Prenatal Checkups Research Articles

Relationship between prenatal checkup status and low birth weight: a nationwide birth cohort–the Japan Environment and Children’s Study

PurposeWe investigated the association between prenatal checkup status and low birth weight (LBW). We also sought to identify the background factors of pregnant women that influence their attendance at prenatal checkups and consider measures that might prove useful in reducing the LBW rate. MethodsUsing data from a large nationwide birth cohort study, the Japan Environment and Children’s Study (JECS), the sample comprised 91,916 unique mother–infant pairs with singleton live births. The outcome variable was cases of LBW, and the exposure variable was prenatal checkup status (number of visits missed). Adjusted odds ratios (AORs) with 95% confidence intervals (CIs) were calculated by logistic regression analysis. ResultsAORs (95% CIs) for cases of LBW were 1.57 (1.46–1.69) for 1 missed checkup, 2.40 (1.97–2.94) for 2 missed checkups, and 2.38 (1.46–3.88) for ≥3 missed checkups. A linear trend was also observed (P < .0001). Further analysis revealed that the main risk factors for missed checkups were divorced or widowed marital status, followed by negative attitude toward pregnancy, and single marital status, whereas protective factors were being employed and better mental health in mid-late pregnancy. ConclusionsOur results suggest the importance of implementing various measures to promote regular attendance at prenatal checkups.

Knowledge, Attitude, and Practices of Pregnant Women Towards Antenatal Care in Tertiary Care Hospital Somalia: A Prospective Study

Introduction: All women, regardless of their pregnancies, deserve high-quality maternal services during pregnancy, delivery, and afterward. This study aims to evaluate the knowledge and attitude of pregnant women toward antenatal care. Materials and Methods: A prospective study was carried out among pregnant women attending at obstetrics outpatient department of Mogadishu Somali Turkish Training and Research Hospital. The sample was obtained using random sampling methods. In addition, information was gathered using a structured interview schedule between August and October 2022. Results: The majority (63.3%) of respondents were aged between 20 and 24, while 21% were between the ages of 25 and 29, and 8% were between the ages of 30 and 34. One hundred sixty-five pregnant women had primary school education, 31% had secondary education, 15% had a university education, and 11% were illiterate. Only 252 (63.3%) correctly identified the first prenatal check-up within three months. Conclusion: According to the findings, most of the study's participants had a high level of knowledge and good practices, and most had a favorable opinion about ANC. The Federal Ministry of Health's public health department should strengthen national health education programs to promote antenatal care.

The Effect of Attitudes, Subjective Norms, and Perceptions of Behavioral Control on Pregnancy Check-ups in Bojonegoro

Background: In Indonesia, the use of antenatal care services has not been carried out according to standards. According to WHO, 99% of maternal deaths are due to the lack of information for pregnant women about the importance of regular prenatal check-ups. Objective: This study aims to examine the relationship strength between attitudes, subjective norms, and perceptions of behavioral control regarding antenatal care with the intention of pregnant women in conducting early pregnancy check-ups (K1) using a quantitative approach with a cross-sectional study design. Methods: The population in this study were 234 pregnant women who had their first antenatal contact with K1 at the Dander Health Center in Bojonegoro Regency, which was collected from March to August 2020. Probability sampling utilizing a basic random sample methodology was employed. Furthermore, 129 pregnant women were used as samples for this study. Data is collected in the form of primary data through a questionnaire, while the secondary data were analyzed using logistic regression. The dependent variable is the intention of pregnancy check-ups, while the independent variables are attitudes, subjective norms, and perceptions. Results: The results showed that there was a relationship between the attitude of pregnant women (p=0.001) and subjective norms (p=0.038) regarding pregnancy check-ups with the intention of pregnant women to visit K1 (α=0.05). However, there was no relationship between perceptions of behavioral control regarding antenatal care and the intention of pregnant women to visit K1 (p=0.142). Conclusion: The findings revealed an association between pregnant women's attitudes and subjective norms about prenatal care and their intention to attend K1. This study suggests that pregnant women’s knowledge needs to be improved, including through classes about the importance of good subjective attitudes and norms related to antenatal care to support the intention to check pregnancy regularly especially K1 visits. As a result, early and regular pregnancy check-ups will detect high-risk pregnancies so that they can be handled immediately, thereby reducing maternal and infant mortality.

Analysis of Pregnancy Outcomes After Fetal Reduction in Monochorionic, Dichorionic, and Trichorionic Triplet Pregnancies

To compare the pregnancy outcomes of pregnancy outcomes after selective fetal reduction treatment in monochorionic, dichorionic, and trichorionic triplet pregnancies. We conducted a retrospective analysis of the clinical data of 118 pregnant women carrying triplets. All subjects underwent regular prenatal check-ups and were admitted for delivery at West China Second University Hospital, Sichuan University between January 1, 2012 and January 31, 2021. According to the chorionicity, the subjects were divided into a monochorionic group ( n=13), a dichorionic group ( n=44), and a trichorionic group ( n=61). Within each group, the subjects were further divided into two subgroups, a reduction group and an expectant treatment group, according to whether they underwent fetal reduction or not. The clinical data and pregnancy outcomes were compared between the subgroups within each group. In the monichorionic group, the reduction subgroup had a lower preterm birth rate and higher neonatal birth body mass than those of the expectant management subgroup, but the differences were not statistically significant. In the dichorionic and trichorionic groups, the rates of preterm delivery, neonatal hospitalization, and serious complications of the reduction subgroups were lower than those of the expectant subgroups ( P<0.05), while the neonatal birth body mass was higher in the reduction subgroups than that in the expectant subgroups ( P<0.05). In the dichorionic group, the incidence of intrahepatic cholestasis during pregnancy was lower in the reduction subgroup than that in the expectant treatment subgroup. In all 3 groups, there was no statistically significant difference between the subgroups in the incidence of gestational diabetes, hypertensive disorders of pregnancy, premature rupture of membranes, and postpartum hemorrhage. The survival curve analysis showed that women receiving fetal reduction during the first trimester had a lower risk of pregnancy loss and more significant prolonged of gestational age than those undergoing the procedure during the second trimester. Fetal reduction of triplets can significantly prolong the gestational age and improve the perinatal prognosis. In addition, selective reduction in the first trimester may lead to greater benefits than selective reduction in the second trimester does.

The levels of peripheral blood TNF-α, Decorin and neutrophils MAPK1 mRNA levels of patients with preeclampsia and their clinical significance

Objective This study analyzed the levels of peripheral blood tumor necrosis factor-α (TNF-α), Decorin (DCN) and Mitogen-activated protein kinase 1 (MAPK1) mRNA in neutrophils of patients with preeclampsia and their correlations, in order to provide more thoughts on the diagnosis and treatment of clinical patients. Methods 81 patients with preeclampsia who had regular prenatal checkups and delivered in our hospital from June 2020 to April 2022 were analyzed, including 26 patients with early-onset and 55 patients with late-onset, and 50 pregnant women with normal pregnancy who had prenatal checkups and delivered in our hospital during the same period were selected as the control group. Record the clinical data of patients, record the expression of peripheral blood TNF-α, DCN and neutrophils MAPK1 mRNA of patients with early-onset, late-onset and the control group, and record the correlation between DCN level, MAPK1 mRNA expression and TNF-α level of patients with preeclampsia. Results The diastolic and systolic blood pressures were significantly higher in early-onset and late-onset patients, and the gestational week of delivery was significantly lower in early-onset and late-onset patients, respectively (p < .05); there was no statistically significant difference in the average age, BMI, average pregnancy time, and average births between the three groups (p > .05). The expressions of peripheral blood TNF-α, DCN, and neutrophils MAPK1 mRNA of the early-onset and late-onset groups were all higher than those in the control group (p < .05); and the expressions of TNF-α, DCN, and MAPK1 mRNA in the peripheral blood of the early-onset group were all higher than those in the late-onset group (p < .05); Pearson correlation analysis showed that DCN level and TNF-α level in patients with preeclampsia were positively correlated (r = 0.98639, p < .05); Neutrophils MAPK1 mRNA expression and TNF-α level were positively correlated (r = 0.9611, p < .05). Conclusion TNF-α, DCN and neutrophils MAPK1 mRNA were all highly expressed in the peripheral blood of patients with pre-eclampsia and were more significantly elevated in patients with early-onset preeclampsia, and the expression levels of DCN and MAPK1 mRNA were positively correlated with TNF-α levels. It is possible that all three factors are involved in the pathogenesis of preeclampsia, and are expected to be used as indicators for early prediction and diagnosis.

PENGALAMAN IBU HAMIL DALAM MELAKUKAN VCT DI ERA NEW NORMAL

Introduction: Human Immunodeficiency Virus (HIV) is a virus that attacks white blood cells that causes the body's immune system to decrease, several ways of transmitting HIV, including transmission of HIV from mother to child. To prevent mother to child transmission of HIV, the government targets that by 2022, all pregnant women must detect it early through an HIV test. VCT is an HIV test that is carried out during pregnancy check-ups to determine the HIV status of pregnant women which is carried out voluntarily. In the new custom, the government advises not to visit health facilities too often, but it does not prevent pregnant women from having prenatal check-up. Purpose was to explore the experience of pregnant women in performing VCT in the new normal era. Method was carried out qualitatively with a phenomenological approach, obtained 5 pregnant women who participated in this study using purposive sampling method. Results this study obtained 3 themes: (1) understanding of pregnant women about HIV and HIV prevention, (2) knowledge of pregnant women about VCT, (3) VCT service procedures provided by the Sidomulyo Public Health Center, RI

Genetic counselling in preconception and prenatal care provided by midwives, an international review

Promote the change from genetic counselling carried out in preconception and prenatal check-ups, to genetic counselling provided by midwives themselves and at the same level of care with an open perspective to multiculturalism and plurality. This would mean improving primary care for women and their families, with a cost-effective activity practised by midwives. However, considering the experience of other countries where midwives undertake this activity, we believe it is essential that within the midwife's training in sexual and reproductive health, there is a high component of training in genetics in order to be able to carry out this task with the safety and effectiveness required by this change in care. Key words: prevention, preconception, counselling, genetic counselling, midwives.

Maternal Risk Factors Associated With Neonatal Outcome in Primiparous, Machala, Ecuador.

Introduction The resulting neonatal, weight of the newborn (NB) is considered as a health indicator since the nutritional status of the neonate can have repercussions on the growth and development of the child until adulthood. Secondly, preterm delivery is associated with several maternal risk factors, such as the presence of anemia, adolescence, or advanced age.The aim of the study was to determine the maternal risk factors related to neonatal outcomes in primiparous. Methods A descriptive, observational, quantitative, longitudinal, and non-experimental study was conducted.Data were collected from women who gave birth from September 2021 to August 2022, in a Microsoft Excel database and the analysis was performed using SPSS software, version 26. Results The study population consisted of 224 pregnant women, aged 16 to 41 years, with a mean of 21 years (SD ± 4 years), the most predominant age range was under 20 years, with 53.33%, 81.7% were of middle socioeconomic status, 50.4% had basic education, 89.7% self-identified as mestizo race, 86.2% were of Ecuadorian nationality, and 96.0% resided in the urban area.A total of 97.8% were term NB, 69.9% were normal weight, and 96.4% had an Apgar score of 8 to 10 in the first minute after birth.Maternal factors related to Apgar 7 were adolescent and elderly women, with an odds ratio (OR) of 2.180; having maternal comorbidity OR: 2.0612; the factors related to preterm and post-term neonates were the degree of primary and basic education, OR: 2.0, without statistical significance (p>0.05). And in relation to low weight and high weight, we have an academic education OR: 3.0417, without statistical significance (p>0.05); and mothers with a history of previous abortions, OR: 8.6000, with high statistical significance (p<0.05). Conclusions Among the main maternal factors related to neonatal outcome in primiparous pregnant women wereeducational level, age, number of prenatal checkups, and history of previous abortions.

Syphilis in pregnancy at Public Health Centre III North Denpasar

Introduction: Syphilis is a sexually transmitted infection (STI) caused by the bacterium Treponema pallidum. Syphilis in pregnancy is often asymptomatic, so early detection of syphilis is needed to prevent a poor pregnancy outcome and transmission of infection to the baby.&#x0D; Case: A 25-year-old woman, pregnant with her second child at 24 weeks of gestation, came without any health complaint for a routine prenatal check-up. On syphilis screening, reactive TPHA and RPR titer of 1:2 were found. The patient was diagnosed with syphilis infection in pregnancy. The patient has been treated with Benzathine Benzylpenicillin 2.4 million IU intramuscular injection once a week for 3 consecutive weeks.&#x0D; Conclusion: Syphilis is a sexually transmitted infection that infects pregnant women. Treponemal transmission in pregnant women was detected early in the ninth week of pregnancy. The diagnosis of syphilis was made by dark-field microscopy, treponemal antibody tests (TPHA, FTA-ABS), and non-treponemal antibody tests (VDRL, RPR). Penicillin is the gold standard therapy for syphilis in pregnant women.

Pregnancy, Childbirth, and Childcare during the COVID-19 Pandemic for Parents Raising a 4-Month-Old Child

This study examined the situation of raising a four-month-old baby after pregnancy and childbirth during the COVID-19 pandemic. A fact-finding survey was conducted using an anonymous self-administered questionnaire for mothers and their husbands (hereinafter referred to as fathers) who came to A City, Osaka Prefecture, for health checkups of their four-month-old infants. The questionnaire was distributed to 733 mothers (252 responses). Valid responses were received from 247 participants (33.7%). The questionnaire was distributed to 733 fathers (191 responses). Valid responses were received from 184 participants (25.1%). Most participants belonged to nuclear family households. Sixty percent parents were primiparous. More than 90% parents did not participate in online parenting classes or attend childbirth. In addition, more than 80% mothers did not participate in face-to-face or online maternity classes, postpartum face-to-face visits from grandparents in the hospital, online home visits, telephone conversations, or support from non-relatives. Parents could not obtain information about childcare due to COVID-19. There were restrictions on prenatal checkups, visits, and use of facilities. Most of them resolved these problems via social media platforms, cooperating and communicating with their respective partners and relatives, and devising ways to play with their child. Health of nearly 30% mothers was affected by childcare stress and the pandemic, and they were either depressed or despondent. Approximately 70% experienced positive changes in family relationships and mindsets, such as time spent with family and cooperation received in childcare. During the COVID-19 pandemic, parents coped with various changes and problems they experienced during pregnancy, childbirth, and childcare by devising solutions based on their personal perspectives.

Association of Vitamin D supplementation in pre-eclampsia: Systematic review and meta-analysis

INTRODUCTION: In the Philippines, hypertensive diseases of pregnancy belong in the top three causes of maternal mortality and complicate up to 10% of pregnancy worldwide. In relation with this, proper interventions must be given during the prenatal check-up to prevent occurrence that may cause feto-maternal mortality and morbidity. During prenatal check-up, pregnant women are given vitamin and mineral supplementations. Vitamin D has an association of having a risk for preeclampsia. Receptors of Vitamin D and 1-a hydroxylase are both expressed in the decidua and trophoblast cells. The active form of Vitamin D affects the transcription and function of genes associated with angiogenesis, invasion of the placenta, and normal implantation. The mechanisms mentioned are all involved in the pathophysiology of preeclampsia.OBJECTIVES: The primary outcome of this study is to determine the association of Vitamin D supplementation in preeclampsia. Specifically, this study aims to compare the following secondary outcomes: Maternal outcomes (complication of gestational diabetes mellitus and underwent cesarean delivery) and fetal outcomes (preterm delivery and birth weight).METHODOLOGY: Meta-analysis and systematic review of eight randomized controlled trials.RESULTS: Vitamin D reduced the risk of preeclampsia (risk ratio [RR] 0.45, 95% confidence interval [CI] 0.30–0.69; P = 0.0002). No significant difference on risk of gestational diabetes mellitus (RR 0.84, 95% CI 0.48–1.48) and risk of preterm delivery (RR 0.71, 95% CI 0.49–1.03). Results showed that newborns of mothers who had no Vitamin D supplementation had a higher birthweight (P = 0.010). No significant difference on cesarean section rate (RR 1.12, 95% CI 0.87–1.45).CONCLUSION: Evidence suggests that Vitamin D supplementation can reduce the risk of preeclampsia. This study encourages obstetricians in our country to add Vitamin D supplementation as prenatal medication to prevent preeclampsia, thereby reducing maternal morbidity and mortality.

Strategies for health services in women, newborns, children, and adolescents during the COVID-19 pandemic in countries of Americas

The article analyzes the perceived challenges and strategies implemented in five Latin American and Caribbean countries to ensure continuity of care and access to health services for women, newborns, children, and adolescents during the COVID-19 pandemic. The study corresponds to a quick assessment based on semi-structured interviews with key informants in countries selected by convenience: Colombia, Ecuador, Guatemala, Grenada, and the Dominican Republic. Interviews were conducted with 23 key informants: (a) decision makers at the national and/or subnational level, (b) healthcare professionals, and (c) representatives of civil society organizations; from December 2020 to January 2021. Among the findings, at the beginning of the pandemic, priority was given to the COVID-19 care, with measures to limit the flow of people to health facilities in the countries involved, closing or limiting outpatient visits and restricting care schedule. For women, this affected family planning services and access to contraceptive methods, implying a reduction in prenatal check-ups. As a result of this deinstitutionalization of care, among newborns, a decrease in pediatric check-ups, a decrease in timely immunization and late detection of pathologies or growth problems were reported. Among adolescents, a strong restriction of family planning services, the limitation of other friendly counseling spaces and difficulties in accessing contraceptives were observed.

Exposure of reproductive-aged pregnant and nonpregnant women to common environmental pollutants and endocrine-disrupting chemicals: A cross-sectional survey at the University of the Philippines-Philippine General Hospital

CONTEXT: Exposure to environmental pollutants (EP) and Endocrine-disrupting chemicals (EDCs) is associated with several general negative health effects which compromise women's reproductive health, maternal, and neonatal outcomes. Unfortunately, many nonpregnant and pregnant women are unaware of their active exposure to these potentially slow-acting toxic substances, EPs, and EDCs. At any stage of life, and in the long-term minute exposures, there is no established safe level of exposure to these substances. Due to the potentially harmful effects on women in general, and to the pregnant and her unborn child in particular, it is important to establish the prevalence of their exposure.AIMS: The aim of this study was to determine the magnitude (prevalence) of exposure among nonpregnant and pregnant women aged 18–49 years to common EPs/EDCs such as bisphenol A, pesticides, phthalates, and perfluorinated compounds among others.SETTINGS AND DESIGN: This study was conducted at the Philippine General Hospital, University of the Philippines Manila.SUBJECTS AND METHODS: The study participants were nonpregnant and pregnant women, with low-risk singleton pregnancy, and had a prenatal checkup and eventual delivery at the Philippine General Hospital. After consent, women were asked to answer a survey focused on their sociodemographics and frequency of exposure to EP- and EDC-containing items.STATISTICAL ANALYSIS USED: Descriptive statistics were used to summarize the demographic and clinical characteristics of the patients. Null hypotheses were rejected at 0.05 α-level of significance. The computer software STATA 13.1 was used for data analysis.RESULTS: One hundred and fifty-nine survey responses by women were analyzed. Possible EDC-containing household items (carpets, linoleum, upholstered, and stain-resistant furniture) are more prevalent in the homes of pregnant women compared to nonpregnant women. Pregnant women are also exposed to wallpapers compared to nonpregnant individuals. Nonpregnant women were 1.5 times more exposed to lotions. Unexposure to hand sanitizers is 1.3 times higher among pregnant individuals.CONCLUSIONS: There are differences in the prevalence of exposure to household EDC-containing items between pregnant and nonpregnant women, with pregnant women having a higher prevalence of exposure.

Insomnia in response to stress in pregnant women: description of the problem, complications, identification of risk groups and therapeutic options

Insomnia is a major clinical problem in pregnant population, with almost 40% of women in the third trimester being affected. If left untreated, insomnia reduces the quality of life and increases the risk of other disorders, both somatic and mental. Sleep disorders can affect the course of pregnancy, delivery, and perinatal outcomes, as well as prevent the formation of a proper bond between mother and infant, which is crucial for the child’s further development. The term “sleep reactivity,” defining a certain tendency to exhibit sleep disturbance in response to a stressful stimulus, increasingly appears in literature. Sleep reactivity is a part of the body’s overall response to stress. It has been shown that high sleep reactivity can be a risk factor for chronic insomnia, which confirms its clinical significance. Ford Insomnia Response to Stress Test (FIRST) is an available and easy-to-use tool to measure this tendency. Due to the high prevalence and multiple complications of pregnancy insomnia, it is worth using appropriate screening tools to diagnose the disorder during prenatal checkups with the attending physician. In the light of current medical knowledge, cognitive-behavioural therapy of insomnia is the method of choice and should be used in every symptomatic patient. The latest data also indicate its efficacy and safety in advanced pregnancy patients.

BREASTFEEDING SELF-EFFICACY IN PREGNANT WOMEN AND EFFECTIVE FACTORS IN THE COVID-19 PANDEMIC

This study was conducted to identify the factors affecting the breastfeeding self-efficacy of pregnant women in the COVID-19 pandemic.This descriptive correlational study was conducted between 15 January and 15 June, 2021. The sample consisted of 320 pregnant women’, who were in their third trimester, had a single and healthy fetus, a spontaneous pregnancy and no health problems. The data of the study were collected using an Information Form and the Prenatal Breastfeeding Self-Efficacy Scale.The mean total Prenatal Breastfeeding Self-Efficacy Scale score of the participants was 79.08±13.86. The seven variables with significant effects on the mean total Prenatal Breastfeeding Self-Efficacy Scale scores of the participants were, being knowledgeable on COVID-19, thinking breastfeeding is beneficial for the baby, going to prenatal care checkups on time, gestational week, educational status, age, and receiving breastfeeding consultancy in the COVID-19 pandemic.&#x0D; Especially young pregnant women who have low educational status and are not experienced or knowledgeable about breastfeeding should be provided with counseling on breastfeeding. This study is believed to contribute to the literature and guide interventional studies to be conducted in the future by evaluating the prenatal breastfeeding self-efficacy levels and affecting factors.

The correlation between the intensity of prenatal yoga participation on anxiety levels for third trimester pregnant women in facing childbirth in Kartasura district

Background:Data from the World Health Organization (WHO) show that pregnant women experience anxiety by 8-10% during pregnancy, and it increases to 13% when they are about to give birth. The incidence of anxiety in pregnant women in Indonesia reaches 373,000, 28.7% of which anxiety occurs in pregnant women when facing childbirth. Sustained anxiety will increase the likelihood of cesarean section, prolonged second stage, asphyxia and affect fetal neurodevelopment and fetal cognitive. One of the physical exercises that can reduce anxiety is prenatal yoga. The purpose of this study was to determine the relationship between the intensity of prenatal yoga participation on the level of anxiety of pregnant women in the third trimester in facing childbirth in Kartasura District.Methods: Cross-sectional study design. The population in this study were all third trimester pregnant women who did prenatal yoga and did prenatal checkups at midwife Wulan, Anik Midwife Health House and Auliya Husada Clinic with a total population of 42 people. The sample of this study used accidental sampling and total sampling. The research instrument used the Perinatal Anxiety Screening Scale (PASS), and used univariate and bivariate data analysis with the Spearman test.Results: A total of 22 pregnant women who did not participate in prenatal yoga experienced severe anxiety by 54.6% (12 people), while of the 20 pregnant women who participated in prenatal yoga, most experienced mild anxiety by 50% (10 people). Based on statistical tests using the Spearman test, p-value &lt;0.05 was obtained.Conclusion: There is a relationship between the intensity of prenatal yoga participation on the level of anxiety of pregnant women in the third trimester in facing childbirth in Kartasura District.Suggestion: It is hoped that pregnant women who have not followed prenatal yoga regularly participate in prenatal yoga in order to reduce discomfort and anxiety.

Clinical-epidemiological characteristics of early-onset neonatal sepsis in a public hospital, Lima, Peru

Objective: To determine the clinical-epidemiological characteristics of newborns with early-onset neonatal sepsis in a public hospital in Lima, Peru, 2016-2017. Materials and methods: An observational, retrospective study of 303 newborns born in Hospital Nacional Dos de Mayo, diagnosed with early-onset neonatal sepsis (2016-2017) and with complete medical records. Maternal variables: age, education, marital status, prenatal care, PROM, type of delivery, UTI, chorioamnionitis, anemia; neonatal variables: sex, gestational age, weight, Apgar, clinical signs, hemoculture, isolated organism, treatment, antibiotic sensitivity. Data processed in Excel and analyzed in SPSS Statistics V25. The incidence of early-onset neonatal sepsis was determined. Results: Incidence of early-onset neonatal sepsis: 67.08/1,000 (2016) and 127.85/1,000 (2017) live births. Incidence of confirmed early-onset neonatal sepsis: 2.98 (2016) and 4.7 (2017). Out of all mothers, 45 % received no adequate prenatal checkup or no checkups; 25 % presented anemia, UTI, history of abortion. Newborns had tachypnea (52.80 %), tachycardia (17.50 %), hypotonia (18.20 %), fever (9.20 %). The therapy included ampicillin-amikacin for probable (86.54 %) and confirmed (85 %) sepsis. Germs, mostly gram positive, were isolated from 8.4 % of the newborns. Coagulase-negative Staphylococcus was the most common bacteria, resistant to clindamycin, oxacillin, ampicillin, cefotaxime, gentamicin, and sensitive to linezolid, vancomycin. Burkholderia gladioli was the only identified gramnegative organism, sensitive to levofloxacin, ciprofloxacin, ceftriaxone but resistant to gentamicin, amikacin. Conclusions: The clinical presentation of neonatal sepsis included tachypnea, tachycardia, hypotonia and fever. Grampositive bacteria were the most commonly isolated species, prevailing coagulase-negative Staphylococci.

The impact of community midwives on maternal healthcare utilization.

Globally 800 women die every day from preventable causes related to pregnancy and childbirth. One of the major reasons for high maternal mortality ratios in many developing countries is the low proportion of births attended by Skilled Birth Attendants (SBA). To address the high number of maternal deaths, in 2008 the Government of Pakistan introduced the Community Midwives Program. Under the program, women from across the country were trained and deployed as Community Midwives. In this study, I use six rounds of Pakistan Social and Living Measurement Survey to estimate the impact of this program on maternal healthcare utilization. I find that women residing in districts with higher Community Midwives per capita were 9 percentage points more likely to be attended by a SBA at the time of delivery and were 8 percentage points more likely to give birth at a medical facility as opposed to birthing at home. I find no evidence of impact on take up of prenatal and post-natal check-ups. The use of Community Midwives may be a cost effective tool to reduce maternal deaths, especially for developing countries with low health budgets.

Implementation of Outreach and Mentorship Program of Pregnant Mothers in Prevention of Human Immunodeficiency Virus Transmission from Mother to Child in Rural Areas of Banyumas Regency

BACKGROUND : Outreach of pregnant women in the use of HIV testing is the target of prioritized HIV / AIDS prevention programs. Outreach of VCT services requires community social involvement in participating in efforts to detect early the spread of HIV / AIDS in their respective regions. The Banyumas District Government issued a policy of Citizens of AIDS Care to strengthen outreach and mentoring pregnant women in preventing HIV / AIDS transmission from mother to baby in rural areas of Banyumas District.&#x0D; AIM :The aim of the study is to describe the implementation of outreach and mentoring programs for pregnant women in the prevention of HIV / AIDS transmission from mother to baby in the rural areas of Banyumas Regency.&#x0D; METHODS: This study uses qualitative methods with a phenomenological approach. Research instruments use in-depth interviews. Research informants include, among others, AIDS care citizens, village midwives, village heads, community leaders, health cadres and pregnant women.&#x0D; RESULTS: The results showed that the implementation of outreach and mentoring programs for pregnant women in the prevention of HIV / AIDS transmission from mother to baby in rural areas of Banyumas District went well. The factors that drive the success of the program are the understanding of program implementers about the contents of the policy, individual communication methods carried out on pregnant women through prenatal checkups, counseling and classes of pregnant women as well as adequate communication intensity. Positive willingness and desire, as well as commitment from stakeholders at the village level to the program, clear Standard Operating Procedures on HIV / AIDS checks on pregnant women, as well as positive responses and adherence to pregnant women in the use of the program.&#x0D; CONCLUSIONS :The empowerment of the Caring AIDS Community's bureaucratic structure is not optimal in the program, even in some villages the organization has not been established as the main implementer of the program other than the village midwife.

PENCEGAHAN COVID-19 PADA IBU HAMIL DENGAN VAKSINASI

Coronavirus 2019 (COVID-19) caused by severe acute respiratory syndrome coronavirus 2 (SARSCoV-2) has been worrying the world since its first appearance. Although the absolute risk for maternal morbidity and mortality is low, pregnancy remains a risk factor for hospitalization, ICU admission, and COVID-19-related extracorporeal membrane oxygenation requirements compared to nonpregnancy. Protection of pregnant women from SARS-CoV-2 infection is very important to reduce maternal morbidity and mortality. Vaccination is the most promising method to control the spread of COVID-19. This descriptive study aims to determine the description of pregnant women who are vaccinated against covid-19, with the population who perform pregnancy checks at the Gayaman Health Center, Data collection was carried out in April 2022, using a questionnaire that was given directly to respondents and still complied with health protocols. Sampling by total sampling where 36 pregnant women were obtained who did prenatal check-ups and completed the questionnaire. The results of the study Most of the respondents had received the covid-19 vaccine, namely 31 respondents (86.11%). Health workers still have to provide information regarding the importance of covid-19 vaccination for pregnant women so that the coverage of COVID-19 vaccination for pregnant women can be increased.