Pregnant Women Gestational Age Research Articles

Study of triglyceride changes during pregnancy and neonatal birth weight and adverse outcomes.

Changes of maternal triglyceride concentrations are closely associated with intrauterine fetal growth and development, but the effect of mid- to late-term triglyceride changes on birth weight is uncertain. This study investigated the association between changes in triglycerides in mid to late in pregnant women gestational age ≥ 35 weeks on neonatal birth weight and adverse outcomes. This cohort study was based on 931 pregnant women with a singleton delivery at gestational age ≥ 35 weeks from January 1, 2022 to December 31, 2022 at Nanjing Lishui People's Hospital (NJLSPH) in China, with all maternal triglyceride concentrations measured at mid-term and late-term before delivery. The primary outcomes were neonatal birth weight and the risk of macrosomia. Late term triglyceride levels were positively associated with birth weight (β = 126.40, 95% CI: 61.95, 190.84, p < .001) and risk of macrosomia (OR = 2.11, 95% CI: 1.12, 3.98, p = .022). Late mid-term triglyceride was positively associated with birth weight (β = 27.58, 95% CI: 9.67, 45.50, p = .003), and no correlation with risk of macrosomia (OR = 1.12, 95% CI: 0.95, 1.31, p = .178). Mid-term triglyceride was not associated with birth weight (β = 45.79, 95% CI: -28.73, 120.30, p = .229) and risk of macrosomia (OR = 1.83, 95% CI: 0.89, 3.78, p = .101). Late triglyceride levels were associated with birth weight and risk of macrosomia, while late to mid-term triglyceride were associated with birth weight but not with risk of macrosomia. This suggests that maternal triglyceride changes may affect fetal growth and development, and more studies focusing on the effects of gestational triglyceride profiles are warranted.

Efficacy (In Terms of Avoiding Hysterectomy) of the Triple P Procedure in Managing Morbidly Adherent Placenta

Objective: To determine the efficacy (in terms of avoiding hysterectomy) of the Triple P procedure in managing morbidly adherent placenta. Study Design: Case series. Place and Duration of the Study: Department of Obstetrics &amp; Gynaecology, Combined Military Hospital, Peshawar Pakistan, from Dec 2018 to Mar 2020. Methodology: A total of 56 pregnant women of gestational age ≥32 weeks with the morbidly adherent placenta were included. Caesarean section was done in each patient by the consultant gynaecologist, and then the Triple P procedure was done. Efficacy in each patient was noted. Results: The mean age of the study participants was 30.79±4.42 years. In our analysis, the mean parity was 3.05±0.88. The mean number of caesarean sections was 2.00±1.11. The Triple P procedure was effective (in avoiding hysterectomy) in managing morbidly adherent placentas in 53(94.64 %) participants. Conclusion: This study concluded that the Triple P procedure's efficacy (in terms of avoiding hysterectomy) in managing morbidly adherent placenta is very high.

Frequency of Uterine Rupture and Its Maternal and Fetal Outcomes of Uterine Rupture among Pregnant Women

A uterine rupture is when the uterine wall is torn during labor or right after birth. It is although not common but when occurs it is catastrophic obstetrical emergency for both mother and fetus needs prompt diagnosis and expert management. Moreover it may leads women to irreversible infertility as it rottenly ends at hysterectomy. Objective: To determine the frequency of uterine rupture and its maternal and fetal outcomes among pregnant women. Methods: This Cross Sectional study was conducted at Civil Hospital Karachi in the department of Obstetrics and Gynecology Unit II from 8th December 2018 to 7th June 2019. A total of 317 pregnant women of gestational age &gt;28 weeks, fulfilling the inclusion criteria were enrolled .The data were collected on prepared proforma. Results: This study includes 317 patients with age ranges from 25 to 35 years with mean age of 28.44 ± 3.62 years. In this study, frequency of uterine rupture among pregnant women was found in 7(2.2%) women and maternal mortality 1(7.69%). Conclusions: Findings of this study suggests that uterine perforation is still high and remained important factor for maternal and fetal outcome.

Early Detection of Preeclampsia Through Urine Protein Examination as a Means of Maternal Emergency Prevention

A decrease in urine albumin levels in pregnant women, which can be checked through urine protein examination, is an indicator used to determine whether a pregnant woman is experiencing preeclampsia. Preeclampsia has become a cause of increasing morbidity and mortality rates which affects both mothers and newborns. This research aimed to early detect the preeclampsia through urine protein examination and see the correlation between the characteristics of the research subjects and urine protein. Used a descriptive design with a correlational design, the urine protein from 36 pregnant women was examined in their second and third trimesters of pregnancy. Next, univariate analysis was carried out and Spearman Correlation test was used in bivariate analysis for abnormally distributed ordinal data while the Contingency Coefficient Correlation test was carried out for data that used abnormally distributed nominal scale. Based on the bivariate analysis, the variables of age, education, employment, and obstetric history obtained a significant value of p value&gt;0,05, showed no correlation with urine protein. Contrarily, the blood pressure variable had a significant value of p 0,049 &lt; 0,05. Pregnant women in gestational age of &gt;20 weeks with high blood pressure must examine the urine protein immediately to early detect preeclampsia and prevent maternal emergencies.

Outcome of pregnancy in previous cesarean section comparing elective versus trial of labor (VBAC) at KRL Hospital, Islamabad.

Objective: To determine feto maternal outcome in patients with cesarean section and comparing outcome following TOLAC and elective repeat cesarean delivery. Study Design: Descriptive, Cross-sectional study. Setting: Department of Obstetrics &amp; Gynecology, Kahuta Research Laboratory (KRL) Hospital, Islamabad. Period: 10th September 2019 to 9th March 2020. Material &amp; Methods: 93 pregnant women of gestational age 37-42 weeks with previous transverse cesarean section were included. Patients with a history of multiple pregnancies, ruptured uterus, placenta previa, polyhydramnios or oligohydramnios, and fetal malpresentation were excluded. In each patient, the labor trial was done; if not possible, then a cesarean section was done on the elective list. Each case was done by the researcher herself in the presence of a consultant gynecologist and the mode of delivery (vaginal/cesarean), was noted. After this fetal outcome i.e. live birth (yes/no), NICU admission (yes/no), and Apgar score &gt;6 at 5 minutes (yes/no) was noted. Results: Maternal outcomes in a previous cesarean section was found to be a cesarean section in 60 (64.52%) and VBAC in 33 (35.48%), an APGAR score &gt;6 at 5 minutes after VBAC was seen in 100.0% and after elective cesarean delivery in 81.67% of neonates. NICU admission is 0.0% in TOLAC compared to 20.0% with elective repeat LSCS. Live birth after emergency cesarean delivery was seen in 93.33% and 100% after VBAC. Conclusion: This study concluded that the maternal outcome in a previous cesarean section was found to be a cesarean section in 64.52% and VBAC in 35.48% of women and fetomaternal outcome following TOLAC is better.

PROSPECTIVE STUDY ON PREVALENCE OF ANEMIA IN PREGNANT WOMEN AND ITS ASSOCIATION WITH MATERNAL AND FETAL OUTCOME

Anaemia is one of the most common nutritional deciency disorders affecting the pregnant women in the developing countries. Anaemia during pregnancy is commonly associated with poor pregnancy outcome and can result in complications that threaten the life of both mother and foetus. Objective: The objective of the study was to estimate the prevalence of anaemia among the women who are pregnant and to determine its association with maternal and foetal outcomes. Materials and methods: Two hundred pregnant women of gestational age &gt;37 weeks with previous and recent Haemoglobin report were included in the study and were followed up till 7 days post delivery. Appropriate statistical tests were applied. Results: Among the study group, 63% of pregnant women had anaemia from which about 24% of the women had maternal and foetal morbidity. Out of the 63% of anemic pregnant women,2.38 % had postpartum hemorrhage,2.74% had preeclampsia, 3.17% went into LSCS,1.58% had obstructed labour. The fetal complications include low birth weight (27.7%) followed by preterm delivery (3.17%) and birth asphyxia(2.38%). Conclusions: A high prevalence of anaemia in pregnant women increases the maternal and foetal risks. To improve the maternal and foetal outcome, all the pregnant women must be prevented of anaemia by prophylactic iron administration, must be diagnosed of anaemia at an early stage, and be treated to avoid further antenatal and postnatal complications

Role of parenteral iron sucrose in the treatment of iron-deficiency anemia in pregnant women of gestational age 20–34 weeks

Role of parenteral iron sucrose in the treatment of iron-deficiency anemia in pregnant women of gestational age 20–34 weeks

Iron Supplementation in Anemic Pregnant Women: A Comparison of Different Prescription Options in Pakistan

Background &amp; objectives: Many pregnant women in Pakistan have iron deficiency anemia (IDA), a dietary deficit. It affects both the mother's and the foetal' health. Oral iron supplementation usually relieves IDA symptoms. Oral iron supplements are hazardous to the GI mucosa, and sensitivity is common. Poor therapeutic compliance leads to treatment failure. Ferrous ascorbate (FeA) and iron hydroxide polymaltose complex (IPC) reportedly improve gastrointestinal discomfort and increase patient compliance compared to ferrous sulphate (FS). These preparations reportedly improve hemoglobin levels and iron stores more quickly than FS. This analysis compared FS's efficacy and safety to IPC and FeA. Place of Study: Rashid Latif Medical College Lahore Duration of Study: February 2019 and October 2021 Methods: It was a randomized, parallel, open label, investigation among pregnant women of gestational age from 10 to 28 weeks with moderate anemia. Patients were randomly selected to receive either FS, IPC or FeA. They were then followed up for 3 months to look for improvement in the hemoglobin levels and other hematological indicators or any adverse drug response. Results: With the exception of 3 months, when the FeA group had a significantly higher hemoglobin level in comparison to the FS group (P &lt;0.05), the hemoglobin levels were comparable across the three groups. The overall risk profiles for side effects were likewise equal across the research groups, with the exception of epigastric discomfort, which was more frequently reported in the FS group. Conclusions: The findings of the study indicated that FS, IPC, and FeA all have an efficacy and safety profile in the treatment of IDA associated with pregnancy that is comparable to one another. Keywords Anemia, ferrous ascorbate , ferrous sulphate ,iron hydroxide polymaltose ,pregnancy

Frequency of Asymptomatic Bacteriuria in Pregnant Women

Objectives: To determine the frequency of asymptomatic bacteriuria in pregnantwomen. Study design: Descriptive, Cross sectional study Place and Duration: Department of Obstetrics &amp; Gynaecology, Benazir Bhutto Hospital, Rawalpindi. 26th December 2017 to 25th June 2018 Materials &amp; Methods: A total of 151 pregnant women of gestational age ≥28 weeks, 18 to 40 years of age were included. Patients with genital tract trauma, history of UTI in the past one year and urinary tract stones were excluded. Then clean-catch midstream urine was collected from each woman into a sterile universal container and sample was sent to the institutional laboratory for presenceor absence of asymptomatic bacteriuria. Results: Age range in this study was from 18 to 40 years with mean age of 28.78 ± 3.90 years. Majority of the patients 84 (55.63%) were between 18 to 30 years of age. Mean gestational age was 31.06 ± 1.67 weeks. Mean parity was 3.17 ± 0.99. Mean BMI was 27.44 ± 3.02 kg/m2. In our study, frequency of asymptomatic bacteriuria in pregnant women was found in 25 (16.56%) patients. Conclusion: This study concluded that frequency of asymptomatic bacteriuria in pregnant women is quite high. Keywords: Asymptomatic Bacteriuria, Pregnancy, Urinary Tract Infection.

Group B Streptococcus in Asymptomatic Pregnant Women at 35-37 Weeks of Gestation

Background: A group B streptococcus bacterium is one of the principal cause for death and causing different comorbidities in both mother and their neonates. It inhabits without symptoms in vaginal and rectal areas of the body. There is a great variance in their inhabitant subjecting to topography, hence there is lack of data from Pakistan. Objective: To determine the prevalence of Group B Streptococcus in asymptomatic pregnant women at 35-37 weeks of gestation attending the antenatal clinic of JPMC Karachi. Study Design: Cross Sectional Study. Settings: Department of Obstetrics & Gynecology, Jinnah Postgraduate Medical Centre JPMC Karachi Pakistan. Duration: Six months from 1st January 2018 to 30th June 2018. Methodology: 163 patients of asymptomatic pregnant women of gestational age 35-37 weeks were enrolled in the study after taking informed consent from patient, high vaginal swab (HVS) and rectal swab were collected from these patients, Presence of GBS was confirmed by standard microbiological studies including graham stain, catalase reaction and hemolytic activity on blood agar plate. Results: Mean age was 28.2 ± 4 years; Mean gestational age was 35.8 ± 0.78 weeks. In eleven (6.7%) women group B streptococcus was detected as compared to this one hundred. Conclusion: Group B Streptococcus colonization in asymptomatic pregnant women is present in our population so GBS infections in the prenatal and neonatal period might not be uncommon in Pakistan, so routine screening should be carried out.

Comparison of efficacy & safety of iron polymaltose complex & ferrous ascorbate with ferrous sulphate in pregnant women with iron-deficiency anaemia.

Background & objectives:Iron-deficiency anaemia (IDA) is a common nutritional deficiency among pregnant women in India. It has a significant impact on the health of the mother as well as that of the foetus. IDA generally responds well to treatment with oral iron supplementation. However, oral iron supplements are toxic to the gastrointestinal mucosa and intolerance is common, resulting in poor compliance and failure of treatment. The iron salts such as iron hydroxide polymaltose complex (IPC) and ferrous ascorbate (FeA) are claimed to have low gastrointestinal intolerance, therefore better patient compliance than the conventionally used ferrous sulphate (FS). These preparations also claim to increase haemoglobin level faster as well as improve the iron storage better than FS. This study was done to compare the efficacy and safety of FS with IPC and FeA.Methods:It was a randomized, parallel, open label, study among pregnant women of gestational age between 12 to 26 wk with moderate anaemia. Patients were randomly allocated to receive either FS, IPC or FeA. They were then followed up for 90 days to observe for improvement in the haemoglobin levels and other haematological parameters or any adverse drug reaction.Results:The haemoglobin levels were comparable in the three groups except at day 90 when FeA group had significantly higher haemoglobin level as compared to FS group (P<0.05). The overall adverse effect profiles were also comparable among the study groups except epigastric pain which was more commonly reported in the FS group.Interpretation & conclusions:The results of the study showed that FS, IPC and FeA have comparable efficacy and safety profile in the treatment of IDA of pregnancy.

Prevalence and predictors of gestational diabetes mellitus in rural Assam: a cross-sectional study using mobile medical units

ObjectiveTo determine the prevalence and predictors of gestational diabetes mellitus (GDM) in rural Assam, India using a network of Mobile Medical Units.Study designA field-based cross-sectional study.SettingsRural areas of Assam state,...

RELAXIN AND IMMUNE FACTORS AS PREDICTORS OF BIOLOGICAL PREPARATION FOR LABOUR

Introduction. Biological preparedness for childbirth plays an important role in ensuring the normal course of spontaneous labour, as well as determining the criteria for preinduction and induction of labour with obstetrics pathologies. Recent studies have shown that labour involves a complex interaction between maternal and fetal factors that contribute to cervical maturation and myometrial contraction. In its turn it prompts the search for predictors that allow early identification of pathologies and improve the prognosis. The Relaxin hormone may function as one of the aforementioned predictors due to the emerging evidence for its involvement in the pathogenesis of abortion. Studies show that Relaxin plays a key role in the adaptation of a female 51 body by targeting the cervix among other organs. Relaxin acts on the cervix by degrading extracellular matrix components through activation of proteolytic enzymes, known as matrix metalloproteinases (MMPs). Remodeling of the cervix is a combination of endocrine and immune interactions. One of the hallmarks of cervix remodeling is infiltration of leukocytes prior to labour. These tissue granulocytes become the source of proinflammatory cytokines that upregulate MMPs. Relaxin controls the local inflammatory response by modulating matrix metalloproteinases. Thus, understanding the regulatory role of Relaxin in systemic production of cytokines and its effect on neutrophils at different stages of cervical maturation is of great interest. Aim: characterise the interplay between Relaxin, cytokines and their joint role in regulation of proteolytic enzymes to establish new criteria for prognosis of cervical maturation. Materials and methods. 69 pregnant women of gestational age 38-40 weeks were examined. The examined women were divided into 3 clinical groups, depending on the degree of cervix maturity at the time of hospitalisation. The degree of cervix maturity was assessed by the EH Bishop scale. Group I consisted of 23 patients with a mature cervix (9-13 points), group II included 21 pregnant women with an immature cervix (6-8 points), group III contained 25 pregnant women with a completely immature cervix (0-5 points). The control group consisted of 15 women of gestational age 35-36 weeks, who were pregnant for the first time. Women of the control group were examined prior to the start of physiological processes of remodeling of cervical tissues before labour and displayed no signs of premature labour. Control group was compared to women from the I, II and III groups by disease history and somatic data. All pregnant women underwent standardized clinical examination and immunological testing. Serum concentration of cytokines IL-6 and TNF-α, MMP-1 and MMP-9, and Relaxin levels were determined by enzyme-linked immunosorbent assay using commercial kits. Statistical analysis of the results was performed using the program "STATISTICA-6". Statistical significance was calculated by Student's t-test. Spearman's rank correlation coefficient was determined between the obtained parameters. The differences were considered accurate with a significance level of p&lt;0.05. Results. The average age of the examined pregnant women was 25 years 7 months (18-33). All patients of the examined groups could be compared to each other by their age, genital features and menstrual function (p ≤ 0.05). The study has shown that the lowest serum concentration of Relaxin was found in women with immature or completely immature cervix, which accounted to 189.7±34.6 pg / ml and 208, 9±27.6 pg / ml, respectively. This suggests that serum concentration of Relaxin could serve as a possible predictor of biological readiness of the body for labour. Furthermore, serum Relaxin concentration can serve as a prognostic marker of the effectiveness of induction and preinduction of labour. The data presented shows that women with mature cervix display maximum levels of matrix metalloproteinases MMP9 and MMP-1. Specifically, the concentration was 1.8 times higher than in the group of women with immature cervix. Thus, maturation of the cervix uterus involves a significant increase in the concentration of matrix metalloproteinases by peripheral neutrophils with a gradual increase in their proteolytic activity. Our study showed that high serum concentrations of the proinflammatory cytokines in pregnant women with a mature cervix before labour were higher compared to women with an immature or completely immature cervix. The interplay between proinflammatory cytokines and other modulators presented here during the preparation of the body for labour was evident from the observed correlation. We observed a strong correlation between the level of Relaxin and matrix metalloproteinases (r = 0, 78), as well as positive correlation between their content and the cytokines of interest. Conclusion. The study allowed to identify the most prognostically significant molecular predictors that characterize the body's preparation for labour, which include the "birth hormone" Relaxin. Furthermore, our analysis implicates immune mechanisms in regulating cervical maturation before labour.

Study on the distribution and related factors of birth weight of live births in Guangxi Zhuang Autonomous Region of China from 2016 to 2018

Objective: To investigate the distribution and related factors of birth weight of live births and full-term infants in Guangxi Zhuang Autonomous Region of China. Methods: Based on Guangxi women and children information system from 2016 to 2018, a large real-time database about maternal and live-birth information was established. It covered 1 712 midwifery institutions in Guangxi. A total of 2 394 240 cases of live births were collected and 2 243 129 cases of which were full-term infants. The multivariate logistic regression model was used to analyze the related factors of low birth weight. Results: The birth weight of 2 394 240 live births, (3 123.49±461.08) g, in Guangxi was approximately normal distribution with a peak distribution to the left. The incidence of low birth weight was 8.05%, and the incidence of macrosomia was 2.07%. The incidence of low birth weight was 10.92% for the puerpera with body mass index (BMI, kg/m(2)) <18.5, 16.82% for the puerpera with height <145 cm, 8.92% for the puerpera with age <20 years old, 7.67% for the puerpera with age ≥35 years old, and 54.65% for the puerpera with premature birth. The birth weight of 2 243 129 full-term infants, (3 176.01±400.78) g, was approximately normal distribution with a peak distribution to the right. The incidence of low birth weight was 2.97%, and the incidence of macrosomia was 2.19%. The incidence of low birth weight was 4.73% for puerpera with BMI<18.5, 8.17% for puerpera with height<145 cm, 4.83% for puerpera with age <20 years old, and 3.05% for puerpera with age ≥35 years old. The risks of low birth weight [OR (95%CI) value] of pregnant women aged <20, 25-29 and 30-34 years old were 1.31 (1.28-1.35), 0.88 (0.86-0.90) and 0.89 (0.87-0.91) times of those aged ≥35 years old. The risks of low birth weight [OR (95%CI) value] of pregnancy BMI <18.5 and 18.5-23.9 kg/m(2) group were 1.98 (1.94-2.03) and 1.20 (1.18-1.23) times of those pregnancy BMI ≥24 kg/m(2). The risks of low birth weight [OR (95%CI) value] of pregnant women's height (cm)<145, 145-154, 155-159 and 160-164 cm were 4.67 (4.39-4.97), 2.36 (2.29-2.44), 1.58 (1.53-1.63) and 1.22 (1.18-1.26) times of those heights ≥165 cm group. The risks of low birth weight [OR (95%CI) value] of pregnant women's gestational age <28, 28-31 and 32-36 years old were 136.65 (124.33-150.20), 1 704.37 (1 509.02-1 925.02) and 33.45 (32.98-33.94) times of those gestational age ≥37 years old. Conclusion: The incidence of low birth weight of live births was higher in Guangxi from 2016 to 2018. There is a higher risk of low birth weight for younger, older, low height, low BMI and preterm women in Guangxi from 2016 to 2018.

Accuracy and factors influencing Leopold’s manoeuvres in determining vertex presentation during late third trimester of pregnancy

This prospective descriptive study was conducted for examine the accuracy of Leopold’s manoeuvres in determining vertex presentation and to identify factors which may influence the accuracy. Pregnant women gestational age more than 34 weeks were examined using Leopold’s manoeuvre for foetal presentation, and findings confirmed on subsequent ultrasonographic (US) examinations. Our study found Leopold’s manoeuvre for foetal presentation determination during the late third trimester of pregnancy has high sensitivity but low specificity. Accuracy of performance of Leopold’s manoeuvre for foetal presentation and lie were 89 and 96%, respectively. The sensitivity, specificity and PPV for vertex presentation diagnosis were 93.2, 30 and 94.9%, respectively. A larger foetal abdominal circumference decreased the accuracy of performance of Leopold’s manoeuvre (Adjusted OR 0.821, 95% CI 0.703–0.959, p = .013). Using an AC cut-off value of ≥33.01 cm, the sensitivity, specificity, PPV and NPV for accurate vertex presentation diagnosis were 54.3, 57.6, 91 and 13%, respectively.IMPACT STATEMENTWhat is already known about this subject? Leopold’s manoeuvre is a method for assessing fetal presentation. Previous studies have found the overall accuracy of Leopold’s manoeuvre to be 63–88%.What the results of this study add? Leopold’s manoeuvre has high sensitivity but low specificity. Increased fetal AC influences the accuracy of Leopold’s manoeuvre.What the implications are of these finding for clinical practice and/or further research? Fetal non-vertex presentation and fetal AC ≥33.01 cm measured by ultrasonographic examination during late third-trimester pregnancy should be followed for determine the fetal presentation by ultrasonographic examination, patient’ counselling and planning the route of delivery for non-vertex presentation in case of emergency. Further investigations about the cost effectiveness of universal ultrasonographic examination for fetal presentation determination in late third-trimester pregnancy are needed.

Compliance of iron tablets consumption related to anemia status in pregnant women in Cikarang Health Center Bekasi

Anemia in pregnancy is one of the national problems that reflects the value of the socio-economic welfare of the community which also influences the quality of human resources. Factors that can influence the emergence of anemia among pregnant women include socioeconomic, knowledge, frequency of antenatal care visits, maternal age, distance of pregnancy, parity, infectious diseases, lack of consumption of iron, folic acid, vitamin B12, chronic bleeding, nutritional status, diet, compliance to consume Fe tablets, impaired absorption of iron in the body, and gestational age. The purpose of this study was to determine the association of food sources of Fe consumption, compliance to consume Fe Tablets and knowledge about anemia with anemia status in pregnant women. This research used cross sectional design. The number of samples in this study were 51 pregnant women with gestational age ≥ 36 weeks. Analysis of this research data used Fisher’s Exact. The results of statistical tests showed that there was a significant relationship between compliance to consume Fe tablet adherence to taking Fe tablets (p=0,000) and anemia status in pregnant women gestational age ≥ 36 weeks. Meanwhile, the consumption of Fe (p &gt; 0,05) and knowledge about anemia (p &gt; 0,05) had no significant relationship with anemia status in pregnant women ≥ 36 weeks. Thus, the level of compliance with Fe tablet consumption needs to be maintained and improved. Pregnant women still need to be educated about anemia, the effects and food sources of Fe that should be consumed during pregnancy, so that the level of knowledge can increase.&#x0D; Keywords: Anemia, Compliance of Iron Tablet Consumption, Knowledge, Pregnant Women

Prevalence of colonisation by group B streptococcus in pregnant patients in Taguatinga, Federal District, Brazil: a cross-sectional study.

Group B streptococcus is responsible for severe infections in neonates resulting from vertical transmission from pregnant women colonized in the anal, perineal or vaginal regions. The identification of colonized patients and use of intrapartum prophylaxis may reduce the risk of neonatal infection. A cross-sectional study of pregnant women of gestational age between 35 and 37weeks was conducted. Material was collected from patients for laboratory identification of group B streptococcus. Epidemiological data, including weight, height, body mass index, antibiotic use during pregnancy, pathologies during pregnancy (diabetes, hypertensive diseases, and hypothyroidism), twinning, and others, were also collected from patients. The sample consisted of 501 pregnant women, and the prevalence of group B streptococcus was 14%. The mean age was 29years, and the mean BMI was 30.7. During pregnancy, 204 patients had some type of infection, and 201 used antibiotics. Ninety-five patients were diagnosed with gestational diabetes mellitus and 74 with some type of hypertensive disease. The prevalence of group B streptococcus observed did not differ from that observed in other studies. None of the factors studied can be considered as risk or protective factors for maternal colonization by group B streptococcus.

Comparison of cervical cancer screening by visual inspection with acetic acid versus cervical-cytology in pregnancy

Abstract Aims: The aim of this study was to compare visual inspection with acetic acid (VIA) with cervical cytology for cervical cancer screening in pregnant women. Settings and Design: A prospective cohort study was conducted after institutional ethical committee approval in a tertiary care hospital in Northern India. Pregnant women of gestational age &lt;28 weeks were randomly recruited from the antenatal clinic. Subjects and Methods: All eligible women had a Pap smear followed by VIA; colposcopy was performed if either test was positive. Swede score was used for grading of the acetowhite lesion; biopsy was planned if Swede score was ≥8. Statistical Analysis Used: The sensitivity, specificity, and predictive values for both screening methods were compared with colposcopy as the reference standard. Results: There were 370 low-risk pregnant women in the age group of 20–36 years in the study with a mean parity was 2.1, and the median period of gestation of 14.6 weeks. Abnormal Pap cytology was seen in 5.9% (n = 22) of patients; the abnormalities were ASCUS in 13 (59%), LSIL in 4 (18.2%), and AGC-NOS in 5 (22.7%) patients. VIA positivity was found in 8.4% (n = 31). The positive predictive value was 31.8% for cervical cytology and 48.4% for VIA (P = 0.001). No invasive lesion was detected. Positive predictive value of VIA was significantly higher than Pap cytology for detection of abnormal lesions. Conclusions: VIA is a cost-effective method with better predictive value than Pap smear for cervical cancer screening in pregnant women.

Association between genetic risk variants and glucose intolerance during pregnancy in north Indian women

BackgroundGestational diabetes (GDM) is a more common problem in India than in many other parts of the world but it is not known whether this is due to unique environmental factors or a unique genetic background. To address this question we examined whether the same genetic variants associated with GDM and Type 2 Diabetes (T2D) in Caucasians also were associated with GDM in North Indian women.MethodsFive thousand one hundred pregnant women of gestational age 24–28 weeks from Punjab were studied by a 75 g oral glucose tolerance test (OGTT). GDM was diagnosed by both WHO1999 and 2013 criteria. 79 single nucleotide polymorphisms (SNPs) previously associated with T2D and glycemic traits (12 of them also with GDM) and 6 SNPs from previous T2D associations based on Indian population (some also with European) were genotyped on a Sequenom platform or using Taqman assays in DNA from 4018 women.ResultsIn support of previous findings in Caucasian GDM, SNPs at KCJN11 and GRB14 loci were nominally associated with GDM1999 risk in Indian women (both p = 0.02). Notably, T2D risk alleles of the variant rs1552224 near CENTD2, rs11708067 in ADCY5 and rs11605924 in CRY2 genes associated with protection from GDM regardless of criteria applied (p < 0.025). SNPs rs7607980 near COBLL1 (p = 0.0001), rs13389219 near GRB14 (p = 0.026) and rs10423928 in the GIPR gene (p = 0.012) as well as the genetic risk score (GRS) for these previously shown insulin resistance loci here associated with insulin resistance defined by HOMA2-IR and showed a trend towards GDM. GRS comprised of 3 insulin secretion loci here associated with insulin secretion but not GDM.ConclusionsGDM in women from Punjab in Northern India shows a genetic component, seemingly driven by insulin resistance and secretion and partly shared with GDM in other parts of the world. Most previous T2D loci discovered in European studies did not associate with GDM in North India, indicative of different genetic etiology or alternately, differences in the linkage disequilibrium (LD) structure between populations in which the associated SNPs were identified and Northern Indian women. Interestingly some T2D risk variants were in fact indicative of being protective for GDM in these Indian women.

A comparative study to evaluate effect of advanced uncomplicated pregnancy on forced vital capacity and peak expiratory flow rate on healthy North Indian women

Background: Pregnancy is characterized by profound changes in the function of several integrated physiological control systems. During pregnancy due to various physical, hormonal, and physiological changes, there is the effect on pulmonary function. There are documented variations among western and Indian women toward changes in forced vital capacity (FVC) and peak expiratory flow rate (PEFR) in advanced pregnancy. Aims and Objectives: The objectives are as follows: (i) To evaluate the extent of changes of lung function in pregnancy in comparison to non-pregnant counterpart and (ii) to determine the effect of gestational age on the pulmonary function of pregnant women. Materials and Methods: A total of 150 study participants comprising 50 pregnant women of gestational age 29–34 weeks, 50 pregnant women of gestational age >34 weeks, and 50 height and age-matched controls (non-pregnant ladies) were included in the study. FVC, forced expiratory volume in one second and PEFR were taken using HELIOS 401 (Spirometer) in standing position. Results: A reduction in percentage predicted values of FVC is seen in the pregnant females as compared to their non-pregnant counterpart. There is also a gradual not significant decline in the values of FVC as a period of gestation increases. There was no significant difference observed between non-pregnant and pregnant subjects. PEFR was found to decrease as a period of gestation increased. PEFR was found to be significantly decreased during pregnancy in comparison to non-pregnant state. Conclusion: Decline in FVC and PEFR during pregnancy among Indian women was found in this study which is in contrary to literature of western countries. Clinicians should be take care of these changes while dealing with Indian pregnant women.