Duration Of Pregnancy Research Articles

Reproductive outcomes after fertility-sparing surgery for cervical cancer - results of the multicenter FERTISS study

IntroductionFertility-sparing treatment (FST) for patients with cervical cancer intends to achieve oncologic outcomes comparable to those after radical treatment while maximizing reproductive outcomes, including the ability to conceive and minimizing the risk of prematurity. MethodologyInternational multicentre retrospective FERTISS study focused on patients treated with FST analysed timing of FST relative to pregnancy, conception attempts and methods, abortion rates, prophylactic procedures reducing the risk of severe prematurity, pregnancy duration, and delivery mode. ResultsOf the 733 patients treated at 44 centres in 13 countries, 49.7% attempted to conceive during median follow-up of 72 months and 22.6% (166/733) patients achieved a successful pregnancy. Success rate was significantly higher after non-radical surgery (63.2%; 122/193) compared to radical trachelectomy (25.7%; 44/171, p < 0.001). Available perinatological data shows that 89.5% (111/124) of the patients became pregnant naturally. There was no significant difference in the abortion rate in the first pregnancy nor delivery success rates between non-radical and radical procedures patients. Preterm delivery (<38 weeks gestation) occurred more frequently after radical than non-radical procedures (76.5% vs. 57.7%, p = 0.15). Almost all patients (97.3%; 73/75) who underwent regular ultrasound cervicometry in pregnancy with subsequent prophylactic procedures delivered a live fetus, compared to 30.6% (15/49) women without such management, p < 0.001. ConclusionPatients who underwent non-radical surgery had significantly higher pregnancy rates. Most pregnancies resulted in a viable fetus, but radical trachelectomy led to a higher rate of preterm births in the severe prematurity range. Half of the patients did not attempt pregnancy after FST.

Cardiograms and Electrography Are Crucial Diagnostic Procedures In Pregnant Women

Certain examinations place significant emphasis on the gestation period. Strictly passing every examination is of utmost importance for every woman, as failure to do so may result in the birth of children with various deformed and incapacitating disorders. The diagnostic procedures of cardiotomy, electrocardiography, ultrasonography, doppler ultrasonography, and phenocardiography are highly significant for pregnant women. Every expectant mother should undertake these tests comprehensively. The duration of pregnancy and developmental abnormalities like as hypotrophy, hydrocephaly, and microcephaly can be determined using these techniques. Furthermore, these techniques facilitate the surveillance of the foetal placenta and the estimation of the water content, particularly in cases of multiple pregnancies. Sonography examination is safe for both the pregnant woman and the developing foetus. Today, X-ray diagnostics is seldom employed. However, this approach strictly relies on the use of the vagina as the sole means of assessing the state and abnormalities of the foetus, in the absence of ultrasound equipment.

Main etiological factors and comorbid pathology in severe cerebral palsy

Introduction The largest number of factors contributing to the development of cerebral palsy (CP) relate to the pre- and intranatal periods. Premature birth and low birth weight are the most important predictors of cerebral palsy and are associated with persistent brain and motor disorders. Purpose To evaluate the main etiological factors of severe cerebral palsy and comorbid pathology in children with severe motor disorders.Material and methods A retrospective observational study included 170 patients with severe forms of cerebral palsy, divided into two groups (85 subjects each) depending on motor disorders: GMFCS IV, GMFCS V. Perinatal risk factors for severe cerebral palsy were assessed, correlations between perinatal risk factors for expressed movement disorders and height/weight indicators, comorbid pathology in children at the time of admission to the trauma and orthopaedic hospital.Results Prenatal risk factors were responsible for the development of cerebral palsy in children in 71 % of cases. In the GMFCS IV group, gestational age had an inverse correlation with preterm birth (R = –0.53; R2 = 28 %). In the GMFCS V group, disorders caused by a shorter gestational age were interrelated with the duration of the antenatal period (R = –0.79; R2 = 62 %), and also directly correlated with delivery by cesarean section (R = 0.58; R2 = 34 %). Among the comorbid pathologies, eye diseases and psychological development disorders were most often detected.Discussion Low height/weight parameters of patients were due to comorbid pathology, rather than phenotypic constitutional features. Inverse correlation between the disorders caused by the gestational age, low birth weight and duration of pregnancy, risk of developing respiratory disorders, and a direct correlation with cesarean section seem logical. Severe conmobid diseases were more frequently diagnosed in patients with GMFCS V, indicating more extensive perinatal catastrophes in the central nervous system and the relationship between the developed pathology and severe motor disorders.Conclusions The main risk factors for the development of cerebral palsy in patients with severe GMFCS IV–V motor impairments are associated with the pre- and intranatal periods. Comorbid pathology of patients with severe forms of cerebral palsy is caused by severe brain damage and movement disorders that have developed against this background.

Colostrum conductivity, pH and Brix index as predictors of passive immunity transfer in foals.

Foal immunity relies heavily on the absorption of colostrum immunoglobulins; thus, colostrum evaluation is used to predict the transfer of passive immunity (TPI), and its conductivity is associated with TPI in cattle. Leading up to and at parturition, a reduction in colostrum pH and conductivity is thought to be necessary for TPI; however, this remains to be determined. To assess conductivity, pH, and Brix refractometer index of colostrum to predict the TPI in foals. Field study. The colostrum of 241 mares was assessed for conductivity, pH, and Brix index using handheld devices immediately after parturition. Twenty-hour postpartum foals had complete blood cell count and plasma IgG concentrations assessed. Foals were split in complete versus incomplete TPI (i.e., IgG ≥8 g/L vs. <8 g/L). Mare (breed, duration of pregnancy, parity, and age), foal (sex), and colostrum (conductivity, pH, and Brix index) data were computed to assess factors affecting TPI. Multivariate regression and receiver operating characteristic (ROC) curves were employed for analysis. Complete TPI was achieved in 89.4% of foals. The ROC TPI values were conductivity ≤5 mS/cm (AUC = 0.68), Brix ≥23.4% (AUC = 0.70), and pH ≤6.4 units (AUC = 0.73). The odds ratio for TPI in 24 h post-partum was 6.1 (2.1-17.1, 95% CI) for conductivity, 3.2 (1.2-9.3, 95% CI) for pH, and 4.5 (1.5-12.7, 95% CI) for Brix index. Sensitivity and specificity of 93% (88-96 95% CI), 56% (44-7, 95% CI), 92% (87-96, 95% CI), 28% (14-47, 95% CI), 94% (88-97, 95% CI) and 18% (14-47, 95% CI) for conductivity, Brix and pH, respectively. Low incidence of incomplete TPI. Conductivity, pH and Brix are strong predictors of foals that succeed in the transfer of passive immunity; however, all three presented low to moderate specificity. The established cutoff values obtained herein can be used on-field by other foaling programs. All three handheld devices used in the study are inexpensive and ready to use on-farm.

Alteration in sB7-H4 Serum Levels and Placental Biomarker Expression after Therapeutic Plasma Exchange in Early-Onset Preeclampsia Patients.

Therapeutic plasma exchange (TPE) is a widely used treatment for numerous diseases including pregnancy-related conditions. Our prior study on 20 early-onset preeclampsia patients undergoing TPE revealed a significant extension in pregnancy duration and reduced serum levels of sFlt-1, sFlt-1/PlGF, and sEndoglin. Here, we investigated the impact of TPE on serum sB7-H4, an immunological checkpoint molecule, and placental proteins (Flt-1, Eng, B7-H4, iNOS, TNF-α) in TPE-treated early-onset preeclampsia patients (N = 12, 23 + 2-28 + 5 weeks), conventionally treated counterparts (N = 12, 23 + 5-30 weeks), and gestational age-matched controls (N = 8, 22 + 4-31 + 6 weeks). Immunoblotting, ELISA, and co-immunohistochemistry were used for biomarker analysis, including placental inflammation factors (iNOS, TNF-α). The results showed that TPE extended pregnancy by a median of 6.5 days in this cohort of early-onset preeclampsia. Serum sB7-H4, sFlt-1, and sEndoglin levels decreased, along with reduced expression of their membrane-bound proteins in placental tissue upon TPE treatment. Moreover, TPE-treated patients displayed reduced placental inflammation compared to preeclampsia patients receiving standard-of-care treatment. In conclusion, TPE may improve pregnancy outcomes in early-onset preeclampsia by lowering circulating levels of sB7-H4, sFlt-1, and sEndoglin, as well as reducing placental inflammation. This translational approach holds promise for enhancing placental function and extending gestation in high-risk pregnancies including very preterm PE or HELLP cases.

Forensic assessment of maternal deaths from the COVID-19 during the 2021 pandemic

BACKGROUND: According to the literature, the mortality rate from SARS-CoV-2 infection among pregnant women is up to 25%. The high-risk group for the development of severe forms of COVID-19 includes pregnant women with extragenital pathology. Obstetric tactics are determined by the severity of the condition of the mother and fetus, as well as the duration of pregnancy. The decision on early delivery is made as a result of an interdisciplinary medical consultation. Delivery in the midst of the disease is associated with an increase in maternal mortality. According to the literature, including our own research, it has been established that the basis for favorable perinatal outcomes in patients with severe and moderate forms of COVID-19 is: an adequate assessment of the condition of the pregnant woman and fetus (especially at the outpatient stage, where the pregnant woman goes first), early hospitalization, early initiation of intensive care and timely delivery before the onset of irreversible organ changes in pregnant women. AIM: The aim of this study was to analyze the tactics of pregnancy management, delivery and perinatal outcomes, assessing the quality of medical care at the outpatient and hospital stages provided to pregnant women who died in a specialized obstetric hospital from the extremely severe new coronavirus infection COVID-19 (based on the data of commission forensic examinations). MATERIALS AND METHODS: This retrospective study of pregnancy outcomes was performed in 11 patients who died from complications of extremely severe COVID-19 in a regional specialized obstetric hospital in Russia based on the data of commission forensic examinations performed in the Bureau of Forensic Medical Examination (Saint Petersburg, Russia) in 2021, at gestation periods of 28–34 weeks (n = 7) and 37–39 weeks (n = 4) in the context of assessing the quality of medical care in the field of obstetrics and gynecology. We confirmed the diagnosis of the new coronavirus infection COVID-19 in 10 (90.9%) patients by SARS-CoV-2 RNA identification using polymerase chain reaction in a nasopharyngeal smear on an average of 4.9 ± 3.6 days from the onset of the disease. In one patient, the clinical diagnosis was confirmed postmortem by the detection of SARS-Cov-2 RNA during autopsy (in the trachea, lungs, and spleen). All patients in the hospital underwent a comprehensive anamnestic, clinical and laboratory examination in the amount regulated by the administrative regulations of the Ministry of Health of the Russian Federation that were relevant at the time of providing medical care. Nine (81.8%) patients sought medical help from a local therapist on 3.1 ± 1.6 days from the onset of the disease and received outpatient treatment for 3.4 ± 1.8 days, two patients not seeing a doctor and receiving outpatient care. The average time before admission to the specialized obstetric hospital was 6.0 ± 2.2 days from the onset of the disease. RESULTS: During the forensic assessment of the medical records of deceased patients, significant defects in the quality of medical care were identified in the framework of this study at the stages of information collection, diagnosis, treatment, and succession. An indirect causal relationship was established between the most significant defects in the quality of medical care and adverse pregnancy outcomes, since the cause of death or critical conditions were individually determined severe complications, rather than defects in medical care, which, nevertheless, does not exclude their significance in the totality of causes of severe maternal outcomes. CONCLUSIONS: The data obtained indicate the need for earlier delivery in pregnant women with the new coronavirus infection COVID-19 before the appearance of irreversible changes in patients with progressive respiratory failure, multiple organ failure syndrome, systemic inflammatory response syndrome, and cytokine storm.

Causal Inference Over a Subpopulation: The Effect of Malaria Vaccine in Women During Pregnancy.

Preventing malaria during pregnancy is of critical importance, yet there are no approved malaria vaccines for pregnant women due to lack of efficacy results within this population. Conducting a randomized trial in pregnant women throughout the entire duration of pregnancy is impractical. Instead, a randomized trial was conducted among women of childbearing potential (WOCBP), and some participants became pregnant during the 2-year study. We explore a statistical method for estimating vaccine effect within the target subpopulation-women who can naturally become pregnant, namely, women who can become pregnant under a placebo condition-within the causal inference framework. Two vaccine effect estimators are employed to effectively utilize baseline characteristics and account for the fact that certain baseline characteristics were only available from pregnant participants. The first estimator considers all participants but can only utilize baseline variables collected from the entire participant pool. In contrast, the second estimator, which includes only pregnant participants, utilizes all available baseline information. Both estimators are evaluated numerically through simulation studies and applied to the WOCBP trial to assess vaccine effect against pregnancy malaria.

Features of the dynamics of the reproductive cycle of female reindeer in the taiga and tundra zones

Reindeer remains one of the least studied animals from the point of view of genetics and reproduction of all animals that are use by humans in economic activities. In Russia, reindeer is use as a farm animal to produce environmentally friendly meat with high nutritional value. Reindeer is also the basis of economic activity for the indigenous peoples of the Arctic. Depending on the climatic zone, there are two methods of breeding reindeer - tundra and taiga. For more effective breeding and planning of reproduction work of this species of animals, it is necessary to have clear knowledge about the features of their reproductive cycle. Reindeer are animals with a pronounced seasonal reproduction; in addition, the timing of calving and rutting season can shift significantly depending on changes in weather conditions. According to researchers, the gestation period of northern females has a very high variability. The aim of this work was to conduct research on the differences in the timing of the beginning and end of the calving and rutting periods, their dynamics, as well as the duration of pregnancy in female reindeer in reindeer herding farms in the taiga and tundra climatic zones. To compare the dynamics and timing of calving and rutting, data were collected on the recording of matings and calvings in reindeer herding farms in the tundra zone of the Arctic regions of the Russian Federation (Taimyr Peninsula and Yamal Peninsula) and in the taiga zone (Buryatia). Because of the research, it was found that not only the timing of the rut, but also the timing of calving have differences in time in the tundra and taiga habitat zones of reindeer, in addition, they can shift even within the same climatic zone depending on weather conditions. The pregnancy period under unfavorable weather conditions can be shorten or extend.

Live weight peculiarities of the Tsigai breed young sheep during the suckling period in connection with the terms of sheep ewes’ gestation

The correlation of the Tsigai breed ewes’ gestation period with the patterns of growth and development of the sheep growing stock during the suckling period was explored in the article. The dates of inseminations and calvings were selected for analysis to calculate the duration of ewes' gestation and indicators of live weight of young animals at birth and at weaning with subsequent calculation of correlations between these traits. The average duration of the ewes’ gestation period is 157.76 ± 0.61 days (Cv=7.6%). The single-born ewe lambs of the No. 01684 line were higher in live weight by 6.9% (р ≤ 0.001), and higher in average daily gain by 6.0% (р ≤ 0.001) than the sample averages at weaning. The single-born ram lambs the No. 80077 line have a significant advantage in terms of live weight at weaning by 9.1% (р ≤ 0.01), and in terms of average daily gains by 11.8% (р ≤ 0.05). Single-born ram lambs of the No. 01684 and No. 66796 lines with a reduced live weight at birth grow more intensively: a significant advantage in terms of live weight at weaning and average daily growth, respectively, is 12.1% (р ≤ 0.001) and 9.6 % (р ≤ 0.01) higher in comparison with the average sample values. Twin ewe lambs of the No. 80077 line with a lower live weight at birth by 0.2% and an increased weight at birth by 0.4, the difference of which is also not reliable, nevertheless have a significant advantage in average daily growth compared to the average – by 9.1% (р ≤ 0.001), while the twin ram lambs have no significant difference in the indicators of the suckling period. Milkiness is negatively associated with the duration of pregnancy of ewes and positively with the lambs live weight at weaning period. In order to establish a line for increased multiplicity, it is necessary to select ewe lambs to be used in the replacement stock from twin litters in the line No. 80077. The increased live weight of young animals from single litters is formed by the parent livestock of No. 01684, 20832, 65204 and 80077 lines. The advantage of twin ram lambs in terms of live weight over the average values has not been proven.

Vitamin D concentration in the blood of women with twin pregnancies and in the umbilical cord blood of newborns in relation to environmental factors.

There is a huge gap in the knowledge of the body's nutrient resources in women with multiple gestations. Due to the increased demand hypothesis and taking into account common vitamin D deficits in women with singleton pregnancies, this issue should also be investigated in twin pregnancies. This study evaluated blood vitamin D concentration in women with twin pregnancies and in the umbilical cord blood of their newborns as well as analyzed environmental factors that may affect the level of this nutrient. The study included 56 women with twin pregnancies. Venous blood samples were collected from the women before delivery and umbilical cord blood at delivery to determine the total 25(OH)D concentration. The women were interviewed by a dietitian to collect data on their diet and lifestyle. The average maternal 25(OH)D concentrations were 38.4 ± 11.0 ng/mL vs. 23.7 ± 6.1 ng/mL determined in the umbilical cord blood of the newborns. The concentration of 25(OH)D in the umbilical cord blood was strongly correlated with the concentration in the mother (p < 0.001). Vitamin D deficiency was found in 7% of women and 21% of newborns. Factors increasing the risk of too low 25(OH)D concentration in the mothers were age below 27 years (p = 0.002) and short duration of pregnancy (p = 0.011). In newborns, the risk factors included low maternal concentrations (p < 0.001) and delivery before 36 weeks of gestation (p = 0.008). The mean cord blood 25(OH)D levels were almost identical in both twins and amounted to 24.0 ± 6.1 ng/mL in the first-born and 23.4 ± 6.1 ng/mL in the second-born infant. Vitamin D supplementation was declared by 98% of the women, with 85% taking ≤2,000 IU vitamin D daily. Only a small percentage of women with twin pregnancies presented with vitamin D deficiency, which was probably related to the widespread supplementation of this nutrient. It can therefore be assumed that a dose of 2,000 IU vitamin D currently recommended for pregnant women may also be appropriate for twin gestations, although further research is required to validate this finding.

The role of the RHOA/ROCK pathway in the regulation of myometrial stages throughout pregnancy

BackgroundControlling uterine contractile activity is essential to regulate the duration of pregnancy. During most of the pregnancy, the uterus does not contract (i.e., myometrial quiescence). The myometrium recovers its contractile phenotype at around 36 weeks (i.e., myometrial activation) through several mechanisms. The RHOA/ROCK pathway plays a vital role in facilitating muscular contractions by calcium sensitization in humans. Yet, the role of this pathway during different myometrial stages, including quiescence, has not been elucidated. Objectivewe aimed to study the role of the RHOA/ROCK pathway in the regulation of the different myometrial stages throughout pregnancy. Specifically, we hypothesized that the inhibition of the components of the RHOA/ROCK pathway play an important role in maintaining uterine quiescence. Study designMyometrial samples were obtained from pregnant individuals who underwent cesarean section. Pregnant individuals who delivered preterm without labor (myometrial quiescence), preterm with labor (nonphysiological myometrial stimulation), term not in labor (activation), and term in labor (physiological myometrial stimulation) were included. The mRNA and protein expression of RHOA, ROCK I, ROCK II, RND1-3, and ROCK activity through pMYTP1 were evaluated. ResultsWe found that the human myometrium constitutively expressed RHOA/ROCK pathway components throughout pregnancy. No changes in the components of the RHOA/ROCK pathway were found during quiescence. Moreover, the RHOA protein and ROCK activity increased in the myometrium during labor, supporting the hypothesis that this pathway participates in maintaining the contractile activity of the myometrium. This study provides insight into the role of the RHOA/ROCK pathway in controlling myometrial contractile activity during pregnancy.

Birth parameters and parental factors influence on breastfeeding incidence in Polish population across three decades.

Background: The purpose of the study was to select factors which importantly influencing the decision of breastfeeding in the first period of life over twenty years in the three cohorts in central Poland. Materials and methods: The analysis included 2159 children (1017 girls and 1142 boys). The data come from three cohorts investigated in the following years: 1993-1997, 2004-2008 and 2015-2017. In each cohort, parents completed questionnaires on the type of nutrition in the first months of life (breastfeeding versus formula feeding), child-birth parameters, duration of pregnancy, age and education of parents, and maternal smoking during pregnancy. Information about birth parameters, i.e., birth weight, birth length, birth head and chest circumference, gestational age (week of pregnancy) and Apgar score were taken from children's medical records. The Chi2 test, U-Mann Whitney test and logistic regression were performed to check which factors significantly affected mother decision of breastfeeding. Results: We observed differences between factors which favor breastfeeding among three investigated cohorts. The factors significantly associated with breastfeeding only in cohort 1993-1997 were: birth parameters (higher birth length, higher body mass and higher chest circumference) and lower prevalence of exposition to cigarettes smoke during pregnancy. However, independently on tested cohort the logistic regression model indicated that the following factors correlated with the lack of breastfeeding: lower gestational age (E = -0.1663, p = 0.0182), higher maternal age (E = 0.1326, p < 0.0001), lower paternal age (E = -0.0526, p = 0.0345), secondary paternal education (E = 0.5138, p = 0.0024) vs. higher, lower maternal education (E = 0.7577, p = 0.0003) vs. higher, other season of birth than summer (E = -0.3650, p = 0.0439). Conclusions: Factors influencing the mother's decision to breastfeed independently on tested cohort were as a following: parental education and parental age, season of birth and duration of pregnancy.

Intrauterine Shaping of Fetal Microbiota.

Mechanisms resulting from the physiological immaturity of the digestive system in children delivered before 32 weeks of gestation and, in particular, different interactions between the microbiome and the body have not been fully elucidated yet. Next-generation sequencing methods demonstrated the presence of bacterial DNA in the placenta and amniotic fluid, which may reflect bacterial populations that initiate intestinal colonization in utero. Numerous studies confirmed the hypothesis stating that intestinal bacteria played an important role in the pathogenesis of necrotizing enterocolitis (NEC) early- and late-onset neonatal sepsis (EONS and LONS). The model and scale of disorders within the intestinal microbiome are the subject of active research in premature infants. Neonatal meconium was primarily used as an indicator defining the environment in utero, as it is formed before birth. Metagenomic results and previous data from microbiological bacterial cultures showed a correlation between the time from birth to sample collection and the detection of bacteria in the neonatal meconium. Therefore, it may be determined that the colonization of the newborn's intestines is influenced by numerous factors, which may be divided into prenatal, perinatal, and postnatal, with particular emphasis put on the mode of delivery and contact with the parent immediately after birth. Background: The aim of this review was to collect available data on the intrauterine shaping of the fetal microbiota. Methods: On 13 March 2024, the available literature in the PubMed National Library of Medicine search engine was reviewed using the following selected keywords: "placental microbiome", "intestinal bacteria in newborns and premature infants", and "intrauterine microbiota". Results: After reviewing the available articles and abstracts and an in-depth analysis of their content, over 100 articles were selected for detailed elaboration. We focused on the origin of microorganisms shaping the microbiota of newborns. We also described the types of bacteria that made up the intrauterine microbiota and the intestinal microbiota of newborns. Conclusions: The data presented in the review on the microbiome of both term newborns and those with a body weight below 1200 g indicate a possible intrauterine colonization of the fetus depending on the duration of pregnancy. The colonization occurs both via the vaginal and intestinal route (hematogenous route). However, there are differences in the demonstrated representatives of various types of bacteria, phyla Firmicutes and Actinobacteria in particular, taking account of the distribution in their abundance in the individual groups of pregnancy duration. Simultaneously, the distribution of the phyla Actinobacteria and Proteobacteria is consistent. Considering the duration of pregnancy, it may also be concluded that the bacterial flora of vaginal origin dominates in preterm newborns, while the flora of intestinal origin dominates in term newborns. This might explain the role of bacterial and infectious factors in inducing premature birth with the rupture of fetal membranes.

Медико-психологічні предиктори емоційно-поведінкового періоду материнства

Being in a war area or during regular rockets or artillery attacks, the inability to leave the location of a pregnant woman or a woman in postpartum period can affected the psycho-emotional condition of a woman. Therefore, in today's context, attention should be focused on creating predictors and identifying factors that can negatively affect a pregnant woman, the duration of pregnancy and labor, and the postpartum period. During pregnancy, one of the physiological changes in a woman's body is a change in the functioning of the nervous system. This is because during the implantation of the blastocyst, several types of receptors send impulses to the central nervous system, where information is received, scanned and analyzed in the cerebral cortex and produces the phenomenon of increased excitability. As a result of physiological transformations of this increased excitability, due to physiological mechanisms, it is transformed and reduces the excitability of the nervous system for the formation of the embryo and its complementary structures. As a result, pregnant women may experience psycho-emotional changes, sometimes with an unstable duration, mood changes, fatigue or drowsiness, sometimes obsession with pregnancy and worries about the correct growth of the fetus in the womb or various effects or nutritional factors (consumption or exclusion of certain foods or drinks) that may negatively affect it. The factors affecting the psycho-emotional condition during pregnancy (prenatal period) are identified and analyzed: external, social, economic, physiological, psychological, emotional and willed. The factors affecting the psycho-emotional well-being of women in the postnatal period are analyzed: medical, emotional and psychological, and communicative.

Subacute thyroiditis during pregnancy: clinical characteristics of seven cases.

There are few reports of subacute thyroiditis (SAT) during pregnancy. This study aimed to clarify the clinical characteristics of SAT in pregnant patients. Seven patients diagnosed with SAT during pregnancy at our institution from January 2004 to December 2021 were identified, and their clinical findings were retrospectively examined. At SAT diagnosis, the median age was 34 (range: 31-42) years, the median duration of pregnancy was 5 (4-24) weeks, and all patients had neck pain but no fever. On laboratory examination, median (range) free thyroxine, free triiodothyronine, and C-reactive protein levels were 2.66 (1.14-7.77) ng/dL, 7.1 (3.3-16.1) pg/mL, and 2.22 (0.42-5.79) mg/dL, respectively, and all patients had a hypoechoic lesion of the thyroid gland. Three patients (43%) were treated with steroids, and three patients (43%) received replacement therapy with levothyroxine for hypothyroidism following destructive thyroiditis. There were no pregnancy complications in any of the cases. These seven patients (pregnancy group) were compared with 217 non-pregnant female patients (non-pregnancy group) aged 31 to 42 years who were diagnosed with SAT at our institution from 2016 to 2019. The frequency of body temperatures above 37°C was lower in the pregnancy group than in the non-pregnancy group (0% vs 65%). Patients who develop SAT during pregnancy may have less fever than non-pregnant patients with SAT. There were no pregnancy complications in the pregnancy group in this study. This suggests that adverse pregnancy outcomes may be avoided by the appropriate management of SAT, including hypothyroidism after destructive thyroiditis.

The effect of Orem's Self-Care Deficit Theory-based care during pregnancy and postpartum period on health outcomes: A systematic review and meta-analysis.

To examine the effect of the provision of care on health outcomes when provided based on Orem's Self-Care Deficit Theory during perinatal period. The perinatal period is a process with multidimensional care needs for the mother, baby and family. Care based on nursing theories can improve the quality of perinatal care. A systematic review and meta-analysis. Studies on this topic from 2006 to 2020 have been accessed by nine database searches. The methodological quality of the studies was assessed using the Critical Appraisal Checklists for experimental and quasi-experimental studies, developed by the Joanna Briggs Institute. This study was conducted by following the Preferred Reporting System for Systematic Reviews and Meta-Analyses. This systematic review included nine studies with a total sample size of 839 women. These studies showed that care based on Orem's theory significantly helped prolong the mean duration of pregnancy, reduced the incidence of preterm labor, improved hygiene behaviour and increased empowerment. Concerning the perinatal period, this intervention significantly improved self-care and readiness for hospital discharge, adaptation and breastfeeding self-efficacy and reduced nipple pain and pain due to abdominal distension. The implementation of this theory into care during the perinatal period can contribute to improved health outcomes. What is already known about this topic? The quality of pregnancy and postpartum care is important for the maternal health. The use of nursing theories-which nursing knowledge is produced-improves care quality and ensures that care is organized systematically. What this paper adds? There is insufficient research that supports Orem's theory of self-care deficit in pregnancy and postpartum care and also no systematic review about this topic, but the current meta-analysis showed that postnatal and prenatal treatments based on Orem's theory have a positive impact on the self-care agency. The implications of this paper: The use of Orem's theory helps nurses understand women and their needs during pregnancy and postpartum periods. Integrating Orem's theory of self-care deficit into pregnancy and postpartum nursing care services can help increase women's self-care power.

A Situational Overview of Prenatal Screening Services in Bhutan

ABSTRACTPrenatal genetic testing is to determine the possibility of the fetus having a genetic aberration or birth defect. Prenatal screening consists of serum analytes screening with or without nuchal translucency (NT) scanning or with cell‐free DNA (CfDNA) screening. Prenatal screening is recommended for all pregnant women regardless of the duration of pregnancy and maternal age or baseline risk. It is not advisable to screen with serum analytes and CfDNA concurrently to avoid discordant results. In developed countries, prenatal testing has been a part of routine antenatal care for a long time with adopting newer methods of screening and testing. In Bhutan, since the integration of the Safe Motherhood Program into primary healthcare in 1994, there has been an unprecedented improvement in obstetric care services. Almost all pregnant women attend antenatal and postnatal care, and 98.5% of deliveries are attended by trained health workers. The maternal mortality has reduced to 53 in 2023 from 770 per 100,000 live births in 1984 and the neonatal dealth has reduced to 15.2 per 1000 live births in 2023. However, despite improvements in the care of pregnant women, many babies are detected with congenital anomalies, syndromes, and birth defects during the postnatal period. Bhutan, being an underdeveloped country, could not initiate any form of prenatal testing program except for the anatomical scanning performed at 18–22 weeks of gestation. Early ultrasound dating scans, limited anomaly scanning, and growth scanning are offered to all pregnant women. There is a need to start centralized prenatal testing services in Bhutan to provide a comprehensive package of obstetric care to pregnant women. In addition, legal rights for parents to terminate severely deformed fetuses or severe genetic diseases before 24 weeks of pregnancy need to be established.

Влияние теплового стресса на оплодотворяемость и многоплодие свиноматок

Abstract. The study of the effect of heat stress on the reproductive parameters of pigs is an urgent problem all over the world. Knowing the degree of influence of heat stress on pigs of different breeds will allow you to choose economically sound solutions to this problem in specific conditions. The propose is to study the effect of heat stress on some indicators of reproduction of sows of different breeds (large white, landrace, duroc, MAXGRO). Methods. The study was conducted on a large pig breeding complex. The material for the analysis was data on changes in air temperature in the breeding farm in the period from June to August (13 weeks) and data on the fertilization and duration of pregnancy of sows fertilized during this period and the size of the offspring obtained from them. Scientific novelty. For the first time, a comparative analysis of the effect of heat stress on fertilization, duration of pregnancy and the size of the offspring of sows of four breeds – large white, landrace, duroc, MAXGRO – was carried out on a wide population of pigs. Different sensitivity of sows to heat stress was revealed. Results. From the 4th to the 6th week of the experiment, the sows were in a state of increasing heat stress – the average daily temperature during this period increased to 27.68 ± 1.36 °C. The negative effect of hyperthermia on fertilization was recorded with a delay of 1–3 weeks, depending on the breed. The most sensitive to heat stress were sows of the duroc breed – fertilization decreased by 25.00 % compared to the pre-stress period, the least – sows of the large white breed – fertilization decreased by 9.82 %. The duration of pregnancy was not affected by heat stress. As well as fertilization, heat stress had a negative effect on the size of the litter. The most sensitive were sows of duroc and MAXGRO breeds – the litter size decreased by 3.77 and 3.61 heads compared to the pre-stress period, the least – sows of the large white breed, the size of the litter decreased by 0.38 heads. duroc sows are the most sensitive to heat stress, then, according to sensitivity reduction, MAXGRO, landrace and large white.

Predictors, prevalence and outcome of hypertensive disorders in pregnancy in Nigerian tertiary health facilities.

Determine prevalence, risk factors and outcomes of hypertensive disorders in pregnancy (HDP). Cross-sectional analysis of data captured in the Maternal and Perinatal Database for Quality, Equity and Dignity (MPD-4-QED) between September 2019 and August 2020. Fifty-four referral level facilities in Nigeria. Women whose pregnancy ended (irrespective of the location or duration of pregnancy) or who were admitted within 42 days of delivery. Descriptive statistics and multilevel mixed-effects logistic regression models. Prevalence of HDP, sociodemographic and clinical factors associated with HDP and perinatal outcomes. Among the 71 758 women 6.4% had HDP and gestational hypertension accounted for 49.8%. Preeclampsia and eclampsia were observed in 9.5% and 7.0% of all pregnancies, respectively. The predictors of HDP were age over 35 years (OR1.96, 95% CI 1.82-2.12; p < 0.001), lack of formal educational (OR 1.18, 95% CI 1.06-1.32; p = 0.002), primary level of education (OR 1.20, 95% CI 1.03-1.4; p < 0.002), nulliparity (OR 1.21, 95% CI 1.12-1.31; p < 0.001), grand-multiparity (OR 1.36, 95%CI 1.21-1.52; p < 0.001), previous caesarean section (OR 1.26, 95%CI 1.15-1.38; p < 0.001) and previous miscarriage (OR 1.22, 95% CI 1.13-1.31; p < 0.001). Overall 3.7% of the patients with HDP died, with eclampsia having the highest case fatality rate of 27.9%. Stillbirth occurred in 11.9% of pregnancies with hypertensive disorders. Hypertensive disorders in pregnancy are not uncommon in Nigeria. They are associated with adverse outcomes with over one-quarter of women with eclampsia dying. The main predictors include older age, poor education, extremes of parity and previous CS or miscarriage. Maternal and perinatal outcomes are poor with about a quarter developing complications and about 1 in 10 having stillbirths.

Women’s health in focus: Real-world data on valproate prescriptions during pregnancy – a cohort study in Catalonia (Spain)

ObjectivesTo characterise the exposure to valproate within a cohort of pregnant women using electronic health records (EHRs) from Catalonia (System for the Development of Research in Primary Care, SIDIAP).DesignDrug-utilisation cohort...