Multiparous Pregnant Women Research Articles

Prevalance of Lumbo-Sacral Dysfunction in Multiparous Women

Background: In pregnancy there is progressive anatomical, physiological, psychological and biochemical changes at various trimesters. These alterations might induce low back pain or lower pelvic discomfort during pregnancy or after delivery, restricting normal movement and causing misery. Objective: To identify the prevalence of lumbosacral dysfunction in women who have had two or more pregnancies. Methods: The study was an observational which includes 100 multiparrous women in and around Karad and the female residing in urban and rural areas were taken and the consent form were signed by the participants were explained regarding the test and then it was undertaken. The test performed was Specific lumbar spine torsion test. Result: On the basis of this study 58% women showed dysfunction of lumbosacral joint and 48 % have excellent joint conditions the women of both urban and rural areas were included. According to the number of gravida the women were having issues. Conclusion: The study concluded that there is prevalence of lumbo-sacral joint dysfunction is highly significant in multiparous pregnant women.

Investigating the relationship between personality types and resilience in pregnant women. A cross-sectional study

BackgroundChildbirth is considered a critical experience in a woman's life when she needs mental adaptation and reorganization of relationships. Factors such as personality and self-perception can help facing and solving crises. This study aimed to investigate the relationship between personality types and stress resilience among pregnant women. MethodsThis was a cross-sectional study on 210 multiparous and nulliparous pregnant women who were 32–37 weeks pregnant and referred to Shiraz medical hospitals for delivery selected via convenience sampling. Data collection tools were personal and midwifery information questionnaires and the Goldberg personality and visual pain assessment scale that were completed through interviews. Data analysis was performed by SPSS software using descriptive tests to describe the data and the Pearson correlation test to analyze the data. ResultsThe highest personality type was conscientiousness (48.1%) and the lowest was extraversion (2.4%). Maternal resilience had a significant positive relationship with extraversion (p=.001) and conscientiousness (p=.001). There was no significant relationship between the 2 variables of neuroticism and maternal resilience (p=.12). There was a significant positive relationship between the 2 variables of openness to experience and maternal resilience (p=.005). ConclusionWomen's healthcare providers can help to mitigate the negative effects of psychological distress, and psychologically empower this vulnerable group by considering the resilience and personality type of pregnant women during prenatal care.

The effect of neurolinguistic programming on labor pain, fear, duration and maternal satisfaction: A randomized controlled trial

ObjectivesLabor pain is one of the most severe pains experienced by women. In the literature, there is no research examining the effect of Neurolinguistic Programming (NLP) on birth pain and fear. It was aimed to determine the effect of NLP on labor pain, fear, duration, and maternal satisfaction in both nulliparous, and multiparous pregnant women. DesignThis study consists of each with two arms, parallel-group randomized controlled trials, on two different samples for both nulliparous and multiparous women. Data were collected between 3 October 2023–21 January 2024. A total of 124 women (62 nulliparous and 62 multiparous women) who gave birth vaginally constituted the sample of the study. Both nulliparous and multiparous women were randomly assigned to groups. The primary outcomes were labor pain, fear, duration, and satisfaction. When the cervical span was 3–4, 5–6, and 7–8 cm, NLP was applied to the experimental group for 20 min each, the control group rested for 20 min each. ResultsAccording to the measurement times, the mean pain score of the experimental group was lower than the control group. The mean VAS pain score measured over time decreased by 90.3 % in the NLP group compared to the control group for primiparous and 64.5 % compared to the control group for multiparous. In both nulliparous and multiparous, the fear of labor of the NLP group was lower, the duration of labor was shorter, and the satisfaction with labor was higher compared to the control group (p < 0.05). ConclusionNLP reduces labor pain and fear, shortens the duration of labor, and increases maternal satisfaction in labor.

The Impact of Embracing New Antenatal Screening Guidelines on Complications Related to Grand Multiparity in a Jordanian Tertiary Referral Center

Background: Universal screening, including thyroid dysfunction, gestational diabetes, and performing morphology and growth scans, was introduced in the healthcare system to improve perinatal care and pregnancy outcomes. Pregnancy-related complications are usually higher in grand multiparous women and their advanced maternal age. This study aimed to compare the impact of implementing a universal screening strategy protocol versus the selective screening for grand multiparous pregnant women aged ≥35 years on the incidence of adverse pregnancy outcomes and the associated risk factors. Methods: A retrospective cohort study of two groups (n = 89/group) of healthy grand multiparous women aged ≥35 years and who either delivered between 2011–2012 and underwent selective screening, or between 2016–2017 and were universally screened, was conducted at the Department of Obstetrics and Gynecology, Jordan University Hospital. Results: The universal screening protocol detected more cases of women with gestational diabetes, gestational hypertension, and polyhydramnios 7, 4, and 9 more times, respectively, than the selective screening procedure. However, the results of universal screening tests for thyroid function and glucose tolerance were abnormal in only a small number of women. Furthermore, the cesarean section rate was reduced from 45% in the selective screening group to 1% in the universal screening group. No other significant differences in pregnancy or neonatal complications between the two groups were noted. Conclusions: Implementing new perinatal care protocols, including universal screening for thyroid disease and gestational diabetes, morphological and growth scans significantly decreased the rate of cesarean section in grand multiparous women with advanced maternal age, but did not affect pregnancy or neonatal complications. However, larger studies are needed to obtain more representative results among women in high-risk group for gestational diabetes mellitus (GDM) and thyroid dysfunction.

The Relationship Between Multiparous Pregnant Women's Knowledge of Effleurage Massage and Back Pain in Pregnant Women in the Third Trimester at the Polyclinic RS. Bhayangkara Indramayu

The Relationship Between Multiparous Pregnant Women's Knowledge of Effleurage Massage and Back Pain in Pregnant Women in the Third Trimester at the Polyclinic RS. Bhayangkara Indramayu

CLASSİFİCATİON OF CLİNİCAL SYMPTOMS DEPENDİNG ON THE SEVERİTY OF ANEMİA İN PREGNANT WOMEN

The article provides information on the results of research conducted to study the changes in clinical signs during pregnancy in women with different degrees of iron deficiency anemia (IDA). Hemogram parameters were studied using the “ Mythic 18” (Switzerland) hematological analyzer. For this purpose, the mutual relationships between the main indicators of iron metabolism and the main symptoms of anemia were analyzed using clinical-biochemical methods in the blood of 110 women of reproductive age at various stages of pregnancy. The main contingent of the study consisted of 80 pregnant women with IDA (main group). 30 pregnant women without anemia were included in the comparison group, and 21 healthy women without pregnancy were included in the control group. It has been determined that in multiparous pregnant women, the hemoglobin level in mild anemia is Me = 10.4 (10.0-10.5), in moderate anemia Me = 8.9 (8.3-9.5), in severe anemia Me = 6.9 (6.3-6.9) p&lt;0.001; the level of iron in mild anemia is Me = 9.0 (8.0-9.4), in moderate anemia Me = 6.7 (6.1-7.7), in severe anemia Me = 5.3 (3.5-5.8) p&lt;0.001; the level of ferritin in mild anemia is Me = 19.3 (12.0-28.0), in moderate anemia Me = 9.9 (9.1-12.0), in severe anemia Me = 3.0 (2.0-8.0) p&lt;0.001. During pregnancy, significant changes occur in iron metabolism in iron deficiency anemia. Pregnancy anemia is a significant risk factor for fetal and maternal morbidity. Thus, depending on the severity of anemia, complications such as intrauterine growth retardation, chronic fetal hypoxia, preeclampsia, preterm birth, and primary birth weakness during delivery have been predominant. This allows us to carry out corrective treatment.

Effect of pelvic floor fascial mobilization on pelvic floor dysfunction in multiparous pregnant women - A randomized pilot study

BackgroundPelvic floor fascial mobilization (PFFM) is an innovative intravaginal and/or intrarectal manual therapy technique developed to treat pelvic distress by improving fascial gliding and muscle function. AimThe effect of PFFM on pelvic floor distress during pregnancy was compared to conventional pelvic floor muscle training. MethodsA pilot prospective randomized clinical trial. The primary outcome was the strength and function of the pelvic floor muscles measured via the Oxford grading scale, perineometry, and hip range of motion. Each subject was treated twice, one week apart. ResultsForty multiparous pregnant women at 24–30 weeks gestation, with pelvic distress, were allocated to PFFM (study group (n = 20)) vs. pelvic floor muscle training (control group (n = 20)). There was no difference in the severity of pelvic distress between the study and control groups before the interventions (PFDI-20: 27.1 ± 12.2 vs. 26.0 ± 13.5, respectively, p = 0.7). Twenty-six subjects completed the study protocol. PFDI-20 showed significant improvement: 42% improvement in the study group vs. 12% improvement in the controls (p = 0.001 for both groups). Group-by-time interaction (Cohen's d) was significant after the first treatment session for Oxford score, right hip internal rotation range of motion, and cervical length in the PFFM group and for perineometry and right hip internal rotation at the end of the study. ConclusionsBased on this pilot randomized trial, PFFM may potentially and partially 1. Alleviate symptoms, 2. Improve pelvic floor function and strength, and 3. Elongate the cervix after one or two treatment sessions. Further, a more extensive study is needed to confirm these results.

Assessment of serum levels and placental bed tissue expression of IGF-1, bFGF, and PLGF in patients with placenta previa complicated with placenta accreta spectrum disorders.

This study aims to detect the serum levels of IGF-1, bFGF, and PLGF and their expressions in placental bed tissues of patients with placenta previa complicated with PAS disorders. This case and control study included 40 multiparous pregnant women with complete placenta previa between 34 weeks and 38 weeks of gestation and they were divided into two groups: 25 patients with PAS (case group) and 15 patients without PAS (control group). The venous blood samples were collected 2 h before the cesarean section, and the placental bed tissues were taken intraoperatively at the placental implantation site and then were histologically examined to evaluate the gravity of the myometrial invasion of the placenta. According to FIGO PAS increasing grading, the 25 patients were also divided into three groups: PAS grade I group, PAS grade II group, and PAS grade III group. The concentrations of IGF-1, bFGF, and PLGF in serum were measured using ELISA, and the mean ratio of the relative mRNA expression of each biomarker in placental bed tissues was calculated using qRT-PCR. The staining intensity and the positive cells were quantitatively measured and expressed as means by using Image J software for IHC analysis. IGF-1 had low serum levels and high placental bed expression in placenta previa patients with PAS disorders compared to those without PAS (all p < 0.0001). PLGF had high serum levels (p = 0.0200) and high placental bed expression (p < 0.0001) in placenta previa patients with PAS disorders compared to those without PAS. IGF-1 serum levels decreased up to PAS grade II (means were 24.3 ± 4.03, 21.98 ± 3.29, and 22.03 ± 7.31, respectively for PAS grade I, PAS grade II, PAS grade III groups, p = 0.0006). PLGF serum levels increased up to PAS grade II (means were 12.96 ± 2.74, 14.97 ± 2.56, and 14.89 ± 2.14, respectively for the three groups, p = 0.0392). However, IGF-1 and PLGF mRNA placental bed expression increased up to PAS grade III. The relative expression of mRNA means for the three groups was 3.194 ± 1.40, 3.509 ± 0.63, and 3.872 ± 0.70, respectively for IGF-1; and 2.784 ± 1.14, 2.810 ± 0.71, and 2.869 ± 0.48, respectively for PLGF (all p < 0.0001). Their IHC (immunohistochemical) staining also had increasing trends, but p > 0.05. bFGF was not significantly expressed in placenta previa with PAS disorders in most of the analysis sections (p > 0.05). Low serum levels and high expression in placental bed tissues of IGF-1, or high serum levels and high expression in placental bed tissues of PLGF, may differentiate placenta previa patients with FIGO PAS grade I and PAS grade II from those without PAS disorders. However, they could not significantly predict the degree of placental invasiveness in FIGO PAS grades II and III.

THE IMPACT OF PREGNANCY ON DISTAL FEMORAL CARTILAGE- A PROSPECTIVE COHORT STUDY

Aim: Cartilage destruction has been associated with many factors such as overweight, excessive use of joints and forced movements, abrasion due to the aging process, and genetic factors. Obesity is a modifiable risk factor for osteoarthritis. This study aimed to determine the thickness of knee joint cartilage and demonstrate the impact of the pregnancy process on osteoarthritis development during pregnancy.&#x0D; Matherial and Method: Fifty pregnant women aged 15-42 years, were included in this study. The ultrasound image of dominant knee distal femoral cartilage was measured at the 1st and 3rd trimesters in the lateral condyle, intercondylar area, and medial condyle from the strong anechoic area between the bone cortex and the suprapatellar fat pad.&#x0D; Results: We found that the third trimester cartilage measurements for each of the nulliparous and multiparous pregnant women were significantly thinner than the first trimester cartilage measurements (p=0.001, p=0.005, p

Predicting preterm birth using explainable machine learning in a prospective cohort of nulliparous and multiparous pregnant women.

Preterm birth (PTB) presents a complex challenge in pregnancy, often leading to significant perinatal and long-term morbidities. "While machine learning (ML) algorithms have shown promise in PTB prediction, the lack of interpretability in existing models hinders their clinical utility. This study aimed to predict PTB in a pregnant population using ML models, identify the key risk factors associated with PTB through the SHapley Additive exPlanations (SHAP) algorithm, and provide comprehensive explanations for these predictions to assist clinicians in providing appropriate care. This study analyzed a dataset of 3509 pregnant women in the United Arab Emirates and selected 35 risk factors associated with PTB based on the existing medical and artificial intelligence literature. Six ML algorithms were tested, wherein the XGBoost model exhibited the best performance, with an area under the operator receiving curves of 0.735 and 0.723 for parous and nulliparous women, respectively. The SHAP feature attribution framework was employed to identify the most significant risk factors linked to PTB. Additionally, individual patient analysis was performed using the SHAP and the local interpretable model-agnostic explanation algorithms (LIME). The overall incidence of PTB was 11.23% (11 and 12.1% in parous and nulliparous women, respectively). The main risk factors associated with PTB in parous women are previous PTB, previous cesarean section, preeclampsia during pregnancy, and maternal age. In nulliparous women, body mass index at delivery, maternal age, and the presence of amniotic infection were the most relevant risk factors. The trained ML prediction model developed in this study holds promise as a valuable screening tool for predicting PTB within this specific population. Furthermore, SHAP and LIME analyses can assist clinicians in understanding the individualized impact of each risk factor on their patients and provide appropriate care to reduce morbidity and mortality related to PTB.

Maternal and neonatal consequences of cystocele and rectocele in the delivery process.

The study aimed to investigate the effects of cystocele and rectocele on the stages of vaginal birth and maternal and newborn outcomes. A total of 672 multiparous pregnant women between the ages of 18 to 40 who underwent normal vaginal delivery in our tertiary center between November 2022 and February 2023, were included in this prospective study. Among the participants, 348 (51.8%) had no abnormalities, 78 (11.6%) had rectocele only, 112 (16.7%) had cystocele only, and 134 (19.9) had both cystocele and rectocele. Patients with the coexistence of cystocele and rectocele experienced a notably extended duration for both the first stage and second stage of labor, although the extension in the second stage was not statistically significant. Among the maternal complications, the development of maternal laceration and chorioamnionitis was significantly more common in the patient group with cystocele and rectocele compared to the other groups. When the groups were assessed for postpartum bleeding, while the bleeding risk increased from the normal group to the rectocele + cystocele group, this increase was not statistically significant. There was no difference between the groups in terms of neonatal outcomes. The delivery time of pregnant women with cystocele and rectocele, in the absence of additional risk factors, was determined to be significantly longer than that of the control group. We think that these patients should receive more vigilant monitoring, and this criterion should be kept in mind when assessing the indication for a cesarean section.

Factors associated with the intention of pregnant women to give birth with epidural analgesia: a cross-sectional study

BackgroundIn Belgium most women receive epidural analgesia during labour. Although, it offers satisfactory pain relief during labour, the risk on a series of adverse advents has been reported. The objective of this study was to determine factors associated with the intention of pregnant women, anticipating a vaginal birth, of requesting epidural analgesia during labour.MethodsA cross-sectional study, using an online self-report questionnaire was performed, including socio-demographic and personal details. Associated factors were examined with the HEXACO-60 questionnaire, the Mental Health Inventory-5, the Tilburg Pregnancy Distress Scale and the Labour Pain Relief Attitude Questionnaire for pregnant women. The level of intention to request epidural analgesia was based on two questions: Do you intend to ask for epidural analgesia (1) at the start of your labour; (2) at some point during labour? Data were collected predominantly during the second and third trimester of pregnancy. Descriptive analysis and a multiple linear regression analysis were performed.Results949 nulliparous (45.9%) and multiparous (54.1%) pregnant women, living in Flanders (Dutch-speaking part of Belgium) anticipating a vaginal birth completed the questionnaires. Birth-related anxiety (ß 0.096, p < 0.001), the attitude that because of the impact of pregnancy on the body, asking for pain relief is normal (ß 0.397, p < 0.001) and feeling more self-confident during labour when having pain relief (ß 0.034, p < 0.001) show a significant positive relationship with the intention for intrapartum epidural analgesia. The length of the gestational period (ß − 0.056, p 0.015), having a midwife as the primary care giver during pregnancy (ß − 0.048, p 0.044), and considering the partner in decision-making about pain relief (ß − 0.112, p < 0.001) show a significant negative relationship with the intention level of epidural analgesia. The explained variability by the multiple regression model is 54%.ConclusionsA discussion during pregnancy about the underlying reason for epidural analgesia allows maternity care providers and partners to support women with pain management that is in line with women’s preferences. Because women’s intentions vary during the gestational period, pain relief should be an issue of conversation throughout pregnancy.

Comparison of Obstetric Outcomes Between Controlled-Release Dinoprostone Vaginal Delivery System (PROPESS) and Administration of Oral Dinoprostone for Labor Induction in Multiparous Women at Term.

The aim of this study was to compare the rate of vaginal delivery and adverse outcomes of a controlled-release dinoprostone vaginal delivery system (PROPESS) and the administration of oral dinoprostone for labor induction in multiparous women at term. This retrospective case-controlled study included 92 multiparous pregnant women (46 and 46 in the PROPESS and oral dinoprostone groups, respectively) who required labor induction at ≥37 weeks of gestation. The primary outcome was the success rate of vaginal delivery following the insertion of PROPESS only or the administration of oral dinoprostone (up to six tablets) only. The secondary outcomes were uterine tachysystole with non-reassuring fetal status, the proportion of cases requiring pre-delivery oxytocin, and the rate of cesarean delivery. The proportion of pregnant women who delivered vaginally as the primary outcome was significantly higher in the PROPESS group (33/46 [72%]) than in the oral dinoprostone group (16/46 [35%], p < 0.01). In the secondary outcomes, the proportion of cases requiring pre-delivery oxytocin in the PROPESS group was significantly lower than that in the oral dinoprostone group (24% vs. 57%, p < 0.01). In multiparous women at term, PROPESS may be able to induce labor and lead to a higher vaginal delivery rate without adverse outcomes compared to oral dinoprostone.

Examining Medial Longitudinal Arch: A Review of Symptom among the Multiparous Pregnant Women

To evaluate the changes in the medial longitudinal arch of the foot in the third trimester of pregnancy among multiparous women, A Cross-sectional observational study was conducted. Women of age 18-30 in 34-38 gestational weeks were included. Those women who were nulliparous, primiparous, flat foot prior to pregnancy, and had undergone through abortion were excluded from the study. The sample was collected by using non-probability purposive sampling and analyzed by SPSS (Statistical Package for Social Sciences). Navicular drop test of the left foot was 36.4% negative and 63.6% positive, whereas for the right foot it was 52.7% negative and 47.3% positive. The study results indicated that the changes in the medial longitudinal arch of the left foot were more evident as compared to the right foot.

Karakteristik ibu hamil yang melakukan tindakan sectio caesarean di rumah sakit sitti khadijah makassar periode 2019 - 2021

All women want to give birth well and perfect parturition. There are two methods of parturition, namely vaginal parturition, which is better known as natural parturition, and caesarean section, in which the baby is removed through an incision in the abdominal wall and uterus. The number of caesarean deliveries in Indonesia continues to increase in 2018. Cesarean procedures account for 17.6% of all deliveries in Indonesia, exceeding the WHO standard of 15%. To find out the characteristics of pregnant women who perform caesarean sections at Sitti Khadijah Hospital Makassar for the period 2019 - 2021. An observational study with a descriptive approach, a cross-sectional study was used as the research design. There were 100 pregnant women who had Caesarean Sections at Sitti Khadijah Hospital Makassar for the period 2019-2021. The results showed that the characteristics of pregnant women who had Caesarean Sections based on the highest age was 20-35 years as much as 69% compared to other age groups, based on education the highest was undergraduate as much as 41% compared to other educational groups, based on work the highest were patients who did not work as much as 65% compared to patients who worked as much as 35%, based on medical indications the highest were Post SC patients as much as 38%, based on the highest type of SC is a patient with SSTP of 96% compared to Classic SC of 4%, based on parity, the highest were patients who were multiparous as much as 73% compared to primiparas as much as 27%. Pregnant women who did caesarean section based on the most age were aged 20-35 years, the most education was undergraduate, the most jobs were pregnant women not working, the most medical indications were pregnant women with a history of post SC, the most type of SC was SCTP, and the most parity was multiparous pregnant women

Rubella seroprevalence among pregnant women in the region of Rabat, Morocco: a cross-sectional study

ObjectivesThe aim of the present research is to update data on the seroprevalence of rubella and to identify the associated risk factors among pregnant women in the Rabat region of...

Seroprevalence of Toxoplasma gondii IgG and IgM antibodies and associated risk factors among pregnant women consulted in three health centers in Dschang, Cameroon

BackgroundToxoplasmosis is a zoonosis caused by Toxoplasma gondii, an obligate intracellular protozoan responsible for one of the most common congenital infections in the world. This study aimed to determine the seroprevalence and risk factors associated with toxoplasmosis in pregnant women consulted in three health centers in the city of Dschang. MethodsThis study was a cross-sectional study that was conducted, with a total of 242 participants. A questionnaire was administered after obtaining the free and informed consent of the participants. Blood sample was collected to assay IgG and IgM antibodies specific to Toxoplasma gondii using the enzyme-linked immunosorbent assay (ELISA) kit, and potential risk factors were evaluated with the administration questionnaire using a binary logistic regression model. Statistical significance was measured at P < 0.05. ResultsThe overall seroprevalence of toxoplasmosis was 82.7%,with a seroprevalence of toxoplasma IgG of 62.8% (152), that of IgM at 11.6% (28) and that of IgG/IgM at 8.3% (20). The Saint Vincent Paul Hospital had a seroprevalence of 43.8% IgG and 8.7% IgM; followed by the Dschang District Hospital (11.6% IgG and 2.1% IgM). The seroprevalence of toxoplasma IgG (35.5%) and IgM (6.2%) was higher in multiparous pregnant women, and in the group of women who performed their first toxoplasmosis serology in the first trimester of pregnancy, 70 (28.9%), 9 (3.7%) respectively for IgG and IgM. The multivariate logistic regression analysis showed that the possession of a cat at home or its presence in the neighborhood, the consumption of undercooked or uncooked meat and having a history of blood transfusion were found to be statistically significant risk factors associated with toxoplasmosis seroprevalence among pregnant women. ConclusionThe present study revealed a high seroprevalence of toxoplasmosis. Given this high seroprevalence, screening for toxoplasmosis in women of childbearing age should be encouraged.

Factors influencing maternal-fetal attachment in pregnant women during the COVID-19 pandemic: a cross-sectional study.

Coronavirus disease 2019 (COVID-19) has spread widely throughout the world, causing psychological problems such as fear, anxiety, and stress. During the COVID-19 pandemic, pregnant women have been concerned about both their own health and the health of their fetuses, and these concerns could negatively affect maternal-fetal attachment. Thus, this study aimed to explore the level of COVID-19 stress, resilience, and maternal-fetal attachment among pregnant women during the COVID-19 pandemic, and to identify factors influencing maternal-fetal attachment. In total, 118 pregnant women past 20 weeks gestation were recruited from two maternity clinics in Daegu, Korea, to participate in this descriptive correlational study during COVID-19. The factors influencing maternal-fetal attachment were analyzed using hierarchical multiple regression analysis. The mean scores for COVID-19 stress, resilience, and maternal-fetal attachment were 57.18±10.32 out of 84, 67.32±15.09 out of 100, and 77.23±9.00 out of 96, respectively. Nulliparous pregnant women reported greater maternal-fetal attachment than multiparous pregnant women (p=.003). Religious pregnant women also reported greater maternal-fetal attachment than non-religious pregnant women (p=.039). Resilience (β=.29, p=.002), COVID-19 stress (β=.20, p=.030) and parity (β=-.17, p=.047) were factors influencing maternal-fetal attachment, and these factors explained 26.4% of the variance in maternal-fetal attachment (F=10.12, p&lt;.001). Converse to common sense, COVID-19 stress exerted a positive influence on maternal-fetal attachment in pregnant women during the COVID-19 pandemic. Healthcare providers need to recognize the positive influence of COVID-19 stress and implement intervention strategies to strengthen resilience in pregnant women to improve maternal-fetal attachment.

Labor Induction with Intravaginal Misoprostol versus Spontaneous Labor: Maternal and Neonatal Outcomes.

To compare the maternal and neonatal outcomes of pregnant women who had labor induction with intravaginal misoprostol or had spontaneous labor in our clinic. Material-Method. The records of 213 pregnant women, who were followed up in Acibadem Maslak University Hospital for vaginal delivery between June 2021 and December 2021, were retrospectively evaluated. The pregnant women, who gave birth, were divided into 3 groups as follows: spontaneous labor (SL), those induced by a single dose of misoprostol (SDM), and those induced by multiple doses of misoprostol (MDM). The groups were compared in terms of delivery type, the vaginal birth rate within 12 hours, need for intervention, duration of the second stage of labor, cesarean section ratio due to fetal distress, time from the last dose to delivery, and 1st and 5th minute APGAR scores. Among the primiparous pregnant women, 84.7% of SL group, 65.2% of SDM group, and 37% MDM group delivered vaginally within 12 hours (p < 0.05). The time from the last misoprostol dose to delivery was also statistically significantly shorter in pregnant women, who received a single dose of misoprostol (483 vs. 720 min, respectively). When the hospitalization time was evaluated, in the SDM group, the MDM group, and the SL group, it was found to be 611, 831, and 379 min, respectively. In multiparous pregnant women, the hospitalization time was 735 min in the SDM group, 494 min in the MDM group, and 261.5 min in the SL group (p < 0.05). Other than the hospitalization time, when the aforementioned variables were studied in multiparous pregnant women, no statistically significant difference among groups was observed (p > 0.05). Intravaginal misoprostol seems to be a promising medical agent for labor induction due to its high delivery rates within 12 hours and the absence of negative fetal outcomes, its ease of storage, and affordable cost.

Upper Respiratory Microbiome in Pregnant Women: Characterization and Influence of Parity.

During pregnancy, the woman's immune system changes to support fetal development. These immunological modifications can increase the risk of respiratory diseases. Because the respiratory microbiome is involved in airway homeostasis, it is important to investigate how it changes during pregnancy. Additionally, since parity is associated with immune system alterations and cohabitants shared a similar microbiome, we investigated whether having a child may influence the respiratory microbiome of pregnant women. We compared the microbiome of 55 pregnant with 26 non-pregnant women using 16S rRNA gene sequencing and analyzed taxonomy, diversity, and metabolic pathways to evaluate the differences among nulliparous, primiparous, and multiparous women. The microbiome was similar in pregnant and non-pregnant women, but pregnant women had higher alpha diversity (Chao1 p-value = 0.001; Fisher p-value = 0.005) and a lower abundance of several metabolic pathways. Multiparous pregnant women had a higher relative abundance of Moraxella (p-value = 0.003) and a lower abundance of Corynebacterium (p-value = 0.002) compared with primiparous women. Both multiparous (pregnant) and primiparous/multiparous (non-pregnant) women reported a higher abundance of Moraxella compared with primiparous (pregnant) or nulliparous ones (p-value = 0.001). In conclusion, we characterized for the first time the upper airway microbiome of pregnant women and observed the influence of parity on its composition.