Delivery Of Baby Research Articles

Prenatal Care, Son Preference, and the Sex Ratio at Birth.

The sex ratio at birth (SRB) in Spain jumped abruptly in the late 1970s and temporarily reached values of more than 109 boys per 100 girls in the early 1980s. This article shows that health care system expansion increased the likelihood of male births in Spain between 1975 and 1995. By facilitating the delivery of preterm and dystocic babies and improving overall maternal conditions, these developments increased the survival chances of male fetuses, who are biologically weaker than females. However, biological factors alone cannot explain the biased SRB. Our analysis shows that the availability of prenatal sex determination technologies and a strong son preference nurtured by the Francoist dictatorship fostered gender-biased behaviors that resulted in an excessively high SRB. The lack of evidence on sex-specific abortions suggests that women took better care of themselves when carrying a son. The spread of gender-egalitarian values brought about by the end of the dictatorship and the transition to democracy undermined son preference and returned the SRB to normal levels.

COVID-19 status and utilisation of essential maternal and child healthcare services during the pandemic in Ahmedabad, India

BackgroundAccess to essential healthcare services is pertinent to the achievement of universal health coverage in any nation. The COVID-19 lockdown was used to mitigate the spread of the pandemic. Consequently, there was a reduction in the Utilisation of Basic Healthcare Services (UBHS) in diverse dimensions. However, variation existed in the UBHS by COVID-19 status, but the extent of this disparity has not been extensively addressed in Ahmedabad, India. Therefore, this study explores the relationship between COVID-19 status and utilisation of essential maternal and child healthcare services during the pandemic in Ahmedabad, India.MethodsA mixed-method approach was used for the data (both quantitative and qualitative) collection from November 2021 to October 2022. Four zones were purposefully selected from the 6 zones in Ahmedabad. The quantitative part of the study included pregnant women or those who had a baby delivery from April 2020 to October 2021 (n = 278), while 10 of these women participated in the qualitative part. Data were analysed using descriptive statistics, Chi-square test, and binomial logistic regression (α = 0.05). A deductive approach was used to analyse the qualitative data.ResultsOf the total 278, almost 43% of the women were infected with COVID-19 during their pregnancy. Women who tested positive availed lesser antenatal care (ANC), and Postnatal care (PNC). There were diverse experiences documented regarding access to essential maternal and child healthcare services during the pandemic. Women without COVID-19 are more likely to receive maternal healthcare services, such as visits of any healthcare workers [aOR = 2.59 (1.03- 6.49)], counseling services [aOR = 1.92 (0.61- 6.06)], delivery at the planned place [aOR = 1.98 (0.99- 3.92)] as compared to those who are positive. Women without COVID-19 were more likely to be accompanied by healthcare workers during labor ([aOR = 2.91(1.04- 8.11) and to receive appropriate birth spacing counselling [aOR = 1.38 (0.7–2.71)].ConclusionUtilisation of essential maternal and child healthcare services was lower among women who were COVID-19 positive compared to those who were not. Social and health system determinants for disrupting healthcare services during the pandemic were fear of infection and unavailability of the health workforce. Health planners and policymakers are encouraged to take into consideration of these findings while building resilient health care for managing future pandemics.

Prevalence of vitamin D deficiency and its association with adverse obstetric outcomes among pregnant women in Uganda: a cross-sectional study

ObjectiveThere is a dearth of published data on the vitamin D status of the Ugandan population; the objective of the study was to determine the prevalence of vitamin D deficiency...

Observational study on the effectiveness of misoprostol for induction of labour as a low-cost method in a tertiary care hospital in Sri Lanka

Labour induction is a critical obstetric intervention to ensure safe delivery for both mother and baby. In resource-limited settings like Sri Lanka, cost-effective methods for labour induction are essential. Misoprostol, a prostaglandin E1 analogue, has emerged as a promising option due to its affordability and effectiveness. This observational study investigates the efficacy of misoprostol for labour induction in a tertiary care hospital in Sri Lanka. By analysing real-world data, this research aims to provide insights into misoprostol’s efficacy, safety, and cost-effectiveness as an induction method in this setting, ultimately aiming to improve maternal and neonatal outcomes1.

Collective Forgetting of American Vaginal Breech Delivery.

When asked why nearly all doctors refer their breech cases to surgery, despite non-surgical breech birth being permitted throughout the United States, an obstetrician will likely cite the Term Breech Trial (TBT). This study, conducted in 2000, decisively concluded that planned cesarean delivery is safer than vaginal breech delivery. However, a review of the literature suggests that the decline of vaginal breech deliveries was a long time in the making. From the 1950s, once the perceived risks of breech births were accepted as a fact, numerous studies advocated more liberal use of cesarean delivery for breech babies and suggested strategies to limit vaginal breech births. By the late 1970s, as the majority of breech patients underwent surgery, a vicious cycle of collective forgetting began. Hospitals and medical training programs abandoned the non-surgical option, leaving younger generations of unskilled doctors reluctant to perform the complex procedure. As health organizations criticized the overuse of cesarean sections in the ensuing decades, obstetricians faced a growing dilemma in breech management, continuing to perform surgeries even while questioning their benefits. The 2000 study sanctioned this existing state of practice, which had been evolving over decades and in which collective forgetting played a crucial part.

Case Report: Orbital cellulitis with panophthalmitis during pregnancy: a rare case in Bangladesh

Background It is uncommon to develop vision-threatening orbital cellulitis with panophthalmitis during pregnancy. Typically, the reasons are trauma-related or endogenous. It requires immediate diagnosis and treatment, but this has proven difficult because of local and systemic medications’ safety and adverse effects during pregnancy. Globe salvage has a poor prognosis, with most patients undergoing enucleation or evisceration of the diseased eye. Case presentation We presented a 22-year-old woman in her third trimester of pregnancy who encountered orbital cellulitis with panophthalmitis caused by methicillin-positive Staphylococcus aureus (MSSA). Despite rigorous intravenous and topical antibiotics, she underwent evisceration of the affected eye. However, the pregnancy, progressed without incident, with the delivery of a healthy baby at full-term. Conclusion Bacterial infection is uncommon during pregnancy, but may cause endogenous panophthalmitis and orbital cellulitis, especially in immunosuppression and anemia, with a poor visual outcome.

Laparoscopic repair combined with hysteroscopy of cesarean section scar after cesarean scar pregnancy resulting in a live birth: A case report

We report a case where a spontaneous pregnancy and delivery of a live baby were achieved after laparoscopic repair combined with hysteroscopy of the cesarean section scar secondary to treatment for a prior cesarian section scar pregnancy. [Case] 31 years old, three pregnancies, and one delivery. A spontaneous abortion. Her first child was delivered by elective cesarean section due to pelvic position (breech presentation). During her second pregnancy, she was diagnosed with cesarean section scar pregnancy and underwent dilation and curettage. Subsequently, a laparoscopic repair of the uterine scar was performed using hysteroscopy owing to thinning of the cesarean section scar area. At six months postoperative, she conceived spontaneously and delivered a live baby by elective cesarean section at 38 weeks 2 days gestation. Conclusion: Thus, laparoscopic repair combined with hysteroscopy of the uterine scar can be a useful treatment option for patients with uterine scarring secondary to cesarean section scar pregnancy.

Final Report of Trends in Pregnancy and Birth Survey after the Great East Japan Earthquake and Fukushima Daiichi Nuclear Power Plant Accident: The Fukushima Health Management Survey

This study aimed to assess long-term changes in pregnancy and birth outcomes after the Great East Japan Earthquake and the accident at the Tokyo Electric Power Company's Fukushima Daiichi Nuclear Power Plant in Fukushima Prefecture. This is the final report on perinatal outcomes of the Prefectural Health Survey, which ended after a 10-year observation period. Questionnaires based on a pregnancy and birth survey conducted by the Radiation Medical Science Center for the Fukushima Health Management Survey were sent to women who had received maternal and child health handbooks from municipal officers in Fukushima Prefecture. Annual data from six geographic areas in Fukushima Prefecture were separately analyzed. The number of eligible respondents, which was approximately 16,000 in 2011 when the earthquake occurred, declined temporarily the following year, recovered temporarily one year later, and has gradually declined since then. However, the response rate remained at approximately 50% throughout the decade. The incidence of preterm deliveries, low-birthweight infants, and congenital anomalies did not vary over the decade and showed a similar trend in national surveys and general reports. Our analysis shows that the disaster had no significant adverse perinatal outcomes in Fukushima Prefecture and we recommend measures to ensure the safe delivery of babies in the region.

Preimplantation genetic testing for structural rearrangements by genome-wide SNP genotyping and haplotype analysis: a prospective multicenter clinical study.

Preimplantation genetic testing for chromosomal structural rearrangements (PGT-SR) has been widely utilized to select euploid embryos in patients carrying balanced chromosomal rearrangements (BCRs) by chromosome copy number analysis. However, reliable and extensively validated PGT-SR methods for selecting embryos without BCRs in large-cohort studies are lacking. In this prospective, multicenter, cohort study, carriers with BCRs undergoing PGT-SR were recruited across 12 academic fertility centers within China. PGT-SR was performed using genome-wide SNP genotyping and haplotyping approach. Parental haplotypes were phased by available genotypes from a close relative or an unbalanced embryo. The karyotypes of embryos were inferred from the haplotypes. Only a single embryo was transferred in each cycle. Between April 2018 and March 2023, 1298 carriers we randomly enrolled. A total of 7867 blastocysts from 1603 PGT-SR cycles were biopsied, in which 7750 (98.51%) were successfully genotyped and analyzed. Overall, 75.98% (1218/1603) of cycles obtained euploid embryos and 53.15% (852/1603) generated non-carrier embryos. The proportion of carrier and non-carrier embryos was similar in different subgroups. A total of 1030 non-carrier and 439 carrier embryos were transferred, 817 healthy babies were delivered cumulatively. Our results demonstrate that SNP-haplotyping method is highly accurate (sensitivity 95% CI: 98.34%-100%, specificity 95% CI: 96.63%-100%, respectively), and can be applied universally to different BCR types. Moreover, the clinical outcomes were comparable between the carrier and non-carrier embryo groups. This study demonstrates the effectiveness of preimplantation genetic genome-wide SNP-genotyping and haplotyping method, resulting in the delivery of more babies with a normal karyotype. This study was funded by the National Key Research and Development Program of China (2022YFC2703200, 2021YFC2700600, 2021YFC2700500), National Natural Science Foundation of China (82201807, 82171639, 82071717). Shanghai Science and Technology Innovation Action Plan Program (18411953800), and the Municipal Human Resources Development Program for Outstanding Young Talents in Medical and Health Sciences in Shanghai (2022YQ075).

Unusual presentation of Evans syndrome with hypokalemic paralysis during pregnancy, management and outcome

Background: Evans Syndrome (ES) is a rare autoimmune disorder characterized by autoimmune hemolytic anemia (AIHA) and immune thrombocytopenic purpura (ITP). Its occurrence in association with Sjögren’s Syndrome (SS) during pregnancy, compounded by hypokalemic paralysis, is exceedingly rare. Case Description: A 24-year-old primigravida at 17 weeks of gestation presented with limb weakness due to hypokalemic paralysis. She had a history of ES and SS diagnosed prior to conception, managed initially with corticosteroids and vitamin B12 supplementation. During pregnancy, she experienced hypokalemia, renal tubular acidosis, and moderate anemia, which were managed effectively with potassium, bicarbonate, prednisolone, and hydroxychloroquine. The pregnancy was monitored closely, culminating in a cesarean delivery of a healthy baby at 39 weeks. Postpartum care included transfusions and anticoagulation therapy. Both mother and baby showed favorable outcomes without major complications. Conclusion: The coexistence of ES and SS during pregnancy, further complicated by hypokalemic paralysis, presents unique challenges. Early diagnosis, multidisciplinary management, and close monitoring are pivotal in achieving successful maternal and neonatal outcomes.

Pure Leydig cell tumor of the ovary: a rare presentation of a rare entity in a pregnant patient.

Aim: Leydig cell tumors (LCT) are rare neoplasms that represent less than 0.1% of all ovarian tumors. This tumor usually presents with signs and symptoms of excess androgen levels. Diagnosis is made based on a combination of history, laboratory findings, imaging techniques and histopathological findings.Case: We present the case of a 35-year-old gravida five para 3+1 pregnant woman with a unilateral ovarian cystic mass that was discovered incidentally during a cesarean section. The cyst measured 9cm in its maximum dimension. A left oophorectomy was performed after the delivery of an alive male baby. Morphological and immunophenotypic findings were consistent with those of a pure Leydig cell tumor.Conclusion: Leydig cell tumors are uncommon and usually present with hyperandrogenism. The presentation could be polymorphic, ranging from the rapid onset of virilization to being asymptomatic.

Successful pregnancy after preimplantation genetic testing for structural rearrangements in a couple with complex chromosome rearrangement and recurrent in vitro fertilization failures: a case report

To present a case of a couple with 20 years of infertility and 10 recurrent invitro fertilization (IVF) failures, identifying a paternal complex chromosome rearrangement using high-resolution karyotype together with preimplantation genetic testing for structural rearrangements (PGT-SR) and utilizing IVF-intracytoplasmic sperm injection to achieve a successful pregnancy. Case report. Al Ain Fertility Center, Abu Dhabi, United Arab Emirates. A 40-year-old male patient and a 37-year-old female patient with a history of infertility and recurrent IVF failures. Invitro fertilization-intracytoplasmic sperm injection with high-resolution karyotype and PGT-SR. Identification of chromosomal abnormalities, successful embryo development, pregnancy outcome, and newborn karyotyping. Karyotyping revealed a paternal complex chromosome rearrangement, t(3;4;12) (q21;q33;q21), and a chromosomal polymorphism in the female (1qh+). Invitro fertilization-intracytoplasmic sperm injection with PGT-SR produced one euploid/balanced female embryo from 20 embryos across 8 cycles. The patient conceived after hormone replacement therapy and frozen embryo transfer, resulting in an uneventful, full-term pregnancy and delivery of a healthy baby via C-section. Newborn karyotyping was normal (46,XX). High-resolution karyotype and PGT-SR should be offered to patients undergoing IVF, especially those with severe male factors, recurrent IVF failures, implantation failures, or recurrent pregnancy losses, to enhance the chances of a successful pregnancy.

A Comparative Study To Assess The Anxiety Related To Pregnancy And Delivery Of The Baby Among Primigravida Mothers In Selected Rural And Urban Areas Of Maharashtra

Primigravida mothers are those who conceived for the first time. There are many changes occur during the pregnancy that make them very stressful. And respond to this stress by feeling anxious which may be influenced on the woman herself and her baby. As anxiety and fear of childbirth may cause many complications such as severe labor pain, postpartum depression, and impaired mother–fetus attachment. Many studies support the hypothesis that pregnancy-related anxiety is strongly linked to postpartum depression, preterm births, low birth weight, fetal growth restriction, pregnancy complications, and negative infant outcomes. Purpose: Comparative study to assess the levels anxiety among rural and urban primigravida mothers planned for normal vaginal delivery and caesarean section.Methods: The levels of anxiety assessed by using 17 items self-structured anxiety assessment tool related to pregnancy and delivery of the baby. Data was collected from 60 samples, in that 30 from rural and 30 from urban. Data was analyzed by descriptive and inferential statistics Result: Rural mother result shows that 63.33% of them have moderate level and 36.67% mothers have severe level of anxiety. Average anxiety score of mothers in selected rural areas was 31.93 with standard deviation of 4.54 and in urban area 3.33% mother have mild anxiety, 93.33% of them have moderate level and 3.33% mother have severe level of anxiety. The average anxiety score among primigravida mothers in selected rural areas was 31.93 with standard deviation of 4.54. The average anxiety score among primigravida mothers in selected urban areas was 25.63 with standard deviation of 4.03. The test statistics value of unpaired t test was 5.68 with p value 0.00. The p value less than 0.05, hence reject null hypothesis and accept alternative hypothesis. It shows, significant difference in levels of anxiety towards pregnancy and delivery of baby among primigravida mothers in selected rural and urban areas of Maharashtra.Conclusion: This study concluded that rural primigravida mothers having more anxiety than the urban primigravida mothers related to pregnancy and delivery of the baby.

77 Antenatal MgS04 in very preterm babies is not related to improved 36 month neurodevelopmental outcomes once accounting for neonatal interventions

Abstract Background Magnesium Sulphate (MgSO4) has become a standard practice for fetal neuroprotection prior to delivery of very-preterm babies due to an association with MgSO4 and reduction of cerebral palsy at 2 years of age in randomized clinical trials. Objectives In a prospective cohort of very preterm babies, we aimed to define the association between antenatal MgSO4 administration and neurodevelopmental outcome. Design/Methods We included a prospective cohort of 265 infants born ≤ 32 weeks’ gestation recruited at three tertiary neonatal intensive care units (NICU). Infants underwent two brain MRIs, one in the initial weeks after birth and one at term-equivalent age. Neurodevelopmental follow-up assessments were completed using the Bayley-3 at 3 years. Univariate analysis was undertaken to determine whether MgSO4 was associated with outcome. Multiple maternal and neonatal factors were analyzed according to their relationship with outcome. Gestational age was accounted for in all models. Maternal factors associated with MgSO4 administration were hypertension, multiple births and antenatal corticosteroid administration. Neonatal factors were sex, neonatal resuscitation, major surgery, and moderate-severe white matter injury (volume >40mm3). Multivariable linear regression models of maternal and neonatal risk factors were used to account for potential confounders based on those factors that were significantly (p<0.05) associated in univariate analysis. Results On univariate analysis, MgSO4 administration was inversely associated with 36-month motor scores (p<0.05). On the multivariable analysis, no maternal confounders had an impact on the relationship between MgSO4 and outcome (Table 2). MgS04 was no longer statistically related to any Bayley outcomes after adjusting for confounders at 36 months (Table 2). Neonatal surgery was related to poorer 36-month motor and cognitive outcomes. Conclusion Antenatal MgSO4 exposure was not associated with improved measures on the Bayley scales at 3 years after adjusting for potential confounders. However, neonatal interventions remained significant risk factors for poorer neurodevelopmental outcome.

Doppler abnormalities and perinatal outcome in growth restricted fetuses in a tertiary care center: A retrospective study

Intrauterine Growth Restriction (IUGR), is a significant contributor to foetal and neonatal morbidity and mortality. The majority of prenatal problems that result in negative outcomes can be avoided with early identification and prompt management measures. Doppler ultrasonography is widely used to make the diagnosis of IUGR in foetuses and to monitor the progression in-utero. The purpose of the current study is to predict the perinatal prognosis of foetuses with growth restriction based on doppler abnormalities. A retrospective analysis was conducted among 134 cases of diagnosed IUGR in routine ultrasound from the year 2015 to 2021. Socio-demographic data, baby delivery details, and the ultrasound details regarding doppler evaluation of Umbilical Artery (UA) and Middle cerebral artery (MCA) were collected. The fetal cerebro-placental ratio (CPR) was then analysed with the fetal outcomes in the cases. Abnormal doppler was found in 31 out of 134 cases, with a CPR<1. There was significant association of gestational age, mode of delivery and birth weight variables with abnormal doppler. The mean birth weight of the baby (2052 grams), and NICU admission of the babies (17.6%) have also shown statistical association with abnormal doppler (p<0.05).Doppler velocimetry is the non-invasive method for identifying foetal growth restriction and anticipating perinatal difficulties, which aids the obstetrician in providing good antenatal care and prompt intervention and prevention of perinatal morbidity and mortality.

Outcomes in term breech birth according to intended mode of delivery-A Swedish prospective single-center experience of a dedicated breech birth team.

The appropriate mode of delivery for breech babies is a topic of ongoing debate. After the publication of the Term Breech Trial in 2000, the proportion of breech babies delivered vaginally in Sweden rapidly dropped to 7% from 26%. In 2015, international guidelines changed to once again recommend offering vaginal breech deliveries in select cases. In 2017, a Swedish hospital established a dedicated Breech Team to provide safe vaginal breech deliveries according to the new guidelines. The aim of this study is to compare neonatal morbidity in the group planned for cesarean breech delivery with the group planned for vaginal breech delivery treated in accordance with the new guidelines. The study adds to the literature by providing insights into the consequences of reintroducing vaginal breech births in a high-resource health-care setting. A prospective observational study was conducted at Södersjukhuset's maternity ward with 1067 women who gave birth to a single breech fetus at term. Outcomes were compared between the planned vaginal and planned cesarean delivery groups using intention-to-treat analysis and multivariate analysis to control for confounders. Out of the 1067 women, 78.9% were planned for cesarean delivery and 21.1% were planned for vaginal delivery. The planned vaginal group had a significantly greater risk for neonatal morbidity compared to the planned cesarean group (3.1% vs. 0.7%; OR 4.44, 95% CI 1.48-13.34). The risk difference remained significant after controlling for confounders. Planned vaginal breech delivery was associated with an increased risk of neonatal mortality and short-term morbidity compared to planned cesarean breech delivery in accordance with the new guidelines. The potential risks and benefits of planned vaginal breech delivery should be carefully weighed against those of planned cesarean delivery.

Successful delivery in the setting of SDHB metastatic paraganglioma.

Pregnancy in the setting of metastatic paraganglioma is challenging, particularly in the context of tyrosine kinase use. We describe a 26-year-old female with a background of metastatic paraganglioma harboring a pathogenic SDHB variant, requiring sunitinib, which was withheld to facilitate the safe conception and delivery of a healthy baby. She required no alpha- or beta-blockade during her pregnancy and exhibited no signs of tumor progression or symptoms throughout this period. Historically, higher rates of fetal and maternal morbidity and mortality have been experienced in the setting of pregnancy. Although limited data exist on the management of metastatic paraganglioma in pregnant patients, this case suggests that careful treatment modifications, such as temporary tyrosine kinase therapy cessation and vigilant monitoring, can result in successful pregnancies without compromising maternal or fetal well-being. Paraganglioma in pregnancy has been associated with poor fetal and maternal morbidity and mortality. Many of the treatment modalities for metastatic paraganglioma, including tyrosine kinase inhibitors, can affect fertility or cannot be utilized in pregnancy, necessitating the temporary suspension of these treatments. This case exemplifies that careful clinical and biochemical monitoring during pregnancy is required to avoid maternal and fetal harm while balancing the risk of disease progression off treatment.

Risk Factors Associated With Low-Birth-Weight Babies in Tertiary Health Care Facilities in Lahore, Pakistan: A Case-Control Study.

Introduction Low birth weight (LBW) is a well-known contributing factor to neonatal health, emphasizing the importance of maternal health and socio-economic conditions. The birth weight of a newborn is a major public health problem, which is more common in low-middle-income countries (LMICs). Objective The objective of this study is to assess the association of different socio-economic and maternal factors with LBW babies in Lahore. Methods This case-control study was carried out at the Obstetrics and Gynecological Department in Mayo Hospital, Lahore, Pakistan from September 25, 2023 to December 31, 2023. A total of 186 mothers who delivered in the maternity ward, categorized into two groups (93 cases and 93 controls), were included and data was collected with the help of a self-administered structured tool. A chi-square test was used to identify maternal risk factors significant for LBW babies. The strength of association between maternal risk factors and LBW babies was presented using the odds ratio (OR) with the respective 95% confidence interval (CI). Results The study revealed that maternal anemia [OR: 3.378, 95% CI: 1.568, 7.275] and inadequate nutritional status [OR: 1.031, 95% CI: 0.014, 0.071] were more likely to cause delivery of LBW babies. Regarding socio-demographic factors, household income < 25000 [OR: 5.185, 95% CI: 2.770, 9.707] and illiterate mothers [OR: 3.325, 95% CI: 1.820, 6.074] were associated with increased likelihood of LBW babies. Maternal age < 20 had a strong association [OR: 10.920, 95% CI: 2.455,48.575]with delivery of LBW children. Conclusion The study concludes that multiple risk factors including anemia, inadequate nutritional status, household income < 25000, illiterate mother, and maternal age < 20 are strongly associated with LBW babies. It is apparent that a multimodal strategy is necessary to reduce the risk of LBW babies.

A Case Report on the Obstetric Anesthesia Management of a Patient with Gorham–Stout Disease for Elective Cesarean Section

ABSTRACT Gorham–Stout disease (GSD) is a rare bone condition characterized by osteolysis, angiomatosis, and lymphangiomatosis. This paper presents a case, in which a 38-year-old pregnant female with GSD underwent cesarean delivery due to a low-lying placenta. Her medical history, which included a previous surgical intervention for an intraoral mass attributed to GSD and a course of radiotherapy, suggested potential difficulties in both securing the airway and instituting neuraxial anesthesia, as well as potential complications, including perioperative bleeding. In this case, tailored anesthetic management strategies and interdisciplinary collaboration helped achieve optimal outcomes for the mother and successful delivery of a healthy baby. In particular, combined spinal and epidural anesthesia avoided the need for GA, and provided a rapid onset and titratable anesthesia with minimal systemic effects. Furthermore, vigilant monitoring of hemodynamic parameters was also paramount in mitigating the risks associated with both GSD and pregnancy itself.

Perspectives of pregnant women on the utilisation of a maternity waiting home near Onandjokwe Lutheran Hospital in Oshikoto Region, Namibia.

Despite the efforts of Namibia's Ministry of Health and Social Services to build maternity waiting homes (MWHs), few pregnant women make use of them. Long distances among the general population in Namibia limit the utilisation of MWHs. Little research has investigated what factors are limiting the use of these facilities despite the urgent need for them. The aim of this study thus was to explore and describe the perspectives of pregnant women on the utilisation of the MWHs near Onandjokwe Lutheran Hospital in Oshikoto Region. A qualitative, exploratory, descriptive and contextual design was employed. The accessible population in this study comprised 18 participants who were selected for the study using a purposive sampling technique. Participants reported numerous barriers to visiting MWHs in Namibia, including an inadequate number of rooms, theft, food scarcity and the effects of poverty on the living conditions of the MWH users. Enablers visiting MWHs included the safe delivery of babies by skilled staff, reduced transport costs, access to timely management of labour complications and affordable accommodation. The study revealed that a number of barriers must be overcome before the desired number of women take advantage of MWHs. Multiple factors act as constraints to their use, including inadequate number of rooms, theft, food scarcity and the long distance between patients' homes and MWH services.Contribution:The study's findings can be used to develop targeted interventions and strategies that can be used by MWH providers to address the identified barriers.