Women In Third Trimester Research Articles

SUCCESSFUL MANAGEMENT OF SEVERE CONGENITAL FACTOR X DEFICIENCY DURING PREGNANCY AND LABOR WITH PCC IN TWO SISTERS

Factor X (FX) deficiency is an autosomal recessive disorder caused by quantitative or qualitative defects in the FX protein. FX deficiency has an estimated worldwide prevalence of one in 1000000. (1) Pregnancy in women with congenital FX deficiency has been associated with adverse fetal outcomes (abortion and preterm labor) (2,11). We report two cases of successful pregnancy with factor X deficiency. A 29-year-old woman with congenital factor X deficiency and prior abortion on prophylaxis PCC every 4 weeks. She was treated with PCC 25unit/kg twice weekly during the pregnancy course. At week 32 of pregnancy, she presented with labor pain. Lab showed PT 20.7 PTT 52.5 INR1.5 Fibrinogen 3.8 Hb13.8 platelet 195 WBCs 7.6 factor X 0.15. She was given PCC 25 units/kg until a level of 0.4 was achieved. She delivered a healthy, 1.9 kg baby by normal vaginal delivery. The estimated blood loss was 150 ml. She then received FX 15 units/kg for 3 days postpartum to maintain FX level >30% and INR <1.5. No episodes of abnormal bleeding were observed during pregnancy, labor or post-partum. A 36-years-old woman with congenital factor X deficiency and two prior abortions, on prophylaxis PCC every 4 weeks. She received prophylaxis PCC 25units/kg twice weekly during the course of this pregnancy. At week 38 of pregnancy, she delivered a healthy 3.2 kg baby by cesarean section (CS) after failing labor induction. Lab showed PT 23.7 PTT 50.4 INR1.7 Fibrinogen 2.3 CBC was normal.FX 0.13. She was given PCC 25 units/kg until a level of 0.4 was achieved. The estimated blood loss was 500 ml. She then received FX 15 units/kg for 7 days postpartum to maintain FX level >30% and INR <1.5. She was discharged on tranexamixc acid. No episodes of abnormal bleeding were observed during pregnancy CS or post-partum. Although FX activity increases during normal pregnancy, levels usually remain insufficient for hemostasis at delivery in women with severe FXD (4,5,6). FX replacement therapy with PCC or FX concentrate may be required to treat or prevent bleeding in FXD.Therefore, a therapeutic dose of PCC 20–30 iu/kg is expected to increase plasma FX activity by 0.4–0.6 iu/ml. Further infusions at 1- to 2-d intervals may be required if sustained treatment is necessary (3) . There are reports of FX replacement with PCC during pregnancy in women with previous adverse pregnancy outcomes (7,8) and FX replacement during labor with PCC or FFP, but with different regimens (9) . Our patients were treated with PCC prophylaxis during pregnancy and 25 units/kg during labor. No bleeding nor thrombosis was seen in both cases. The British guidelines recommend PCC 20–40 iu/kg during the third trimester for women with history of bleeding and with FX activity <03 iu/ml with the goal of achieving FX activity >04 iu/ml. They also recommend, to consider further PCC 10–20 iu/kg once daily to maintain FX activity >03 iu/ml for at least 3 days post-partum. (10) Prophylactic PCC resulted in excellent hemostasis in two of our patients, including one that delivered by C-section.

Assessment of Risk Factors in Pregnant Women in third Trimester in Baghdad City

Assessment of Risk Factors in Pregnant Women in third Trimester in Baghdad City

Gambaran Tingkat Kecemasan Ibu Hamil Pada Trimester III di Wilayah Kerja Puskesmas Banda Sakti

Pregnancy is a physiological process that occurs and experienced by women. During pregnancy there can be various psychological changes, anxiety is a common psychiatric condition and often occurs in pregnancy, especially during third trimester. The purpose of this study is to find out the anxiety level of pregnant women in third trimester at The Banda Sakti Health Center Work Area. The method used is descriptive research with cross sectional study approach. The sample in this study was 106 pregnant women. The sampling technique used is consecutive sampling. The results: majority of respondents were aged 20-35 years as many 74 people (69,8%), had high school as many 44 people (41,5%), unemployed as many as 82 people (77,4%), and majority of gestational age respondents were 28 weeks (43,4%). A total of 36 people (34%) experienced moderate anxiety, mild anxiety as many 31 people (29,2%), severe anxiety as many 16 people (15,1%), did not experience anxiety as many 23 people (21,7%). Based on status of gravida, multigravida as many 64 people (60,4%), primigravida as many 35 people (33%), and grandemultigravida as many 7 people (6,6%). Conclusion: the majority of multigravida pregnant women experience moderate anxiety with high school education level/equivalent, unemployed and gestational age were 28 weeks.

Stress and psychiatric morbidity in working and non-working pregnant women in third trimester

Background: Pregnant women experience dramatic changes both physically and mentally in preparation for birth and breastfeeding. Stress during pregnancy is known to affect the physiological and psycho-social health of the mother and also influences the fetal health. Stress during pregnancy is related to preterm birth (PTB), low birth weight and infant abnormalities. Working women are subject to duties and responsibilities both at home and work place leading to various psychological problems like role-conflict, job strain, mental fatigue and emotional disturbances. Methods: 150 Pregnant women in their third trimester of pregnancy attending the antenatal clinic of Kempegowda Institute of Medical Sciences, Bangalore were included for the study which consists of 75 working and 75 non-working. The scales used were A to Z Stress Rating Scale, Brief PHQ and semi structured sociodemographic profile. Results: The mean age with standard deviation was 25.12±2.96 for non working women and 26.84±3.09 for working women. The A-Z Stress Rating Scale (86.71±26.41) and Brief PHQ (12.27±4.16) in working women showed higher scores compared to non-working women which showed A-Z Stress Rating Scale (71.12±32.07) and Brief PHQ (10.09±5.52). They were also statistically significant

ASSOCIATION BETWEEN THIRD TRIMESTER MID-UPPER ARM CIRCUMFERENCE (MUAC) AND ANEMIA IN NEONATUS

Introduction: Nutritional problems in pregnant women in Indonesia reach 50%, this is still a concern. Based on Basic Health Research (Riskesdas) 2018, 17.5% CED pregnant women in Central Java. Mid-Upper Arm Circumference (MUAC) is an examination to determine nutritional status of pregnant women. Poor nutritional status can cause anemic neonates. According to research at RSUP Dr. Hasan Sadikin Bandung 2018, prevalence of anemic neonates is 14.5% which is still a problem. Objectives: This study aimed to determine relationship between MUAC in third trimester and incidence of anemic neonates. Methods: This study used a cohort study of pregnant women and neonates at Dr. Oen Solo Baru. The sampling technique was purposive sampling. The samples were 80 respondents with the independent variable being MUAC in third trimester and the dependent variable being anemic neonates. Data were analyzed using Spearman's correlative test. Results: In 40 (50%) respondents with normal MUAC which is 23.5 – 28.5 cm, there were 31 (77.5%) normal haemoglobin (Hb) neonates and 9 (22.5%) anemic neonates. In 40 people (50%) were malnourished which is &lt;23.5 cm, there were 13 (32.5%) normal Hb levels neonates and 27 (67.5%) anemic neonates. Based on statistical tests, there is a relationship between third trimester MUAC and incidence of anemic neonates with p = 0.000 (&lt;0.05) and the correlation coefficient value is 0.452 which indicates a sufficient correlation. Conclusions: The conclusion is there is a relationship between MUAC for pregnant women in third trimester and incidence of anemic neonates.

Ultrasound correlation of transcerebellar diameter with last menstrual period for gestational age in second and third trimester of pregnancy

Background: Foetal biometry is useful modality in assessment of gestational age (GA) for good obstetric outcome. Objectives: To compare ultrasonographic measurement of transverse cerebellar diameter (TCD) with other previously established foetal ultrasound biometric parameters. Methods: An analytical cross-sectional study was conducted from August 2020 to February 2021 in Department of Radiology at Kathmandu Medical College after ethical clearance. Convenience sampling technique was utilised to include all pregnant women in second and third trimester with known last menstrual period (LMP). Written informed consent was taken from those willing to participate. Congenital malformations, multiple pregnancies, irregular menstrual cycle, and maternal illness were excluded. Data were entered and analysed by using SPSS v.22. Descriptive statistics like mean, standard deviation, and percent were used. Inferential statistics (t- test and Pearson correlation) was also used to see the correlation between different variables. Results: Among 100 participants who participated in the study, 63 (63%) were primigravida with singleton pregnancy without any congenital anomalies. The mean foetal heart rate was 144.9 ± 13.6. The mean GA based on LMP, TCD, and other parameters were 30.86 ± 7.76 weeks, 31.07 ± 8.45 weeks, and 29.75 ± 6.61 weeks respectively. In 15-28 weeks, all parameters had nearly equal r-values. Among all, TCD revealed highest correlation (0.888). In 29-40 weeks, there was considerable difference in r-values. The second most accurate correlation was seen with head circumference (r = 0.874). Conclusion: TCD being stable parameter not affected by foetal growth status maybe preferred over other parameters in estimating foetal gestational age.

P-718 How do bicornuate uteri alter pregnancy, intra-partum and neonatal risks? A population based study of more than 3-million deliveries and more than 6000 bicornuate uteri

Abstract Study question What are the obstetrical outcomes in the third-trimester in women with bicornuate uteri based on analysis of the Healthcare-Cost and Utilization Project-Nationwide Inpatient Sample(HCUP-NIS)database? Summary answer Bicornuate uteri increased risks in pregnancy. Notably risks of premature-delivery, Cesareans, PPROM, placental-abruption, hysterectomy, SGA and IUFD were increased 250%-500%. What is known already Bicornuate uterus is the most frequent uterine malformation. Previous individual studies were mostly small and yielded conflicting results regarding the effect of bicornuate uterus on pregnancy outcomes. In a recent systematic review of all congenital anomalies, 124 pregnancies with bicornuate uteri were included, and it was associated with increased rates of first-trimester miscarriage preterm birth, and fetal malpresentation. Study design, size, duration This retrospective population-based cohort study utilizing data from the Healthcare-Cost and Utilization Project-Nationwide Inpatient Sample (HCUP-NIS) from 2010 to 2014, inclusive. There were 3,846,342 births between 2010 and 2014, included in the study. Six thousand and one hundred ninety five deliveries were to women with bicornuate uterus, and the remaining deliveries without other uterine anomalies were categorized as the reference group (n = 3,840,147). Participants/materials, setting, methods HCUP-NIS is the largest inpatient database in the USA and is comprised of hospitalizations throughout the USA. It provides information relating to seven-million inpatient stays yearly, includes 20% of admissions, and represents over 96% of the Americans. Multivariate logistic regression, was conducted to explore associations between bicornuate uteri and delivery outcomes and control for confounding effects. According to the Tri-Council Policy Statement (2018), IRB approval was not required, given data was anonymous and publicly available. Main results and the role of chance Pregnant women with bicornuate uteri were older and more likely to be obese (P = 0.0001) with previous CD (31% vs. 17.1%, P = 0.0001). After adjustment for confounders, they were more likely to experience pregnancy-induced HTN (aOR 1.21, 95%CI: 1.1-1.3, P = 0.0001), preeclampsia (aOR 1.4, 95%CI: 1.2-1.6, P = 0.0001) and placenta previa (aOR 1.7, 95%CI: 1.3-2.2, P = 0.0001). Moreover, women with bicornuate uterus were more likely to deliver preterm (aOR 2.8, 95%CI: 2.6-3.1, P = 0.0001), deliver by CD (aOR 5, 95%CI: 3.1-4.1, P = 0.0001), experience PPROM (aOR 3.5, 95%CI: 2.6-3.1,P=0.0001), and have a placental abruption (aOR 3.0, 95%CI: 2.5-3.5, P = 0.0001). There were increased risks of PPH (aOR 1.4, 95%CI: 1.2-1.6, P = 0.0001), wound-complications (aOR 2.0, 95%CI: 1.5-2.7, P = 0.0001), hysterectomy (aOR 2.6, 95%CI: 1.6-4.1, P = 0.0001), blood-transfusion (aOR 1.7, 95%CI: 1.5-2.1, P = 0.0001), and DIC(aOR 1.6, 95%CI: 1.1-2.5), P = 0.014) in the group with bicornuate uteri. Pregnant women with bicornuate uterus had a higher risk of SGA (aOR 2.9, 95%CI: 2.6-3.2, P = 0.0001) and IUFD (aOR 2.5, 95%CI: 1.8-3.3, P = 0.0001). There was no increased risk for chorioamnionitis (P = 0.47) or maternal infection (P = 0.8) in women with bicornuate uteri. Limitations, reasons for caution This is a retrospective analysis utilizing an administrative database that relies on data coding accuracy and consistency. Wider implications of the findings The present study demonstrates that women with bicornuate uteri tend to deliver preterm, by CD, and with increased probability of PPROM or abruption placenta. Neonatal outcomes were also worse in women with bicornuate uteri including a 250%-300% increase in the risk of SGA and IUFD. Trial registration number Not Applicable

Factors associated with poor sleep quality and excessive daytime sleepiness in late pregnancy: A pilot study in an antenatal unit

Objectives: To assess factors associated with poor sleep quality and excessive daytime sleepiness (EDS) in late pregnancy.Methods: A cross sectional study was carried out on 109 pregnant women in their third trimester admitted to Teaching Hospital Peradeniya using validated Sinhala translations of both Pittsburgh Sleep Quality Index (PSQI) and Epworth Sleepiness Scale (ESS). Consecutive sampling was used from February to April 2021.Results: Application of PSQI demonstrated that 59.6% had a poor overall sleep quality (PSQI score&gt;5). Subcomponent analysis showed poor sleep duration (&lt; 06 hours per day) in 27.5%, sleep latency of over 30 minutes in 29.4%, poor sleep efficiency among 33.9% and day-time dysfunction in 30.3%. Poor overall sleep quality was associated with presence of foetal movements (OR=11.8, 95% CI=1.5-93.5) and backache (OR=3.8, 95% CI=1.2-12.3). Poor sleep duration was associated with the presence of one or more pregnancy related complications (OR=3.4, 95% CI=1.4-8.5) and advanced maternal age over 35 years (OR=3.7, 95% CI=1.4-9.7). Increased sleep latency over 30 minutes was seen in mothers over 34 weeks of gestation (OR=9.1, 95% CI=2.9-28.6) and over 10kg of weight gain (OR=5.3, 95% CI=1.2-24.4). Application of ESS demonstrated 26.6% had EDS, which was associated with maternal employment (OR=2.8, 95% CI=1.1-7.1) and higher educational status (OR=4.7, 95% CI=1.5-15.1). EDS did not result in poor sleep quality, however, mothers experiencing insomnia had a higher PSQI score (Mean ± SD 7.2±3.7 vs 6.2±3.4 hours, p=0.044).Conclusion: Majority of pregnant women in third trimester had poor overall sleep quality. EDS was seen among one fourth. Modifiable risk factors were associated with poor sleep quality and EDS.

Evaluation of Doppler Indices for Umbilical Artery in Hypertensive Women in Third Trimester of pregnancy

Background: The hypertensive disorders affect pregnant women and can create complications for the women in last trimester of pregnancy. To assess the impact of high hypertension, doppler scan is recommended in the third trimester.&#x0D; Objective: Present explores values of PSV, EDV, S/D ratio, RI and PI among normotensive and hypertensive pregnant women during third trimester of pregnancy in Islamabad, Pakistan.&#x0D; Material and Methods: A Cross-sectional study was conducted at PIMS hospital Islamabad with objectives to evaluate doppler indices in fetal umbilical artery among hypertensive pregnant women in the third trimester of pregnancy. Data were collected from 1st February 2022 to 15th May 2022. A total of 93 pregnant women were recruited from already registered at maternal child health care center of PIMS and recommended for doppler indices scan. Toshiba Aplio 300 Ultrasound System was used for the assessment. Data about S/D ratio, RI and PI was analyzed by using IBM SPSS® software platform.&#x0D; Results: Mean Age of pregnant women in our study conducted was 26.722 ± 4.133. Also the mean gestational week for pregnant women was 32.163 ± 2.35. Doppler indices were significantly raised in hypertensive women as compared to normotensive women. Doppler indices i.e. Pulsatility Index (Mean 1.049 ± 0.312 vs 1.360 ± 0.421), Resistivity Index (Mean 0.631 ± 0.114 vs 0.743 ± 0.01), Systolic/Diastolic flow (Mean 2.672 ± 0.512 vs 3.818 ± 0.986) were increased in third trimester of hypertensive women as compared to normotensive patients.&#x0D; Conclusion: In this study, among doppler indices pulsatility index and resistivity index were identified as significant after applying null hypothesis test. Doppler ultrasound should be used to identify vascular resistance and evaluating degree of fetoplacental blood flow in hypertensive pregnant women.

Prenatal stress perturbs fetal iron homeostasis in a sex specific manner

The adverse effects of maternal prenatal stress (PS) on child’s neurodevelopment warrant the establishment of biomarkers that enable early interventional therapeutic strategies. We performed a prospective matched double cohort study screening 2000 pregnant women in third trimester with Cohen Perceived Stress Scale-10 (PSS-10) questionnaire; 164 participants were recruited and classified as stressed and control group (SG, CG). Fetal cord blood iron parameters of 107 patients were measured at birth. Transabdominal electrocardiograms-based Fetal Stress Index (FSI) was derived. We investigated sex contribution to group differences and conducted causal inference analyses to assess the total effect of PS exposure on iron homeostasis using a directed acyclic graph (DAG) approach. Differences are reported for p < 0.05 unless noted otherwise. Transferrin saturation was lower in male stressed neonates. The minimum adjustment set of the DAG to estimate the total effect of PS exposure on fetal ferritin iron biomarkers consisted of maternal age and socioeconomic status: SG revealed a 15% decrease in fetal ferritin compared with CG. Mean FSI was higher among SG than among CG. FSI-based timely detection of fetuses affected by PS can support early individualized iron supplementation and neurodevelopmental follow-up to prevent long-term sequelae due to PS-exacerbated impairment of the iron homeostasis.

Voice, Speech, and Clinical Aspects During Pregnancy: A Longitudinal Study

Pregnancy involves anatomical, physiological, and metabolic changes in a woman's body. However, the effects of these changes on the voice remains unclear, particularly regarding the clinical characteristics. We aimed to evaluate changes in vocal and speech acoustic measures and the relationship between them and clinical aspects in women during pregnancy. A prospective, longitudinal study was carried out with 41 low risk, adult, pregnant women, followed for prenatal care. Demographic and anthropometric data as well as lifestyle habits and health conditions were collected. Voice recordings of sustained vowels, and automatic and spontaneous speech were held over each trimester and analyzed by PRAAT®to evaluate acoustic, aerodynamic, and articulatory measures. There were no changes in fundamental frequency, jitter, shimmer, and harmony to noise ratio during pregnancy. Maximum phonation time (MPT), pause rate, and pause duration reduced at the end of pregnancy. MPT was lower in sedentary pregnant women. The fundamental frequency peak rate was higher in eutrophic participants and lower in the third trimester in women with BMI ≥25 kg/m2. Pause rate was higher in pregnant women with BMI ≥25 kg/m2. There was no relationship between sleep quality, reflux, and vocal symptoms and acoustic and aerodynamic measures. Differences were shown in MPT and temporal pause measurements during pregnancy. Acoustic measurements did not change. There was a relationship between acoustic and aerodynamic measures and clinical variables (BMI, physical activity, and body mass gain).

The psychological impact and perception of COVID -19 pandemic on pregnant women presenting to a tertiary care hospital, KPK, Pakistan.

Purpose: To determine the psychological impact and perception of covid -19 pandemic on pregnant women presenting to a tertiary care hospital, KPK, Pakistan.&#x0D; Methodology: An observational cross-sectional study was conducted on pregnant women in the outpatient department of Lady Reading Hospital, Peshawar from 1st February 2020 to 31st March 2021. All pregnant women (n=424) visiting gynae OPD who fulfilled the inclusion/exclusion criteria were included. The questionnaire was filled out by physicians for patients and the Kessel-10 scale was used to classify the anxiety.&#x0D; Findings: Fifty one 51% females fall in the 19-25 years age group. 54.5% were illiterate with most of the women (94.6%) being housewives. The majority of the 424 women in the study were multiparous (59%) and 59.1% presented in their third trimester. The highest number of patient women in the age group 19-25 years suffered mild distress. Moderate stress was found in 54 women. In all age groups, a total of 11 patients suffered severe psychological distress. 144 women reported having no stress. Nulliparous women were 109 in total and most of them had either mild disorder (n=54) or no stress at all (n=48). the majority of ladies who were housewives stated that they have been mildly stressed (n=208) or not stressed at all (n=139). A total of 11 women had faced severe stress. 247 women had third-trimester pregnancies and most of them (n=129) had mild stress. Severe distress affected 8 of the third-trimester women and 3 of the 2nd-trimester women. Most women (71.9%) believed that elective Cesarian surgery is not better than vaginal delivery during the covid -19 pandemic. COVID-19 pandemic has created anxiety in more than half (53%) of pregnant women visiting OPDs. The literacy rate and occupational status of women had little effect on the occurrence of psychological distress.&#x0D; Recommendations: Strict SOPs must be observed in hospitals and pregnant women should receive counseling regarding their fears and anxiety from medical care-takers. More studies are needed to measure mental health challenges in pregnant and postpartum women, as well as the resilience and risk factors associated with beneficial outcomes, to attenuate the pandemics' long-term mental health impacts.

Asymptomatic Bacteriuria (ASB) in Pregnancy: Prevalence and Fetal Risk

Objective: To evaluate the prevalence of Asymptomatic Bacteriuria (ASB) and its association with fetal outcome at tertiary care Hospital. Material and Methods: This was a descriptive cross-sectional study was conducted at the Obstetrics and Gynaecology department of Liaquat University of Medical and Health Sciences for six months from February 2021 to August 2021. Total 2838 pregnant women in third trimester (more than 28 weeks of gestion) whose urine sample were taken, aged 18 to 41 years of either parity or booking status were included. Following the clinical examination, the investigator gave each mother a labeled sterile container and instructed them about how to obtain midstream urine, after that the urine samples were obtained and were sent to the Hospital diagnostic laboratory for the urine culture. A positive culture of each case was considered Asymptomatic Bacteriuria (ASB). All the data were gathered using the self-made study proforma. SPSS version 26 was used to analyze the data. Results: Total 2838 women were assessed regarding Asymptomatic Bacteriuria (ASB), and the overall incidence of Asymptomatic Bacteriuria (ASB) was (5.32%). Mean age of the women was 27.70+4.83 years and the average gestational age was 37.11+2.91 weeks. Most of the females were primiparous 90(59.6%). Majority of the cases 93(61.6%) were un-booked. As per fetal complications 31(20.5%) new born were low birth weight babies, PROM was 22(14.6%) and preterm deliveries were 28(18.5%). Fetal complications were statistically significant according to maternal age and gestational age (p-&lt;0.05), while they were statistically insignificant according to parity and booking status (p-.0.05). Conclusion: Asymptomatic Bacteriuria (ASB) was observed to be 5.32%. Asymptomatic Bacteriuria (ASB) observed to be the causative factor for adverse fetal outcome. Urine culture should be done during the antenatal care to improve the fetal outcome by early diagnosis and management. Keywords: Asymptomatic Bacteriuria (ASB), incidence, fetal complications

Investigating the relationship between Vitamin D level and Polycystic ovarian syndrome- A case control study

Accurate gestational age estimation improves other and foetal care. Most commonly employed fetal parameters for estimation of gestational age, intrauterine growth and fetal weight are biparietal diameter (BPD), head circumference (HC), abdominal circumference (AC) and femur diaphysis length (FL). The objective of the present study was to evaluate the correlation of BPD and FL with gestational age in the population of Chhattisgarh state of India. In present study, 380 pregnant women of second and third trimester of pregnancy with known last menstrual period (LMP) had undergone routine ultrasonography for evaluation of Biparietal Diameter and Foetal Length. Biparietal Diameter and Foetal length was noted and correlation with gestational age was calculated. We observed a total of 158 cases in 2nd trimester and 220 cases were in 3rd trimester of pregnancy and they were aged between 18 and 35 years (two cases excluded). Mean of Biparietal diameter and FL observed was 73.1mm (±12.8 standard deviation and 11.6 standard error) and 56.2 (±0.63 standard deviation and 0.57 standard error) respectively. There was a strong positive correlation between gestational age and BPD (0.980). Correlation was maximum between 20 to 24 weeks of gestation (r=0.987) and minimum between 35 to 38 weeks of gestation (r=0.947). Ultrasonographic measurements of BPD and FL corelates with gestational age in second and third trimester (r value 0.980, 0.987 for, BPD and FL respectively). Correlation between Biparietal Diameter (BPD) and Gestational age consequently decreases according to gestation age from 20 weeks to 38 weeks. Correlation is maximum between.

Effect of Nursing Intervention Package on Prevention of Uterine Prolapse among Pregnant Women in Third Trimester

Effect of Nursing Intervention Package on Prevention of Uterine Prolapse among Pregnant Women in Third Trimester

The Effect Of Progressive Muscle Relaxation and Slow Deep Breathing Combinations on Sleep Quality of Pregnant Women

Several studies suggest that poor sleep quality has an impact on both the mother and the fetus. Providing relaxation exercises in the form of progressive muscle relaxation and slow deep breathing can be a non-pharmacological effort to improve sleep quality in pregnant women. This study aims to analyze the effect of a combination of progressive muscle relaxation and slow deep breathing in pregnant women of third trimester. This research method is pre-experimental designs with a pretest-posttest control group design. The number of samples was 24 pregnant women trimester III with the sampling technique using consecutive sampling. The independent variable is the provision of progressive muscle relaxation and slow deep breathing exercises which are carried out for 3 times on a week over a period of 3 weeks. The dependent variable is sleep quality which is measured using the Pittsburgh Sleep Quality Index questionnaire. Data analysis used the Wilcoxon signed rank test. The results showed a decrease in the mean value in the direction of improved sleep quality by a difference of 4.5 in the experimental group. Whereas in the control group there was an increase in the value which led to a deteriorating sleep quality by a difference of 1.42. The test results showed a difference in the pretest and posttest of the two groups p = 0.000 (p &lt;0.05). These data indicate that there is an effect of a combination of progressive muscle relaxation and slow deep breathing on the sleep quality pregnant women of third trimester.

Study on types of anaemia and foetomaternal outcome in antenatal patients.

ABSTRACTAnemia is the most common haematological disorder in pregnancy. Anemia increases maternal morbidity and mortality. It is a condition that can be diagnosed and treated during antenatal period, preventing the serious complications of anemia during pregnancy and labour.Aims:This study investigated the prevalence of types of anemia during pregnancy and fetomaternal outcomes among pregnant women.Study Design:This was a cross-sectional study that enrolled 1100 pregnant women who were in the third trimester of pregnancy with haemoglobin level <11.0 gm/dl between March 2019 and August 2020.Methods and Material:Participants were selected by consecutive sampling and baseline data were collected by using a predesigned and pretested structured questionnaire.Data Analysis:Data were entered and analysed by using SPSS version 20.Results:The prevalence of anemia in third-trimester pregnancy in this study was 91.05%. Iron deficiency anemia was most common (69.18%) among pregnant women followed by megaloblastic anemia (2.5%). Most of pregnant women (45.90%) were mildly anemic. Mean ± SD of haematological parameters among the anemic pregnant women during third trimester of pregnancy were haemoglobin (8.08±2.24 gm/dl), haematocrit (28.92±7.78%), mean corpuscular volume (MCV) (93.02±11.32fl), mean corpuscular haemoglobin (MCH) (26.03±2.90 pg), mean corpuscular haemoglobin concentration(MCHC) (27.99 ± 2.01 gm/dl), RBC count (3.05 ± 0.67million/mm3). Most common maternal complications due to anemia in pregnancy was preterm labour (30%). Fetal outcome in the form of an alive term, most commonly seen in mild anemia (34.7%), fetal complications like Preterm alive (11.3%), preterm intrauterine fetal death (IUFD) (2.7%) most commonly associated with severe anemia.Conclusion:The present study concludes that the prevalence of anemia among pregnant women in third trimester of pregnancy was 91.05% which is a serious public health problem. Proper counselling to the patients and their family members regarding cause of anemia, effect of anemia and complications of anemia. So, that such preventable condition can be prevented.

Influenza vaccination among pregnant women in two hospitals in Sydney, NSW: what we can learn from women who decline vaccination.

Pregnant women are recognised as being at risk of serious illness from influenza. Despite this, and longstanding national recommendations for vaccination in pregnancy, vaccine uptake remains suboptimal. This study aims to determine factors associated with women declining influenza vaccination in pregnancy. We surveyed pregnant women from antenatal clinics at two Sydney hospitals as part of an evaluation of the New South Wales (NSW) Health 2017 influenza vaccination in pregnancy campaign. Factors associated with a woman's decision to decline influenza vaccination were assessed using Pearson's chi-square test and multivariable logistic regression. Among 642 women surveyed, 58% self-reported influenza vaccination during pregnancy and 19% reported they had declined vaccination. Factors associated with a decision to decline vaccination included lack of a recommendation from a maternity care provider (adjusted odds ratio [aOR] 6.06; 95% confidence interval [CI] 3.50, 10.50), recommendation against vaccination (aOR 4.17; 95% CI 2.07, 8.38), having never previously been vaccinated for influenza (aOR 2.75; 95% CI 1.64, 4.59) and, among third-trimester women, not having been vaccinated for pertussis (aOR 2.55; 95% CI 1.32, 4.89). On univariate analyses, women who declined vaccination were more likely to disagree or feel uncertain about vaccine safety or effectiveness compared with women who chose to be vaccinated. Recommendations from maternity care providers remain key to a woman's decision to be vaccinated for influenza during pregnancy. Time should be allocated for vaccine discussions early in pregnancy as part of routine care. Continued efforts are needed to improve messaging to pregnant women on the benefits, safety and efficacy of influenza vaccination.

Vitamin B12 in Pregnancy and its Relationship with Maternal BMI and Gestational Diabetes Mellitus

Objectives:To determine the levels of vitamin B12 in pregnant women and to explore the relationship of vitamin B12 with maternal BMI and gestational diabetes mellitus.Methods:This cross-sectional study was conducted at Department of Physiology, UHS, Lahore from February 2019 to March 2020. Ninety pregnant women in early third trimester of pregnancy were selected. Forty-five women had gestational diabetes and forty-five were healthy pregnant women. Serum vitamin B12 and fasting blood glucose (FBG) levels were determined by ELISA and glucose oxidase method respectively. 1st trimester BMI was also recorded. SPSS version 23 was used to analyze the data.Results:Serum vitamin B12 was significantly lower in GDM group (149.41±13.66) as compared to non-GDM group (357.49±42.07). BMI was significantly higher in GDM group (32.94±2.10) as compared to non-GDM group (23.52±1.83). Significant negative correlation (-0.78**) was observed between 1st trimester BMI and vitamin B12 in late pregnancy. Regression analysis revealed that high BMI was associated with decrease in vitamin B12 and increased risk of gestational diabetes mellitus (3.26***). Moreover, vitamin B12 was partially mediating the relationship between BMI and FBG.Conclusion:Low vitamin B12 levels have an association with maternal BMI and gestational diabetes mellitus.

A randomized controlled trial on the effect of blue-blocking glasses compared to partial blue-blockers on melatonin profile among nulliparous women in third trimester of the pregnancy

ObjectiveIn pregnancy melatonin regulates circadian rhythms, induce sleep, and has a neuroprotective positive effect on fetal development. Artificial blue light in the evening delays and suppresses melatonin production. Thus, we investigated the effect of blocking blue light on the melatonin profile. MethodsA randomized controlled trial (n=30 blue-blocking glasses vs. n=30 control glasses with partial blue-blocking effect) including healthy nulliparous pregnant women in the beginning of the third trimester. Salivary melatonin and subjective sleep were measured before and after two weeks of intervention/control condition. Saliva was sampled at 30-min intervals from 3 h before normal bedtime. Melatonin onset was set at 4.0 pg/ml. ResultsDue to missing data melatonin onset was estimated for 47 participants. At posttreatment, melatonin onset advanced by 28 min in the blue-blocking group compared with the control condition (p=.019). Melatonin levels were significantly higher, favoring the blue-blocking glass condition, at clock time 20:00, 21:00 and 22:00 h, and for sample number 3 and 4. The phase angle (time interval) between melatonin onset and sleep bedtime and sleep onset time increased within the blue blocking group (+45 min and +41 min, respectively), but did not reach statistical significance compared to control condition (+13 min and +26 min, respectively). ConclusionBlocking blue light in the evening had a positive effect on the circadian system with an earlier onset and rise of melatonin levels in healthy nulliparous pregnant women. This demonstrated the effectiveness and feasibility of a simple non-pharmacological chronobiological intervention during pregnancy.