Disease In Pregnant Women Research Articles

Impact of antenatal corticosteroid therapy on sickle cell disease in pregnant women

Impact of antenatal corticosteroid therapy on sickle cell disease in pregnant women

Причины мертворождений при пандемии COVID-19

The COVID-19 pandemic is over, but in light of the potential for new mutations, an in-depth understanding of the mechanisms of this pathology development is necessary. Most unpredictably, this viral disease occurred in pregnant women. Therefore, in order to identify potential markers of the new viral disease in pregnant women, we analyzed changes in the causes of stillbirths during the first wave of COVID-19 (during which there were no previously ill and vaccinated people) in pregnant women without detected pathology (including COVID-19). The analysis showed that the number of cases of chronic fetoplacental insufficiency significantly increased by 33% in 2020 compared to 2019, and the number of placentas significantly decreased by 2.2 times. A significant increase in the number of stillbirths as a result of chronic fetoplacental insufficiency and a decrease in cases of placentitis is a marker indicating asymptomatic infection of pregnant women with the new viral infection.

Effects of in Utero SARS-CoV-2 Exposure on Newborn Health Outcomes

The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has infected over 600 million people worldwide, including millions of pregnant women. While newborns exposed to other viruses in utero are sometimes at high risk for vertical transmission, a substantial body of literature since early 2020 has demonstrated that vertical transmission of SARS-CoV-2 from infected mother to neonate is rare, and that newborns who do become infected with SARS-CoV-2 generally have favorable outcomes. In this review, the authors evaluate the existing literature on vertical transmission of SARS-CoV-2 and its potential mechanisms and discuss short- and long-term health outcomes in newborns who were exposed to SARS-CoV-2 in utero. The authors conclude that vertical transmission and adverse neonatal and infant/child outcomes are unlikely, but that neonates exposed to prenatal maternal SARS-CoV-2 infection may be at slightly higher risk for preterm birth, possibly related to increased risk of severe COVID-19 disease in pregnant women, placental changes, or infection timing. Ultimately, the need for additional and longer-term follow-up data in this population is highlighted.

Penanganan Penyakit Jantung Pada Ibu Hamil

Abstract – Pregnant women with heart disease cannot be denied, even though heart disease is a disease that is considered serious and can pose a risk of death. Treatment of pregnant women with heart disease must be carried out carefully to minimize the occurrence of dangerous risks for both the mother and the fetus. Therefore researchers want to find out more about the treatment of heart disease in pregnant women. The purpose of this study is to find out the appropriate handling procedures for pregnant women with heart disease. The research method used is qualitative with library research so that the data collected is in the form of a variety of information that is spread either through journals, research or books according to the research objective. The data found were then analyzed to find out the results of the research. The results of the study show that if a patient is known to have heart disease before pregnancy, he or she usually has to consult first with the cardiologist who handles it. However, if you don't have a history of heart disease before, you will continue to be monitored by a multidisciplinary doctor to reduce the risk of harm to both the pregnant woman and the fetus, bearing in mind that during pregnancy the heart works harder than when you are not pregnant.

Relationship Between the Periodontal Status of Pregnant Women and the Incidence and Severity of Pre-term and/or Low Birth Weight Deliveries: A Retrospective Observational Case-Control Study.

Literature worldwide has linked periodontitis to preterm births and/or low-birth-weight infants. However, to our knowledge, research on this topic is scarce in India. The United Nations Children's Fund (UNICEF) reports that South Asian nations, particularly India, have the highest rates of preterm births and low-birth-weight infants as well as periodontitis due to poor socioeconomic conditions. Overall, 70% of perinatal fatalities result from prematurity and/or low birth weight, which also increases the incidence of morbidity and drives up the cost of postpartum care by a factor of ten. The frequency and severity of the illness may be greater among the Indian population due to their poor socioeconomic status. To lower the mortality rate and the cost of postnatal care, it is necessary to investigate the impact and severity of the effect of periodontal conditions on pregnancy outcomes in India. Following the collection of obstetric and prenatal records from the hospital in compliance with inclusion and exclusion criteria, a sample of 150 pregnant women were chosen from public healthcare clinics for the research. Within three days of delivery following enrolment in the trial, a single physician recorded each subject's periodontal condition using the University of North Carolina-15 (UNC-15) probe under artificial lighting and the Russell periodontal index. The gestational age was calculated based on the latest menstrual cycle, and a medical professional would order an ultrasound if they felt it was essential. The doctor weighed the newborns soon after delivery and in accordance with this prenatal record. The acquired data was analyzed using a suitable statistical analysis technique. The severity of a pregnant woman's periodontal disease was significantly correlated with the infant's birth weight and gestational age. Preterm births and low-birth-weight infants became more prevalent as the severity of the periodontal disease rose. The results demonstrated that periodontal disease in pregnant women may increase the risk of preterm delivery and low birth weight in infants.

Frequency of types of cardiac diseases in pregnant women with cardiac disease presenting to tertiary care hospital

Frequency of types of cardiac diseases in pregnant women with cardiac disease presenting to tertiary care hospital

Association between the history of abortion and gestational diabetes mellitus: A meta-analysis.

Gestational diabetes mellitus (GDM) is a common metabolic disease in pregnant women. The purpose of this study was to determine whether a history of abortion increases the risk of GDM by meta-analysis. A comprehensive literature search was conducted in nine databases of studies on the association between abortion history and GDM up to April 12, 2022. Fixed- or random-effects models were used to estimate the pooled odds ratio (OR) and 95% CI. The I square value (I2) was used to assess heterogeneity. Possible sources of heterogeneity were explored by conducting subgroup analysis and meta-regression. A sensitivity analysis was also performed for this meta-analysis. Publication bias was assessed by funnel plots and Egger's tests. Thirty-one studies enrolling 311,900 subjects were included in this meta-analysis. The risk of GDM was higher in women who experienced abortion than in those who did not (OR = 1.41 95% CI: 1.28-1.55, I2 = 66.8%). The risk of GDM increased with an increasing number of abortions (1 time: OR = 1.67, 95% CI = 1.26-2.22; 2 times: OR = 2.10, 95% CI = 1.26-3.49; ≥3 times: OR = 2.49, 95% CI = 1.24-5.01). Both spontaneous abortion (OR = 1.52, 95% CI = 1.30-1.78) and induced abortion (OR = 1.07, 95% CI = 1.03-1.11) were associated with an increased risk of GDM. A history of abortion was associated with an increased risk of GDM in pregnant women, which may be a risk factor for predicting GDM.

Analysis of the course of the new coronavirus infection COVID-19 in pregnant women under treatment in the Infection Department of Clinical Hospital no. 1 in Smolensk

BACKGROUND: The physiological features of the pregnant womans body include her in the risk group for a more severe course of the disease, therefore, the management and treatment of such patients requires the most careful monitoring, as well as the coordinated work of a gynecologist and an infectious disease specialist.
 AIM: To evaluate the variants of the course of the disease in pregnant women with confirmed coronavirus infection.
 MATERIALS AND METHODS: The medical records of patients who were treated in the infectious diseases department of the Clinical Hospital No. 1 in Smolensk from May 2020 to September 2021 were analyzed, the necessary data were included in the protocols of our study. Such indicators as the main diagnosis and severity of the course of the disease, complaints at admission, the presence and stage of fever, age, gestational age, the presence of concomitant pathology and a complicated obstetric and gynecological history were evaluated.
 RESULTS: Analysis of the course of the disease according to the medical history showed that a moderate form of a new coronavirus infection dominates pregnant women.
 CONCLUSIONS: A trend towards a moderate course of a new coronavirus infection COVID-19 has been established. The probability that this is due to the presence in most patients with a history of diseases of the cardiovascular system, kidneys, liver, as well as diabetes, obesity, anemia.

Thrombocytopaenia and COVID-19 infection during pregnancy increases the risk of preeclampsia: a multicentre study

Research question: Is a low platelet count related to an increased risk of severe disease in pregnant women with active severe acute respiratory syndrome coronavirus 2 infection?Design: A cross-sectional multicentre study in pregnant women with COVID-19 confirmed by polymerase chain reaction, antigen test, antibody test, or all.Results: A total of 153 pregnant women with COVID-19 were included in the study, of whom 12.4% had thrombocytopaenia. Pregnant women with thrombocytopaenia were on average 3.1 years older (95% CI 0.18 to 6.38) than women without thrombocytopaenia. Pregnant smokers had a higher risk of thrombocytopaenia than non-smokers (OR 6.55, CI 95% 1.29 to 33.13). B Rh negative (B Rh–) pregnant women had a much higher risk of thrombocytopaenia than pregnant women with other blood groups (OR 16.83, CI 95% 1.42 to 199.8). Pregnant women with thrombocytopaenia had a much higher risk of suffering from preeclampsia (OR 16.2, CI 95% 1.35 to 193.4).Conclusions: COVID-19 infection is not a risk factor for a low platelet count in pregnant women, although the risk is increased by smoking and in women with blood group B Rh–. In case of pregnancy with thrombocytopaenia, COVID-19 infection leads to an increased risk of preeclampsia.

Vanishing lung syndrome in a pregnant woman: case report and literature review

The presence of an underlying lung disease in pregnant women can present as a challenging case. The Vanishing Lung Syndrome is considered a rare condition, in which pulmonary emphysema is usually observed. We describe a unique case of Vanishing Lung Syndrome in pregnant patient. Female patient, 29 years old, started having progressive dyspnea on exertion in 2019, without other associated symptoms. She was hospitalized and a chest imaging study showed the presence of a large bulla in the upper right hemithorax with “hypertensive” behavior. The patient was lost to follow-up and returned two years later, pregnant, with a gestational age of 17 weeks, with an important restrictive component described in the spirometry. A bullectomy and right middle lobectomy were performed, and the patient showed significant symptom and pulmonary evaluation improvement. There are no documented cases of this rare condition in a pregnant patient, with an emphasis on seeking to maintain maternal and fetal well-being. The management of Vanishing Lung Syndrome in pregnant women is challenging, especially when lung function is impaired, as in the described case.

Point-of-care NT-proBNP for the screening of PREGnancy-related Heart Failure – the PREG-HF study

Abstract Introduction Cardiovascular disease is an important cause of maternal mortality worldwide. However, diagnosing heart failure (HF) during pregnancy remains challenging. Patients with HF present with symptoms that are often attributed to the physiological changes of pregnancy. Although the measurement of natriuretic peptides (such as NT-proBNP) has been recommended as a cost-effective screening test for HF, its value in predicting underlying structural heart disease on echocardiography during pregnancy is unclear. Purpose To evaluate the accuracy of point-of-care (POC) NT-proBNP to predict echocardiographic evidence of structural heart disease in pregnant women. Methods All consecutive consenting pregnant women with symptoms of HF (New York Heart Association functional class [NYHA FC] II–IV), who underwent echocardiography at Groote Schuur Hospital (a tertiary hospital in South Africa) between 1 March 2021 and 15 March 2022 were recruited and compared with asymptomatic pregnant women (NYHA FC I). Demographic and obstetric data were collected, as well as clinical and echocardiographic parameters. POC NT-proBNP was measured; a receiver operating characteristic (ROC) curve was used to determine the level of NT-proBNP that would have the best predictive value for detecting structural heart disease on echocardiography. Results We included 121 women with a median age of 31.3 years (IQR 24.9–36.4) and a median gravidity of 3 (2–4), mostly in their third trimester of pregnancy (75.2%). Symptomatic women (66.1%) presented mainly with dyspnoea (92.5%) and fatigue (73.8%). Most common signs of HF were peripheral oedema (46.8%), jugular venous distension (17.7%) and pulmonary crackles (17.7%). Overall, the median POC NT-proBNP was 98pg/ml (60–506) but was not statistically different between symptomatic and asymptomatic participants. However, NT-proBNP levels were significantly elevated in those with left ventricular (LV) dilatation (376 [86–744] vs 65 [60–191], p=0.001), left atrial enlargement (395 [65–744] vs 60 [59–108], p<0.001), LV systolic dysfunction (510 [113–1668] vs 65 [60–210], p<0.001), diastolic dysfunction (300 [77–1450] vs 78 [60–257], p=0.031), mitral regurgitation (167 [60–672] vs 78 [60–243], p=0.038) and pericardial effusion (440 [81–1031] vs 71 [60–243], p=0.011) (Figure 1). An NT-proBNP of <200pg/ml had the highest negative predictive value (83%) to rule out structural heart disease (AUC 0.68 [0.59–0.77]). Patients with NT-proBNP of ≥200pg/ml were at increased risk of having echocardiographic evidence of structural heart disease (diagnostic odds ratio 4.9 [95% confidence interval 2.0–11.7]). Conclusion In this cohort of pregnant women with symptoms suggestive of HF, POC NT-proBNP identified those with structural heart disease with acceptable discrimination. POC NT-proBNP testing might be particularly useful as a screening test in settings where pregnant women do not readily have access to echocardiography. Funding Acknowledgement Type of funding sources: Foundation. Main funding source(s): World Heart Federation Salim Yusuf Emerging Leaders Programme

Assessment of the Community Periodontal Index of Treatment Needs (CPITN) in Pregnant Women Referring to the Health Centers in Arak, Iran

Objectives: The periodontal disease during pregnancy is considered to be significant because not only does it affect the tissues supporting the teeth, but also it is connected with systemic conditions such as adverse pregnancy outcomes. The present study aimed at assessing periodontal disease in pregnant women and other relevant demographic factors. Materials and methods: This is a cross-sectional, descriptive-analytical study that was conducted among 275 pregnant women visiting the health centers in Arak, Iran, in 2021. Cluster random sampling method was used to select the samples. The demographic information was gathered and periodontal statues was examined using the Community Periodontal Index of Treatment Needs (CPITN). The data were analyzed by SPSS18 software, using logistic regression. Results: According to the results, 55.4% of the pregnant women had periodontal disease (CPI>0). Bleeding on probing (BOP), dental calculus, and periodontal pocket depth (PPD) between 4 and 5 mm were observed of 17.5%, 36.4%, 5.1% of women, respectively. No periodontal pocket deeper than 6mm was observed. Brushing frequency was the main predictor for gingival health, and the women with under diploma education (OR: 2.26, 95% CI: 1.14-4.48) and having one or more children were (OR: 1.40, 95% CI: 1.02-1.94) more likely to have periodontal disease than women with academic education or having no children. Conclusion: According to the findings, pregnant women were not in good health condition in terms of periodontal disease. Considering the demographic and behavioral differences, designing the health promotion programs during pregnancy is recommended.

S2981 Drug-Induced Autoimmune-Like Hepatitis Due to HemoHIM in a 28-Year Old Pregnant Woman

Introduction: Drug-induced autoimmune-like hepatitis (DIAIH) is a pathologic immune response against proteins in the liver that can be triggered in susceptible individuals by drugs or herbal remedies. While any supplement can cause idiosyncratic hepatotoxicity, up to 16% of drug-induced liver injuries are attributable to herbal supplements. To date, there are still limited data on herbal medicine-related hepatotoxicity. This topic is particularly understudied in pregnant patients, with most current clinical information coming from case reports. While use of supplements is common during pregnancy, there is still limited information regarding their safety. Case Description/Methods: A previously healthy G4P2A1 28-year-old presented at 5 weeks of pregnancy with right upper quadrant pain and fevers, and was presumed to have acute cholecystitis resulting in a laparoscopic cholecystectomy. Despite this, her liver enzymes continued to worsen (AST 2893, ALT 2664, TBili 2.6, Alk Phos 460, INR 1.3). The patient also had laboratory evidence of AIH including Anti-Mi+ 34.5, U1-RNP/RNA-A68 2.4, Chromatin Abs 1.6. She underwent liver biopsy showing drug-induced liver injury and autoimmune hepatitis (AIH). Given that AIH often presents during pregnancy, it was unclear if this presentation represented DIAIH or AIH. Notably, the patient had recently started taking an herbal supplement with purported immune support called HemoHIM that was thought to be a possible driver of DIAIH, The supplement was discontinued and she was started on a 60mg prednisolone with subsequent clinical and laboratory improvement. Despite improvement, the patient suffered spontaneous abortion early in the treatment course and in retrospect underwent unnecessary cholecystectomy. Given concern for possible AIH and slow normalization of LFTs, she was started on azathioprine, but self-discontinued after 7 months. Her liver enzymes remained stable 6 months later; supporting a diagnosis of DIAIH due to HemoHIM rather than AIH which would have likely rebounded with such early treatment withdrawal. Discussion: While DIAILH is an underreported disease in pregnant women this case demonstrates the importance of early diagnosis and treatment. Additionally, it illustrates he challenges in distinguishing between DAILH and AIH especially in patients taking herbal supplements.

The immunological role of B7-H4 in pregnant women with Sars-Cov2 infection.

ProblemT‐cells are key players in fighting the coronavirus disease 2019 (COVID‐19). The checkpoint molecule B7‐H4, a member of the B7 family, can inhibit T‐cell activation and proliferation by inhibiting NF‐kb expression. We aimed to elucidate the immunological role of soluble B7‐H4 (sB7‐H4) and B7‐H4 in pregnant women suffered from an acute Sars‐Cov2 infection.MethodsExpression levels of sB7‐H4 and cytokines were detected by enzyme linked immunosorbent assay. B7‐H4 and cytokines mRNA expression was analyzed by qPCR, and B7‐H4 and NF‐κb (p65) protein levels were investigated by western blot and immunofluorescence staining in placenta chorionic villous and decidual basalis tissues of COVID‐19 affected women and healthy controls.ResultsFibrinoid necrosis in the periphery of placental villi was increased in the COVID‐19‐affected patients. sB7‐H4 protein in maternal and cord blood serum and IL‐6/IL‐10 were increased while leukocytes were decreased during SARS‐CoV‐2 infection. Serum sB7‐H4 level was increased according to the severity of SARS‐Cov‐2 infection. Cytokines (IL‐6, IL‐18, IL‐1β, TNF‐α), B7‐H4 mRNA and protein in the decidual basalis tissues of COVID‐19‐infected pregnant women were significantly increased compared to healthy controls. IL‐18 and IL‐1β were significantly increased in the placenta chorionic villous samples of COVID‐19 affected patients, while NF‐κb (p65) expression was decreased.ConclusionsThe expression of the immunological marker sB7‐H4 correlated with the severity of COVID‐19 disease in pregnant women. sB7‐H4 and B7‐H4 can be used to monitor the progression of COVID‐19 infection during pregnancy, and for evaluating of the maternal immune status.

EVALUATION OF THE EFFECTIVENESS OF THE USE OF NON-DRUG THERAPY FOR PRECONCEPTION PREPARATION OF WOMEN WITH BACTERIAL VAGINOSIS

Bacterial vaginosis (BV) is one of the most common conditions in women of reproductive age. BV is detected in 80–87% of women with abnormal vaginal discharge, the incidence of the disease in pregnant women reaches 37–40% and is a risk factor for complications. The purpose of the research is to study the clinical and microbiological efficacy of a two-stage scheme for the correction of vaginal dysbiosis using cavitated low-frequency ultrasound (LUS) as an alternative method for preconception preparation in women with bacterial vaginosis. Materials and methods. The study involved 67 patients with BV aged 19 to 35 years who consulted an obstetrician-gynecologist in connection with pregnancy planning. The results of bacterioscopic and bacteriological studies, the state of vaginal microbiocenosis were evaluated by PCR with real-time detection of results (RT-PCR). All patients according to the state of microbiocenosis were divided into two groups: I-moderate dysbiosis with the content of Lactobacillus spp.from 20% to 80% (n=39) and II-pronounced dysbiosis with the content of Lactobacillus spp.less than 20% (n=28). A two-stage scheme was applied to correct vaginal dysbiosis. At the first stage, all women underwent vaginal treatment with cavitated NUS aqueous 0.05% chlorhexidine solution.At the second stage, a lyophilized culture of lactobacilli was used to normalize and renew the vaginal microflora. The results of the study. In women of group I with moderate dysbiosis, a decrease in the content of lactoflora below the value of 107/g was revealed. The proportion of Gardnerella vaginalis was 35.9% (n=14), Atopobiumvaginae 25.6% (n=10), Eubacterium 23.1% (n=9), Megasphera 17.9% (n=7), Mobiluncus spp.20.5% (n=8), Peptostreptococcus 8% (n=3), Snethia spp.20.5% (n=8), Lachnobacterium spp.15.3 (n=6). In group II of examined women with severe dysbiosis, the content of lactoflora was less than 105/g; in most cases, lactobacilli were not detected. The majority of patients had microbial associations of Gardnerella vaginalis and Atopobiumvaginae 67.8% (n=19), Eubacterium 17.8% (n=5), Megasphera 14.2% (n=4), Mobiluncus spp.25% (n=7), Peptostreptococcus 28.5% (n=8), Snethia spp. 32.1% (n=9), Lachnobacterium spp.25% (n=7). After the course of treatment, the positive dynamics of the state of microbiocenosis according to real-time PCR was noted after the completion of the course of vaginal irrigation. The proportion of women with severe anaerobic dysbiosis decreased from 41.8% (n=28) to 13.4% (n=9), with moderate dysbiosis - from 58.2% (n=39) to 19.4% (n=13) among all examined women. At the same time, in 61.2% (n=41) of women, the microbiocenosis was restored to normocenosis. Conclusions. The proposed scheme for the correction of vaginal dysbiosis demonstrates the high efficiency of the method: restoration of normocenosis was achieved in every second patient. Positive dynamics was noted due to an increase in the proportion of lactoflora content in almost all observed women.

Varicose disease in pregnant women: clinical patterns and duplex ultrasound investigation of the veins

The objective of the study was to improve the medical care of pregnant women with varicose disease based on the results of duplex ultrasound examination of the veins of the lower extremities, as well as on the clinical and laboratory parameters.We evaluated the data of 128 pregnant women with varicose veins and performed ultrasound to examine the venous system measuring the diameter of the great saphenous vein (GSV) into saphenofemoral junction, midthigh, lower thigh and investigating the venous reflux.The diameter of competent and incompetent GSVsincreased between the first and third trimester in the both groups(p < 0.001). The mean diameter was 4.3 (2.69–5.86) mm in the main group at 22–24 weeks of gestation, 4.6 (2.96‒5.86) mm at 32‒34 weeks, 4.5 (2.91–5.74) mm ‒ after delivery. The diameter of the GSV with reflux was significantly larger than that of GSVs without reflux in the saphenofemoral junction (R = 0.758, p < 0.001).Pregnancy induces the alterations of venous physiology. Examination of clinical and ultrasound data of pregnant women with varicose veins is an important step to prevent the disease progression during pregnancy and childbirth.

The Risk and Clinical Treatment of Hypertensive Diseases in Pregnant Women.

Hypertensive disorders of pregnancy are a group of pregnancy-related diseases characterized by the coexistence of pregnancy and elevated blood pressure, which seriously endanger the health of mothers and infants, and are one of the main causes of maternal and perinatal deaths. The purpose of this paper is to investigate the clinical analysis of vitamin E and astragalus in the adjuvant treatment of hypertensive disorders in pregnancy and to describe the learning model. This paper puts forward the problem of clinical treatment, which is established on the basis of adjuvant therapy, then narrates around the clinical characteristics of gestational hypertension, and designs and analyzes the experimental design and analysis of adjuvant therapy with vitamin E and astragalus. The experimental results showed that the delivery methods of the three groups of patients were compared P < 0.05. Compared with the traditional Chinese medicine control group and the vitamin E control group, there were more vaginal births in the experimental group, 36 patients in total. It shows that astragalus and vitamin E can alleviate the disease in different aspects and can effectively intervene in gestational hypertension.

Assessment of the Association of Periodontal Diseases in Pregnant Women and the Efficacy of Periodontal Treatment in the Context of Premature Births and Pregnancy Complications - a Narrative Review.

Introduction Periodontal diseases are widespread in women of reproductive potential. Although their treatment of these disorders contributes to oral health, there is still no conclusive evidence that this intervention has a beneficial effect on the course of pregnancy, in particular the rate of premature births. On the one hand, the aim of the paper is a systematic assessment of the association between periodontal diseases and pregnancy complications, based on the current literature. On the other hand, the efficacy of periodontal treatments vs. no treatment in pregnant women should be assessed with the target criterion of premature birth or other pregnancy complications. Materials and methods The narrative review was based on the PRISMA statement. Premature births were defined as primary endpoints, while various perinatal and maternal outcomes were grouped together as secondary endpoints. An electronic database search for relevant meta-analyses and systematic reviews was carried out in PubMed and the Cochrane database. Methodological characteristics and the results of the included studies were extracted. The RR or OR (95% CI) was used to measure the result. The quality of the included studies was assessed according to the AMSTAR checklist. Results Seven publications were included (total number of subjects n = 56755). The majority of included studies do not demonstrate a significant association of periodontal disease and/or periodontal treatment with certain childhood and/or maternal outcomes. The quality of the included studies was deemed to be sufficient. Conclusion Even today, there is insufficient evidence to confirm the correlation between periodontal disease and certain maternal and/or infantile outcomes. Periodontal treatment during pregnancy also does not seem to affect the risks of pregnancy. Nevertheless, it is recommended that all pregnant women are advised to improve their daily oral hygiene in order to prevent inflammatory diseases, regardless of the progress of the pregnancy.

Prevalence and characteristics of gastroesophageal reflux disease in pregnant women

Introduction and aimsThe prevalence of gastroesophageal reflux disease (GERD) has been reported to be increasing in recent years. However, there have been few reports on the prevalence of GERD during pregnancy in the Asian population. The aim of our study was to evaluate the prevalence and characteristics of GERD in Vietnamese pregnant women. Materials and methodsThis cross-sectional study was conducted at the antenatal clinic of the Nhan Dan Gia Dinh Hospital, Ho Chi Minh, Vietnam. Four hundred females, at various stages of pregnancy, were enrolled. GERD was diagnosed if there was troublesome heartburn and/or acid regurgitation, at least once a week, during the current pregnancy. ResultsThe overall prevalence of GERD in pregnancy was 38.5% (154/400). The prevalence of GERD in the third trimester was significantly higher than that in the second trimester (46.8% vs. 30.7%, P=0.008) and tended to be higher than its prevalence in the first trimester (46.8% vs. 35.4%, P=0.051). In the pregnant women with GERD, the frequency of regurgitation was significantly higher than that of heartburn (92.9% vs. 30.5%, P<0.001). Those typical symptoms were more prevalent in the daytime, compared with nighttime. ConclusionOur study showed that GERD was prevalent during pregnancy in Vietnam. In the pregnant women with GERD, regurgitation was much more common than heartburn, and those typical reflux symptoms occurred more frequently in the daytime, compared with nighttime.

Optimization of prevention of dental diseases in pregnant women

Effective prevention of dental diseases during pregnancy, as well as the correct tactics of a dentist and obstetrician-gynecologist is important factors in improving the level of dental health in pregnant women. The aim of research was to increase the effectiveness of the prevention of dental caries and periodontal diseases by introducing a complex of prophylactic and therapeutic measures in pregnant women. The implementation of the prophylaxis scheme is performed in 136 women aged 18-35 years. In the main group (70 women) prophylaxis was carried out using the complex of prophylactic and therapeutic measures developed by us, which includes: professional oral hygiene, oral health treatment, nutrition correction, prescribing the medicines of systemic and local action, training in proper teeth brushing, active sanitary and educational work. In the control group (66 women), the generally accepted prophylaxis scheme was used. Evaluation of the effectiveness of prophylactic and therapeutic measures was determined by indicators of caries incidence during pregnancy, reduction of caries, the dynamics of Papillary-Marginal-Attached Index and Papillary Bleeding Index. The effectiveness of the proposed algorithm of dental diseases prevention for pregnant women was confirmed by 3.45 times lower incidence of dental caries in women of the main group compared to the control group (0.44±0.06 versus 1.52±0.13 tooth, respectively); significant decrease (p&lt;0.001) of Papillary-Marginal-Attached Index values (14.01±1.17 versus 49.25±1.86%), as well as bleeding indices (0.32±0.08 versus 1.82±0.13) and Green-Vermilion (0.89±0.08 versus 1.71±0.12 scores). Regular prophylactic and therapeutic examinations of pregnant women by a dentist, hygienic education and training of expectant mothers, active motivation of women to carry out individual oral hygiene with a constant monitoring of its implementation, correction of nutrition and mineral metabolism, influence on cariogenic and periodontal microbiota of the oral cavity, improvement of physiological enamel mineralization and increasing of hard tooth tissues resistance contributed to the reduction of caries incidence by 71.05±5.42% and the effectiveness of periodontal diseases treatment by 88.46±3.81% in the main group versus 36.84±5.94% in the control group (p&lt;0.001).