Mean Age Of Pregnant Women Research Articles

Spiritual Health and Physical Activity Among Iranian Pregnant Women.

This study was aimed to investigate the relationship between spiritual health and physical activity among Iranian pregnant women during 2015. A cross-sectional descriptive-analytic design was adopted. A total number of 411 participants were selected by convenience sampling from Iranian women who regularly attended health centers for prenatal care. Data were collected using demographic questionnaire and Health-Promoting Lifestyle Profile questionnaire, 2nd edition. (Spiritual health and physical activity are two components of health-promoting lifestyle.) The data were analyzed, using descriptive statistics, t test, one-way ANOVA, Pearson's correlation coefficient, and regression. p values <0.05 were considered significant. The mean age of pregnant women was 27.90±6.03years. Spiritual health had the highest score (25.86±4.7) and physical activity had the lowest score (11.31±3.27), among six Health-Promoting Lifestyle Profile subscales. In fact, there was a statistically significant correlation between spiritual health and physical activity (p=0.000). According to results, pregnant women have higher spiritual health and lower physical activity scores. There was a statistically significant correlation between spiritual health and physical activity. The findings of this study can be used in prenatal care, midwifery education, and maternal health policies.

Knowledge on dietary patterns among pregnant women attending antenatal care check-up in Narayani hospital, Nepal

Background: Pregnancy is the period from conception to birth during which there is the requirements of diet that provide the required essential nutrients to keep the mother healthy and allow the fetus to grow and develop in favorable conditions. The objective of the study was to identify the knowledge on dietary pattern among pregnant women attending ANC checkup in Narayani sub-regional hospital. Methods: The study was of descriptive, cross sectional type. The random sampling technique was applied. The study design was conducted in Narayani sub-regional hospital in Parsa district, Nepal. Participants included 96 pregnant women using semi structured questionnaire through face to face interview. Data analysis was done both manually and with the help of SPSS. Results: The study showed that there were more women 56(58.3%) from rural areas than that of urban. About seven out of 10 pregnant women were between the ages of 20 to 35 years of age and the study showed that one-fifth of the pregnant women were married before legal age. The mean age of pregnant women was 24. 1 year. There were 6.2% of pregnant women who were illiterate and six out of 10(59.4%) pregnant women had agriculture as their main occupation. The total sampled 96 pregnant women interviewed all knew about nutrition and mostly the source of information was family, neighbors and friends (34.4%). Almost two-fourth (45.8%) of pregnant women still have the wrong perception regarding consumption of green vegetables and coldness (61.4%) is the main reason behind not consumption of green vegetables. The reason for consumption of processed food was because of easy availability and nine in ten pregnant women replied media influenced them to eat processed food. Two-third pregnant women replied right answer for reason of taking iron tabs. In the study found that there is no association between women literacy and knowledge on nutrition. About 6 in 10 (59.3%) sampled women had moderate knowledge on nutrition whereas only one forth-pregnant woman had high knowledge on nutrition. One-sixth pregnant women had low knowledge. Conclusions: The study revealed that, although every pregnant woman had some sorts of knowledge on nutrition, still there is lack of sufficient knowledge on dietary patterns during pregnancy and some wrong perceptions following diet consumption during pregnancy was found. Health education and awareness programs that influences to develop positive attitude can only ultimately brings changes in the behavior.

معرفة وموقف النساء الحوامل من أنماط الولادة في عيادة لرعاية الحوامل في بغداد

Background: Since 1985 the World Health Organization (WHO) had stated: “There is no justification for any region to have Caesarian Sections (CS) rates higher than 10-15%”. Since then, CSs have become increasingly common in both developed and developing countries. The rate of CS has been reported to be as high as 24.5% and 25.8% among Iraqi women in the years 2009 and 2010 respectively.Objectives: The study was designed to provide data on the level of existing knowledge, attitudes and preference of modes of delivery, which can be used as a platform to raise knowledge among pregnant women and their partners and thereby empowering women to make informed choices.Patients and Methods: This cross-sectional study was undertaken in an antenatal care clinic in Baghdad Teaching Hospital, Medical City, and Baghdad from 1st Feb. -31st May 2016. All 300 pregnant attending antenatal clinic were interviewed with a structured questionnaire that solicited information on their knowledge, attitudes and preference towards modes of delivery.Results: Mean age of pregnant women was 28.3 ± 9.8SD years and84.7% were not employed. More than half of them (54.3%) had married at younger age (<20 years). Educational levels were 43.3% primary, 18% secondary and 20.4% university levels. Knowledge of majority of pregnant mothers (82.6%) about modes of delivery were obtained from relatives. Half of pregnant women had good knowledge about modes of delivery, 51.3% of them had negative attitude toward CS, and 62% had positive attitude towards CS delivery in current pregnancy.Conclusion: Study results emphasize the need for educating families, especially pregnant women and their partners about the pros and cons of different modes of giving birth to their babies.

Knowledge and attitude of pregnant women towards modes of delivery in an antenatal care clinic in Baghdad

Background: Since 1985 the World Health Organization (WHO) had stated: “There is no justification for any region to have Caesarian Sections (CS) rates higher than 10-15%”. Since then, CSs have become increasingly common in both developed and developing countries. The rate of CS has been reported to be as high as 24.5% and 25.8% among Iraqi women in the years 2009 and 2010 respectively.Objectives: The study was designed to provide data on the level of existing knowledge, attitudes and preference of modes of delivery, which can be used as a platform to raise knowledge among pregnant women and their partners and thereby empowering women to make informed choices.Patients and Methods: This cross-sectional study was undertaken in an antenatal care clinic in Baghdad Teaching Hospital, Medical City, and Baghdad from 1st Feb. -31st May 2016. All 300 pregnant attending antenatal clinic were interviewed with a structured questionnaire that solicited information on their knowledge, attitudes and preference towards modes of delivery.Results: Mean age of pregnant women was 28.3 ± 9.8SD years and84.7% were not employed. More than half of them (54.3%) had married at younger age (&lt;20 years). Educational levels were 43.3% primary, 18% secondary and 20.4% university levels. Knowledge of majority of pregnant mothers (82.6%) about modes of delivery were obtained from relatives. Half of pregnant women had good knowledge about modes of delivery, 51.3% of them had negative attitude toward CS, and 62% had positive attitude towards CS delivery in current pregnancy.Conclusion: Study results emphasize the need for educating families, especially pregnant women and their partners about the pros and cons of different modes of giving birth to their babies.

Nivel de proteína C-reactiva en comparación con el recuento leucocitario materno en la predicción de corioamnionitis histológica en gestantes con rotura prematura de membranas pretérmino

Objetivo: Demostrar la utilidad del nivel de proteína C-reactiva en comparación con el recuento eucocitariomaterno en la predicción de corioamnionitis histológica en gestantes con rotura prematura de membranas pretérmino. Diseño: Estudio no experimental, tipo validación de prueba diagnóstica. Institución: Instituto Nacional Materno Perinatal, Lima, Perú. Participantes: Gestantes con rotura prematura de membranas pretérmino, entre enero y junio del 2013. Intervenciones: Se incluyó gestantes pretérmino con edad gestacional ≥22 semanas y &lt;37 semanas, con rotura prematura de membranas, fetos únicos e historia clínica disponible con información requerida completa. Para el análisis estadístico se usó el programa SPSS 19. Principales medidas de resultados: Índices diagnósticos del nivel de proteína C-reactiva y recuento leucocitario. Resultados: La incidencia de corioamnionitis histológica fue 76,3% (71/93). La edad promedio de las gestantes fue 29,0 +- 6,6 años. La rotura ocurrió con más frecuencia con edad materna de 25 a 30 años (31,2%) y en nulíparas; la edad gestacional promedio fue 29,2 + 3,4 semanas, más frecuente entre las 27 y 31 semanas (51,6%) y en nulíparas de riesgo social mediano. El periodo de latencia promedio fue 12,6 + 10,9 días y el parto ocurrió dentro de los 15 días de la rotura (74%). El nivel de PCR promedio fue 29,6 + 26,9 mg/L, con diferencia altamente significativa (p=0,00) para la corioamnionitis histológica. Su sensibilidad fue 98,6%, especificidad 45,5%, valor predictivo positivo 85,4% y valor predictivo negativo 90,9%. La curva ROC predijo corioamnionitis histológica con un área bajo la curva de 0,861 (IC95%: 0,77 a 0,95) (p = 0,000); estableciendo en 12,45 mg/L el punto de corte por encima del cual se puede predecir el riesgo de corioamnionitis histológica. El recuento leucocitario fue 15 519,5 + 4 410,5 cel/mL, sin diferencia significativa (p=0,790). Su sensibilidad fue 52,1%, especificidad 63,6%, valor predictivo positivo 82,2% y valor predictivo negativo 29,2%.El área bajo la curva ROC 0,714 (IC 95% 0,587 a 0,84) demostró significancia estadística (p= 0,002), teniendo como punto de corte 13 490 cel/mL.Conclusiones: El nivel de proteína C-reactiva fue más confiable que el recuento leucocitario materno en la predicción de corioamnionitis histológica en gestantes con rotura prematura de membranas pretérmino.

Haematological Parameters in Pregnant Women Attended Antenatal Care at Sabratha Teaching Hospital in Northwest, Libya

The aim of this study was to evaluate the values of hematological parameters at different trimesters of pregnancy in pregnant women who attended antenatal care at Sabratha Teaching Hospital, Northwest Libya. This cross-sectional survey included consecutive pregnant women who attended the obstetrical department in Sabratha Teaching Hospital for prenatal booking. This study was carried out over period of 6 month from April 2016 to September 2016. The study involved 120 pregnant women as the study group and 40 non-pregnant women as control. The study pregnant women were between the ages of 18 to 45 years. 5 ml of venous blood samples were taken from each pregnant woman in K₃-EDTA tubes for the haematological examinations. The analysis of haematological indices was done using automated hematological analyzer. The obtained results showed that the mean age of pregnant women was 30 years ± 5.8 SD, 48.4% of pregnant women were between 21-30 years old, 40.8% were at age between 31-40 years. The most prevalent blood group in pregnant women was group O, 47.5%; followed by blood group A, 28.3%; blood group B, 17.5% and blood group AB, 6.7%. 15.8% of the pregnant women were observed to lack Rh antigen in their blood. Highly significance decrease in Hb, Hct, MCH, MCHC, lymphocytes%, RBCs and blood platelets count and significant decrease in MCV as compared with non pregnant women. On the other hand, highly significance increased in WBCs count, and neutrophils % of pregnant women compared with non pregnant women. A progressive decline in Hb concentration and haematocrite values from the first to third trimester was observed. The mean corpuscular volume was significantly decreased in the second trimester. The values of MCH showed highly significant decrease in the second and third trimester, and MCHC decreased significantly in the first trimester. WBC count and neutrophils % showed highly significant increase from the first to the third trimester. Lymphocytes % were highly significant decreased from the first to the third trimester. Mixed percentage of leukocytes (eosinophil, basophil and monocytes) decreased significantly in the third trimester. Platelets count exhibited a highly significant decrease in the second and third trimesters, and a significantly decrease in the first trimester. It can be concluded that a significant changes in the haematological parameters at different trimesters of pregnancy in pregnant women. So it is essential to monitor and manage these parameters during pregnancy.

The relationship between expectation, experience and perception of labour pain: an observational study.

The present study was aimed to assess the relationship between pain expectation before labour, labour pain and pain perception after the labour. Pregnant women were asked to rate their pain level on a standard continuous visual analogue scale at various time points. Pain expectancy (PE), labour pain (LP) and postpartum pain perception (PPP) scores were calculated. The final study group was composed of 230 pregnant women after exclusions. Mean age of pregnant women was 26.2 ± 5.79. The mean PE, LP, and PPP scores were 70.11 ± 18.82, 75.72 ± 19.2 and 65.84 ± 19.56, respectively. The difference among pain scores was statistically significant (p < 0.001). There was a positive correlation between PE and LP or PE and PPP scores (p = 0.27 and p = 0.21). The correlations were statistically significant (p = 0.01 or p = 0.01). In addition, there was a positive correlation between LP and PPP scores (p = 0.87) and the correlation was statistically significant (p = 0.01). This study showed that, if pregnant women had lower expectations of pain before the labour, they indeed experienced lower amount of pain during the labour.

Measurement of Health Belief Model Construct in Relation With Nutritional Practices of Pregnant Women in Saveh University of Medical Sciences

Introduction: Healthy and adequate diet during pregnancy is critical to maternal health as well as to infant growth and development. Te aim of this study was to measure health belief model (HBM) constructs in regards with nutritional practices of pregnant women in Saveh University of Medical Sciences. Methods: A cross- sectional and analytical study was conducted in 2014. Te study population was a random multi-stage selection of 260 pregnant women in health centers dependent to Saveh University of Medical Sciences. Te data were collected through a self-administered questionnaire based on HBM constructs and the checklist of pregnant women’s practice on diet and was analyzed by statistical methods such as logistic regression test and chi- squared test through SPSS version 18. Results: According to the fndings, the mean age of pregnant women was 27.4 ± 5 years. Regression analysis showed that all HBM constructs were signifcant predictors for nutritional practices (P > 0.05). In addition, variables of perceived barriers, self efcacy and perceived sensitivity were identifed as the most important constructs of the HBM in predicting nutritional practices. conclusions: Our study highlights the need for improving the beliefs related with nutritional behaviors, designing educational programs with emphasis on increasing self-efcacy, and removal of barriers to healthy diet behaviors.

Birth Preparedness and Complication Readiness: Attitude and Level of Preparedness among Pregnant Women in Benin City, Edo State, Nigeria

Lack of advance planning for use of skilled attendants at birth contributes significantly to delays in receiving obstetric care. This study assessed attitude and level of birth preparedness and complication readiness (BPACR) plan among pregnant women in Benin City, with a view to improving utilization of skilled attendants at birth and health facility deliveries. Materials and Methods: A community based analytical cross sectional study was conducted, involving interviewer administration of pretested structured questionnaires to 252 consenting pregnant women in Benin City, Edo State. Results: The mean age of pregnant women studied was 28.9±4.9 years. Two hundred and thirty eight (94.4%) respondents had positive attitude towards BPACR. Furthermore, 197 (78.2%) and Original Research Article

Anaemia in pregnant mothers attending antenatal clinic at primary health centre, Devarayasamudra, Kolar, Karnataka, India

Background: Anaemia in pregnancy continues to be a problem inspite of national programs for its prevention and control. It is an important factor in maternal morbidity and mortality. Nutrition education during pregnancy and the consumption and supply of iron and folic acid tablets is still not universal as envisaged in the RCH programme. The objectives of the study were to study the prevalence of anaemiaamong pregnant mothers attending antenatal clinic and to study the knowledge and practices regarding prevention of anaemia in pregnant mothers. Methods: A cross sectional study was conducted at PHC Devarayasamudra on 50 pregnant women attending antenatal clinic. A pre tested questionnaire was applied to know the utilization and delivery of ANC services. Hemoglobin estimation was done by using Sahli’s method. A focused group discussion was conducted to find the knowledge and practices regarding anaemia and its prevention. Results: The mean age of pregnant women in the study is 22 years and 6% were below 18 years. Primi constituted to 40%. 60% had at least one child. At least one home visit by ANM was made in all of the women. 54% of the women received IFA tablets from PHC and 10% were given prescription for IFA and 40% of the women never consumed it. Only 46% of women had ever used any temporary family planning method. 70% of women did not use sanitary latrine and 14% of them did not wear footwear during open field defecation. 64% of the women had anemia. About 52% of the women had no knowledge on the importance of consuming iron rich nutritious diet during pregnancy. Conclusions: Anaemia in pregnancy continues to be a problem. The delivery of services to prevent and control anaemia is not as expected under RCH programme. The knowledge of the pregnant mothers regarding anaemia and its prevention is poor.

Knowledge and attitiudes of pregnant women and their providers towards recommendations for immunization during pregnancy

ObjectivesTetanus, diphtheria and acellular pertussis (Tdap) and influenza vaccination is recommended during each pregnancy but uptake is suboptimal. We evaluated knowledge and acceptance of vaccination recommendations among pregnant women. MethodsProspective, convenience survey of pregnant women presenting for antenatal care at the Pavilion for Women, Texas Children's Hospital, Houston, and their healthcare providers. Results796 of 825 (96.5%) of women and 63 of 87 (72.4%) providers completed surveys. Mean age of pregnant women was 30.2 (18–45) years. Self-identified race/ethnicity was 45% white, 26% Hispanic, 13% black, 12% Asian and 4% other. Most women had college degrees (84%) and private health insurance (83%). Mean gestation was 28.5 weeks with 4.8%, 37.8% and 57.4%, in the 1st, 2nd and 3rd trimesters, respectively. Women used various sources for pregnancy information (personal contacts, providers, print, audiovisual and online media) but 89.1% cited a provider as their most trusted source, predominantly (85.8%) their physician. 668 (84%) knew vaccines are recommended during pregnancy, specifically influenza (77%) and Tdap (61%) vaccines. 659 (83%) were willing to receive vaccines if recommended by their physician. Factors impacting vaccination decisions included safety for baby, safety for mother and sufficient information, scoring 4.7, 4.5 and 4.2, respectively, on a 5-point scale; less important were additional visit time (2.6), cost (1.9) or needle phobia (1). Women surveyed in the 3rd trimester showed greater acceptance than those earlier in gestation (87% vs 78%; P0.003). Maternal education, ethnicity, insurance, multiple gestation or history of serious illness in a prior infant did not affect willingness to receive vaccines. ConclusionsPregnant women are willing to accept vaccination in pregnancy if recommended by their physician and if sufficient discussion of safety and rationale occurs. Strong physician recommendation, as reported for pediatric vaccination, is essential to optimizing uptake of vaccines during pregnancy.

Extrahepatic portal-vein obstruction in pregnancy

BackgroundExtrahepatic portal-vein obstruction (EHPVO) is a common cause of portal hypertension in developing countries. The main risk in pregnant women with this condition is variceal bleeding, which may be life-threatening. The objective of our study was to assess the outcome of pregnancy in women with EHPVO. Materials and MethodsA retrospective analysis of 21 pregnancies in 12 women with EHPVO was carried out at a tertiary hospital in India. ResultsThe mean age of pregnant women with EHPVO was 25.3 years, and the mean duration of disease since diagnosis was 6.1 ± 1.2 years. All the patients had chronic EHPVO, and two patients were diagnosed in the index pregnancy. The incidence of abortion, preterm deliveries, and small for gestational age fetus was 23.8%, 18.7%, and 12.5%, respectively. Thrombocytopenia was found to complicate 61.9% of the pregnancies, while anemia was detected in 40% of the pregnancies. Variceal bleeding occurred in one woman, who was diagnosed during pregnancy and was managed successfully with endoscopic sclerotherapy. None of the patients who were diagnosed prenatally had variceal bleeding during pregnancy. The outcome in nine pregnancies, in which prenatal endoscopic variceal ligation was done, was compared with eight pregnancies, in which endoscopic sclerotherapy was done. No significant difference between the two groups in terms of pregnancy outcome and complications was found. There were no stillbirths or maternal mortality. ConclusionWomen with EHPVO who have been diagnosed and treated prenatally have a good pregnancy outcome. They should be managed in a tertiary care center with a multidisciplinary approach.

Seroprevalence of Antibodies to Hepatitis E Virus Among Pregnant Women

Background: Hepatitis E virus (HEV) infection is a major public health problem in developing countries, which could progress to an acute self-limited hepatitis. Young adults and middle-aged people are more likely to be infected than children and elderly persons. The disease is usually mild in general population; severe infection is more seen among pregnant women and leads to a high rate of mortality in this population. Objectives: This study aimed to assess seroprevalence of HEV infection and related risk factors among pregnant women referred to Fatemieh Hospital in Hamadan, Iran. Patients and Methods: A total of 1050 pregnant women were included in this prospective cross-sectional study, conducted from 2010 to 2011. Anti-HEV specific IgG was measured with ELISA method. A questionnaire containing research purposes was also fulfilled for each participant. Results: The mean age of pregnant women was 27.2 ± 5.6 years. The overall seroprevalence of anti-HEV was 7.4%. There was a significant association between anti-HEV seropositivity and age (P < 0.001), degree of education (P = 0.017), number of household members (P = 0.002), siblings (P = 0.005), and parities (P = 0.007). However, no significant relationship was observed between positive anti-HEV and variables such as place of residence, occupation, history of animal contacts, agricultural activities, type of drinking water, and the method of washing vegetables (P > 0.05). Conclusions: According to the results, 92.6% of pregnant women were anti-HEV negative. However, there is no available effective vaccine for its prevention in human yet. Therefore, education about environmental and personal hygiene before and during pregnancy may be helpful for decreasing the rate of HEV infection in this high risk population.

Seroprevalence rates of Toxoplasma gondii, rubella, cytomegalovirus, syphilis, and hepatitis B, seroprevalences rate in the pregnant population in İstanbul

We retrospectively evaluated the rate of Toxoplasma gondii, rubella, syphilis, cytomegalovirus, and hepatitis B in Istanbul to compare these results with those of other literature and to contribute to the national screening program. The study was conducted in 2011 with women in the first trimester of pregnancy, with ages ranging between 16 and 48 years, in Bakırköy Training and Research Hospital's outpatient pregnancy clinic between January 2008 and January 2013. The mean age of pregnant women was 28.12±5.53, and the mean gravidity was 1.76+0.84.The seropositivities of T. gondii IgM and IgG, cytomegalovirus IgM and IgG, rubella IgM and IgG, VDRL (syphilis), HbsAg, anti-HBsAg were evaluated by ELISA method and evaluated in relation with age and parity. The seropositivity rates were as follows: T. gondii IgM: 0.8%, T. gondii IgG: 31.4%, cytomegalovirus IgM: 0.8%, cytomegalovirus IgG: 99.3%, rubella IgM: 0.2%, rubella IgG: 95.7%, VDRL: 0%, HbsAg: 1.2%, and anti-HbsAg: 26.3%. Also, pregnant women with T. gondii IgG(+) were older than pregnant women with T. gondii IgG(-), and this was statistically significant (p<0.005). Pregnant women with anti-HbsAg(+) were older than pregnant women with anti-HbsAg IgG(-), and this was statistically significant (p<0.005). Also, pregnant women with anti-HbsAg(+) had higher gravidity rates than pregnant women with anti-HbsAg(-), and this was statistically significant (p<0.005). To protect from perinatally transmitted diseases, vaccination programs against rubella and hepatitis B should be extended, and educational programs including the whole country should be arranged. Screening of high-risk pregnant women will be more appropriate when considering the financial charges of screening programs performed for early detection of perinatal infections and for protecting the fetus.

Relationship between maternal age and hypertensive disorders in pregnancy

To explore the current status of maternal age and hypertensive disorders in pregnancy related to maternal age in China. The clinical data were collected from 39 hospitals in mainland China. All deliveries were performed after 28 weeks of completed gestation between January 1 and December 31, 2011. A total of 110 450 cases were enrolled and divided into 6 groups at 5-year intervals according to maternal age. The 25-29 age group was selected as a reference group. The odds ratio (OR) and 95% confidence interval (CI) were calculated by unadjusted binary-Logistic regression as appropriate. The mean age of pregnant women at the time of delivery was 28.18 ± 4.70 (14-52) years. The risk of hypertensive disorders in pregnancy increased in the 3 age groups above 30 years (OR: 30-34 age group = 1.3, 35-39 age group = 2.3, ≥ 40 age group = 3.3) . The risks of chronic hypertension and pregnancy-induced hypertension increased gradually with maternal age. The risks of preeclampsia and severe preeclampsia showed a U-type distribution. The risk was the lowest in the 25-29 age group and the highest in the ≥ 40 age group (OR = 3.6 and 3.4). The rate of eclampsia was 0 in the ≥ 40 age group and the highest in the teenage group (OR = 8.7). And it was higher in the 20-24 age group (OR = 2.6). No significant difference existed between other age groups and the 25-29 age group. The risk of hypertensive disorders in pregnancy increases gradually with age in pregnant women aged over 35 years. And the risks of preeclampsia and eclampsia rise in teenage pregnancy. Better management helps to reduce the incidence of eclampsia and improve the outcomes of pregnancy in pregnant women with advanced maternal age and teenages.

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Objectives The association between increased resistance to flow in the uterine artery and adverse pregnancy outcomes has been demonstrated, but there are no studies evaluating their relationship with outcomes after birth. Our aim was to evaluate the relationship of the pulsatility index of the uterine artery in the second trimester of pregnancy with the neurodevelopment of children in the second year of life. Methods A cohort study was performed involving 1370 women with singleton pregnancies. Pulsatility index of the uterine artery between 20 and 25 weeks was obtained. The psychomotor development of the children of these women was evaluated in the second year of life with the Bayley Scales of Infant and Toddler Development Third Edition (Bayley-III Screening). Results The mean age of pregnant women was 25.8 years and the mean gestational age of 23.6 weeks review. The average pulsatility index of the uterine artery was 0.89 and 1.47 for the 95th percentile. Evaluation of children, showed no increased risk associated with delay in pulsatility index of uterine artery greater than or equal to the 95th percentile development (cognitive performance: RR 0.76, 95% CI 0.3–1.96, receptive communication: RR 1.17, 95% CI 0.46–3.01, expressive communication: RR 0.66, 95% CI 0 0.67–1, 36, fine motor: RR 1.26, 95% CI 0.5–3.27, gross motor: RR 1.14 95% CI 0.44–2.94). Conclusions The high flow resistance of the uterine artery in the second quarter, without deleting other perinatal factors, cannot be considered as a risk factor for the delay in child development. Additional studies should be performed excluding the perinatal risk factors such as prematurity that may adversely affect psychomotor performance of children. Disclosures M.M. Okido: None. L.B. Martins: None. T.V. Bertagnolli: None. M.A. Barbieri: None. H. Bettiol: None. V.C. Cardoso: None. R.C. Cavalli: None.

Controlling congenital and paediatric chagas disease through a community health approach with active surveillance and promotion of paediatric awareness.

BackgroundChagas disease (CD) is endemic in countries of continental Latin America. Congenital transmission is a major concern worldwide. In 2010, the Public Health Agency of Catalonia (ASPCAT) launched a screening protocol for Trypanosoma cruzi infection in pregnant women and their newborns. In 2012, ASPCAT detected appropriate follow-up of pregnant women but incomplete information about their offspring.MethodsThe PROSICS community health team carried out active surveillance and community health action in target populations. These activities included active case searches, group awareness workshops and visualization campaigns as well as investigation of all lost children born from pregnant women with CD and their families.ResultsOverall, 42/179 (23.5%) cases were included in the study: 35/42 (83.3%) children were born in Hospitalet de Llobregat (Catalonia, Spain); 4/42 (16.7%) were born in Latin America; two were miscarried and one was stillborn. The mean age of pregnant women was 31.3 years (SD 5.52; range: 21–44): 90.5% were Bolivian, of whom 74% were diagnosed with CD during pregnancy. Of the 35 newborns, 31 were recovered by community health action; 12/31 were correctly controlled at Hospitalet de Llobregat and 19/31 were controlled at a primary health centre. Of these 19 (73.7%) cases, 14 were not tested for CD by family paediatricians and were recovered by the PROSICS community health team. Finally, two (6.9%) of the 29 newborns tested with serology were positive.ConclusionsIt is essential to implement active surveillance, education and information activities at paediatric primary care and community levels to avoid the loss of CD-infected mothers and their newborns. Training sessions addressed to paediatricians and other involved health professionals would consolidate surveillance and care reference circuits, improving the control of congenital CD.

Pregnancy outcome in patients with idiopathic thrombocytopenic purpura

To study the outcome of pregnancy in women with idiopathic thrombocytopenic purpura. A retrospective analysis of 30 pregnancies in 26 women with idiopathic thrombocytopenic purpura was carried out at a tertiary hospital in India. The courses of the disease, maternal and perinatal outcome in these pregnancies were studied. Mean age of pregnant women with idiopathic thrombocytopenic purpura was 27.3 years and 61.5 % was primigravidae. Out of 26 patients with idiopathic thrombocytopenic purpura, 16 were already diagnosed while the other 10 were diagnosed during pregnancy. The incidence of bleeding episodes in antenatal period, severe thrombocytopenia and hemorrhagic complications at the time of delivery was 30, 37 and 11.1 %, respectively. Oral steroids were required in 40 % of pregnancies. Two patients received intravenous immunoglobulin therapy. Severe thrombocytopenia at the time of delivery was more commonly seen in women in whom ITP was diagnosed during pregnancy as compared to those in whom ITP was diagnosed prior to pregnancy (P = 0.04). Severe thrombocytopenia was seen in 18.5 % of neonates and intracranial hemorrhage was detected in 1 neonate. There were no still births or maternal mortality. Pregnancy outcome in patients with idiopathic thrombocytopenic purpura is generally good.

Effectiveness of breastfeeding education on the weight of child and self-efficacy of mothers - 2011.

Background:Breastfeeding is the most natural and essential way for feeding newborn babies. This is an ideal approach for physical and emotional development of babies, as well as for the recovery of mothers. This study was aimed to determine the effect of breastfeeding education based on the health belief model (HBM) toward primiparous women.Materials and Methods:In a case–control group, quasi-experimental study, 88 subjects were allocated in control and experimental groups. Subjects who were assigned to the experimental group were provided a program consisting of group education based on HBM during their prenatal period. Instrument for data gathering was made by the researchers and standard questionnaire from Dennis and Faux for Breastfeeding Self-efficacy Scale (BSES). Baseline interviews were conducted before delivery and follow-up visits were conducted after 30 days and at the fourth month after delivery. Data were analyzed using SPSS (version 16) with c2, independent sample t-tests, and paired t-test.Results:Mean age of pregnant women who participated in the study was 22 ± 3.29 years. After the program, the experimental group had significantly better scores in terms of self-efficacy, knowledge, and attitude scores statistically. In the fourth month, the mean of child weight in the experimental group was significantly higher than that of the control group (P=0.001) and exclusive breastfeeding was significantly higher than in the control group (P=0.007).Conclusion:Prenatal education in this study based on HBM was successful, and knowledge, attitude, self-efficacy, and related indicators improved. The necessity of producing standard education package and education of pregnant mothers, especially in their first pregnancy, by health professionals is perceived.

Amniyosentez ile Tanı Konulan 4707 Olgunun Sitogenetik Bulgularının Değerlendirilmesi

PURPOSE: Amniocentesis is a very crucial diagnostic procedure for preventing the birth of genetically defective fetuses in order to decrease the prevalence of genetic diseases in populations. METHODS: The karyotyping of 4707 fetuses was carried out in our department during the years of 2000-2009 from the samples of amniotic fluids, CVS, fetal tissues and urines which were sent from departments of Gynecology and Obstetrics of Balcali Hospital and other regional hospitals. RESULTS: The mean maternel and gestational age of pregnant women evaluated for prenatal diagnosis were 29.1 years of age and 18.8 months respectively. Among 4707 fetuses that were karyotyped; 2284 fetuses were males and 2205 fetuses were females and 218 (4.63%) fetuses had various chromosomal abnormalities. Consequently, male to female ratio of fetuses that were examined was 1.03. The advanced maternal age pregnancies followed by positive triplescreening were related to the highest rate of chromosomal abnormalities. The mean age of pregnant women having fetuses with chromosomal abnormalities was found to be 33 years of age which suggest that fetal chromosomal abnormalities were associated with maternal age. Numerical chromosomal abnormalities predominated the structural chromosomal abnormalities (55.5% vs to 44.5%). The numerical chromosomal abnormalities with an incidence of 47.9% trisomy 21, 14.1% trisomy 18, 8.7% Klinefelter Syndrome, 7% monosomy X, 6.6% trisomy 13, 1.7% trisomy X, 1.7% XYY Syndrom, 10% mosaics and the others represented the remaining. Of the structural abnormalities 35% were balanced while the 4% were unbalanced. The frequent structural abnormalities were 25.3% 46,XX/XY, inv(9)(p11;q12) and 19.5% 46,XX/XY, inv(9)(p11;q13). Balanced and unbalanced translocations, deletions and duplications were alsocontributed to chromosomal abnormalities in lesser extent. CONCLUSIONS: Corollary to literature and our findings revealed that the advanced maternal age and certain environmental factors can increase the risk of fetal chromosomal abnormalities. Fetal chromosomal abnormalities representing 4.63% in our study group is crucial and underlines the importance of prenatal diagnosis for healthier pregnancies.