Disease In Pregnant Women Research Articles

The activity of commercial antimicrobials, and essential oils and ethanolic extracts of Olea europaea on Streptococcus agalactiae isolated from pregnant women

BackgroundStreptococcus agalactiae also known as Group B Streptococcus (GBS) is a major cause of disease in pregnant women and new born babies where it causes early and late onset disease characterised by sepsis, pneumonia and meningitis. Ten to 37 % of pregnant women in the world are colonised with GBS while intrapartum antibiotic prophylaxis has led to significant reduction in early onset disease. The increase in drug resistant microorganisms has become a major threat. Development of vaccines is still in progress so there is need for new and safer alternatives to treatment.MethodsBenzyl penicillin, Ampicillin, Cefotaxime, Ceftriaxone, Levofloxacin, Erythromycin, Clindamycin, Linezolid, Vancomycin, Tetracycline and Cotrimoxazole, Olea europaea leaf extracts and essential oil were tested against GBS isolates from South Africa and Namibia.ResultsThe isolates showed 100% sensitivity to benzyl penicillin, ampicillin, ceftriaxone, levofloxacin, linezolid, vancomycin, O. europaea leaf extracts and essential oils. Only one isolate (0.6%) was resistant to cefotaxime and 23.4 and 10.4% were resistant to clindamycin and erythromycin respectively.ConclusionGBS isolates showed sensitivity to O. europaea extracts at low minimum inhibitory concentrations. Β lactams are still the drugs of choice for treatment of GBS disease but O. europaea extracts potent as an alternative source of antimicrobials.

Deficiency of vitamin D in most common complications of pregnancy and periodontal disease in pregnant women - a review

Deficiency of vitamin D in most common complications of pregnancy and periodontal disease in pregnant women - a review

MODERN APPROACHES TO PREVENTION OF PERIODONTAL DISEASES IN PREGNANCY: A REVIEW

Introduction: In the modern literature, a variety of treatment regimens for periodontal diseases in pregnant women have been suggested and recommended for use in practical public health. And yet the concept of "dental diseases prevention in pregnancy" does not fully reflect the essence of the necessary measures to maintain the dental health of women during this period. The aim: The aim of the present paper is to study the scientific literature on the issue of preventing periodontal diseases in pregnancy. Materials and methods: The subject under discussion was considered on the basis of 59 sources on this issue, using the method of content analysis, comparative and contrastive, analytical and biblio-semantic methods. Review and conclusions: The analysis of scientific literature justifies the need for an integrated approach to treatment and prophylactic measures during the entire pregnancy period. Furthermore, the review of literature sources allows us to advocate the need to improve the existing approaches and to develop new individual programs for primary and secondary prevention of periodontal diseases in pregnant women, taking into account pathogenesis and the peculiarity of their course. Diagnosis of dental status in pregnant women with assessment of early and long-term clinical observations provides a prognostic model of the course and outcome of dental diseases. Meanwhile, the introduction of the follow-up observation for the maternity leave group enhances the dental health of pregnant women and prevents multiple pathological conditions of the unborn child.

Educational banner as a media to oral health during pregnancy phase information for pregnant women with lower secondary social economy

Aims and Objective: Pregnant women become groups that need special attention with regard to their oral health and the health of their baby candidates. Gingivitis is very common in pregnant women due to increased estrogen and progesterone hormones. Surabaya Public Health Centre recorded incidence of periodontal disease in pregnant women between September and October 2017, that is, 42.8%. From epidemiological research conducted, the primary data collected and problem priority listed to get the risk factor causing gingivitis with tartar caused one of them by lack of facility and infrastructure of pregnant woman to know about the importance of visit to dental health service. Subjects and Methods: This descriptive-analytical study conducted with 31 participants, with pre- and posttest design. The type of program evaluation we use in this empowerment program is the type of outcome evaluation. Evaluation of the results was conducted to measure whether pregnant mothers have already understood the material on educational banner media. Results: There is score increase between pre- and posttest. Total score on pretest of 220 is as much as 44% while the total score of posttest is 460, that is, as much as 92%. This indicates an increase in the number of questions answered correctly by 52%. Conclusions: Educational banner can improve the understanding of pregnant women about the importance of visits to the dentist.

Preeclampsia - a disease of pregnant women

Preeclampsia, also known as EPH-gestosis, is a pregnancy-specific syndrome. It affects 3-5% of pregnant women and is characterized by edemas, high blood pressure and proteinuria. Moreover, in women with preeclampsia dysfunction of many organs, such as kidney and liver, is diagnosed, while in the case of fetus growth restriction is observed. Preeclampsia, when left untreated, can lead to death. In low-income countries, this disorder is one of the main causes of maternal and child mortality. Preeclampsia predisposes women in later life to cardiovascular diseases. So far, in acute cases of preeclampsia stabilization of the mother and fetus and finally termination of pregnancy at a time optimal for both sides can only be considered. In this work, available literature data concerning the causes of preeclampsia, its symptoms, techniques for diagnosis, methods for prevention and new approaches to treatment were collected.

Characterizing the Subgingival Microbiome of Pregnant African American Women

ObjectiveTo generate preliminary data about the subgingival microbiome of pregnant African American women to calculate power for a future larger study and to explore associations among the microbiome, periodontal inflammation, and preterm birth. DesignComparative descriptive pilot study design. SettingUrban area in the southeastern United States. ParticipantsThirty-four African American women in the third trimester of pregnancy. MethodsBased on visual assessment, participants were placed in two groups: healthy gingiva and gingivitis. Saliva samples were analyzed for interleukin-1β (IL-1β), matrix metalloproteinase–8 (MMP-8), and C-reactive protein (CRP). DNA was extracted from subgingival plaque samples, and amplicons of the fourth hypervariable region were sequenced. ResultsWe found no differences in overall microbiome diversity between the healthy gingiva (n = 22) and the gingivitis (n = 12) groups although significant differences were found among the bacterial taxa present. The gingivitis group had greater levels of salivary IL-1β and MMP-8, whereas CRP was not different between groups. Overall microbiome diversity was positively associated with the CRP level. We found no significant relationships among the subgingival microbiome, periodontal inflammation, and preterm birth. ConclusionGingivitis in pregnancy did not appear to shift the overall composition or diversity of the subgingival microbiome although differences in several bacterial taxa suggest that inflamed gingiva in pregnant women are associated with a disruption in the stability of the subgingival microbiome. A correlation between the abundance of bacteria and CRP also suggests an association between the microbiome and systemic inflammation. These findings provide support for future research about how the oral microbiome and progression of periodontal disease in pregnant women link with adverse pregnancy outcomes.

Predictors of maternal cardiac complications in pregnant women with severe cardiac valve disease

Maternal mortality in general has decreased in the past decade, but over the same period, cardiac maternal death has not declined. In emerging countries, rheumatic valve disease is the most common cardiac disease in pregnant women. We conducted this study in order to determine predictors of cardiac complication in such pregnant condition. It was a retrospective study including all pregnant women with at least one severe cardiac valve disease and who gave birth in our hospital between 2010 and 2017. Maternal cardiac event was defined as cardiac death, arrhythmia requiring treatment, heart failure, thromboembolic event, endocarditis. We included 60 pregnancies in 54 women during the study period. The mean age was 32.55 ± 5.6 years, the mean gestity was 2.8 ± 1.6 (1–9), the valvular disease was discovered during pregnancy in 45%, a multiple valve disease was diagnosed in 47% of cases. The most frequent severe cardiac valve disease was mitral stenosis (65% of the cases). Cardiac complications occurred in 37 patients (61%). On Univariate analysis, the predictors of such complications was gestity (3.16 ± 1.8 versus 2.21 ± 1.16, P = 0.038), parity (2.45 ± 1.21 varsus 1.69 ± 0.87, P = 0.01), discovery of the valvylar disease during the pregnancy ( P = 0.039), mitral stenosis (86.5% versus 47.8%, P = 0.001), atrial fibrillation (48.6% versus 21.7%, P = 0.37, and systolic pulmonary pressure (57.29 ± 15.8 versus 40.39 ± 9.7, P < 0.001), but on multivariate analysis, the independent factors of cardiac complications was severe mitral stenosis ( P = 0.035, OR = 6.8, 95% CI (1.14–41.05), pulmonary systolic pressure (OR = 1.08, 95% CI (1.015–1.14), parity ( P = 0.023, OR = 2.41, 95% CI (1.12–5.16). Severe Mitral stenosis was the main cause of cardiac complication in pregnant cardiac woman. The percutaneous mitral dilatation could improve the maternal prognosis and should be attempted when anatomic data are in favor.

Prevalence of Thyroid Disorders in Pregnant Women In Hospital Tengku Ampuan Afzan &amp; International Islamic University Malaysia Medical Centre

Introduction: Data on the burden of thyroid disease in pregnant women in our community is scarce albeit the detrimental effects it brought to both the mother and fetus if left untreated. The aim of this study was to determine the prevalence of thyroid disorders, socio-demography distribution, and method of diagnosis in pregnant women of both tertiary centres in Kuantan, Pahang. Materials and Methods: A retrospective cross sectional study involving patients under follow ups at the Endocrine and Obstetric Clinics of Hospital Tengku Ampuan Afzan (HTAA) and International Islamic University Malaysia Medical Center (IIUM MC) from the 1st January until the 30th June 2017. Out of 923 pregnant women, 29 were found to have thyroid disorders. Detailed demographic data and thyroid function test readings were taken from their medical records and thyroid status were determined from TSH and FT4 readings using the trimester-specific thyroid reference range. Results: The prevalence of thyroid disorders in both centres was 3.14%, with specific prevalence of 2.80% for HTAA and 6.12% for IIUM MC. Nearly half of them were hyperthyroid (47.85%), 17.4% was hypothyroid and Graves’ disease dominated the diagnosis of thyroid disease (30.43%). Significant association was found in weight changes with patients’ thyroid status; reduction in weight in first trimester and increment in weight in second trimester were mainly seen in the hyperthyroid group (p&lt;0.01, p=0.027). Conclusion: The acceptable prevalence of 3.14% for thyroid disorders in pregnancy could be contributed by the iodine availability in this community. High prevalence of Graves’ disease warrants future screening for maternal thyroid stimulating immunoglobulin amongst hyperthyroid women.

PERIODONTAL DISEASE STATUS, KNOWLEDGE, ATTITUDE, PRACTICE AND TREATMENT NEEDS OF PREGNANT WOMEN

Background: Periodontal disease is a prominent and important issue of public health, especially in pregnant women. The objective of this study is to describe the clinical characteristics; learn knowledge, attitudes, practice oral hygiene and assess the need for treatment of periodontal disease in pregnant women. Subjects and Methods: A cross-sectional study of 210 pregnant women who visited the Department of Obstetrics and Gynecology at the Hue University of Medicine and Pharmacy Hospital. Clinical examination and interview questions on knowledge, attitudes and practice of oral care for all subjects. Results: The incidence of gingivitis was 100%, with mild gingivitis of 4,3% and moderate gingivitis of 95.7%. There was a difference in incidence rates of gingivitis in the gestational period (p&lt;0.001). The incidence of periodontitis is 17.6% and there is no difference in gestational age (p&gt;0.05). The mean values of GI and BOP indices differed by gestation period (p&lt;0.05) and PD, OHI-S, PlI have statistically significant relationship with gestation period (p&gt;0.05). The incidence of periodontal disease is 80.5%; The percentage of pregnant women who abstain from brushing their teeth after birth is 61.4%. Prevalence of brushing once a day: 7.1%; Twice a day: 70.5% and 3 times daily: 22.4%; The mean values of GI, PD, BOP, OHI-S and PlI were inversely proportional to the number of brushing (p&lt;0.001). The rate of dental hygiene is just 3.3%; The rate of oral hygiene, dental plaque and plaque removal was 94,3%; The proportion of subjects required for intensive treatment is 2.4%. Conclusion: Periodontal disease, especially for pregnant women, is high. It is necessary to educate the knowledge, attitudes and practice of proper oral hygiene and to better meet the demand for periodontal disease treatment for pregnant women. Key words: Periodontal disease, pregnant women, knowledge, attitude, practice for oral hygiene, treatment needs

Thyrotropin receptor antibody: A novel risk indicator for pregnancy loss

BackgroundThyroid autoantibody has been associated with adverse pregnancy outcomes. However, thyroid-receptor antibody (TRAb) has not been considered as a potential risk assessment indicator for adverse pregnancy outcomes. Therefore, we assessed the role of TRAb in evaluation of the risk of adverse pregnancy outcomes. MethodsPregnant women residing in Chongqing were enrolled in the study from 2012 to 2014. The TRAb, thyroid-stimulating hormone (TSH), free thyroxine (FT4), and free triiodothyronine (FT3) of all patients were analyzed via electrochemiluminescence assays. All data were recorded and analyzed statistically using SPSS. ResultsA total of 468 pregnant women were included in the analysis. TRAb levels were higher in women with adverse pregnancy outcomes than those in women without adverse pregnancy outcomes. The incidence rate of pregnancy loss was significantly higher in the TRAb-positive group than that in the negative group, but this difference was not found in preterm delivery and early preterm delivery. In the logistic regression model, TRAb was an independent risk factor for pregnancy loss, but not for preterm delivery and early preterm delivery. The optimal cutoff point for TRAb was 3.53 IU/L, and the sensitivity and specificity of TRAb to assess the risk of pregnancy loss are 83.5% and 85.3%, respectively. Receiver-operating characteristic (ROC) curves revealed that TRAb was superior to the combination of TSH, FT4 and FT3 as an indicator for assessment. ConclusionsTRAb as a more sensitive indicator providing valuable detection to assess the potential risk of pregnancy loss, and it can be used as an effective tool to improve the clinical management of thyroid disease in pregnant women.

Аналіз перебігу вагітності та пологів у жінок з пренатально діагностованими вродженими вадами розвитку легенів і грудної клітки у плода

The objective: to analyze the course of pregnancy and labor in women with prenatally diagnosed congenital malformations of the lungs, thorax and diaphragm in the fetus, the condition of the fetuses and newborns with this pathology. Materials and methods. In-patient and out-patient medical records of pregnant women, the medical records of the newborns of 30 patients who gave birth to children with congenital malformations of the lung, diaphragm and thorax in the obstetric clinics of «I PAG named by O.M. Lukyanova of NAMSU» (main group) and of 250 women with normal fetal development, which were followed at the women’s consultation clinic №5 of Shevchenkivskyi district of Kiev during the period of 2011–2013 (control group). Results. A significantly higher rate of pregnant women younger than 19 years of age, pregnant women with burdened obstetric and gynecological anamnesis, as well as a high incidence of infectious gynecological and extragenital diseases, other extragenital pathology was found among the patients in the main group compared to controls. The rate of threatened abortion in the 1 trimester of pregnancy was significantly higher in the main group (30%) compared with the control (9.2%). Polyhydramnios was registered significantly more often in the main group (33.3%) than in the control group (1.6%), Oligohydramnios was found group in a small part of the patients from the main group (6.7%). In main group delivery was more often performed by cesarean section (53.3% vs. 12,4% in the control group, p&lt;0.01), partly as a consequence of the standard delivery plan for the congenital diaphragmatic hernia in the fetus. Despite the more gentle way of delivery, children from the main group after birth were in most cases in severe condition: 46.6% after birth had an Apgar score of 4–6 points, 46.6% – less than 4 points, and only 6,6% newborns received score of more than 6 points. In the control group, a score of &lt;7 points after birth hada significantly lower number of children – 4.4% (p&lt;0.01). Conclusions. The high incidence of infectious diseases in pregnant women from the main group gives grounds to suggest the influence of the factors associated with the infection and/or systems of inflammatory reactions, on the formation of congenital malformations of the lungs, diaphragm and thorax in the fetus; The influence of these factors may also be the cause of the risk threatened abortion in the I trimester. In the overwhelming majority of cases children with congenital malformations of the lungs, diaphragm and thorax were in a severe condition immediately after birth, which should be taken into account when planning specialized care for the newborn. Key words: congenital malformations, lungs, congenital diaphragmatic hernia, extragenital diseases, TORCH-infections, pregnancy, labor.

The role of arterial hypertension in the development of cerebrovascular diseases in pregnancy

Nowadays, the risk factors, improvement of diagnosis and treatment of cardiovascular diseases are of particular interest. Arterial hypertension (HTN) is known to contribute to cardiovascular disease and to be a risk factor for cerebrovascular diseases. HTN during pregnancy and in the postpartum period draws particular attention. Throughout the world, hypertension during pregnancy remains the leading cause of maternal and child morbidity and mortality. To our knowledge, only a few works studied neurological disorders associated with HTN in pregnant women. In this connection, the purpose of our review was to analyze the role of HTN in the development of cerebrovascular diseases in pregnancy. Pregnant women with HTN show 5,2-fold higher frequency of strokes than normotensive women. The risk of stroke increases from the third trimester of pregnancy to six weeks of the postpartum period. The pregnant women with HTN develop changes in the coagulation system leading to the formation of arterial and venous thromboses in the cerebrovascular circulation. The presence of preeclampsia (PE) is associated with the 7–9-fold increase in the risk of stroke. Endothelial dysfunction is one of the leading links in the pathogenesis of PE. The PE is associated with an increase in anti-angiogenic factors and a decrease in angiogenic factors. Thus, the measures preventing the development of cerebrovascular diseases in pregnant women with HTN, include identification of prehypertension in women of childbearing age, the improvement of HTB management strategies, and an interdisciplinary approach to the diagnostic and treatment process involving the obstetrician, the therapist, the cardiologist and the neurologist.

SIGNIFICANCE OF INFLAMMATION MARKERS DETERMINED IN PREGNANT WOMEN WITH ANEMIC SYNDROME AND OBESITY

The purpose of the present study was to specify a role of inflammatory mediators in pathogenesis of various types of anemia in pregnant obese women. We determined IL-1, IL-6, TNFα, C-reactive protein and hepcidin concentrations in blood serum of pregnant women with obesity depending on the type of anemic syndrome, either iron-deficiency anemia, or anemia of chronic diseases. We showed that the content of IL-6 in blood of the obese women exceeds the value of this index in healthy pregnant women (p &lt; 0.05), and it does not depend on the presence and type of anemic syndrome. We found that the C-reactive protein concentration in pregnant women with obesity is higher than reference values (p &lt; 0.05). Moreover, the contents of C-reactive protein in blood serum of pregnant women with anemia of chronic diseases is significantly higher (p &lt; 0.05) than in women with iron deficiency anemia. Hepcidin concentration in blood of pregnant women with obesity and anemia of chronic disease was a specific feature: its content was significantly higher than in healthy pregnant women (p &lt; 0.05), or in pregnant women with anemia-free obesity (p &lt; 0.05). Hepcidin levels also exceeded 2-fold its contents in serum from pregnant women with obesity and iron deficiency anemia (p &lt; 0.05). We have found that only pregnant women with obesity and anemia of chronic diseases have shown a positive correlation between the concentrations of C-reactive protein and blood levels of hepcidin (r = 0.733, p &lt; 0.05), or IL-6 (r = 0.679, p &lt; 0.05).The discussion concerns potential mechanisms of evolving anemia of chronic disease combined with subclinical inflammation in pregnant women with metabolic disorders. We conclude that a combination of obesity with gestational diabetes is a risk factor of anemia of chronic diseases in pregnant women. Development of an algorithm for differential diagnosis of iron deficiency anemia and anemia of chronic diseases in this cohort of patients is advisable for future studies in the area.

Alteration of the colostrum whey proteome in mothers with gestational hypothyroidism.

BackgroundGestational hypothyroidism (G-HypoT) is one of the most common thyroid diseases in pregnant women. Human milk, which closely links the mother with infant, is an important factor to the infant health. Here, we analyzed the colostrum whey proteome of women with or without G-HypoT.Methods and resultsUsing high–mass accuracy and high-resolution liquid chromatography-tandem mass spectrometry (LC-MS/MS), 1055 proteins were identified. Tandem Mass Tags (TMT) analysis identified differentially expressed proteins between G-HypoT and non-G-HypoT mothers. Of 44 proteins identified, 15 proteins were significantly increased in G-HypoT colostrum whey, while 29 were significantly decreased. Analysis revealed that enzymes involved in carbohydrate metabolism, and that reflect the metabolic activities in breastfeeding women, including fructose-1, 6-bisphosphatase 1, phosphoglycerate mutase 1 were down-regulated. Cell structural proteins, biomarkers of mammary integrity development, including Glyceraldehyde-3-phosphate dehydrogenase (GAPDH) and actin were lower in G-HypoT colostrum whey. However, immune protein fragments like Ig gamma-3 chain C region increased in G-HypoT colostrum whey.ConclusionThese results implied that G-HypoT may changed human colostrum whey protein in composition level, decreasing levels of metabolic proteins and cell-structure proteins, while increasing levels of immune-related proteins, which may compromise or reflect mothers’ and infants’ health.

A study on rate pressure product in south Indian pregnant women with anaemia

Background: Anaemia is a cause of serious concern and contributes to a significantly higher maternal mortality. Rate Pressure Product (RPP) is a major determinant of myocardial oxygen consumption and blood flow. There is an increase in oxygen demand in anemia. Thus, in the present study, we have compared the difference in RPP between a normal pregnant women and pregnant women with anemia.Methods: A total of 180 pregnant women (normal pregnant woman - 90 and pregnant woman with anaemia - 90) belonging to different trimesters of pregnancy were included in the study. Age, height, and weight were recorded, and their body mass index was calculated. The systolic blood pressure, diastolic blood pressure, heart rate was recorded and RPP was calculated.Results: There was a significant increase in RPP in pregnant woman with anaemia in all three trimesters of pregnancy, but the significant increase was more in the third trimester.Conclusions: The present study shows that there is an increase in RPP in pregnant woman with anaemia and they are more prone to hemodynamic stress and cardiovascular risks, especially in their third trimester of pregnancy. This hemodynamic change may be taken into account to prevent the cardiovascular complications associated with anemia in pregnancy. Thus, RPP can be used as a sensitive non-invasive simple marker for early diagnosis of cardiovascular disease in pregnant woman.

ATYPICAL HEMOLYTIC-UREMIC SYNDROME IN GENERAL AND IN PREGNANCY

Atypical hemolytic-uremic syndrome (aHUS) is an ultra-rare (orphan) disease, a form of thrombotic microangiopathy, which arises from a disturbance of the activation of an alternative complement pathway. Pregnancy is a frequent trigger for the onset of obstetric aHUS. Against the background of the disease in pregnant women, there is a high risk of developing pre-eclampsia, acute renal damage and consequently maternal mortality. In the world over the past 5 years, the number of confirmed cases of aHUS has increased. However, this is due not so much to the increase in the occurence of the disease as to the improvement in the methods of its diagnosis. The genetic nature of the aHUS dictates the need to create modern sensitive tests for the study of the complement system: measurement of the plasma concentration of factor H and factor I, C3, C4, genetic screening of regulatory genes, and others. It is also necessary to develop new drugs that, along with Eculizumabum (Soliris®, Alexion Pharmaceuticals, Cheshire, CT, USA) would be used in the therapy of aHUS.

The burden of infant group B streptococcal infections in Ontario: Analysis of administrative data to estimate the potential benefits of new vaccines

ABSTRACTGroup B streptococcus (GBS) is a leading bacterial cause of neonatal sepsis and meningitis in many countries as well as an important cause of disease in pregnant women. Currently, serotype-specific conjugate vaccines are being developed.We conducted an epidemiological analysis of health administrative data to estimate the burden of infant GBS disease in Ontario, Canada and combined these estimates with literature on serotype distribution to estimate the burden of disease likely to be vaccine-preventable.Between 1st January 2005 and 31st December 2015, 907 of 64320 health care encounters in Ontario in patients under 1 year old had codes specifically identifying GBS as the cause of the disease, of which 717 were under one month of age. In addition, application of epidemiological data to the remaining patients allowed us to estimate a further 2322 cases and among them 1822 were under one month of age. In the same period, 579 confirmed neonatal invasive GBS cases in patients up to one month of age were reported to public health. Depending on serotype distribution, vaccination coverage and early versus late onset disease (0–6 days and 7–90 days of age respectively), the preventable fraction ranged widely. With a vaccine that is 90% effective and 60% immunization coverage, up to 52% of early and late onset disease could be prevented by forthcoming vaccines.GBS is under-reported in Ontario. Uncertainty about the potential impact of vaccine indicates that further analysis and research may be needed to prepare for policy-decision making, including clinical validation studies and an economic evaluation of GBS vaccination in Ontario.

Seroprevalence of Maternal and Cord Antibodies Specific for Diphtheria, Tetanus, Pertussis, Measles, Mumps and Rubella in Shunyi, Beijing

Maternal antibodies contribute to the protection of young infants from infectious diseases during the early life. However, vaccinations for women of child-bearing age are not routine in China. Therefore, we investigated the level of protective immunity against vaccine preventable diseases in pregnant women and newborns in China. A total of 194 paired maternal and cord blood samples were collected in Beijing from 2016 to 2017. Antibodies specific for the antigens covered by diphtheria-tetanus-pertussis (DTP) and measles-mumps-rubella (MMR) vaccine were determined by ELISA (Euroimmun, Lübeck, Germany). The cut off value of ≥0.1 IU/ml (anti-diphtheria), >0.1 IU/ml (anti-tetanus), >40 IU/ml (anti-pertussis toxin), ≥200 IU/l (anti-measles), ≥45 RU/ml (anti-mumps) and ≥10 IU/ml (anti-rubella) were used to assess the percentage of newborns with protective IgG concentrations, respectively. The results revealed that 61.3%, 73.2%, 97.4%, 30.4%, 65.5% and 17.0% of newborns had no protection against diphtheria, tetanus, pertussis, measles, mumps and rubella. Only 1.0% and 23.7% of newborns had protection against all three components of DTP or MMR, respectively. The finding suggested that most of newborns were susceptible to diphtheria, tetanus, pertussis and mumps, almost one-third of this population had no immune protection against measles, and about one-sixth of them were under threat of rubella infection. These data supported the immunization program for DTP and MMR vaccine in women at child-bearing age.

Cardiac Drugs in Pregnancy

AbstractHeart disease complicating pregnancy is an indirect cause of maternal mortality and its incidence in India is 1 to 4%. Cardiac disease in pregnant women is most commonly due to rheumatic heart disease (RHD), congestive heart failure, and less commonly due to ischemic heart disease or cardiomyopathy. Though the frequency of RHD has decreased worldwide, it is still predominant in developing countries such as India. Around 15 to 52% of cardiac abnormalities first diagnosed during routine antenatal checkups or due to the signs and symptoms caused by physiologic changes of pregnancy. The most common clinical features of cardiac lesions such as breathlessness, pedal edema, and murmurs that mimic normal physiologic changes in pregnancy pose a diagnostic difficulty for obstetricians.

Maternal Serum Uric Acid as an Index of Perinatal Outcomes in Severe Preeclampsia

Preeclampsia is a multisystem disorder characterized by gestational hypertension after the 20th week of gestation with proteinuria, is common and dangerous adverse event of pregnancy. Several studies reported relationship between uric acid concentrations and severity of disease in pregnant women. The objective of this study was to explore the relation between serum uric acid level and perinatal outcomes. A case–control study conducted in Sulaimani Maternity Teaching Hospital from January 2014 to July 2014. Included 100 pregnant women in third trimester with signs and symptoms of labour, who had no comorbid diseases. Grouped to 30 control without hypertension, 30 with pregnancy induced hypertension (PIH) and 40 with severe preeclampsia based on clinical and laboratory evaluation. SPSS v21 was used for obtain mean, standard deviation, frequency and percentage. One way ANOVA test used to obtain P value with consider &lt;0.05 significant value. Results show serum uric acid mean and standard deviation (±SD) for control, PIH and severe preeclampsia groups were (5.83 ± 9.544), (4.35 ± 1.372) and (7.59 ± 0.508) respectively. The positive and significant (˂ 0.001) correlation coefficient was found between high serum uric acid level and oligohydramnios, low birth weight and low Apgar score. The highest level of serum uric acid was recorded in preeclampsia group and the lowest level was in PIH group. Significant and adverse perinatal outcomes relation were noted in the patients with high serum uric acid (&gt;7 mg/dl); decreased amniotic fluid index (AFI), caused low birth weight and low Apgar score. In&#x0D; &#x0D; conclusion that severity of illness in pregnant preeclampsia cases can be estimated by serum uric acid level and high serum uric acid indicate high risk cases. Maternal serum uric acid is a useful index for estimate fetal health status and predict neonate outcomes.