Antenatal Checkup Research Articles

Obstetric Outcome and its Relationship with Mode of Delivery in Preterm Labour- A Study of 86 Patients in Combined Military Hospital, Dhaka

Background: Caesarean section in preterm pregnancy may add further pressure to the already existing poorly developed facilities for intensive perinatal care in low resource countries. The objective of the study was to determine the feto-maternal outcome and its relationship with mode of delivery in preterm labour. Methods: This was a descriptive type of cross-sectional study conducted at Department of Obstetrics and Gynecology, Combined Military Hospital (CMH), Dhaka, during March to August 20l8. The study population was total eighty-six patients having 28 to 36 weeks of gestation who were admitted in the above department and were in labour. Data were edited and analyzed by using computer-based software, statistical package for social sciences (SPSS) version 20.0. Results: Majority of the patients belonged to 26-30 years age group and were from low socioeconomic family (71.4 to 72.7) % and had below average nutritional status (88.1 to 93.2) %. The mean gestational age was 31 weeks and 35 weeks. Nulliparous (77.3 to 85.7) % and patients taking irregular antenatal check-up (69.0 to 72.8) % were predominant. About (59.1 to 66.7) % patients had vaginal delivery and (33.3 to 40.9) % patients had undergone caesarean section. Maternal morbidity was more in caesarean section (37.5%) than vaginal delivery (33.3%). Live birth babies were found 100% in caesarean section and 94.4% in vaginal delivery and among them 95.7% were from group I and 97.6% were from group ll. Perinatal mortality was higher in vaginal delivery than caesarean section (7.40% vs 2.7%) and also higher in group I than group ll (8.3% vs 2.3%). But late perinatal complications were more in caesarean section (47.2%) than vaginal delivery (45.1%) baby, and majority (60%) of them were from group l. Conclusion: Preterm pregnancy when leads to an early delivery, brings a grave consequence for both the mother and foetus. After birth, the premature newborn is at risk for complications related to incomplete development of its organ system. Caesarean section delivery in preterm labour improves foetal outcome to some extent, but not significantly, and leads the mother to more maternal morbidity. Perinatal mortality and morbidity is also inversely related to the gestational age at the time of delivery, in preterm labour - more the gestational age, less the perinatal mortality and morbidity. Bangladesh Armed Forces Med J Vol 57 No (1) June 2024, pp 43-49

Men’s perception and participation in maternal and child health care in the field practice area of a teaching hospital: A cross-sectional study from rural Bengal

ABSTRACT Introduction: Participation of men in maternal and child health (MCH) is crucial for the reduction of infant and maternal mortality. MCH care services have been focused on providing information and services to women, but males’ behaviour and decisions affect the health of the child and mother. Objectives: The objectives of the study were to assess the perception and participation of males in MCH care as well as, to identify the association of their perception and participation with socio-demographic characteristics and to find out the correlation between perception and participation regarding MCH care. Materials and Methods: A descriptive type of observational study with a cross-sectional design was conducted among 125 male residents from selected subcentres in Budge Budge II block of South 24 Parganas. Data were collected by face-to-face interviews using a predesigned, pretested, structured schedule. Multivariable binary logistic regression was done to identify the association between dependent and independent variables (P < 0.05). The correlation between perception and participation was assessed by Spearman’s rho. Results: The mean age of the participants was 34.3 (±5.6) years with most (59.2%) between the ages of 31–40 years of age. About 24% were unaware of pregnancy registration time, and 30.4% did not know the number of minimum antenatal check-ups. In total, 20% of study participants did not accompany their partner to the Antenatal Care (ANC) clinic, 6.4% did not accompany them during delivery, and almost 33.6% did not accompany their child to the immunization session. No variables were found to be significantly associated with the dependent variables. A statistically significant positive correlation was found between perception and participation (ρ = 0.3). Conclusion: Men’s perception and participation in MCH care services were found to be reasonably good though they can be improved. Awareness raises about the importance of men’s role in supporting their partner’s health during pregnancy and postpartum, as well as the overall well-being of their children through public health campaigns, community events, and targeted educational programs.

Weight gain in pregnancy and impact of obesity on the obstetric outcome: A retrospective study in a secondary care hospital in South India

ABSTRACT Objective: To evaluate the patterns of weight gain in pregnancy and the outcomes of pregnancy in overweight and obese mothers. Materials and Methods: A retrospective cohort study was performed on 1,352 mothers between October 2020 and August 2021. All pregnant women who presented for antenatal checkups from 20 weeks or earlier, with a singleton pregnancy, were included in the study. Details such as comorbidities, total duration of labor, complications during labor, and neonatal complications were included. Results: At the first antenatal visit, 16% of mothers were underweight, 51% of mothers were normal weight, and 33% of mothers were overweight or obese. Women with poor weight gain were two times more prone to give birth to a child with low birth weight than those with adequate weight gain. Excess weight gain in pregnancy in women with a normal body mass index (BMI) had an association with the development of pre-eclampsia. The odds of overweight/obese pregnant women developing gestational diabetes mellitus (GDM) were 2.1 times higher than in pregnant women with normal BMI. The odds of pregnant overweight/obese women undergoing cesarean section were 1.6 times higher than in pregnant women with normal BMI. Conclusion: Overweight/obese pregnant women had increased odds of developing GDM and undergoing a cesarean section. Excess weight gain was also seen in overweight/obese women. It is therefore important for physicians to educate women on acceptable weight gain during their pregnancy.

A STUDY OF MATERNAL OUTCOME IN SEVERE PRE-ECLAMPSIA

Background&MaterialsandMethods:Pre-eclampsiaisapregnancy-induced hypertensive disorder seen after 20 weeks of gestation with multi-systeminvolvement.Inhealthynulliparouswomen,theprevalenceofpreeclampsia ranges between 2% and 7%. It is a major cause of maternal morbidity and mortality in healthy nulliparous women.Itis amultisystemdisorderthatleadstocertaincomplicationslikeplacentalabruption,HELLPsyndrome,eclampsia,DIC,pulmonaryedema,adultrespiratory distress syndrome (ARDS), and acute renal failure leading to highmaternal morbidity and mortality. The aim of the study is to evaluate the maternaloutcomein severe preeclampsia. Cases with severe preeclampsia (B.P readingof 160/110mmHgwith1+ormorealbuminuria)after 28weeksof gestational age were included in the study and followed upto 6weeks postpartum.Atotal number of 100 cases were included in the study. Study variables were modeofdelivery,maternalmorbidity-mortality. Result: This study analyzed 100 patients with severe preeclampsia.Out of the 100 patients in the present study, maximum (43.0%) cases were inthe agegroupof 21to 25years,most (62.0%) of them were primigravida,and most of the cases were < 34 weeks of pregnancy. Inourstudy,themostcommonmodeofdelivery(61.0%) was cesarean delivery. (39.0%) of patients delivered vaginally. Outof all normal deliveries, (29.0%) of patients delivered spontaneously, around(9.0%) of all deliveries are preceded by labor induction, and (1.0%) ofpatients needed vacuum delivery during the secondstage of labor. The most common maternal complication in the present studywas abruption (10.0%), followed by oligohydramnios (9.0%) and PPH(6.0%),HELLP(6.0%),eclampsia (4.0%), posterior reversible encephalopathy syndrome (PRES-3.0%), PPCM (2.0%), multiple organ dysfunction syndrome (2.0%), pulmonaryedema(1.0%) andDIC (1.0%). In ourstudyabruptio placenta was the most common one. Conclusion:Preeclampsia continues to be a significant cause of maternal morbidity and mortality. Regular antenatal check-ups are very important to emphasizeearlywarningsymptoms&signssothatlife-threateningcomplications can beprevented.Provision ofqualitymaternalhealth careservices,increasingpatientawarenessaboutvariouswarningsymptoms, investigations, timely referral of patients to higher centers, the timely use ofantihypertensivedrugs,timelydelivery&intensivemonitoringintheintrapartum &postpartum period can result in improvement in maternaloutcome.

Epidemiology of Syphilis in Tokyo from 2019 to 2022: a Descriptive Epidemiological Study.

In recent years, the incidence of syphilis in Tokyo has increased. This descriptive epidemiological study aimed to elucidate the status of syphilis within the city. Data regarding age, sex, disease stage, and presumed sexual partners of patients with syphilis reported in Tokyo were compiled and analyzed. A total of 9,419 patients with syphilis were diagnosed between 2019 and 2022. A sharp rise was observed in the number of reported cases from 2021 to 2022. Between 2020 and 2022, the number of women in their 20s who developed syphilis rapidly increased by more than 3-fold. Furthermore, the number of pregnant women with syphilis increased the end of 2022. Despite a rapid increase in the number of young women with syphilis, the incidence of congenital syphilis has remained stable. This stability may be attributed to the early detection of syphilis during pregnancy, facilitated by the high rate of antenatal checkups in Tokyo. However, the growing incidence of syphilis among young women could potentially lead to a rise congenital syphilis cases in the future. Therefore, public health strategies should include educational initiatives targeting high-risk populations and adolescents, along with early and appropriate testing and treatment to prevent the progression of syphilis.

TO ASSESS THE EFFECTIVENESS OF VIDEO ASSISTED TEACHING PROGRAMME ON KNOWLEDGE REGARDING IMPORTANCE OF UMBILICAL CORD BLOOD PRESERVATION FOR FUTURE TREATMENT MODALITIES AMONG EXPECTANT COUPLES AT SELECTED HOSPITALS

Health is the general condition of a person in all aspects it is also a level of functional and metabolic efficiency of an organism. Nothing is more important than protecting the health of your family. A healthy future starts with saving - or banking - your newborns cord blood stem cells. Its a one-time opportunity that can change or even save a life. After a baby is delivered, the mothers body releases the placenta, the temporary organ that transferred oxygen and nutrients to the baby while in the mothers uterus. Stem cell research holds enormous promise for easing human suffering. We have a lot to gain through furthering stem cell research, but medical breakthroughs should be fundamentally about saving, not destroying, human life. Therefore, support stem cell research that does not destroy the embryo. The aim of this study is to assess the effectiveness of video assisted teaching programme on knowledge regarding importance of umbilical cord blood preservation for future treatment modalities among expectant couples. The main objective of the study was to assess the knowledge regarding importance of umbilical cord blood preservation for future treatment modalities among expectant couples. Methodology: The sample size was 60 expectant couples and the setting of the study was selected hospitals where the couples come for antenatal checkup. Sampling technique was convenient sampling technique. One group pretest posttest design was used. Result: The study shows that in pre-test 81.67% of couples were having inadequate knowledge and 18.33% of them having moderately adequate knowledge and none of them having adequate knowledge. While in post test 55% of expectant couples were having Moderately Adequate knowledge and 45% of them having adequate knowledge and none of them having inadequate knowledge. The result shows that the video assisted teaching was effective in improving the knowledge. There was significant association between selected demographic variables and post test score. Conclusion: The teaching was effective in increasing the knowledge of expectant couples and similar awareness programmes should be given to the public so that they can understand regarding the newer treatment modalities.

Quality of birth care and risk factors of length of stay after birth: A machine learning approach.

Length of stay (LOS) is an outcome measure and is assumed to be related to quality. The objective of this study is to examine the quality of birth care and risk factors associated with LOS after birth. A nationwide population-based Turkish Demographic and Health Survey (TDHS) was used for the year 2018. A total of 1849 women ages 15-49 were included. Explanatory factor analysis and machine learning predictors such as Random Forest, Support Vector Machine, Neural Network, k-Nearest Neighbor, and Naïve Bayes were used to identify the quality of birth care and risk factors associated with LOS after birth. As a result of the explanatory factor analysis, factor structures of quality of birth care, antenatal check-ups and supplements, and risk factors associated with birth were obtained using the Categorical Component Analysis method. The type of delivery, place of delivery, age, and type of place, which are under the quality of birth care, and risk factors associated with birth factors were found to be the variables that had the highest impact on LOS estimation. Random forest (Accuracy = 0.5789), support vector machine (radial) (Accuracy = 0.5766), and neural network (Accuracy = 0.5750) models outperformed, respectively. Type of delivery which is an indicator of quality of birth care is a strong predictor of LOS after birth according to the Random Forest model. We demonstrated that machine learning techniques offer precise LOS prediction after birth. Further studies assessing the effect of quality of birth care on predicting LOS at birth would be beneficial.

Lived experiences of women who survived from pre-eclampsia and eclampsia in public hospitals of Shashemene Town, Oromia Region, Ethiopia: a qualitative study.

Objective: The main purpose of this study was to explore experiences of women who survived pre-eclampsia and eclampsia in Shashemene referral hospital and Melka Oda general hospital, 2021. Design: An institution-based exploratory qualitative study with a descriptive phenomenological study design Setting: The present study was conducted in Shashemene referral hospital and Melka Oda general hospital from March 03 to May 18, 2021. Participants: A total of 17 individual in-depth interviews (IDIs) were conducted with women who experienced and survived pre-eclampsia and eclampsia. Data were analyzed through thematic analysis using Atlas-ti software. Result: The present study revealed that women’s level of awareness on raised blood pressure and or convulsion occurring during pregnancy was poor. Barriers that limit pregnant women from getting treatment at the earliest point included misconception, lack of insight, failure to accept counseling from health care providers, low income, and influence from husbands. Discussions with the women in this study showed that these mothers were not counseled on danger signs during antenatal care check-ups. Almost all of the women were very concerned and frustrated due to their diagnosis. Conclusions: Women’s awareness of pre-eclampsia and eclampsia was poor and antenatal care was not offered as per expected quality. Improving awareness of hypertensive disorders in pregnancy and enhancing the quality of antenatal care is essential.

Prevalence of hemoglobinopathies detected by high performance liquid chromatography in tertiary care centre, Kota, Rajasthan

Background: Hemoglobinopathies are the most common heterogeneous group of monogenetic disorder in the world. Their prevalence varies with geographical regions. India is developing country and many studies have shown a significant burden of hemoglobinopathies in India. Our aim is to estimate prevalence of various hemoglobinopathies in our region. Methods: The present study was conducted at the department of pathology, Government Medical College, Kota on patients referred for antenatal or voluntary premarital checkup, patients with clinical history and complete blood count (CBC) suggestive of hemolytic anemia, and family members of known cases of hemoglobinopathies. Transfusion-dependent patients were also included. However, patients with history of blood transfusion within the last 1 month were excluded. EDTA samples were used for CBC using 6-part differential cell counter and high-performance liquid chromatography (HPLC) using BIORAD D10 analyzer. The results were tabulated and analyzed. Results: Of the 226 cases studied, 139 (61.5%) were females and 87 (38.5%) were males. Most common age group was 21 to 30 years. The number of thalassemia traits were 26 (11.5%), sickle cell traits were 7 (3.1%), sickle cell homozygous was 1 (0.4%), compound heterozygous for sickle cell and thalassemia were 2 (0.9%), while the remaining 190 patients (84.07%) were found to have normal HPLC, with presence or absence of nutritional deficiency. Conclusions: In our study, we found a high prevalence of hemoglobinopathies among patients. The most common disorder detected was beta thalassemia trait. Most of the hemoglobinopathies found in our study could be accurately quantified by HPLC which is a rapid, sensitive, and reproducible method for the detection of different hemoglobinopathies.

Evaluation of the Patients with Placenta Praevia in Mymensingh Medical College Hospital, Bangladesh

Placenta praevia is a life-threatening condition both for mother and foetus and defines high risk pregnancy. A cross-sectional, observational study was conducted from July to December of 2021 in the Department of Obstetrics & Gynaecology of Mymensingh Medical College Hospital, Mymensingh, Bangladesh, to assess the relationship between previous Caesarean scar and subsequent development of placenta praevia. A total of 48 women of placenta parevia were taken in this study as diagnosed through ultrasonogram. In age distribution of these patients, peak incidence was found in the 26-35 years age group (54.10%) and the oldest was at her 42 years. Most of the patients (35.41%) did not take any antenatal check-up before their admission into hospital. The majority patients (64.58%) had history of previous Caesarean scar than vaginal delivery (35.41%) and previous two scars (51.61%) were most common. Ultrasonographically, partial variety was more (29.10%) common than others. Most pregnancies were (78.08%) delivered abdominally. In fetal outcome, 22.91% of babies were premature but did not need any NICU support, whereas 22.83% needed admission into NICU. Primary postpartum haemorrhage was the most common among complications (37.50%). This study suggests identifying the risk factors for placenta praevia. Early diagnosis, creating awareness and organizing a strong supportive surgical skilled team are needed to reduce maternal and foetal morbidity and mortality in such cases. CBMJ 2024 July: vol. 13 no. 02 P: 135-140

Alteration of Maternal Serum Ferritin in Pregnancy and Maternal-fetal Infections: A retrospective cohort study.

To investigate the association of altered serum ferritin during pregnancy with chorioamnionitis and neonatal sepsis. This retrospective cohort study included 78,521 pregnant women who attended antenatal check-ups at maternal and child health centers in Fujian Province, China. Study lasted from January 2014 to January 2019. A total of 59,812 pregnant women were followed up. Patients with suspected infection before the delivery were selected and divided into the chorioamnionitis and non-chorioamnionitis groups according to placental pathology. Differences in late and early pregnancy serum ferritin between the two groups were compared. Multiple logistics regression was used to adjust for confounding factors and to analyze the association between serum ferritin changes and pregnancy outcomes. Importance of altered serum ferritin during pregnancy was assessed by receiver operating characteristic (ROC) curve and net reclassification index (NRI). Clinical records of 8506 pregnant women were included in the study. there were 1010 (11.9%) cases of confirmed chorioamnionitis and 263 (3.1%) cases of neonatal sepsis. There was a significant difference in maternal serum ferritin changes between the groups with and without chorioamnionitis. No significant difference was detected in cases with or without neonatal sepsis. Multiple logistic regressions, corrected for confounding factors yielded similar conclusions. Maternal serum ferritin difference NRI 12.18% (p = 0.00014) was similar to the ROC results in predicting the occurrence of chorioamnionitis. Differential serum ferritin during pregnancy may predict chorioamnionitis but does not correlate well with neonatal sepsis.

Socio-demographic factors affecting the first and second dose of measles vaccination status among under-five children: Perspectives from South Asian countries

BackgroundThe measles vaccine is crucial in preventing fatalities and reducing widespread childhood infections worldwide, yet achieving the desired immunization rates remains a challenge in developing countries. Our study aims to identify the impact of socio-demographic factors on measles vaccination among children in South Asian countries. MethodsParticipants (89513) were taken from the most recent Demographic and Health Survey (DHS) datasets of South Asian countries between 2015 and 2021. Descriptive statistics and multivariable analyses were employed to find out the factors associated with measles vaccination among South Asian countries. ResultsOur study found that the first dose of vaccinated children was 51.7 % in Afghanistan which is the lowest among South Asian countries. The key determinants related to two doses of measles vaccination include parental characteristics, media access, and antenatal care (ANC). Mothers who had done baby postnatal checkups (AOR = 1.22, CI = 1.17–1.26) and made more than four ANC (AOR = 1.77, CI: 1.65–1.89) were more likely to fully immunize their child than mothers with no postnatal and antenatal checkups. ConclusionThe complete dose of measles vaccination rate in South Asia is still low compared to the first dose of measles vaccination among children. The government and stakeholders should organize frequent awareness programs through media and health personnel to inform people about routine vaccinations to eliminate measles.

Knowledge and utilization of Integrated Child Development Services among antenatal women during COVID-19 pandemic.

The coronavirus disease 2019 (COVID-19) pandemic has affected the healthcare delivery system in both developed and developing countries. Many antenatal women skipped their regular antenatal check-ups due to fear of viral contamination and lack of transport facilities. Integrated Child Development Services (ICDS), which plays a major role in antenatal care, also suffered a great deal during the pandemic. 1. To assess knowledge and utilization of ICDS services by antenatal women during the COVID-19 pandemic. 2. To determine factors influencing the knowledge and utilization of ICDS services by antenatal women. 3. To determine the barriers to utilization of ICDS services during the pandemic. This study was conducted as a descriptive study in a tertiary care center. Antenatal women whose pregnancy period coincided with the second wave of the COVID-19 pandemic were interviewed using a structured questionnaire. The sample size was calculated as 198. Data were entered in Microsoft Excel and analyzed using Statistical Package for Social Sciences (SPSS). Around 61% of the study population had adequate knowledge about ICDS services. The proportion of antenatal women utilizing ICDS services reduced from 87.8% to 69.6% during the pandemic. Only a few of the mothers were followed up by the Anganwadi workers during the pandemic. The main barriers to not utilizing ICDS services were fear of the spread of the pathogen and lack of awareness about the availability of services during the pandemic. There has been a reduction in the utilization of ICDS services by antenatal women during the COVID-19 pandemic. Measures should be taken by the government to ensure undisrupted care for antenatal women during such hard times.

Association between the MTHFR (rs1801133) gene variation and serum trace elements levels (Copper and Zinc) in individuals diagnosed with neural tube defects

Background and AimsNeural tube defects (NTDs) occur when the neural tube fails to close within 28 days of human embryonic development. This results in central nervous system disorders like anencephaly, spina bifida, and encephalocele. Early diagnosis and treatment are crucial to minimize their impact on an individual’s health and well-being. The present study aims to define the association between prenatal exposure to trace elements (Cu and Zn) and the single nucleotide polymorphism (SNP) of the MTHFR gene involved in folate metabolism pathways in neural tube defects in children and their mothers. Material and MethodsA cross-sectional study involving 331 participants (90 NTD cases, 88 healthy mothers, 85 NTD children, and 68 healthy children) from antenatal check-ups in Obstetrics and Gynaecology and Pediatric Surgery for Neural Tube Defects in the Outpatient Department (OPD) and Inpatient Department (IPD). Assessed Cu and Zn concentrations and their associations. Genomic DNA was extracted, and real-time PCR was used to determine genotypes. Atomic absorption spectrophotometry measured trace elements. Statistical analyses included Chi-Square tests, odds ratios, and Mann-Whitney U tests. ResultsSignificant associations were found between MTHFR C677T genotypes and NTD risk in mothers (p = 0.0491) and children (p = 0.0297). Allelic frequency analysis indicated a T allele association with NTD risk in children (p = 0.0107). Recessive models showed significant associations in mothers (p = 0.0169) and children (p = 0.1678). Cu levels differed significantly between NTD cases and controls (p < 0.0001), with MTHFR genotypes influencing Cu levels. Zinc levels also varied significantly (p < 0.0001). ConclusionThis study reveals complex associations between MTHFR C677T genotypes, trace element concentrations, and NTD risk in mothers and children. This targeted approach allows healthcare providers to identify at-risk pregnancies early, enabling personalised interventions like folic acid supplementation and counselling to moderate neural tube defect (NTD) risk in a future pregnancy.

Mid-upper arm circumference predicts the risk of gestational diabetes in early pregnancy

BackgroundThe present work aimed to assess the value of mid-upper arm circumference (MUAC) at 8 to 12 weeks in predicting the occurrence of gestational diabetes mellitus (GDM).MethodsAccording to eligibility criteria, 328 women with singleton pregnancies who underwent routine antenatal check-ups at Qinhuangdao Maternal and Child Health Hospital from September 2017 to September 2020 were included. The patients were divided into the gestational diabetes mellitus (GDM) and non-GDM groups according to oral glucose tolerance test (OGTT) data from gestation weeks 24 to 28. Clinical data were compared between the two groups. Logistic regression analysis was performed to determine factors independently predicting GDM. Receiver operating characteristic (ROC) curve analysis was employed to analyze the value of MUAC in predicting the occurrence of GDM. The optimal cut-off points were calculated.ResultsIn logistic regression analysis, pre-pregnancy weight, waist circumference, MUAC, UA, TG, and HDL-C independently predicted the occurrence of GDM (P < 0.05). MUAC retained statistical significance upon adjustment for various confounders (OR = 8.851, 95%CI: 3.907–20.048; P < 0.001). ROC curve analysis revealed good diagnostic potential for MUAC in GDM (AUC = 0.742, 95%CI: 0.684–0.800, P < 0.001), with a cut-off of 28.5 cm, sensitivity and specificity were 61% and 77%, respectively.ConclusionPregnant women with MUAC >28.5 cm are prone to develop GDM during pregnancy, indicating that MUAC as an important predictive factor of GDM in early pregnancy.

Prevalence of intestinal parasitic infections among the pregnant women in South and South East Asian countries: A systematic review and meta-analysis.

Intestinal parasitic infections (IPIs) are a major health concern in resource-limited countries of South/South-East Asian region. Despite posing a potential threat to maternal and fetal health, there is limited data available on the actual burden of IPI among pregnant women. Through this systemic review and meta-analysis, we sought to determine the pooled prevalence of IPI and species-specific prevalence among pregnant women in this region. Subgroup analysis was done by region, stool examination technique, and study settings. Among 220 retrieved studies, 21 studies from 8 countries across the region were found eligible and included in this study. The estimated overall pooled prevalence of IPIs among pregnant women was 43.15% (95% confidence interval: 30.66-56.10). The most prevalent IPI was Ascaris lumbricoides (25.14%) and predominant protozoa was Entamoeba histolytica/dispar (6.96%). In subgroup analysis, the estimated pooled prevalence of IPIs in Nepal, India, Thailand, and Thai-Burmese Border was 40.88%, 28.33%, 55.38%, and 23.78%, respectively. Studies using Kato-Katz technique for stool examination showed the highest estimated pooled IPI prevalence (62.70%). The prevalence of IPI was found to be lower in facility-based studies (38.12%) than that of studies done in the community (66.21%). Considering the high burden of IPI in pregnant women as estimated in our review and the already established impact of IPI infection on maternal health and fetal outcomes, we recommend implementation of the preventive chemotherapy during routine antenatal checkups.

Knowledge, myths and acceptability of covid-19 vaccination among expectant women attending out- patient department of the private and public sector hospitals

This cross-sectional study was conducted to explore pregnant women's knowledge, attitudes, and acceptance of the COVID-19 vaccination. A total of 237 pregnant women were included from January 2021 till December 2021. After enrolment in the hospitals and before antenatal checkup all patients sent for COVID-19 vaccinations, those who had reservations regarding vaccination in pregnancy and willing to participate and share their knowledge were included. Data was collected using a pre-designed structured proforma. There were 84 pregnant women (35.4%) from rural residences, 67.1% with middle socioeconomic status, 84.8% were literate, 83.5% with 1 -3 antenatal visits, 46.8% with 21 – 26 weeks of gestational age, the mean gestational age of samples was 21.7 weeks. The source of information regarding hazards of COVID vaccine during pregnancy, there were 35 (44.3%) reported family, 24 (30.4%) reported friends, 15 (19%) reported healthcare providers and 5 (6.3%) reported media as the main source of information regarding hazards of COVID vaccine in pregnancy. Most of the expectant ladies who has misconceptions and were worried about birth defects and long-term effects on babies, the safety and prevention of COVID infection by the vaccine had information from the family.

Multidimensional influencing factors of postpartum depression based on the perspective of the entire reproductive cycle: evidence from western province of China

ObjectiveChina has a serious burden of Postpartum depression (PPD). In order to improve the current situation of high burden of PPD, this study explores the factors affecting PPD from the multidimensional perspectives with physiology, family support and social support covering the full-time chain of pre-pregnancy–pregnancy–postpartum.MethodsA follow-up survey was conducted in the Qujing First People’s Hospital of Yunnan Province from 2020 to 2022, and a total of 4838 pregnant women who underwent antenatal checkups in the hospital were enrolled as study subjects. Mothers were assessed for PPD using the Edinburgh Postnatal Depression Scale (EPDS), and logistic regression was used to analyse the level of mothers’ postnatal depression and identify vulnerability characteristics.ResultsThe prevalence of mothers’ PPD was 46.05%, with a higher prevalence among those who had poor pre-pregnancy health, had sleep problems during pregnancy, and only had a single female fetus. In the family support dimension, only family care (OR = 0.52, 95% CI 0.42–0.64) and only other people care(OR = 0.78, 95% CI 0.64–0.96) were the protective factors of PPD. The experience risk of PPD was higher among mothers who did not work or use internet.ConclusionThe PPD level in Yunnan Province was significantly higher than the global and Chinese average levels. Factors affecting mothers’ PPD exist in all time stages throughout pregnancy, and the influence of family support and social support on PPD shouldn’t be ignored. There is an urgent need to extend the time chain of PPD, move its prevention and treatment forward and broaden the dimensions of its intervention.

Factors affecting asthma control in pregnancy: A cross-sectional study.

Asthma control in pregnant women remains of utmost importance; suboptimal control can have adverse repercussions on both fetal and maternal health. The objective was to identify the factors that affect asthma control in pregnant Pakistani women presenting to a tertiary care hospital. This descriptive, cross-sectional research was conducted at KRL General Hospital between 1st November 2022 to 30th April 2023. Non-probability technique was used to sample one hundred and forty-five pregnant women with confirmed bronchial asthma irrespective of their trimester presented. Data regarding demographics and factors affecting asthma control was collected. The mean age was 30.39 ± 4.33 years, with two-thirds (65%) being multiparous. Approximately 48% of participants were non-compliant with treatment, and less than 40% achieved adequate asthma control. A chi-squared test applied showed that multiparity (p = 0.003), treatment compliance (p < 0.001), BMI (p < 0.001), and proper inhaler technique (p < 0.001) were statistically significant factors affecting asthma control in pregnant women while, the level of education and household income did not exhibit a significant association. Multiple regression analysis qualified higher BMI, multiparity, treatment compliance, and inhaler technique as significant predictors of asthma control amongst pregnant women. Ensuring asthma control during pregnancy is important. This study identified BMI, multiparity, inhaler technique, and treatment compliance as factors that affect asthma control in pregnant women. Addressing these factors through regular antenatal check-ups can significantly mitigate risks and promote the optimal health of both maternal and fetal lives.

Prevalence of Thyroid Disorder in First Trimester of Pregnancy, Study from Lumbini Province Nepal

INTRODUCTION Thyroid disorder is the second most common endocrine disorder of pregnancy. The most common thyroid disorder is hypothyroidism which often goes undiagnosed during pregnancy without screening. It has influence in maternal and fetal outcome of pregnancy. The objective of this study is to determine the prevalence of thyroid disorder in the first trimester of pregnancy. MATERIAL AND METHODSThis was cross-sectional observational study conducted for a period of 6 months (Jan - June 2022) at Universal College of Medical Sciences, Bhairahawa, Nepal. All the pregnant women in their first trimester who came for antenatal check-up in gynae OPD was included after taking consent. RESULTSTotal 393 cases were evaluated. 58% were primigravida and 42% were multigravida. Mean age was 26 years with minimum 17 years and maximum 41 years. Majority of cases were of the age group 20 to 30 years 76.6%. Thyroid disorder noted in 21.3%. Hypothyroidism found in 18.6% with overt hypothyroidism in 12.8% and subclinical hypothyroidism in 5.8%. Hyperthyroidism noted in 2.7% with overt hyperthyroidism in 1.5% and subclinical hyperthyroidism in 1.2%. CONCLUSIONThyroid disorder in pregnancy in common health problem in first trimester in pregnancy. Early diagnosis and treatment is needed to reduce complications associated with this endocrine disorder of pregnancy.