Pregnant Ladies Research Articles

Seroconversion Toxoplasmosis as a predictor for gestational diabetes mellitus among pregnant ladies in Iraq

Background. Toxoplasma gondii (T.g.) can reach many host organs including the pancreas and pancreatic tissue may be directly attacked and compromised by the organisms. Aim. This study aimed to evaluate the risk of toxoplasmosis infestation as a predictor of gestational diabetes mellitus (GDM) among pregnant ladies in Thi-Qar, Southern Iraq. Methodology. A case-control study was conducted on 151 pregnant ladies classified (61) with GDM and (89) healthy pregnant ladies attending a tertiary Endocrine Center. All patient data were gathered from direct interviews and the digital records of the tertiary center, which used an internal network system and Microsoft Access program. Each pregnant woman was diagnosed with new GDM according to the American Diabetes Association (ADA) definition criteria. Results. The mean ages of the whole participants were 28 ±6 years old and more than half of them were in the second decade of life, their mean weight was 75.38±13.29) kg and their body mass index was 29.82 ± 5.23 (Kg/m2). Family history of DM, history of toxoplasmosis infestation, and positive serological test of IgG for toxoplasmosis was significantly predominant among women with GDM rather than those without (p-value= 0.007, 0.002, 0.004 respectively). Conclusions. The second decade of age is the independent risk factor for developing new GDM, while toxoplasmosis infestation and positive IGG were additive-dependent risk factors for developing new GDM in collaboration with other patients' profiles. Pregnant women with GDM were significantly older, heavier in body weight, and obese than those without GDM making them at higher risk factors for getting hyperglycemia.

Comparison of American Thyroid Association and Conventional Criteria in Diagnosing Hypothyroidism among Pregnant Ladies Attending a Tertiary Care Hospital

ABSTRACT Background: There is continuing debate regarding universal screening, the use of a thyroid-stimulating hormone (TSH) cutoff value, and levothyroxine replacement in frequently encountered issues like subclinical hypothyroidism in pregnancy. The study was intended to compare the American Thyroid Association (ATA)-2011 defined trimester-specific TSH with conventional TSH values in the diagnosis of newly detected hypothyroidism in pregnancy, as there are no trimester-specific reference ranges of TSH in Bangladesh. Methods: This cross-sectional, observational study enrolled 175 pregnant women recruited by convenient sampling from the Department of Obstetrics and Gynecology, BIRDEM General Hospital. As per the study protocol, investigations were advised. TSH, free thyroxine, and antithyroid antibodies were tested using the chemiluminescent technique. Data were analyzed by SPSS version 25. Nonparametric tests were chosen for statistical analysis. Results: The majority (53%) of the participants, were 30 years of age or younger. Using the ATA-2011 defined trimester-specific reference ranges of TSH, 32% had hypothyroidism. While using the conventional criteria (TSH – 0.4–4 mIU/L), hypothyroidism was diagnosed in 20.6% of cases. Conclusions: There is statistically significant discordance in diagnosing hypothyroidism in pregnancy between the two criteria.

Indications and Outcomes of Blood Transfusion among Pregnant Ladies

Indications and Outcomes of Blood Transfusion among Pregnant Ladies

The Effect of Giving Warm Ginger in Reducing Emesis Gravidarum in 1st Trimester Pregnant Women

Due to an increase in the hormone estrogen and progesterone produced by Human Chronic Gonadotropin (HCG), which causes emesis gravidarum, during pregnancy, the mother experiences hormonal changes. This study means to decide the impact of giving warm ginger in diminishing emesis gravidarum in pregnant ladies in the principal trimester PMB Lilis Nurhasanah, S.ST., Keb., Bd. SKM 2024. This exploration utilizes a Semi Trial technique with a One Gathering Pretest Posttest plan. This study's participants were pregnant women in their first trimester who had emesis gravidarum at PMB Lilis Nurhasanah, S.ST., Keb., Bd. SKM upwards of 30 respondents. The examining strategy in this examination is Complete Testing. Shapiro-Wilk normality test analysis yielded sig data (0.05). The Wilcoxon test has a p-worth of 0.000, and that implies there is an impact of giving warm ginger in diminishing emesis gravidarum in first trimester pregnant ladies. This end shows that there is an impact of giving warm ginger in lessening emesis gravidarum in first trimester pregnant ladies at PMB Lilis Nurhasanah, S.ST., Keb., Bd. SKM 2024.

Frequency of Low Birth Weight in Babies Born to Anemic Pregnant Women at Term Gestation; A Cross-Sectional Study

OBJECTIVES To assess the potential impact of maternal health on the frequency of low birth weight in newborns of anemic pregnant women at term gestation. METHODOLOGY It is a cross-sectional (Descriptive) study in the Department of Obstetrics & Gynecology, from 1st August 2022 to 31st July 2023. We recruited 169 pregnant ladies of any gravidity, 18-45 years of age at term gestation (37 ± 0 weeks to 41 ± 6 weeks), who presented with anemia and were included in this study. Patients who refused to participate in the study or had any other medical disorder leading to low birth weight, i.e., pregnancy-induced hypertension, chronic kidney disease, antiphospholipid syndrome, autoimmune conditions, and uteroplacental insufficiency, were excluded from the study. RESULTSOne hundred sixty-nine patients were enrolled in this study; 45 patients were between 18 and 27 years of age, 80 were between 28 and 37 years, and 44 were recorded at 37-45. Mean and Standard Deviations for age was 32 Years ± 6.68, for gestational Age 38 Weeks ±1.23, for Parity 3±1.31, for Hemoglobin Level it was 10.7 g/L ±14.95, and for Birth Weight, it was recorded as 2500 grams ± 279.24. The frequency of low birth weight was recorded in 36 (21.30% ) newborns of anemic pregnant women at term gestation. CONCLUSION The prevalence of low birth weight in newborns of anemic pregnant women at term was found to be high. A comprehensive approach regarding health education and anemia management in pregnant women is required.

Cost-effectiveness of screenings for mental health in pregnancy: A systematic review

Mental disorders posses significant obstacles both during and after pregnancy for many women. Birth weight, premature birth, perinatal and infant deaths, postpartum psychopathology, emotional difficulties, inappropriate behavior in children and adolescents, and adverse effects on other people are just a few of the negative impacts that mental disorders are linked to during pregnancy in that family. Women with mental disorders may experience issues after giving birth, affecting their health throughout pregnancy. Infections, including depression, frequently go undiagnosed and receive subpar treatment despite routine interactions with medical providers during pregnancy. Hormonal changes impact Mother's body movements; for example, she moves more slowly and gets exhausted more rapidly. Pregnant ladies who are in this scenario tend to become indolent. A systematic assessment of research findings on the effectiveness of economic evaluation of mental health screening instruments during pregnancy is frequently used to encourage early detection of mental health in pregnant women as maternal reactions become more sensitive, irritable, and irritable. These investigations mostly used the EPDS and PHQ-9. For the systematic review portion of this investigation, the PRISM ScR 2020 Flowchart was employed, and the A search of the literature was done using the databases Pubmed and Whiley. This article was assessed using the CHEC-Extended checklist. Two reports satisfied the inclusion criteria after an investigation of 890 chosen papers. The systematic review identified three themes: cost, effectiveness, and threshold. Given the variety of treatments used to treat mental health issues in pregnant women, it is clear that using two approaches rather than just one will result in greater cost-effectiveness

Association between IL-6 -174G/C Polymorphism and unexplained Recurrent Abortion among Pregnant Ladies

Association between IL-6 -174G/C Polymorphism and unexplained Recurrent Abortion among Pregnant Ladies

Analysis of efficacy of metformin in pregnant women with Polycystic Ovarian Syndrome (PCOS).

Objective: (1)To analyze of efficacy of metformin in pregnant women with POCS regarding occurrence of gestational diabetes mellitus (2) To analyze parity distribution for efficacy of metformin regarding occurrence of gestational diabetes mellitus in pregnant women with POCS. Study Design: Descriptive Cases Series. Setting: Sheikh Zaid Hospital, Lahore. Period: July 1, 2019 to December 31, 2019. Methods: Till delivery 200 pregnant ladies were followed up to see if they developed GDM or not. A pre-prepared form was used to record metformin efficacy frequency and GDM in pregnant ladies with PCOS. For efficacy and parity (qualitative variables), percentages and frequencies were got calculated using SPSS.16. Results: Thirty two (16%) women got ‘0’ parity. Forty four (22%) got ‘1’parity. Fifty (25%) got ‘2’ parity. Forty two (21%) got ‘3’parity.While thirty two women (16%) got ‘4’ parity. Twenty two (78.57%) was efficacy for nulliparous patients. Thirty three (76.74%) was efficacy for primiparous patients. One hundred nine (84.50%) was efficacy for multiparous patients. Insignificant difference was noted as p was more than 0.05. In one hundred sixty six (83%) women metformin efficacy got achieved. Conclusion: Multiparous patients with PCOS showed relatively more efficacy (84.50%) of metformin against gestational diabetes mellitus while twenty five percent pregnant women with PCOS with a thorough use of metformin delivered two live neonates.

Proportion of Newly Detected Hypothyroidism among the Diabetic and Nondiabetic Pregnant Ladies and Correlation of Different Parameters with Thyroid Stimulatory Hormone in Pregnancy Attending a Tertiary Care Hospital

ABSTRACT Background: Subclinical hypothyroidism and gestational diabetes are the two most common endocrinopathy encountered in daily clinical practice. Many literature showed a higher frequency of hypothyroidism in the persons with diabetes but others did not find it. Objectives: The study was intended to compare the proportion of newly detected hypothyroidism in persons with diabetes and without diabetes in pregnancy (DIP). Materials and Methods: This cross-sectional, observational study enrolled 175 pregnant women by convenient sampling from the Department of Obstetrics and Gynecology, BIRDEM General Hospital, with or without diabetes after IRB clearance. According to the study protocol, Thyroid function test (TFT) and oral glucose tolerance test were done in the participants. Thyroid stimulatory hormone (TSH), free thyroxin, and antithyroid antibodies were tested using the chemiluminescent technique by the ADVIA centaur, Siemens. Plasma glucose was analyzed by Advia-1800, SIEMENS, USA by glucose oxidase method. Data were analyzed by SPSS version 25. Nonparametric tests were chosen for statistical analysis. Results: The median maternal age was 30 years, and half of the participants had a family history of diabetes mellitus (DM). Hundred patients had diabetes either gestational DM or DIP or preexisting diabetes. Among the persons with diabetes, 34% had hypothyroidism, and in euglycemic patients, 29.3% had hypothyroidism. There was no statistically significant (P = 0.785) difference in the median values of TSH across the glycemic status among the hypothyroid subjects. TSH had a positive correlation with thyroid peroxidase antibody (P = 0.174) within the hypothyroid patients. In the study subjects, TSH was inversely correlated with hemoglobin (P < 0.001). Conclusions: There is no statistically significant concordance in diagnosing hypothyroidism in pregnancy between the persons with diabetes and without diabetes.

A COMPARATIVE STUDY BETWEEN SERUM MAGNESIUM AND CALCIUM LEVELS IN PRE ECLAMPSIA VERSUS NORMOTENSIVE PATIENTS

Preelampsia is one of the most common causes of maternal and fetal morbidity and mortality. It is a recognised health challenge with devastating feto-maternal consequences. Nutritional deficiencies are commonly found in pregnant women and it is well established that the pregnant women from developing countries usually consume diets that are low in minerals and vitamins. Since the pathogenesis of preeclampsia has not been fully elucidated, the search for predictive markers and preventive strategies remains an unfulfilled issue. The study was conducted in the department of obstetrics and gynecology at Pravara Rural Hospital, Loni, Maharashtra, India to assess serum levels of calcium and magnesium in pregnant females who suffered from pre-eclampsia in comparison with normal pregnant ladies.

IJCM_24A: Determinants of unintended pregnancy among women attending Antenatal clinic at AIIMS Patna – a cross-sectional study

Background: Every day 67,385 babies are born in India, that’s around one- sixth of the world’s childbirths. Every minute one of these new-borns dies, with an annual birth rate of 25 million which accounts for nearly one-fifth of the world’s annual childbirth. Objectives: 1. To find out the proportion of unintended pregnancy among women of reproductive age group attending ANC Clinic of AIIMS Patna USING LUMP SCALE. 2. To determine the Factors contributing to unintended pregnancy. Methodology: This was a hospital based cross-sectional study done for 6months (March 2022 to September 2022) conducted in Department of Obstetrics and Gynaecology OPD, AIIMS Patna and included all the pregnant ladies who visited the ANC clinic. Consecutive sampling was done and a sample size of 237 was taken rounding off to 250 with 5% absolute precision, 95% confidence and 10% non-response rate. A predesigned, semi-structured questionnaire was used and the information collected was downloaded from Epicollect5/Google forms in an MS Excel sheet and analysis was done using the IBM SPSS version20. Results: Out of 255 participants who were more than 20 years of age 31% (79) participants had unplanned pregnancies compared to 50% (17) out of 34 participants whose age was less than 20. This association was statistically significant with a p-value of 0.027. Out of 289 participants attending the ANC clinic, 32.87% (95) participants had a history of abortion among which only 23.2% (22) participants had an unplanned pregnancy. This association was statistically significant with a p-value of 0.011. Conclusion: In our study we found the prevalence of unintended pregnancy to be 33.2% which is comparable with 33% prevalence of unintended pregnancy in African continent study.

Glycated hemoglobin (HbA1c) in diagnosis of gestational diabetes mellitus

Objective: To evaluate the diagnostic accuracy of glycated hemoglobin for diagnosing gestational diabetes mellitus. Material and Methodology: This cross-sectional comparative study was conducted at the Department of Chemical Pathology and Endocrinology, Reference Laboratory, Rawalpindi from June 2023 to October 2023. The study included women having gestational amenorrhea between 24th to 28th weeks, who gave informed written consent for a 75-gram oral glucose tolerance test (OGTT) at Reference Laboratory Rawalpindi. Women with diabetes, hypertension, hemoglobin< 10g/dl, on steroid treatment, with gastrointestinal or thyroid diseases were excluded. The medical history and anthropometric measurement (height, weight, body mass index (BMI) and blood pressure were recorded on a predesigned proforma. Blood sample for glucose was taken in sodium fluoride tubes and HbA1c in potassium EDTA tubes. American Diabetes Association criteria 2023 was used to diagnose gestational diabetes mellitus (GDM). Study participants were divided into two groups on basis of 75g- OGTT results; Group 1 included GDM and Group 2 Normal Glucose Tolerance (NGT). Results: A total of 100 pregnant ladies were enrolled whose ages ranged from 15-45 (mean & SD 29±5 & 31±6 years in groups 1& 2 respectively). Mean fasting plasma glucose (FPG) was 5.11±0.6 mmol/l & 4.57±0.4mmol/l, and HbA1c was 6.12%±1 & 5.26% ±0.48 in groups 1& 2 respectively. GDM was found in 19 (group 1) of 100 patients, while 81 responded normally. HbA1c at 5.6% has 84.2% sensitivity, 87.6% specificity, 61.5% PPV, 95.9% NPV and 87% diagnostic accuracy. FPG, 1hr glucose and HbA1c exhibited an Area Under Curve (AUC) by Receiver Operating Characteristic (ROC) Curve of 0.762, 0.801 & 0.894 respectively. Conclusion: HbA1c has shown higher diagnostic yield for gestational diabetes mellitus and can be used as a screening test. Keywords: Glycated hemoglobin, Oral glucose tolerance test, Gestational diabetes mellitus

Blood Transfusion for Iron Deficiency Anaemia in Antenatal and Postnatal in Maternal Specialist Hospital, 2018-2019: An Analytical Cross-sectional Study

Objective: Estimate the proportion and outcomes of blood transfusion in iron deficiency anemia in a specialist maternal hospital in Dubai, United Arab Emirates (UAE). Methods: In a cross-sectional study, data were collected from 177 pregnant inpatients and delivered outpatients with haemoglobin less than 12g/dL at the hospital in Dubai (UAE) between the 1st of February 2018 to 31st of January 2019. Sociodemographic factors were age, parity (number of birth to a live neonate or gestational age more than 24 weeks), and ethnicity. The outcome variable is blood transfusion. Different variables such as age, parity, nationality, gestational age at diagnosis, most severe haemoglobin reading, serum ferritin, haemoglobin electrophoresis, treatment, gestational age at delivery, mode of delivery, postpartum haemorrhage, neonatal birthweight, neonatal haemoglobin were tested using frequencies and means (standard deviation), chi-square and sample T-test was used. Results: One hundred and seventy-seven ladies had anemia, and one hundred and twenty-two (68%) had iron deficiency anemia (ferritin<30ng/dL). 52.5% (N=93) had moderate to severe anemia, and only 7.3% (N=13) received a blood transfusion. Anaemia was mostly diagnosed in the first trimester (40.7%; N=72) and second trimester (38.4%; N=68). 11 (6.2%) ladies had hemoglobinopathies such as beta-thalassemia, 138 (78%) ladies didn’t have hemoglobin electrophoresis reading. 37.9% (N=67) of vaginally delivered ladies and 4.5% (N=8) of cesarean section-delivered ladies had a postpartum hemorrhage. The majority of anemic antenatal and postnatal were Emiratis (74.6%; N=132), and a greater number fell in the middle age group between 30-39 (58.2%; N=103). The larger part had normal neonatal birthweight (76.8%; N=136) and only had a low neonatal birthweight (18.1%; N=32). 105 (59.3%) of neonates had abnormal hemoglobin readings. Conclusion: This is the first study in the UAE that assess both maternal and fetal outcome due to iron deficiency anemia in pregnant ladies. The prevalence of blood transfusion increased as iron deficiency anaemia was more severe. We endorse health practitioners to regularly measure serum haemoglobin, to treat anaemia early in pregnancy to avoid the need for blood transfusion.

Posttreatment symptoms in hypothyroidism and correlations with thyroid-stimulating hormone and free triiodothyronine and free thyroxine: A ThyPRO-based follow-up study

ABSTRACT Background: Treatment of primary hypothyroidism with levothyroxine does not fully alleviate its symptoms. Though there have studies to correlate levels of tri-iodothyronine with symptomatology, its role still remains controversial. Aims: To study symptoms of hypothyroidism before and after levo-thyroxine therapy using ThyPRO 39 scores and to correlate these with thyroid hormone levels. Materials and Methods: This quasi-experimental study was conducted at the in and outpatients' departments of Internal Medicine and Endocrinology of St John's Medical College Hospital. Patients were enrolled if they were aged over 18 years and were diagnosed with hypothyroidism (TSH>/= 10 IU/l). Pregnant ladies and patients who had undergone radioiodine therapy or were diagnosed with thyroid cancers were excluded. Results: A total of 46 (F=28) patients were enrolled into the study. The mean age of the study group was 41.63 +/-SD 12.078 years.Among hypothyroid symptoms at diagnosis, Tiredness and Emotional Susceptibility had the highest effect size. Tiredness, Cognitive complaints and Depressive symptoms had significant negative correlation with fT3.While Goitre, Tiredness, and Cognitive complaints showed significant association with TSH, no correlations were noted with fT4 and many scores. There was a statistically significant negative correlation between fT3 and post therapy domain scores of Goitre, Tiredness, Impaired Daily Life and Impaired Social Life. There was a significant difference in the QoL domain between those with and without co-morbidities, the latter group having lower scores signifying better QoL. Conclusion: Symptoms of hypothyroidism may have a correlation with fT3 levels. Larger well-designed studies with supplementation of T3(triiodothyronine) and correlation with symptoms and tissue levels of fT3 will give conclusive answers.

SARS CoV-2 Antibodies in Cord Blood of Neonates Delivered to Pregnant Mothers Vaccinated for COVID-19

Background: The recent novel coronavirus (severe acute respiratory syndrome coronavirus 2 [SARS-CoV-2]) pandemic has been responsible for millions of deaths globally. Several vaccines against the SARS-CoV-2 virus have been developed. Objective: To estimate the proportion of newborns who acquire IgG anti-SARS-CoV-2 antibodies from mothers vaccinated against COVID-19. Methods: Eligible study subjects seeking care in the Obstetrics & Gynecology department for delivery were recruited in this cross-sectional analytic study. Demographic and clinical characteristics of the study subjects were noted and around 3–5 mL venous blood was collected from each study participant duo (mother and newborn) to detect IgG antibodies to SARS-CoV2 “S” protein. Results: Over the entire study period, 125 pregnant ladies who were vaccinated with two doses of any COVID-19 vaccine were included in the study. A sizeable proportion (44.0%) of vaccinated pregnant women were seropositive for IgG antibodies to SARS-CoV2 “S” protein. A significantly high number of seropositive newborns (82.8%) were delivered to seropositive mothers as compared to seronegative mothers (OR 41.1; 95% confidence interval 14.6–116.1, p < .0001). Conclusions: The present study reveals that a substantial proportion of newborns acquired SARS-CoV-2 antibodies from their vaccinated seropositive mothers through transplacental transfer.

The Prognosis of Crimean-congo Hemorrhagic Fever in Thiqar City, South of Iraq, in 100 Cases over 2022

Background:: The study of Crimean-Congo hemorrhagic fever (CCHF) worldwide is of low rate as it is an uncommon disease. The outbreak in Iraq in 2022 is high. Aim:: To study the prognosis of hemorrhagic fever patients in Thi-Qar governorate, where the highest rate of the disease is, so that we might expect the fat of the disease. : Patients and Methods: A descriptive cases series of cross-section studies that included all patients with severe or life-threatening Crimean-Congo hemorrhagic fever(CCHF) PCR-positive cases (out of the total 100) admitted and followed up in AL-Hussain Teaching Hospital in 2022. To study patients' features that indicate the prognostic factors of the disease. Results:: All cases proved to be CCHF by PCR were 100 patients of variable severity, 14 cases were admitted to intensive care units (ICU), 13 patients died, 2 pregnant ladies were infected with CCHF unfortunately died, 16 children admitted to hospital 2 of them died and 14 cases completely cured. The most serious cases are intrapulmonary hemorrhage and neuropsychiatric presentation. Conclusion:: There are many clinical and laboratory prognostic markers. The riskiest clinical bad prognostic factor is the neuropsychiatric and pulmonary hemorrhage and CCHF in pregnant ladies.

A Comprehensive Review of Alternative Therapeutic Approaches for Nausea and Vomiting Relief in Pregnancy

Abstract: Alternative medication is used for treating the common problems associated with pregnancy. 80% of women suffer from morning sickness during pregnancy. Treatment during pregnancy via using non-pharmacological therapy is quite popular all over the world as it is safe and has no negative effects on the fetus. Nausea and vomiting are one of the most prominent problems faced by pregnant women. Acupressure and Aromatherapy have been used by pregnant ladies nowadays for relieving nausea and vomiting symptoms. Conventional therapies also aid in medication of morning sickness in pregnancy duration that covers drugs like Antiemetics, Corticosteroids, Antihistaminic, IV fluids and Vitamin-B6 supplements. Many scientific studies have demonstrated that few drugs that come under conventional treatment cause severe birth defects and stillbirth. This is the leading reason pregnant women prefer to use herbs instead of using conventional medical treatment. The prospective of this review article is to find out the alternative and conventional therapeutic approaches for alleviating the symptoms of morning sickness during pregnancy.

Maternal and Fetal Outcome in Actively Managed of PROM at Elhasahisa Teaching Hospital 2020

Background Prelabour rupture of membrane (PROM) is linked to significant maternal perinatal mortalities and morbidity. Objectives: To evaluate maternal and fetal outcome in pregnant ladies that actively managed due to PROM at Elhasahisa Teaching Hospital, from March 2020 to September 2020. Methods This is an observational, descriptive, cross sectional hospital-based study, conducted in the period from March 2020 to September 2020 at Elhasahisa Teaching Hospital included pregnant ladies that actively managed due to PROM. The data was collected by the researcher from women after informed consent. The data was analyzed by computer using SPSS- version 25. Results A total of 104 pregnant ladies that actively managed due to PROM were enrolled in this study, the frequency of PROM was 3.8%, about 53 (51.0%) women in age group 20-35 years (mean age 26.03), 99 (95.2%)of ladies were literate . 63 (60.6%) women received antenatal dexamethasone, 75 (72.1%) had duration of membrane rupture of less than 24 hours and 29 (27.9%) women has duration of membrane rupture of more than 24 hours, 50 (48.1%) women received oxytocin, 45 (43.3%) women received castor oil and oxytocin and 9 (8.7%) women received castor oil, 81 (77.9%) women delivered vaginally, 23 (22.1%) women underwent caesarean section, maternal complication included postpartum haemorrhage was found in 11 (10.6%), sepsis in 6 (5.8) and postpartum haemorrhage and sepsis in 1 (1.0%) woman, mean Apgar score at 5 minute was found to be 9.23 (p value 0.000), fetal complications included respiratory distress in 19 (18.3%) babies, 2 (1.9%) babies referred and 1 (1.0%) baby was stillbirth. Conclusion Maternal outcomes in pregnant ladies that actively managed due to PROM were postpartum haemorrhage and sepsis, no admission to ICU and no maternal mortality. Fetal outcomes in pregnant ladies that actively managed due to PROM were RDS, FSB, Apgar score less than 7 and referred. the frequency of pregnant ladies actively managed due to Pre Labour Ruptured of Membrane was 3.8%. The successful rate of induction of labour due to Pre Labour Rupture of Membrane was 77.9%.

Knowledge and Attitude of Obstetricians about the Effects of Oral Health, Dental Care and Management among Pregnant Ladies in Omdurman Maternity Hospital and Gynecological Omdurman Military Hospitals, Sudan in 2020

Background: Every expectant mother should receive a comprehensive oral health education and risk assessment. Numerous reports have shown an association between oral diseases and preterm, low birth weight. The aim of this study was to assess the knowledge and attitude of obstetricians about the effects of oral health, dental care and management among pregnant ladies in Omdurman Maternity Hospital and Gynecological Omdurman Military Hospitals, Sudan in 2020. Methods: This cross sectional study involved a survey of 100 obstetricians (male and female) from Omdurman maternity hospital and military hospital, the data derived from this research has been collected by self- administered questionnaire. Data has been analyzed using SPSS version 23. Result: This study included 100 participants 52% female and 48% male. The age of the participants started from 25 years old with the most of the respondents aged between (25 and 35 years old) and the result showed that 92% of obstetricians referred their patients to dentists, 84% believed that gingival disease affects birth weight, 40% agreed that abortion is the effect of oral disease in pregnancy. Conclusions: In this study regarding the knowledge and attitude of obstetricians about dental care during pregnancy we found that 92% of obstetricians referred their patients to dentists, 40% agreed that abortion is the effect of oral disease in pregnancy and 36% believed that gingival bleeding is the effect of pregnancy on oral health.

The Effect of Antenatal Breast Milk Care Bundles on the Availability of Breast Milk in Preterms ≤32 Weeks: A Cohort Study

Background Though early enteral nutrition with Mother’s own milk (MOM) is the norm in preterms, it is a difficult challenge to get it into the intensive care unit due to various medical and logistic issues. Awareness about this among pregnant ladies and their caregivers from the antenatal period may help to overcome some of these difficulties. Objective To compare the effect of the implementation of an antenatal breast milk care bundle on the availability of adequate breast milk on day 7 for preterm babies ≤ 32 weeks when compared to a postnatal breast milk care bundle alone. Methodology This prospective study was conducted among neonates ≤32 weeks born in Government Medical College, Thiruvananthapuram from January 2021 to May 2022. Antenatal bundles were implemented in the antenatal OPDs and wards. Postnatal bundles were implemented in the NICU and postnatal wards. The outcome was compared among babies of mothers who got both the care bundles and those who received only the postnatal care bundle. Results A total of 110 babies were included in the study. There was a 1.32 times increase in the adequacy of milk volume on day 7 (CI: 1.04–1.68), a significant increase in the proportion of mothers expressing within 24 hours, and babies getting discharged on exclusive MOM in those who received the antenatal BMC bundles. The risk for inadequate milk volume was high in those who have <2 ml of milk at 48 hours (RR: 1.67, CI:1.26–2.20]. Conclusion Antenatal breast milk care bundles can increase the availability of adequate MOM for preterm babies.