Antenatal Women Research Articles

Human cytomegalovirus (HCMV) trends in Sri Lanka: insights from a hospital-based seroprevalence analysis

BackgroundHuman Cytomegalovirus (HCMV) spreads through direct contact with blood, and other body fluids such as urine, saliva and breast milk. It is transmitted sexually and can also be passed from a pregnant mother to fetus via the placenta. While often asymptomatic in healthy individuals, HCMV causes symptomatic infections in immunocompromised people and congenital infections in fetuses. It is a common global congenital infection and can lead to morbidity and occasional mortality in newborns. Latent HCMV may reactivate in immunosuppressed individuals. This study aimed to determine the age and gender specific seroprevalence of HCMV in selected populations in Sri Lanka.MethodsA total of 820 blood samples obtained from 820 participants of selected low and high-risk populations in Sri Lanka, namely; hospital inpatients (n = 200), antenatal women (n = 80), blood donors (n = 80), cancer patients (n = 200), Sexually Transmitted Disease (STD) clinic attendees (n = 160) and Chronic Kidney Disease (CKD) patients on haemodialysis (n = 100) were tested for IgG antibodies against HCMV by Enzyme Linked Immunosorbent Assay (ELISA). Statistical analysis was performed using IBM SPSS Statistics version 30 (IBM® Corporation, New York, USA).ResultsOverall HCMV seroprevalence was found to be 94.9% (778/820), whereas in males it was 95.2% (395/415) and in females it was 94.6% (383/405) (p = 0.691). Seroprevalence of HCMV in hospital inpatients, antenatal women, blood donors, cancer patients, STD clinic attendees and CKD patients on haemodialysis were found to be 92.5% (185/200), 100% (80/80), 90% (72/80), 96% (192/200), 93.1% (149/160) and 100% (100/100) respectively. Overall seroprevalence of HCMV increases with age ranging from 94.3% (33/35) in 15–19 years age group to 98.8% (84/85) in ≥ 60 years age group.ConclusionsSeroprevalence of HCMV in diverse low and high-risk populations of Sri Lanka was studied for the first time. HCMV seroprevalence is similar between genders (p > 0.05) and increases with age. Over 90% of individuals are infected with HCMV by age 15, indicating a high prevalence of primary infections from early childhood to adolescence. This study provides essential background information on HCMV infection and its impacts in diverse populations of Sri Lanka and aids in executing preventive and therapeutic measures in high-risk populations.

Optimizing Maternal Healthcare Access: A Mixed Method Study on Dual Utilization of Public and Private Antenatal Care Services in Puducherry, India

Abstract Background: Access to antenatal care (ANC) services has improved. However, it is also noted that some antenatal women seek multiple healthcare services. Exploring this practice will identify gaps in service provision and pave the path toward improving the quality of services. Objective: This study aimed to measure the concurrent use of public and private healthcare services for various components of ANC and understand the reasons for the dual utilization. Methodology: This explanatory mixed-method study enrolled 177 mothers residing in Puducherry, who had given birth in the last three years. A pretested, semi-structured questionnaire was administered, and six key informant interviews were conducted. Integration was performed in the interpretation stage, and a joint display was used to depict the results. We adopted the Donabedian model during the analysis and organized the codes under these major themes[1] Access;[2] Delivery of the Services;[3] and Quality of Care. Result: Most pregnant women (81.9%, 95% CI = 75.2%–86.8%) sought care from both public and private healthcare facilities, however, they preferred public facilities for delivery (74.6%, 95% CI = 67.6%–80.4%). The qualitative analysis revealed three major themes[1] Access;[2] Delivery of the Services;[3] and Quality of Care. Primary reasons for opting for private facilities included perceived superior ANC quality, organized care evident in scheduled appointments, reduced waiting time, frequent ultrasounds, personalized medication, and enhanced rapport with family. Women also believed that visits to government facilities are essential to avail the monetary benefits and have a seamless admission during delivery. They felt that government hospitals perform fewer cesarean sections. Conclusion: Strengthening public-private partnerships could enhance antenatal care utilization, benefiting pregnant women and streamlining healthcare delivery.

What Do Antenatal Women Want From Their Antenatal Education? A National Survey.

Antenatal education (ANE) equips pregnant women with knowledge and skills for pregnancy, birth, and the postnatal period. It should facilitate preparation for the whole spectrum of the maternal journey and empower women to make informed decisions. This study aimed to explore the antenatal education needs and preferences of women who are currently pregnant or planning a pregnancy. A UK wide cross-sectional survey was conducted (September 2019 to July 2020), recruiting women living in the UK, above 16, who were currently pregnant or planning a pregnancy. The survey gathered demographic information, details of current or planned class attendance, preferred ANE providers and desired skills and information. Quantitative data were analysed descriptively, and free-text responses underwent thematic analysis. Of 553 participants included in the analyses, 77% preferred free National Health Service (NHS) classes and 60% planned to attend multiple class types, including paid options. Participants valued practical skills, particularly for labour and the postpartum period, and actively sought perinatal social networks. Multiparous women were less likely to attend classes, citing prior experience or practical barriers. Despite high interest in NHS classes, regional variations in availability and limited accessibility were noted. NHS antenatal classes are a trusted source of ANE, forming a core element of many women's antenatal journey. However, inconsistent provision highlights the need for a standardised, comprehensive curriculum. Flexible delivery models and tailored content are crucial to address diverse needs, particularly for multiparous women and underrepresented groups. Enhanced accessibility could reduce inequalities in ANE provision and improve maternal outcomes.

Assessment of Birth Preparedness and Complication Readiness among Pregnant Women: A Cross-sectional Study

Introduction: Maternal deaths are a significant cause of death in women in the 15-49 years of age group, and they make up a larger proportion of all causes of death in the rural areas of poorer states, compared to other regions of India. Birth Preparedness and Complication Readiness (BPACR) is an overarching program to improve the use and effectiveness of maternal and newborn health services, based on the premise that preparing for birth and being ready for complications reduces all three phases of delays in receiving services. Aim: To assess the level of BPACR among pregnant women. Materials and Methods: This was a cross-sectional study conducted among 360 antenatal women admitted at Indira Gandhi Medical College and Research Institute, Puducherry, India, over three months. A modified Johns Hopkins Program for International Education in Gynaecology and Obstetrics (JHPIEGO) questionnaire was used for data collection. BPACR steps include arranging a mode of transport, saving money for pregnancy and childbirth, identifying an institute for delivery and arranging a blood donor. Among these participants, those who followed ≤2 practices were considered less prepared, and more were considered well prepared. The Chi-square test was used to demonstrate the difference between study subject characteristics, and the level of significance set at p≤0.05. Results: Of the 360 participants, 49 (13.6%) had good knowledge about antenatal danger signs, and a significant association was observed with educational status (p-value=0.023), occupational status (p-value=0.072), and number of Antenatal Care (ANC) visits (p-value=0.046). A good knowledge of childbirth danger signs was seen in 19 women, with a significant association observed with education (p-value <0.001), working women (p-value=0.014). Conclusion: This study revealed that a very small portion of the participants had good knowledge of obstetrical danger signs. Hence, more effort needs to be employed to educate women and motivate them about the importance of regular ANC visits and create awareness about the complications.

Prevalence of suicidal ideation and associated factors among perinatal women living with HIV: a systematic review and meta-analysis

ABSTRACT Perinatal women living with HIV face increased susceptibility to mental health challenges, including suicidal ideation (SI). This study aimed to determine the prevalence of SI among perinatal women with HIV and identify associated factors. A systematic search was done across PubMed, Embase, Scopus, ScienceDirect, and Google Scholar. Data analysis was executed using R software. Publication bias was assessed via funnel plot and Egger's test, while heterogeneity was investigated using the I2 statistic. A total of 11 studies involving 4329 participants were included. The pooled prevalence of SI was 23.4% (95% CI: 16.3–32.4). Subgroup analysis showed higher prevalence in postnatal women (36.4%) than antenatal women (27.8%), although this difference was not statistically significant. Studies employing the Edinburgh Postnatal Depression Scale reported a higher prevalence (38.9%). Studies published between 2013–2017 showed a higher prevalence (37.6%) compared to those published between 2018–2022 (18.2%). Factors associated with SI included depression during pregnancy or postpartum, unplanned pregnancy, intimate partner violence, undisclosed HIV status, lack of social support, and recent diagnosis of sexually transmitted infections other than HIV. The high prevalence of SI emphasizes the need for mental health screening and interventions. Mental health assessments should be integrated into routine antenatal and postnatal care.

A protocol to study the effect of targeted parental education intervention to identify early childhood development disorder – multisite interventional study

BackgroundIn India, approximately 3.5 million children are affected by Developmental Delay (DD), often stemming from preterm births. These delays contribute to neurological and motor development delays, placing a significant financial burden on families. Maternal unemployment rates are also elevated in such cases. Delayed Developmental Milestones identification, often due to a lack of parental awareness, further compounds these challenges. This study introduces a multiphasic approach aimed at educating antenatal women on monitoring neurological maturation, with the overarching objective of assessing the effectiveness of a targeted multi-method parental education intervention in improving parents’ knowledge and early detection of developmental disorders in early childhood.MethodsAntenatal women will be assigned to intervention or control groups. The intervention group will undergo specialized training in a multiphasic study, while the control group will receive routine care. A meticulously developed intervention module for early detection of neurodevelopmental disorders will empower mothers to monitor their newborns for potential deficits. Outcomes will be assessed through questionnaires, analyzing knowledge improvement and early identification of DD using statistical methods such as chi-square tests. The study involves three phases: preparatory, implementation, and evaluation, aiming to empower mothers to detect developmental concerns early and improve maternal awareness of child development. The study was approved by the SRM Institutional Ethical Committee with the reference number 8688/IEC/2023.DiscussionThis study will identify DD and improve parental awareness by providing tools for early detection thereby empowers parents to identify developmental concerns early. The study supports policy goals to reduce the burden of DD, enhance early intervention, and improve long-term outcomes for children. It is anticipated that this intervention will complement existing health policies, contributing to better child health and developmental outcomes in India.Trial registrationTrail is registered under Clinical Trails Registry - India (CTRI/2024/04/065008) registered on 01 April 2024.

Why women refuse Postpartum IUCD?

ABSTRACT Background: Women are highly motivated and receptive to accepting family planning methods during the antenatal period. Hence, we conducted this study to evaluate the refusal rate and reasons for the refusal of postpartum Intrauterine Contraceptive Devices (PPIUCD). Material and Methods: The present cross-sectional study was conducted in the Department of Obstetrics and Gynaecology, at a tertiary Care Centre, on 400 antenatal women from November 2023 for 2 months. Results: In present study, 331 (82.8%) subjects were knowing condom as contraceptive, followed by 310 (77.5%) subjects knowing about copper T. 282 (70.5%) subjects were knowing tubectomy, 264 (68.5%) were knowing oral contraceptives, 264 (66%) were knowing vasectomy, 205 (51.2%) were knowing natural methods, 179 (44.8%) were knowing injectable contraceptive, 83 (20.8%) were knowing Saheli, and 27 (6.8%) subjects were not knowing any contraceptive method. In total, 185 (46.5%) subjects knew that Copper T could be inserted immediately after delivery followed by 83 (20.9%) who knew that copper T could be inserted after menses. Sixty-nine (17.3%) knew that copper T could be inserted during a cesarean section. A total of 352 (88%) subjects refused postpartum copper T as a method of contraception. Only 48 (12%) subjects were willing to insert postpartum copper T. After counseling, the rate of acceptance of copper T insertion increased from 48 (12%) to 102 (25.5%). Conclusion: Knowledge of PPIUCD in the present study was good, but the refusal rate was high. The commonest reason was fear of side effects.

Linking platelet indices and uterine artery Doppler parameters for preeclampsia prediction and its severity

Preeclampsia is one of the most common medical complications of pregnancy and the second largest cause of maternal and fetal mortality and morbidity. Preeclampsia is a multi-systemic hypertension condition with an unknown cause. A Prospective Observational Study was conducted on antenatal women with gestation age of 11 to 13+6 weeks. Participants underwent routine investigations including Platelet Indices and Uterine Artery USG Doppler. Selected patients were specifically evaluated at 22-24 weeks, 31-34 weeks, and >36 weeks until delivery along with routine antenatal care visits. Among the platelet indices, the platelet Count, Mean Platelet volume (MPV), Platelet/Lymphocyte ratio were found significant and among Uterine Artery Doppler Parameters- Pulsatility Index was found significant in prediction of preeclampsia. The Combination of platelet indices and uterine artery doppler parameters showed better sensitivity in prediction of early onset and severe form of preeclampsia can be incorporated into routine prenatal care using the existing infrastructure can be used in the prediction and early diagnosis of preeclampsia.

Maternal factors affecting foetal outcome in rural area of district Amritsar, Punjab

Background: Birth weight not only indicates health of mother, nutrition and quality of life but also a pivotal factor in determining growth, survival and development of children. The key aspect influencing birth weight is maternal factors. Stress during pregnancy also affects a child's growth and development. So the present study was planned to assess the maternal factors affecting foetal outcomes. The level of stress among antenatal women was also determined in the study. Methods: A prospective observational type of study was conducted from January to March, 2022. All the registered antenatal women were followed till outcome of pregnancy. Information was collected on predesigned and pretested proforma. Data analysis was done using SPSS version- 23. Results: A total of 114 antenatal were registered in rural field practice area under Department of Community Medicine, SGRDIMSAR, Amritsar. There were 108 singleton live births and 6 miscarriages among registered antenatal women. Almost half (47.2%) of subjects got their pregnancy registered before 12 weeks. Recommended more than minimum 4 antenatal visits were conducted in almost half (49.1%) of women. Three fourth (75.9%) women in first trimester of pregnancy were suffering from moderate stress while 24.1% women were suffering from low stress. Conclusions: In the present study maternal factors found to be significantly associated with birth weight of newborn were maternal age at first child, timing of 1st Antenatal visits, weight gain during pregnancy, number of Td (Tetanus diptheria) doses taken and consumption of IFA tablets. Perceived stress score (PSS) was also found to be significantly associated with birth weight of newborn.

Anxiety, depression, and perceived wellbeing in antenatal women at risk of preterm birth: a retrospective cohort study.

Women identified at risk for preterm may be vulnerable to developing mental health difficulties due to the increased likelihood of poor pregnancy outcome and uncertainty surrounding their delivery. Formal assessment of mental wellbeing in specialist preterm birth clinics is not routinely offered, but may offer the opportunity for early intervention. We aimed to investigate if demographic characteristics and obstetric risk factors were associated with psychological wellbeing in women at risk of preterm birth. We explored associations between mental wellbeing and risk factors for preterm birth using hierarchical regression analyses. When demographic variables were considered alone, high body mass index (BMI) was significantly associated with anxiety (p = .026), however became non-significant when obstetric risk factors were also considered. Previous late miscarriage was associated with high anxiety (p = .049). Lower maternal age at estimated date of delivery (p = .019) and non-European ethnic heritage (p = .029) were significantly associated with depression. High maternal BMI (p < .001), being of any other non-European ethnic heritage (p = .043), currently smoking (p = .002), and previous spontaneous preterm birth (p = .017) were associated with lower perceived wellbeing. The results of this study highlight the importance of routinely monitoring mental health in women with relevant risk factors, particularly if they are already at risk of preterm birth.

Human intestinal nematode infections in Sri Lanka: A scoping review.

Sri Lanka, an island located in South Asia, once experienced a notable prevalence of human intestinal nematode infections (HINIs). With the implementation of control programs, infection prevalence was reduced. Detailed information on prevalence, distribution and temporal trends of HINIs is limited. This review aims to explore Sri Lanka's HINI distribution, trends, diagnostics, control and challenges. We reviewed published information on HINIs in Sri Lanka in electronic databases, local journals and grey literature from inception to September 2022. Based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-Scr), a systematic strategy was used for searching, screening, reviewing and data extraction. The screening was initiated with a review of titles and abstracts using specific keywords, followed by a full-text screening based on predefined eligibility criteria. A total of 105 studies were included in the review, with 28 selected for pooled prevalence analysis. The first nationwide survey in 1924 reported a hookworm infection prevalence of 93.1%. By 2017, soil-transmitted helminth (STH) infection prevalence across the island was 0.97% (ascariasis-0.45%, trichuriasis-0.25%, and hookworm infection-0.29%), and the enterobiasis prevalence between 2003 and 2017 ranged from 0% to 42.5%. Strongyloidiasis had been understudied, with a prevalence of 0.1% to 2%. Over the past two decades, the islandwide pooled HINI prevalence was 13.3%. Within specific demographics, it was 6.96% in the general community, 33.4% in plantation sector, and 11.6% in slum communities. During the colonial period, hookworm infection was the commonest HINI, but ascariasis is now more prevalent. The prevailing data relied solely on microscopy, often utilising single stool smears. Mass deworming programs were widely pursued in the first half of the 20th century, initially targeting antenatal women and schoolchildren, and now focusing on specific community groups. National surveys continue monitoring the three main STH infections. The significant reduction in STH prevalence in the country over the past ten decades highlights the effectiveness of public health interventions, particularly mass deworming programs. Despite the success, STH prevalence disparities persist in vulnerable populations like plantation and slum communities, where hygiene and living conditions continue to pose challenges. Reliance on single stool smear microscopy highlights the need for more sensitive diagnostics to better assess infections. Fluctuating enterobiasis prevalence and limited strongyloidiasis data underscore the importance of continued surveillance and targeted interventions for sustained control and eventual elimination. Sri Lanka's experiences and control measures offer valuable insights for low-income countries in South Asia and beyond, particularly in managing HINIs with limited resources.

Obstetric danger signs in context: A mixed methods study exploring knowledge and sociocultural factors among pregnant women.

Maternal morbidity and mortality persist due to delays in seeking care for obstetric complications. Deficits in comprehending danger signs contribute to preventing early identification. There is limited research on awareness levels among rural Indian women. The present study aimed to assess knowledge of obstetric danger signs among pregnant women in rural Gujarat and explore associated sociodemographic and obstetric history factors. Qualitative methods further elucidated experiences, attitudes, and perceptions underlying maternal health literacy. A mixed-methods study was conducted among 390 antenatal women selected through multistage sampling from six community health centers in Jamnagar district. A structured questionnaire and in-depth interviews were used for data collection. Quantitative data were analyzed with regression modeling, and qualitative data were thematically analyzed. Out of 490, the majority correctly identified pregnancy bleeding (73.3%, n = 361), leakage of fluid (71%, n = 347), and swelling (74.3%, n = 364) as danger signs. About 56.5%, n = 277, had good knowledge of danger signs. Knowledge was significantly higher among women aged >25 years (aOR 3.11, 95% CI 2.02-4.7), literate women (aOR 2.14, 95% CI 1.12-4.08), and those counseled during ANC (aOR 2.2, 95% CI 1.2-8.1) and PNC (aOR 4.4, 95% CI 1.8-10.7). Qualitative findings revealed gaps in recall, poor comprehension of symptoms, and sociocultural barriers to care-seeking. Despite interfacing with health services, awareness of obstetric danger signs was incomplete among rural antenatal women. Tailored education through enhanced counseling and family-centered care can improve maternal health literacy.

Serial evaluation of morphological and biophysical placental attributes in women with normal outcome and preeclampsia.

The study's aim was to perform serial placental biometry and Doppler assessments in antenatal women and compare the characteristics of preeclampsia (PE) and normal outcome. This prospective cohort study was carried out after ethical clearance. Placental length (PL), thickness, and plavental volume (PV), along with the uterine artery (Ut), middle cerebral artery (MCA), and umbilical artery (UA) blood flow were evaluated serially at 11-14, 20-24, and 28-32 weeks of gestation. The women were followed until delivery, those with PE were considered cases, and those with no other adverse outcome were controls. The placental attributes between cases and controls were compared. A total of 135/1008 (13.4%) had hypertensive disorders of pregnancy (HDP) and 44/1008 (4.4%) had PE, and no maternal or fetal adverse outcomes were seen in 600 (59.5%) women. The PL and PV were significantly less in those with PE (P = 0.005) than in controls. The ratios of PL/Ut A PI and PV/Ut A PI were significantly lower in cases than in controls in all trimesters (P <0.001). In the first trimester, the area under the curve (AUC), sensitivity, and specificity of PV/Ut A PI for PE prediction were 0.801, 81.8%, and 70.5%, respectively. The sensitivity and specificity of the PL/Ut PI ratio was 81.8% and 70.5%, whereas that at 28-32 weeks was 73.3% & 70.7%. Placental parameters were significantly lower in PE than in normal outcome, and the ratios of PL/Ut A PI and PV/Ut A PI proved to be promising markers.

Incidence of Severe Acute Maternal Morbidity in Severe Preeclampsia

Background: Hypertensive disorders of pregnancy are among the most common complications, with an incidence ranging from 5 to 10%. It is the third leading cause of maternal mortality in India, contributing to 7% of all maternal deaths. Aims: This study aims to determine the incidence of severe acute maternal morbidity in women with severe preeclampsia. The most affected organ and perinatal outcomes in women with severe preeclampsia were evaluated as secondary objectives. The association between severe preeclampsia and severe acute maternal morbidity which is indicated by dysfunction of cardiovascular, respiratory, renal, coagulation and neurological systems was observed. The perinatal outcomes such as fetal growth restriction, preterm birth, fetal distress, neonatal encephalopathy, still birth, NICU admission and neonatal death were assessed. Methodology: This was a prospective observational study done at a tertiary care centre in India between May 2022 and July 2023. All antenatal and postnatal women i.e. up to 42 days from the day of delivery, diagnosed with severe preeclampsia were included in the study. Women without severe preeclampsia and those who were referred with Multiple Organ Dysfunction Syndrome (MODS) were excluded from the study. Results: A total of 12,359 women delivered during the study period. Out of these, 360 women were diagnosed with severe preeclampsia with an incidence of 2.91%. Amongst 360 women who were diagnosed with severe preeclampsia severe acute maternal morbidity was seen in 68 women with an incidence of 19%. Women with severe preeclampsia had eclampsia as the most common serious complication followed by thrombocytopenia. Most of the women had preterm delivery by caesarean section and more than half of the babies required NICU admission. A considerable number of babies were low birth weight and stillborn. Conclusion: This study has shown the adverse effects of severe preeclampsia on the mother and the fetus leading to morbid condition. Early diagnosis and referral to higher centre for early intervention can prevent the morbid condition.

Impact of Hypothyroidism in Pregnancy on Feto-Maternal Outcomes: A Prospective Observational Study.

Introduction Hypothyroidism represents an endocrine disorder marked by the insufficient production of hormones by the thyroid gland, with significant effects on bodily functions. Its occurrence during pregnancy is of particular concern due to its profound effects on both maternal and fetal health outcomes. Aim To study the impact of hypothyroidism in pregnancy and its correlation with feto-maternal outcomes. Methodology The present study is a two-year prospective observational study carried out at a tertiary care hospital from July 2022 to June 2024. A total of 350 antenatal women withsingleton pregnancies and without any pre-existing medical disorder were screened. Serum thyroid stimulating hormone (TSH) was evaluatedwith a cut-off value of 4.0 mIU/L. If serum TSH was abnormal, free thyroxine (FT4) and free triiodothyronine (FT3) levels were assessed. The participants were categorized into three groups designated as euthyroid, overt hypothyroidism, and subclinical hypothyroidism. TSH was periodically re-evaluated at 16 weeks, 20 weeks, and 32 weeks. All patients were monitored up to the point of delivery, allowing for comparison of outcomes across the three groups. Results The prevalence of hypothyroidism in the present study was 11.14% (n=39). Eight percent(n=28) of the cases had subclinical hypothyroidism whereas 3.14% (n=11) of cases had overt hypothyroidism. Hypothyroidism was more common in the 26-30 years age group. There was a higher incidence of hypothyroidism in multigravida patients. Lower segment caesarean section (LSCS) was the most common mode of delivery in the women with hypothyroidism. Maternal outcomes included preeclampsia, eclampsia, anemia, gestational hypertension, gestational diabetes mellitus (GDM), spontaneous miscarriage, preterm labor, oligohydramnios, etc. The fetal outcomes included intrauterine growth restriction (IUGR), low birth weight (LBW) and fetal distress. Conclusion Early diagnosis and adequate treatment of maternal hypothyroidism leads to successful pregnancy outcomes. Therefore, universal thyroid screening in pregnancy is recommended in order to preventmaternal and fetal complications.

Determinant factors and coping strategies for depression among pregnant women: an intervention-based qualitative study in Lahore, Pakistan

BackgroundThe present study is an intervention-based qualitative study that explores the factors causing depression among antenatal women and analyses coping strategies based on the modified version of the Thinking Healthy Programme (THP) intervention in the urban setting of Lahore, Pakistan.MethodsAn exploratory qualitative evaluation approach was used in the present study. The study comprises four phases, i.e., the screening phase, exploratory phase, intervention phase, and evaluation phase. During the first phase, pregnant women aged 18–45 years were screened for anxiety and depression by using the Urdu-translated Patient Health Care Questionnaire-9. In the second phase, identified women were interviewed to explore the factors responsible for depression. In the third phase, the intervention was administered via the THP intervention. In the last phase, the same women were reinterviewed to analyse the outcomes of the intervention. Thematic analysis was performed for the analysis of the interviews.ResultsData was analyzed using thematic analysis following an deductive and indictive approach in both pre- and post-intervention phase. Three main themes emerged in the pre-intervention phase: (1) the impact of adverse life events on the mental health of pregnant women, (2) the adverse effects of marital relationship issues on pregnant women, and (3) depression-causing factors due to the joint family system. Furthermore, four themes emerged in the post-intervention stage: (1) development of positivity in thinking and attitude, (2) learning about stress management through the provision of compassion and sharing avenues, (3) gaining self-esteem to address matters positively, and (4) improving relationships with the unborn child and family. Numerous pregnant women praised the THP project and recommended that hospitals adopt it to assist pregnant patients in the Pakistani health system.ConclusionThe study concludes that THP can be a valuable tool for helping many pregnant women who are experiencing prenatal depression recover, however, there is a further need for exploring its benefits in varying social and cultural contexts.Trial registrationThe study has been registered at https://clinicaltrials.gov/ (NCT04663243).

Evaluation of efficacy of mentzer index for screening of beta - Thalassemia trait in antenatal women

People with thalassemia trait should be distinguished from those who have anemia due to iron deficiency since they typically have mild microcytic hypochromic anemia and are mostly asymptomatic. : To evaluate efficacy of Mentzer index for screening Beta- Thalassemia trait in pregnant women.From January 2023 to October 2023, the observational study was carried out in the Department of Gynecology &amp; Obstetrics at Sri Guru Ram Das Charitable Hospital Amritsar. The study comprised 130 pregnant women with anemia. To assess microcytic hypochromic anemia, tests like complete blood count (CBC), peripheral blood smears, iron studies, and hemoglobin electrophoresis were performed. Mentzer Index (MI) was computed, and its specificity and sensitivity assessed. Of the 130 patients, 112 had Mentzer Index greater than 13 and 18 had Mentzer Index less than 13 but only 12 out of these18 had beta thal-trait according to HPLC. There were total 15 females having beta thal-trait as per HPLC, however 3 of the 15 had Mentzer &amp;#62;13. Conserding Beta thal-trait, the Mentzer Index's sensitivity and specificity were 80% and 95.65% in this study, and 95.33% and 86.96% for IDA. Mentzer Index (MI) is a helpful tool to distinguish iron deficiency from thalassemia trait as its specificity and sensitivity is high as electrophoresis in diagnosis. In situations with limited resources, this proves to be advantageous in terms of cost-effectiveness.

Randomized comparative study between ferric carboxymaltose and iron sucrose for correction of anemia in antenatal women

Anemia during pregnancy is a significant global health concern. This study aims to evaluate the efficacy and safety of Ferric Carboxymaltose (FCM) compared to Iron Sucrose (ISC) in treating mild to moderate iron deficiency anemia (IDA) in pregnant women. A randomized prospective control study was conducted with antenatal women suffering from mild to moderate anemia at Sri Dharmasthala Manjunatheshwara College of Medical Sciences and Hospital from December 2018 to November 2019. Participants were randomly assigned to either Group A (FCM) or Group B (ISC). A total of 128 women were randomized, with 64 in each group. The mean increase in hemoglobin was significantly higher in the FCM group (1.34 g/dl) compared to the ISC group (0.98 g/dl) (p &amp;#60; 0.001). FCM required fewer administrations, improving patient compliance. Both treatments were well-tolerated, with minor local reactions observed. FCM offers a more effective, convenient, and well-tolerated treatment option for IDA in pregnancy compared to ISC.

The role of neutrophil to lymphocyte ratio and platelet to lymphocyte ratio in determining the severity of pre-eclampsia in antenatal women: A case control study

Pre-eclampsia (PE) remains a significant global health concern, affecting 2-8% of pregnancies and contributing to maternal and perinatal morbidity and mortality. Characterized by hypertension and proteinuria after 20 weeks of gestation, PE often involves systemic inflammation and endothelial dysfunction. Its exact etiology is multifactorial, involving immune dysregulation and vascular abnormalities. Early identification of high-risk pregnant women is crucial to mitigate adverse outcomes. In India, PE affects 8-10% of pregnancies.Inflammatory markers such as the Neutrophil-to-Lymphocyte Ratio (NLR) and Platelet-to-Lymphocyte Ratio (PLR) have emerged as potential indicators of systemic inflammation. Elevated NLR and PLR levels in PE suggest a role in the disorder's pathophysiology, reflecting immune responses to placental ischemia and pro-inflammatory cytokine release.This study aims to compare NLR and PLR levels between PE patients and normotensive pregnant women, evaluate their association with PE severity, and discuss their potential as predictive biomarkers. A case-control study was conducted with 84 participants, following eligibility criteria via convenient sampling. Demographic characteristics, obstetric history, and CBC-derived biomarkers were assessed.Among 84 pregnant women, 42 had preeclampsia (PE) and 42 were normotensive. The PE group had significantly higher Neutrophil-to-Lymphocyte Ratios (5.11 ± 2.88 vs. 2.74 ± 0.78) and Platelet-to-Lymphocyte Ratios (108 ± 46.7 vs. 85.4 ± 29.4) compared to controls. PE incidence peaked between 34-38 weeks. Higher PLR and NLR values were linked to severe PE. ANC booking was lower in the PE group. Obesity trends were not statistically significant.Significant associations were found between elevated NLR and PLR and PE severity, highlighting their potential clinical utility.Our findings indicate NLR and PLR as valuable biomarkers for predicting and managing PE. Integration of these markers into routine prenatal care could enhance clinical management and improve maternal and fetal outcomes.

Stress, Anxiety, and Depression During Pregnancy: A Survey Among Antenatal Women Attending Primary Health Centers.

Background/Objectives: Maternal mental health problems such as stress, anxiety, and depression (SAD) in antenatal women are major public health challenges. This study aimed to determine the levels of SAD in antenatal women and associate the selected variables with them. Methods: A cross-sectional study was conducted in selected primary health centers (PHC) in Al-Ahsa, Saudi Arabia. The pregnant women were selected using systematic randomization, and their SAD levels were assessed using the perceived stress scale (PSS), the state anxiety scale (SAS), and the patient health questionnaire (PHQ-9), respectively. Linear regression was used to associate factors related to stress, anxiety, and depression. Results: Out of 346 antenatal women, 4% had a high level of stress and 27.2% had a moderate level of stress. Regarding the level of anxiety, 2.6% of them had high anxiety, and 32.9% had moderate anxiety. Around 32 (9.2%) women had moderate depression, and 4 (1.2%) had severe depression. The mean score of SAD was 11.99, 28.88, and 4.73, respectively. A linear regression proved that there was an association between stress and age, occupation, gestational age (GA), gravida, para, abortions, and social support (SS) (p < 0.05). Anxiety was associated with age, GA, gravida, para, abortions, past obstetrical complications, and SS (p < 0.05). Depression was related to age, education, occupation, para, abortions, past obstetrical complications, and SS (p < 0.05). Conclusions: Due to the prevalence of SAD in pregnancy, the screening of these conditions and awareness creation about the associated factors can help to identify potential risks earlier and prevent maternal and fetal complications.