Pregnancy Planning Research Articles

Are 6 more accurate than 4? The influence of different modes of delivery on postpartum depression and PTSD

BackgroundEmpirical evidence shows that 4.6–6.3% of all women develop a post-traumatic stress disorder (PTSD) and approximately 10–15% postpartum depression (PPD) following childbirth. This study explores the relationship between delivery mode and the occurrence of PTSD and PPD, specifically examining four distinct caesarean section (CS) modes: primary on maternal request (Grade 4), medically indicated primary (Grade 3), secondary CS from relative indication (Grade 2) and emergency secondary CS (Grade 1), compared to vaginal and assisted vaginal delivery (AVD). The research aims to understand how these six subcategories of delivery modes impact PPD and PTSD levels. Common predictors, including the need for psychological treatment before childbirth, fear of childbirth, planning of pregnancy, induction of labor, birth debriefing, and lack of social support after childbirth, will be analyzed to determine their association with postpartum mental health outcomes.MethodsThe study was planned and carried out by a research team of the psychology department at the Medical School Hamburg, Germany. Within an online-study (cross-sectional design) N = 1223 German speaking women with a baby who did not die before, during or after birth were surveyed once between four weeks and twelve months postpartum via an anonymous online questionnaire on demographic and gynecological data, delivery mode, PTSD (PCL-5) and PPD (EPDS).ResultsFor both psychiatric disorders, ANOVA revealed significant differences between delivery mode and PPD and PTSD. With weak effects for PPD and medium to strong effects for PTSD. Post-hoc tests showed increased levels of PPD for two CS types (Grade 1, Grade 3) compared to vaginal delivery. For PTSD, secondary CS from relative indication (Grade 2), emergency secondary CS (Grade 1) and assisted vaginal delivery (AVD) were associated with elevated levels of PTSD. Regression analysis revealed delivery mode as a significant predictor of EPDS- (medium effect size) and PCL-5-Score (medium to high effect size).LimitationDelivery was considered as the potential traumatic event, and any previous traumas were not documented. Additionally, the categorization of delivery modes relied on subjective reports rather than medical confirmation.ConclusionThe study highlights the influence of delivery mode on the mental health of postpartum mothers: different modes influence postpartum disorders in various ways. However, the definition of delivery mode was only stated subjectively and not medically confirmed. Further research should investigate which aspects of the different delivery modes affect maternal mental health and explore how the perception of childbirth may be influenced by specific delivery experiences.

Differences in reproductive health discussions in an urban Hispanic population with SLE: lessons from the field

ObjectiveManagement of reproductive health-related issues is crucial for patients with SLE, given this is a disease that primarily affects women of childbearing age. Little is known as to how the...

Asuhan Kebidanan Komprehensif Pada Ny. K Umur 27 Tahun Dengan Anemia Ringan Di PMB Ny. S Wilayah Kerja Puskesmas Kaliwadas Kabupaten Brebes Tahun 2023

The success of maternal and child health can be seen from the indicators of maternal mortality rate (MMR) and infant mortality rate (IMR). One of the causes of maternal mortality is bleeding that occurs due to anemia during pregnancy. Anemia conditions can be prevented by antenatal care (ANC) checks, and can help make labor run physiologically. Objective To provide comprehensive midwifery care to the patient, family, community or closest friends in order to get appropriate care.This study used a qualitative descriptive method with a case study approach. In the first visit pregnancy care found the incidence of Mild Anemia, at the second visit found the incidence of Mild Preeclampsia. In the care of childbirth, there were cases of premature rupture of membranes and chepalopelvic disporpotion so that delivery was carried out by Sectio Caesarea. And in the care of newborns, postpartum and family planning there are no problems and the condition of the mother and baby is normal. Based on the comprehensive care provided to Mrs. K, there were no gaps in the care of pregnancy, puerperium, newborn, and family planning, but in the care of childbirth there were some gaps between theory and practice.

Asuhan Kebidanan Komprehensif Pada Ny. M Umur 35 Tahun Dengan Kekurangan Energi Kronis Di Wilayah Kerja Puskesmas Bantarkawung Kabupaten Brebes Tahun 2023

According to WHO (2021) MMR is about 395,000 cases of deaths worldwide due to pregnancy and childbirth. According to ASEAN (2021) MMR is 235,000. Per 100,000 live births, In Indonesia the number of MMR is 7,389, cases, Central Java Province contributes to MMR 199 per 100,000 live deaths Brebes Regency 105 cases of MMR, Data from Bantarkawun Health Center in 2021 MMR 5 cases and IMR 4 cases. To find out how Comprehensive Midwifery Care on Mrs. M Age 35 Years With Chronic Energy Deficiency at the Puskesmas Bantarkawung Research Methods In this study, researchers used a qualitative descriptive method. From the care given to Mrs.M, no significant gaps were found. From the care that has been given to Mrs. M comprehensively from pregnancy, childbirth, postpartum, LBW, and family planning in the Bantarkawung Puskesmas work area and at Mrs.M's home, using the Varnay approach flow, and SOAP documentation.

Analysis of Factors Related to the Incidence of Postpartum Blues in Adolescent Mother

BACKGROUND: Adolescent marriage in Indonesia is very high, this will have an impact on the psychological aspects of adolescents. Postpartum psychological disorders of adolescent mothers are postpartum blues. AIM: The study aimed to identify factors related to the incidence of postpartum blues in adolescent mothers. METHODS: This quantitative study used a cross-sectional method involving 90 respondents taken by consecutive sampling. Research sites in Bandung City Special Hospital for Mothers and Children and Al-Ihsan Regional Public Hospital, Bandung District. This research was conducted from May to September 2019. Data collection instruments in this study use the Edinburgh Postpartum Depression Scale. Pregnancy planning uses the London Measure of Unplanned Pregnancy questionnaire. Social support uses a postpartum support system and a family coping questionnaire. The last questionnaire is the psychosocial condition of the mother Postpartum Postnatal Risk Questionnaire. Multivariate analysis using logistic regression tests to determine the factors most related to the incidence of postpartum blues in adolescent mothers. RESULTS: The results showed that there were 44.4% of adolescent mothers experience postpartum blues. There was a significant relationship between social support and the incidence of postpartum blues (p = 0.001; odds ratio [OR] 11,777; 95% confidence interval [CI] = 3604–109,534) and home living also had a significant relationship with the incidence of postpartum blues (p = 0.002; OR = 9,653; 95% CI = 0.001–0.225). A negative B value at the home living indicated that home living is a preventative factor for postpartum blues in adolescent mothers. CONCLUSIONS: Postpartum blues are influenced by social support, psychosocial conditions, and pregnancy planning. Adolescent mothers need to get attention, especially from their husbands and families during the period of puerperium.

Pre-marital education (PME) program for marriage readiness and stunting prevention to women of childbearing age

Background: Indonesia is one of the countries with a high burden of malnutrition, including stunting. One preventive measure for stunting is the optimization of pre-pregnancy services (preconception). Preconception services, especially for prospective brides and grooms, aim to identify and modify biomedical, psychological, and social risks related to women's health and pregnancy conditions through an optimal early detection strategy. Current issues regarding stunting can indeed be prevented through optimal pregnancy and marriage planning. Therefore, a strategy is needed to develop comprehensive pre-marriage planning through premarital classes.Purpose: To determine the effectiveness of pre-marital education (PME) program for marriage readiness and stunting prevention to women of childbearing ageMethod: This research used a quantitative research design with a quasi-experimental one-group pretest-posttest approach. The instrument used a questionnaire on the physical, psychological, and social readiness of premarital individuals that had been tested for validity and reliability. The sampling method used accidental sampling, and 49 prospective brides and grooms were obtained as participants.Results: The results indicated that the "Paketin Canting" class titled "Paket Kelas Catin Cegah Stunting" had an effect on the biopsychosocial readiness of premarital individuals. In future research, the Catin class method can be further developed to enhance motivation and utilization. Additionally, further research is needed on the impact of Catin classes on reducing stunting rates in Indonesia, and statistical tests show a significant difference before and after the Paketin Canting intervention on the biopsychosocial readiness of premarital individuals (p-value = 0.000).Conclusion: There is an effect of the "Paketin Canting"- a pre-marital education program on the physical, psychological, and social readiness of premarital individuals.

Maternal Exposure to Stress During Covid-19 and Non-Syndromic Orofacial Clefts: A Cohort Retrospective Study.

The coronavirus (COVID-19) pandemic presents an opportunity to study stress's effect on the development of non-syndromic orofacial clefts (NSOFCs). This study was aimed at assessing maternal stress exposure during the pregestational to first trimester pregnancy periods and the development of NSOFCs during a year of the COVID-19 pandemic. Cohort study of infants with NSOFCs and controls matched based on recruitment site and age. Government hospitals in Saudi Arabia between November 2020 and November 2021. Data collection included NSOFC clinical examination and maternal stress exposure assessment using the Modified Life Events Questionnaire, the Fear of COVID-19 Scale, and a focus on the lack of pregnancy planning and a threatened miscarriage. Of the 557 infants recruited, 191 had NSOFCs. Logistic regression analysis with adjusted odds ratios (AORs) that removed the effects of confounders showed that any of the seven stressful life events (AOR:3.78, P < .001) and the family histories of relatives with NSOFCs (AOR:9.73, P < .001) increased the AOR for NSOFC development. In contrast, maternal folic acid (AOR:0.56, P.010), threatened miscarriage (AOR:0.17, P = .001), fear of COVID-19 (AOR:0.83, P = .038), and suspected COVID-19 infection (AOR:0.43, P = .008) decreased the AOR for NSOFC development. Along with an established risk associated with family history of birth defects, stressful life events may be a risk factor for NSOFC development. Beyond folic acid's known benefit, it may be that higher maternal health concerns contribute to increased protective health behaviors during pregnancy. Ongoing research is needed to specify the maternal risk factors for NSOFC.

What preconception health services would the public find when searching the internet in Australia?: results from a simulated internet-search study

BackgroundAustralian preventive health strategy outlines the importance of preconception health in improving health in the community, across multiple generations and places primary and community healthcare services as a central pillar to effective preconception care. However, there is no national implementation plan to see preconception care proactively offered in healthcare settings in Australia. Instead, there is evidence that most women search the internet for information about pregnancy planning and preparation. In response, this study explores the availability and characteristics of health services found by searching for preconception care online in Australia.MethodSimulated Google searches were conducted using search terms ‘preconception’ and the name of a city/town with a population > 50,000. Related terms, ‘fertility’ and ‘pregnancy’ were also searched. Characteristics of the health services and the information available on relevant websites were extracted and reported descriptively.ResultsThe searches identified 831 website links, including 430 websites for health services. The health services were most often located in cities/towns with populations equal to or less than 200 000 (54.2%), and housing multiple health professionals (69.8%) including a specialist doctor (66.5%), nurse (20.9%), psychologist/counsellor (2.0%) and/or naturopath (13.0%). All the health services identified online explicitly mentioned women among their target populations, while 69.1% (n = 297) also referred to providing services for men or partners. More than one third of websites included blogs (36.9%) while external links were included in 10.8% of the online sites.ConclusionsThis study provides a preliminary examination of health services that may be found through internet-based searching by Australian consumers seeking health advice or support prior to becoming pregnant. Our descriptive results suggest couples may find a variety of health professionals when seeking health services for preconception care. Future research involving co-design of search terms with consumers, ongoing monitoring of health services and ensuring access to meaningful, and accurate information found through internet-searching are all necessary to ensure people of reproductive age are able to access the preconception health information and care they need.

The experience of pregnancy and motherhood in the career of Brazilian’s sportswomen: a qualitative study

Motherhood is a period there is a deconstruction of one identity and reconstruction of another, including changes in self-concept, commitment, and learning. For athletes who become mothers, these changes also occur and impact in their career. We aim to describe the experience of being pregnant for a group of Brazilian athletes, understanding the impact of maternity on the career and the postpartum for these women. A qualitative descriptive and exploratory study was conducted followed the guideline Standards for Reporting Qualitative Research (SRQR). We are using the semi-structured interviews with nine Brazilian athletes all of whom were professional athletes at the time they became pregnant. Maximum Variation Sampling and the snowball technique were used. The analysis was done using Iramuteq software, which performed Descending Hierarchical Classification (DHC) and Similarity Analysis. The nine athletes had a mean age of 38.3 years (SD: 5.5 years), from different levels and sports, and all had at least one child. We identified 488 text segments, which resulted in two branches, divided into five classes: History in sport (class 2); Pregnancy planning and immediate postpartum (class 5); reconciling the routines of athlete and mother (class 3); Social support narrative (class 4); Childcare (class 1). The findings indicate that athletes can have emotional ga ins in reconcile motherhood with their sports careers to the extent that they have social support, relative planning to become pregnant, and reconcile their athletic routine with baby care. Keywords: Athletes; Pregnancy; Maternity, Sportswoman; Qualitative research; Career transition; Iramuteq.

P-53 Resistant macroprolactinoma

Abstract Introduction Dopamine agonists (DAs) are considered to be the mainstay treatment for prolactinomas. Primary DA-resistance has been reported in approximately 20–30% of the patients on bromocriptine, and in around 10% of those on cabergoline. The DA-resistance is usually defined as a failure to achieve normal prolactin levels on maximally tolerated doses of DAs for at least 3-6 months and failure to achieve 30-50% reduction in tumor size in case of macroprolactinoma. Most of resistant prolactinomas have shown to be large and/or invasive tumors. We present a clinical case of microprolactinoma, resistant to cabergoline. Clinical Case A 21-year old woman reported of a 2-year history of amenorrhea. Primary examination revealed hyperprolactinemia up to 361 ng/ml (bioactive prolactin 256 ng/ml). MR imaging with contrast enhancement showed the ovoid microadenoma in the right half of the adenohypophysis up to 10 mm without invasion to cavernous sinus (Figure 1). Hormone tests excluded the overproduction of ACTH, GH and TSH by the tumor (Table 1), and revealed no signs of hypopituitarism. The patient was prescribed cabergoline (0.5 mg per week), which was followed by the initial decrease of prolactin level to 116 ng/ml. However, subsequent increase of cabergoline dose up to 4,5 mg per week did not lead to further prolactin decrease and normoprolactinemia and there was no resumption of menstrual function. On the follow-up MR images (6 months after the first one) no dynamics was revealed: the tumor was up to 10 mm in size without invasive spreading to cavernous sinus or chiasm. Taking into account the resistance to cabergoline, young age and pregnancy planning, the patient underwent transnasal debulking of the tumor. A week after the operation, normalization of prolactin level was noted, and there were no any signs of hypopituitarism. Within a month after operation, the patient reported of resumption of regular menstrual cycle. r4 months later the woman got pregnant. The pregnancy proceeded without complications and ended in timely delivery.Figure 1.MR image of pituitary microadenoma (contrast enhanced) Table 1.Primary hormone examination

P-12 Postpartum vertebral compressive fractures in a young female with osteoporosis - A case report

Abstract Introduction Osteoporosis is а metabolic disorder characterized by low bone mass and deep changes in bone architecture that lead to an increased vertebral or hip fracture in elderly. Osteoporosis in young population is a very rare condition especially when is associated with compressive fractures. Pregnancy and postpartum-related osteoporosis is condition that occurs in the last trimester of pregnancy оr in the first months of lactation. It is self-limited condition that return to normal after 12-18 months. In rare cases leаds to spinal compressive fractures. Clinical Case We present a 33-year-old female with back pain that occurs after birth during the early lactation period. In consultation with an orthopedic surgeon, an X-ray was made on the thoracolumbar spinal column with a finding of vertebral compressive fractures. A DEXA scan (double energy-X rays of absorptiometry) is also made with the finding of vertebral osteoporosis and hip osteopenia. We calculate BMI and perform blood tests for vitamin D3, calcium, hormones and markers for bone metabolism. This was our patient's first birth, she was thin with height 157 cm, weight 42 kg and calculated BMI-17. Blood test showed very low concentration of vitamin D3- 16 ng/ml (20-44) with normal level of calcium- 1,20 mmol/l (1,10-1,40) and PTH-31,01 pg./ml (15-65). Thyroid, gonadal and adrenal axis was with normal function. We told the patient to stop the lactation and to take a supplementation of vitamin D3 2000 IE, Calcium 1000 mg and bisphosphonates (alendronate). After two years of treatment, we made a control DEXA scan. Our patient now has vertebral osteopenia, normal serum concentration of vitamin D (44 ng/ml) and her weight is 48 kg. She feels good, has no pain and no new fractures. Conclusion Pregnancy and lactation increase need for calcium and this condition is complemented by increased intestinal absorption of calcium and increased bone resorption of the mother's skeleton. Risk factors for low bone density are deficit of 1-25 OH vitamin D3, malnutrition, low body mass index, treatment with low dose of enoxaparin (LMWH), physical inactivity. Our patient has an increased risk of low bone density (she has a low body mass index, low serum concentration of 1–25 OH vitamin D3 and this was her first pregnancy). Normal serum level 1–25 OH vitamin D concentration is required to establish calcium metabolism and prevent low bone density, osteopenia or osteoporosis. Antiresorptive therapy with bisphosphonates lead to rapid improvement in bone density, prevent new fractures and relieves pain. Treatment of postpartum osteoporosis is debatable because this condition is reversible, so when we decide to treat or not to treat, we must consider present of fractures, pain and plan for future pregnancy.

Twenty Years of Subcutaneous Interferon-Beta-1a for Multiple Sclerosis: Contemporary Perspectives.

Multiple sclerosis (MS) is a chronic, progressive, inflammatory disorder of the central nervous system. Relapsing-remitting MS (RRMS), the most common form of the disease, is characterized by transient neurological dysfunction with concurrent accumulation of disability. Over the past three decades, disease-modifying therapies (DMTs) capable of reducing the frequency of relapses and slowing disability worsening have been studied and approved for use in patients with RRMS. The first DMTs were interferon-betas (IFN-βs), which were approved in the 1990s. Among them was IFN-β-1a for subcutaneous (sc) injection (Rebif®), which was approved for the treatment of MS in Europe and Canada in 1998 and in the USA in 2002. Twenty years of clinical data and experience have supported the efficacy and safety of IFN-β-1a sc in the treatment of RRMS, including pivotal trials, real-world data, and extension studies lasting up to 15years past initial treatment. Today, IFN-β-1a sc remains an important therapeutic option in clinical use, especially around pregnancy planning and lactation, and may also be considered for aging patients, in which MS activity declines and long-term immunosuppression associated with some alternative therapies is a concern. In addition, IFN-β-1a sc is used as a comparator in many clinical studies and provides a framework for research into the mechanisms by which MS begins and progresses.

Understanding Fertile Window: A Key to Pregnancy as well as Contraception

Abstract: Though population explosion is a major problem of the world today, infertility also exists and needs attention. Understanding reproductive health, the menstrual cycle, and adopting natural methods by couples can manage both fertility as well as infertility. During the preparation of the present review article, several search engines, such as Research Gate, Google Scholar, shodhganga, Scopus, emerging source citation index, chemical abstract services, academic journals database, open access medical journals, scirus, journal informatics, and various referred and nonreferred journals were used for the extraction of scientific information. Hence, this article has been prepared meticulously, which would help married couples in adopting an effective life plan for managing their reproductive activities. It explains about means of avoiding unwanted pregnancies using some naturally proven methods available. It also addresses issues related to infertility. Understanding ovulation symptoms and the fertile window is the key to determining the right time for intercourse in order to avoid or plan pregnancy. The ovulation technique uses the indicators of ovulation to determine the fertile window. A rise in body temperature and changes in cervical mucus (wet, clear, slippery) are the best indicators of ovulation. Understanding the concept of the fertile window enables women to strategically plan the timing of intercourse in order to either facilitate conception or prevent it.

Pregnancy Planning and its Association with Autism Spectrum Disorder: Findings from the Study to Explore Early Development.

To examine associations between pregnancy planning and autism spectrum disorder (ASD) in offspring. The Study to Explore Early Development (SEED), a multi-site case-control study, enrolled preschool-aged children with ASD, other DDs, and from the general population (POP). Some children with DDs had ASD symptoms but did not meet the ASD case definition. We examined associations between mother's report of trying to get pregnant (pregnancy planning) and (1) ASD and (2) ASD symptomatology (ASD group, plus DD with ASD symptoms group combined) (each vs. POP group). We computed odds ratios adjusted for demographic, maternal, health, and perinatal health factors (aORs) via logistic regression. Due to differential associations by race-ethnicity, final analyses were stratified by race-ethnicity. Pregnancy planning was reported by 66.4%, 64.8%, and 76.6% of non-Hispanic White (NHW) mothers in the ASD, ASD symptomatology, and POP groups, respectively. Among NHW mother-child pairs, pregnancy planning was inversely associated with ASD (aOR = 0.71 [95% confidence interval 0.56-0.91]) and ASD symptomatology (aOR = 0.67 [0.54-0.84]). Pregnancy planning was much less common among non-Hispanic Black mothers (28-32% depending on study group) and Hispanic mothers (49-56%) and was not associated with ASD or ASD symptomatology in these two race-ethnicity groups. Pregnancy planning was inversely associated with ASD and ASD symptomatology in NHW mother-child pairs. The findings were not explained by several adverse maternal or perinatal health factors. The associations observed in NHW mother-child pairs did not extend to other race-ethnicity groups, for whom pregnancy planning was lower overall.

Ethnobotanical study on medicinal plants used by the Yi people in Xiaoliangshan, Yunnan Province, SW China

Ethnopharmacological relevanceThe Yi people in the Xiaoliangshan region in southwest China have a unique practice of combining ritual treatment and traditional medicine to care for patients. Despite increasing urbanization in the area, they have managed to preserve their distinctive lifestyle and extensive knowledge of traditional medicinal plants, setting them apart from other regions. However, there is a lack of systematic documentation on the knowledge of traditional medicinal plants used by the Yi people in Xiaoliangshan. Aim of the studyThis research aims to achieve the following objectives: 1. Document the diversity of medicinal plants used by the Yi people and explore their therapeutic usages. 2. Evaluate and analyze the main types of diseases with a high incidence in the local area and identify the types of medicinal plants used to treat these diseases. 3. Explore the underlying geographical and human factors influencing both disease prevalence and medicinal plant usage. MethodsEthnobotanical research methods were used to record and analyze the medicinal plants used by the Yi in Xiaoliangshan. Experts identified all plant specimens collected during ethnobotanical field surveys. The types of diseases treated by medicinal plants were classified according to the International Classification of Primary Care -2nd. ResultsA total of 125 medicinal plants were recorded after interviewing 193 participants. Of the medicinal plants identified, those with over 100 use reports were Paris polyphylla (202 use reports), Taxillus sutchuenensis (183), Artemisia indica (149), and Papaver somniferum (113). A total of 14 disease categories were recorded, with those related to the following categories having higher Informant Consensus factor values (ICF ≥0.85): Pregnancy, Childbearing, Family Planning, General and Unspecified, Urological, Respiratory, Musculoskeletal, and Skin. The highest quantity of medicinal plants is utilized to improve specific diseases and health problems, namely those related to Digestion, Skin, and Musculoskeletal. Fewer plant species were utilized for diseases or health issues associated with Eyes, Psychological, or Pregnancy, Childbearing, and Family Planning. The use reports from the informants also revealed how some medicinal plants are used to treat a variety of diseases or health issues. For instance, Malva pusilla is used for inducing abortion, treating postpartum hemorrhage, and joint sprains; Artemisia indica is used for treating malaria; Argentina lineata is used to remedy tuberculosis and malaria. Taxillus sutchuenensis is used for dealing with cold, pneumonia, and other ailments. ConclusionsThe Yi people in Xiaoliangshan have a rich knowledge of traditional medicinal plants. Decoction and wine brewing are the most common processing methods used for these plants, which are utilized to treat a wide range of diseases. The characteristics of the medicinal use of the Yi people reflects the alpine mountainous environment in which they live, and their medical practices are closely related to traditional healing culture. This study enhances our understanding of the Yi traditional medicine via documentation and offers a valuable reference for future research and the development of new drugs.

Paying for Parenthood: Understanding Parental Leave Policies in Infectious Disease Fellowship.

Many physician trainees plan pregnancy during residency and fellowship. A study of internal medicine program directors (PDs) demonstrated frequent misinterpretation of American Board of Internal Medicine (ABIM) leave policies applied to parental leave. The primary aim was to investigate how infectious disease (ID) PDs interpret current ABIM leave policies. We surveyed 155 ID PDs in an online anonymous questionnaire about knowledge of ABIM leave policies and application toward trainee leaves. Of 155 PDs, 56 (36%) responded to the survey. Nearly 70% incorrectly identified leave limits permitted. A majority mistakenly chose to extend training when a competent fellow was within the allowed duration of leave. PDs reported that the majority of ID trainee maternity/birth parent leaves (60%) were ≤7 weeks and only 7% were ≥12 weeks; 50% of paternity/nonbirth parent leaves were ≤3 weeks. Surveyed ID fellowship PDs often misinterpret ABIM leave policies and apply policies incorrectly when given sample scenarios..

Serum magnesium in women with a history of adverse pregnancy outcomes

Aim. To study of serum magnesium in women with a history of adverse pregnancy outcomes.Materials and Methods. 74 women of child-bearing age, subject to voluntary informed consent, participated in a prospective cohort study. The main group (n = 31) included non-pregnant women who had a history of unfavorable gestation outcomes: premature birth, spontaneous miscarriage, habitual miscarriage, undeveloped pregnancy. The comparison group (n = 43) consisted of non-pregnant women with a history of two or more urgent deliveries. In all women, in preparation for pregnancy, the content of serum magnesium was determined by colorimetric method with xylidine blue.Results. 77.6% of women with a burdened obstetric history of miscarriage (the main group) had various menstrual cycle disorders (FIGO, 2018). When analyzing the levels of magnesium in the blood serum of the examined women, it turned out that the obtained indicators in women of both groups corresponded to the established reference range of normal values of serum magnesium levels. At the same time, in the women of the main group, the average magnesium content in the blood serum was significantly lower and was closer to the lower limit of the range of normal values, and in the comparison group – in the middle of the range of normal values: 0.719 (0.672-0.767) mmol/l and 0.844 (0.778-0.922) mmol/l, respectively, p&lt;0.001.The optimal threshold value of the serum magnesium index in the study was 0.796 mmol/l with the sensitivity and specificity of the proposed prognostic model of 80.6% and 81.4%, respectively.Conclusion. Determination of the level of magnesium in the blood serum of women at the stage of pre-pregnancy counseling is of particular importance. Despite the fact that all the examined women had serum magnesium levels within the range of its normal values, significantly lower serum magnesium levels were found in women with adverse pregnancy outcomes in the anamnesis, which necessitates prescribing magnesium-containing medications to such patients at the stage of pregnancy planning. For the prevention of miscarriage within the framework of preconception preparation with serum magnesium values ≤0.796 mmol/l, the intake of organic magnesium salts is recommended.

Risk factors for self-reported alcohol consumption during pregnancy.

Fetal alcohol syndrome (FAS) is the most common preventable cause of impaired fetal development. The amount of alcohol consumed by expectant mothers varies by country. Studies on the prevalence of alcohol use among pregnant women in Slovakia and the risk factors linked to alcohol consumption during pregnancy are scarce. Similarly lacking are the data regarding pregnant women's awareness of the negative consequences of alcohol use during pregnancy. The study comprised women who gave birth at the 2nd Department of Gynecology and Obstetrics between July 1, 2023, and December 31, 2023. All respondents received an anonymous retrospective questionnaire following childbirth. The questionnaire investigated alcohol consumption throughout the year preceding conception as well as during each of the trimesters. The questionnaire also included questions on the woman's plans to become pregnant, her demographics, and her awareness of the hazards associated with alcohol consumption during pregnancy. Afilled-out questionnaire was obtained from 402 women. Of these, 51 women (12.8%) reported being completely abstinent before becoming pregnant. Complete abstinence before pregnancy was the greatest strongest protection against drinking during pregnancy (RR: 0.03). Among the 351 women who drank before pregnancy, 108 women (30.8%) continued to drink while pregnant, which constitutes 26.9% of all pregnant women. Risk factors of alcohol use during pregnancy included unplanned pregnancy (RR: 1.32), inadequate knowledge of the negative consequences of alcohol intake during pregnancy (71.9% vs 75.4%), and heavy drinking prior to pregnancy (RR: 2.55). In accordance with certain European data, the best means of protection against alcohol consumption during pregnancy include complete abstinence prior to conception, pregnancy planning, and high-quality education regarding the negative effects of alcohol during pregnancy (Tab. 4, Ref. 19). Text in PDF www.elis.sk Keywords: fetal alcohol syndrome spectrum, alcohol drinking in pregnancy, pregnancy planning, prenatal alcohol exposure, pregnancy.

Pregnancy Planning and 3-times Maternity Life of One Young Researcher

Pregnancy Planning and 3-times Maternity Life of One Young Researcher

Results of the study of the attitude of women of reproductive age to the integrated gynecological care provision by family physicians.

Aim: To study and analyze the attitude of women of reproductive age to the integrated gynecological care provision by family physicians, their readiness to receive some gynecological services from family physicians, as well as to analyze the level of women's support and readiness for the integrated provision of gynecological care depending on age and level of education. Materials and Methods: For the survey, anonymous questionnaires containing questions on the attitude of women of reproductive age to the integrated provision of certain types of gynecological care by family physicians were developed. 181 women from the Kyiv region took part in the survey. Results: Support of more than 80% of respondents regarding the integrated gynecological care provision by family physicians received the following questions: counseling on the prevention of sexually transmitted infections and human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS) (92,3%); counseling on family planning and prevention of unwanted pregnancy (83,4%); counseling on the use of various methods of contraception (82,3%); examination and palpation of mammary glands (80,1%); referral of women to a higher level of obstetric and gynecological care (if necessary (86,2%). Conclusions: The majority of respondents (67,4%) are ready or better ready than not ready to receive certain types of gynecological care services from family physicians. Almost the same percentage ratio (more than 60%) of women of each age group and all levels of education are ready or better ready than not ready to receive gynecological care services, which they supported, from family physicians.