High-risk Pregnancies Research Articles

Evaluating the Quality of Screening Process for High-Risk Pregnancies in Paser District, East Kalimantan

Health service programme success is measured by maternal mortality. There have been efforts to reduce maternal and neonatal fatalities. Field observations suggest that high-risk pregnancy referral rates are still low, delaying access to better services. Screening for high-risk pregnancies is an operational technique to prevent maternal and newborn emergency issues by allowing early treatment and referral planning. Health cadres and personnel can provide quality information. Lack of knowledge and awareness will harm society, especially pregnant women, in dealing and seeking health care. This study uses descriptive methods to assess high-risk pregnancy screening in Paser Regency, East Kalimantan, by collecting individual data and watching written and verbal behaviour. This research is qualitative and phenomenological. Health workers, ob-gyns, GPs, and pregnant women were informants. The data was collected through interviews from November to December 2023. The research found that high-risk pregnancy screening was still poor due to lack of knowledge, understanding, staff, time, site, and community culture. This research aims to improve high-risk pregnancy screening in Paser Regency, East Kalimantan Province, so that the policy can become permanent and help the planned referral process by motivating, socialising, training health cadres, and requiring cross-sectoral and cross-program support.

Prevalence of Human Pegivirus Infection during High Risk Pregnancy and its Vertical Transmission to the Newborn

Human Pegivirus (HPgV-1), which was known as hepatitis G virus (HGV) or GB virus C (GBV-C) is a single – stranded positive RNA virus belonging to the genus Pegivirus of Flaviviridae family. Its genomic organization is similar to that of HCV with which it has only 25% homology at the nucleotide level. The aim of this study is to evaluate the prevalence of HPgV-1 among high risk pregnant women (with HCV infection or history of previous blood transfusion) and normal pregnant women. In addition to detect the vertical transmission of the virus to their newborns. Thirty term high risk and thirty term normal pregnant females were screened for HPgV-1 RNA using the reverse transcription PCR technique. HPgV-1 was detected in six females among those who have HCV infection (33.3%) and in two females among recipients of blood transfusion (16.6%), also it was detected in one female of the control group (3.3%). The outcome of newborns showed three newborns with HPgV-1 infection out of six born to the females who have both HCV and HPgV-1 infection and one newborn of the infected mother of the control group, however, liver functions of the newborns were in the normal range for age requiring long term follow up.

Evaluation of The Poedji Rochjati Score Card (PRSC) on Digital Platform @hamilku.id Based on The Delphi Method

The number of cases and deaths of mothers and babies in Indonesia is increasing, which is mediated by low-risk detection in early pregnancy, and a lack of knowledge resulting in the dissemination of pregnancy-related information tends to be poorly understood. As a solution to this problem, the purpose of this study was to analyze the effectiveness and usability of the Poedji Rochjati Score Card (PRSC) feature on the @hamilku.id Digital Platform based on the Delphi method. Qualitative research methods with technical observations were carried out online by obstetricians and gynecologists. The main focus of this research was usability testing involving 46 pregnant women who used the application and 9 randomly selected respondents. The assessment and evaluation were guided by the Delphi method, which involved two rounds of testing by six obstetricians and gynecologists. The results were descriptively analyzed. The findings showed that pregnant female respondents aged between 17 and 34 years had a higher education level, were dominated by people without jobs/housewives, were domiciled in Sidoarjo, had undergone antenatal care (ANC) ≤ 6 times, and had undergone ≥ 5 pregnancies. According to the PRS, 52.2% of pregnant women were classified as having high-risk pregnancies (HRPs). Based on the evaluation of the application from the usability aspect, 83.3% of the participants stated that the information was comprehensive and that the medical terminology was easy to understand. However, only half of them considered visualization in the form of images or animations to be very helpful in illustrating pregnancy risks. Delphi testing with obstetricians and gynecologists revealed that the digital PRSC features generated positive ratings, indicating that the tool is accurate, informative, easy to understand, and effective at improving the quality of health services. The second round showed an improvement in the quality and relevance of the digital PRSC features, with more diverse feedback from the respondents providing a broader perspective for future research and feature development. As a result, the digital PRSC feature can help individuals precisely and accurately identify pregnancy risks.

“Unfortunately, we couldn’t reach a definitive diagnosis”: the interactional management of uncertainty in genetic counseling

This paper examines how participants in genetic counseling sessions interactionally manage situations where the results of tests to investigate the causes of identified fetal malformations are inconclusive or missing. The dataset consists of 54 audio-recorded interactions at a unit specialized in moderate- and high-risk pregnancies at a Brazilian public hospital. Conversation analysis was used to examine the data, revealing that the participants deployed interactional actions that exhibited highly negative valence toward diagnostic inconclusiveness, demonstrating that when there is a motivation for a medical examination, insofar as its results will serve as a basis for subsequent decision-making (in this case about future pregnancies), there is a preference for bad diagnostic news over absent or inconclusive diagnostic news. These findings are consistent with prior interactional studies.

Interactive Support in The Tambak Wedi Village Area of Surabaya City to Avoid Stunting

ABSTRACT Stunting remains a serious challenge for Indonesian society. The 2018 basic health research reported that the prevalence of stunting among toddlers reached 30.8%. The impact of stunting is not only on physical growth but also on cognitive development and the risk of diseases in adulthood. Community service plays a crucial role in supporting government efforts to address stunting through nutrition education, infant and child feeding practices, sanitation, hygiene, and family economic empowerment. Based on this, the involvement of higher education institutions is necessary to improve public health through an approach of interprofessional collaboration and interprofessional education designed in community service activities that focus on empowering communities through integrative assistance. This community service is carried out in 2024, located in Tambak Wedi Village, Surabaya. The activities conducted include training and assistance in the production of processed foods based on moringa leaves and fish, health education on healthy living behaviors, guidance on parenting and breastfeeding/MPASI, training for early detection of high-risk pregnancies for families, and checking hemoglobin and protein levels for pregnant women in a state of chronic energy deficiency who receive supplementary feeding based on moringa leaves and fish. At the beginning of the community service activities, the results of health and laboratory examinations were as follows: several mothers were found to have a mid-upper arm circumference (MUAC) below 23.5 cm, which may indicate a risk of chronic energy deficiency (CED). Pregnant women were still found with hemoglobin levels below 11 g/dL, indicating anemia during pregnancy. Additionally, protein levels in pregnant women were found to be 6.2 g/dL, and there was one stunted child and seven children in a pre-stunting condition. Following up on the results of the initial health examination, interventions were carried out for pregnant women with chronic energy deficiency and toddlers at risk of stunting by providing snacks made from moringa and fish for two weeks. The Surabaya Hebat cadres also received a refresher on early detection screening for high-risk pregnant women INDEX TERMS Stunting, Moringa leaves and fish, Tambak Wedi

Factors influencing happiness and depression in high-risk pregnant women: a cross-sectional study using the ecological systems approach.

The increasing number of high-risk pregnancies has led to a greater emphasis on psychological well-being in nursing care. However, reducing depression does not automatically equate to increasing happiness. This study aimed to systematically examine the factors influencing happiness and depression among high-risk pregnant women in South Korea. This correlational, cross-sectional study was based on the ecological systems theory. In total, 152 high-risk pregnant women completed a self-report survey questionnaire available online or offline. Data were analyzed using hierarchical regression analysis. The first model (individual system) identified pregnancy stress and mindfulness as significant factors influencing both happiness and depression. The second model (microsystem) identified medical status at the time of the survey, maternal-fetal interaction, marital intimacy, and social support as additional significant factors influencing either happiness or depression. In the third model (mesosystem), maternal-fetal interaction and paternal-fetal attachment were no longer identified as significant factors. Although the fourth model (exosystem) did not identify community service as a significant factor, individual (pregnancy stress, mindfulness) and microsystem (marital intimacy) factors were found to influence happiness and depression. Medical status at the time of survey and social support were additional factors that influenced happiness, but not depression. These factors explained 51.2% and 55.5% of the variance in happiness and depression, respectively, among high-risk pregnant women. Different factors at the individual and microsystem levels affected happiness and depression among high-risk pregnant women. Hence, efforts to reduce depression among these women should be accompanied by efforts to actively promote happiness.

Insights into obstetric anesthesia practices: a quantitative survey among physicians across Arab countries

BackgroundObstetric anesthesia guidelines are essential for standardizing obstetric anesthesia practices globally and ensuring high-quality patient care. However, practices may vary across different settings, and there are limited data from Arab countries. This study aims to gain insights into obstetric anesthesia practices in several major hospitals across Arab countries.MethodsA questionnaire was emailed to 85 obstetric anesthesiologists/anesthesia chairpersons in major hospitals, including academic medical institutions and central hospitals, across 11/22 Arab countries. This survey gathered data on key structural and process-related obstetric anesthesia indicators.ResultsOut of 85 contacted, we had 56 responses (65.8%), with 41 being fully completed, providing insights into obstetric anesthesia indicators. Regarding structure: 31 (76%) hospitals had an operating room adjacent to the delivery room, all had intensive care units, and 22 (54%) had a lead obstetric anesthesiologist. For equipment, 19 (46%) had a video laryngoscope in the delivery suite, and 20 (49%) occasionally used ultrasound for epidurals. Regarding process: 33 (81%) held regular meetings, and 21 (51%) conducted research. Before epidural and spinal procedures, 26 (63%) and 28 (68%) required coagulation studies for patients without a history of hemorrhagic complications, while 38 (93%) and 36 (88%) mandated a platelet count, respectively. For labor analgesia, 34 (83%) primarily used epidurals, and 15 (37%) placed preemptive catheters in high-risk pregnancies. For cesarean delivery, 40 (98%) used spinals, with 16 (39%) using intrathecal morphine and 22 (54%) administering aspiration prophylaxis before general anesthesia. Regarding spinal-induced hypotension, 6 (15%) used prophylactic phenylephrine infusion.ConclusionThis survey highlights variations in obstetric anesthesia practices among various major hospitals in several Arab countries, compared to international recommendations. It emphasizes the need for obstetric anesthesia registries in the Arab world for future research. Further studies are required to outline country-specific practices, improve resource allocation, and enhance obstetric population safety and satisfaction.

High Risk Pregnancy

A quasi experimental study to assess the effectiveness of structured teaching programme regarding management of High Risk Pregnanacy among nursing students in selected schools of nursing, Ludhiana, Punjab.

Oligohydramnios at term in the high-risk population- how severe is severe?

The term oligohydramnios is linked to pregnancy complications. We previously presented the outcome of the low-risk population (no pregnancy complications) with term oligohydramnios. This study aims to address the high-risk group (Any maternal complication during pregnancy, such as gestational diabetes, pre-gestational diabetes, chronic hypertension, preeclampsia, anemia, asthma, obesity, and multi parity.). This retrospective cohort study of 1,114 singleton term (≥37), oligohydramnios (AFI <50 mm) pregnancies from Shamir Medical Center between 2017 and 2021. Compering the low-risk to high-risk groups with subdivision by severity of oligohydramnios. A total of 211 subjects (19 %) were high-risk cases and 903 (81 %) low-risk cases. Comparing these two groups, subjects of the high-risk group were older (31.34±5.85 vs. 29.51 vs. 4.96), had earlier gestational age at delivery 39.53±1.18 vs. 40, had higher mean AFI (35±12.7 vs. 33±14.5), were subject to more labor inductions (81 vs. 69.7 %), and CS rate (19.9 vs. 12.4 %). Logistic regression revealed a need for more cesarean sections in the high-risk group. Additionally, more labor inductions and a higher risk of negative fetal outcomes. This study highlights the importance of considering pregnancy risk factors when we are approaching oligohydramnios in high-risk pregnancies.

Anxiety in Pregnancy: Comparing High-Risk and Normal Pregnant Women through the Beck Anxiety Inventory

Aim: Pregnancy is a critical life event that necessitates adaptation to numerous physical and psychological changes. While it often brings positive emotions, it can also induce significant stress and anxiety, especially in high-risk scenarios with potential maternal and fetal health concerns. This study aims to investigate whether there is a difference in anxiety levels between pregnant women under routine obstetric care and those under perinatology care for high-risk pregnancies. Material and Method: This cross-sectional survey was conducted at the Giresun Training and Research Hospital Obstetrics and Gynecology Hospital. Ninety pregnant women aged 18-40 were divided into two groups: 45 women receiving routine obstetric care (Group I) and 45 women receiving perinatology care for high-risk pregnancies (Group II). Data were collected using a 20-question socio-demographic and medical characteristics questionnaire, along with the Beck Anxiety Inventory. Results: The study found no significant difference in socio-demographic characteristics such as education, employment, and income status between the two groups (p&gt;0.05). The Beck Anxiety Inventory scores indicated that both groups predominantly experienced low-level anxiety: 82.2% in Group I and 86.7% in Group II. Moderate anxiety was reported by 15.6% of Group I and 11.1% of Group II. Only 2.2% of participants in each group experienced severe anxiety. There was no significant difference in the overall anxiety levels between the two groups (p&gt;0.05), although Group I reported higher heart palpitations (p

Religious-Based Peer Education in Preeclampsia Prevention: Social Cognitive Theory and Information, Motivation, Behavioral Skill Model Approach to Improve Preeclampsia Preventive Behavior in Indonesia

Background:Preeclampsia is the second leading cause of maternal death, largely due to the failure to identify the condition early. Prevention behaviors for preeclampsia in pregnant women can be developed through the Social Cognitive Theory (SCT) and the Information-Motivation-Behavioral Skills (IMB) Model. Utilizing religious organizations with unique values and cultures to foster high levels of compliance, a Religious-Based Peer Education approach can optimize these preventive efforts. Objective:This research aims to analyze the influence of knowledge, skills, motivation, observational learning, husband's support, and self-efficacy on the formation of preeclampsia prevention behaviors. Methods:A non-equivalent pre- and post-test design was conducted in Bojonegoro district from August 2022 to February 2023. The sample consisted of 179 pregnant women in the intervention group and 168 in the control group. The intervention involved Religious-Based Peer Education, with peers being members of the Muslimat NU religious organization, while the control group received routine assistance from existing health cadres. Data were analyzed using path analysis. Results:The mean scores for knowledge, skills, and behavior in the intervention group were significantly higher than those in the control group (13.81 vs. 12.34; 2.37 vs. 1.95; 30.33 vs. 28.19; p &lt; 0.001). The strongest factors influencing the formation of preeclampsia prevention behavior were screening skills (b = 0.74, p = 0.010; 95% CI: 0.03–0.23) and self-efficacy (b = 0.36, p = 0.010; 95% CI: 0.23–0.48). Conclusion:The SCT and IMB models, when applied through Religious-Based Peer Education, have proven effective in improving preeclampsia prevention behaviors. Ongoing training for peers and consistent support for pregnant women are essential to identify high-risk pregnancies and prevent maternal complications. Keywords: social cognitive theory; information-motivation-behavioral skills model; preeclampsia; religious-based peer education; behavior

A Cross-Sectional Study Comparing Placental Characteristics in Pregnancy-Induced Hypertension and Sickle Cell Anaemia.

Placental health plays a critical role in pregnancy outcomes as it serves as the interface between the mother and fetus. High-risk pregnancies, such as those complicated by pregnancy-induced hypertension (PIH) and sickle cell anaemia (SCA), are associated with significant alterations in placental morphology and histopathology, potentially leading to adverse maternal and fetal outcomes. While previous studies have explored placental changes associated with either PIH or SCA, nobody has comparatively analysed these conditions to understand their unique and overlapping effects on placental pathology. This study aimed to compare and contrast the morphological and histopathological changes in the placenta associated with high-risk pregnancies likePIH and SCA. A comparative analysis was conducted using data fromstudies at two different tertiary care centres. The study populations included 100 pregnant women diagnosed with PIH and 56 pregnant women with SCA, alongside a matched control groupof 100 healthy pregnant women for the PIH group and 56 healthy pregnant women for the SCA group. Inclusion criteria were restricted to singleton pregnancies in women aged 18 to 35 years with gestational ages ranging from 28 to 40 weeks. Following delivery, placental specimens were collected, and various parameters such as weight, volume, surface area, number of cotyledons, and umbilical cord attachment were meticulously measured. Histopathological examinations were conducted to identify specific pathological features like infarcts, calcifications, syncytial knots, and fibrin deposition. Data analysis was performed using SPSS software version 25.0 (IBM Corp., Armonk, NY, USA), with a p-value of less than 0.05 considered statistically significant. The study revealed significant differences in placental parameters between the PIH and SCA groups compared to their respective controls. Placental weight, volume, and surface area were significantly reduced in both the PIH and SCA groups, with more pronounced reductions observed in PIH (p < 0.001). The umbilical cord attachment was predominantly marginal in the PIH group (75%), compared to a central attachment in the SCA group (70%), suggesting different patterns of placental development. Histopathological analysis demonstrated a higher incidence of infarcts (65% vs. 30%), calcifications (80% vs. 45%), syncytial knots (90% vs. 50%), and fibrin deposition (70% vs. 35%) in the PIH group compared to the SCA group, indicating more severe placental pathology in PIH. This study offered a comprehensive comparison of placental changes in pregnancies affected by PIH and SCA. It identified both structural abnormalities in terms of placental weight, volume, and surface area and distinctive pathological features like infarctions, calcifications, syncytial knot formation, and fibrin deposits in the placenta. When compared to control groups, these findings strongly suggest that placental dysfunction is a key contributor to the adverse outcomes associated with these high-risk pregnancies.

A systematic review and meta-analysis of the globally reported International Classification of Diseases to Perinatal Mortality (ICD-PM).

Accurate recording and identification of perinatal mortality causes are crucial to reducing the global burden of perinatal mortality through targeted interventions. However, existing studies on the International Classifications of Diseases to Perinatal Mortality (ICD-PM) are limited by inconsistent results and variations by gestational age. Thus, this review aims to synthesize and document updated data on the causes of death using the ICD-PM classification. Electronic databases such as the PubMed via MEDLINE, SCOPUS, Web of Sciences, EMBASE, Cochrane Library, and PROSPERO were searched to retrieve studies published from 2016 to February 2024. The Newcastle-Ottawa Scale (NOS) was used to assess the quality of the included studies, and heterogeneity between the studies was assessed using I2 statistics. ICD-PM coded reported data were extracted to Microsoft Excel, and aggregate data of frequencies and percentages were reported. Out of the 23 included studies, 48,596 perinatal mortalities were reported, and approximately 96% (46,816 deaths) were classified according to the ICD-PM. The pooled rate of stillbirths in high-income countries was 23/1,000 births; in low-income countries, it was found to be approximately twice as in high-income countries. Regarding the category of deaths, 25,563 (54.6%) deaths were recorded in the antepartum period, and more than half, 14,887 (58.2%), were classified under unspecified causes (A6). Moreover, 6,148 (13.7%) and 14,835 (31.7%) deaths were coded with intrapartum and neonatal period causes, respectively. The leading causes of perinatal mortality during the intrapartum were acute intrapartum events (I3) 3,712 (57.8%). Furthermore, neonatal death was caused by low birth weight and prematurity (N9) 4,091 (27.6%), congenital malformations, and chromosomal abnormalities (N1) 2,512(16.9%). Congenital malformations, and chromosomal abnormalities contribute to 1 in every 10 perinatal deaths and 1 in every 4 neonatal deaths. Other specified antepartum disorders are responsible for over half of antepartum deaths, while acute intrapartum events are the leading cause of intrapartum deaths, with a significant proportion remaining unexplained. Maternal complications related to the placenta, membranes, cord, labor, and delivery play a significant role in antepartum and intrapartum deaths. Targeted interventions and improved monitoring of high-risk pregnancies are crucial to reducing perinatal mortality rates. Further investigation is needed to enhance understanding and address unexplained perinatal deaths. [https://clinicaltrials.gov/], identifier [CRD4202452549].

Factors Influence Breastfeeding Duration after High Risk and Low Risk Pregnancies.

Breastfeeding provides vital nutrients and fosters maternal-infant bonding, benefiting both mother and child. However, breastfeeding duration is influenced by various factors, especially in women of high-risk pregnancy. This study aims to identify predictors of breastfeeding duration among women of high-risk and low-risk pregnancy, focusing on exclusive and mixed feeding practices. Conducted at a public hospital in Attica, Greece, this 20-month prospective cohort study (May 2020-January 2022) included 380 pregnant women, divided into high-risk and low-risk groups. The final sample of 157 women, after excluding non-breastfeeding participants, was assessed across five phases from prenatal to six months postpartum using interviews, calls, and surveys. Multiple linear regression identified key predictors, with statistical methods applied. Results revealed birth weight as a consistent significant predictor of breastfeeding duration. For women with high-risk pregnancy, additional factors like infant gender, jaundice, and early introduction of solid foods influenced breastfeeding duration. The mixed breastfeeding model for women with high-risk pregnancy explained 72.9% of the variance. Exclusive and mixed breastfeeding models for women with low-risk pregnancy also highlighted birth weight's influence. The findings highlight the important role of birth weight and other specific factors in determining breastfeeding duration among women of high-risk and low-risk pregnancy. Further research is needed to validate these findings across diverse populations.

Enfermedad microvascular coronaria en gestante con antecedente de síndrome antifosfolípidos

Objective: to report the case of a pregnant woman with antiphospholipid syndrome history, in whom coronary microvascular disease was documented. Antenatal medical treatment improved prognosis and maternal and perinatal outcomes. Case: multigravida woman, 29.6 weeks pregnant, diagnosed with acute coronary syndrome, referred from a first level hospital. Diagnostic workup revealed microvascular disease. After receiving adequate management, she was discharged from hospital and included in the high-risk pregnancy program. Results: the diagnosis was made based on echocardiography, electrocardiography, troponin levels and cardiac catheterization. Anti-ischemic therapy was indicated considering the risk-benefit trade-off; management with aspirin was continued and the baby was born healthy. Conclusions: coronary microvascular disease should be considered, as a differential diagnosis in a pregnant woman with chest pain and history of antiphospholipid syndrome. Patients benefit from receiving antiplatelet and anticoagulant therapy soon after the diagnosis is made. Studies are required to evaluate the safest and most effective management of this condition.

Effectiveness of Psychological Counseling Intervention in High-Risk Pregnancies in Italy.

The longitudinal study examines the effectiveness of a psychological support treatment for high-risk pregnancies using a between-groups design. It assesses the treatment's impact on depression and fear of COVID-19 at three time points, and on prenatal attachment between the 20th and 24th weeks of gestation (T0), postnatal attachment 15-20 days after birth (T1), and three months after birth (T2). Additionally, the study evaluates the treatment's effectiveness on PTSD related to childbirth and parental distress at T1 and T2. The study involved 117 parents experiencing high-risk pregnancies from a Sicilian hospital: 84 mothers (40 in the experimental group, 44 in the control group) and 33 fathers (19 in the experimental group, 14 in the control group). ANOVA results showed that the psychological treatment was effective for maternal variables such as postnatal attachment and parental distress, and for paternal variables such as depression, prenatal attachment, PTSD symptoms, and parental distress (ANOVA, p < 0.05). The study highlights the growing evidence for providing continuous psychological support to couples with high-risk pregnancies, emphasizing that this support should extend beyond childbirth to assist families through this transition.

Ensemble machine learning framework for predicting maternal health risk during pregnancy

Maternal health risks can cause a range of complications for women during pregnancy. High blood pressure, abnormal glucose levels, depression, anxiety, and other maternal health conditions can all lead to pregnancy complications. Proper identification and monitoring of risk factors can assist to reduce pregnancy complications. The primary goal of this research is to use real-world datasets to identify and predict Maternal Health Risk (MHR) factors. As a result, we developed and implemented the Quad-Ensemble Machine Learning framework to predict Maternal Health Risk Classification (QEML-MHRC). The methodology used a vacxsriety of Machine Learning (ML) models, which then integrated with four ensemble ML techniques to improve prediction. The dataset collected from various maternity hospitals and clinics subjected to nineteen training and testing tests. According to the exploratory data analysis, the most significant risk factors for pregnant women include high blood pressure, low blood pressure, and high blood sugar levels. The study proposed a novel approach to dealing with high-risk factors linked to maternal health. Dealing with class-specific performance elaborated further to properly understand the distinction between high, low, and medium risks. All tests yielded outstanding results when predicting the amount of risk during pregnancy. In terms of class performance, the dataset associated with the “HR” class outperformed the others, predicting 90% correctly. GBT with ensemble stacking outperformed and demonstrated remarkable performance for all evaluation measure (0.86) across all classes in the dataset. The key success of the models used in this work is the ability to measure model performance using a class-wise distribution. The proposed approach can help medical experts assess maternal health risks, saving lives and preventing complications throughout pregnancy. The prediction approach presented in this study can detect high-risk pregnancies early on, allowing for timely intervention and treatment. This study’s development and findings have the potential to raise public awareness of maternal health issues.

Peningkatan Pengetahuan Kepada Ibu Hamil tentang Kehamilan Risiko Tinggi di Rumah Pelita Manyaran

Maternal mortality rates (MMR) are frequently used to evaluate a community's level of health. In general, the effectiveness of maternal health initiatives may also be assessed using MMR. One factor that contributes to the maternal mortality rate is high-risk pregnancies. High-risk pregnancies are those that have conditions that might raise the fetus's chance of abnormalities or injury. Low- and lower-middle-income nations, such as Indonesia, account for about 95% of all maternal mortality. Numerous studies have have shown that pregnant women lack knowledge of health risks during pregnancy. A potential strategy for lowering MMR is educating women about high-risk pregnancies. The purpose of this community service project is to educate expectant mothers about pregnancy risks in order to reduce complications for both the mother and the fetus at Rumah Pelita Manyaran, Semarang City. Providing education is done through the counseling method. The media used is leaflet media. Pregnant women who attended the Pregnant Women Class at Rumah Pelita Manyaran in Semarang City were the targets of this social project. The results of the measurement indicated a significant growth in knowledge. Pregnant women in the good category had a knowledge level of 45% before counseling, and that level of knowledge increased to 60% after counseling.

The relationship between maternal environmental temperature exposure and preterm birth: A Risk prediction based on machine learning

Global warming and the risk of preterm birth are both major factors that impact population health. This study investigated the impact of environmental temperature during different stages of pregnancy on the probability of preterm birth (PTB) in Wuhan, China through 2014 to 2016. The results revealed that temperature exposure throughout the entire pregnancy exhibited a U-shaped relationship with the risk of PTB; when temperature exposure during the entire pregnancy was below 14 °C or above 20 °C, the risk of PTB increased. Early pregnancy exposure to temperatures below 7 °C or above 22 °C, and late pregnancy exposure to temperatures below 7 °C or above 26 °C, were associated with an increased risk of PTB. Additionally, elevated PM2.5 exposure increased PTB risk, while O3 exposure exhibited a U-shaped relationship with preterm birth. Compared to non-high-risk pregnancies, high-risk pregnancies exhibited a higher risk of preterm birth across all stages of pregnancy. Notably, when late pregnancy temperature exposure exceeded 28 °C, the risk of PTB rapidly increased for non-high-risk pregnancies. This research has significant implications for improving maternal and new-born health by future sustainable city planning and the optimization of temperature forecast warning systems, particularly under the dual pressures of rapid urbanization and climate change.

Single vs. multi-slice assessments of in vivo placental T2∗ measurements

IntroductionPlacental health is vital for maternal and fetal well-being, and placental T2∗ has been suggested to identify in vivo placental dysfunction prior to delivery. However, ideal regions of interest to best inform functional assessments of the placenta remain unknown. The aim of this study is to compare global and slice-wise measures of in-vivo placental T2∗ assessments. MethodsThis prospective study recruited pregnant people with singleton pregnancies between December 2017 and February 2022.3D multi-echo RF-spoiled gradient echo sequences were acquired, and placental T2∗ values were derived from global and slice-wise approaches. Statistical analyses included Pearson correlation coefficients, concordance correlation coefficients (CCC), intraclass correlation coefficients (ICC), and Bland-Altman analyses. ResultsOf 115 participants (mean gestational age, 29.25 ± 5.05 weeks), 68 were healthy controls, and 47 were high-risk pregnancies. Global and slice-wise placental T2∗ assessments for the entire cohort showed no significant difference nor for individual subgroups (healthy controls or high-risk). Pearson correlation values ranged between 0.88 and 0.99 for mean global and slice-wise placental T2∗. CCC analyses ranged from 0.88 to 0.99 for mean T2∗, and ICC analyses ranged between 0.88 and 0.99 for mean T2∗, showing a strong agreement between measurements. Bland-Altman analyses depicted T2∗ differences across coverage methods, and groups resided within the 95 % limits of agreement. DiscussionSingle-slice placental assessments offer robust, comparable T2∗ values to global assessments, with the added benefit of reducing post-processing time and SAR exposure. This supports slice-wise approaches as valid alternatives for assessing placental health in various pregnancies.