Bad Obstetric History Research Articles

Successful Management of High-Risk Pregnancy with TORCH Infection History and Chronic Hypertension

A 41-year-old pregnant woman of Javanese ethnicity attended the outpatient clinic of a private hospital, presented with fifth pregnancy and no living children due to a history of ectopic pregnancy, two times IUFD, and one time neonatal death. The patient also had a history of chronic hypertension and asthma. The examination showed positive IgG Toxoplasma and CMV antibody levels. The patient's blood pressure also never touched the normal limit since the beginning of pregnancy. At the end of pregnancy, she had very high blood pressure and proteinuria. According to WHO Maternal Mortality Rate (MMR) is still very high, where two of the five highest causes are infection and hypertension in pregnancy. High risk pregnancies require special attention in monitoring during pregnancy and management. In a history of bad obstetrical history it is necessary to screen for infection which can be done by antibody serology testing. A positive IgG indicates immunity to the virus, if possible it is necessary to check IgG Avidity to determine whether therapy is still needed or can rely on the immune system that has been formed. Chronic hypertension (Systolic Blood Pressure (SBP) > 140 mmHg and / or Diastolic Blood Pressure (DBP) > 90 mmHg since < 20 Weeks Gestational Age (WGA) until 42 days after delivery). First-line Labetalol and Nifedipine or second-line Methyldopa and Hydrochlorothiazide should be considered depending on the condition and gestational age. If there are signs of preeclampsia, termination should be done if possible, along with antihypertensives and anticonvulsants such as MgSO4.

Evaluation of Sectio Cesaria Response Time to Maternal and Neonatal Outcomes in Severe Preeclampsia - Eclampsia Patients

This research is finding out an overview of the response time evaluation of Sectio Cesaria in patients with severe Pre-eclampsia - Eclampsia at Sitti Khadijah 1 Muhammadiyah Hospital Makassar Branch. Severe preeclampsia and eclampsia are complications in pregnancy and childbirth that increase maternal and infant morbidity and mortality rates. To prevent the problem of eclampsia, early management of preeclampsia must be carried out properly. Cesarean sections are classified into two categories, namely SC categories 1 and 2. Category 1 Caesarean sections are SCs that must be carried out as soon as possible and most decisions must be taken within 30 minutes, namely in cases that immediately threaten the lives of the mother and baby, such as fetal distress, non-reassuring fetal status, antepartum hemorrhage, and the threat of uterine rupture. While SC category 2 is one that endangers the mother and fetus but not immediately, such as two previous CS, dystocia, hypertension in pregnancy, premature rupture of membranes, breech position, failed induction, bad obstetric history, macrosomia, cephalopelvic disproportion, facial presentation, and most decisions must be taken within 75 minutes. This research method is observational research using a cross sectional approach. The results of this research is maternal outcome most affected by SC response time <75 minutes is postoperative ICU care, and the most influential neonatal outcome is the APGAR Score. Based on the research results, it can be concluded that response time has a significant influence on maternal and neonatal outcomes in patients with severe preeclampsia - eclampsia.

Gestational diabetes mellitus - Neonatal and maternal outcomes in women treated with insulin or diet: A propensity matched analysis

AimsPregnant women worldwide face the risk of developing gestational diabetes mellitus (GDM), if left untreated, can cause complications. The study explores factors influencing the choice between diet control and insulin therapy for pregnant women with GDM. It aims to understand how these choices impact maternal and neonatal outcomes. MethodsIn this quasi-experimental study, clinicians determined treatment (diet control or insulin) for 1030 individuals with GDM at a private practice from 2010 to 2020 based on baseline characteristics. Propensity scores (PS), reflecting the probability of treatment allocation, were derived through multiple logistic regression. ResultsAfter PS matching, 386 individuals were paired from two study groups. The insulin-treated group exhibited a 4.43 times higher risk of neonatal hypoglycemia than the diet group. Insulin-treated individuals, stratified by PS, revealed that the high-risk quartile had significantly higher mean insulin requirements and a doubled dose at full term compared to the lower-risk quartiles. The mean insulin dose did not significantly differ in the first three quartiles, but the last quartile showed a significant increase (p = 0.008), particularly for individuals with PS exceeding 0.70, indicating a higher insulin dose requirement for effective glucose control. ConclusionThis study reveals that individuals with a bad obstetrics history, a family history of diabetes, obesity, and elevated baseline glycemic parameters necessitate higher insulin doses. This insight improves clinicians' decision-making in diagnosis and treatment planning, enhancing the precision of medical practices.

A rare case of hemolytic disease-associated thrombocytopenia mimicking alloimmune thrombocytopenia: Salvaging a precious baby

Abstract: Thrombocytopenia associated with hemolytic disease of fetus and newborn (HDFN) is usually mild-to-moderate severity. Neonatal alloimmune thrombocytopenia (NAIT) is one of the leading causes of severe thrombocytopenia in neonates. We describe a rare case of very severe thrombocytopenia (5 g/L) with bleeding manifestations associated with HDFN mimicking NAIT. The baby was a preterm female, born to a 34-year-old multiparous mother with a bad obstetric history and multiple alloantibodies (anti-D, anti-C, anti-E, and anti-Jka). She was managed with phototherapy, exchange transfusion with phenotype-matched packed red blood cells, random donor platelets and intravenous immunoglobulin as platelet crossmatching could not provide compatible platelets. NAIT was ruled out with human platelet antigen (HPA) genotyping of the baby, the mother, and the father. It was concluded that the very severe thrombocytopenia might be due to HDFN after ruling out the other causes. HDFN can rarely cause very severe thrombocytopenia. However, when a newborn presents with severe/very severe thrombocytopenia, NAIT is to be ruled out with HPA genotyping, even in resource-limited settings, to plan out subsequent pregnancies.

Level of optimal antenatal care utilization and its associated factors among pregnant women in Arba Minch town, southern Ethiopia: new WHO-recommended ANC 8+ model.

To fully realize the life-saving and health-promoting benefits of antenatal care (ANC), the latest World Health Organization (WHO) recommendations call for pregnant women to have at least eight contacts with skilled healthcare providers. This increased number of recommended ANC visits represents a shift toward a more comprehensive, individualized approach to prenatal care. The focus is on health promotion, disease prevention, and the early detection and management of complications during pregnancy. However, in sub-Saharan African countries, including Ethiopia, the coverage rate for this level of recommended antenatal care is only 58%. Given this relatively low utilization, identifying the key risk factors that prevent adequate antenatal care would have significant implications for increasing overall ANC uptake in these regions. The aim of the present study was to assess the level of optimal antenatal care utilization and its associated factors among pregnant women in Arba Minch town, southern Ethiopia in 2023 using the new WHO-recommended ANC 8+ model. An institution-based cross-sectional study was conducted among 416 mothers who were enrolled between 1 December 2022 and 30 January 2023. The total sample size was allocated proportionately to the number of women who delivered at each public health facility. Thus, systematic sampling was applied. Kobo Toolbox was used for data collection and cleaning, which was then analyzed using SPSS Version 26. Statistical significance was determined at a p-value <0.05. In this study, the level of optimal antenatal care was 41% [95% confidence interval (CI): 37-45.3]. The associated factors with optimal antenatal care were the presence of pregnancy danger signs [adjusted odds ratios (AOR) = 4.1, 95% CI: 1.87-8.82], having bad obstetric history (AOR = 3.90, 95% CI: 1.94-7.83), antenatal contact at hospital (AOR = 5.11, 95% CI: 2.28-11.21), having good knowledge about antenatal care (AOR = 2.26, 95% CI: 1.15-4.44), women's high decision-making power (AOR = 3.9, 95% CI: 1.2-7.63), and male partner involvement (AOR = 2.0, 95% CI: 1.04-3.78) were positively associated with optimal antenatal care utilization. The level of optimal antenatal follow-up is still low. Therefore, it is crucial to provide more information during the antenatal contacts to lower the rate of women discontinued from antenatal care.

Prevalence of Human Parvovirus B19 and Associated Risk Factors in Women with Bad Obstetric History in Babylon Province, Iraq

Abstract Background: Parvovirus infection is an important cause of fetal loss during all three trimesters of pregnancy. Objectives: This study was conducted to investigate the prevalence, susceptibility rate, and risk factors of B19-V in women aged 15 to 45 in the Al-Hamza region of Babil, Iraq, considering the negative effects of the infection. Materials and Methods: Between January 2022 and March 2023, blood samples were taken from 116 women, including those with and those without a history of bad obstetric history (BOH). Enzyme-linked immunosorbent assay (ELISA) was used to test sera taken from the study participants for B19 IgM and immunoglobulin G (IgG) antibodies. Those samples tested positive for IgG B19 were further subjected to polymerase chain reaction amplification and sequencing, targeting partial gene sequences of the nonstructural viral protein 1 (VP1) gene. Results: For human parvovirus IgG and IgM, the seropositivity was 44% and 16.5%, respectively. The following variables were associated in this study with greater seroprevalence rates of IgG and IgM, respectively: age 36–45 years (72.7%, 36.4%); abortion (80%, 32.5%); education (82.2%, 33.3%); unemployment (61%, 22.2%); and overcrowding (73.3%, 31.1%). In this case–control study, positive amplicons (700 bp) were detected from 27 samples out of 40 women of childbearing age who tested positive for IgG. Sequence analysis of the partial sequence of the VP1 gene in all positive amplicons was 100% identical with each other and with human parvovirus B19 (NC: 00088.3). According to the current study, about 66% of women are serologically negative and at risk of contracting parvovirus B19. Conclusion: Our findings conclude that pregnant women in Iraq, particularly those with BOH, must undergo frequent serological screening for B19-V during all three trimesters and be given the necessary advice to avoid B19-V infection to improve their pregnancy outcomes.

Proportion of Emergency Cesarean Section in Maternity Hospitals in Kirkuk Governorate, in 2022–2023

Abstract Background: Emergency cesarean sections are undertaken before or during labor when there is an immediate concern for the mother or the fetus. Inadequate maternal management and unreliable referral systems are responsible for the massive incidence of emergency cesarean section. Objectives: This study aims to identify the rate of emergency cesarean section in Kirkuk governorate. Subjects and Methods: A cross-sectional study was conducted at the postoperative Obstetrical and Gynecological wards in Azadi Teaching Hospital and Kirkuk General Hospital, Kirkuk, Iraq, from December 1st, 2022, to February 28th, 2023. Four hundred women, who have had cesarean sections, were directly interviewed using a structured questionnaire. Official approval was obtained. Categorical data were analyzed using the Chi-square or Fisher’s exact tests P &lt; 0.05 was considered statistically significant. Results: One hundred and ninety-nine (49.8%) mothers were within 26–35 years of age. One hundred and forty-three (35.8%) had an emergency cesarean section, whereas 257 (64.3%) had an elective cesarean section. Emergency indications included failure to progress 45 (31.5%), cephalopelvic disproportion (CPD) 36 (25.2%), fetal distress 32 (22.4%), and severe preeclampsia 22 (15.4%). Poor pregnancy outcomes included bad obstetrical history 49 (12.3%), macrosomia 7 (1.8%), premature rupture of membrane 4 (1.0%), and postterm 21 (5.3%). Elective cesarean sections were significantly higher in husbands &gt;35 years, with husbands’ education (primary school), parity of 2–4, and with no pregnancy-induced hypertension (P = 0.035, P = 0.034, P &lt; 0.001, and P &lt; 0.001), respectively. Emergency cesarean sections (CSs) were significantly higher among diabetic mothers; P = 0.022. Conclusions: One-third of all CSs in Kirkuk were done as emergency operations with failure to progress, CPD, and fetal distress as the main indications.

Association Between Thyroid Dysfunction Among Pregnant Women with Bad Obstetric History A Comprehensive Study

Background: Thyroid dysfunction is increasingly prevalent globally, particularly in developing countries where dietary and hygiene practices during pregnancy contribute to its incidence. This condition significantly affects maternal and fetal health, necessitating closer examination, especially in populations with adverse obstetric histories. Objective: To evaluate the prevalence of thyroid dysfunction among pregnant women with a history of adverse obstetric outcomes and to underscore the necessity for targeted screening and management strategies. Methods: A cross-sectional study involved 260 pregnant women aged 18 to 40 with a history of poor obstetric outcomes. Participants were selected through non-probability consecutive sampling. After obtaining informed consent, demographic data were collected, and thyroid function was assessed by measuring TSH, T3, and T4 levels in a hospital laboratory. Data analysis was performed using SPSS version 16.0, utilizing means and standard deviations for quantitative data and frequencies and percentages for qualitative data. Results: The average age of participants was 30.31 ± 3.11 years. Mean thyroid hormone levels were recorded at T4: 1.84 ± 1.12 and TSH: 4.32 ± 0.91. Thyroid dysfunction was identified in 45.4% of the women, with 65.2% having subclinical hypothyroidism and 34.7% exhibiting subclinical hyperthyroidism among those diagnosed. Conclusion: The study highlights a significant prevalence of thyroid dysfunction in pregnant women with poor obstetric histories, indicating a critical need for comprehensive screening and tailored management to improve maternal and fetal health outcomes.

Microbiome Review: Ethnicity, Diet, and Lifestyle in Bad Obstetric History

This systematic review explores the intricate relationship between the maternal microbiome and adverse obstetric outcomes in women with a history of recurrent miscarriages, preterm birth, or stillbirth, collectively known as Bad Obstetric History (BOH). The microbiome, encompassing bacteria, viruses, and fungi, within the reproductive tract is increasingly recognized as a crucial factor in pregnancy maintenance and complications. The study explores BOH's multifactorial causes—genetic, anatomical, endocrine, thrombophilic, immunological, and environmental. Despite one-third of cases being unexplained, it underscores the importance of evaluating uterine macro and microenvironments. Emerging evidence challenges prior beliefs by supporting the existence of an endometrial microbiome, hinting at its impact on pregnancy outcomes. The methodology follows a systematic approach adhering to PRISMA guidelines, incorporating electronic database searches yielding 125 relevant articles, with 47 meeting inclusion criteria. The selected studies focus on human samples from stool, oral, or vaginal swabs, including randomized clinical trials, systematic reviews, and meta-analyses. In conclusion, the review emphasizes the significance of understanding the microbial changes in pregnant females and their potential impact on obstetric outcomes. The findings propose a connection between altered microbiota and maternal complications, highlighting the potential for personalized medicine interventions. Additionally, the study delves into the nuanced relationship between ethnicity, dietary patterns, and the microbiome, underscoring the importance of personalized and culturally sensitive healthcare interventions. Overall, this comprehensive review provides valuable insights into the role of the microbiome in obstetric outcomes, paving the way for future research and targeted interventions to optimize pregnancy outcomes globally.

Incidence and development of validated mortality prediction model among asphyxiated neonates admitted to neonatal intensive care unit at Felege Hiwot Comprehensive Specialized Hospital, Bahir Dar, Northwest Ethiopia, 2021: retrospective follow-up study

IntroductionPerinatal asphyxia is failure to maintain normal breathing at birth. World Health Organization indicates that perinatal asphyxia is the third major cause of neonatal mortality in developing countries accounting for 23% of neonatal deaths every year. At global and national level efforts have done to reduce neonatal mortality, however fatalities from asphyxia remains high in Ethiopia (24%). And there are no sufficient studies to show incidence and prediction of mortality among asphyxiated neonates. Developing validated risk prediction model is one of the crucial strategies to improve neonatal outcomes with asphyxia. Therefore, this study will help to screen asphyxiated neonate at high-risk for mortality during admission by easily accessible predictors. This study aimed to determine the incidence and develop validated Mortality Prediction model among asphyxiated neonates admitted to the Neonatal Intensive Care Unit at Felege-Hiwot Comprehensive Specialized Hospital, Bahir Dar, Ethiopia.MethodRetrospective follow-up study was conducted at Felege-Hiwot Comprehensive Specialized Hospital from September 1, 2017, to March 31, 2021. Simple random sampling was used to select 774 neonates, and 738 were reviewed. Since was data Secondary, it was collected by checklist. After the description of the data by table and graph, Univariable with p-value < 0.25, and stepwise multivariable analysis with p-value < 0.05 were done to develop final reduced prediction model by likelihood ratio test. To improve clinical utility, we developed a simplified risk score to classify asphyxiated neonates at high or low-risk of mortality. The accuracy of the model was evaluated using area under curve, and calibration plot. To measures all accuracy internal validation using bootstrapping technique were assessed. We evaluated the clinical impact of the model using a decision curve analysis across various threshold probabilities.ResultIncidence of neonatal mortality with asphyxia was 27.2% (95% CI: 24.1, 30.6). Rural residence, bad obstetric history, amniotic fluid status, multiple pregnancy, birth weight (< 2500 g), hypoxic-ischemic encephalopathy (stage II and III), and failure to suck were identified in the final risk prediction score. The area under the curve for mortality using 7 predictors was 0.78 (95% CI 0.74 to 0.82). With ≥ 7 cutoffs the sensitivity and specificity of risk prediction score were 0.64 and 0.82 respectively.Conclusion and recommendationIncidence of neonatal mortality with asphyxia was high. The risk prediction score had good discrimination power built by rural residence, bad obstetric history, stained amniotic fluid, multiple pregnancy, birth weight (< 2500 g), hypoxic-ischemic encephalopathy (stage II and III), and failure to suck. Thus, using this score chart and improve neonatal and maternal service reduce mortality among asphyxiated neonates.

Pregnancy-related Factors Responsible for Delivering Low Birth Weight Babies: An Institutional-based Cross-sectional Study, Jamnagar, Gujarat.

The WHO defines LBW as "Birth weight less than 2500 grams" regardless of gestational age. Being born with a low birth weight also incurs enormous economic costs, including higher medical expenditures and social service expenses, and decreased productivity in adulthood. To study distribution of newborns' according to pregnancy related factors and its association with newborns' birth weight. An institutional based cross-sectional study. New-borns delivered at study institute were considered as study participants. Estimated final sample size was 500. Guardians (mothers) were face-to-face interviewed and also recorded data were collected from the case file and Mother and Child Protection Card. Prevalence of LBW newborns was higher in mothers with late ANC registration, <4 ANC visits, chronic medical conditions, infection during pregnancy, PIH, anemia, consuming tobacco, exposure to second hand smoke, LSCS/Assisted delivery, in female newborns', current pregnancy birth order number more than 2, in pre term newborns' and mothers with bad obstetric history. Create awareness and adoption of suitable family planning methods. Need to do early (within 12 weeks) ANC registration with minimum four ANC visits for better pregnancy outcome. Effective tracking and suitable intervention provided to improve current pregnancy outcome. Health care professional should pay special attention to high-risk pregnancy. Develop social culture in such a way that females are neither addicted nor exposed to any tobacco containing products in their life.

Rhesus alloimmunization in pregnancy. A Tertiary Care Center Experience in Kenya. A Case Report

Background: Rhesus alloimmunization is a significant cause of perinatal morbidity in sub-SaharanAfrica.Case presentation: A 28-year-old para 2+2 gravida 5, rhesus-negative mother with no living childpresented to the Kenyatta National Hospital (KNH) antenatal clinic at 20 weeks of gestation as a referralbecause of a bad obstetric history secondary to rhesus D alloimmunization following a positive indirectCoombs test. She was started on methylprednisolone, and serial middle cerebral artery peak systolicvelocity (MCA-PSV) monitoring was performed until 32 weeks of gestation when the fetus developedhemolytic disease of the newborn diagnosed via cordocentesis. She underwent two sessions ofintrauterine transfusion and had a successful cesarean delivery at 34 weeks and 1 day of gestation. Theneonate was admitted to the KNH neonatal intensive care unit where he was managed for hemolyticdisease of the newborn, 33 days after which he was successfully discharged home.Conclusion: The role of maternal-fetal specialists in the diagnosis, antenatal follow-up, and timelymanagement of rhesus D alloimmunization is key in the prevention of adverse perinatal outcomes.

TORCH Infection and Ayurveda Treatment: A Blessing to Infertility

Pregnancy and childbirth are the most important phases of a woman's life. In India, approximately 15% of couples are affected by infertility. There are many reasons contributing to infertility and bad obstetric history (BOH), among which TORCH infection is most common. The overall TORCH infection rate was 61.1%, while 32% of neonatal mortality was associated with multiple TORCH infections. Women who have the ability to get pregnant but are unable to continue their pregnancy may also be considered infertile. According to Ayurveda, at the time of the formation of the foetus (Garbha), due to vitiated blood (Shonita), the product of conception expels repeatedly before attaining viability, which is known as Putraghni Yonivyapad. So it is important to achieve a full-term pregnancy with healthy progeny. It is evident that maternal infections play a vital role in the loss of pregnancy. In this article, a 28-year-old patient with two abortions earlier and a TORCH IgG positive was treated with pure herbal medicine for 4 months. The patient conceived after that and attended a full-term pregnancy. During the whole duration of pregnancy, Ayurveda medication for healthy growth and full-term delivery was also continued. Thus, this article represents an example of successful management of TORCH infection through Ayurveda and also emphasises the potential of herbal management in TORCH infection with medicines like dalachini churna, kuberaksha vati, sariva-manjistha phant, and Shatavari churna.

Uptake of cervical cancer screening and associated factors among human immune virus positive women attending antiretroviral therapy clinic in public health facilities, Northeast Ethiopia, 2022: A cross-sectional study.

Although cervical cancer is the most prevalent cancer in women and has a high morbidity, mortality, and low quality of life burden among human immune virus-positive women, there is little evidence of it in northeastern Ethiopia. Sought to determine the magnitude and associated factors of cervical cancer screening among human immune virus-positive women in public health facilities in northeastern Ethiopia. A multicentered, institution-based cross-sectional study with 401 participants using the systematic random sampling technique was employed. The data was gathered through personal interviews and chart reviews. The predictors were established via multivariate logistic regression analysis. The magnitude of cervical cancer screening was 19.2% (15.7%-22.9%). Multiparity, bad obstetric history, hearing about cervical cancer, recommendations from medical professionals, duration of antiretroviral therapy >10 years, a family record of cervical cancer, and knowing cervical cancer were revealed to be predictors of testing for cervical cancer. The magnitude of cervical cancer screening was 19.2% (15.7%-22.9%). Multiparity, bad obstetric history, hearing about cervical cancer, recommendations from medical professionals, duration of antiretroviral therapy >10 years, a family record of cervical cancer, and knowing cervical cancer were revealed to be predictors of testing for cervical cancer.

Mermaid baby: Fairy tale in practical

Sirenomelia, also called Mermaid syndrome is a rare and fatal anomaly which is characterized by a single lower extremity featuring a Mermaid like appearance where head and trunk is like humans and lower extremity is like tail of a fish. It is associated with other gastro-intestinal, genito-urinary and other organ abnormalities. Most patients die shortly after birth. The exact cause of Sirenomelia is unknown. Here we present a newborn baby with Sirenomelia. Mother had bad obstetric history, antenatal ultrasonography revealed severe oligohydramnios and renal agenesis. On examination there was dysmorphic facies, fusion of lower limbs, single leg with two foot and ten toes. There was no identical external genitalia and anus.

A retrospective study on proportion and indications of cesarean section in a tertiary care hospital

Background: The cesarean section (CS) stands as a prevalent and frequently conducted surgical procedure in obstetrics, both within India and globally. The rising rates of cesarean deliveries prompt a necessity to examine the factors that influence this trend. Aims and Objectives: To analyze the proportion and different indications of CS to reduce the CS rate (CSR) in a tertiary care hospital. Materials and Methods: This was a retrospective observational study, conducted over a period of 6 months, from July 1st, 2022, to December 31st, 2022, in the Department of Obstetrics and Gynaecology at Midnapore Medical College and Hospital, West Bengal, India. The data pertaining to patients who underwent C-section deliveries at our hospital during the specified period was documented, followed by a statistical analysis conducted to assess the proportions and various indications for CS. Results: Out of 6365 women who gave birth during the study period, 2296 women underwent CS. This indicates that the proportion of CSs was 36.07%. The primary indication for CS was previous CS, accounting for 39.50%, followed by fetal distress (16.38%), preeclampsia with severe features and eclampsia (13.50%), severe oligohydramnios (7.40%), arrest of labor (5.70%), malpresentation (4.18%), antepartum hemorrhage (2.96%), premature rupture of membrane (2.70%), cephalopelvic disproportion (1.83%), induction failure (1.44%), fetal growth restriction (1.18%), multifetal gestation (1.09%), bad obstetric history (0.60), big baby (0.48%), cord prolapse (0.35%), and medical disorder (0.70%). Conclusion: As a tertiary care hospital, we observed a high rate of cesarean deliveries. However, by individualizing indications and conducting careful evaluations in accordance with standardized guidelines, practicing evidence-based obstetrics, and conducting audits within the institution, we can work towards limiting the CSR. In addition, encouraging a trial of labor after a cesarean can be beneficial in reducing the overall rate of CS.

Prevalence of traditional uvulectomy and its associated factors among parents who had less than 6 months of infants in Gondar City, north-west Ethiopia: Mixed study design.

Traditional uvulectomy is widely practiced in Africa especially in sub-Saharan countries including Ethiopia. Limited Studies conducted in different times and areas of the world have shown that the prevalence of uvulectomy and its associated factors are varied from country to country. There is limited evidence to determine the prevalence and reasons of malpractice in Ethiopia. Therefore, this study aimed to assess the prevalence of traditional uvulectomy, and its associated factors among parents who had children aged less than 6 months. A community-based cross-sectional mixed study design was conducted among 630 participants selected by a systematic sampling technique. Data were collected using a pretested interviewer-administered questionnaire. The collected data were entered into Epi-data, and analyzed by using STATA version 14software. Descriptive statistics were computed and presented using tables, figures and texts. Factors associated with the prevalence of uvulectomy were selected for multiple logistic regressions at the probability value (p-value) of less than 0.2 in the X2- analysis. Statistically significant associated factors were identified at the probability value (p-value) less than 0.05 and adjusted OR (AOR) with a 95% CI. A total of 10 individual depth interviewees and 5 key informants were included using purposive sampling techniques. For the qualitative study, and thematic content analysis was employed to analyze the data, which were transcribed, translated, coded, screened, thematized, analyzed, synthesized, and finally supplemented the quantitative finding. The prevalence of traditional uvulectomy was 84.60% (CI: 81.77%n-87.42%). Being rural residence (adjusted OR = 2.08, CI = 1.06-4.12), mothers aged 30 to 34 years (adjusted OR = 2.9, CI = 1.28-6.60), having no antenatal care visit (adjusted OR = 3.91, CI = 1.33-11.47), having no bad obstetric history (adjusted OR = 2.11, CI = 1.12-3.98), having no postnatal care visit (adjusted OR = 3.88, CI = 1.36-11.12) and mothers' poor attitude (adjusted OR = 3.32, CI = 2.01-5.47) were statistically significant associated factors of traditional uvulectomy. Seeking traditional uvulectomy, lack of information and third-party pressure were the main themes of the qualitative study that support the findings of the quantitative study. The prevalence of traditional uvulectomy was high. Being rural residents, mothers aged 30 to 34 years, having no antenatal care visit, having no complications of obstetric history, having no postnatal care visit and mothers with poor attitude were statistically significant associated factors of traditional uvulectomy. Lack of information about uvulectomy and third-party pressure was the reason for seeking traditional uvulectomy.

An examination of the seroprevalence of torch infections and their correlation with adverse reproductive outcomes in females exhibiting a bad obstetric history

: The term TORCH infections refer to a group of diseases including Toxoplasma, Other (syphilis, varicella-zoster, parvovirus B19), Rubella, Cytomegalovirus (CMV), and Herpes infections. These are a set of pathogens capable of traversing the placental barrier, subsequently causing congenital infections. Often these infections are asymptomatic initially and pose significant diagnostic challenges during gestation, potentially leading to undesirable obstetric outcomes. This research intends to explore the correlation between TORCH infections and perinatal outcomes within pregnancies deemed high-risk.: We examined 143 high-risk pregnant patients aged 18-46 from the Obstetrics and Gynecology Department at the Baghdad Gynecology and Obstetrics Hospital. Hundreds of normal pregnancy group were also included. The high-risk group encompassed women with recurring pregnancy loss, fetal congenital anomalies, intrauterine fetal death, and low birth weight intrauterine neonatal death. The presence of IgG and IgM antibodies against TORCH agents in patients’ serum control serum were assessed using ELISA kits. We compared perinatal outcomes between TORCH seropositive and seronegative high-risk pregnant women.: Among the 143 high-risk pregnancies, a significant proportion of young, low-parity women from diverse residences were co-seropositive for Toxoplasma gondii, rubella virus, Cytomegalovirus, and Herpes Simplex infections. Of these, 55 cases (48.4%) were seropositive for all the four TORCH agents compared to 88 cases (38%) were seropositive for antibodies to one to three of the TORCH agents. IgG seropositivity was 74.5%, while IgM seropositivity was 31.8% for Toxoplasma gondii, 3.6% for CMV and 0% for RV infections, respectively. Significantly, high-risk pregnancies with TORCH seropositivities exhibited a clearly strong correlation with Habitual abortions outcomes.: High-risk manifestations demonstrated for Toxoplasma gondii, Rubella virus, Cytomegalovirus and Herpes Simplex infections strongly associated with habitual abortions compare to high but less significant association in those seropositive to one, two or three of the TORCH agents

“A STUDY OF MATERNAL FACTORS INFLUENCING VERY LOW BIRTH WEIGHT BABIES”

Background: In developed countries, because of improvement in health care facilities and increased funds spent for health ,the problem of VLBW has been reduced. But in developing countries like India, where lacunae in health care facilities and funds, the survival and long term complications of very low birth weight babies still remain the challenge. 1.To study Objectives: the inuence various maternal factors like age, parity, occupation, obstetric history etc on the outcome of birth weight babies. Materials And Methods: Study design: Study area: Prospective case control study Government general hospital, siddhartha medical college, vijayawada, Krishna district, Andhra pradesh. January 2019 to July 2019. All newborn babies with birth w Study period: Study population: eight &lt;1500 gms irrespective of gestational age Study consisted of 100 newborns (50 cases and 50 control Sample size: Sample method: s). Simple random sampling method. All newborns less than 1500 gms irrespective of gestational age, examined and det Study tools and data collection: ailed antenatal, natal history was obtained and recorded. The incidence of very low birth Results: weight newborn was found to be 2.08%, and the most common cause is preterm delivery. There is NO relation found between family structure, mother occupation, antenatal visits and incidence of very low birth weight. As the literacy rate of mothers increases, the weight of the baby increases. Birth weight of babies has Conclusion: signicant association with maternal factors like parity, birth interval and previous bad obstetric history. Literacy rate of mothers had a positive correlation.

The Association of Antiphospholipid Syndrome Stimulated by Cytomegalovirus Infection with Pregnancy Outcome Among Women with Bad Obstetric History in Babil/ Iraq

The Association of Antiphospholipid Syndrome Stimulated by Cytomegalovirus Infection with Pregnancy Outcome Among Women with Bad Obstetric History in Babil/ Iraq