Multigravid Women Research Articles

A systematic review and meta-analysis of asymptomatic malaria infection in pregnant women in Sub-Saharan Africa: A challenge for malaria elimination efforts.

BackgroundIn Sub-Saharan Africa (SSA), where malaria transmission is stable, malaria infection in pregnancy adversely affects pregnant women, fetuses, and newborns and is often asymptomatic. So far, a plethora of primary studies have been carried out on asymptomatic malaria infection in pregnant women in SSA. Nevertheless, no meta-analysis estimated the burden of asymptomatic malaria infection in pregnant women in SSA, so this meta-analysis was carried out to bridge this gap.MethodsPubMed, Web of Science, Scopus, Embase, and ProQuest were systematically searched for relevant studies published until 4 August 2020, and also the expansion of the search was performed by October 24, 2020. We assessed heterogeneity among included studies using I-squared statistics (I2). Publication bias was assessed by visual inspection of the funnel plot and further quantitatively validated by Egger’s and Begg’s tests. The pooled prevalence and pooled odds ratio (OR) and their corresponding 95% Confidence Interval (CI) were estimated using the random-effects model in Stata 15 software.ResultsFor this meta-analysis, we included 35 eligible studies. The overall prevalence estimate of asymptomatic Plasmodium infection prevalence was 26.1%% (95%CI: 21–31.2%, I2 = 99.0%). According to species-specific pooled prevalence estimate, Plasmodium falciparum was dominant species (22.1%, 95%CI: 17.1–27.2%, I2 = 98.6%), followed by Plasmodium vivax, Plasmodium malariae and Plasmodium ovale, respectively, found to be 3% (95%CI: 0–5%, I2 = 88.3%), 0.8% (95%CI: 0.3–0.13%, I2 = 60.5%), and 0.2% (95%CI: -0.01–0.5%, I2 = 31.5%). Asymptomatic malaria-infected pregnant women were 2.28 times more likely anemic (OR = 2.28, 95%CI: 1.66–3.13, I2 = 56.3%) than in non-infected pregnant women. Asymptomatic malaria infection was 1.54 times higher (OR = 1.54, 95%CI: 1.28–1.85, I2 = 11.5%) in primigravida women compared to multigravida women.ConclusionIn SSA, asymptomatic malaria infection in pregnant women is prevalent, and it is associated with an increased likelihood of anemia compared to non-infected pregnant women. Thus, screening of asymptomatic pregnant women for malaria and anemia should be included as part of antenatal care.

COMPARATIVE ANALYSIS OF THE NEONATE BIRTH WEIGHT IN DIFFERENT TYPES OF TIN PREGNANCY

The relevance of the study lies in the significant increase in multiple pregnancies connected with the higher risk of perinatal complications, the controversy over the effects of chorionicity and sex of the babies on their birth weight, the need for timely diagnosis of fetal growth restriction, and associated morbidity.
 The objective of this study was to compare fetal weights at the birth of different variants of twins depending on chorionicity, gestational age, and sex.
 Materials and methods. During 2016-2020, 440 pairs of twins were examined: 375 dichorionic diamniotic and 65 monochorionic diamniotic (38 – boys, 27 – girls). Among dichorionic couples there were 186 (49.6%) opposite-sex, 98 (26.1%) same-sex males and 91 (24.3%) same-sex females. Fetal weight was measured at birth, and its relationship to chorionicity, fetal sex, a combination of same-sex or opposite-sex co-twins, and gestational age was assessed.
 Results. The average weight of 750 fetuses from dichorionic pairs (2570.0 ± 506.43 g) significantly exceeded the weight of 130 fetuses from monochorionic pairs (2333.4 ± 567.24 g, p < 0.0001). The same-sex male (2603.8 ± 532.29 g) and opposite-sex dichorionic diamniotic (2595.6 ± 490.17 g). twins’ masses significantly surpassed the mass of all other twins (p <0.05). In the group of dichorionic twins, the weight of boys exceeded the weight of girls (2638.1 ± 525.96 g vs. 2499.4 ± 475.84 g, p = 0.0002). This pattern was observed both inside the opposite-sex pairs (2674.2 ± 518.17 g vs. 2517.1 ± 448.24 g, p = 0.0019), and same-sex couples of boys compared to same-sex couples of girls (2603.8 ± 532.29 g and 2481.4 ± 503.08 g, respectively, p = 0.0224). No significant difference in the weight of girls of opposite-sex twins compared to same-sex couples was seen. In monochorionic pairs, the weight of male and female fetuses did not differ significantly. Birth weight discordance was found in all types of twins, the highest percentage of discordance was registered in monochorionic boys – 23.7%, second place in frequency took male dichorionic twins – 20.4%. Among the 30 discordant dichorionic opposite-sex twins in 19 (63.3%) cases, the male fetus was heavier. There was no significant difference in fetal weight when women were fertilized naturally and using assisted reproductive technologies. The average weight of children born by surrogate mothers exceeded the weight of children born by non-surrogate mothers (p = 0.0466). In the first pregnancy, children were born with a lower body weight compared to children born as a result of repeated pregnancies and in women who had a history of childbirth.
 Conclusion. The average weight of the fetuses of dichorionic twins was higher than the weight of the neonates f monochorionic pairs. The prevalence of the weight of boys over the weight of girls from dichorionic pairs and the absence of sex difference in fetal weight in monochorionic twins indicates the possibility of different functional activity of the placenta in fetuses of different sexes. Small for gestational age newborns were most often found in the group of female monochorionic twins and opposite-sex dichorionic pairs. Discordance of fetal mass was most common in monochorionic same-sex male twins. In discordant opposite-sex couples, the male fetus more often was heavier. There was no significant difference in newborn weight when women were fertilized naturally and with the use of assisted reproductive technologies. The average weight of surrogate-born children exceeded the weight of children born by non-surrogate mothers. In the first pregnancy, children were born with a lower body weight compared to children of multiparous and multigravida women.

A Comparison of Tramadol and Pethidine Analgesia on the Duration of Labour

Background: A standard obstetric analgesic should have a good analgesic effect without reducing the intensity of uterine contraction. The present study aimed to evaluate and compare the efficacy of intramuscular tramadol and pethidine on labor pain and duration. Material and Methods: A total of 170 multigravida women in active labor were randomly assigned to two identical groups, so that 85 pregnant women received pethidine (50mg/2ml) and 85 pregnant women received tramadol (100mg/2ml) intramuscularly. Results: The labor duration in the tramadol group was shorter than in the pethidine group. In 1st stage of labor, 64.7% of the participants in the tramadol group received the drug for 120±30 minutes, while 67.1% in the pethidine group received the drug for 180±30 minutes. In the 2nd stage, 44.7% of the participants in the tramadol group received the drug for 15±5 minutes, while 51.8% in the pethidine group received the drug for 25±5 minutes. The Visual Analog Scale (VAS) was used before, and 1 and 3 hours after drug administration. The pethidine group obtained a lower VAS mean score compared to those in the tramadol group at 1 hour after drug administration (4 vs 6; P≤.001). Moreover, there was a significant higher level of vomiting and dizziness among women in the pethidine group (29.4% vs 1.2%; P≤.001). Conclusion: Tramadol appears to lead to a shorter labor duration and cause lower maternal side-effects, although its analgesic efficacy was not as much as pethidine.

Prevalence of Compression Neuropathies During Pregnancy

Abstract Background: It is a common perception that Pakistani women suffer from compression neuropathies during pregnancies which may lead to functional limitations. To know the frequency of common neuropathies during pregnancy, nerves commonly involved and common causes of compression neuropathies. Methodology: The design of this study was cross sectional study. Duration of the study was 3 months after approval of synopsis. Convenient sampling was used. This study was conducted at private hospitals of Lahore (Iqra medical complex, Saira Memorial hospital and UOL teaching Hospital). A total of 35 female pregnant women were evaluated for s igns and symptoms of compression neuropathies. A Performa was used for each patient, which was fillrdlled out based on their symptoms. Results: Data from the 35 multigravida pregnant women, compression of sciatic nerve and median nerve are common during the 3rd trimester. The increased body weight during pregnancy and bad posture are significant causes. Among them,51.42% took physiotherapy treatment.Conclusion: The result of this study showed that compression of sciatic and median nerves are most commonly involved during pregnancy in multigravida women. The compression neuropathies occur commonly in the 3rd trimester of pregnancy. The increased weight during pregnancy, poor economic status and bad posture are significant causes of compression neuropathies. Keywords: Neuropathy, Prevalence, Pregnancy

Bacterial Colonization of Vagina in Indian Women During Labor and Its Association With Puerperal and Neonatal Sepsis: A Tertiary Hospital Study.

ObjectiveThe aim was to find the prevalence of colonization of vagina with aerobic bacteria among low-risk Indian women in active labor and its association with early-onset neonatal sepsis (EONS) and puerperal sepsis.MethodsThe study was conducted prospectively from October 2018 to March 2020 in a tertiary hospital in New Delhi, India. Low-risk pregnant women (N=920) in active labor with intact membranes were recruited. High vaginal swabs were collected, cultured by standard methods to detect aerobic bacteria. The primary outcomes were the development of puerperal sepsis and EONS.ResultsIn a total of 920 low-risk subjects, vaginal colonization was found in 484 (52.6%), coagulase-negative Staphylococcus being the predominant colonizer (13.2%) followed by Escherichia coli (8.9%). Multigravida women were at 1.4 times higher risk of colonization than primigravida (odds ratio [OR] 1.399; 95% CI 1.064, 1.84). Women whose sample was collected at the first vaginal examination were at 0.34 times lower risk of colonization as compared to women with more than one vaginal examination (OR 0.34; 95% CI 0.241, 0.481). The incidence of colonization increased with progressive vaginal examinations (p<0.001). None of the colonized women and their neonates developed puerperal sepsis or EONS, respectively.ConclusionVaginal colonization of aerobic bacteria in active labor is not associated with an increased risk of puerperal sepsis or EONS.

Adverse maternal and perinatal pregnancy outcomes related to very advanced maternal age in primigravida and multigravida in the Netherlands: A population‐based cohort

The age at which women give birth is rising steadily in the western world. Advanced maternal age has been associated with adverse pregnancy outcomes. We assessed the association between advanced maternal age and the risk of adverse maternal and perinatal outcome in primigravid and multigravid women. The study was a population-based cohort study and included women giving birth between January 2000 and December 2018 using data from the Dutch perinatal registration of Perined. Women were divided into age groups. We compared outcomes between women of 40-44, 45-49, and over 50years old (the study groups) with women of 25-29years old (reference group), stratified for parity. We employed multivariable regression to correct for possible confounders including methods of conception, multiple pregnancies, ethnicity, and socio-economic status. Our primary outcomes were maternal and perinatal mortality. Secondary outcomes included common maternal and perinatal complications, as well as cesarean section rate. A cohort of 3700326 women gave birth during the study period. Of these women, 3.2% were above 40years of age. Maternal mortality was rare in all groups, but significantly higher in multigravid women over 50years old. Perinatal mortality was significantly higher in all pregnancies of women over 40years old, but not for primigravida over 50years old. The most notable results with the steepest increase were in maternal complications. Both primigravida and multigravida over 40years old were at a two times higher risk of perinatal mortality, cesarean section, gestational diabetes, hypertensive disorders, and a low Apgar score after 5minutes. The risk for women over 45 was almost tripled for perinatal mortality and gestational diabetes and six times higher for cesarean section. Women over 50years old had a seven times higher risk of cesarean section, a four times higher risk of gestational diabetes, postpartum hemorrhage, and neonatal intensive care unit admission, and a 10 times higher risk of hypertensive disorders. The risk of adverse maternal and perinatal outcomes for women over 40years old surges as age increases. A novel aspect was the consistent increased risks not only for primigravid women but also for multigravida.

Alternative Labor Policy in Multigravida Pregnant Women History Sectio Caesarea at Graha Juanda Hospital, Bekasi

The incidence of childbirth with actions in Indonesia increased. The results of the 2013 Riskesdas were delivered by sectio caesarean delivery by 9.8% with the highest proportion in DKI Jakarta (19.9%). This research is to find out alternative labor policies in multigravida pregnant women with a history of cesarean section. This type of research uses a qualitative method, in the implementation of this study is an interview guide during the interview, using the technique of triangulation of data sources and methods namely SWOT approach EFE, EFI, Matching Stage, Matrix SWOT and QSPM. The respondents in this study were 7 respondents from Graha Juanda Hospital Bekasi, by producing 4 alternative policies, namely the making of labor SOPs for multigravida pregnant women with history of SC making parenting keals, cooperating with Faske level I to conduct regular counseling, and adding facilities and infrastructure related to the hospital's tensile strength. The most dominant alternative to be carried out in accordance with the results of the analysis conducted, namely the making of SOPs for labor procedures for multigravida pregnant women with a history of elective and emergency SC needs to be separated and adjusted to their implementation

Awareness of obstetric danger signs among pregnant women in the Democratic Republic of Congo: evidence from a nationwide cross-sectional study

BackgroundPoor awareness of obstetric danger signs is a major contributing factor to delays in seeking obstetric care and hence to high maternal mortality and morbidity worldwide. We conducted the current study to assess the level of agreement on receipt of counseling on obstetric danger signs between direct observations of antenatal care (ANC) consultation and women’s recall in the exit interview. We also identified factors associated with pregnant women’s awareness of obstetric danger signs during pregnancy in the Democratic Republic of Congo (DRC)MethodsWe used data from the 2017–2018 DRC Service Provision Assessment survey. Agreement between the observation and woman’s recall was measured using Cohen’s kappa statistic and percent agreement. Multivariable Zero-Inflated Poisson (ZIP) regression was used to identify factors associated with the number of danger signs during pregnancy the woman knew.ResultsOn average, women were aware of 1.5 ± 1.34 danger signs in pregnancy (range: 0 to 8). Agreement between observation and woman’s recall was 70.7%, with a positive agreement of 16.9% at the country level but ranging from 2.1% in Bandundu to 39.7% in Sud Kivu. Using multivariable ZIP analysis, the number of obstetric danger signs the women mentioned was significantly higher in multigravida women (Adj.IRR = 1.38; 95% CI: 1.23–1.55), in women attending a private facility (Adj.IRR = 1.15; 95% CI: 1.01–1.31), in women attending a subsequent ANC visit (Adj.IRR = 1.11; 95% CI: 1.01–1.21), and in women counseled on danger signs during the ANC visit (Adj.IRR = 1.19; 95% CI: 1.05–1.35). There was a regional variation in the awareness of danger signs, with the least mentioned signs in the middle and the most in the eastern provinces.ConclusionsOur findings indicated poor agreement between directly observed counseling and women’s reports that counseling on obstetric danger signs occurred during the current ANC visit. We found that province of residence, provision of counseling on obstetric danger signs, facility ownership, gravidity and the number of ANC visits were predictors of the awareness of obstetric danger signs among pregnant women. These factors should be considered when developing strategies aim at improving women’s awareness about obstetric danger signs in the DRC

PERBEDAAN TINGKAT KECEMASAN IBU HAMIL PRIMIGRAVIDA DENGAN MULTIGRAVIDA DI ERA PANDEMI COVID-19 DI WILAYAH KABUPATEN KENDAL

Anxiety that occurs in pregnant women is a serious problem because the mortality rate for pregnant women is 80% due to high anxiety. The emergence of anxiety due to influencing faktors, including internal faktors of pregnancy it self and external faktors due to the family environment and the environment outside the family. In developed countries the level of anxiety is around 7-20% and in developing countries more than 20%. The level of anxiety that occurs in primigravida pregnant women is greater than that of multigravida pregnant women, but in the era of the Covid-19 pandemic it can increase anxiety in pregnant women, especially those who are approaching childbirth process. The Objective of this research is there a difference in the level of anxiety between primary and multi-pregnant women in the era of Covid-19 pandemic.The design of this research uses crosscectional study, where between exposure and outcame is seen at the same time. The sampling method used accidental sampling, obtained a total of 72 respondents, consisting of 21 respondents with primigravida status and 51 respondents with multigravida status. The research analysis used the compare mean of independent sample t-test. The primigravida-pregnant women is more anxiety (57.1%) compared to multi-pregnant women (27.4%). There is a significant difference in the value of anxiety between primary and multi pregnant women in the trimester III in the era Covid-19 pandemic, (p value 0.003 0.05)

Ultrasound guidance versus the classical method for intrauterine insemination in oral medication-stimulated cycles: A randomized, single-blind, controlled trial

ObjectiveThis study was conducted to compare the pregnancy rates of ultrasound-guided intrauterine insemination (UG-IUI) and classical intrauterine insemination (C-IUI) cycles. Study designA total of 320 infertile women were enrolled and randomized into an UG-IUI group, and a C-IUI group. All participants received an oral medication for ovarian stimulation. With both groups, the IUIs were scheduled and performed by doctors in their residency and fellowship training, under supervision. The duration and difficulty of the procedures were assessed. A pregnancy test was offered 3 weeks later if the participants did not have menstruation. ResultsThe demographic and other baseline characteristics of the groups (baseline hormone levels, cervical length, uterine position, endometrial thickness, and expertise of the providers) were comparable. The pregnancy rates were similar, with 6.9 % and 6.3 % for the UG-IUI and C-IUI groups, respectively. In the UG-IUI group, the pregnancy rate of the multigravida women was three times higher than that of the nulligravida women (15.4 % vs. 5.0 %; p = 0.13). Although the duration of the procedure was shorter for the UG-IUI group (p < 0.05), the level of difficulty was similar for the two groups. ConclusionsFor oral-medication stimulated cycles, UG-IUI did not increase the pregnancy rate more than with C-IUI. However, the pregnancy rate tended to increase with UG-IUI for multigravida women.

Pregnancy-induced humoral sensitization overrides T cell tolerance to fetus-matched allografts in mice.

Immunological tolerance to semiallogeneic fetuses is necessary to achieving successful first pregnancy and permitting subsequent pregnancies with the same father. Paradoxically, pregnancy is an important cause of sensitization, resulting in the accelerated rejection of offspring-matched allografts. The underlying basis for divergent outcomes following reencounter of the same alloantigens on transplanted organs versus fetuses in postpartum females is incompletely understood. Using a mouse model that allows concurrent tracking of endogenous fetus-specific T and B cell responses in a single recipient, we show that semiallogeneic pregnancies simultaneously induce fetus-specific T cell tolerance and humoral sensitization. Pregnancy-induced antibodies, but not B cells, impeded transplantation tolerance elicited by costimulation blockade to offspring-matched cardiac grafts. Remarkably, in B cell-deficient mice, allogeneic pregnancy enabled the spontaneous acceptance of fetus-matched allografts. The presence of pregnancy-sensitized B cells that cannot secrete antibodies at the time of heart transplantation was sufficient to precipitate rejection and override pregnancy-established T cell tolerance. Thus, while induction of memory B cells and alloantibodies by pregnancies establishes formidable barriers to transplant success for multigravid women, our observations raise the possibility that humoral desensitization will not only improve transplantation outcomes, but also reveal an unexpected propensity of multiparous recipients to achieve tolerance to offspring-matched allografts.

Group B Streptococcal Colonisation among Pregnant Women Attending a Tertiary Care Hospital of Northeast India

Introduction: Group B Streptococcus (GBS) is an important cause of maternal as well as neonatal morbidity and mortality worldwide. Early identification of colonisation of GBS among pregnant women plays an important role in preventing neonatal disease by taking measures such as antibiotic prophylaxis. In India, the spectrum of disease caused due to GBS is largely unrecognised due to lack of screening practices and also there is no specific guideline to prevent the disease. Aim: To determine the group B streptococcal colonisation and their antibiotic susceptibility profile among pregnant women of North-east India. Materials and Methods: The study was a hospital based cross- sectional survey conducted from April to June 2019. A total of 295 pregnant women with gestational age more than 35 weeks attending the Outpatient and Inpatient Departments were included in the study. Two vaginal swabs and two rectal swabs were collected from each participant and were processed according to standard laboratory protocol. Identification of GBS was done on the basis of Christie-Atkins-Munch-Peterson (CAMP) test and Lancefield grouping by latex agglutination test. Antibiotic susceptibility profile was also obtained for these isolates for certain antibiotics. Chi-square test was applied to determine the association of isolation among different types of cases. Results: Out of 295 pregnant women, 15(5.1%) showed GBS colonisation. There was no significant association found with age or socioeconomic status. However, GBS colonisation was found to be significantly associated with increasing gravidity (p-value=0.03). GBS colonisation of vaginal flora is siginficantly associated with rectal colonisation (p-value &lt;0.01). Although certain isolates were found to be resistant to macrolide antibiotics (66.7%), all strains were uniformly sensitive (100%) to penicillin, levofloxacin, quinupristin-dalfopristin, vancomycin and linezolid. Conclusion: A low rate of colonisation was determined among the pregnant women and it is not associated with age and socioeconomic status. However, it is suggested that routine screening of pregnant women especially multigravida women should be done to prevent the transmission to the newborn.

Glycemic control and its associated factors among women with gestational diabetes mellitus in a tertiary care Centre, Puducherry, South India.

Background:Worldwide, one in ten pregnancies is related with diabetes; 87.6% of which are gestational diabetes mellitus (GDM). Maternal hyperglycaemia affects the successful progression of pregnancy.Objectives:To determine the proportion and the factors associated with poor glycaemic control among women with gestational diabetes.Methods:This hospital-based cross-sectional study was conducted in a tertiary care hospital, Puducherry, South India from September to October 2019. Pregnant women diagnosed as GDM and on treatment for at least one month were approached consecutively for the study. A fasting blood sugar (FBS) ≥92 mg/dl and postprandial blood sugar (PPBS) 1 hour ≥180 mg/dl or PPBS 2 hour ≥153 mg/dl were considered as poor glycaemic control.Results:A total of 301 women with GDM were included and the mean (SD) age was 27 (5) years. Of total, 29 (10%) reported GDM during their previous pregnancy and 95 (32%) got diagnosed before reaching the tertiary care hospital. Lifestyle modifications (77%) were the most common mode of management for GDM. Of total, 116 (38.5%; 95% CI 33%-44.3%) had poor glycaemic control. Multigravida women (46.9%) and those on pharmacological treatment for GDM had poor glycaemic control.Conclusion:One-third of women with GDM at a tertiary care centre had poor glycaemic control. Therefore, a novel approach to improve awareness about GDM control both among pregnant women and the medical fraternity is needed.

The effectiveness of gentle prenatal yoga on the recovery of anxiety level in primigravid and multigravid pregnant women

ObjectiveThis study aimed to analyze the effectiveness of gentle prenatal yoga on the anxiety problem in primigravida and multigravida pregnant women. MethodThis study was conducted at Bara-Baraya Health Center, Antang Health Center, Kapasa Health Center, and Mamajang Health Center. The applied research design in this study was a quasi-experiment with a non-equivalent control group design approach. Samples were selected using a purposive sample technique. Furthermore, the instrument used was the Hamilton Anxiety Rating Scale (HARS) questionnaire. The number of samples in this study was 24 respondents divided into two groups, 12 in the intervention group and 12 in the control group. Meanwhile, the criteria of samples in this study were pregnant women in the first to fifth pregnancy, having been in trimester II-III with the gestational age of ≥20–30 weeks, and not having complications in pregnancy. Resultsthe HARS scores in the intervention group showed that the mean rank of the pre-test was 23.75, In the mid-test, it was 20.00, and in the post-test, it was 16.00. Meanwhile, in the control group, its mean rank was 23.50, mid-test it was 21.58, and the post-test it was 20.41 showed that the intervention group experienced a significant decrease in anxiety levels. From the results of the Mann Whitney test, the intervention group p=0.001<(α 0.05) showed that there were significant changes. ConclusionThere were differences in HARS (Hamilton Anxiety Rating Scale) scores between the intervention and control groups before and after a gentle prenatal yoga treatment.

Patterns and determinants of prescribed drug use among pregnant women in Adigrat general hospital, northern Ethiopia: a cross-sectional study

BackgroundA vigilant prescription of drugs during pregnancy can potentially safeguard the growing fetus from the deleterious effect of the drug while attempting to manage the mother’s health problems. There is a paucity of information about the drug utilization pattern in the area of investigation. Hence, this study was implemented to investigate the pattern of drug utilization and its associated factors among pregnant women in Adigrat general hospital, Northern Ethiopia.MethodsAn institution-based cross-sectional study was conducted among randomly selected 314 pregnant women who attended obstetrics-gynecology and antenatal care units of the hospital. Relevant data were retrieved from the pregnant women’s medical records and registration logbook. The drugs prescribed were categorized based on the United States Food and Drug Administration (US-FDA) fetal harm classification system. Data analysis was done using SPSS version 20 statistical software. Multivariate logistic regression was employed to analyze the association of the explanatory variables with the medication use, and p < 0.05 was declared statistically significant.ResultsThe overall prescribed drug use in this study was found to be 87.7%. A considerable percentage of the study participants (41.4%) were prescribed with supplemental drugs (iron folate being the most prescribed drug) followed by antibiotics (23.4%) and analgesics (9.2%). According to the US-FDA drug’s risk classification, 42.5, 37, 13, and 7% of the drugs prescribed were from categories A, B, C, and D or X respectively. Prescribed drug use was more likely among pregnant women who completed primary [AOR = 5.34, 95% CI (1.53–18.6)] and secondary education [AOR = 4.1, 95% CI (1.16–14)], who had a history of chronic illness [AOR = 7.9, 95% CI (3.14–19.94)] and among multigravida women [AOR = 2.9, 95% CI (1.57 5.45)].ConclusionsThe finding of this study revealed that a substantial proportion of pregnant women received drugs with potential harm to the mother and fetus. Reasonably, notifying health practitioners to rely on up-to-date treatment guidelines strictly is highly demanded. Moreover, counseling and educating pregnant women on the safe and appropriate use of medications during pregnancy are crucial to mitigate the burden that the mother and the growing fetus could face.

Awareness, knowledge and risk factors of Toxoplasma gondii infection among pregnant women in the Western Black Sea region of Turkey

Toxoplasma gondii (T. gondii) infection causes serious problems leading to maternal complications and foetal anomalies during pregnancy. The aim of this study was to identify risk factors for toxoplasmosis and to determine the seroprevalence of the disease with regard to the awareness levels of patients. A total of 214 pregnant women who were admitted to Karabuk University, Gynaecology and Obstetrics Clinic between July 2018 and November 2018 and accepted to participate were included this cross-sectional study. Venous blood samples were obtained and anti-T. gondii IgG and IgM levels were analysed. The demographic characteristics of the patients were recorded and a questionnaire investigating about T. gondii risk factors were completed. The relationship between toxoplasmosis and risk factors was evaluated using multivariate regression analysis. The prevalence of toxoplasmosis among the pregnant women was 14% (35/214). The potential risk factors of toxoplasmosis were primigravidity (AOR = 2.56 95% CI: [1.26–8.26]), cat ownership (AOR = 10.29, 95% CI: [3.58–29.60]), and sausage/salami consumption (AOR = 2.96, 95%CI: [2.10–7.46]);22.4% of the women were aware of toxoplasmosis, and awareness was significantly higher in multigravida women compared with primigravida women (p=.042). Congenital toxoplasmosis can be prevented through pregnancy screening programmes and education aimed at increasing awareness and protection. IMPACT STATEMENT What is already known on this subject? The seroprevalence of toxoplasmosis is very variable and may differ significantly between countries, and even different geographic regions of the same country. Raising awareness of the disease among persons in risk groups through education is a primary objective in prevention. What do the results of this study add? T. gondii seropositivity was found to be related with being primigravid, cat ownership and having close contact with cats, and consumption of meat products such as salami and sausages. In addition, primigravidity is a risk factor for toxoplasmosis because the awareness of the disease was lower than in multiparous women. What are the implications of these findings for clinical practice and/or further research? It should also be known that women of childbearing age are in the high-risk group for toxoplasmosis, and studies on preventive measures should be performed. Increased awareness can prevent infection and the possibility of complications due to congenital toxoplasmosis, especially in the reproductive period of women.

Effect of Anemia on Pregnancy Outcome in Labour Ward: Study in a Tertiary Level Public Hospital

Objectives: To determine the pregnancy outcome among anemic women admitted in labour ward of a tertiary level hospital.&#x0D; Methodology: This is a descriptive type of cross-sectional study. All women who were admitted at labour room for delivery with anemia and gestational age more than 28 weeks were included with purposive sampling under the GU-3 of Shaheed Suhrawardy Medical College &amp; Hospital. Respondents were recruited on the basis of clinical findings correlating with lab investigation. Blood samples were collected during the time of admission and hemoglobin (Hb) level were tested by automated machine in the laboratory of ShSMCH. Outcome of pregnancy was observed against the anemic state defined by Hb% done in laboratory. The mother who delivered, intra-partum &amp; post-partum observation up to 7 days were made for pregnancy outcome.Results: This study conducted in a tertiary level public hospital, included 100 pregnant anemic mothers admitted at labor ward. Prevalence of anemia was 30.12% among the pregnant women at delivery. It revealed that women went into labor having mild anemia in 77% and moderate anemia in 23% cases. Importantly it was observed that moderate anemia was found more in younger age group. Additionally, it was also more pronounced (&gt;50%) among the illiterate and primary education group. There was significant inverse relationship between educational status (p =.003) and anemia. Regarding family history, about two thirds anemic mother came from nuclear family and they also lives with small members. Most of the multigravida women presented with moderate anemia. Among the moderately anemic mothers’ interval of pregnancy were less than two years. It has been observed that 60.9% moderate anemic mother was not on regular antenatal checkup and total 11% respondents had no antenatal checkup. Regarding maternal outcome preterm labour (PTL), premature rupture of membrane (PROM), wound infection were more among moderately anemic group. There was significant relationship between degree of anemia with birth weight (p=.014). Adverse fetal outcome like prematurity, NICU admission, IUD were found more among moderately anemic mothers.&#x0D; J Shaheed Suhrawardy Med Coll, December 2019, Vol.11(2); 155-160

ATTITUDE OF ANTENATAL MOTHERS TOWARDS CAESAREAN SECTION DELIVERY

Background: Globally the rate of caesarean section delivery has been increasing among women. The perceptions surrounding caesarean section delivery may have a significant role in the decision-making process which influenced by multiple complex factors like cultural values, beliefs and anticipations of the birth, possible traumatic events in life, available social support, and personal sense of control, are only a few. Aim: To compare the attitude towards caesarean section delivery between primigravid women and multigravid women with and without previous history of caesarean section delivery, and also to find the association of attitude of antenatal mothers with their selected demographic variables. Methodology: The descriptive study approach has been used in view of accomplishing the main objectives of the study. The tools consist of demographic profile along with structured attitude questionnaire. The subject consisted of 10 antenatal mothers and was selected by purposive sampling technique. Data was analyzed by using descriptive and inferential statistics. Results: The attitude assessed using attitude scale showed that majority of antenatal mothers (60%) had favorable attitude towards caesarean section. There was no significant relationship between the attitude of primi gravid and multi gravid mothers. There was no significant association found between the attitude of antenatal mothers with their selected demographic variables like age, religion, type of family, education, income per month, residence, and parity. Conclusion: Although findings revealed that most pregnant women prefer caesarean section delivery, it was found that pregnant women need more guidance by midwives and obstetricians.

Population attributable fraction estimates for factors associated with different types of anaemia among women in Ethiopia: multilevel multinomial analysis.

This study aimed to identify factors for different levels of anaemia among Ethiopian women and to estimate the population attributable fraction (PAF). This study was a detailed analysis of data of the 2016 Ethiopian Demographic and Health Survey data. Adjusted OR (AOR) with 95 % CI was computed using multilevel multinomial regression models, and the PAF were estimated using these AOR. This study was conducted in Ethiopia. Women of reproductive age. The PAF showed that the proportion of mild anaemia cases attributable to having no formal education was 14·6 % (95 % CI 3·4, 24·5), high gravidity (≥4) was 11·2 % (95 % CI 1·2, 19·9) and currently breast-feeding was 5·2 % (95 % CI 0·0, 10·7). Similarly, the proportion of moderate-severe anaemia cases attributable to being in a rural residence was 38·1 % (95 % CI 15·9, 54·8); poorest wealth quantile, 12·6 % (95 % CI 2·9, 24·6); giving birth in the last 5 years, 10·5 % (95 % CI 2·9, 18·2) and unimproved latrine facilities, 17 % (95 % CI 0, 32·5). The PAF suggest that rural residency, low education, low wealth status, high parity, pregnancy and breast-feeding contribute substantially to the occurrence of anaemia among women in Ethiopia. Mild anaemia could be reduced by setting intervention strategies targeting women with low education, multigravida women and breast-feeding women, while preventing moderate-severe anaemia may require increasing income and improving living environments through the accessibility of hygienic latrines.

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