Pregnant Women In First Trimester Research Articles

The effectiveness of acupressure combination neiguan and zuzanli points to decrease emesis gravidarum in the first trimester of pregnancy

<p><strong><em>Background:</em></strong> Emesis gravidarum is the most common symptoms<em> in pregnancy</em><em> which about</em><em> 50-90% causing a decrease in appetite and will affect changes in potassium, calcium and sodium electrolyte balance, thus will impact on changes in body metabolism. As much as 2% of pregnant women experienced excessive nausea and vomiting (hyperemesis gravidarum) which can harm the mother and fetus. The current management of emesis gravidarum still uses pharmacological therapy, but pharmacological methods are more expensive, and more potential to have side effects. Instead of pharmacological methods, non-pharmacological methods are cheap, simple, effective, and have no side effects. One of the non-pharmacological methods to treat nausea and vomiting is acupressure. </em></p><p><strong><em>Objectives:</em></strong><em> was to determine the effectiveness of the combination Neiguan point (PC6) & Zusanli point (ST 36) to decrease emesis Gravidarum in </em><em>the </em><em>first trimester of pregnancy in midwives independent practice Sidoarjo.</em></p><p><strong><em>Methods:</em></strong><em> This research used quasi-experimental with one group pretest-posttest design. The study population are pregnant women in the first trisemester who experienced emesis gravidarum, who met inclusion criteria and were willing to be studied and had no with consecutive sampling technique from February 2 to March 20, 2022 totaling 40 respondents. Measurement of emesis gravidarum using the Rhodes index instrument. Data analysis using Wilcoxon test with </em>α<em> 0.05.</em></p><p><strong><em>Results:</em></strong><em> The results showed that the score for emesis gravidarum before acupressure was Mean+SD 22.0+4.01, while the score for emesis gravidarum after acupressure was Mean+SD 13.0+3.14. The results of the Wilcoxon test showed P value = 0.001 </em>< <em>0.05 so there was a significant difference in the emesis gravidarum score before and after acupressure was given. <strong>Conclusions:</strong> Acupressure at the Neiguan point (PC6) and Zusanli point (ST 36) is effective in reducing emesis gravidarum in first trimester of pregnant women. </em></p><em>Health workers, especially midwives, can apply and teach acupressure to pregnant women to reduce nausea and vomiting complaints.</em>

Efektivitas Essential Oil Lemon dan Grapefruit (Lemon Paradisi) Terhadap Penurunan Mual pada Ibu Hamil Trimester Pertama di Wilayah Kerja Puskesmas Kayangan

Background: Orange essential oil is well known for its flavor and fragrance properties, as well as many aromatherapeutic and medicinal applications. The lemon essential oil can be used to treat emesis of gravidarum. Purpose: To determine the difference in the effect of inhalation of lemon and grapefruit essential oils on reducing the frequency of emesis gravidarum in first-trimester pregnant women. Methods: This study used a quasi-experimental design with a pretest-posttest control group design method. The sampling technique was consecutive sampling with a sample size of 30 first trimester primigravida mothers. The study was conducted in Kayangan, North Lombok Regency. Measurement of the frequency of nausea and vomiting using the Pregnancy Unique Quantification of Emesis Scale (PUQE), statistical analysis using the Independent T-Test. Results: There was a significant effect between lemon essential oil and emesis of gravidarum with a p-value of 0.01. There is no difference between the results of the pre-test and post-test with a p-value > 0.05. There was no significant effect between grapefruit essential oil on the decrease in emesis gravidarum with a p-value of 0.3. There is a significant difference with a p-value of 0.009 between the results of the pre-test and post-test. Conclusion: Lemon essential oil affects reducing nausea and vomiting in pregnant women, while grapefruit essential oil does not affect reducing nausea and vomiting in pregnant women.

Does Being Diagnosed As Anemic in Early Pregnancy Have an Impact on the Household Expenditure for Food? Evidence From a Maternal Cohort in Rural Sri Lanka

ObjectivesAnemia, commonly attributed to nutritional issues, affects more than one third of pregnancies worldwide. Early screening for anemia in pregnancy aims to provide appropriate treatment, including lifestyle modifications, to prevent the morbidity and mortality of the condition on both mother and the baby. We investigated the impact of the “diagnosis of anemia” in early pregnancy on household food expenditure in rural Sri Lanka.MethodsAll first-trimester pregnant women registered at the public health midwives in Anuradhapura district, Sri Lanka, during the third quarter of 2019 were invited to participate in a pregnancy Cohort. Hemoglobin level was assessed at the baseline. Self-administrated questionnaires were used to collect data on the household economic status, household food expenditure, and pregnancy-related food expenditure during the first (T1), second (T2), and third (T3) trimesters. Descriptive statistics and Mann-Whitney U tests were used for data analysis.ResultsThe mean (SD) age of participants (n = 1573) was 28.3 (5.6) years and 21.2% (n = 295) were employed. Mild (Hb < 100g/l) and moderate anemia (Hb < 110g/l) were observed in 11.1% (n = 161) and 3.5% (n = 51), in T1 respectively. Monthly household income (median [IQR]) = USD 226.8 [170.09–328.84]) was not significantly different in women with and without anemia (U = 92,365.00, p = 0.85). The median (IQR) household food expenditure was USD 56.70 (39.69–85.04) in both T1 and T2, and the pregnancy-related food expenditure in T2 and T3 were USD 11.34 (5.67–17.01) and USD 8.50 (5.24–11.34), respectively. There was no statistically significant difference in the household food expenditure during T1 (p = 0.85) and T2 (p = 0.98), and the pregnancy-related food expenditure in T2 (p = 0.09) and T3 (p = 0.62) between anemic and non-anemic women. The percentage of household food expenditure spent as pregnancy-related food expenditure in T2 (p = 0.65) and T3 (p = 0.25) were also not significantly different between anemic and non-anemic women.ConclusionsHousehold and pregnancy-related food expenditure were not significantly different in women diagnosed with anemia in early pregnancy. Possible explanations for this observation, including effectiveness of nutritional education given to anemic pregnant women, need to be explored further.Funding SourcesAHEAD Operation, Ministry of Higher Education, Sri Lanka.

Показники деяких статевих гормонів та кортизолу в динаміці вагітності в жінок, які мали різні види безплідності в анамнезі

Changes in the endocrine-metabolic balance in women with a history of various types of infertility are so weighty that they determine not only the nature of menstrual and reproductive disorders, but subsequently significantly distort the course of the gestational period. Purpose - to study some indicators of sex hormones and stress hormone cortisol in women in pregnancy dynamics who had a history of different types of infertility. Materials and methods. Some hormonal profile indicators have been studied: free testosterone index (FTI), dihydrotestosterone (DHT) and cortisol in women with a history of different types of infertility at 11-12 weeks and 36-38 weeks of pregnancy. 84 women aged 20 to 49 years were examined. Among these women to the group I were included 26, these are pregnant women who had a history of endocrine infertility; to the group II - 25 pregnant women with a history of tubular-peritoneal infertility; to the group III - 13 pregnant women who had a history of a combination of endocrine and tube-peritoneal factors; to the group IV (the control group) - 20 patients who independently became pregnant without infertility. Results. There was an increase in cortisol concentration already at the beginning of gestation in the first trimester in pregnant women of the group I (80.8%), II (80%) and III (76.9%), while in the control group this indicator was significantly lower and was in 90% of patients at the level of physiological normal. In the third trimester, a further increase in cortisol was observed, both in women with a history of infertility (groups І-ІІІ) and in those who did not have infertility in the past (group ІV). FTI in pregnant women of groups I and III was significantly increased, both in the first trimester (65.4% and 76.9%) and in the third trimester (69.2% and 84.6%), compared to the indicators in groups II and IV. DHT in pregnant women I and III, both in the first trimester (61.5% and 84.6%) and in the third trimester (65.4% and 92.3%), exceeded the norm compared to the rates in the groups II and IV. Conclusions. The detected deviations in the concentration of the stress-associated hormone cortisol with a high degree of probability may indicate an increased stress load, which in pregnant women after the use of treatment cycles and assisted reproductive technologies has been manifested since the beginning of pregnancy. FTI and DHT in pregnant groups I and III were significantly increased compared to those in groups II and IV. The research was carried out in accordance with the principles of the Helsinki Declaration. The study protocol was approved by the Local Ethics Committee of the participating institution. The informed consent of the patient was obtained for conducting the studies. No conflict of interests was declared by the authors. Keywords: pregnant women with a history of various types of infertility, dihydrotestosterone, free testosterone index, cortisol.

HUBUNGAN PENGETAHUAN TENTANG ANTENATAL CARE TERHADAP KUNJUNGAN KEMBALI MINAT IBU HAMIL TRIMESTER I DI PUSKESMAS TAPEN JOMBANG

Pregnancy is something that every married couple looks forward to, especially newly married couples. The government's efforts in tackling the maternal mortality rate are by focusing on the availability of maternal health services in the community. Knowledge of ANC is very important for pregnant women's interest in doing examinations. The sample in this study was all pregnant women who had at least made ANC visits in the Tapen health center area. The sampling technique used in this study is total sampling, namely the sampling technique taken from the entire population. Then analyze the data using the Chi-Square test. Based on the Independent Chi-Square test, the results were significant 0.01 &lt; 0.05. It can be said that there is a relationship between knowledge about antenatal care and revisit interest in the first trimester of pregnant women at the Tapen Jombang Health Center.

The effect of maternal and nutritional factors on birth weight: a cohort study in Tehran, Iran

PurposeThis study aims to examine the effect of maternal food intake before and during pregnancy on birth weight.Design/methodology/approachAs a prospective cohort study, a total of 585 pregnant women of first trimester, visiting Tehran Metropolitan Area public health centers and private sectors (clinics and hospitals), were interviewed at first phase, and pregestational dietary intake was obtained by a 168-item semiquantitative food frequency questionnaire. At the third trimester, dietary recalls were collected via interview. Finally, birth weight information was extracted from health records. Univariate and multivariate analysis was used to explore the effect of maternal and nutritional factors on birth weight.FindingsThe results of the analysis show that direct measures of nutrition, measured as food group consumption at first and third trimester of pregnancy, had no significant effect on birth weight once the confounding factors were controlled (p > 0.05). Of control variables included in the analysis, twin pregnancy outcome (p = 0.000), pregnancy number (p = 0.04), prepregnancy weight (p = 0.004) (marginally significant) and gestational age (p = 0.000) (marginally significant) were associated with birth weight.Originality/valueThe results of this study show no significant role of mother’s nutrition during pregnancy on birth weight, while long-term nutrition outcomes such as prepregnancy weight had significant role. It seems the main reasons behind less important role of pregnancy nutrition on birth weight in this study include the following: food intake deficiency is not a major problem for participants, and cross-sectional data on food intake are less important on outcome of pregnancy weight than long-term nutritional status outcome variables such as mother’s weight and height. This finding should be addressed in public health planning for women at childbearing age.

Non-alcoholic fatty liver disease (NAFLD): a significant predictor of gestational diabetes mellitus (GDM) and early pregnancy miscarriages—prospective study in Rajarata Pregnancy Cohort (RaPCo)

Background and aimsNon-alcoholic fatty liver disease (NAFLD) is increasing globally with a mounting body of evidence on various adverse effects on pregnancy. Yet, prospective studies, especially from low-income and middle-income...

Prevalence and aetiologies of anaemia among first trimester pregnant women in Sri Lanka; the need for revisiting the current control strategies

BackgroundThe Sustainable development goals, which focus strongly on equity, aim to end all forms of malnutrition by 2030. However, a significant cause of intergenerational transfer of malnutrition, anaemia in pregnancy, is still a challenge. It is especially so in the low- and middle-income settings where possible context-specific aetiologies leading to anaemia have been poorly explored. This study explores the prevalence of etiological factors significantly contributing to anaemia in pregnancy in Sri Lanka, a lower-middle-income country with a high prevalence of malnutrition albeit robust public health infrastructure.MethodsAll first-trimester pregnant women registered in the public maternal care programme in the Anuradhapura district from July to September 2019 were invited to participate in Rajarata Pregnancy Cohort (RaPCo). After a full blood count analysis, high-performance liquid chromatography, peripheral blood film examination, serum B12 and folate levels were performed in anaemic participants, guided by an algorithm based on the red cell indices in the full blood count. In addition, serum ferritin was tested in a random subsample of 213 participants. Anaemic women in this subsample underwent B12 and folate testing.ResultsAmong 3127 participants, 14.4% (95%CI 13.2–15.7, n = 451) were anaemic. Haemoglobin ranged between 7.4 to 19.6 g/dl. 331(10.6%) had mild anaemia. Haemoglobin ≥13 g/dl was observed in 39(12.7%). Microcytic, normochromic-normocytic, hypochromic-normocytic and macrocytic anaemia was observed in 243(54%), 114(25.3%), 80(17.8%) and two (0.4%) of full blood counts in anaemic women, respectively. Microcytic anaemia with a red cell count ≥5 * 106 /μl demonstrated a 100% positive predictive value for minor haemoglobinopathies. Minor hemoglobinopathies were present in at least 23.3%(n = 105) of anaemic pregnant women. Prevalence of iron deficiency, B12 deficiency and Southeast Asian ovalocytosis among the anaemic was 41.9% (95%CI 26.4–59.2), 23.8% (95%CI 10.6–45.1) and 0.9% (95%CI 0.3–2.3%), respectively. Folate deficiency was not observed.ConclusionEven though iron deficiency remains the primary cause, minor hemoglobinopathies, B 12 deficiency and other aetiologies substantially contribute to anaemia in pregnancy in this study population. Public health interventions, including screening for minor hemoglobinopathies and multiple micronutrient supplementation in pregnancy, should be considered in the national programme for areas where these problems have been identified.

Red blood cell folate level and associated factors of folate insufficiency among pregnant women attending antenatal care during their first trimester of pregnancy in Addis Ababa, Ethiopia.

Objective:Folate is an essential vitamin for de novo DNA synthesis and cell proliferation. Folate insufficiency at the time of conception and during the first trimester of pregnancy is associated with unintended pregnancy and birth outcomes, particularly neural tube defects. Hence, this study aimed to assess folate status and associated factors of folate insufficiency among pregnant women attending antenatal care during their first trimester of pregnancy in Addis Ababa, Ethiopia.Materials and methods:A cross-sectional study was conducted from 8 August 2017 to 3 January 2018 in Addis Ababa. In this study, 160 participants were enrolled via the convenience sampling method. Red blood cell folate was measured by the electrochemiluminescence binding assay method. Data were entered into Epi-Data version 3.1 and analyzed by SPSS version 22.0. Descriptive statistics were used to describe demographic characteristics and to determine the magnitude of folate deficiency. Logistic regression was used to identify the risk factors for folate deficiency. A p-value of less than 0.05 was considered statistically significant.Results:In this study, 44/160 (27%) participants had red blood cell folate level <400 ng/mL, insufficient to prevent neural tube defect. Multivariate regression showed that regular vegetable consumption was an independent determinant factor for red blood cell folate level (adjusted odds ratio: 0.41, confidence interval: 0.18–0.93).Conclusion:This study shows that a large magnitude of the first-trimester pregnant women had red blood cell folate concentrations below levels that are maximally protective against neural tube defects. Folic acid supplementation and supplemental nutrition containing green leafy vegetables should be promoted during the periconceptional period. In addition, the policymakers should set rules for mandatory folic acid fortification.

Early screening biomarker HbA1c and Hematocrit for gestational diabetes mellitus

Gestational diabetes mellitus (GDM) is a metabolic disturbance in pregnancy, traditionally defined as glucose intolerance with onset or first recognition during pregnancy with the outcome of perinatal and offspring complications. The common diagnostic criteria of oral glucose tolerance test in the second or third trimester of pregnant women help to detect the later complications of GDM. Early detection is lacking and highly essential to prevent GDM. We aim to assess the role of glycated hemoglobin and hematocrit for the early screening of GDM.We recruited 403 study participants, collected demographic profiles and medical histories. The levels of glucose, hemoglobin (Hb), glycated hemoglobin (HbA1c), hematocrit (PCV), and thyroid-stimulating hormone (TSH) were measured in the serum samples of study participants. The ROC curve was plotted, cut-off, an area under the curve, specificity, and sensitivity of glycated hemoglobin and hematocrit was calculated using statistical software.In our study, we observed there is a significant difference in the levels of Hb, PCV, and HbA1c between non-GDM and GDM patients. We found the prevalence of GDM 20.88% in our study population. An HbA1c cut of at 5.25% and PCV 34.5%, the sensitivity and specificity of HbA1c as 64.4% and 36.1%, the sensitivity and specificity of PCV as 58.6% and 43.1% respectively. The combined HbA1c & PCV screening results had shown the sensitivity of 36.8% and specificity of 85.4% using the ROC curve.In conclusion, the cut-off values, specificity, and sensitivity of HbA1c and Haematocrit and its combined calculation in the first trimester of pregnant women will be more specific and sensitive early screening tools for GDM.

Urinary Iodine Concentration as an Indicator of Iodine Status and its Correlation with the Thyroid Hormones and Hemoglobin Levels in First Trimester Pregnant Women - An Exploratory Study

During pregnancy, the daily requirement of iodine increases making those most at-risk population for iodine deficiency disorders. The available confined data shows that pregnant women are iodine deficient even in iodine sufficient regions with this background the objectives of the current study were to assess the urinary iodine concentration (UIC) and evaluate the relationship between the levels of hemoglobin, UIC, and thyroid status in first-trimester pregnant women. A cross-sectional hospital-based study with a total sample size of n=110 pregnant women at the13th week of gestation in the Mysuru district was selected. The UIC, anthropometric measurements, iodine intake, and selected biochemical parameters (TSH, FT3, FT4, and Hb) were assessed. The data was analysed using SPSS (v 16.0). Spearman’s rank correlation test was used to analyse correlations. The Mann- Whitney U test was used to compare differences between groups. ANOVA was used to study the comparison of pregnancy complications with UIC and hemoglobin. The median UIC (mUIC) was 194.2 µg/L and Hb was 10.5 g/dL. Even though the mUIC was normal, around 38.2% had insufficient UIC. Significant inverse relationship between UIC and TSH (r = -0.487, p&lt;0.001), Hb and TSH (r = -0.355, p &lt; 0.001), and between TSH and iodine intake (r=-0.476, p&lt;0.001) were observed. It was interesting to observe that those with insufficient UIC were found to have mild anaemia and low FT4 levels and those with excess UIC had lower TSH levels. The pregnant women in the present study were found to have the normal median urinary iodine concentration and were mildly anaemic. Increased attention among pregnant women should be focused on iodine status along with iron status and thyroid functions. Larger comparative studies need to be performed to study the impact of altered iodine status on neonatal outcomes.

Screening for Vaginal and Endocervical Infections in the First Trimester of Pregnancy? A Study That Ignites an Old Debate.

Objectives: Vaginal and endocervical infections are considered a global health problem, especially after recent evidence of their association with preterm delivery and other adverse obstetric outcomes. Still, there is no consensus on the efficacy of a screening strategy for these infections in the first trimester of pregnancy. This study evaluated their prevalence and whether screening and treatment resulted as effective in reducing pregnancy and perinatal complications. Methods: A single-center prospective observational study was designed; a sample size of 400 first-trimester pregnant women was established and they were recruited between March 2016–October 2019 at the Puerta de Hierro University Hospital (Spain). They were screened for vaginal and endocervical infections and treated in case of abnormal flora. Pregnancy and delivery outcomes were compared between abnormal and normal flora groups by univariate analysis. Results: 109 patients had an abnormal flora result (27.2%). The most frequently detected infection was Ureaplasma urealyticum (12.3%), followed by Candida spp. (11.8%), bacterial vaginosis (5%), Mycoplasma hominis (1.2%) and Trichomonas vaginalis (0.8%). Patients with abnormal flora had a 5-fold increased risk of preterm premature rupture of membranes (5.3% vs. 1.1% of patients with normal flora, Odds Ratio 5.11, 95% Confidence Interval 1.20–21.71, p = 0.028). No significant differences were observed regarding preterm delivery or neonatal morbidity. Conclusions: Considering the morbimortality related to prematurity and that the results of our study suggest that the early treatment of abnormal flora could improve perinatal outcomes, the implementation of a screening program during the first trimester should be considered.

Efektivitas Pemberian Aromaterapi Lemon Dengan Aromaterapi Peppermint Dalam Mengurangi Emesis Gravidarum

Background: During pregnancy, mother experienced some discomfort. One of them that occurred in early pregnancy was the appearance of nausea symptoms and vomiting (emesis gravidarum). If they were not treated immediately, it can cause hyperemesis gravidarum. The management of nausea and vomiting can be done with complementary therapy, namely by using aromatherapy. In this study, two types of aroma therapy were used, they were lemon and peppermint aromatherapy. Objective: To determine the difference in the effectiveness of giving lemon and peppermint aromatherapy in reducing emesis gravidarum in first trimester of pregnant women. Methods: This study used a quasi-experimental method with a two-group pre-test and post-test design with a sample of 20 respondents using a simple random sampling technique. Data collection was carried out on May 20 to June 16, 2021 at Titin Widyaningsih’s MSP using the RINVR questionnaire. Results: There was a difference before and after being given lemon aromatherapy in reducing nausea and vomiting in first trimester of pregnant women with the paired t-test, the p-value was 0.001. There was a difference before and after being given peppermint aromatherapy in reducing nausea and vomiting in first trimester of pregnant women with the paired t-test, the p-value was 0.006. There was no difference between giving both aromatherapy in reducing nausea and vomiting in first trimester pregnant women with independent t-test p-value 0.738. Conclusion: There was an effect of lemon and peppermint aromatherapy in reducing emesis gravidarum in first trimester of pregnant women. There was no difference between giving both aromatherapy in reducing nausea and vomiting in first trimester of pregnant women.Keywords: Emesis Gravidarum, RINVR, lemon and peppermint aromatherapy

Pengaruh Jus Rumput Laut (Eucheuma Sp) terhadap Peningkatan Kadar Hb Ibu Hamil Trimester I dengan Anemia

The effect of anemia in pregnancy is not good for the mother, both during pregnancy, childbirth, and in the puerperium. One of the foods that contain iron is seaweed. Seaweed (Eucheuma sp) is one of the foodstuffs that contain several intermediate compounds needed in the synthesis of hemoglobin such as iron, protein, and vitamin B complex. The purpose of this study was to determine the effect of seaweed juice (Eucheuma sp) on increasing hemoglobin levels of pregnant women in the first trimester of anemia. This study was a pre-experimental study with a one-group pretest-posttest design with a sample of 30 pregnant women in the first trimester who met the inclusion criteria of the study. Researchers measured Hb levels before after being given seaweed juice, the statistical test used was the Paired T-Test test, p-value= 0,000. The conclusion from this study was that seaweed juice could increase Hb levels in first-trimester pregnant women with anemia.

THE EFFECT OF ACUPRESSUR THERAPY IN REDUCING NAUSEA AND VOMITING PREGNANT WOMEN TRIMESTER I : QUASI-EXPERIMENTAL STUDY

Introduction: Nausea and vomiting are the most common symptoms experienced by pregnant women in the first trimester, and these symptoms are experienced by 70-85% of women. Nausea and vomiting are often experienced by pregnant women, especially in the first trimester, affecting about 50-80% of pregnant women. Management of nausea and vomiting in pregnancy consists of pharmacological and non-pharmacological. This study aims to analyze the effect of acupressure therapy on nausea and vomiting. Methods: This type of research is a quasi-experimental design using a two-group pre-post design involving 30 first trimester pregnant women who experience nausea and vomiting selected by purposive sampling. The criteria for the participants were gestational age at 10-16 weeks and maternal age at 20-35 years (productive age), while mothers taking nausea and vomiting drugs were excluded from this study. Data analysis used the Wilcoxon test and Mann-Withney test. Results: a significant decrease group with p-value &lt;0.05. Based on the Mann Whitney test, it was found that the p-value for the pre in the frequency of moderat nausea and vomiting scores before and after acupressure in the intervention -test (&lt;0.0001), and the post-test was 0.55, post test scores showed no difference between the two study groups. Conslusion: The study shows encouraging signs about reducing the frequency of nausea and vomiting in first-trimester pregnant women, so this therapy can be used as an alternative intervention for pregnant women who experience nausea and vomiting.

Level and predictors of dietary diversity among pregnant women in rural South-West Ethiopia: a community-based cross-sectional study

ObjectiveTo assess the magnitude of dietary diversity and associated factors among pregnant women in the rural communities of Jimma Zone, south-west Ethiopia.DesignA community-based cross-sectional study was conducted from 1 June...

ORAL HEALTH STATUS AMONG PREGNANT AND NONPREGNANT WOMEN: A COMPARATIVE STUDY

Background: Physiological alterations manifesting during pregnancy may influence oral health of women by increasing the susceptibility to oral infections. This study was carried out to assess oral hygiene status, gingival status, periodontal status and treatment needs (TNs) among pregnant and nonpregnant women. Methods: A comparative cross-sectional study was conducted in patients attending Outpatient Depart­ment of Obstetrics and Gynaecology, Chitwan Medical College and Teaching Hospital, Bharatpur, Chit­wan, Nepal from December 2020 to June 2021. A total of 102 pregnant (34 in each trimester) and 102 nonpregnant women of 15-49 years fulfilling all inclusion criteria were evaluated for oral health status by various indices including oral hygiene index-simplified (OHI-S), gingival index (GI), and community periodontal index and treatment needs (CPITN). Convenience sampling technique was done. Data was analysed in SPSS v.26.0. Results: The mean scores of OHI-S, GI and CPITN were statistically (p value&lt;0.001) higher in pregnant women compared to nonpregnant women; highest in third trimester followed by second and first tri­mesters. In both groups, majority were found to have score 2 for treatment needs. TN2, encompassing oral hygiene instructions and oral prophylaxis was required by 92.2% of nonpregnant women, 100% of pregnant women in first trimester, 88.2% and 5.9 % in second and third trimesters respectively. Majority (94.1%) of pregnant women in third trimester required TN3 complex treatment. Conclusions: Pregnant women found to have poor oral hygiene status, more gingivitis and periodontal diseases as compared to nonpregnant women. Implementation of proper oral hygiene practices can pre­vent oral diseases and its further complications.

Trophoblastic volumetric bloodflow evaluation in women with trombophylia on 7–10th week of pregnancy

Spontaneous abortion occur in 15–20% of all detected pregnancies, and 45–70% of all spontaneous miscarriages take place up to 10 weeks. Thrombophilia is one of the main causes of miscarriage and its effect on the course of pregnancy remains poorly understood. In this regard, there is great interest in the problem of diagnosing thrombophilia and further prevention of thrombosis in obstetric practice.Purpose. Compare the parameters of volumetric blood flow in the chorion with different types of trophoblastic blood flow disturbance in pregnant women with thrombophilia in the first trimester for their quantitative verification.Materials and methods. The study included 129 pregnant women at the 7th to 10th week of gestation with a diagnosis of thrombophilia and a control group - pregnant women with a normal course of this pregnancy and a successful outcome of past pregnancies.The patients were divided into III clinical groups:I. Pregnant women with a normal course of this pregnancy and a successful outcome of past pregnancies (n = 33) – comparison group;II. Pregnant women with thrombophilia, in whom current pregnancy occurred on anticoagulant therapy (n = 28);III. Pregnant women with thrombophilia without taking anticoagulant drugs before registration of pregnancy (n = 68).Ultrasound was performed on Voluson E8 and S8 machines. All pregnant women underwent transabdominal and transvaginal ultrasound in B-mode, in color-doppler (CD) mode, and volumetric reconstruction of chorion was performed using the VOCAL program. In B-mode, the state of the embryo and extraembryonic structures were examined. The identification of trophoblastic vessels was carried out using the CD – region of interest was placed in the trophoblast area detected in B-mode, size and shape was adapted for a particular section.Using three-dimensional echography, the chorion volume was performed. The degree of blood supply in chorionic volume were calculated; vascularization index (VI), flow index (FI) and perfusion index (VFI) were displayed on a histogram with quantitative indicators.ResultsIn the CD mode, the types of trophoblastic blood flow were identified in the chorionic vessels:1) continuous type – blood flow loci are continuously identified over the entire area of the basal surface of the trophoblast;2) intermittent type – blood flow loci are unevenly identified along the basal surface of the trophoblast;3) single loci – single blood flow loci are identified along the basal surface of the trophoblast;4) lack of blood flow – blood flow loci are not determined along the basal surface of the trophoblast.Assessment of the quantitative parameters of the volumetric blood flow was used in the corresponding type of blood flow to verify the classification of types of trophoblastic blood flow in the CD mode.Statistical analysis of the volumetric blood flow indices using three-dimensional chorionic reconstruction showed a high degree of reliability (p &lt; 0.0001) in the VI and VFI values between all corresponding types of blood flow.Discussion. High incidence of spontaneous abortion and the significant role of thrombophilia in this pathology leads to necessity of expanding the research in this area. There has been a lot of research done over the past decade. The quantitative threshold values of the resistance indices in the chorionic vessels were calculated using pulse-wave Doppler, the chorionic blood supply indices were determined using volumetric reconstruction for various pathologies.However, we have not previously met the classification of chorionic blood supply in the CD mode. This technique is very simple to perform and is a highly informative for predicting miscarriage in the first trimester. For the first time, we proposed the above classification of trophoblastic blood flow; for the first time, we proved the reliability of the classification developed by us using the method of volumetric reconstruction of the chorion with an assessment of trophoblastic blood flow, which allows us to recommend its use when writing a protocol for ultrasound of the fetus in the first trimester in pregnant women with thrombophilia.Conclusion. The classification of trophoblastic blood flow was verified by three-dimensional echography with quantitative indicators of the volumetric blood flow of the trophoblast vessels, with a high degree of reliability (p &lt; 0.001) which to indicates the reliability of this classification. It can be recommended to conduct a multicenter study for investigating fetal ultrasound with the additional use of the CD in the first trimester in pregnant women with a diagnosis of thrombophilia.

The Effectiveness of Banana Flower in Reducing Emesis Gravidarum in First Trimester Of Pregnant Women

Continuous emesis gravidarum will become hyperemesis gravidarum, which can increase the risk of pregnancy disorders. Pregnant women with hyperemesis gravidarum are at risk of experiencing dehydration, lack of carbohydrate and fat reserves in the body, small tears in the esophagus and stomach's mucous membrane. One of the diets in the case of emesis gravidarum is consuming foods high in carbohydrates. Banana flower is a food high in carbohydrates and vitamins, and antioxidants. Objectives; to determine the effectiveness of Banana flower in reducing emesis gravidarum in first-trimester pregnant women. Methods; quasi-experiment with pretest and post-test control group approaches. The sampling technique was simple random sampling. Banana flower with 200 g / day dose is given for seven days to pregnant women who experience emesis in the first trimester. The research group was divided into two: the banana flower treatment group and the control group, with 32 samples. Data analysis using the Shapiro-Wilk test and Wilcoxon test. Result; There was a significant difference in the intensity of emesis gravidarum between the group given banana flower and the control group with a p-value of 0.014. The banana flower can reduce the intensity of emesis gravidarum.

Association between Gestational Diabetes and Proinflammatory Cytokine(IL-1β)

Gestational diabetes mellitus (GDM) defined according to the (World Health Organization) as glucoseintolerance of varying degrees of severity with start or first recognition during pregnancy. This definitionapplies whether or not insulin is needed and whether or not it disappears after pregnancy. It is not apply topregnant women with a pre-pregnancy diagnosis of T1DM or T2DM. This study included (150) pregnantwomen in first trimester (9-13 weeks) of pregnancy, during follow up in [late second trimester and earlythird trimester (24-28 weeks) of pregnancy], 75 of them diagnosed of GDM, and 75 of them without GDM(Control group).