%) respectively. The prevalence of unintended pregnancies decreased with the use of emergency contraceptives and being married. However, it increases in lower age 15 to 20 years 67.3% (99/147) at first pregnancy, those who have high parity 54.5% (12/22), divorced 57.1% (4/7) and not married 62.7% (37/59). The prevalence was independent of the use of modern contraceptives, the number of sexual partners, and the level of education of the mother. Conclusion: Unintended pregnancy is one of the major reproductive health problems since approximately over a quarter (24.3%) of the pregnant women attending ANC had unintended pregnancy experience. There is a need to inaugurate a community-based program through increasing knowledge of family planning by designing strategic policy programs aimed at creating more sensitization on reducing the unintended pregnancy reflecting those with young age, high parity, and not married.
Introduction: Evidence suggests that health care providers habitually fail to provide respectful maternity care during facilitybased delivery. This study explored the relationship between disrespect and abuse experienced by women during child birth and postpartum depression. Methods: This was a cross-sectional study targeting women attending postnatal services within 28 days of delivery preceding the survey. A random sample of 306 women from 20 health facilities were selected and interviewed. Self-reported disrespect and abuse included physical abuse, non-consented care, non-confidential care, verbal abuse, and discrimination based on specific attributes. The Edinburgh Postnatal Depression Scale (EPDS) was used to assess postpartum depression. Results: Findings reveal that 13% and 12% of the women had mild and severe symptoms of emotional distress respectively. One third (33%) experienced at least one form of disrespect and abuse. Further, the risk of having severe emotional distress symptoms was; (RRR=2.52, 95%CI: 1.256 5.057); (RRR=1.90, 90%CI: 0.905 3.985); (RRR=2.23, 90%CI: 0.874 5.669); (RRR=2.32, 95%CI: 1.146 4.692) and (RRR=4.41, 99%CI: 1.769 10.980) times higher for women who experienced; Physical abuse; Non-confidential care; Non-dignified care; Abandonment or denial of care; and Detention in facilities respectively. Similarly, the risk of having mild emotional distress was (RRR=2.44, 95%CI: 1.201 4.939) and (RRR=2.34, 95%CI: 1.176 4.672) times higher for women who experienced; Non-confidential care and Abandonment or denial of care respectively. Conclusion: Disrespect and abuse during Labour and delivery have potential of crafting adverse health outcomes such as postpartum depression hence negative child birth experiences defile the fundamentals for healthy motherhood. Recommendation: There is need to address the various forms of disrespect and abuse in order to ensure respectful maternity care and elude the potential adverse outcomes of postpartum depression. Postnatal services should incorporate critical assessment of signs of mental illness among women for early intervention. Citation: Nyirenda HT, Mubita B, Choka N, Mulenga D, Kapesha R, et al. (2020) Postpartum Depression among Postnatal Women as a Result of Disrespect and Abuse During Labour and Delivery. J Preg Child Health 03: 109. DOI: 10.29011/JPCH-109.100009 2 Volume 03; Issue 0
Background: Prenatal care is one of the recommended interventions globally to improve maternal and neonatal outcomes. In most Sub-Saharan African countries, high rates of poor pregnancy outcomes coexist with high Antenatal (ANC) coverage rates. Therefore, in order to understand this inconsistency, this study was designed to explore the association between adequacy of prenatal care received and low birth weight in Ndola and Kitwe, Zambia. Method: A cross sectional study on 384 women and their babies was conducted in Ndola and Kitwe based health facilities. Adequacy of prenatal care was evaluated according to the seven parameters defined by the Zambian Ministry of Health in the Program for Maternal and Child Health: 1. Obstetric history 2. Intermitted Presumptive Treatment of Malaria 3. Nutritional supplements (folic acid/iron) 4. Tetanus toxoid vaccination 5. Deworming 6. Health Education and 7. Screening tests. Data was analysed using Stata version 13.1; low birth weight and adequacy of prenatal care were described. Associations between adequacy of prenatal care and low birth weight were calculated and statistical significance was set at 5%. Results: A low birth weight of 13.5% was found in the study population. The most received screening test was abdominal pelvic scan (84.9%) and the least was the blood group (19.5%) and Rhesus factor (18.0%). On average, women received 60.9% of the ANC screening tests. Based on our classification, only 2.9% of the participants received adequate content of prenatal care. Only slightly above a quarter (25.8%) of women started their ANC visit in the first trimester. The study demonstrated a statistically significant association (p value 0.001) between basic screening tests and timing of prenatal care initiation. Similarly, a statistically significant association (p value 0.001) between essential screening tests and timing of prenatal care initiation was observed. Receiving essential screening tests was statistically significantly associated (p value 0.025) with low birth weight and no association observed between prenatal care and low birth weight. Conclusion: Evaluating the adequacy of prenatal care received by mothers using appropriate classification tools is an efficient means of identifying deficiencies in the provision of preventive services to women during pregnancy. The findings in Kitwe and Ndola, Zambia indicate that mothers who initiated prenatal care in the first trimester were more likely to receive all the screening tests compared to those that started in subsequent trimesters. Therefore, interventions to improve quality of prenatal care should target timing of ANC initiation and factors related to the availability and accessibility to screening tests during pregnancy. Citation: Mulenga D, Nyirenda T, Nyirenda HT, Mobegi D, Mubita B, et al. (2020) Adequacy of Prenatal Care and its Association with Low Birth Weight in Ndola and Kitwe, Zambia. J Preg Child Health 03: 108. DOI: 10.29011/JPCH-108.100008 2 Volume 03; Issue 01
Introduction: The ARRIVE study found that induction of labor decreased the rates for cesarean section and was not associated with adverse neonatal outcomes. However, it is unclear if their study results are generalizable. Here, we aimed to analyze the perinatal and maternal outcomes of women undergoing elective induction of labor versus expectant management at a single center tertiary hospital. Methods: We retrospectively investigated outcomes in 188 low risk nulliparous women who either underwent labor induction (n=66) or had spontaneous labor (n=122). Results: There were no statistically significant outcomes between the two groups as it relates to the mother and neonate. The rate of cesarean delivery was 20% in the induction group versus 16% in the active labor group (p = 0.713). The woman who underwent induction had a relatively higher risk for morbidity including third degree laceration (p = 0.329), hypertensive disorders of pregnancy (p = 0.246), chorioamnionitis (p = 0.828), hemorrhage (p = 0.586) and infection (p = 0.586). Women in the induction group also spent more time in the labor (p < 0.001). Neonates in the induction group did have a relatively higher risk for meconium aspiration syndrome (p = 0.246), requiring respiratory support within 72 hours (p = 0.398), hyperbilirubinemia requiring phototherapy (p = 1.00), and shoulder dystocia (p = 0.732). Conclusions: We provide evidence of higher rate of maternal and neonatal morbidity in women undergoing inductions, although not statistically significant. Thus, providers should have an informed discussion when deciding timing of delivery.
Background: To determine the perinatal outcome in patients attending Joint obstetric and diabetic clinic who had diabetes and one previous caesarean section.Methods: A prospective service evaluation was conducted in a secondary care hospital having approximately 5100 deliveries per year. The combined cesarean section rate during the study period for all pregnant women and for all diabetic patients were 31% and 60%, respectively. Patients attending joint obstetric diabetic clinic from July 2015 to July 2016 were considered for the study. Fifty five (55) patients with both pregestational diabetes and gestational diabetes requiring pharmacotherapy and one previous caesarean, out of 358 patients who attended the clinic, were identified. The perinatal care, including timing, mode of delivery and indication for Cesarean section, maternal and neonatal outcomes were studied.Results: Out of 55 women, 8 (15%) had type 2 diabetes mellitus and 47 (85%) had gestational diabetes mellitus requiring pharmacotherapy. Initially, during antenatal follow up, 23 women (41%) were planned for vaginal birth after caesarean and 32(59%) were planned for elective cesarean section. Seven (7) women (13%) had a successful vaginal birth after cesarean section. These women had no additional risk factors and delivery was uneventful. Forty eight (48) women (87%) had cesarean section (elective, 60% and emergency, 27%). Eleven (75%) out of these 15 emergency cesarean section patients had additional risk factors that contributed to the decision for cesarean section. Most of the maternal complications 13/55 (23%) were in the cesarean section group and the majority were from emergency cesarean section group. Fifteen out of the fifty five cases (27%) were due to intra-uterine growth restriction, preeclampsia, eclampsia, abruption and postpartum hemorrhage. Similarly in all neonatal complications 14/55 (25%) were from the Cesarean section group (2 cases of small for gestational age, 6 cases of respiratory distress syndrome, 6 cases of Large for date). Among the 8 type 2 diabetes mellitus patients, 7 delivered by Cesarean section (4 emergencies and 3 elective) and only one had a successful vaginal birth after cesarean section. All 4 of the emergency Cesarean cases had additional risk factors.Conclusion: We found an exceptionally high caesarean section rate of 87% in our study which is almost twice as high as was found in the general diabetic pregnant population from other studies. Our study is the first of its kind to determine the cesarean section rate and perinatal outcome in combined pregestational and gestational diabetic patients requiring medical treatment and with one prior cesarean section. This study highlights the need for multi-centered studies to determine the optimal cesarean section rate that affords the lowest perinatal and maternal morbidity and mortality and also on how to modify these confounding factors so as to decrease the high caesarean section rate amongst this high risk group of patients.
Objective: This scientific research work aims to assess the knowledge, attitudes and practices of systematic prophylaxis of rhesus alloimmunization during the third quarter of pregnancy in the city of Parakou during 2017.Materials and methods: It was a descriptive, cross-sectional and analytical study carried out from March 15 to June 15, 2017, among gynecologists, midwives and general practitioners, through implementation of pregnancy monitoring in Parakou.Results: The health care providers’ mean age was 38 ± 6.3 years. For 5.5% of cases, the health care providers interviewed had knowledge of the latest recommendations for clinical practices as far as prophylaxis of alloimmunization rhesus is concerned. 95.4% of health care providers did not approve the systematicity of prophylaxis because they considered that they did not have sufficient information’s to justify that practice. None of them prescribed systematically injection of 300 μg of anti-D immunoglobulin (Ig) between 27 and 29 weeks of amenorrhea to rhesus negative patients. And only 1.8% of them had indicated that prevention of rhesus alloimmunization is regulated by a referenced protocol in their health centers. Occupational category appeared to be a critical factor associated with health care providers’ knowledge and their approval of the systematic character of that injection during the third quarter of pregnancy (p<0.001).Conclusion: Health care providers have an insufficient or little knowledge of the latest Recommendations for clinical practices. They should benefit from Continuing Medical Education (CME) i.e. regular training courses in order to enhance their knowledge and professional skills. In addition, a national reference system should be put in place for systematic prophylaxis of Rhesus alloimmunization during the third quarter of pregnancy.
Background: Contraception is an effective mean of Family Planning (FP) and fertility control, promotes maternal and child health. It is interesting to explore the perception and use of contraceptives among Saudi women. So this study aims to determine the prevalence of contraceptives use (types), to study some determinants of the contraceptions used, to assess the availability and satisfaction of the family health planning services and to record their opinion about the current situation in KSA. This study will provide up-to-date situational analysis helping the health policymakers. Methodology: A cross-sectional study targeting 1215 Saudi women who fulfilling the inclusion criteria. A Multistage sampling technique was used to randomly select women from Primary Health Care Centers (PHCCs) all over the 20 health regions in KSA. Using a well-structured pretested questionnaire composed of four main parts to collect the data after an exempt IRP approval and informed written consent. The data analyzed using the appropriate tests using the Spss program version 22. Result: A wide age range (16-49 y) with the mean age of 37.5. The majority (56.7%) were university-educated or above, 93.1% were married. The prevalence of the current contraception use is 68.8%. The most common methods for contraception were OCP, IUD, coitus interruption and condom in order (42.1, 15.6, 7.8 and 5.7%) respectively. The main causes for using contraception is birth control 55.4%, don't want to get pregnant (31.2%) and medical causes (17.8%). The main sources used for contraception methods, were HCP, relatives, friends (38.2%, 36.5%, 21. 8%) and bought from pharmacies, private clinics and then private hospitals (54.8%, 20.2%, 18.5%). Conclusion: The contraceptive pills are the commonest contraceptive methods used among Saudi women. Appropriate strategies should be implemented to raise awareness and provide services.
Background: Postpartum Depression (PPD) is a common and critical complication for mothers after delivery. The present study aims to analyze the relationship between key exposures and the outcome of PPD in Nevada mothers.Methods: Data (n=3,579) was gathered through the 2015-2016 Nevada Baby Birth Evaluation and Assessment of Risk Survey (BEARS), response rate 31.1%. This study focused on whether mothers who were diagnosed with PPD had 1) a history of pre-pregnancy depression 2) experienced Intimate Partner Violence (IPV) 3) used cannabis and 4) had a home healthcare worker visit during pregnancy. Weighted multiple logistic regressions were conducted using SAS 9.4.Results: There are 8.84% (n=286) mothers who reported a PPD diagnosis since delivering their new baby. After adjusting simultaneously for all other factors, pre-pregnancy depression, intimate partner violence before and/or during pregnancy and home healthcare visitor remained significant with aORs of 11.11 (p-value ≤ 0.01, 95% CI=7.81, 15.81); 3.06 (p-value ≤ 0.01, 95% CI=1.35, 6.92) and 2.54 (p-value ≤ 0.01, 95% CI=1.40, 4.95) respectively.Conclusion: Mental and maternal healthcare must adjust care for mothers who report these exposures. PPD is a negative maternal health outcome and must be a prevention priority in public health.Overview: The present study will explore data on several key exposure factors relating to postpartum depression in Nevada mothers utilizing data collected from the 2015-2016 Baby Birth Evaluation and Assessment of Risk Survey (BEARS). Results from this study can be used to expand and improve upon current postpartum depression screening and treatment, in both prenatal and postpartum care settings.
Introduction: The purpose of this study was to investigate the influence of socio-demographic characteristics on use of Skilled Delivery Services (SDS) at health facilities by pregnant women in the central region of Ghana.Methods: A descriptive cross-sectional study design was used to conduct the study. A stratified sampling technique was used to select a sample of 1100 pregnant women. Structured questionnaire was used to collect the data and analyzed using frequencies, percentages and binary logistic regression where missing values were imputed using multiple imputation by chained equations.Results: The sociodemographic factors that determine the use of SDS were religion (OR=1.70, 95% CI=1.11-2.58, p=0.015) and person in authority who takes decision on where a person should deliver (OR=2.60, 95% CI=1.61-4.39, p=0.0004) and having valid national health insurance (OR=1.78, 95% CI=1, 06-3.00, p=0.030).Conclusion: In conclusion, more need to be done to address the issue of minority Muslim communities in the Central Region by providing cost effective and easy access to health facility within those communities, place more emphasis on facility delivery education, and counselling. Women need to be empowered to be independent in taking decision regarding health facility delivery.
Background: Hospitalization rates for threatened or arrested preterm labour pains are high but often unnecessary. The main aim of this study was to determine the need for hospitalization in patients with threatened Preterm Labor (PTL) after testing for the presence of Phosphorylated Insulin like Growth Factor Binding Protein-1 (phIGFBP-1) in cervicovaginal secretions followed by cervical length assessment.Methods: A prospective study was conducted in a cohort of one hundred patients of threatened PTL. They were evaluated for presence of phIGFBP-1 in cervicovaginal secretions using a bedside kit followed by cervical length measurement by Transvaginal Sonography (TVS). If either phIGFBP-1 test was positive and/or cervical length was less than or equal to 25 mm, the patient was admitted and hospital protocol was followed. If phIGFBP-1 was negative and cervical length was more than 25 mm, then the patient was counselled for home management. All patients were followed till delivery.Result: Implementation of these tests resulted in hospitalization rate of 16% in patients with threatened PTL which was a reduction by 80% and was statistically significant with p value of <0.001. No patient assigned to home management (n=84) delivered either within 48 h or 7 days of testing. Nine patients (10.7%) delivered between one to four weeks whereas the remaining 75 patients (89.2%) delivered after four weeks. Approximate cost savings varied from INR 1,62,000 to INR 1,536,570 ($2323 to $22030) for 100 patients.Conclusion: The use of these tests will decrease burden of hospitalization amongst patients thereby resulting in minimising unnecessary treatment and medical expenses.
Severe Combined Immunodeficiency (SCID) is the most severe form of primary immunodeficiency. This syndrome is caused by genetic mutations that block the development of T cells. Based on the records from a combined prospective data analysis from the neonatal screening program in the United States of America, the incidence of SCID is approximately 1 in 58,000 infants. The early diagnosis of SCID before any clinical symptom or the occurrence of serious complications is proven to improve the survival rates after the hematopoietic stem cell transplantation, which is the recommended treatment. This literature review aims at analysing all the advantages and disadvantages of the implementation of SCID testing in the neonatal screening programs. The presentation of SCID, the available screening methods to detect the disease and the cost effectiveness related to the screening are also presented. The search engine used to conduct this review was PubMed. To conclude, the screening method for SCID that quantifies the T-cell receptor excision circles using reverse transcription for real-time quantitative polymerase chain reaction is proven to be cost-effective has a sensitivity and specificity of nearly 100% and allows to detect the disease at an early stage, while it still has a good prognosis. This method has already been implemented in some countries with good results. *Corresponding author: Gonçalo Espírito Santo Matos, Abel Salazar Institute of Biomedical Sciences, University of Porto, Porto, Portugal, Tel: +351968728278; E-mail: goncaloespiritosantomatos@gmail.com Received: May 24, 2018; Accepted: July 09, 2018; Published: July 16, 2018 Citation: Matos GES, Marques L (2018) Neonatal Screening for Severe Combined Immunodeficiency. J Preg Child Health 5: 383. doi:10.4172/2376-127X.1000383 Copyright: © 2018 Matos GES, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Objectives: To study the epidemiological and prognostic aspects of trauma during pregnancy at the University Teaching Hospital Bogodogo (UTH-B) of Ouagadougou, Burkina Faso. Patients and Methods: This was a descriptive retrospective study over a 2 year period from January 1, 2015 to December 31, 2017. Included in our sample were all pregnant women admitted for trauma during pregnancy in the department of gynecology and obstetric in the University Teaching Hospital Bogodogo of Ouagadougou. Results: We recorded 112 emergency consultations for trauma and pregnancy out of a total of 13,367 gynecoobstetrical consultations, or a frequency of 0.9%. The average age of our patients was 25.9 ± 5 years and the average parity was 3 with extremes of 0 and 8. Housewives accounted for 50% of patients and evacuation was the mode of admission in 74.6%. The etiologies of trauma were dominated by road accidents in 82.6% of cases, falls in 9.8% of cases and brawls in 7.6% of cases. The mean gestational age of onset of trauma was 26.3 ± 7. A notion of polytrauma was found in 4 patients. The fetal prognosis was marked in the 1st quarter by 3 cases of abortion, in the 2nd quarter by 5 cases of intrauterine fetal death and in the 3rd quarter by 10 cases of threatened premature delivery. Conclusion: Trauma during pregnancy is frequent in the UTH-B. The implementation of a national prevention strategy for this association will improve the prognosis of mothers and children. *Corresponding author: Adama Ouattara, Assistant Professor at the Training and Research Unit in Health Sciences (TRU/HS), University Ouaga I Pr Joseph KI-ZERBO, Ouagadougou, Burkina Faso, Tel: +22670112819; E-mail: ouattzangaadama@yahoo.fr Received: October 07, 2018; Accepted: November 15, 2018; Published: November 22, 2018 Citation: Ouattara A, Natacha LB, Smaila O, Alidou P, Aline TS, et al. (2018) Epidemiological and Prognostic Aspects of the Trauma during Pregnancy at the University Teaching Hospital Bogodogo (UTH-B) of Ouagadougou, Burkina Faso. J Preg Child Health 5: 397. doi:10.4172/2376-127X.1000397 Copyright: © 2018 Ouattara A, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Sandra Acevedo Gallegos, María José Rodríguez Sibaja, Juan Manuel Gallardo Gaona, Jose Antonio Ramírez Calvo, Berenice Velázquez Torrez and Dulce María Camarena Cabrera-Congenital Adenomatoid Cystic Malformation: Expectant Management Outcomes
