3rd Pregnancy Research Articles

Characteristics of Central Serous Chorioretinopathy Patients at Padang Eye Center Hospital in 2019-2023

Background: Central Serous Chorioretinopathy (CSCR) is a condition where serous fluid collects in the retinal pigment epithelium (RPE) which results in detachment of the neurosensory layer of the retina. Several risk factors that cause CSCR are gender, age, use of corticosteroids, 3rd trimester pregnancy, stress, type A personality, and use of anti-psychotic drugs. Objective: The purpose of this study was to describe the characteristics of Central Serous Chorioretinopathy (CSCR) patients at RSKM Padang Eye Center in 2019-2023. Method: The scope of this research is the field of eye disease. This research was conducted from December 2023 the study was conducted using categorical descriptive study. The population of this study were all Central Serous Chorioretinopathy (CSCR) patients recorded in the medical records at RSKM Padang Eye Center with a total of 34 samples using a total sampling technique. Data analysis uses univariate analysis, the data obtained will be processed with SPSS Statistics 26.0 and presented in table form. Results: From 34 patients with Central Serous Chorioretinopathy (CSCR) at RSKM Padang Eye Center, the majority were in the late adult age category ranged from 36-45 years old (52.9%). The most common gender is male by 73.5%. The initial visual acuity of the patients was good (6/6-6/18) were 35.3%, moderate visual acuity (<6/18-6/60) were 41.2%, and poor visual acuity (<6/60) were 23.5%. The most common treatment was diclofenac sodium as much as 73,5%. The patient's final visual acuity was good (6/6-6/18) were 82.4%, moderate visual acuity (<6/18-6/60) were 14.7%, and poor visual acuity (<6/60) were 2.9%. A total of 82.4% experienced improved visual acuity. Conclusion: Central Serous Chorioretinopathy (CSCR) were mostly 36-45 years old, male, with moderate initial visual acuity, received diclofenac sodium management, and good final visual acuity, most of the patient’s experienced improvement in visual acuity.

Family Planning Practices, Knowledge, Decision Making, and Factors Associated with Unplanned Pregnancies among Women Working in A Selected Garment Industry in Urban Bengaluru, India

Background: According to UN population estimates, India has surpassed China as the world’s most populated nation, marking the biggest upheaval in global demography since records have been kept. Providing universal family planning services is an important strategy to reduce maternal morbidity and to control population growth. Even though the country has multiple programs addressing family planning issues, they are missing out on working women. Thus, this study aims to estimate the prevalence of unmet needs of family planning and determinants for improper access to family planning methods among women working in a selected Garment industry in Urban Bengaluru. Methodology: A community based cross-sectional study was conducted in a selected garment factory for a period of two months. Women workers in Reproductive age group (18-49 years) and who gave voluntary consent to participate in the study were taken up. Total sample of 454 women were included. The data was collected using a semi-structured and validated questionnaire. Collected data was entered in Microsoft Excel and was analysed using SPSS version 16. Results: Among 454 participants, 42.3% (n=192) of them had used contraceptive method. Out of 192 women, most of them (72.9%, n=140) had chosen tubectomy as the contraceptive measure. Among 407 women, 14.3% (n=58), 13.3% (n=42), and 20.9% (n=9) of them had not planned for their 1st pregnancy, 2nd pregnancy, and 3rd pregnancy respectively. Conclusion: Less than half of them had used any form of contraceptive method. Among that half, nearly three-fourths had chosen tubectomy.

Risk factors for spontaneous preterm deliveries above twenty-eight complete weeks of gestation

Purpose: To identify risk factors for spontaneous preterm delivery (SPD) given that it is associated with high neonatal morbidity and mortality. Material and methods: This case-control study was carried out between 1st February and 31st July 2021. Women who delivered spontaneously between 28 and ˂37 weeks (cases) or at ≥37 weeks (controls) were recruited. The main variables recorded included maternal age and parity, inter-pregnancy interval, if the pregnancy was intended, medical, obstetrical and family past-histories, gestational age at delivery, number of gestation and pathologies during current gestation. Fisher exact test, t-test and logistic regression were used for comparison. P<0.05 was considered statistically significant. Results: Our frequency of preterm delivery was 15.3% (116/759 births), with 9.9% (75/759) being SPD. Significant risk factors for SPD were premature rupture of membranes (aOR 19.96, 95%CI 11.04-45.82), inter-pregnancy interval ˃60 months (aOR 13.02, 95%CI 6.11-33.01), Nulliparity (aOR 10.21, 95%CI 5.72-21.31), 1st degree family history of SPD (aOR 7.73, 95%CI 1.54-11.39), malaria in the 3rd trimester (aOR 6.89, 95%CI 2.15-8.63), multiple pregnancies (aOR 6.43, 95%CI 3.21-9.79), severe anemia (Hb ˂6g/dl) in the 3rd trimester (aOR 5.73, 95%CI 2.04-10.60) and unintended pregnancies (aOR 2.44, 95%CI 1.98-7.88). Conclusion: Women with multiple or unintended pregnancies and those with the pre-gestational risk factors identified above should be well followed up during pregnancy to allow prevention, if not, early diagnosis of SPD. Moreover, prevention of the above-identified pathologies in pregnancy is mandatory if we want to reverse the rate of SPD

Evaluation of Fibrinogen Level and Platelet Count among the Apparently Healthy Pregnant Women at 3rd Trimester

Background: Different physiological changes affect normal coagulation and fibrinolytic system during pregnancy. Hemostatic abnormalities are often associated with various complications of pregnancy. Objectives: This study was aimed to evaluate the fibrinogen level and platelet count among pregnant women at third (3rd) trimester as compared to non-pregnant healthy women. Methods: This cross-sectional study was conducted at the Department of Physiology, Rajshahi Medical College (RMC), Rajshahi, Bangladesh, from July 2016 to June 2017 on 60 healthy women, out of them 30 were apparently healthy pregnant women of third trimester in the age group of 20-35 years (cases), and 30 were age matched non-pregnant healthy women (controls). Their detailed case history was taken and relevant clinical examinations were done. Plasma fibrinogen level and platelet count were measured using auto analyzer. Data were analyzed and compared by statistical test. Results: The mean±SD age of the pregnant women was 27.27±3.72 years and that was 27.13±4.01 years in non-pregnant healthy women. The maximum (40.0%) study women were in 26-30 years age group followed by 38.3% was in 20-25 years age group and 21.7% was in 31-35 years age group. Most of the cases were primipara [22(36.66%)] and majority women in the control group were multiparous [17(28.33%)]. Mean±SD body mass index (BMI), pulse rate, systolic blood pressure (SBP), and diastolic blood pressure (DBP) were nearly similar between the groups. Plasma fibrinogen level was significantly high (p<0.001) and platelet count was relatively low among women at 3rd trimester of pregnancy in comparison to non-pregnant healthy women. Conclusion: Plasma fibrinogen level is significantly high and platelet count is relatively low at 3rd trimester of pregnancy. Coagulation parameters are altered in a balanced way during normal 3rd trimester pregnancy.

298 Alternative regimens in the treatment of toxoplasmosis during 2nd & 3rd trimester pregnancies

298 Alternative regimens in the treatment of toxoplasmosis during 2nd & 3rd trimester pregnancies

105 Medication effectiveness in the treatment of Insomnia in 3rd trimester pregnancies

105 Medication effectiveness in the treatment of Insomnia in 3rd trimester pregnancies

Sleep disorders and changes in melatonin concentrations in pregnant women with preeclampsia

Melatonin plays a significant role in the development of normal pregnancy, in particular, it contributes to the successful implantation of the fertilized egg, affects the act of childbirth, is actively produced by the trophoblast and placenta, reduces oxidative stress, in particular, with preeclampsia. In addition, melatonin is one of the essential hormones in the protection of the endothelium and stem cells from the oxidant stress. Objective – to study the mechanisms of development, terms of manifestation, and types of sleep disorders, as well as changes in the concentrations of melatonin in the blood of pregnant women with preeclampsia. Material and methods. 50 pregnant women at a mean age of 29.1±3.4 years who had preeclampsia in the 3rd pregnancy trimester were examined (experimental group). All women in the research group had a gestation term of 30-32 weeks of pregnancy. The control group consisted of 33 women with a mean age of 31.2±6.6 years who had an uncomplicated pregnancy. The presence of sleep disorders was established using a questionnaire: pregnant women were asked about the term of pregnancy in which complaints of sleep disorders appeared, the nature of sleep disorders, the frequency of episodes of sleep disorders (how many times a week such a condition was noted), etc. The concentration of melatonin in the venous blood of the examined pregnant women was also determined, for which IBL melatonin ELISA diagnostic kits manufactured by IBL, Germany were used. Blood was taken at 9:00 a.m., on an empty stomach, and all patients were analyzed at the same time of a day. Results and their discussion. The study showed that sleep disorders in pregnant women with pre-eclampsia, which complicates the pregnancy in the 3rd trimester, occurred earlier, compared to women with an uncomplicated course of pregnancy: pregnant women with pre-eclampsia were more likely to notice worsening of sleep, starting from 22-30 weeks of pregnancy (in 26.0 % of cases), while in pregnant women with a physiological course of gestation, similar complaints appeared mainly after 30 weeks. In the third trimester of pregnancy women with preeclampsia were more likely to wake up 2 or more times per night (in 68.0 % of cases) compared to controls (in 23.3 % of cases, p < 0.001) and 3 or more times per night per week (in 54.0 % of cases, in controls – in 16.7 % of cases, p < 0.001), which may be a consequence of a disorder of the function of the pineal gland. Women with preeclampsia were more likely (56.0 % vs. 13.3 % in the control group, p < 0.01) to use gadgets (electronic devices, mainly smartphones) for more than 2 hours after 9:00 p.m., which also negatively affects the function of the pineal gland. In pregnant women whose pregnancy was complicated by preeclampsia in the 3rd trimester, a significant (1.78-fold) decrease in the level of melatonin in venous blood taken at 9 a.m. was observed, compared to women with an uncomplicated pregnancy (p = 0.029). Conclusions. Sleep disorders in pregnant women with preeclampsia occur earlier and are more expressed compared to women with an uncomplicated course of pregnancy. The appearance of complaints of insomnia in the second trimester of pregnancy, in our opinion, can be considered a diagnostic sign of pineal gland dysfunction in preeclampsia. A decrease in the level of melatonin in pregnant women with preeclampsia, established against the background of minimal daily activity of the pineal gland (at 9 a.m.), indicates a decrease in the melatonin-producing function of the placenta which might have an impact on the condition of stem cells of fetus and placenta.

FRI400 A Rare Case Of Acute Sheehan's Syndrome In An Antepartum Patient

Abstract Disclosure: E. Jalal: None. C. Baldwin: None. Sheehan’s syndrome (SS) is a known complication of postpartum hemorrhage. It is typically diagnosed several years after birth given slow symptom onset related to hypopituitarism. We report a rare case of life-threatening antepartum pituitary ischemia secondary to hypotension, representing an acute presentation of SS. A 19-year-old primigravid woman at 31 weeks of gestation was admitted to the intensive care unit for septic shock secondary to Klebsiella pneumoniae pyelonephritis. Despite appropriate treatment, persistent hypotension prevented weaning of vasopressor support. Due to concurrent mild hyponatremia, the following studies were obtained: morning cortisol (2.46 mcg/dL [4.5-23 mcg/dL]), thyroid stimulating hormone (TSH) (0.379 IU/L [0.47-4.7 IU/L]), free triiodothyronine (2.1 pg/mL [2.8-5.3 pg/mL]), and free thyroxine (0.77 ng/dL [0.7-1.8 ng/dL]). Endocrinology was consulted for evaluation of adrenal insufficiency and abnormal thyroid function tests. Her prolactin was measured at 10.3 ng/mL, far below the expected range in a 3rd trimester pregnancy (35-600 ng/mL). Her remaining anterior pituitary hormone panel was unremarkable. MRI brain without contrast showed no evidence of an acute stroke or hemorrhage and commented that the prominence of the pituitary gland was likely related to current pregnancy. Stress dose hydrocortisone 100mg thrice daily and levothyroxine 50 mcg daily were initiated, allowing for weaning of vasopressor support. By discharge, she was titrated to levothyroxine 75mcg daily and hydrocortisone 20mg in the morning and 5mg in the afternoon. Repeat outpatient pituitary function testing found increase of prolactin to 397 ng/mL (35-600 ng/mL) and of IGF-1 to 486 ng/mL (113-408 ng/mL) as well as normalization of TSH to 3.210 (0.45-4.5IU/L), indicating likely recovery of pituitary axis. When readmitted at 38 weeks gestation for scheduled induction, she was given stress dose hydrocortisone 100mcg for labor. On discharge, she was tapered to prednisone 10mg daily and levothyroxine 50mcg daily. Appropriate hormone replacement and stress dose hydrocortisone resulted in an uncomplicated delivery and signs of clinical pituitary recovery postpartum as she was able to breastfeed without need for supplementation and maintain normotension after self-discontinuing prednisone and levothyroxine. The leading diagnosis to explain this patient’s hypopituitarism is acute SS, which is defined as symptom onset within 6 weeks postpartum. In our case, septic shock caused an abrupt onset of persistent hypotension leading to hormone levels suggestive of panhypopituitarism while the patient was pregnant at 31 weeks of gestation, which has not been reported in prior literature. While known as a chronic diagnosis in the postpartum population, further research should explore possible stunning effect of acute hypotension manifesting as acute SS in peripartum patients. Presentation: Friday, June 16, 2023

The effect of N-arachidonoylethanolamide administration on energy and fat metabolism of early lactating dairy cows

The aim of the study was to investigate the effect of N-arachidonoylethanolamide (AEA), an endocannabinoid with orexigenic characteristics, on plasma endocannabinoid concentrations, feed intake, energy balance, lipomobilisation, and hepatic lipid metabolism of early-lactating dairy cows. The experiment involved 10 pairs of Holstein half-sibling cows (end of 2nd–3rd pregnancy). Half-sibs of each pair were randomly assigned to either AEA (n = 10) or control (CON) group (n = 10). From day 1 to 30 postpartum, the AEA group received 5 intraperitoneal injections per week of 3 µg/kg body weight AEA and the CON group 0.9% NaCl. In week 1–3 postpartum, AEA administration had no effect on dry matter intake, body weight, or lipomobilisation, but increased plasma triglyceride concentration on d 21 p.p. and mRNA abundances of genes related to hepatic triglyceride synthesis. In week 4 postpartum, the AEA group showed reduced feed intake and whole-body carbohydrate oxidation, but increased whole-body fat oxidation and hepatic lipid accumulation, likely as a result of a counter-regulatory leptin increase. In conclusion, the present study shows a tissue-specific AEA insensitivity and may point to a leptin-controlled regulation of the ECS in early-lactation.

The Effort to Healthy Pregnancy Through Education on Physical Activity, Nutrition and Body Mechanics

Pregnancy as a physiological process is often an obstacle to maintaining optimal health due to the discomfort that occurs during this period. Various obstacles due to discomfort can prevent pregnant women from being physically active, implementing a healthy diet. In addition, in the 3rd trimester of pregnancy, most pregnant women experience the discomfort of back pain, and many are not aware of the management that can be done. This condition causes pregnant women to be unfit during the pregnancy process. This community service program aims to increase the knowledge of pregnant women related to physical activity, nutrition and body mechanics so that the pregnancy is a quality process. This community service was conducted in Noyontaansari sub-district, the working area of Pekalongan City Noyontaan Health Center, which 29 pregnant women attended. The activity was carried out through education in pregnant women's class activities. There was an increase in the knowledge level of pregnant women before and after the education. The knowledge tested included knowledge about physical activity (exercise), nutrition, and body mechanics for pregnant women. The pre-test results showed that most (62%) had a moderate level of knowledge, 7% had less knowledge and only 31% had good knowledge. After the training, the post-test results showed that all pregnant women had a good level of knowledge. This is an indication of the success of the PkM activities in improving knowledge.

Effect of prenatal exposure to organophosphates and pyrethroid pesticides on neonatal anthropometric measures and gestational age

Several studies have examined the association between prenatal exposure to organophosphate and pyrethroid pesticides and their impact on foetal growth and newborn anthropometry; however, the available evidence is limited and inconclusive. This study examined whether prenatal organophosphate and pyrethroid pesticide exposure was associated with anthropometric measures at birth (weight, length, head circumference), ponderal index, gestational age, and prematurity in 537 mother-child pairs. These were randomly selected from the 800 pairs participating in the prospective birth cohort GENEIDA (Genetics, early life environmental exposures and infant development in Andalusia). Six non-specific organophosphate metabolites (dialkylphosphates, DAPs), one metabolite relatively specific to chlorpyrifos (3,5,6-trichloro-2-pyridinol, TCPy) and a common metabolite to several pyrethroids (3-phenoxybenzoic acid, 3-PBA) were measured in maternal urine from the 1st and 3rd pregnancy trimesters. Information on anthropometric measures at birth, gestational age and prematurity was retrieved from medical records. The sum on a molar basis of DAPs with methyl (ƩDMs) and ethyl (ƩDEs) moieties and the sum of the 6 DAPs metabolites (ƩDAPs) was calculated for both trimesters of pregnancy. High urinary levels of dimethyl phosphate (DMP) during the 3rd trimester were associated with a decrease in birth weight (β = −0.24; 95% CI: 0.41; −0.06) and birth length (β = −0.20; 95% CI: 0.41; 0.02). Likewise, ΣDMs during 3rd trimester were near-significantly associated with decreased birth weight (β = −0.18; 95% CI: 0.37; 0.01). In turn, increased urinary TCPy during 1st trimester was associated with a decreased head circumference (β = −0.31; 95% CI: 0.57; −0.06). Finally, an increase in 3-PBA in the 1st trimester was associated with a decreased gestational age (β = −0.36 95% CI: 0.65–0.08), whereas increased 3-PBA at 1st and 3rd trimester was associated with prematurity. These results indicate that prenatal exposure to organophosphate and pyrethroid insecticides could affect normal foetal growth, shorten gestational age and alter anthropometric measures at birth.

Cantrell Pentalogy Associating Acrania and Iniencephaly: Antenatal Ultrasound Diagnosis at the CHU Pr BSS of Kati

Introduction: Cantrell's pentalogy is a rare malformation, which associates 5 cardinal malformations: supraumbilical hernia of the abdominal wall, defect of the anterior part of the diaphragm and diaphragmatic pericardium, abnormality of the lower part of the sternum, heart defects. Ultrasound is essential in antenatal diagnosis. We report a case of polymaformative syndrome, including Cantrell pentalogy, acrania and iniencephaly. Observations: Mrs. BS, 24 years old, housewife, resident in rural areas, 3rd pregnancy, two live children, no medical-surgical history or known fetal malformation, no notion of teratogenic drug intake. Coming for his first ultrasound, which, performed by two radiologists concluded to a polyformative syndrome associating cantrell pentalogy, acrânie and iniencephaly: by the presence of a defect of closure of the anterior thoraco-abdominal wall resulting in an evisceration of the intra-abdominal organs, a cardiac malformation, the absence of formation of the bones of the skull, and absence of cervico-occipital bone formation with neck shortening and hyper extension of the head. The pregnancy was estimated at 27 weeks, the couple was informed of the fate of the future baby and the pregnancy intervention was proposed. After their agreement the labor was triggered, after 8 hours, she expelled a live newborn male, polymalformed confirming the ultrasound diagnosis, weighing 1900grams and lived only thirty minutes after birth. Conclusion: The polymalformative syndrome associating cantrell pentalogy, acrania and iniencepahlia is exceptional. Ultrasound is essential in diagnosis. Termination of pregnancy is the rule.

Prenatal exposure to synthetic phenols and phthalates and child respiratory health from 2 to 36 months of life

Exposure to phthalates and synthetic phenols is ubiquitous. Some of them are suspected to impact child respiratory health, although evidence still remains insufficient. This study investigated the associations between prenatal exposure to phthalates and phenols, individually and as a mixture, and child respiratory health assessed by objective lung function measures since 2 months of age. Among 479 mother-child pairs from the SEPAGES cohort, 12 phenols, 13 phthalate and 2 non-phthalate plasticizer metabolites were measured in 2 pools including each 21 urine samples collected at the 2nd and 3rd pregnancy trimesters. Lung function was measured at 2 months using tidal breathing flow-volume loops and nitrogen multiple-breath washout, and at 3 years using oscillometry. Asthma, wheezing, bronchitis and bronchiolitis were assessed by repeated questionnaires. A cluster-based analysis was applied to identify exposure patterns to phenols and phthalates. Adjusted associations between clusters as well as each individual exposure biomarker and child respiratory health were estimated by regression models. We identified four prenatal exposure patterns: 1) low concentrations of all biomarkers (reference, n = 106), 2) low phenols–moderate phthalates (n = 162), 3) high concentrations of all biomarkers except bisphenol S (n = 109), 4) high parabens–moderate other phenols–low phthalates (n = 102). At 2 months, cluster 2 infants had lower functional residual capacity and tidal volume and higher ratio of time to peak tidal expiratory flow to expiratory time (tPTEF/tE) and cluster 3 had lower lung clearance index and higher tPTEF/tE. Clusters were not associated with respiratory health at 3 years but in the single-pollutant models, parabens were associated with increased area of the reactance curve, bronchitis (methyl, ethyl parabens) and bronchiolitis (propyl paraben). Our results suggested that prenatal exposure to mixtures of phthalates reduced lung volume in early life. Single exposure analyses suggested associations of parabens with impaired lung function and increased risk of respiratory diseases.

A CROSS-SECTIONAL, OBSERVATIONAL AND ANALYTICAL STUDY TO DETERMINE TOTAL MACULAR VOLUME AND FOVEAL RETINAL THICKNESS IN PREGNANT WOMEN

INTRODUCTION: Owing to the hemodynamic changes due to hormones during pregnancy, multiple anatomical, physiological and biochemical changes occur in all systems. These changes are transient in nature but may cause permanent damage if not caught early. To evaluate Total Macular Volume a PURPOSE: nd Foveal Retinal Thickness in 3rd trimester Pregnancy between (Normal Pregnant, Pregnancy Induced Hypertensives, Gestational Diabetics) and to compare these values with healthy non-pregnant females of the same age matched group. A total of 140 eyes of 70 patients were evaluated for Total m METHODOLOGY: acular volume and foveal retinal thickness changes using OCT (3D Macula scan) and the results were compared by ANOVA and Paired-T test (SPSS software, version-26.0). Notable difference was noted in Total macular volume and Foveal ret RESULTS: inal thickness between pregnant and nonpregnant. Also, notable difference noted between 3rd trimester healthy pregnant, gestational diabetics and pregnancy induced hypertensives (p value <0.05). Pregnancy summated with Diabetes / Hypertension may lead to permane CONCLUSION: nt damage. Hence awareness and screening of pregnant females' post-partum is necessary.

Open versus laparoscopic appendectomy for acute appendicitis in pregnancy: a population-based study.

Laparoscopic appendectomy (LA) is the standard treatment for acute appendicitis (AA) in general population. However, the safety of LA during pregnancy has remained a matter of debate. The purpose of this study was to compare surgical and obstetrical outcomes in pregnant women who underwent LA vs. open appendectomy (OA) for AA. We hypothesized that LA results in improved surgical and obstetric outcomes during pregnancy. Using a nationwide claim-based database in Estonia, a retrospective review of all cases of pregnant women undergoing OA or LA for AA from 2010 to 2020 was performed. Patient characteristics, surgical and obstetrical outcomes were analyzed. Primary outcomes were preterm delivery, fetal loss and perinatal mortality. Secondary outcomes included operative time, hospital length of stay (HLOS) and 30-day postoperative complications. Overall, 102 patients were included of whom 68 (67%) underwent OA and 34 patients (33%) LA, respectively. Patients in LA cohort had a significantly shorter length of pregnancy in terms of gestational weeks when compared to OA cohort (12weeks versus 17weeks, p = 0.002). Most of the patients in their 3rd trimester pregnancy were subjected to OA. Operative time in LA cohort was shorter than in OA cohort (34min. versus 44min., p = 0.038). HLOS in LA cohort was shorter than in OA cohort (2.1days versus 2.9days, p = 0.016). There were no differences between OA and LA cohorts in terms of surgical complications or obstetrical outcomes. Laparoscopic appendectomy for acute appendicitis was associated with a significantly shorter operative time and a shorter hospital length of stay while open and laparoscopic appendectomy cohorts experienced comparable obstetrical outcomes. Our findings support the laparoscopic approach for acute appendicitis in pregnancy.

Medication Effectiveness for New-onset Headaches in 2nd & 3rd Trimester Pregnancies Refractory to Acetaminophen

Pregnant women experiencing new-onset headaches (NOH) is a common occurrence, yet management approaches are highly varied among providers and specialties, with uncertainty arising when a patient fails initial acetaminophen (APAP) treatment. This study sought to determine which alternative medication proved most effective for patients with NOH refractory to APAP.

Risk Factor of Stillbirth among Pregnant Women at Dr. Hasan Sadikin General Hospital Bandung from 2017–2020

Background: Stillbirth is one of the most devastating pregnancy outcomes that affects approximately 2.6 million pregnancies worldwide. Several factors have been identified to be associated with stillbirth, and grouped based on the pathophysiological aspects, such as maternal, placental, fetal, and unknown or unexplained factors. This study aimed to describe the prevalence, along with the baseline and risk factor characteristics of stillbirth among singleton pregnancies at Dr. Hasan Sadikin General Hospital Bandung. Methods: A descriptive, cross-sectional study design was conducted, including all stillbirth medical records from 2017 to 2020 obtained from the Department of Obstetrics and Gynecology, Dr. Hasan Sadikin General Hospital Bandung. Medical records with complete baseline data, 2nd–3rd trimester pregnancies, and singleton pregnancies were collected.Results: The prevalence of stillbirth cases in this study was 2.2%. Most of the cases occurred in the age range of 20–35 years old (64.4%) with the gestational age of >28 weeks (65.8%). Of all risk factors observed, hypertensive disorders were the most common medical conditions found (45.6%), followed by unknown factors (17.8%), and congenital abnormalities (14.2%).Conclusions: The majority of stillbirth patients are at their optimal reproductive age, nulliparity, and have hypertensive disorders during pregnancy, specifically the superimposed preeclampsia subtype. Although the prevalence is considerably low, early management of the risk factors, particularly hypertensive disorder, is important to prevent its occurrence.

Malaria during pregnancy: An insights of complications

Malaria is one of the leading causes of morbidity and mortality around the globe including Pakistan. Plasmodium vivax and Plasmodium falciparum are causing the majority of infections which are increasing and account for approximately 35-40% of cases. Several physiological and pathological changes occur due to adverse effects of malaria in pregnancy. The current study was conducted in District Headquarter Teaching Hospital, Dera Ismail Khan, Khyber Pakhtunkhwa, Pakistan to govern the possessions and complications of malarial parasitaemia in pregnancy. Two thousand pregnant patients associated with malaria were included in this study. Regarding stage, and parity of pregnancy, malarial infections were found more common in primigravida and second gravida than in multigravida. Two commonest pathogens (Plasmodium vivax, and Plasmodium falciparum) were observed in pregnant patients. It was found that 84 (23.01%) of 365 women in their first pregnancy (P0) were parasitaemic. In 2nd, 3rd, and 4th pregnancies, almost 24.49, 28.94, 29.38, and 29.32% of women, respectively were parasitaemic. The maximum incidence of P. vivax was recorded in 3rd trimester followed by the 2nd, and 1st trimesters. Regarding pregnancy outcomes, 1.35% of patients developed puerperal pyrexia, 2.2 had an abortion, 5.50% neonatal death occurred, 6.90% patients had anemia, 1.25% patients have cerebral malaria, and a total of 6.6% complications were recorded in the current study. It is concluded that pregnant women are prone to malaria infections, causing spontaneous abortion, premature birth, reduce baby weight, and stillbirth, particularly in high-endemic areas.

Three consecutive recurrent ectopic pregnancy-A Case Report

Ectopic pregnancy (EP) is a potentially life-threatening condition, leads to increased maternal mortality and morbidity till date. About 2% of all pregnancies are Ectopic one and recurrence rate is as high as 1 in every 10 pregnancies. Here we present a case who had a history of 2 Ectopic pregnancies – 1st one treated surgically and 2nd one by medical method. Unfortunately, 3rd pregnancy was also an Ectopic one and needed surgical management. Thus, her natural reproductive ability went down and had to go for In vitro fertilization (IVF) pregnancy and successfully got twin baby (Girl, on March,2020). Northern International Medical College Journal Vol. 12 No.1 July 2020, Page 511-514

Efecto del peso y la puntuación de la condición corporal de vacas gestantes en las características de la canal de su progenie: Meta análisis

The objective of the meta-analysis was to evaluate the effects of beef cows weight variation during the 2nd and / or 3rd trimester pregnancy on some parameters of the progeny carcass. The cow weight gain during this gestational period was calculated to standardize the treatments: moderate loss (ML= cows that lost 0 to 5 % of weight) and moderate gain (MG= cows that gained 0 to 5 % of weight). The effect size for all parameters was calculated as medium difference (MD) with a 95% confidence interval and heterogeneity determined using the Q test and the I2 statistic. A random effects meta-analysis was performed for each indicator separately as the medium control and experimental groups. The cow’s weight variation during the studied time variation did not influence the progeny carcass characteristics (P>0.05). Although, a trend towards greater hot carcass weight (P=0.15) and thickness of subcutaneous fat (P=0.10) was observed in calves from MG cows in relation to calves from ML cows. However, the meta-analysis demonstrated that small variations in cow weight during the final half of pregnancy do not affect progeny carcass characteristics.