20th Week Research Articles

Функціональний стан фетоплацентарного комплексу у вагітних із HCV-інфекцією

Purpose - to study the functional state of the fetoplacental complex (FPC) during pregnancy in women with hepatitis C virus (HCV infection). Materials and methods. A prospective clinical and statistical analysis of the functional state of the FP during pregnancy in 40 women (main group, MG) with HCV infection was conducted on the basis of the Kyiv City Center of Reproductive and Perinatal Medicine for the period 2020-2021. The control group (CG) consisted of 50 healthy pregnant women. Statistical processing of research results was carried out using standard programs Microsoft Excel 5.0 and Statistica 8.0. Results. The hormonal status of FPK in MG of pregnant women, starting from the 18th week, was characterised by a significant decrease in the secretion of progesterone (PG) (159.314.6 nmol/l in MG versus 205.44.8 nmol/l in CG; p<0.05) and human chorionic gonadotropin (39.24.6 mIU/mL versus 52.85.3 mIU/mL, respectively). Estradiol (E2) levels in MG of pregnant women from the 18th week of pregnancy were significantly lower (26.32.7 nmol/l) than in CG of pregnant women (33.71.4 nmol/l, p<0.05). A synchronous decrease in the level of PG and E2 was observed in the case of threatened abortion against the background of bloody discharge, which indicated clinical manifestations of placental dysfunction (PD). In MG of pregnant women, the level of placental lactogen (PL) at week 18 was almost the same (80.913.2 nmol/l) compared to CG of pregnant women (79.57.1 nmol/l; p>0.05). From the 29th week, the level of E2 in MG of pregnant women is significantly different from CG (25.61.3 nmol/l in MG versus 51.20.7 nmol/l in CG; p<0.05). The most pronounced difference was the level of estriol (E3) and cortisol (Cr) in blood serum relative to CG in MG of pregnant women, which was manifested by a decrease in the level of E3 (up to 86.4±5.2 nmol/l in MG versus 98.42.6 nmol/l in CG; p<0.05) against the background of a simultaneous increase in Cr content (up to 751.118.6 nmol/l in MG versus 625.618.4 nmol/l in CG; p<0.05). Endocrinological disorders also changed before delivery (39-40 weeks): the E2 level decreased (to 45.41.9 nmol/l in MG versus 65.30.6 nmol/l in CG; p<0.05), E3 (up to 28.32.0 nmol/l versus 57.81.8 nmol/l, respectively; p<0.01), PG (up to 499.4±11.6 nmol/l versus 604,216.3 nmol/l, respectively; p<0.05) and PL (up to 201.4±12.4 nmol/l versus 63.418.8 nmol/l, respectively; p<0.05) and the Cr content increased (up to 812.4±16.7 nmol/l versus 651.614.6 nmol/l, respectively; p<0.01). Conclusions. The functional state of the FPC in pregnant women with HCV infection, on the eve of delivery, is characterized by a high level of premature maturation of the placenta, changes in the volume of amniotic fluid, due to which significant hemodynamic and endocrinological subcompensated disorders appear, but in some cases they are decompensated, which causes disorders from the functional state of the fetus and the high frequency of development of fetal growth retardation syndrome in this group of women. The research was carried out in accordance with the principles of the Helsinki Declaration. The study protocol was approved by the Local Ethics Committee of the institution mentioned in the paper. The informed consent of the patient was obtained for conducting the studies. No conflict of interests was declared by the authors.

Prevalence and burden of nausea and vomiting in pregnant women: Interim analysis of the PURITY survey

ObjectivesNausea and vomiting in pregnancy is a common and invalidating condition in early pregnancy. However, no data are available on its prevalence in Italy. This survey aims to evaluate the prevalence and impact of nausea and vomiting during pregnancy on the quality of life of Italian women. Study designThe survey was performed in three Italian public University Hospitals in two distinct periods: a first interview took place between the 18th and 22nd week of pregnancy, using the Questionnaire for Pregnancy Period (14 questions regarding demographic data and 30 questions about nausea and vomiting in pregnancy, including Pregnancy-Unique Quantification of Emesis questionnaire), and a follow-up interview, by telephone call, took place immediately after giving birth and in any case within 14 days of delivery, using the Questionnaire for Post-Pregnancy (9 questions). Included women were Caucasian, in physiological pregnancy and between the 18th and 22nd week (time of morphological ultrasound), able to communicate adequately with the interviewer, understand the questionnaires and able to provide valid informed consent. Twin pregnancies and women who recurred to medically assisted procreation were excluded.This is an interim report on data collected from 232 of the planned 600 women. ResultsMean age of the recruited subjects was 32.6 ± 4.6 years, with approximately 60% primiparous. The prevalence of nausea and vomiting in pregnancy in the sample examined was 65.5% overall (152 out of 232 subjects). Of these 152 women, 63 (41.4%) experienced only nausea, 6 (3.9%) only vomiting, and 83 (54.6%) reported both. Symptoms were reported to begin at 7.2 ± 2.7 weeks, lasted 10.2 ± 5.6 weeks, and persisted at the time of the interview in 32.2% of cases. Overall, over 50% of the women interviewed experienced a negative impact of nausea and vomiting in pregnancy on social relationships and work activity. ConclusionsA high prevalence of nausea and vomiting in pregnancy, 65.5% overall, was found in this interim analysis. These symptoms appeared capable of negatively influencing women quality of life. Screening procedures should be offered during pregnancy and measures that address nausea and vomiting in pregnancy impact warranted.

Fetal Echocardiography Audit in a Tertiary Hospital in Ibadan, Nigeria

Background: Delayed detection of congenital heart diseases in low- and middle-income countries (LMICs) contributes to the poor outcome of infants with cardiac anomalies. Fetal echocardiography (FE) can detect heart defects in-utero as early as the 18th gestational week (GA), giving parents and medical professionals time to prepare for the baby's delivery and appropriate treatment. University College Hospital, Nigeria, is one of the few centres in Nigeria where FE is performed. Objectives: To examine the indications for referral for FE and the diagnoses made in our first four years of performing FE. Methods: FE was performed in the antenatal clinic of the University College Hospital, Ibadan, Nigeria, using the GE Voluson P6 machine with a 2-6-RS probe. Demographic information was obtained from the antenatal clinic records of the women who had FE using a semi-structured questionnaire. FE diagnoses were retrieved from the FE register. Results: A total of 129 women whose records were available were recruited for this study. The mean age of the women was 31.7±5.5 years. Forty-two women (32.6%) were referred because of echogenic foci, making this the most common indication for FE. Twenty-nine (22.5%) fetuses had structural heart defects, the most common being Ventricular Septal Defect. Conclusion: There is a need for Obstetricians and Paediatricians to be aware of the indications for fetal echocardiography and refer women appropriately.

Health anxiety and oppressive support: their impact on decisions for non-urgent use of the emergency department of obstetrics and gynecology

The high number of non-urgent visits to the emergency departments of obstetrics and gynecology (EDOG) is receiving increasing attention from researchers and public health professionals. The decision to access the EDOG is the result of a decision-making process based on three phases, from the problem recognition to the intention to seek medical care, and the decision to visit the EDOG. Each stage may depend on different psychological and social factors, but their specific role is still unclear. The aim of this study was to investigate the psychological and social factors which are implied in the decision-making process leading to non-urgent visits to the emergency department. A questionnaire was administered to 280 women between the 10th and the 14th week of pregnancy. Results showed that health anxiety had a positive effect on all three stages of the decision-making process (problem recognition, seeking medical care, and visiting the emergency department). Satisfaction with the prenatal care service showed a positive effect on the first two stages, while oppressive support had a positive effect on visiting the emergency department. We suggest that educational interventions for patients and family members aimed at reducing health anxiety and oppressive support during pregnancy could reduce the number of inappropriate accesses to the emergency department, with a beneficial effect on its functioning, patient-and-caregiver relationship, and the healthcare system costs.

Cervical ectopic pregnancy – the first case of live birth and uterus-conserving management

A 37-old III gravida II para with two previous cesarean sections (CS) presented in 7 + 3 weeks of pregnancy with cervical ectopic pregnancy (CEP). At 12th week of pregnancy, a cerclage was performed to avoid cervical distention by the expanding placenta. Due to missing experience in CEP management and to avoid emergency operation, we recommended CS in 30th week of pregnancy due to unspecific pain of the patient. Vaginal bleeding never occured.After transverse laparotomy, the urinary bladder was sharply dissected from the anterior uterine and cervical wall. The baby was delivered by transverse cervicotomy caudally of the placenta. The placenta was left in situ. The patient then got prophylactic embolization of the uterine arteries to prevent further severe hemorrhage. 48 h later, ultrasound showed a floating, avascular placenta within a poor echogenic fluid-filled cervical space as well as macrohematuria. After re-laparotomy and cervicotomy at the same day, the placenta was completely and easily evacuated. A bladder injury was recognized and closed. We performed a cervical internal os plasty by inverting the cervical lips and suturing their distal ends on the proximal cervical tissue, resulting in complete bleeding cessation. Although, the patient got 8 erythrocyte concentrates at all, she was always in a stable condition without hemorrhagic shock.This case demonstrates for the first time a live-birth with uterus-conserving management in CEP.

Investigation of maternal serum endocan concentrations in pregnant women with gestational diabetes mellitus; a prospective case-control study

Objective We aimed to investigate the maternal serum endocan concentrations in pregnant women diagnosed with Gestational Diabetes Mellitus (GDM) and to investigate the usability of serum endocan in GDM screening. Methods This prospective case-control study was conducted with 160 pregnant women. The GDM group consisted of 80 pregnant women who had 75 g OGTT between the 24th and 28th weeks of pregnancy and were diagnosed with GDM. The control group consisted of 80 healthy pregnant women who were matched with the GDM group in terms of age and body mass index (BMI) and had a normal 75 g OGTT result. Serum endocan concentrations were evaluated between 24 and 28 weeks of gestation in all participants and the groups were compared in terms of serum endocan concentrations. Results The median maternal serum endocan concentration was found to be significantly higher in the GDM group than in the control group (498 ng/L, and 467 ng/L, respectively, p = 0.024). In the subgroup analysis according to the BMI of the participants, the highest median maternal serum endocan concentration (513 ng/L) was found in the overweight GDM group. ROC analysis was performed to determine the value of maternal serum endocan concentration in predicting GDM. AUC analysis of maternal serum endocan for estimation of GDM was 0.603 (p = 0.024, 95% CI = 0.515 − 0.691). The optimal threshold value for maternal serum endocan concentration was determined as 376 ng/L with 88.75% sensitivity and 32.5% specificity. Conclusion Although serum endocan does not have high enough specificity to be used as an alternative to OGTT in GDM screening between 24 and 28 weeks of gestation, we think that it is somehow involved in the pathogenesis of GDM. The contribution of placental endocan expression to the serum concentration and the effect of blood glucose regulation on serum endocan concentration in GDM remain to be investigated.

Influence of oral microbiome on longitudinal patterns of oral mucositis severity in patients with squamous cell carcinoma of the head and neck.

This study investigated the influence of oral microbial features on the trajectory of oral mucositis (OM) in patients with squamous cell carcinoma of the head and neck. OM severity was assessed and buccal swabs were collected at baseline, at the initiation of cancer treatment, weekly during cancer treatment, at the termination of cancer treatment, and after cancer treatment termination. The oral microbiome was characterized via the 16S ribosomal RNA V4 region with the Illumina platform. Latent class mixed-model analysis was used to group individuals with similar trajectories of OM severity. Locally estimated scatterplot smoothing was used to fit an average trend within each group and to assess the association between the longitudinal OM scores and longitudinal microbial abundances. Four latent groups (LGs) with differing patterns of OM severity were identified for 142 subjects. LG1 has an early onset of high OM scores. LGs 2 and 3 begin with relatively low OM scores until the eighth and 11th week, respectively. LG4 has generally flat OM scores. These LGs did not vary by treatment or clinical or demographic variables. Correlation analysis showed that the abundances of Bacteroidota, Proteobacteria, Bacteroidia, Gammaproteobacteria, Enterobacterales, Bacteroidales, Aerococcaceae, Prevotellaceae, Abiotrophia, and Prevotella_7 were positively correlated with OM severity across the four LGs. Negative correlation was observed with OM severity for a few microbial features: Abiotrophia and Aerococcaceae for LGs 2 and 3; Gammaproteobacteria and Proteobacteria for LGs 2, 3, and 4; and Enterobacterales for LGs 2 and 4. These findings suggest the potential to personalize treatment for OM. Oral mucositis (OM) is a common and debilitating after effect for patients treated for squamous cell carcinoma of the head and neck. Trends in the abundance of specific microbial features may be associated with patterns of OM severity over time. Our findings suggest the potential to personalize treatment plans for OM via tailored microbiome interventions.

Current approaches to respiratory pathology in late preterm infants

Late preterm babies are those born between 340/7 and 366/7 weeks of gestation, constituting the largest subgroup of preterm infants. Despite the relative morphofunctional maturity, these children remain at a high risk of damage to various organs and systems, and there is also a high mortality rate. One of the top places in the structure of morbidity in late preterm is occupied by respiratory disorders. Quite often there is transient tachypnea, respiratory distress syndrome of the newborn, pulmonary hypertension, and congenital pneumonia. Currently, there are various approaches to prevention, treatment, and diagnosis of respiratory disorders in late preterm children. Until now, the issue of the advisability of prenatal prevention of respiratory distress syndrome with corticosteroids after the 34th week of gestation has not been resolved. Non-invasive methods of respiratory support are more popular along with minimally invasive administration of surfactant preparations when indicated. The trend towards an annual increase in late preterm births determines the need to improve the methods of their nursing. The control over respiratory disorders and hypoxia is crucial in the prevention of adverse outcomes in late preterm children.

Dispositional mindfulness profiles in pregnant women: relationships with dyadic adjustment and symptoms of depression and anxiety.

Pregnancy is a time of major transition that can be stressful for women. Dispositional mindfulness may protect individuals when they face stress. Recent studies have adopted a person-centered approach to examine the role of mindfulness by identifying subtypes of individuals based on their scores in five mindfulness facets. Latent profile analysis was used to identify different mindfulness profiles in a sample of pregnant women, and we explored the relationships between these profiles, depression and anxiety symptoms, and whether dyadic adjustment mediated these relationships. A total of 535 women aged 18-45 years in their 26th week of pregnancy completed questionnaires regarding mindfulness, dyadic satisfaction and cohesion, and depression and anxiety symptoms. Three profiles were identified: (1) low mindfulness (53.8%), (2) moderate mindfulness (34.3%), and (3) non-judgmentally aware (11.9%). The most adaptive profile was the non-judgmentally aware profile. Compared to the low mindfulness profile, the non-judgmentally aware profile and the moderate mindfulness profile were related to fewer symptoms of depression and anxiety, and these relationships were partly mediated by dyadic satisfaction. These results suggest that analyzing each pregnant woman's mindfulness profile can improve the prevention of and interventions for anxiety and depression.

Comparison of the initial levelling efficiency of two different self-ligating brackets

Aim: The objective of this study, to evaluate the initial alignment effectiveness of two different passive self-ligating brackets (SLBs) and to compare the differences in arch widths. Materials and Methods: The patients with no skeletal discrepancy, Little’s irregularity index (LII) greater than 3 mm on both arches, who were treated with SLBs and whom had undamaged plaster models at the beginning (T0), 10th week (T1), and 20th week (T2) of their treatment period were enrolled to the study group. Group 1 (Damon) was consisted of 17 patients (mean age=14.5 years) and Group 2 (SmartClip) was consisted of 18 patients (mean age=13.6 years). The analogue dental casts were transferred to a digital model by scanning. Maxillary and mandibular intercanine, intermolar widths and LII were measured by MeshLab software. Wilcoxon signed-rank and Mann Whitney U tests was used for statistical evaluation. Results: There were no significant differences between the groups for the mean LII in T0 (maxillary LII, Group 1= 6.59 mm; Group 2= 6.32 mm; mandibular LII, Group 1= 5.95 mm, Group 2= 5.73mm). The rate of decrease in the LII between T0-T2 and between T1-T2 were found to be significantly higher for Group 1 in the mandible but there was no significant difference between T0-T1 (P= 0.031, P= 0.042, P= 0.113). There was no significant difference for the rate of decrease in the LIIs between the groups in the maxilla. When changes of intermolar and intercanine widths were compared according to the follow-up times, no significant differences were found for the treatment groups. Conclusion: Both SLBs groups were effective for reducing the crowding in maxillary arch. The increases in intercanine and intermolar widths were found to be similar for both groups. Group 1 was found to be better in the speed of the resolution of the crowding only in the lower incisor region.

Maternal inflammatory, lipid and metabolic markers and associations with birth and breastfeeding outcomes.

Conditions in utero influence intrauterine and postnatal infant growth and a few studies indicate that maternal inflammation and insulin resistance might affect birth and breastfeeding outcomes. Furthermore, hormones in human milk (HM) may influence infant appetite-regulation and thereby milk intake, but the associations are less understood. (1) To investigate associations between maternal inflammatory, lipid and metabolic markers and birth and breastfeeding outcomes, and (2) to assess predictors of maternal inflammatory, lipid and metabolic markers in pregnancy. Seventy-one mother-infant dyads participating in the Mothers, Infants and Lactation Quality (MILQ) study were included in the present study. Fasting blood samples were collected around 28th gestational week, and HM samples at three time points from 1.0 to 8.5 months, where milk intake was assessed using 24-h test weighing. Maternal plasma inflammatory, lipid and metabolic markers included high-sensitive C-reactive protein (hs-CRP), tumor-necrosis factor-α (TNFα), interferon-γ (IFNγ), Interleukin (IL)-6, IL-8, high-, low-, and very-low-density lipoprotein (HDL, LDL, VLDL), total-cholesterol, triglycerides, leptin, adiponectin, insulin, C-peptide, the homeostasis model assessment of insulin resistance (HOMA-IR) and glucose concentration at t = 120 min following an oral glucose tolerance test. Of these, TNFα, IFNγ, IL-6, IL-8, leptin, adiponectin and insulin were also measured in HM samples. HDL in pregnancy was inversely associated with gestational age (GA) at birth and GA-adjusted birthweight z-score, whereas triglycerides and glucose (t = 120) were positively associated with GA-adjusted birthweight z-score. Higher hs-CRP, VLDL and triglycerides were associated with a higher placental weight. Furthermore, higher HDL, insulin, leptin and HOMA-IR were associated with longer duration of exclusive breastfeeding (EBF). Higher pre-pregnancy BMI was the main predictor of higher levels of hs-CRP, log-TNFα, leptin, insulin, C-peptide, and HOMA-IR. Maternal lipid and metabolic markers influenced birthweight z-score and placental weight as well as duration of EBF. Furthermore, pre-pregnancy BMI and maternal age predicted levels of several inflammatory and metabolic markers during pregnancy. Our findings indicate that maternal lipid and metabolic profiles in pregnancy may influence fetal growth and breastfeeding, possibly explained by overweight and/or higher placental weight. https://clinicaltrials.gov/, identifier NCT03254329.

The baseline metabolism parameters of 18F‑FDG PET/CT as promising prognostic biomarkers in pediatric Langerhans cell histiocytosis.

Langerhans cell histiocytosis (LCH) is a rare myeloid precursor cell inflammatory neoplasia, which agonizes, maims, and even kills patients. Although clinical outcomes have steadily improved over the past decades, the progression/relapse rate of LCH remains high. The purpose of this study was to evaluate the prognostic value of the pre-treatment metabolism parameters of baseline 18F-fluorodeoxyglucose positron emission tomography/computed tomography (18F‑FDG PET/CT) in children with LCH. This cross-sectional study retrospectively and consecutively included 37 children (24 males and 13 females; median age, 5.1 years; range, 2.4-7.8 years) with pre-treatment 18F-FDG PET/CT from September 2020 to September 2022 in Nuclear Medicine Department, Beijing friendship hospital, Capital Medical University, Beijing, China. These patients were then all admitted to the hospital and diagnosed with LCH by biopsy, in Hematology Center, Beijing Children's Hospital, Capital Medical University, Beijing, China. Five metabolism parameters of 18F-FDG PET/CT were analyzed, including maximum standardized uptake, tumor-to-normal liver standard uptake value ratio, tumor-to-normal bone marrow standard uptake value ratio, sum of metabolic tumor volume (sMTV), and sum of total lesion glycolysis (sTLG) of all lesions. Patients were followed up for at least 1 year or until disease progression/relapse. Univariate and multivariate analyses of progression-free survival was performed. During follow-up, 11 (29.7%) patients had disease progression/relapse. Univariate analysis revealed that the risk organ involvement, the treatment response at the 5th or 11th week, pre-treatment sMTV, and sTLG were significantly associated with progression-free survival (P=0.024, 0.018, 0.006, 0.006, and 0.042, respectively). Multivariate COX analysis revealed that non-response at the 11th week, pre-treatment sMTV >32.55 g/cm3, and sTLG >98.86 g (P=0.002, 0.020, 0.026, respectively) were risk factors for progression-free survival. The baseline metabolism parameters of 18F-FDG PET/CT could be promising imaging biomarkers for predicting prognosis in children with LCH.

Training on Childbirth Preparation on the Self-Efficacy and Psychological State of Pregnant Women in Kakamega County

Pregnant women’s ability to cope with childbirth pain is a significant indicator of self-efficacy during labour. The link between antenatal childbirth knowledge and self-efficacy is largely unknown. This study assessed the impact of training in childbirth preparation on women’s self-efficacy and their psychological status during childbirth in Western Kenya. We used a quasi-pre-test post-test CBS EI design to assess training intervention pinned on self-efficacy theory. Participants were assigned either to the control group or the intervention group at the antenatal care clinic. A pre-test on self-efficacy was performed using the childbirth self-efficacy inventory scale (CBSEI-16). The intervention group received two sessions of 2 hours each of the training between the 3rd–and 33rd weeks of gestation. Evaluation of outcome measures was conducted at the end of the 36th week of gestation and within 48 hours after delivery for childbirth self-efficacy and fear and anxiety, respectively. Childbirth self-efficacy was determined by the CBSEI-16, while fear and anxiety were determined using a five-point Likert scale. Statistical significance was determined by independent t-tests. Mothers in the intervention group had higher post-test scores for Outcome Expectancy (OE) and Efficacy Expectancy (EE), P<0.001. Mothers in the intervention group were more likely to be in control and felt more capable with less fear and anxiety than in the control group P<0.001. Data presented here suggest that training in childbirth preparation improved self-efficacy and decreased anxiety and fear

COVID Infection and Spontaneous Coronary Dissection in a Pregnant Woman — a Therapeutic Challenge

Abstract The link between COVID-19 and cardiovascular diseases, specifically myocardial infarction, has been well documented, but the interactions between these comorbidities in the context of pregnancy has not been elucidated so far. We report an intriguing case of a 35-year-old woman in her 35th week of pregnancy, with SARS-CoV-2 infection, who developed an acute coronary syndrome caused by a spontaneous coronary dissection. To our knowledge, this paper presents one of the first cases reported in the literature of acute coronary syndrome and COVID-19 infection in a pregnant patient.

Unpacking the legality of termination of pregnancy based on ‘social grounds’ under South African law

The topic of abortion was in the limelight again in Dobbs v Jackson, where the US Supreme Court overturned the decision of Roe v Wade, ‘which guaranteed women and pregnant people a constitutional right to abortion’. While not bound by the judgment, this gives us an opportunity to reflect on the current law in South Africa which regulates the termination of pregnancy. The primary piece of legislation which governs abortion is the Choice on Termination of Pregnancy Act. Section 2 of the Act lists the grounds under which one may lawfully terminate a pregnancy. One of those grounds relates to the period of the 13th up until the 20th week of the gestation period, and states that if a medical practitioner, after consultation with the pregnant woman, is of the opinion that the continued pregnancy would significantly affect the social or economic circumstances of the woman, then the pregnancy may be lawfully terminated. The question is: What exactly is meant by ‘social grounds’? This article considers this aspect from a legal perspective and attempts to provide clarity on the issue, in the hope that this will be of assistance to medical practitioners who are concerned about the outcome of their actions, when assisting persons in this position.

Evaluation of impacts of aspirin therapy versus placebo on preeclampsia: An observational study

BackgroundGestational hypertension and pre-eclampsia often increase maternal and neonatal mortality. The illness usually appears after the 20th week of pregnancy due to malnutrition or obesity. Untreated, it can lead to neonatal and maternal mortality. Low-dose Aspirin can prevent preeclampsia if started between 11 and 28 weeks. Several studies support this technique, although others have shown limited effectiveness and negative side effects. ObjectiveThis study aims to assess the effectiveness of aspirin treatment for the prevention of preeclampsia, taking into account any possible adverse reactions. MethodsThis observational research comprised 600 singleton pregnant women at high risk of pregnancy-induced hypertension. The aspirin group had 301 individuals and the placebo group 299. From 11 to 36 weeks of pregnancy, they received 150 mg of aspirin and 150 mg of placebo. Gestational hypertension was assessed at 25 weeks, 36 weeks, and 37 weeks. If any, aspirin and placebo-related adverse pregnancy and neonatal outcomes were reported. ResultsWith aspirin therapy, 4 females and 14 females with placebo developed gestational hypertension before 25 weeks of pregnancy with an odds ratio of 0.283 (0.092–0.87); before 36 weeks, 5 females and 15 females with placebo developed GHD with an odds ratio of 0.331 (0.118–0.922); and after 37 weeks, 17 females and 35 females with placebo developed GHD. Preeclampsia occurred in 5 females in the aspirin group and 17 in the placebo group at <25 weeks (odds ratio 0.292 (0.106–0.802), 7 females in the aspirin arm and 25 females in the placebo arm at <36 weeks (odds ratio 0.278 (0.118–0.652), and 21 females in the aspirin arm and 39 females in the placebo arm at >37 weeks (odds ratio 0.5349 (0.307–0.930). ConclusionIn pregnant women at high risk of prenatal hypertension and preeclampsia, aspirin therapy is very effective with minimal side effects.

Risk of Miscarriage in Relation to Seasonal Influenza Vaccination Before or During Pregnancy.

To evaluate the association between seasonal influenza vaccination and miscarriage using data from an ongoing, prospective cohort study. We analyzed 2013-2022 data from PRESTO (Pregnancy Study Online), a prospective prepregnancy cohort study of female pregnancy planners and their male partners in the United States and Canada. Female participants completed a baseline questionnaire and then follow-up questionnaires every 8 weeks until pregnancy, during early and late pregnancy, and during the postpartum period. Vaccine information was self-reported on all questionnaires. Miscarriage was identified from self-reported information during follow-up. Male partners were invited to complete a baseline questionnaire only. We used Cox proportional hazard models to estimate the hazard ratio (HR) and 95% CI for the association between vaccination less than 3 months before pregnancy detection through the 19th week of pregnancy and miscarriage, with gestational weeks as the time scale. We modeled vaccination as a time-varying exposure and used propensity-score fine stratification to control for confounding from seasonal and female partner factors. Of 6,946 pregnancies, 23.3% of female partners reported exposure to influenza vaccine before or during pregnancy: 3.2% during pregnancy (gestational age 4-19 weeks) and 20.1% during the 3 months before pregnancy detection. The miscarriage rate was 16.2% in unvaccinated and 17.0% among vaccinated participants. Compared with no vaccine exposure, influenza vaccination was not associated with increased rate of miscarriage when administered before (HR 0.99, 95% CI 0.81-1.20) or during (HR 0.83, 95% CI 0.47-1.47) pregnancy. Of the 1,135 couples with male partner vaccination data available, 10.8% reported vaccination less than 3 months before pregnancy. The HR for the association between male partner vaccination and miscarriage was 1.17 (95% CI 0.73-1.90). Influenza vaccination before or during pregnancy was not associated with miscarriage.

MONITORING OF CODLING MOTH CYDIA POMONELLA (L.) THROUGH PHEROMONE TRAPS IN APPLE ORCHARD

A trial was conducted using RCBD design at Barkhan (Baghao) province Balochistan. Pheromone traps (04) were placed among the apple trees for the collection of the adult codling moth. These traps were hung on four randomly selected Apple tree at height of 2.5 meters with adjacent of five trees. The result indicated that the first flight of C. pomonella population (7.20±0.40 moths per trap) was observed in 17th standard metrological week. Afterwards, the C. pomonella population increases gradually 8.50±1.10 moths per trap in the 21ststandard metrological week. The maximum C. pomonella population (12.68±1.12 moths per trap) was recorded during the 28th standard metrological week. Minimum C. pomonellapopulation (5.10±0.51 and 5.53±2.10 moths per trap) was recorded during 18th and 20thstandard metrological week, respectively. Correlation studies indicates that there was positive and highly significant (p&lt;0.01) association (r=0.849) for maximum and minimum temperatures (r=0.7130). While, there was significant but negative association (r= -0.359) for relative humidity with target pest population. In a similar way, there was negative and non-significant relationship (r= - 0.004) for total rainfall with C. pomonella population. After going through the results indetail, it was concluded that pheromone trap were found effective for control codling moth of apple.

Veness Of Music Therapy In Reducing Low Back Pain Among Pregnant Women Third Trimester

Background: Pregnancy is a period that starts from conception to the birth of the fetus. Third trimester of pregnancy, which is the last 3 months of pregnancy which starts from the 28th week to the 40th week. (Setiawati et al., 2019). Physiological changes that occur during pregnancy have pathways that are pathological for pregnant women. Complaints in pregnant women include back pain which is characterized by the enlargement of the uterus affecting the center of gravity, stretching out and bandaging the abdominal muscles, changing body postures, and putting pressure on the back. Therapy Listening to music can produce endorphins (a morphine-like substance supplied by the body which can reduce pain/pain) which can inhibit the transmission of pain impulses in the central nervous system, so that the sensation of pain can be reduced Objective : To determine the effectiveness of the music therapy to reducing low back pain on pregnant women Methodology This study used a quantitative approach with a quasi-experimental design using a one group pretest posttest design. The sampling technique was perposive sampling in third trimester pregnant women, totaling 40 respondents. Result and Discussion: The results showed that the median pretest value was 6.00 and the median posttest value was 2.00 with a p value of 0.00 &lt;0.05, this indicated that there was a decrease in back pain before and after the classical music therapy. Conclusion: Mozart classical music therapy has an effect on reducing back pain in third trimester pregnant women.

Anc Bed For Preeclamsi Early Detection Using Web System

One of the causes of the high maternal mortality rate is dominated by three factors, one of which is preeclampsia. Preeclampsia is a condition in which the mother experiences hypertension and changes in BMI (Body Mass Index) at the 20th week of gestation. Preeclampsia indications in pregnant women are related to examinations, namely Antenatal care (ANC). Antenatal care is one of the prenatal checks with certain standards. Pregnant women need extra antenatal supervision from health workers. Preeclampsia detection carried out in health care facilities is currently considered to be still not optimal so that there are still many cases of preeclampsia that are not handled properly. One of the efforts that can be made to improve services for pregnant women is with a web-based ANC examination. The purpose of this study is to analyze NIBP and BMI data sent and received by IoT media so that they are useful for the diagnostic process. The contribution of this research is knowing the response of NIBP and BMI data sent and received via IoT media. The procedure for achieving this goal is with the MPX5050 sensor and Loadcell whose output will be processed and displayed on a web page. From this study it can be concluded that the sending of IoT-based NIBP and IMT data affects lost data or delays received. The findings from this study are expected to be developed in further research. So that it can be said that the use of the ESP32 module as the delivery of ANC BED inspection results resulted in no loss of data found in sending ANC inspection results with 100% data results being sent without any data loss and delay with an average of 2 seconds.