Description Of Pregnancy Research Articles

Improving Data Collection in Pregnancy Safety Studies: Towards Standardisation of Data Elements in Pregnancy Reports from Public and Private Partners, A Contribution from the ConcePTION Project.

The ConcePTION project aims to improve the way medication use during pregnancy is studied. This includes exploring the possibility of developing a distributed data processing and analysis infrastructure using a common data model that could form a foundational platform for future surveillance and research. A prerequisite would be that data from various data access providers (DAPs) can be harmonised according to an agreed set of standard rules concerning the structure and content of the data. To do so, a reference framework of core data elements (CDEs) recommended for primary data studies on drug safety during pregnancy was previously developed. The aim of this study was to assess the ability of several public and private DAPs using different primary data sources focusing on multiple sclerosis, as a pilot, to map their respective data variables and definitions with the CDE recommendations framework. Four pregnancy registries (Gilenya, Novartis; Aubagio, Sanofi; the Organization of Teratology Information Specialists [OTIS]; Aubagio, Sanofi; the Dutch Pregnancy Drug Register, Lareb), two enhanced pharmacovigilance programmes (Gilenya PRIM, Novartis; MAPLE-MS, Merck Healthcare KGaA) and four Teratology Information Services (UK TIS, Jerusalem TIS, Zerifin TIS, Swiss TIS) participated in the study. The ConcePTION primary data source CDE includes 51 items covering administrative functions, the description of pregnancy, maternal medical history, maternal illnesses arising in pregnancy, delivery details, and pregnancy and infant outcomes. For each variable in the CDE, the DAPs identified whether their variables were: identical to the one mentioned in the CDE; derived; similar but with a divergent definition; or not available. The majority of the DAP data variables were either directly taken (85%, n = 305/357, range 73-94% between DAPs) or derived by combining different variables (12%, n = 42/357, range 0-24% between DAPs) to conform to the CDE variables and definitions. For very few of the DAP variables, alignment with the CDE items was not possible, either because of divergent definitions (1%, n = 3/357, range 0-2% between DAPs) or because the variables were not available (2%, n = 7/357, range 0-4% between DAPs). Data access providers participating in this study presented a very high proportion of variables matching the CDE items, indicating that alignment of definitions and harmonisation of data analysis by different stakeholders to accelerate and strengthen pregnancy pharmacovigilance safety data analyses could be feasible.

Exploring antenatal education content for couples in Blantyre, Malawi

BackgroundDespite advocating for male involvement in antenatal education, there is unmet need for antenatal education information for expectant couples. The objective of this study was to gain a deeper understanding of the education content for couples during antenatal education sessions in Malawi. This is needed for the development of a tailor-made curriculum for couple antenatal education in the country, later to be tested for acceptability, feasibility and effectiveness.MethodsAn exploratory cross sectional descriptive study using a qualitative approach was conducted in semi-urban areas of Blantyre District in Malawi from February to August 2016. We conducted four focus group discussions (FGDs) among men and women independently. We also conducted one focus group discussion with nurses/ midwives, 13 key informant interviews whose participants were drawn from both health-related and non-health related institutions; 10 in-depth interviews with couples and 10 separate in-depth interviews with men who had attended antenatal clinics before with their spouses. All the interviews were audiotaped, transcribed verbatim and translated from Chichewa, the local language, into English. We managed data with NVivo 10.0 and used the thematic content approach as a guide for analysis.ResultsWe identified one overarching theme: couple antenatal education information needs. The theme had three subthemes which were identified based on the three domains of the maternity cycle which are pregnancy, labour and delivery and postpartum period. Preferred topics were; description of pregnancy, care of pregnant women, role of men during perinatal period, family life birth preparedness and complication readiness plan, coitus during pregnancy and after delivery, childbirth and baby care.ConclusionAntenatal education is a potential platform to disseminate information and discuss with male partners the childbearing period and early parenting. Hence, if both men and women were to participate in antenatal education, their information needs should be prioritized. Men and women had similar choices of topics to be taught during couple antenatal education, with some minor variations.

A semantic differential analysis of prospective feelings about pregnancy and retrospective characterization of pregnancy

Objectives: This study’s objective was to explore young Latinos’ prospective and retrospective feelings about and descriptions of pregnancy. To do so, we used semantic differential analysis, an approach for quantifying connotative meaning of words or phrases.

Can laparoscopic removal of Essure device before embryo transfer correct poor reproductive outcome pattern in IVF? A case report

Objective: This report describes a successful surgical approach to multiple in vitro fertilization (IVF) failures in the setting of hydrosalpinges, which had been previously treated with Essure inserts. Materials and Methods: A non-smoking 33-year-old Caucasian G2 P0020 (body mass index: BMI = 22) attended for second opinion. Her history was significant for bilateral hydrosalpinges having been noted on hysterosalpingogram two years earlier. This was managed by hysteroscopic placement of Essure inserts bilaterally. One year later, and now with Essure in situ, the patient completed three IVF cycles elsewhere. Her first and third IVF attempts resulted in biochemical pregnancy, while human chorionic gonadotropin (hCG) was negative after the second cycle. Upon presentation at the authors’ center and before beginning a fourth IVF cycle, further testing and surgical removal of the Essure devices was recommended. Results: Repeat hysteroscopy was unremarkable; laparoscopic bilateral salpingectomy and extirpation of Essure implants was accomplished without difficulty. Following menses, the patient initiated IVF with three embryos transferred. At day 60, a single intrauterine pregnancy was identified with positive cardiac activity (rate >100/min). Her obstetrical course was uneventful; a healthy 4,195 gram male infant was delivered (breech) by Cesarean at 40 weeks’ gestation. Conclusion: Essure inserts comprise inner fibers of polyethylene terephthalate, a stainless steel coil, and a nickeltitanium coil. The product received FDA approval as a contraceptive in 2002 although its use for hydrosalpinx remains off-label. While successful outcomes with IVF following Essure placement have been reported, this is the first description of pregnancy and delivery from IVF after Essure removal. Essure may be considered for sterilization when laparoscopy is contraindicated, but experience with its use specifically for treating hydrosalpinges before IVF is limited. This observed association between prior poor IVF outcomes and Essure with subsequent delivery after surgical Essure removal is the first of its kind to be reported, and warrants further investigation.

Identity work among street-involved young mothers

The Youth Pathways Project tracked the life-course trajectories of street-involved young women (n=75) in Toronto over a one-year period. At first contact, 60% of these women had been pregnant, and 29% of those had children. In the interim leading up to the final interview 12 months later, five participants became pregnant and five had given birth. This paper examines the narratives of these 10 recently pregnant and/or newly parenting young women. Our focus is on the ways in which pregnancy and parenting are discursively constructed as a turning point away from street involvement and drug use. Using the concept of identity talk, we examine young women's descriptions of pregnancy and parenting. We note that risky practices that may have precipitated pregnancy are minimised, while the positive and transforming aspects of pregnancy and parenting are emphasised. Pregnancy and parenting are linked with short-term goals of personal change and leaving the street, but the long-term implications of motherhood, including poverty and poor health, are not addressed by participants. Our analysis contributes to a better understanding of the subjective meaning of pregnancy for street-involved young women. We suggest that these insights are important as part of an overall health promotion strategy for this vulnerable group.

The Other Within: Ethics, Politics, and the Body in Simone de Beauvoir (review)

Reviewed by: The Other Within: Ethics, Politics, and the Body in Simone de Beauvoir Andrea Veltman (bio) The Other Within: Ethics, Politics, and the Body in Simone de Beauvoir. By Fredrika Scarth. Lanham, Md.: Roman & Littlefield, 2004. In the last few decades, critical analyses of Simone de Beauvoir's The Second Sex (1952) developed by feminist philosophers have contested Beauvoir's denigration of the body, her belittling of pregnancy and child rearing as uncreative natural functions, and her general endorsement of masculine conceptions of human subjectivity and embodiment present in the Western philosophical tradition. In The Other Within: Ethics, Politics, and the Body in Simone de Beauvoir, Fredrika Scarth advances the revisionist scholarship on Beauvoir while providing a compelling response to feminist critical analyses of Beauvoir. Scarth provides a reading of The Second Sex as an ethical text alongside Beauvoir's earlier ethical treatises The Ethics of Ambiguity (1948) and Pyrrhus et Cinéas (1944), examining in particular the themes of embodiment, subjectivity, maternity, and the interdependence of human freedoms. Rather than reading Beauvoir as a first-wave feminist theorist keen on equality and economic independence for women, Scarth argues that Beauvoir is primarily concerned with envisioning social and political conditions that transcend relations of domination and subordination, so that women and men can achieve reciprocal recognition of one another as embodied subjectivities. [End Page 217] In responding to feminist theorists who think Beauvoir forecloses the possibility of authentic maternal desire, Scarth draws attention not only to the context in which Beauvoir wrote The Second Sex but also to a crucial and overlooked distinction in the work between enforced maternity and "maternité libre." In France in the 1940s, legislation forbade contraception and abortion at the same time that both laws and mores promoted marriage and child rearing as a vocation for women. In a context of enforced maternity, motherhood does not readily allow the expression of subjectivity or the creation of value; pregnancy blurs with the social imposition of femininity. But motherhood can, in principle, be lived as a human achievement for Beauvoir. If maternity is undertaken in freedom, it can be an intentional connection with a future world, and pregnancy itself can be a project. In a passage on motherhood in The Second Sex, Beauvoir writes, "the child is an enterprise to which one can validly give oneself . . . to have a child is to take on an engagement" (Beauvoir 1949, translation by Scarth). Notably, H. M. Parshley's translation renders Beauvoir's use of "se destiner" as "to devote oneself" ("se devouer"), which obscures Beauvoir's distinction between undertaking motherhood as an engagement with the world and devoting oneself to a child in the absence of other projects. Experiencing maternity as a free engagement with the world requires not only that adequate contraception and legal abortion be available so that maternity can be a genuine choice, but also that women have some involvement with the public world, real alternatives to the vocation of motherhood, and the economic independence to raise a child outside traditional marriage (Scarth 145–49). Given the distinction between enforced and free maternity, Scarth argues, Beauvoir's occasional denigration of maternity as enslavement is a description of maternity as women live it in social contexts of enforced motherhood, rather than a description of maternity per se. The characterizations of pregnancy as mutilation, annihilation, and invasion that confront the reader of The Second Sex also describe the experience of carrying life in patriarchal contexts of enforced maternity, rather than descriptions of pregnancy itself. On the one hand, when maternity effectively becomes a woman's destiny, pregnancy takes on the character of an alienating invasion, the interests of mother and fetus are in conflict, and morning sickness is a "revolt of the organism against the invading species" (Beauvoir 1952, 30, 498). The experience of pregnancy in a context of free maternity, on the other hand, highlights the basic ambiguity of the human condition and directs us to a new conception of maternal subjectivity. The pregnant body undermines our received individualistic conceptions of subjectivity, for the pregnant body symbolizes the relational aspects of subjectivity and human interdependence in a social community. A complex process of creation, pregnancy draws attention...

Childbirth advice literature as it relates to two childbearing ideologies.

Childbirth advice literature as it relates to two childbearing ideologies.