Final Trimester Of Pregnancy Research Articles

The Effect of Endorphin Massage with Jasmine Oil on Severe Back Pain Experienced in the Third Trimester of Pregnancy: A Case Study

Back pain is a common complication during the final trimester of pregnancy. This pain, which begins in the early stages, intensifies in the third trimester due to the enlargement of the uterus and pressure on the skeletal system. One method to alleviate back pain is endorphin massage. Objective: To evaluate the effect of endorphin massage using jasmine oil on a primiparous pregnant woman at the 30th gestational week experiencing back pain. Method: This clinical case study involved applying endorphin massage combined with jasmine oil to the entire back and sacral region of a primiparous woman in her third trimester for a total of 6 sessions over 12 days, every other day, each lasting 20 minutes. Data were collected using the Demographic Characteristics Form and the Brief Pain Inventory (BPI), and the scores were compared. Results: Analysis of the 1st and 6th applications of the massage showed a decrease in the woman’s severe back pain over time. The non-pharmacological approach was well-received by the pregnant woman, enhancing communication between the midwife and herself. The woman reported taking the recommendations more seriously. Conclusion: The study observed that endorphin massage with aromatherapy reduced severe back pain and positively affected emotional well-being. It is recommended as a safe, non-invasive, easy-to-apply, and cost-effective method in midwifery care. Further evidence-based research is suggested to generalize the benefits of jasmine oil back massage for pregnant women.

The unheard voices of academia: overcoming systemic barriers and fostering inclusive spaces for knowledge exchange

Our paper aims to consider how hybrid academic conferences can create inclusive spaces for knowledge exchange. The paper begins by considering the purpose of academic conferences and identifying the groups of people excluded when conferences are run in an in-person-only format. Reasons for exclusion include being disabled, being a carer, being unable to travel (e.g. in the final trimester of pregnancy), being unable to secure a VISA, or being unable to access funds to cover travel and accommodation costs. Next, we consider the existing challenges that individuals and event organizers face concerning academic conferences. Then, pragmatic opportunities for event organizers are presented, making the case for running conferences in a hybrid format. The paper concludes with a call to action for promoting care democracy in the workplace by addressing the humanity deficit and the unheard voice of academics currently excluded from in-person-only academic conferences.

The Effect of Pelvic Rocking on Back Pain Intensity in Third Trimester Pregnant Women

Pregnancy is a physiological process. The most common complaint at the end of the trimester is lower back pain. These complaints will increase in the final trimester of pregnancy, resulting in disrupted daily routine. Various reports state that in pregnant women it is recorded that about 50% of women experience back pain and about 10% of women with chronic back pain begin during pregnancy. Lower back pain is experienced a lot when entering the 6th month of pregnancy. The purpose of this study was to prove that hip rocking has an effect on the intensity of back pain in the third trimester of pregnant women. The research design was a quasi-experiment with one group pretest-postest design. The sample in this study were 21 respondents of third trimester pregnant women. Observation sheet research instrument. The results were analyzed using the Wilcoxon signed ranking statistical test. The results showed that pelvic sway was able to significantly reduce the intensity of back pain in third trimester pregnant women. Therefore, third trimester pregnant women can be given hip rocking therapy as an alternative to non-pharmacological interventions to reduce back pain during pregnancy.

Association of continuity of carer and women's experiences of maternity care during the COVID-19 pandemic: A cross-sectional survey

BackgroundRecent research highlights the impact of the COVID-19 pandemic on maternity services, although none to date have analysed the association between continuity of carer and how women felt about the changes to pregnancy care and birth plans. AimTo describe pregnant women's self-reported changes to their planned pregnancy care and associations between continuity of carer and how women feel about changes to their planned care. MethodsA cross-sectional online survey of pregnant women aged over 18 years in their final trimester of pregnancy in Australia. Findings1668 women completed the survey. Most women reported at least one change to pregnancy care and birthing plans. Women receiving full continuity of carer were more likely to rate the changes to care as neutral/positive (p<.001) when compared with women who received partial or no continuity. DiscussionPregnant women experienced many changes to their planned pregnancy and birth care during the COVID-19 pandemic. Women who received full continuity of carer experienced fewer changes to care and were more likely to feel neutral/positive about the changes than women who did not receive full continuity of carer.

Microbial diversity in the vaginal microbiota and its link to pregnancy outcomes

The vaginal microbiota refers to the microorganisms that reside in the vagina. These microorganisms contribute significantly to a woman’s reproductive and general health. A healthy vaginal microbiota is typically a low-diversity environment with a predominance of lactic acid-producing Lactobacillus species. Factors such as antibiotic use, sexual activity, and hormonal changes can disrupt the balance of the vaginal microbiota, leading to conditions such as bacterial vaginosis. The composition of the vaginal microbiota changes and takes on added importance during pregnancy, serving as a barrier against infection for both mother and fetus. Despite the importance of the microorganisms that colonize the vagina, details of how changes in composition and diversity can impact pregnancy outcomes is poorly understood. This is especially true for woman with a high prevalence of Gardnerella vaginalis. Here we report on a diverse cohort of 749 women, enrolled in the InSPIRe cohort, during their final trimester of pregnancy. We show that Lactobacilli, including L. crispatus are important in maintaining low diversity, and that depletion in this critical community is linked with preterm delivery. We further demonstrate that it is overall diversity of the vaginal microbiota, not specific species, which provides the best indicator of risk.

Factors associated with secretory IgA levels in colostrum and breastmilk

Background Secretory IgA (sIgA) content of breastmilk in the first postpartum month is a reflection of the pregnant woman's immune response to environmental antigen exposure. The role of secretory IgA in breastmilk is to protect and support the development of the neonatal immune response in early life.&#x0D; Objective To examine possible factors associated with sIgA levels in breastmilk and colostrum, including environmental exposure, food consumed, maternal history of atopy, and the appearance of allergic symptoms in infants. As a secondary objective, we determined the association between infant factors (IgE, exposure to cigarette smoke) and maternal factors (sIgA, maternal allergies) with infant allergies.&#x0D; Methods This prospective cohort study of 80 postpartum mothers and their infants was conducted at Sultan Agung Islamic Hospital, Semarang. We collected maternal colostrum on the second or third postpartum day and mature milk between the 22nd to 25th postpartum day. Exposure factors to mothers and infants in the final trimester of pregnancy up to one month postpartum was recorded through a questionnaire and home visits. The infant’s IgE level was measured at 4 months of age.&#x0D; Results Mean colostrum sIgA was 108.9 (SD 16.5) mg/dL (95%CI 97.9 to 121.1 mg/dL) and mean mature milk sIgA was 94.1 (SD 23.9) mg/dL (95%CI 89.1 to 99.2 mg/dL). Mean colostrum sIgA levels were higher in mothers exposed to cigarette smoke [119.1 (SD 1.7) vs. 92.9 (SD 1.5) mg/dL; P=0.026] and frequent infections [128.2 (SD 1.7) vs. 95.9 (SD 1.6) mg/dL; P=0.007] compared to that in unexposed mothers. Mean colostrum sIgA was also higher in mothers with atopic allergy than in those without (136.8 mg/dL vs. 99.3 mg/dL; p=0.017) and in mothers of infants with IgE levels &gt;29 IU/ml than in mothers of infants with IgE levels &lt;29 IU/mL (136.8 vs. 101.2 mg/mg/dL; P=0.045). Elevated colostrum sIgA (&gt;136.8 mg/dL) was not associated with allergies in the infants (P=0.269).&#x0D; Conclusions Maternal atopic allergy and frequent infections are associated with increased colostrum sIgA levels. Breastmilk sIgA levels are not associated with allergies in the infant. Maternal exposure to antigens may stimulate the production of specific breastmilk sIgA.

Placental Development and Physiological Changes in Pregnant Ewes in Silvopastoral and Open Pasture Systems during the Summer.

This study aimed to analyze the reproductive and physiological changes in ewes subjected to heat stress during pregnancy at UTFPR-Brazil. Twenty-four pregnant crossbred ewes were kept in a silvopastoral system (SP) or an open pasture system (OP) throughout the final trimester of pregnancy. Both systems were stressful, but the SP system had lower air temperature than the OP system (26.0 ± 0.38 and 26.9 ± 0.41 °C, respectively; p = 0.0288). Moreover, the radiant thermal load of the two groups presented a difference of 34 Wm-2 (p = 0.0288), and the grass temperature was also lower in the SP system compared to that in the OP system (23.4 ± 0.37 and 25.6 ± 0.44 °C, respectively; p = 0.0043). The respiratory and heart rates of animals from the OP group were higher than those from the SP group (p < 0.001), but no difference was observed in the mobilization of white blood cells (p = 0.4777), and the neutrophil count was only affected by time (p < 0.0001). As regards placental biometry, placentas in twin pregnancies had a greater membrane area (p = 0.0223), but no differences between the systems were observed in placental weight (p = 0.1522) and the number of cotyledons (p = 0.5457). We concluded that the type of rearing system used affects the thermal comfort of pregnant ewes, and that an SP system can offer more amenable microclimatic conditions, which result in greater comfort for the ewes.

Neonatal Docosahexaenoic Acid in Preterm Infants and Intelligence at 5 Years

BackgroundDocosahexaenoic acid (DHA) is a component of neural tissue. Because its accretion into the brain is greatest during the final trimester of pregnancy, infants born before 29 weeks’ gestation do not receive the normal supply of DHA. The effect of this deficiency on subsequent cognitive development is not well understood.MethodsWe assessed general intelligence at 5 years in children who had been enrolled in a trial of neonatal DHA supplementation to prevent bronchopulmonary dysplasia. In the previous trial, infants born before 29 weeks’ gestation had been randomly assigned in a 1:1 ratio to receive an enteral emulsion that provided 60 mg of DHA per kilogram of body weight per day or a control emulsion from the first 3 days of enteral feeds until 36 weeks of postmenstrual age or discharge home, whichever occurred first. Children from 5 of the 13 centers in the original trial were invited to undergo assessment with the Wechsler Preschool and Primary Scale of Intelligence (WPPSI) at 5 years of corrected age. The primary outcome was the full-scale intelligence quotient (FSIQ) score. Secondary outcomes included the components of WPPSI.ResultsA total of 1273 infants underwent randomization in the original trial; of the 656 surviving children who had undergone randomization at the centers included in this follow-up study, 480 (73%) had an FSIQ score available — 241 in the DHA group and 239 in the control group. After imputation of missing data, the mean (±SD) FSIQ scores were 95.4±17.3 in the DHA group and 91.9±19.1 in the control group (adjusted difference, 3.45; 95% confidence interval, 0.38 to 6.53; P=0.03). The results for secondary outcomes generally did not support that obtained for the primary outcome. Adverse events were similar in the two groups.ConclusionsIn infants born before 29 weeks’ gestation who had been enrolled in a trial to assess the effect of DHA supplementation on bronchopulmonary dysplasia, the use of an enteral DHA emulsion until 36 weeks of postmenstrual age was associated with modestly higher FSIQ scores at 5 years of age than control feeding. (Funded by the Australian National Health and Medical Research Council and Nu-Mega Ingredients; N3RO Australian New Zealand Clinical Trials Registry number, ACTRN12612000503820.)

A diverse diet as an alternative to ryegrass can improve the total antioxidant status of dams at lambing

The objective of this experiment was to determine if providing ewes in the final trimester of pregnancy with choice from diverse diet components would reduce markers of oxidative and metabolic stress in ewes and improve lamb birth weights relative to ewes offered only one forage species, repetitively. Fifty-four, twin bearing Coopworth ewes [initial live weight (LW) = 69.82 ± 1.16 kg] were blocked by weight onto iso-energetic diets with either choice from taxonomically diverse plants [DIV; spatially separated strips of ryegrass (Lolium perenne L.), chicory (Cichorium intybus L.), plantain (Plantago lanceolata L.), red clover (Trifolium pratense L.), and alfalfa (Medicago sativa L.)] or a ryegrass only diet (RYE) for the final third of gestation. The ewes offered the DIV diet birthed 8.9% heavier lambs (5.64 ± 0.20 kg) than RYE ewes (5.18 ± 0.20 kg; P = 0.03). In addition, the DIV ewes had greater (P &amp;lt; 0.01) glutathione peroxidase and total antioxidant status, and lower (P = 0.01) plasma non-esterified fatty acid concentrations than the RYE fed ewes 24 h after lambing. The results indicate that the DIV diet can improve antioxidant status and reduce some markers of oxidative and metabolic stress at lambing compared to a conventional RYE diet.

O93 - Association of continuity of carer and women’s experiences of maternity care during the COVID-19 pandemic: A cross-sectional survey

BackgroundRecent research highlights the impact of the COVID-19 pandemic on maternity services, although none to date have asked women how they feel about the changes to care or analysed the association between continuity of carer and women’s experiences.AimThe aim of our research was to discover pregnant women’s self-reported changes to their planned care and associations between continuity of carer and how women felt about changes to their planned care.MethodsA cross-sectional online survey of pregnant women aged over 18 years in their final trimester of pregnancy in Australia was undertaken.Results1668 women completed the survey. Most women reported at least one change to pregnancy care and birthing plans. Women receiving full continuity of carer were more likely to rate the changes to care as positive (p<0.001) when compared with women who received partial or no continuity.ConclusionsPregnant women experienced many changes to their planned pregnancy and birth care during the COVID-19 pandemic. Women who received full continuity of carer experienced fewer changes to care and were more likely to feel positive about the changes than women who did not receive full continuity of carer. Our study demonstrates that women are better together through continuity of carer models.

Neurological factors and Cesarean section in Australian women with epilepsy

ObjectivesTo analyze the records of the pregnancies of 2283 Australian women with epilepsy in the Australian Register of Antiepileptic Drugs in Pregnancy database to identify neurological factors relevant to the Cesarean sections carried out in these pregnancies. ResultsThe Cesarean section rate in Australian women overall increased by an average of 0.59% annually over 20 years, from 26.0% to its calculated 2020 value of 37.3%. For the operations in women with epilepsy, the corresponding figures were 0.71% annually, and 34.4% and 48.7%. The average annual rate of increase for pre-labor operations was 0.89% to a 2020 value of 39.1%, the annual rate for operations during labor showing no statistically significant change. Multivariate regression analysis identified a number of characteristics of women with epilepsy that were statistically significantly associated with an increased likelihood of Cesarean section, but of these only seizures continuing to occur in the third trimester and having chronic illness, in particular migraine, were neurological ones. In 70 migraine-affected women, the Cesarean section rate was 51.4%, compared with 39% in the remaining pregnancies (P < 0.05). ConclusionsHaving seizures in the final trimester of pregnancy and having chronic neurological illness, especially migraine, favored Cesarean section being carried out in Australian women with epilepsy, but did not adequately account for the increasing rates of occurrence of the operation over the past 20 years.

Feed restriction and supplementing with propylene glycol, monensin sodium and rumen-protected choline chloride in periparturient Ghezel ewes: Implications on production and performance of ewes and their offspring

This study was conducted to evaluate the effects of supplementation of propylene glycol, monensin sodium and rumen-protected choline chloride to the late gestational restricted diet on milk production and composition, rumen fermentation and dry matter intake of ewes and their offspring performance. During the final trimester of pregnancy, 48 Ghezel ewes were randomly assigned to one of the 6 treatments: ad libitum feeding (CG, control); feed restriction (FR, 60% of ad libitum intake); feed restriction + propylene glycol (67 g/d) (FR-PG); feed restriction + propylene glycol + monensin sodium (30 mg/d) (FR-MS); feed restriction + propylene glycol + rumen-protected choline chloride (6 g/d) (FR-RPC); feed restriction + propylene glycol + monensin sodium + rumen-protected choline chloride (FR-PMC). Milk samples were collected during the first 4 weeks of lactation and analyzed for fat, protein and solids non-fat contents. Ruminal fluid was sampled on day 125 of pregnancy for the determination of volatile fatty acids and ammonia-nitrogen concentration. Dry matter intake of ewes was calculated daily according to the differences between feed provided and refused. The average daily gain of lambs was recorded until 30 days postnatal and weight on day 87 was considered as weaning weight. The data were analyzed in a completely randomized design using SAS v.9.3. The results showed that FR-RPC and FR-PMC ewes presented approximately a higher milk production (P < 0.05), milk protein and solids non-fat percentages (P < 0.01) than other ewes in almost all recording points. During the first and second weeks of lactation, the milk produced by FR ewes had the lowest fat percentage among all experimental groups (P < 0.0001). The lowest ruminal pH and ammonia-nitrogen concentration was found in FR and FR-MS ewes (P < 0.0001). Ewes in the CG and FR groups produced lower levels of total volatile fatty acids than other experimental groups (P < 0.0001). Besides, compared with other treatments, choline chloride supplementation caused a higher molar proportion of propionate (P < 0.001) while FR treatment resulted in a higher acetate production (P < 0.001) and acetate to propionate ratio (P < 0.01) compared to FR-RPC and FR-PMC treatments. Lambs born from FR-RPC ewes presented a greater average daily gain than those born from other ewes (P < 0.0001). Lambs reared by FR-PMC and FR ewes presented the highest and lowest weaning weight, respectively (P < 0.0001). It can be concluded that although feed restriction diminished animal production and offspring performance, simultaneous administration of propylene glycol, monensin sodium and rumen-protected choline chloride in restricted diets alleviated these negative effects and improved ewes milk production and offspring growth performance.

Analyzing the Impact of Antenatal Depression on Birth Outcomes in Selected Tertiary Level Hospital

Introduction: Psychological problems are one of the primary concerns for pregnant women, and depression is the most prevalent mental health condition that a woman may experience during her pregnancy and the perinatal period anywhere in the world. Aims: The purpose of this research was to determine the correlation between the severity of depression experienced in the final trimester of pregnancy and the outcome of the pregnancy. Materials and Methods: The level of depression experienced during the third trimester was evaluated by means of descriptive research. Data were obtained from fifty pregnant mothers at Krishna Hospital in Karad, Maharashtra, using a straightforward random selection procedure in both the prenatal outpatient department and the postnatal ward. In order to obtain the responses, interviews were conducted with fifty pregnant women who were in their third trimester according to their EDD. The demographic information was gathered through the use of a structured questionnaire, and the level of depression was determined using the Hamilton Depression Rating Scale (HAM-D). The data were summarised and described using frequency, percentage, means, and standard deviation, and inferential statistics like the chi-square (2) test were used to determine whether or not there was a relationship between the variables. Result: The outcomes of the study indicate that a total of 9 mothers (18%) did not suffer from depression, 22 mothers (44%) did suffer from mild depression, 16 mothers (32%) did suffer from moderate depression, and 3 mothers (6%) did suffer from severe depression. It was found that there was a significant association between the level of depression and the type of delivery (p = 0.0141), that there was a significant association between the level of depression of the mother and the weight of the baby (p = 0.0149), but that there was no significant association between the weight of the baby and the type of delivery (p = 0.8765). Conclusion: The findings of the study indicated that pregnant women experience depression during their third trimester, which necessitates the quick attention of medical professionals so that the condition does not have an impact on the outcome of the pregnancy.

Impact of supplementing feed restricted ewes’ diet with propylene glycol, monensin sodium and rumen-protected choline chloride during late pregnancy on blood biochemical indices, body condition score and body weight

The purpose of this study was to investigate the effects of supplementing feed restricted diet with propylene glycol, monensin sodium and rumen-protected choline chloride on blood metabolic status, body condition score (BCS) and body weight of ewes in late pregnancy. At the final six weeks of pregnancy, 48 pregnant Ghezel ewes (body weight 65.53 ± 6.90 kg) were randomly allocated into six groups (n = 8) as follows: control (CG, ad libitum); feed restriction (FR, 60 % of the dry matter intake offered to CG group); feed restriction + propylene glycol (67 g/d) (FR-PG); feed restriction + propylene glycol + monensin sodium (30 mg/d) (FR-MS); feed restriction + propylene glycol + rumen-protected choline chloride (6 g/d) (FR-RPC); feed restriction + propylene glycol + monensin sodium + rumen-protected choline chloride (FR-PMC). Blood samples were collected on days 90, 117, 124, 135 and 140 of pregnancy, at lambing and days 7 and 17 after lambing for analysis of glucose, triglyceride, total cholesterol, total protein, albumin, urea, non-esterified fatty acids (NEFA), ß-hydroxybutyrate (BHBA), aspartate aminotransferase (AST), alanine aminotransferase (ALT) and insulin using the automated biochemical analyzer and ELISA microplate reader. Body weight and BCS of ewes were recorded on days 90, 110, 130 and 140 of pregnancy, at lambing and also day 7 after lambing. All statistical analyses were carried out in a completely randomized design using the MIXED procedure of SAS v.9.3. Results of analysis revealed that pre-parturient administration of rumen-protected choline chloride combined with propylene glycol and monensin sodium elevated both pre- and postpartum concentrations of insulin (P < 0.01), glucose (P < 0.001), triglyceride (P < 0.05), total cholesterol (P < 0.05), total protein (P < 0.01) and albumin (P < 0.01) compared with other treatments. The weight and BCS loss of these ewes were also lower during the pre- and postpartum periods (P < 0.05). In this study, except for day 124 of pregnancy, when the liver enzyme levels of the choline chloride supplemented ewes were numerically low, nutritional treatments did not affect the concentrations of these enzymes at other sampling points (P> 0.05). Regarding BHBA, NEFA and urea, FR and FR-MS ewes had a higher level of these parameters than other groups (P < 0.05). It was concluded that although Ghezel ewes showed some ability in tolerating late gestational feed restriction mainly through lipomobilization, supplementing the restricted diet with rumen-protected choline chloride combined with propylene glycol and monensin sodium during the final trimester of pregnancy could result in beneficial effects on metabolic status and finally good health and condition of animals.

Structural changes in foot and arch dimensions in the third trimester of pregnancy

PurposeThe goal of the study was to investigate changes in foot anatomical characteristics in the last trimester of pregnancy.MethodsTwenty pregnant women (mean age: 30.8 years) from a local clinic were recruited. Body mass, foot length and width, longitudinal arch height, and several angular variables quantifying plantar and arch structure were measured. A foot imprint was obtained with a digital podoscope (CQ Elektronik System, Poland) at the beginning and end of the third trimester of pregnancy.ResultsBody mass was significantly greater at the end of the last trimester. Increases were also observed in the SztriterGodunow index in both feet (&lt;i&gt;p&lt;/i&gt; &lt; 0.007), although foot length and width increased only in the left foot. Among the angular characteristics, the only significant changes involved an increase in the talocalcaneal angle (&lt;i&gt;p&lt;/i&gt; &lt; 0.007) and a decrease in the 1st metatarsophalangeal angle in the right foot (&lt;i&gt;p&lt;/i&gt; &lt; 0.04).ConclusionsSignificant changes in plantar and arch structure were observed in the final trimester of pregnancy, primarily involving a transverse expansion of the left foot and alteration in the angular characteristics of the right foot. The results of the research show anthropometric changes in feet of women in the last trimester of pregnancy. They indicate the foot parts in which the greatest changes occur and what the direction of these changes is. This will allow to create a preventive foot corrective exercise program for pregnant women.

Morphology of the genital organs of the female red-rumped agouti (Dasyprocta leporina, Linnaeus, 1758) during estrous cycle phases and in advanced pregnancy.

The study investigated the gross and microscopic anatomy of the genital organs of 20 agoutis at different stages of the estrous cycle and four in the final trimester of pregnancy. Specimens were euthanized and their reproductive organs were fixed in a 4% paraformaldehyde or 2.5% glutaraldehyde solution and submitted to routine histological techniques for light and scanning electron microscopy. In the ovary, during the proestrus phase, we observed developing follicles and corpus luteum (CL) in regression; during estrus, there were Graafian follicles; during metestrus, there was a hemorrhagic corpus, whereas in diestrus, there was a mature CL. The uterus was partially double because the cervix was cranially septate but caudally, the septum disappeared, forming a single ostium that opened into the vagina. Changes occurred along the estrous cycle in the uterine and vaginal epithelia, that is, an increase in the uterine epithelium height accompanied by an increase of thickness of the vaginal epithelium during the follicular phase and a decrease of thickness of both epithelia during the luteal phase. The endometrial lining was composed of a simple cuboidal epithelium to simple columnar epithelium with basal nuclei. The vaginal mucosa consisted of epithelium that varied from nonkeratinized stratified squamous (luteal phase) to keratinized stratified squamous (follicular phase). The clitoris was external to the vagina. It presented two protruding lateral keratinized spicules and a centralized urethra, with no common parts between the urinary and genital tracts. Anatomical and histological changes were observed mainly in the cervix, vagina and spicules of the clitoris during the EC.

Dietary iron absorption during early postnatal life.

Inadequate iron levels during early life can have adverse consequences for the developing infant. Iron deficiency during this critical period of growth can affect brain development and cognitive function, problems that can be lifelong despite subsequent correction of the iron deficit. Therefore, it is critical that the suckling infant has sufficient iron for their developmental needs. Much of the iron used in the immediate post-natal period is stored iron that was acquired from the mother in the final trimester of pregnancy, however, despite having low iron levels, breast milk can also make a significant contribution to infant iron needs. This reflects the ability of the suckling infant to absorb dietary iron far more efficiently than is possible after weaning. The mechanisms underlying this enhanced iron absorption are poorly understood. The iron export protein ferroportin is essential for this process, as it is in adults, however, the role of other molecules normally involved in iron absorption following weaning is less clear. The composition and distribution of iron in breast milk may be important, as could the contribution of more distal parts of the gastrointestinal tract. This review discusses the potential role of each of the above components in intestinal iron absorption during suckling and highlights the need for further research into this important process.

EFFECTIVENESS OF BREAST CARE ON THE SMOOTH DELIVERY OF BREAST MILK

The breastfeeding program for babies is very encouraged by the government on the grounds that there are many benefits of breastfeeding that can be given to babies. One of the supporting factors for the success of the program is to prepare the breast so that it can produce abundant milk and contains lots of nutrients. Preparation of pregnant women to provide quality breastfeeding is by treating the breast during pregnancy in the final trimester of pregnancy. Warm massage and compresses on the breast have several effects, including improving blood flow and making the nipple more elastic and not easily scratched when breastfeeding later.Key words: Pregnant women, breast care, breastfeeding.

Prediction of fetal ductus arteriosus constriction by systemic and local dermatological formulations of NSAIDs based on PK/PD analysis.

Use of nonsteroidal antiinflammatory drugs (NSAIDs) during the final trimester of pregnancy can cause fetal toxicity, such as ductus arteriosus (DA) constriction. The aim of this study was to predict quantitatively the fetal DA-constrictive effects of NSAIDs after various routes of administration to the mother by means of harmacokinetic/pharmacodynamic (PK/PD) modeling. We evaluated acetaminophen, which is a first-line analgesic/antipyretic for the third trimester of pregnancy, together with the following NSAIDs: indometacin, diclofenac, ibuprofen, flurbiprofen, ketoprofen, loxoprofen, felbinac, naproxen, and celecoxib. Drug concentration data obtained in rats and humans were collected from the literature to calculate PK parameters. Next, the PD parameters for DA constriction in rats were obtained by fitting an Emax model to the DA/pulmonary artery (PA) inner diameter ratio after oral administration of each drug to full-term pregnant rats (data taken from the literature) and the unbound plasma concentration in rat dams estimated from the obtained PK parameters. Finally, the inner DA diameter profile after administration of each drug to human mothers was predicted. This PK/PD model predicted continuous fetal DA constriction in third-trimester women after repeated systemic use of nearly all the NSAIDs evaluated. Local dermatological formulations of NSAIDs were also predicted to potentially cause DA constriction. These results suggest that risk to the fetus should be carefully considered before administration of NSAIDs (especially systemic formulations, but including dermatological formulations) to women in the third trimester of pregnancy.

Procalcitonin and C-Reactive Protein in Umbilical Cord Blood as Markers for Early Suspicion of Infection in Newborns of Women with Prenatal Urinary Tract Infection

Objective: to investigate whether concentrations of procalcitonin (PCT) and C-reactive protein (CRP) in the umbilical cord blood (UCB) are valid biomarkers for the detection of infection in newborns of pregnant women with urinary tract infection (UTI). Methods: PCT and CRP were measured from UCB and were verified through a prospective study of newborns with appropriate birth weights, without asphyxia or signs of bacterial infection whose mothers were diagnosed with untreated or inadequately treated UTI during the final trimester of pregnancy. The blood of newborns was analyzed according to Rodwell criteria. Was calculated the relative risk to detect altered PCT and/or CRP concentration in UCB in newborn with positive Rodwell criteria. Results: samples from 97 newborns at term were analyzed according to Rodwell criteria. Fifty-six of them showed negative criteria. The RR was 2.0 (95% CI – 1.1 – 3.6 p = 0.03) according to PCT and 2.3 (95% CI – 1.1- 4.9) p = 0.03 according to CRP. Conclusion: A normal value to PCT or CRP available from UCB duplicate the possibility to Rodwell negative criteria result in peripheral blood of the neonate, away from the possibility of infection in newborn infants of mothers who had UTI in the pregnancy.