3rd Trimester Of Pregnancy Research Articles

When faced with macrocytic anemia in a pregnant woman, consider a vitamin B12 deficiency: About a case and review of the literature

The demonstration of a macrocytic anemia, especially aregenerative, during pregnancy, especially if associated with other abnormalities of other lineages (white blood cells and platelets) can be severe in pregnant women, hence the need to look for the causal condition which may be a deficiency cause especially in vitamin B12 or other more serious pathology. We report a case of pan cytopenia of deficiency origin during the 3rd trimester of pregnancy treated in our training. Pancytopenia of deficiency origin remains exceptional during pregnancy, especially in vitamin B12, and given its hemorrhagic and infectious severity, its discovery requires investigation and vitamin deficiency must be sought, particularly in the face of macrocytic anemia.

Self-Advocacy Among Black Women During the Perinatal Period: Prevalence and Relationship to Patient Experiences.

Black women experience many barriers to receiving high-quality maternal healthcare. The ability of Black women to self-advocate may mitigate these threats to their health. Limited research describes Black women's self-advocacy during the perinatal period and how self-advocacy related to other relevant concepts. The aim of this study was to describe the relationship between self-advocacy, patient-provider relationships, and mental health outcomes among Black women in the perinatal period. This cross-sectional descriptive pilot study recruited Black women who were either in their 3rd trimester of pregnancy or within a year postpartum to complete surveys describing their self-advocacy (Female Self-Advocacy in Cancer Survivorship Scale adapted for perinatal period) and maternal health outcomes (trust and comfort with maternal healthcare providers-Patient-Provider Relationship Scale; abuse and disrespect during childbirth-Mothers of Respect Index; experiences of discrimination-Experiences of Discrimination scale; depression-Edinburgh Postnatal Depression Scale; and postpartum posttraumatic stress-City Birth Trauma Scale). N = 40 participants were recruited between January and September 2022. Participants reported moderate levels of self-advocacy which were associated with trust and comfort with healthcare providers (r = 0.57-0.76, p < 0.001). Feeling respected by healthcare providers was positively associated with two self-advocacy subscales (r = 0.42-0.44, p < 0.01). Depression was inversely related to all self-advocacy subscales (r = -0.47-0.62, p < 0.001). Black women's self-advocacy during the perinatal period is associated with trust and comfort with healthcare providers, perceptions of respect from their providers, and perinatal depression. Future research should focus on promoting trusting, respectful relationships between Black women and their maternal health providers.

Gestational exposure to organophosphate esters and autism spectrum disorder and other non-typical development in a cohort with elevated familial likelihood

BackgroundGestational exposure to organophosphate esters (OPEs) is known to affect offspring neurodevelopment in animal studies. However, epidemiological evidence is inconsistent. MethodsParticipants were 277 mother-child pairs from MARBLES (Markers of Autism Risk in Babies – Learning Early Signs), a cohort with elevated familial likelihood of autism spectrum disorder (ASD). Nine OPE biomarker concentrations were quantified in maternal urine collected during the 2nd or 3rd trimesters of pregnancy. At age 3 years, children underwent clinical assessment for ASD and were classified into ASD, other non-typical development (non-TD), or typical development (TD). Multinomial logistic regression was used to estimate associations between each OPE biomarker and relative risk ratios for ASD and non-TD compared to TD. We examined effect modification by child sex and socioeconomic status. We also conducted a secondary analysis by using a continuous measure of ASD symptom severity as an outcome. Quantile-based g-computation was performed to examine the associations for an OPE mixture. ResultsOverall, no significant association was observed between the concentrations of each OPE biomarker or their mixture and relative risk for either ASD or non-TD. Effect modifications by child sex and maternal education were not observed. When the analysis was stratified by homeownership, among non-homeowners, ASD likelihood was increased with increased levels of bis(1-chloro-2-propyl) phosphate, bis(butoxyethyl) phosphate, and sum of di-n-butyl phosphate and di-iso-butyl phosphate (DBUP/DIBP) (pint < 0.10). Higher DBUP/DIBP were associated with increased ASD symptom severity scores. ConclusionThere was no clear evidence of gestational OPE exposure in association with relative risk for ASD; however, potential effect modification by homeownership was observed. Although our cohort includes children with elevated familial likelihood of ASD, this is the first study investigating the association between gestational OPE exposure and clinically-diagnosed ASD. Further research is needed to confirm our findings in the general population.

Effects of Dichlorvos on Pregnancy Outcomes in Wistar Albino Rats

Dichlorvos is an organophosphate widely used as an insecticide. This study determines the effect of dichlorvos on pregnancy in Wistar rats. Forty-two bred female rats were divided into 7 groups (A, B, C, D, E, F and G) comprising of 6 rats each. Rats in 3 groups received 4.45mg/kg in the 1st, 2nd and 3rd trimester of pregnancy, respectively. The other 3 groups received 8.9mg/kg in 1st, 2nd and 3rd trimester, respectively. The dam to pups’ ratio decreased as the dose of dichlorvos increased except in the third trimester. The percentage birth weight of the treated groups was not different from the control except at third trimester when there was a significant (p 0.05) decrease in the 8.9mg/kg groups. There were no significant (p 0.05) differences in the crown-rump and gestation length within the groups and trimesters except in the third trimester where there was a significant difference (p 0.05) between 8.9mg/kg group and others. The study shows that dichlorvos is capable of altering pregnancy outcomes in female Wistar rats.

The influence of the perception, attitude, and level of trust on the uptake of COVID-19 vaccinations among pregnant women attending antenatal care clinic in mbeya urban, Tanzania

BackgroundCoronavirus Disease 2019 (COVID–19) has been associated with adverse effects and death among people with low immunity, including pregnant women. Despite introducing the vaccine as the proper means to curb the spread of the pandemic, vaccine uptake is still low. This study assessed the influence of perception, attitude, and trust toward COVID-19 vaccine uptake among pregnant women attending Antenatal Care Clinics.MethodsA cross-sectional study design was used, utilizing a quantitative approach with a cross-sectional analytical design conducted in Mbeya urban, distribution of sample size during data collection based on client’s volume at three government health facilities (one tertiary health facility, one secondary health facility, and one primary health facility) in Mbeya Urban, Tanzania. Data were collected from 333 pregnant women who attended ANC during the data collection period using a questionnaire with closed-ended questions administered to respondents face-to-face. Data cleaning and analysis were done using Excel and Stata/SE 14.1 software for bivariate and multivariate data; Pearson’s chi-squire and Fisher’s test were used to analyze the independent determinants of COVID-19 vaccine uptake.ResultsThe proportion of pregnant women vaccinated with the COVID-19 vaccine was 27%. There was a statistically significant association between the respondents’ vaccine uptake with primary education and < 5 work experience to vaccine uptake P = 0.015 (AOR = 6.58; 95% CI; 1.45–29.85), and P = 0.046 (AOR = 2.45; 95% CI; 1.02–5.89) respectively. The association of attitude influence to COVID-19 vaccine uptake was statistically significant (acceptance of vaccine due to its availability, vaccine acceptance for protection against COVID-19 pandemic to respondent and her baby, experience from other vaccines) was statistically significant at P = 0.011 (AOR = 4.43; 95% CI; 1.41–13.93), P = 0.001 (AOR = 45.83; 95% CI; 18.6-112.89) respectively. The level of trust in the COVID-19 vaccine influenced respondents’ association with vaccine uptake in the 2nd and 3rd trimesters of pregnancy (P = 0.633 (AOR = 1.23; 95% CI; 0.53–2.48), respectively.ConclusionPregnant women’s positive attitude and trust in the COVID-19 vaccine influenced them to uptake it; our conclusion supports the WHO guidelines that the COVID-19 vaccine should be administered to pregnant women since it is a safer means to curb COVID-19 pregnancy-related complications.

Maternal prenatal immune activation associated with brain tissue microstructure and metabolite concentrations in newborn infants

Few human studies have assessed the association of prenatal maternal immune activation (MIA) with measures of brain development and psychiatric risk in newborn offspring. Our goal was to identify the effects of MIA during the 2nd and 3rd trimesters of pregnancy on newborn measures of brain metabolite concentrations, tissue microstructure, and motor development. This was a prospective longitudinal cohort study conducted with nulliparous pregnant women who were aged 14 to 19 years and recruited in their 2nd trimester, as well as their children who were followed through 14 months of age. MIA was indexed by maternal interleukin-6 (IL-6) and C-reactive protein (CRP) in both trimesters of pregnancy.Primary outcomes included: (1) newborn brain metabolite concentrations as ratios to creatine (N-acetylaspartate (NAA)/creatine (Cr) and choline (Cho)/Cr) measured using Magnetic Resonance Spectroscopy; (2) newborn fractional anisotropy and mean diffusivity, measured using Diffusion Tensor Imaging; and (3) indices of motor development, assessed prenatally and postnatally at ages 4- and 14-months. Maternal IL-6 and CRP levels associated significantly with both metabolites in the putamen, thalamus, insula, and the internal capsule. Maternal IL-6 associated significantly with fractional anisotropy in the putamen, caudate, thalamus, insula, and precuneus, and with mean diffusivity in the inferior parietal and middle temporal gyrus. CRP associated significantly with fractional anisotropy in the thalamus, insula, and putamen. Significant associations were found in common regions across imaging modalities, though the direction of associations differed by immune marker. In addition, both maternal IL-6 and CRP (in both trimesters) prenatally associated significantly with offspring motor development at 4- and 14-months of age. The left thalamus mediated effects of IL-6 on postnatal motor development. These findings demonstrate that levels of MIA in mid- to late pregnancy in a generally healthy sample associate with tissue characteristics in newborn brain regions that primarily support motor integration and coordination, as well as behavioral regulation. Those brain effects may contribute to differences in motor development.

Maternal immune response during pregnancy and neurodevelopmental outcomes: A longitudinal approach

Background and objectivesThe neurodevelopment of the offspring is suggested to be influenced by the maternal immune system's responses throughout pregnancy, which in turn is also vulnerable to maternal psychosocial stress conditions. Therefore, our main goal was to investigate whether maternal peripheral immunological biomarkers (IB) during two stages of gestation are associated with distinct neurodevelopmental trajectories in the first two years of life. As a second goal, we also explored the association between maternal distal (childhood) and proximal (gestation) stressful experiences and the immunological markers assessed during pregnancy. MethodsMaternal childhood trauma, depressive and anxiety symptoms, and peripheral IB (IFNγ, IL-10, IL1β, IL6, IL8, TNFα, EGF, IL13, IL17, IL1Ra and IL4) were measured at baseline (8–16 weeks of pregnancy) and at 30 weeks of pregnancy in 160 women. The participants had the blood samples collected from two randomized clinical trials conducted by the same team and methods in the same community. A Principal Component Analysis (PCA) was implemented to create meaningful composite variables that describe the cytokines joint variation. Finally, linear mixed-effects modeling was used to investigate the influence of inflammatory biomarkers, maternal childhood trauma, anxiety, and depressive symptoms on Bayley's III scores trajectories. ResultsThe IB profile during the 3rd trimester of pregnancy predicted the offspring's neurodevelopmental trajectories in the first two years of life. The components derived from PCA were important predictors and captured different immune responses, reflecting both pro- and anti-inflammatory states. Maternal stressful experiences did not correlate with the immunological markers. Although not a reliable predictor alone, maternal psychosocial stress at the 1st trimester of pregnancy interacted with the mother's immune response while predicting the neurodevelopmental scores during the first two years of life. ConclusionsOur results underscore the importance of the maternal immune response during pregnancy in shaping the neurodevelopmental trajectory of the offspring. Additionally, we observed that the maternal distress at the early stages of pregnancy has an incremental effect on the neurodevelopmental outcome but depends upon the immune response.

The association between maternal fruit consumption before and during pregnancy and fetal growth: The Lanzhou birth cohort study

BackgroundThe association between maternal fruit consumption and fetal growth remains inconsistent. The current study aimed to determine whether maternal fruit consumption was associated with low birth weight (LBW) or small for gestational age (SGA) babies. MethodsA large birth cohort study was conducted in Lanzhou, China, from 2010 to 2012 and included 10,076 pregnant women at the 1st, 2nd, and 3rd trimester of pregnancy for analysis. Fruit consumption in the 1st, 2nd, and 3rd trimester of pregnancy was measured by a self-designed food frequency questionnaire (FFQ) and divided into three groups: 1) inadequate fruit consumption: <200 g/d for the1st, 2nd, and 3rd trimester; 2) adequate fruit consumption: 200–350 g/d for the 1st trimester or 200–400 g/d for the 2nd and 3rd trimester; 3) excessive fruit consumption: >350 g/d for the 1st trimester or > 400 g/d for the 2nd and 3rd trimester. A case-control study was used to analyze the association between fruit intake during pregnancy and low birth weight infants. ResultsCompared to adequate fruit consumption, excessive fruit consumption throughout each trimester of pregnancy was associated with a lower risk of LBW, with an odds ratio (OR) ranging from 0.70 to 0.79 (95 % confidence interval, CI: 0.57–0.98); while inadequate fruit consumption was associated with a higher risk of infant LBW, with an OR ranging from 1.26 to 1.36 (95%CI: 1.04–1.66). After stratifying by mother's pre-pregnancy body mass index (BMI), the results were similar among women with underweight BMI. No significance was found between fruit consumption and SGA in the general population. Still, stratified analyses showed that inadequate fruit consumption was associated with an increased risk of SGA in underweight mothers, with an OR ranging from 1.66 to 1.79 (95%CI: 1.13–2.64). ConclusionsFruit consumption during pregnancy reduces the risk of LBW in Chinese women, especially in women with low pre-pregnancy BMI.

Acute Myeloblastic Leukemia Discovered in the 3rd Trimester of Pregnancy

Acute leukemia (AL) rarely occurs during pregnancy. Its incidence is estimated at 1/100 000 pregnancies. In 2/3 of the cases, it is acute myeloblastic leukemia (AML). The dilemma is between chemotherapy which should not be delayed for a better therapeutic prognosis and a foetus at risk of malformation or morbidity and mortality by induced prematurity. We report the observation of a 25-year-old patient in whom we diagnosed AML occurring during a pregnancy at 35 weeks of amenorrhea, and who benefited from obstetrical management then chemotherapy.

Short-Term Practice of Pranayama Based Yoga Ensures Sympathovagal Balance and Facilitates Fetomaternal Outcomes in Gestational Diabetes in the 3rd Trimester of Pregnancy

Short-Term Practice of Pranayama Based Yoga Ensures Sympathovagal Balance and Facilitates Fetomaternal Outcomes in Gestational Diabetes in the 3rd Trimester of Pregnancy

Association between dietary calcium and pregnancy induced hypertension

Background: Pregnancy induced hypertension (PIH) is one of the major complications of pregnancy. Inadequate calcium (Ca) intake is considered a public health problem in some vulnerable groups, especially pregnant women. A balanced diet during pregnancy with adequate Ca should be the ideal solution, and to proceed in this direction, evidence is required on the nature and extent of Ca deficiency in the diet of PIH mothers. Objectives: To assess the dietary intake of Ca in PIH (compared to non-PIH) mothers and to explore the factors affecting the intake of those nutrients. Methods: Under an observational case-control design, we recruited 300 Bangladeshi pregnant women in two groups (150 with and 150 without PIH), aged between 20-40 years (from 3 hospitals in Dhaka) at the 3rd trimester of pregnancy. A pre-tested questionnaire was used to collect the data. The first part of the questionnaire was allocated to general socio-demographic and clinical characteristics. Secondly, a food frequency questionnaire was used to estimate individual dietary Ca intake. Results: The dietary Calcium intake [(mg/day), median (range)] was significantly lower [265(111-487)] (p&lt;0.001) in the PIH compared to the non-PIH [350(201-984) ;(p&lt;0.001)] group. On bivariate analysis, the dietary Calcium intakes had a significantly negative correlation with mean blood pressure which was considered an indicator of the severity of PIH (r=-0.276; p&lt;0.001) for Ca. On regression analysis, PIH was found to be significantly associated with a lower intake of Ca (b=-0.009; p&lt;0.001) when the effects of age, family history of HTN and family income were adjusted. Conclusion: Dietary consumption of Calcium during pregnancy is much lower than those recommended in our population, PIH seems to have an association with dietary deficiency of Calcium in pregnant women. Bioresearch Commu. 10(2): 1612-1618, 2024 (July)

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 (&lt;6/18-6/60) were 41.2%, and poor visual acuity (&lt;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 (&lt;6/18-6/60) were 14.7%, and poor visual acuity (&lt;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.

Analyzing Protein and Glucose Levels in Pregnant Women Attending Antenatal Care at Health Centers in Port Harcourt, Rivers State

Protein and glucose serve as crucial indicators of potential maternal health complications and fetal outcomes during pregnancy. This study aimed to investigate protein and glucose level of pregnant women attending antenatal care in some health centre, in Port Harcourt, Nigeria. A total of sixty pregnant women between ages 16-45 who attended antenatal care in the selected health centres were randomly selected and their urine samples were collected and analyzed for protein and glucose levels using urinometre (combi 2). The result obtained for protein level ranged between 200± 14.0mg/dl to 350± 16.2 mg/dl while the glucose level ranged between 180± 11.0mg/dl to 200± 12.0mg/dl. The least protein level of 200± 14.0mg/dl were recorded among 7-9 months (3rd trimester) pregnancy, while the highest protein level of 350± 16.0mg/dl were recorded between 0-3 months (1st trimester). The least glucose value of 180± 11.0mg/dl was recorded among pregnant women that are in their 1st trimester, while the highest value of 200± 12.0mg/dl was recorded among pregnant women in their 2nd trimester. The result indicates significant fluctuations in protein and glucose levels across trimesters, reflecting dynamic metabolic changes during pregnancy.Factors like advanced maternal age, knowledge gaps, misconceptions, symptoms, and treatment-seeking behaviour highlighted in the questionnaire data can be considered as potential risk factors or indicators concerning protein and glucose levels during pregnancy. Addressing these factors through targeted education, early detection, and appropriate medical intervention is recommended in the study area to ensure an optimal pregnancy outcome

Development of normal reference intervals for renal function in pregnancy: a secondary analysis of clinical trial data

Background Due to its potential nephrotoxicity, screening for pre-existing renal function disorders has become a routine clinical assessment for initiating Tenofovir diphosphate fumarate (TDF)-containing antiretroviral treatment (ART) or pre-exposure prophylaxis (PrEP) in pregnant and non-pregnant adults. We aimed to establish reference values for commonly used markers of renal function in healthy pregnant women of African origin. Methods Pregnant women ≥18 years, not living with HIV, and at 14–28 weeks gestation were enrolled in a PrEP clinical trial in Durban, South Africa between September 2017 and December 2019. Women were monitored 4-weekly during pregnancy until six months postpartum. We measured maternal weight and serum creatinine (sCr) at each visit and calculated creatinine clearance (CrCl) rates using the Cockcroft–Gault (CG) and Modification of Diet in Renal Disease (MDRD) formulae. Reference ranges for sCr and CrCl by CG and MDRD calculations were derived from the mean ± 2SD of values for pregnancy and postdelivery. Results Between 14-–and 40 weeks gestation, 249 African women not exposed to TDF-PrEP contributed a total of 1193 renal function values. Postdelivery, 207 of these women contributed to 800 renal function values. The normal reference range for sCr was 30–57 and 32–60 umol/l in the 2nd and 3rd trimesters of pregnancy. Normal reference ranges for CrCl using the MDRD calculation were 129–282 and 119–267 ml/min/1.73m2 for the 2nd and 3rd trimesters, respectively. Using the CG method of calculation, normal reference ranges for CrCl were 120—304 and 123–309 ml/min/1.73m2 for the 2nd and 3rd trimesters respectively. In comparison, the normal reference range for sCr, CrCl by MDRD and CG calculations postpartum was 40–77 umol/l, 92–201, and 90–238 ml/min/1.73m2, respectively. Conclusions In African women, the Upper Limit of Normal (ULN) for sCr in pregnancy is approximately 20% lower than 6 months postnatally. Inversely, the Lower Limit of Normal (LLN) for CrCl using either MDRD or CG equation is approximately 35% higher than 6 months postnatally. We provide normal reference ranges for sCr and CrCl for both methods of calculation and appropriate for the 2nd and 3rd trimesters of pregnancy in African women.

Airway management and pulmonary aspiration during surgical interventions in pregnant women in the 2nd/3rd trimester and immediate postpartum – a retrospective study in a tertiary care university hospital

BackgroundPregnancy is associated with an increased risk of pulmonary aspiration during general anaesthesia, but the incidence of this complication is not well defined.MethodsWe performed a retrospective database review in a tertiary care university hospital to determine the incidence of pulmonary aspiration in pregnant patients undergoing endotracheal intubation, with and without Rapid Sequence Induction (RSI), as well as face-mask ventilation and supraglottic airway devices. We included Patients in the 2nd or 3rd trimester of pregnancy and immediate postpartum undergoing surgical procedures. The primary endpoint was the occurrence of pulmonary aspiration.ResultsData from 2,390 patients undergoing general anaesthesia for cerclage of cervix uteri, manual removal of retained placenta, repair of obstetric laceration, or postpartum bleeding were retrospectively evaluated. A supraglottic airway device or face-mask ventilation was used in 1,425/2,390 (60%) of patients, while 638/2,390 (27%) were intubated. RSI was used in 522/638 (82%) of patients undergoing tracheal intubation, or 522/2,390 (22%) of the entire cohort. In-depth review of the charts, including 54 patients who had been initially classified as “possible pulmonary aspiration" by anaesthetists, revealed that this adverse event did not occur in the cohort.ConclusionsIn conclusion, in this obstetric surgery patient population at risk for pulmonary aspiration, supraglottic airway devices were used in approximately 60% of cases. Yet, no aspiration event was detected with either a supraglottic airway or endotracheal intubation.

Étude de l’anxiété liée à la grossesse et de la peur d’accouchement et de leurs facteurs associés

Pregnancy and childbirth are periods of major transition characterized by physical, biological, and psychological disruptions that can affect women's mental health. Women are particularly vulnerable to a large variety of anxiety disorders such as tocophobia and pregnancy-related anxiety. Our study aimed to assess the intensity of pregnancy-related anxiety and fear of childbirth during the 3rd trimester of pregnancy, to identify associated factors, and to investigate the relationship between pregnancy-related anxiety, fear of childbirth, marital satisfaction, and social support. Our study was carried on in the gynecology and obstetrics department of the Hedi Chaker Hospital in Sfax – Tunisia from 22 February 2023 to 31 July 2023. To assess pregnancy-related anxiety and fear of childbirth, we used the Pregnancy-related anxiety questionnaire and the Fear of Childbirth Scale, respectively. Social support and marital satisfaction were assessed using the Social Provisions Scale and the Azrin Scale. We enrolled 350 women with a mean age of 29.3 years. In 53.7% of cases, they had not completed secondary school and in 60.9% of cases, they were housewives. In the assessment of marital satisfaction based on the AZRIN score, 38.8% of women had good marital satisfaction (score above 6), 20.9% had poor satisfaction (score below 5) and 40.3% had average satisfaction (score between 5 and 6). Social support scores ranged from 14 to 40, with an average of 30.22 and a standard deviation of 4.66. The mean score for anxiety related to pregnancy was 31.24 and 48.7 for fear of childbirth. Pregnancy-related anxiety and fear of childbirth were positively and strongly correlated. In multivariate analysis, the independent factors associated with pregnancy-related anxiety and fear of childbirth were a negative experience during the last childbirth, episiotomy, lack of information before episiotomy, and intense sympathetic signs. Sufficient psychological support from the health care team was a protective factor against the fear of childbirth. Marital satisfaction and perceived social support were weakly and negatively correlated with pregnancy-related anxiety and fear of childbirth. Birth preparation and marital and social support are the cornerstones of a pregnant woman's well-being.

Pruritic urticarial papules and plaques of pregnancy: An unusual case report from a tertiary care hospital of the Eastern part of India

Pruritic urticarial papules and plaques of pregnancy (PUPPP) is a rare dermatitis of unknown etiology first diagnosed in 1979. It occurs most commonly in the 3rd trimester of pregnancy. Postpartum presentation is extremely rare. Treatment modalities mostly involve the relief of symptoms. We are going to report here one case of a 24-year-old primigravid female who presented in the 9th month of the gestational period with generalized pruritic eruptions in a tertiary care hospital in the Eastern part of India. These eruptions were erythematous, hyperpigmented, and papular, which began within the striae distensae of the abdomen and progressively spread on the skin of upper and lower limbs, trunk, and buttocks. After the delivery of a full-term male child, there was an aggravation of the symptoms such as itching and disturbed sleep. There was also increased spread of the lesions over the skins of the mentioned areas, which persisted for 6 weeks of the postpartum period. The lesions and associated symptoms gradually subsided with topical application of corticosteroids and hydroquinone along with oral antihistaminic for prolonged periods. Our objective behind reporting this case is to make clinicians aware of PUPPP as a differential diagnosis of peripartum and postpartum pruritic eruptions for prolonged periods.

Knowledge, Attitudes and Practices of Pregnant Women on Oral Health in the University Hospitals of Ouagadougou, Burkina Faso

Knowledge of the relationship between pregnancy and oral health is a public health issue. The aim of this study was to assess the knowledge, attitudes and practices of pregnant women regarding oral health in the University Hospital Centers (UHC) of Ouagadougou in 2023. This was a descriptive cross-sectional study from July to September 2023. Data were collected prospectively, and knowledge, attitude and practice scores were generated. A total of 400 pregnant women were included. The [25-34] age group was the most represented at 54%, and 56.3% of women were in their 3rd trimester of pregnancy. The majority had a secondary level school and didn’t have a treating dentist. More than half (51.2%) of the respondents had poor overall knowledge of the relationship between oral health and pregnancy, 76.3% had poor attitudes and 79.5% poor practices, resulting in a poor overall KAP level for their oral health (60.5%). There was a significant variation in KAP level according to level of education (p= 0.015) and according to the information received on oral health and its implications for pregnancy (p = 0.028). Pregnant women&amp;apos;s knowledge, attitudes and practices regarding their oral health are inadequate. Most women were unaware of the potential consequences of oral health neglect on pregnancy and their unborn child. Efforts must be made to educate them about oral health, with a focus on prevention.

Dynamics of serum levels and reference ranges of copeptin in the 3rd trimester of pregnancy in healthy pregnant women with uncomplicated pregnancy and delivery.

Copeptin is a stable fragment of vasopressin. Copeptin levels have been found to reflect the degree of endothelial stress in various conditions, including acute coronary syndrome. Copeptin may be a bio marker for endothelial stress during pregnancy. However, there is still a lack of understanding of its dynamics and levels throughout pregnancy. This study aims to describe intra-individual and longitudinal changes in copeptin levels at 30th and 36th gestational weeks in healthy pregnant women with uncomplicated pregnancy and delivery and to establish specific reference ranges. A total of 125 pregnant women with uncomplicated pregnancy and delivery were included. These women were monitored throughout their pregnancy and gave birth at the Department of Obstetrics and Gynecology Olomouc University Hospital. The blood was taken at ~30 and ~36 gestational weeks. Serum copeptin levels were measured using a Kryptor Compact PLUS analyzer. For statistics, we used R software and the "referenceRanges" package. It was found that serum levels of copeptin were significantly higher in the 36th week group than in the 30th week group (P &lt; 0.05). Cook's distance was used to eliminate outliers. The 30th week median was 3.377 pmol/l, reference range = 1.343-7.829 pmol/l, and the 36 week was median 4.735 pmol/l and reference range = 2.06-13.2 pmol/l. In the 36th week reference range, the median was higher than in healthy, non-pregnant women (P &lt; 0.05). Copeptin values can exceed 10 pmol/l, particularly after the 36th week. In the 3rd trimester, this value may indicate cardiovascular and endothelial overload. Copeptin levels were found to vary significantly depending on gestational week. The proposed reference ranges take into account the increased secretion of vasopressin in pregnancy. The existence of specific upper reference limits represents a potential advantage in detecting pregnant women prone to hypertensive disease in the 3rd trimester.

IJCM_52A: Profile and outcome of gestational diabetes mellitus in a tertiary care teaching hospital

Background: Gestational Diabetes Mellitus (GDM) is a Glucose tolerance disorder first diagnosed during pregnancy. WHO recommend that all pregnant women or at least women with predisposing risk factors should be screened at the beginning of the 3rd trimester of pregnancy with the Oral Glucose Tolerance Test (OGTT). Here, blood glucose level is screened 2hrs after giving a 75g oral glucose load. This is recommended for both screening and diagnosis. Not many studies have been done regarding the outcome of GDM mothers in India. Objective: 1. To describe the Obstetric profile of the mothers 2. To assess the outcome of GDM among the Mothers 3. To determine the neonatal outcome of GDM. Methodology: Study setting: The study was carried out at Kasturba Medical College Hospital, Attavar, and District Lady Goschen Hospital, Mangalore. Study design: Hospital based retrospective study. Study population: Pregnant women admitted to above mentioned hospitals with GDM and the new born. Inclusion criteria: All women diagnosed with GDM and have delivered in District Lady Goschen Hospital or KMCH Attavar. Sample size was 266. Results: Our study concluded that 24.8% of the women with GDM also had Pregnancy Induced Hypertension, which is comparable to the study done in Qatar where they found 19.2% of the women with GDM suffered from PIH. We also found that 15.8% of the women suffered from Pre-Eclampsia, over twice the percentage of people surveyed in the Qatari study. However the amount of babies suffering from Macrosomia was only 6.8% as opposed to 10.3% according to the aforementioned study and 19.3% as was found in a study in Poznan, Poland. Conclusion: No significant association was found between obstetric profile and antenatal &amp; postpartum complications.