Previous History Of Miscarriage Research Articles

Epidemiology of intrapartum stillbirth and associated factors among women who gave childbirth in Ethiopia: systematic review and meta-analysis

BackgroundStillbirth always resulted in a multi-dimensional impact from the individual level to the country level at large. It causes psychological depression, social stigmatization, and decreased quality of life for women. Despite several studies conducted in Ethiopia, no national pooled estimates were done. Therefore, this systematic review and meta-analysis sought to assess intrapartum stillbirth and associated factors among women who had childbirth in Ethiopia using the available published evidence.MethodsThe current review included studies conducted in Ethiopia. The databases used primarily were Medline/PubMed, Google Scholar, Scopus, Web of Science, Ethiopian University Repository Online, CINAHL, African Journals Online and Cochrane Library. All cross-sectional studies conducted in English and met eligibility criteria were included in the final review. A random-effects meta-analysis was performed. Data extraction and analysis were also performed using Microsoft Excel and STATA version 14 software respectively.ResultsIn the current review, eleven studies were included, and their quality was assessed before being chosen for the final review. The pooled prevalence of intrapartum stillbirth among women who had childbirth in Ethiopia was 9.21% [95% CI (7.03%, 11.39%); I2 = 90.2, P = 0.000]. Women with a previous history of stillbirth [OR = 5.14, 95% CI (3.53–6.75), I2 = 60.0%, p = 0.04] and had no use of antenatal care {[OR = 0.43, 95% CI (0.18–0.68) I2 = 85.3%, p = 0.001]} were significantly associated with intrapartum stillbirth among women who gave childbirth. ConclusionsNearly one-tenth of women who had childbirth in Ethiopia had an intrapartum SB. Revitalizing the existing health extension package particularly family health services with emphasis on focused antenatal care and counselling as well as with prompt referral system would reduce intrapartum SB. This review calls for the need to assess the quality of ANC provision and tailor targeted interventions to best improve the service quality.

Predictors of preterm birth following emergency and ultrasound-indicated cervical cerclage: A retrospective study on 136 singleton pregnancies

ObjectiveWe aimed to retrospectively evaluate obstetric and neonatal outcomes in patients who underwent ultrasound-indicated and rescue cervical cerclage and to identify predictors for cerclage failure and consequent preterm birth (PTB). Materials and methodsWe conducted a retrospective analysis on singleton pregnancies between 16 and 27 weeks of gestation who presented with a transvaginal sonographic cervical length (TVS-CL) <25 mm and a previous PTB/second-trimester miscarriage or prolapsed amniotic membranes and/or a TVS-CL <15 mm and underwent cervical cerclage at Mangiagalli Center, Milan, between September 2011 and December 2021. Univariate and multivariate logistic regression analyses were used to identify possible predictive factors of cerclage failure. ResultsDuring the study period, a total of 136 singletons met the inclusion criteria. Overall, 3 % of pregnancies did not reach fetal viability, mostly due to post-cerclage preterm premature rupture of membranes and/or chorioamnionitis. The mean gestational age at delivery was 35.9 ± 4.5 weeks. Neonates were delivered beyond 37 weeks in 63.2 % of cases, between 28 and 37 weeks in 26.5 %, and less than 28 gestational weeks in 10.3 %. At the multivariate analysis, independent risk factors for miscarriage or PTB were cervical length <10 mm (odds ratio, OR 3.44), advanced cervical dilatation (OR 4.76), and in vitro fertilization (OR 4.66). A history of previous miscarriage, premature delivery, and uterine malformations did not increase the risk of post-cerclage delivery before 37 weeks. In the preterm delivery group, 14 % of patients experienced preterm premature rupture of membranes (pPROM) and 10 % had chorioamnionitis, while no case was registered in the term delivery group. A positive vaginal swab at the time of cervical cerclage was not significantly associated with PTB at the multivariate analysis but it emerged as a significant risk factor for both chorioamnionitis (OR 11.03) and pPROM (OR 5.28). ConclusionsUltrasound-indicated and rescue cervical cerclage were effective in prolonging pregnancy, even when placed beyond 24 weeks of gestation. Preoperative cervical length of less than 10 mm, advanced dilatation, and in vitro fertilization are associated with an increased risk of cerclage failure. A positive vaginal swab before cerclage is associated with increased rates of intrauterine infectious-inflammatory processes.

Factors Associated with Postpartum Depression among Women in Eastern Sudan: A Cross-Sectional Study.

Background and Objectives: Postpartum depression is one of the most common complications of childbirth. While the epidemiology of postpartum depression has been extensively studied in African countries, there is little published data on the topic in Sudan. In addition, no studies have been conducted in Eastern Sudan. This study aims to evaluate the factors associated with postpartum depression among Sudanese women in Gadarif in Eastern Sudan. Materials and Methods: A cross-sectional study (using the systematic random sampling technique) of women presenting to Gadarif Maternity Hospital for postnatal follow-up within six weeks of childbirth was conducted. A questionnaire was used to collect sociodemographic information, and the Edinburgh Postnatal Depression Scale was used to assess postpartum depression. Results: Three hundred women were enrolled in the study. The median (interquartile) age and parity were 30.0 (25.0-34.0) years and 2 (1-4). Thirty-one (10.3%) of the women had postpartum depression. A univariate analysis showed that a past history of depression was the only factor associated with postpartum depression (OR = 3.04, 95% CI = 1.03-8.97). Other investigated factors (age, parity, educational level, occupation, history of previous miscarriage or intrauterine fetal death, a family history of depression, financial support, medical insurance, whether the pregnancy was planned or not, and if the gender of the newborn was known before delivery) were not associated with postpartum depression. Conclusions: The current study showed that 1 out of 10 women had postpartum depression that was associated with a past history of depression. Factors that have been reported to be associated with postpartum depression in African countries (age, parity, education, and occupation) were not found to be associated in this study. Mental health assessment needs to be employed for women in their antenatal and postpartum periods.

Preference of cesarean delivery and its associated factors among pregnant women attending ante natal care at public health facilities of Debrebrehan City, Ethiopia: Cross-sectional study.

A Caesarean section is a surgical procedure used to prevent or treat life-threatening maternal or fetal complications. Women's delivery preferences have become a global issue of interest to many researchers and clinicians, especially given the ever-increasing rate of cesarean sections. There is limited data on the preference for cesarean delivery and its associated factors for Ethiopian women, particularly in the study area. The aim of the study is to assess the preference for cesarean delivery and its associated factors among pregnant women attending antenatal care at public health facilities in Debre Berhan, Ethiopia, in 2023. An institution-based cross-sectional study design was done from May 5-20, 2023, among 512 participants, and a multi-stage sampling technique was used. The data were collected by using interviewer-administered semi-structured questionnaires. The data were entered by Epi Data version 4.6 and then transferred to SPSS version 25 for analysis. With logistic regression, those variables with a p-value <0.25 in the bivariate analysis were candidates for multivariate logistic regression, and variables with a p-value <0.05 were considered statistically significant. The preference for a cesarean section was 26%, with a CI of 22.3% to 29.9%. Pregnant mothers who were not satisfied with their previous intrapartum care (AOR; 6.3 CI = (3.5-11), P = 0.01), had no knowledge about cesarean delivery (AOR; 2.9; 95% CI = 1.6-5.3), P = 0.01), had a previous history of spontaneous abortion (AOR; 3.1; 95% CI = (1.5-6.3), P = 0.001), lived in an urban area (AOR; 1.9; 95% CI = (1.0-3.5), P = 0.038), and had a current pregnancy-related problem (AOR; 4.8; 95% CI = 1.9-10), P = 0.001) were significantly associated with the preference for cesarean delivery. In this study, the preference for cesarean delivery was high as compared to the World Health Organization recommendation. Pregnant mothers who were not satisfied with their previous intrapartum care, had no knowledge about cesarean delivery, had a previous history of spontaneous abortion, had an urban residence, and had a current pregnancy-related problem were significantly associated with a preference for caesarean delivery. Clinicians who are working in the delivery room should improve their service provision by using patient-centered care to increase patient satisfaction.

The association between non-viral sexually transmitted infections and pregnancy outcome in Latin America and the Caribbean: A systematic review

IntroductionNon-viral sexually transmitted infections are known to be associated with adverse pregnancy outcomes. For these pathogens, standard antenatal screening is not broadly performed in Latin America and the Caribbean. The aim of this study was to comprehensively review the association of non-viral sexually transmitted infections and neonatal outcomes among pregnant women in the region. MethodsFour databases (PubMed, Embase, SciELO and LILACS) were examined to identify eligible studies published up to September 2022. English or Spanish cross-sectional, case-control and cohort studies assessing the association of non-viral sexually transmitted infections and adverse pregnancy outcomes were evaluated. Articles were firstly screened by means of title and abstract. Potential articles were fully read and assessed for inclusion according to the eligibility criteria. Snowballing search was performed by screening of bibliographies of the chosen potentially relevant papers. Risk of bias within studies was assessed using the Joanna Briggs Institute reviewer's manual. ResultsA selection of 10 out of 9772 search records from five Latin America and the Caribbean countries were included. Six studies associated Treponema pallidum infection with preterm birth (1/6), history of previous spontaneous abortion (2/6), fetal and infant death (1/6), low birth weight (1/6) and funisitis of the umbilical cord (1/6). Three studies associated Chlamydia trachomatis infection with preterm birth (2/3), ectopic pregnancy (1/3) and respiratory symptoms on the newborn (1/3). One study associated Mycoplasma genitalium infection with preterm birth. ConclusionThis review provides evidence on the association of non-viral sexually transmitted infections with adverse pregnancy outcomes. Further investigation is needed to establish more associations between non-viral sexually transmitted infections and pregnancy outcome, especially for Mycoplasma genitalium, Trichomonas vaginalis and Neisseria gonorrhoeae. Overall, this review calls for more research for public health interventions to promote screening of non-viral sexually transmitted infections during pregnancy, among high-risk population groups of pregnant women living in the region.

The factors associated with stillbirths among sub-saharan African deliveries: a systematic review and meta-analysis

BackgroundGlobally, more than 2.6 million stillbirths occur each year. The vast majority (98%) of stillbirths occur in low- and middle-income countries, and over fifty percent (55%) of these happen in rural sub-Saharan Africa.MethodsThis is a systematic review and meta-analysis developed using the Preferred Reporting Items for Systematic Review and Meta-Analyses guidelines. A literature search was performed using PubMed, the Cochrane Library, Google Scholar, EMBASE, Scopus, the Web of Sciences, and gray literature. Rayyan`s software was used for literature screening. A random effects meta-analysis was conducted with STATA version 17. Heterogeneity was checked by using Cochran’s Q and I2 tests. Funnel plots and Egger’s test were used to examine the risk of publication bias. The protocol of the study was registered in PROSPERO with a registration number of CRD42023391874.ResultsForty-one studies gathered from eight sub-Saharan countries with a total of 192,916 sample sizes were included. Nine variables were highly linked with stillbirth. These include advanced maternal age (aOR: 1.43, 95% CI: 1.16, 1.70), high educational attainment (aOR: 0.55, 95% CI: 0.47, 0.63), antenatal care (aOR: 0.45, 95% CI: 0.35, 0.55), antepartum hemorrhage (aOR: 2.70, 95% CI: 1.91, 3.50), low birth weight (aOR: 1.72, 95% CI: 1.56–1.87), admission by referral (aOR: 1.55, 95% CI: 1.41, 1.68), history of stillbirth (aOR: 2.43, 95% CI: 1.84, 3.03), anemia (aOR: 2.62, 95% CI: 1.93, 3.31), and hypertension (aOR: 2.22, 95% CI: 1.70, 2.75).ConclusionA significant association was found between stillbirth and maternal age, educational status, antenatal care, antepartum hemorrhage, birth weight, mode of arrival, history of previous stillbirth, anemia, and hypertension. Integrating maternal health and obstetric factors will help identify the risk factors as early as possible and provide early interventions.

Abstract 17563: Serial ABPM, Antihypertensive Drug Treatment, and Pregnancy Outcomes in Women With Hypertension Found Early During Pregnancy

Introduction: Few data are available on serial ambulatory blood pressure monitoring (ABPM) throughout pregnancyand antihypertensive drug treatment required for good blood pressure (BP) control in hypertensivepregnant women. Hypothesis: Evaluation of BP control, antihypertensive drug treatment intensity, and pregnancy outcomes in patients with hypertension (HTN) found early during pregnancy. Methods: We studied 49 consecutive pregnant patients (mean age 33.4±4.8 years, BMI before pregnancy24.5±3.7 kg/m2) referred for office HTN found early during pregnancy who gave birth to 50 children (1 twin pregnancy) in 2011-2015. Gestational HTN was previouslydiagnosed in 39 women, and 9 women had a history of previous miscarriage or stillbirth, with multipleprevious pregnancies lost in some patients. ABPM was repeated at 5-10-15-20-25-30-33-35-37 weeksof pregnancy. We calculated overall antihypertensive treatment intensity in standard daily drug doses per patient (standard doses: labetalol 200 mg, methyldopa 750 mg, metoprolol 50 mg, nifedipine 20mg, verapamil 120 mg). Statistical analysis was performed using ANOVA. Results: All children were born alive (24 vaginal delivery, 26 cesarean section) and are well at follow-up.Gestational age was 38.0±2.5 (range 29-40) weeks, and birth weight was 3215±653g (range 955-4200). Preeclampsia/eclampsia occurred in 10/3 patients. Four patients had normal BP values by ABPM throughout pregnancy and did not receive antihypertensive drugs. Most patients were treatedwith labetalol and methyldopa. Throughout pregnancy, BP remainedwell controlled (24h mean SBP/DBP 120.3-126.0/75.3-77.1 mmHg), the number of treated patientsincreased from 25 at 5 weeks to 42 at 25-35 weeks, and the average number of daily antihypertensivedrug doses in treated pts increased from 1.82 at 5 weeks to 2.98 at 37 weeks. Conclusions: Serial ABPM-guided antihypertensive drug treatment started early during pregnancywas associated with favorable outcomes. The number of patients requiring treatment increased throughout the pregnancy. No physiological BP fall atthe end of 1 st trimester was observed. Our findings help estimate the expected treatment intensity required in pregnant patients with preexisting hypertension.

Etiology of stillbirth in a tertiary care center: a retrospective cohort study assessing ultrasound, laboratory, and pathology investigations

Background Canadian stillbirth data are limited, and a significant proportion of pregnancies resulting in stillbirth have no attributable cause. The objective of this study was to characterize stillbirth case investigations and management at a tertiary care hospital in Ontario, Canada. Methods This was a retrospective chart review study of all cases of singleton stillbirth at The Ottawa Hospital between 1 January 2012 and 31 December 2017. Terminations and multiples stillbirths were excluded. Chart reviews were conducted to extract maternal sociodemographic, obstetrical, and fetal characteristics, including results from antenatal ultrasounds, autopsy, placenta pathology, and laboratory investigations. Results A total of 155 eligible cases of stillbirth were identified, resulting in a 6-year stillbirth rate of 4.2 per 1000 total births. The median maternal age was 31.0 years (IQR: 29.0, 35.0) and the median gestational age at delivery was 28 weeks (IQR: 24, 35). A total of 9 (5.8%) pregnant individuals had a history of previous stillbirth. Of the 155 stillbirths, 35% underwent the full suite of post-loss laboratory, placental, and fetal autopsy investigations. 63.2% of cases had post-loss laboratory investigations completed. 76% and 71% of cases had fetal autopsy and placenta pathology evaluations completed, respectively. Antenatal characteristics associated with stillbirth included fetal anomalies/genetic markers (27.1%), umbilical cord and placental anomalies (24.5%), fetal growth abnormalities (27.7%), cervical/uterine abnormalities (11.6%), and amniotic fluid abnormalities (25.1%). The most common autopsy findings included evidence of infection (22.7%), fetal anomalies (12.6%), and fetal hypoxia (10%). The most common placental pathology findings included features of placental insufficiency (21.8%), retroplacental abnormalities (16.3%), and umbilical cord accident/infarct (15.4%). Conclusions Our findings demonstrate that as many as two-thirds of singleton stillbirth cases at our center did not receive the post-perinatal loss investigations recommended by clinical practice guidelines. More thorough collection of post-stillbirth data at all levels (institutional, provincial, national) is warranted to improve our understanding of stillbirth epidemiology, etiology, and management in Canada.

Thyroid status in pregnancy: Comparison of thyroid function abnormalities in women with and without a history of miscarriage or stillbirth.

To evaluate thyroid function tests (TFTs) during pregnancy in women with previous history of miscarriage or stillbirth. A cross-sectional study was carried out at the department of Obstetrics & Gynaecology and Endocrinology, Lady Reading Hospital, Peshawar from February 2021 to March 2022. All multigravida women attending the antenatal clinics were included using consecutive sampling. These women were placed into two groups, Group-A comprised of women with no prior history of miscarriages or stillbirths, and those with a history of foetal death during previous pregnancies were assigned Group-B. Free T4, thyroid stimulating hormone (TSH) and anti-thyroid peroxidase (TPO) antibodies were measured and the former two were used to label patients with thyroid dysfunction. A total of 139 multigravida women were included in the study. About 43% of the women had a history of miscarriages or stillbirths. Thyroid dysfunction was observed overall in 36.69 % women, of whom 25.18% had sub-clinical hypothyroidism, 6.47% had hypothyroidism and 5.04 % were sub-clinical hyperthyroid. Women in Group-B had more thyroid functions abnormalities compared to Group-A (p<0.05). Moreover, there was significant difference in median TSH and freeT4 between the groups (p<0.001). Overall, thyroid dysfunction was found in 66.67% of patients who had a history of foetal death. In pregnant women with a history of miscarriage or abortion, thyroid functions abnormalities are common therefore routine thyroid testing is advised in pregnant women to prevent adverse perinatal outcomes.

The Use of Digital Media "Tayo Prenatal" on Anxiety Pregnant Women

Globally, people are experiencing increased feelings of stress, anxiety, and depression as a consequence of the situation that has arisen due to the current pandemic. Pregnant women also often feel anxious and afraid of being exposed to COVID-19, which has an impact on anxiety and mood disorders. Yoga is an ancient way of living in harmony with oneself (body, emotions, and mind) and nature and can improve individual health and reduce stress. This study aims to determine the average difference in anxiety in pregnant women after being given "prenatal tayo". This research is a quasi-experiment using a pretest-Posttest Control Group Design, with 25 respondents fulfilling the inclusion and exclusion criteria. The inclusion criteria in this study were pregnant women with gestational ages between 14 and ≤ 30 weeks, being able to read and write, and owning a smartphone. Exclusion criteria in this study were pregnant women with pregnancy complications and pregnant women with a history of previous miscarriages caused by a weak uterus or heart disease. The sampling technique is purposive sampling. Statistical tests using independent T test and Paired T-Test. There is a difference in the anxiety of pregnant women before and after being given "Tayo Prenatal". More research is needed regarding changes in anxiety in pregnant women measured every week to determine the effect of the intervention of giving "Tayo Prenatal" compared to giving Yoga.

Safety and Effect of the Use of Hydrotherapy during Labour: A Retrospective Observational Study.

Hydrotherapy is a technique used for pain management during labour, but its safety for both the mother and foetus remains uncertain. The main aim of this study is to determine whether the use of hydrotherapy in the first stage of labour is safe for both the mother and newborn. A retrospective observational study was conducted to collect data from the partogram, maternal and neonatal history. A total of 377 women who gave birth at the Costa del Sol Hospital in Malaga between January 2010 and December 2020 were randomly selected. They were divided into a control group (253 women) and an intervention group (124 women) that used hydrotherapy in the first stage of labour. There were no significant differences between the groups in terms of age, history of previous miscarriages, type of delivery, or newborn weight. The results showed that most women who opted for hydrotherapy were nulliparous, and the use of hydrotherapy during labour was safe for both the mother and foetus. There were no significant differences in the variables of maternal arterial hypotension, postpartum haemorrhage, postpartum maternal fever, foetal complications, neonatal admission, 1 and 5 min Apgar scores, umbilical arterial or venous pH, or foetal cardiotocographic recording. However, there was a significant difference (p = 0.005) in the rate of breastfeeding among mothers who opted for hydrotherapy (96% vs. 85.7%). The use of hydrotherapy during the first stage of labour is safe and is associated with increased breastfeeding rates compared to conventional delivery.

Antenatal Care Utilization Factors Among Pregnant Women Attending Antenatal Care Clinic at Kakanju Health Centre III Bushenyi District

The study aimed to determine the factors influencing the utilization of antenatal care (ANC) among pregnant women aged 18-40 attending ANC clinics at Kakanju Health Centre III in Bushenyi District. The research used a descriptive cross-sectional study design, with a sample size of 384 respondents. The results showed that 86.2% of participants had adequate knowledge about ANC utilization, while 13.8% had inadequate knowledge. Women aged 15-20 years, house wives, maids, and shop attendants were also more likely to have inadequate knowledge. Women without education were six times more likely to have inadequate knowledge about ANC utilization. Women in their first pregnancy were three times more likely to have inadequate knowledge. Women with a history of previous stillbirth were three times more likely to have inadequate knowledge. Women with a history of previous cesarean section were two times more likely to have adequate knowledge about ANC utilization. Age, occupation, marital status, and education level were found to be statistically significantly associated with knowledge regarding ANC utilization. Keywords: ANC utilization, Pregnant women, Cesarean section, Stillbirth, ANC services.

Maternal and obstetrical factors associated with short cervical length at midtrimester in women with no history of preterm delivery

Aim To evaluate associations between maternal characteristics and a short cervix in patients without history of preterm delivery, and to determine if these characteristics can predict the presence of a short cervix. Materials and methods This is a retrospective cohort study that included 18,592 women with singleton pregnancies without history of previous preterm deliveries who underwent universal transvaginal cervical length (TVCL) screening between 18 + 0 and 23 + 6 weeks/days of gestation. A short cervix was defined as a cervical length (CL) ≤25 mm, ≤20 mm, and ≤15 mm. Associations between maternal age, weight, height, body mass index (BMI), previous term deliveries, and history of previous miscarriages, with a short cervix were evaluated using logistic regression models. Results The prevalence of a short cervix in our population was: CL ≤25 mm, 2.2% (n = 403); CL ≤20 mm, 1.2% (n = 224); and CL ≤15 mm, 0.9% (n = 161). Women with BMI >30 and/or previous abortions constituted 45.5% of the total population (8463/18,582). Significant associations with short cervix were observed for women with BMI ≥30, and for women with at least one previous abortion (p < .001). Parous women had a significantly lower association with a short cervix than nulliparous women (p < .001). Maternal age or height were not associated with a short cervix. Prediction of short cervix based on presence of any of the following: BMI ≥ 30 or previous abortions showed sensitivities of 55.8% (≤25 mm), 61.6% (≤20 mm), and 63.4% (≤15 mm) with similar specificity (50.1–54.6%) and likelihood ratio positive (1.2–1.5); and prediction based on BMI ≥ 30 and previous abortions showed sensitivities of 11.1% (≤25 mm), 14.7% (≤20 mm), and 16.7% (≤15 mm) with specificity 93%. Conclusions Among low risk women for spontaneous preterm delivery, those with a BMI ≥30 and/or previous miscarriages had a significantly increased risk for a short cervix at 18 + 0 and 23 + 6 weeks/days of gestation. Despite these significant associations, screening by maternal risk factors in a low risk population of pregnant women should not be an alternative to mid-trimester universal CL measurement.

Obstetric Outcome in Present Pregnancy in Patient with History of Previous Spontaneous Abortion

Obstetric Outcome in Present Pregnancy in Patient with History of Previous Spontaneous Abortion

High seroprevalence of syphilis infection among pregnant women in Public Health facilities in Shashemene town, southern Ethiopia

BackgroundSyphilis infection is a major public health problem in developing countries including Ethiopia. Thus, this study aimed to assess the seroprevalence of syphilis and associated factors among pregnant women attending Antenatal Care (ANC) in Public health facilities in Shashemene town, southern Ethiopia. MethodAn institutional-based cross-sectional study design was conducted among 230 pregnant women from the 27th of August to the 30th of September 2018. Data were collected using a structured interviewer-administered questionnaire. Data were entered into Epi-Info 7 and analyzed with SPSS Version 21. A multivariate logistic regression model was used to investigate factors associated with syphilis infection. A p-value of <0.05 was considered statistically significant. ResultThe overall prevalence of syphilis infection was 22(9.6%)(95% CI, [6.1, 14.1%]). Pregnant mothers who had multiple sexual partners (AOR = 5.12, 95% CI 1.51, 17.44), abnormal vaginal discharge (AOR = 18.13 95%CI 3.66, 88.42), previous history of abortion (AOR = 5.6, 95%CI 2.03, 15.36) and previous history of stillbirth (AOR = 9.98, 95% CI: 2.85, 34.92) were among factors associated with syphilis infection. ConclusionAccording to this study, the magnitude of syphilis infection among pregnant mothers attending ANC was high. Pregnant mothers who had multiple sexual partners, previous history of abortion, previous history of stillbirth, and abnormal vaginal discharge were significantly associated with syphilis infection. Thus, health providers should provide comprehensive health education about syphilis transmission, signs and symptoms, and the methods of prevention as well as create awareness about the adverse outcome of getting syphilis infection.

Obstetric Determinants of Birth Weight Status of Babies Born at Jaramogi Oginga Odinga Teaching and Referral Hospital, Kenya

Background: Low birth weight (LBW) is a serious public health problem, especially in developing countries. Globally, 15.5% of all births are born LBW and 95.6% of them are in developing countries. In Kenya, 8% of babies are born LBW and at Jaramogi Oginga Odinga Teaching and Referral Hospital (JOOTRH), it is 11.1%. Despite several efforts such as antenatal care services put in place to improve the quality of maternal and child health, the rates of LBW are still high. LBW is a major cause of mortality and morbidity in infants. Objective: The objective of this study was to assess obstetric determinants of the birth weight status of babies born at JOOTRH, Kenya. Materials and Methods: This was a cross-sectional study with a sample size of 131 babies plus their mothers from a total population of 538 deliveries during the study period. Systematic random sampling was used to select the respondents. Data was collected using a questionnaire and record review checklist. Data analysis was done using descriptive statistics and inferential statistics, specifically logistic regression. Result: The study results showed that the prevalence of LBW was 13.7%. LBW was strongly associated with a birth interval of &lt; 24 months (AOR = 13.722), hypertension (AOR = 11.753), previous history of LBW (COR = 14.0), and gestation at birth (COR = 3.75). Gravidity, previous history of miscarriage and gestation at which antenatal visits started had no association with LBW. Conclusion: The prevalence of LBW is 13.7%, higher than the national rate of 8% and statistically significant with a Z score of 2.398, p = 0.016. The birth interval of &lt; 24 months, hypertension, previous history of LBW, and gestation at birth influenced the occurrence of LBW. Focused antenatal care to ensure early detection and management of high-risk pregnancies and educate pregnant mothers on the birth spacing of more than two years between two successive pregnancies to allow replenishment of nutrient stores is important in reducing LBW.

A STUDY OF PREGNANCY OUTCOME IN CASES WITH PREVIOUS FIRST TRIMESTER SPONTANEOUS ABORTION

Introduction:Abortion is dened as pregnancy termination or loss before 20 weeks gestation or with a fetus delivered weighing &amp; lt; 500g. About 80% of spontaneous pregnancy losses occur in rst trimester. Aim: To evaluate &amp;amp; study pregnancy outcome in cases with history of previous spontaneous abortions. Objective: To compare the outcomes of pregnant women with history of previous spontaneous abortion and pregnant women without any history of previous abortion. Methods: Total 200 patient were studied 100 cases(with previous history of spontaneous abortion) and 100 control(without history previous abortion) for foetomaternal outcome. Results: A total of 100 patients with history of previous spontaneous abortion were admitted. Majority (58 %) of patients belong to the age group 21-25 years. Maximum patients (77%) were with history of previous one abortion followed by previous two abortions (17%). The nal outcomes were term live birth (64%), abortion (6%), preterm delivery (16%), and PROM (10%). Caesarian section was done in 33% patients for various indications in cases. In control group term live birth (93%),abortion(1%),preterm (4%) and IUGR (1%).Caesarian section was done in 2% control group. Conclusions: Our study showed that previous history of spontaneous abortion is associated with adverse pregnancy outcome like increased risk of abortion, preterm delivery, need for caesarean sections and fetal loss in cases of previous spontaneous abortions

The Association between Some Demographic Characteristics and the Types of Miscarriage among Women in Rania City

Background: Miscarriage or spontaneous abortion is one of the prevalent adverse reproductive outcomes, which seriously threatens maternal health around the world. Some demographic features might associate with an elevate risk of spontaneous miscarriage which include cervical incompetence, infection, previous history of miscarriage, maternal passive smoking, age, and body weight. Objectives: The current study was carried out in order to investigate the association between socio-demographic characteristics of women undergoing miscarriage and their risk for spontaneous miscarriage in Rania city. Methodology: Quantitative design, a descriptive cross-sectional study was performed to assess the types of miscarriage and associated factors among women in Rania City. Samples of the study are Non probability purposive of (158) sample who attend Rania maternity and pediatric teaching Hospital. Besides two participants induced miscarriage were excluded. The data were collected from 1st June to 15th August 2022 through the utilization of construct questionnaire, data were collected by interview technique face to face approach of the study samples. Results: The study illustrate socio-demographic characters of miscarried women, the average age was 34.6 years and majority of them have diploma qualification (27.8%), and (61.4%) were house wife, also (48.7%) were in sufficient level of income, furthermore most of the study sample were in normal weight include (50.6%) while only (2.5%) were under weight,( 38.6%) of samples were in passive cigarette of smoking, moreover the samples’ weight and smoking cigarette associated to miscarriage (P= 0.022),(P= 0.003) respectively. Conclusion: The present study concluded that most common factor where associated with miscarriage was related to sociodemographic features. Excessive focusing on cigarette smoking exposure and maternal weight. Regarding the results of this study, mother’s demographic had relationship to miscarriage.

A Rare Case of Choriocarcinomatous Pulmonary Embolism revealed by Ischemic Strokes

Choriocarcinoma is a malignant tumor with high metastatic potential belonging to the spectrum of gestational trophoblastic tumors, which can be of germ cell origin (nongestational) or gestational. Choriocarcinomatous pulmonary embolism represents a rare and aggressive extra-gonadal form of gestational trophoblastic disease, most often occurring after a normal or pathological pregnancy. The presentation is similar to that of cruoric embolism, but it is characterized by local invasion and significant hematogenous dissemination leading to distant metastases. Increased Human chorionic gonadotropin hormone (hCG) levels are suggestive of the diagnosis. We report a case of choriocarcinomatous pulmonary embolism involving the inferior lobar artery of the left lung in a 44-year-old female patient admitted for multiple ischemic strokes. The diagnosis of choriocarcinoma was done on CT scan in the presence of high levels of Human chorionic gonadotropin hormone (hCG) contrasting with negative pelvic imaging and a history of previous spontaneous abortion. The outcome was favourable after chemotherapy which was an additional argument in favor of the diagnosis of choriocarcinoma.

Basic biochemical and hematological parameters of structural hemoglobin variants in the postpartum women and their respective newborn from Manaus, Amazonas, Brazil

The present study aimed at estimating the prevalence of structural hemoglobinopathies in newborn and describing the hematological and biochemical characteristics between postpartum women (PW) and their respective newborns (NB) at a public maternity hospital in Manaus, Amazonas state, Brazil. In total, 825 NB and 820 PW were included in the study. Hematological and biochemical analysis and screening of structural hemoglobinopathies were performed and compared in groups of individuals (NICU or not; hemoglobin genotypes; gestational age and prenatal). The age of PW ranged from 13 to 44 years old (mean of 23.7 ± 6.6 years), with 45.9% pregnant for the first time and 54.1% multiparous. Reported receiving prenatal care 88% and regarding the type of delivery, 47.7% had delivered by cesarean section. Among the births, 19.4% were born premature and 8.3% were admission to the neonatal intensive care unit (NICU). The male NB represented 53.4% of the total. Sickle cell trait (FAS) was found in 16 (1.94%) and heterozygous for D hemoglobin (FAD) in 6 (0.73%) newborns. A statistically significant values was found between the previous history of miscarriage and increase of Mean corpuscular volume (MCV) (p < .001), Red blood cell distribution width (RDW) (p = .003), total and indirect bilirubin concentration (p < .001) and LDL cholesterol (p = .004). Hemoglobin levels below 13.5 g/dL was found in 66% black newborns, compared with 15% of Afro-Brazilian and 5% of whites. The frequency of structural hemoglobinopathies was higher in African-Brazilian newborn babies (78%) and those who with low birth weight had a higher frequency of NICU (35.7%). Interestingly, underage mothers had a higher frequency of NB with low birth weight and premature birth. Postpartum women who had children carriers of FAS and FAD had a higher frequency of urinary tract infection (65.2%) and moderate anemia (23.8%). This study estimated for the first time the prevalence of structural hemoglobinopathies in NB in Manaus, Amazonas, Brazil. Despite the small prevalence of, we highlight the importance of early diagnosis of hemoglobin variants, contributing to the improvement of the quality of life of PW and your NB, reinforce the need to implement educational and prevention programs to raise awareness among the population and in order to counsel parents regarding the probability of having a child with abnormal hemoglobins homozygous as HbSS or HbCC.