Preterm Labor Research Articles

The preventive health management self-efficacy related to preterm labor scale in reproductive-aged women: Validation of Turkish reliability and factor structure.

This study aims to test and adapt the Turkish psychometric properties of the preventive health management self-efficacy related to premature labor (PHMSE-PL) scale for women of reproductive age. The study follows a methodological approach. The original scale comprises 34 items distributed across 5 subscales and is structured on a five-point Likert scale. The study sample consisted of 351 women aged 19 to 49, all without any physical or mental disabilities, irrespective of marital status or pregnancy status. Exclusion criteria encompassed women engaged in healthcare professions such as medical faculty, nursing, or midwifery, as well as those with a history of preterm birth during pregnancy. During the validity assessment of the scale, language, content, and construct validity were scrutinized. In the reliability phase, internal consistency and stability over time -analyses were conducted. Following confirmation of language validity, all items achieved a content validity index value exceeding 0.80. Exploratory and confirmatory factor analyses were employed to assess structural validity, revealing that the scale retained its original grouping into five sub-factors. These factors collectively accounted for 81.5% of the variance. The Cronbach's alpha coefficient for the entire scale reached 0.98, indicating high internal consistency. Test-retest analyses yielded a correlation coefficient of 0.99 between overall scale scores, demonstrating excellent consistency between the two measurement measurements. The PHMSE-PL scale adapted to Turkish culture demonstrated high levels of validity and reliability.

Is there a relationship between morphokinetic parameters and obstetrical complications? An analysis of singleton live births after single fresh embryo transfer

BackgroundWith the advancement in embryology and the introduction of time-lapse monitoring system, the embryologists' goal might be to find not only the embryo with the highest probability of live birth, but also the embryo with the highest probability to progress to a healthy full-term delivery. Thus, we aimed to investigate the association between morphokinetic time-lapse parameters and obstetrical and perinatal complications.MethodsA cohort study reviewing fertility and delivery files of all singletone births from IVF patients whose embryos were cultured in a time-lapse monitoring system and had a single fresh embryo transfer at our center between 2013–2019. We conducted multiple comparisons between complicated and uncomplicated pregnancies of each perinatal complication, including: gestational diabetes mellitus (GDM); small for gestational age (SGA); pre-eclamptic toxemia (PET); preterm labor < 37 weeks of gestation (PTL); and third stage of labor complications. A comparison between pregnancies with and without a composite outcome of placental complications including GDM, SGA, PET and PTL was also conducted. Baseline characteristics, treatment and morphokinetic parameters in complicated and uncomplicated gestations were compared. Logistic regression analysis was utilized to adjust results for potential confounders.ResultsOne hundred seventy-six single embryo transfers resulted in 176 live births. Morphokinetic time-lapse parameters were similar between the groups, except for a shorter time to full blastulation in the SGA group (tB-tPNf = 75.5 ± 1.3 h vs. 79.5 ± 4.8 in the non-SGA group, p < 0.001), and shorter third cell cycle duration in the PET group (CC3 = 12.4 ± 1.1 h vs. 13.6 ± 2.9 in the non-PET group, p = 0.02). On multivariate regression analysis, none of the morphokinetic parameters were found to be significantly correlated with any of the perinatal complications.ConclusionTime-lapse morphokinetic parameters of the embryo transferred are not associated with adverse obstetric and perinatal outcomes.

Serum Ferritin Level as a Marker of Preterm Labor- A Prospective Observational Study

Serum Ferritin Level as a Marker of Preterm Labor- A Prospective Observational Study

7589 A Survey On the Current Status of Universal Screening Thyroid Indicators During Pregnancy in Real World Study

Abstract Disclosure: N. Zhou: None. W. Sun: None. H. Meng: None. Y. Huang: None. J. Zhao: None. Y. Gao: None. H. Yang: None. Y. Zhang: None. A Survey on the current status of universal screening thyroid indicators during pregnancy in real world study Background: Thyroid dysfunction and thyroid auto-immunity (TAI) are common in women of childbearing age, which have been proven to increase the risk of maternal and fetal adverse pregnancy outcomes. China has adhered to the strategy of universal screening for early pregnancy thyroid indicators since 2012, and is currently the only country that recommends universal screening. This study aimed to investigate the implementation situation of universal screening for thyroid indicators during pregnancy in real world study. Methods: We retrospectively collected medical record information from 18,932 women who underwent regular prenatal examinations at Peking University First Hospital from January 2014 to December 2016 until the end of pregnancy, grouping based on whether thyroid indicators were screened during pregnancy, and comparing the general characteristics and pregnancy outcomes. Furthermore, the treatment compliance status of women who took levothyroxine and antithyroid drugs (ATD) before pregnancy was also analyzed. Results: The screening rate for thyroid indicators in pregnancy was 88.7% in our hospital, 93.3% of pregnant women underwent screening in early pregnancy, with a median gestational age of 7.0 (6.6, 10.1) weeks. Non-screening ones were more inclined to be aged&amp;gt;40 years or &amp;lt;25 years, with a BMI ≥24 kg/m2, pluriparity (≥2), and without thyroid disease history prior to conception (P &amp;lt; 0.05). After correcting covariates, the risks of early miscarriage (8-12 weeks) (OR=21.96, 95% CI: 19.2, 25.1) and late miscarriage (12-28 weeks) (OR=3.0, 95% CI: 2.5, 3.6) were significantly higher in non-screening group than in the screening group, but there was no significant difference in the risk of preterm labor between the two groups (P=0.985). The achievement rate (0.23≤TSH&amp;lt;2.5uIU/mL, FT4 within normal range, 53.7%-64.2%) of early pregnancy thyroid function among levothyroxine intervention participants increased from 2014 to 2016. Compared with those in the thyroid function controlled group, the patients in the uncontrolled group had earlier screening gestational weeks (6.7 vs. 8.0 weeks), higher TPOAb positivity (58.6% vs. 44%), and a greater incidence of other autoimmune disorders (14.2% vs. 9.8%) (P&amp;lt;0.05). The achievement rate of early pregnancy thyroid function among ATD intervention participants ranged from 63.6 to 71.2%. Conclusions: The screening rate for thyroid indicators in pregnancy is nearly 90% in comprehensive hospitals. The lack of screening may be related to miscarriage to some extent. The current treatment compliance status pre-pregnancy neither for levothyroxine nor ATDs was not satisfactory. Presentation: 6/2/2024

Improving Amniotic Fluid Index with L-Arginine Supplementation

Background: Oligohydramnios, characterized by a low Amniotic Fluid Index (AFI), is associated with adverse pregnancy outcomes, including fetal growth restriction, preterm labor, and low birth weight. Effective interventions for improving AFI are critical, particularly in resource-limited settings. L-Arginine, a nitric oxide precursor, has shown promise in enhancing uteroplacental circulation and increasing AFI. This study aimed to evaluate the efficacy of L-Arginine supplementation in improving AFI and associated maternal and neonatal outcomes in pregnant women with oligohydramnios in Bangladesh. Methods: This study was conducted at Islami Bank Hospital over one year (July 2023 to June 2024), involving 90 pregnant women diagnosed with oligohydramnios. Participants received daily L-Arginine supplementation, and AFI was measured before and after the intervention. Maternal and neonatal outcomes, including gestational age at delivery, birth weight, and neonatal intensive care unit (NICU) admissions, were recorded. Statistical analysis was performed using paired t-tests, with p &lt; 0.05 considered statistically significant. Results: The mean AFI increased significantly from 5.4 cm (SD ±1.7) before the intervention to 8.6 cm (SD ±2.1) after supplementation, with a mean difference of 3.2 cm (p &lt; 0.001). Low birth weight was observed in 20% of the neonates, while 17.78% required NICU admission. There was a notable improvement in neonatal outcomes with L-Arginine supplementation. Conclusion: L-Arginine supplementation significantly improved AFI and neonatal outcomes, making it a viable intervention for managing oligohydramnios in pregnant women. Further research is recommended to confirm these findings in larger populations.

Dépistage et prévention de la prééclampsie par l’algorithme de la Fetal Medicine Foundation : une étude avant-après

ObjectiveIn order to identify women at high risk of pre-eclampsia and offer them aspirin prophylactic treatment, the Fetal Medicine Foundation (FMF) recommends a first-trimester screening test. The commonly used threshold for aspirin administration is a risk >1/100, which implies treating an important number of patients. We aimed to assess the use of this strategy with a more restrictive threshold: risk >1/70 and evaluate the impact of this strategy on the prevalence of pre-eclampsia with premature delivery in nulliparous women. MethodsA before-and-after cohort study conducted from 01/09/2014 to 01/12/2018, including nulliparous women undergoing first-trimester ultrasound at the University Hospital of Toulouse. Between 09/2014 and 09/2016 (“before cohort”), women did not undergo pre-eclampsia screening. Between 01/2017 and 12/2018 (“after cohort”), women underwent targeted pre-eclampsia screening using the FMF algorithm, and those with a risk >1/70 received 100mg aspirin. The primary outcome was pre-eclampsia with premature delivery. A univariate and then a multivariate analysis were performed to take into account potential confounding factors. ResultsAmong the 1030 women of the before cohort, 17 women (1.7%) experienced pre-eclampsia with premature delivery, compared to 8 women (1.3%) among the 629 of the after cohort, with no significant difference between the two groups (Adjusted Odd Ratio (95%CI)=0.73 [0.31–1.74]). In the after cohort, 18 women (2.9%) had a risk greater than 1/70 and therefore received aspirin. According to the FMF screening test, 89 women (14.1%) had a risk>1/100, which is the usual threshold for prescribing aspirin for prophylaxis. This means that 71 women had a risk greater than 1/100 but less than 1/70 and therefore did not receive aspirin in this study, even though they would have received aspirin at the usual threshold. ConclusionsThe screening and prevention strategy for pre-eclampsia using restrictive thresholds did not decrease the rate of preeclampsia with premature delivery.

Comparison of the Effect of Oral Dydrogesterone with Oral Nifedipine on the Treatment of Threatened Preterm Labor: A Randomized Controlled Trial

Background: Determining the most effective treatment for women at risk of preterm labor is crucial in reducing potential complications and neonatal mortality. This study aimed to compare the effects of two oral medications, Dydrogesterone and nifedipine, on managing preterm labor in pregnant women admitted with threatened preterm labor. Objectives: The trial aimed to compare the efficacy of Dydrogesterone versus nifedipine in preventing preterm labor. Methods: In this randomized controlled clinical trial, 54 pregnant women aged 18 to 45 years, with a gestational age of 26 to 34 weeks and at risk of preterm labor, were randomly assigned to receive either 40 mg oral Dydrogesterone or a standard dose of nifedipine (10 mg for the first dose) as a tocolytic. Key maternal and neonatal outcomes, including the interval between intervention and delivery, delivery type, neonatal intensive care unit (NICU) admission, NICU stay duration, and Bishop scores, were evaluated and compared between the two study groups. Results: The mean age of participants was 27.78 ± 2.53 years in the nifedipine group and 27.67 ± 2.53 years in the Dydrogesterone group. There were no significant differences (P &gt; 0.05) between the two groups in baseline characteristics. The mean NICU stay in the Dydrogesterone group (2.3 ± 0.5 days) was significantly shorter than in the nifedipine group (4.6 ± 0.5 days) (P = 0.001). Although the frequency of gestational age at delivery, NICU admission, the interval between intervention and delivery, and repeated preterm labor were lower in the Dydrogesterone group, the differences between the groups were not statistically significant (P &gt; 0.05). Conclusions: The findings suggest that Dydrogesterone is effective in treating preterm labor. Both drugs prevented preterm labor; however, nifedipine, despite being a standard treatment, has potential side effects and may not be suitable for all patients. These results indicate that Dydrogesterone, with fewer side effects, could be an alternative for patients who cannot use nifedipine. Further studies with larger sample sizes are needed to confirm or refute this finding.

Surgical management of obstructing ureteral stones during pregnancy: A systematic review of different techniques.

Renal colic is the most common non-obstetric cause of abdominal pain during pregnancy and is associated with a higher risk of complications in these women. When invasive treatment is required, options are temporary drainage with ureteral stent (JJ) or percutaneous nephrostomy (PCN), or immediate definitive treatment with ureteroscopy (URS). Our goal was to review the safety and efficacy of these procedures in treating urolithiasis during pregnancy. Adhering to the PRISMA checklist guidelines, we searched PubMed, Embase, and Scopus databases for articles on the efficacy and complications of the three procedures in pregnant women. The quality of evidence and risk of bias were evaluated using the Critical Appraisal Skills Programme and the Institute of Health Economics tools. We included 45 articles, totaling 3424 interventions in pregnant women - 2188 URS, 719 JJ, and 517 PCN. URS was the most assessed procedure, with stone-free rates comparable to the non-pregnant patients. The most frequent complications were lower urinary symptoms and infections independently of the intervention. Obstetric complications for all interventions included 167 cases of preterm labor, resulting in 24 premature births. No statistically significant differences in post-operative complications were reported between the procedures in the few comparative studies. Despite the absence of high-quality studies, current evidence suggests that URS, JJ, and PCN are all safe and effective during pregnancy. As most patients submitted to temporary drainage require a second procedure post-delivery, primary URS appears more efficient. Therefore, it is the preferred option unless there are indications for temporary drainage.

Case study: May human norovirus infection be associated with premature delivery?

Human norovirus (HuNoV) is the leading cause of acute gastroenteritis. The varying severity of chronic infection in patients with underlying immune deficiencies poses additional burdens on public health. However, the potential effects of HuNoV infection during pregnancy, a specific immune perturbed state, have been rarely reported. Recently, four cases of HuNoV-infected patients in the late stages of pregnancy were admitted to the Guangzhou Women and Children's Medical Center, and premature rupture of membranes as primary adverse outcome was observed in these cases. Samples of fetal accessory tissue were collected from two of these cases at delivery to explore the potential pathogenesis. Pathological analysis showed placental malperfusion in both maternal and fetal vascular, while a decrease in vessels was not observed in villi of placenta. There was obvious pathological change in the chorion of fetal membrane, accompanied by a tendency of Th-1 immune bias. Notably, aggregation of M2 macrophages was observed in the chorion of the fetal membrane, potentially recruited for tissue repair. Next-generation sequencing showed minimal changes in immune pathways within placenta tissue. A gene panel associated with immunosuppression was identified in the fetal membrane of HuNoV-infected women compared to those of normal parturient. Taken together, this study provides clues for the association between the HuNoV and premature delivery, which requires the attention of the clinicians.

Pregnancy and Long-Term Postnatal Outcomes of Congenital Sacrococcygeal Teratoma: A Single Institution's 18-Year Experience.

The objective of this study is to evaluate outcomes of fetal sacrococcygeal teratoma (SCT) from an academic tertiary center. This is a retrospective study evaluating pregnancy and postnatal outcomes of fetal SCT management at a single institution between 2006 and 2023. Results are reported as median (range). Fourteen patients with fetal SCT were studied. Hydrops fetalis occurred in 2 (14.3%) cases. Pregnancy course included expectant management in 12 (85.7%) and palliative preterm induction in 1 patient (7.1%). Indications for delivering timing included fetal deterioration in 7 patients (50%), preeclampsia in 3 (21.4%), elective induction of delivery in 3 (21.4%), and preterm labor in 1 (7.1%). Delivery GA was 36.4 weeks (26.4-40.1 weeks), with 11 (78.5%) cesareans and 3 (21.4%) vaginal deliveries. There were 13 (92.9%) live births and 11 (78.6%) long-term survivors. Postnatal resection pathology demonstrated 7 (53.8%) mature, 3 (23.1%) immature, and 3 (23.1%) malignant SCTs. Of the 11 long-term survivors, 3 (27.3%) had teratoma recurrences, including 2 (18.2%) with metastatic disease requiring chemotherapy. Notable long-term complications involved gastrointestinal (n = 7, 63.6%), genitourinary (n = 4, 36.4%), and musculoskeletal (n = 2, 18.2%) systems. SCT confers significant morbidity to both the pregnant patient and neonate. Multidisciplinary prenatal and postnatal care is needed to comprehensively manage this complex condition.

Association Between Antepartum Admission and Postpartum Depressive Symptoms: Short Title: Antepartum Hospital Admission and Postpartum Depressive Symptoms

BackgroundPostpartum depression affects 14% of pregnant individuals and is a leading cause of preventable maternal mortality. Complications of pregnancy, such as preterm labor or pre-eclampsia, may require hospitalization for close monitoring and management. The impact of an antenatal hospitalization during pregnancy on postnatal depression remains understudied. ObjectiveTo evaluate whether hospital admission during pregnancy was associated with postpartum depressive symptoms in individuals who were enrolled in a collaborative care model and to evaluate whether enrollment in the collaborative care model during pregnancy mitigated this association. Study DesignThis secondary analysis of a prospective cohort study included perinatal people enrolled in a collaborative care model at a quaternary academic center between 2017-2021. The primary outcome was presence of moderately severe or severe postpartum depressive symptoms at 6 weeks postpartum defined as a score of 15 or greater on a PHQ-9. The prevalence of symptoms of this severity was compared between those who experienced an antepartum hospitalization and those who did not using bivariable and multivariable analyses. A Breslow Day test was used to evaluate whether any observed association between antepartum hospitalization and postpartum depressive symptoms differed based on timing of enrollment in the collaborative care model. ResultsDuring the study period, 1897 individuals met inclusion criteria. Of these, 162 (8.5%) were admitted to the hospital during pregnancy. Of those with an antepartum hospitalization, 20 (12.4%) developed moderately severe to severe postpartum depressive symptoms compared to 136 (7.8%) of those who were not hospitalized (p=0.046). After adjustment for confounders identified through use of a directed acyclic graph, this difference did not persist in multivariable analysis (aOR 1.55, 95% CI [0.87-2.75]). A Breslow Day test demonstrated heterogeneity across enrollment timing, so subgroup analyses were performed for those enrolled during pregnancy (n=930) vs postpartum (n=967). Hospital admission was associated with higher rates of moderately severe to severe postpartum depressive symptoms in those enrolled in the collaborative care model postpartum (19.7% vs 10.6%, p=0.015, aOR 2.25, 95% CI [1.07-4.71]), but not those enrolled antenatally (5.8% vs 5.0%, p=0.735, aOR 1.09, 95% CI [0.38-3.19]). ConclusionsAntepartum hospital admission was associated with higher rates of moderately severe to severe depressive symptoms. This association did not exist among individuals enrolled in collaborative care model during pregnancy, suggesting a potential protective effect afforded by engagement in a mental health support programming.

Lamellar Body Count (LBC) in amniotic fluid for prediction of fetal lung maturity

Background: Neonatal respiratory distress syndrome (RDS) is a disorder due to pulmonary immaturity with a high mortality characterized by low levels of pulmonary surfactant. RDS is one of the important causes of mortality in neonates. Objective: The aim of the study is to determine the lamellar body count (LBC) cutoff value for foetal lung maturity and to evaluate the clinical usefulness of LBC in predicting the neonatal respiratory distress syndrome (RDS) and to find if the Measurement of LBC can replace the conventional Lecithin/Sphingomyelin ratio. Methods: This prospective observational study was performed on total 47 pregnant women divided as 19 patients with premature labor and 28 patients with healthy full-term singleton pregnancy as controls, with gestational age between 28 – 41 weeks at Ain Shams university maternity hospital in period between April 2014 and January 2015 with inclusion and exclusion criteria. Results: RDS was diagnosed in 20 neonates, two neonates in the 1st group (7.1%) While 18 neonates in 2nd (94.7%) showed development of RDS. Mean lamellar body count in newborns with RDS: 39,200 ± 12,438 with median 37,500 and p-value was &lt;0.0001. ROC (receiver operator characteristics) curve showed that by using 51000/µL as a cut-off point for LBC it is a good predictor for fetal lung maturity with sensitivity 95% and specificity 96.3%. There is a direct relationship between the gestational age and the lamellar body count as the lamellar body count increases as long as the gestational age proceeds with a highly significant positive correlation (p value &lt;0.0001). Conclusion: As evident from the current study, LBC count now replacing the conventional Lecithin/Sphingomyelin ratio because the test can be performed with equipment found in most clinical analysis laboratories and is reliable in predicting foetal lung maturity. This study suggests that LBC cutoff value of ≥51,000/µL can predict pulmonary maturity and reduce the risk of neonatal respiratory distress syndrome.

Public Health Nurse Perspectives on Predicting Preterm Labor Using Risk Factors and Simple Machine Learning Algorithms

Public Health Nurse Perspectives on Predicting Preterm Labor Using Risk Factors and Simple Machine Learning Algorithms

Indications for Transfer and Care Pathways of Inuit Transferred to a Tertiary Centre for Childbirth in Québec, Canada: A Chart Review 2015–2019

ObjectivesChildbirth evacuation, the transfer of patients from rural and remote communities to urban centres for pregnancy care or childbirth, can be associated with numerous adverse health outcomes and contributes to widening health disparities between Inuit and non-Indigenous populations in Québec. We examined the indications and outcomes of childbirth evacuations among Inuit from Nunavik, Northern Québec transferred to a southern tertiary care centre. MethodsA 5-year retrospective chart review included 677 pregnancies of 597 Inuit with obstetric indications transferred to a tertiary care centre between 2015 and 2019. ResultsThe most common reasons for transfer were diabetes (70/677, 10.3%), hypertension (69/677, 10.2%), abnormal prenatal screen/soft markers (57/677, 8.4%), and threatened preterm labour (55/677, 8.1%). Of the 534 (78.9%) Inuit who gave birth at the tertiary centre, 84.1% (449/534) were vaginal births. Overall, 27.0% (144/534) had obstetric complications, with postpartum hemorrhage (58/534, 10.9%) and retained placenta (34, 6.37%) being the most common. Of the 549 neonates, 9 were stillbirths (1.6%), and 69 neonates (12.6%) required admission to the neonatal intensive care unit. Approximately 3.4% (18/534) had complications within the postpartum period, with the most common being retained products of conception (4/18, 22.2%) and postpartum preeclampsia (4/18, 22.2%). ConclusionsA relatively young and multiparous population, Inuit from Nunavik have unique health profiles and care needs. Further investment in health care capacity in Nunavik, alongside locally adapted, prevention-focused perinatal health programming, might improve perinatal health profiles and reduce the rates of childbirth evacuation.

Neonatal outcomes after intervention for suspected renal colic in pregnancy

ObjectiveTo compare neonatal outcomes following URS, stent, or PCN in pregnant women presenting with suspected renal colic. MethodsWomen undergoing a procedure for suspected renal colic during pregnancy at a large multi-center institution between 2008–2022 were retrospectively reviewed and categorized by initial intervention. Neonatal outcomes were recorded and linked to maternal and obstetric data. Groups were compared by a Kruskal-Wallis, ANOVA, or Fisher’s Exact test, followed by pairwise post-hoc testing as appropriate (α = 0.05). Multivariate analyses were also conducted. Results95 patients were analyzed, of whom 32 were managed with PCN, 47 with stent, and 16 with URS. Maternal baseline characteristics were similar between groups, except for lower gravidity and parity in the stent group. Rates of premature delivery did not differ, but gestational age at delivery was lower in the PCN group versus the stent and URS groups (p = 0.006 and p = 0.025, respectively). Neonatal Intensive Care Unit (NICU) admission rates were higher in the PCN group versus the stent and URS groups (p = 0.006 and 0.036, respectively). Respiratory distress syndrome significantly differed between groups (p = 0.041). Neonatal birth weight, Apgar scores, and other complications did not significantly differ. ConclusionThis study demonstrated higher rates of NICU admissions and lower gestational age at delivery for neonates born to mothers managed with PCN compared to stent and URS. Larger multi-institutional studies are warranted to further explore these associations.

FREQUENCY OF BACTERIAL VAGINOSIS AMONG WOMEN PRESENTING WITH PRETERM LABOUR

Background: Preterm delivery is of major medical, economic, and social importance worldwide. The incidence is between 5–10% in most developed countries. Both short-term and long-term issues may arise from preterm delivery. Preterm delivery is the cause of almost 85% of long-term disabilities in healthy babies and 75% of new-born deaths. This study aimed to determine the frequency of bacterial vaginosis among women presenting with preterm labour. Methods: This cross-sectional descriptive study was conducted in Department of Obstetrics &amp; Gynaecology, Women Medical College, Abbottabad, and Women &amp; Children Hospital Abbottabad from Jun to Dec 2023. A total of 174 women with preterm labour were included in the study. All women were examined as per Amsel’s clinical diagnostic based on four factors, i.e., Thin grey homogeneous vaginal discharge, fishy smell on Amine test, clue cells of &gt;20% on microscopy, and vaginal pH&gt;4.5. Results: Age limit 15–45 years with mean age of 27.471±3.77 years, mean gestational age 29.546±3.45 weeks, mean parity 1.396±1.45 and mean Gravida was 2.396±1. Bacterial vaginosis was seen in 11.5% patients. Conclusion: There is a correlation between premature labour and bacterial vaginosis. It requires attention to lower morbidity and mortality. Pak J Physiol 2024;20(3):59–61, DOI: https://doi.org/10.69656/pjp.v20i3.1704

Prevalence of Bacterial Urinary Tract Infection among Pregnant Women in Wasit Province in Iraq

Background: Urinary tract infections (UTIs) are the most common type of infection during pregnancy. UTI include a spectrum of disorders, ranging from those affecting the lower urinary tract, like asymptomatic bacteriuria and cystitis, to those affecting the kidney, such as pyelonephritis. In pregnancy UTI can lead to preterm labor, anemia and septicemia. Escherichia coli is the most common pathogenic microorganisms associated with UTI and counting up to 60–80% of all UTIs. Objective: The aim of this study is to determine the prevalence of urinary tract infection (UTI) among pregnant women in wasit province. Materials and Methods: Mid-stream urine samples from 100 pregnant women who attending to Al- Shaheed Fairuz hospital and private clinics in wasit province between the periods of March 2024 to July 2024 with the age range of (16-35) years. The urine samples were cultured on MacConkey and blood agars then examined by Macroscopic and Microscopic examination by Gram's stain. The colonies were examined by biochemical tests (Oxidase, catalase, manitol salt agar, novobiocin tests, IMViC) and confirmatory tests (API 20E and API Staph) for isolates. Results: The results showed that the percentage of bacterial growth culture among the pregnant women was 33%. Gram negative bacteria were the higher percentage with (73%). Eschirishia coli bacteria were the most frequently isolated organism (40%) while, the lower percentage for Streptococcus spp. (3%). UTI in pregnant women was commonest in the age group 20-24 years (42%). According to trimesters of pregnancy, the highest percentage of UTI was in third trimester (43%) followed by second trimester (39%), while the the first trimest was the the lowest percentage with (18%). Conclusions: Urinary tract infections (UTIs) are common during pregnancy. Untreated UTIs can lead to complications such as preterm labor, low birth weight and sepsis. E.coli is the predominant pathogen presently causing urinary tract infections at all stages of pregnancy. Urine culture and sensitivity tests are mandatory for all pregnant women during the different trimesters.

The Influence of Prenatal Yoga Exercise on Mother Anxiety Pregnant

Anxiety during pregnancy not only affects the health of pregnant women but can also have an impact on the delivery process such as premature labor, prolonged labour, cesarean delivery, low birth weight. Based on WHO data, there are around 10% of pregnant women with psychological disorders and about 13% of postpartum women worldwide. This incidence is higher in developing countries in pregnant women, namely 15.6% and 19.8% in postpartum women. The purpose of this study is The Effect of Prenatal Yoga Exercise on the Anxiety of Pregnant Women at TPMB Mamah Suhaeriah in 2022. Research method This type of research uses the Pre-Experimental method with a one group pretest-posttest design approach. Sampling using total sampling with a total sample of 20 respondents. The research instrument used was an observation sheet. The data analysis used is the Wilcoxon Sign Rank Test statistical test. Research results based on the results of statistical tests using the Wilcoxon Sign Rank test, the p-value (0.000

Effects of Hydroxychloroquine on Maternal and Fetal Outcomes in Pregnant Patients with Lupus: A Systematic Review and Meta-Analysis

Background: The effects of hydroxychloroquine (HCQ) on maternal and fetal outcomes in pregnant patients with systemic lupus erythematosus (SLE) have not been fully elucidated in recent research. This study aimed to provide a more comprehensive evaluation of the efficacy and safety of HCQ in pregnant patients with SLE. Methods: A systematic search of relevant articles was conducted using Medline, Embase, Scopus, Web of Science, and the Cochrane Library from inception to October 4th, 2023. The risk of bias in the included studies was assessed using the Newcastle-Ottawa Scale or Cochrane's Quality Assessment Form. Data on maternal and fetal outcomes of the HCQ treatment groups (HCQ+) and control groups (HCQ–) were extracted, analyzed and evaluated. Pooled odds ratios (ORs), pooled relative risks (RRs), and weighted mean differences with 95% confidence intervals (95% CIs) were calculated for the meta-analysis using Stata/MP V.18. Results: This meta-analysis included 17 studies, involving a total of 2238 pregnant patients with SLE. Compared to the HCQ– groups, the HCQ+ groups exhibited a significant reduction in the incidence of preeclampsia (RR = 0.51, 95% CI: 0.37–0.71), high lupus activity (RR = 0.77, 95% CI: 0.64–0.92), gestational hypertension (OR = 0.41, 95% CI: 0.18–0.91), premature delivery (RR = 0.71, 95% CI: 0.60–0.84), and fetal growth restriction (OR = 0.61, 95% CI: 0.43–0.85). Additionally, the HCQ+ groups exhibited a significant increase in fetal birth weight of 0.21 kg (95% CI: 0.09–0.33). No significant differences were revealed in the other 15 pregnancy outcomes between the two groups. Conclusions: Despite the presence of a certain heterogeneity among the included studies, this study provides a more comprehensive evaluation of the efficacy and safety of HCQ in pregnant patients with SLE.

Diagnosis of 42 Cases of Intrauterine Twin Pregnancy Complicated With Ectopic Pregnancy: A Retrospective Cohort Study.

The coexistence of intrauterine twin pregnancy and ectopic pregnancy (EP), known as heterotopic pregnancy, is a rare but potentially life-threatening condition. In this study, we aimed to investigate the pregnancy outcomes in women with intrauterine twin pregnancies complicated with EP after assisted reproductive technology. This retrospective study analyzed the medical records of 42 women diagnosed with intrauterine twin pregnancies complicated with EP via ultrasound or surgery at our hospital between January 2005 and December 2020. We collected data on patient general characteristics, high-risk factors, clinical symptoms, ultrasound features, treatment methods, and pregnancy outcomes. Among the 42 included women, 47.6% (20/42) had a history of tubal surgery, while 52.4% (22/42) and 47.6% (20/42) received the transfer of 2 and 3 embryos, respectively. In terms of treatment, 21.4% (9/42) women received expectant management, whereas 78.6% (33/42) underwent surgical treatment, with laparoscopic surgery accounting for 71.4% (30/42). Tracking the pregnancy outcomes revealed a live birth rate of 81.0% (34/42) and a full-term birth rate of 50.0% (21/42). The preterm birth rate was 31.0% (13/42), with a breakdown of 1 singleton (7.7%, 1/13) and 12 twin births (92.3%, 12/13) among the total 13 premature deliveries. Among the neonates, 33.3% (14/42) were singletons and 47.6% (20/42) twins. Caesarean section accounted for 31 out of 34 deliveries (91.2%). Though the incidence of EP in twin pregnancies has declined in the last decade, early diagnosis and proper management are still crucial for favorable outcomes in twin pregnancies with EP.