Pregnant Women Research Articles

A clinical study to evaluate the efficacy of Shaliparnyadi Yusha in Garbhini Parshwagraha (Flank Rigidity with Lower Back Pain) During the Second and Third Trimester

This study investigates the efficacy of Shaliparnyadi Yusha, a traditional Ayurvedic formulation, in the management of Garbhini Parshwagraha (flank rigidity associated with lower back pain) during the second and third trimester of pregnancy. The study was conducted on 32 patients, with outcomes measured by reductions in pain and improvements in mobility. The results indicate significant relief of symptoms, supporting the use of this Ayurvedic therapy for pregnant women experiencing discomfort due to musculoskeletal strain.

PREVALENCE AND RISK FACTORS OF HEPATITIS C INFECTION AMONG PREGNANT WOMEN IN ILORIN, KWARA STATE, NIGERIA

Hepatitis C virus (HCV) poses a significant risk to the well-being of pregnant women and their offspring with about 1.5 million new infections occurring annually. The data on the prevalence and associated risk factors among pregnant women in Nigeria remains limited. This study therefore aimed to determine the prevalence and associated risk factors of hepatitis C infection among pregnant women in Ilorin, Kwara State, Nigeria. This cross-sectional study enrolled 180 eligible pregnant women who visited and received antenatal care at Cottage and Civil Service Hospitals in Ilorin, Nigeria between November 2021 and January 2022. Demographic and clinical data were collected using a structured questionnaire while the antibody screening was via Enzyme-Linked Immunosorbent Assay (ELISA). The data were analyzed with IBM SPSS version 26 at p<0.05 significant level. Of the 180 pregnant women, 8 (4.4%) were positive for HCV. The highest proportion of HCV positivity was recorded among women aged 20-30 years (75%), those with tertiary education (100%), Civil Servants (100%), married women (100%), and those in the second trimester gestational age (100%). Furthermore, 87.5% of HCV-positive patients had a history of blood transfusion and 62.5% reported scarification. However, no significant statistical association was recorded between demographic characteristics, risk factors, and HCV seropositivity (p ˃ 0.05). Although the prevalence of active HCV infection among pregnant women in Ilorin was low, the outcome underscores the importance of routine screening of pregnant women for HCV to prevent maternal and neonatal complications in line with Sustainable Development Goal 3 on good health and wellbeing. This warrants further research for comprehensive data on HCV prevalence among pregnant women across Nigeria.

Profile of triple elimination in maternal at Wangaya regional hospital in 2023

Background: Triple elimination is a program implemented by the Ministry of Health of the Republic of Indonesia, this program was adopted from the World Health Program or WHO to combat the transmission of HIV (Human immunodeficiency virus), syphilis and hepatitis B in pregnant women to their babies The aim of this study of this research is to determine the profile of pregnant women who undergo triple elimination testing. Methods: This study was a descriptive observational study with a retrospective study design. The data was collected from the medical records of pregnant women at Wangaya Regional Hospital from January 2023 to December 2023. Results: In this study involving 101 subjects, in this study, there were 65 people who underwent triple elimination examination and 36 people did not undergo triple elimination. These included HIV with 13 cases (12.8%) and hepatitis b with 4 cases (3.9%) and syphilis with 2 cases (1.98%). Conclusions: The triple elimination screening is a mandatory examination for pregnant women conducted during the first trimester of pregnancy. Pregnant women who do not undergo the triple elimination screening may lack knowledge, sufficient information and proper education and communication from healthcare providers about the triple elimination program. Improving these factors will enhance pregnant women's motivation to utilize and access healthcare services.

The effect of coronavirus disease 2019 vaccination on pregnant women: A scoping review

Background: Globally, reports have shown that pregnant women refuse to receive the coronavirus disease 2019 (COVID-19) vaccine. This has posed a significant concern given the global impact of the COVID-19 pandemic.Aim: This study aims to explore the current evidence on the effect of COVID-19 vaccination on pregnant women.Method: A scoping review was conducted using Levac et al.’s five-stage framework. Relevant articles were searched in the Web of Science, PubMed, Scopus and EBSCOhost (CINAHL) databases. The identified articles were screened based on predetermined inclusion and exclusion criteria. Data from the selected articles were charted and summarised into meaningful units.Results: Twelve articles from developed countries were included in the review. Studies have reported that COVID-19 vaccination during pregnancy is generally safe and does not increase the risk of pregnancy complications. There was no significant difference in delivery outcomes between vaccinated and unvaccinated women. Neonatal outcomes were not affected by the vaccination. However, one study identified a potential risk of spontaneous abortion between 6 and 9 weeks of gestation among vaccinated women.Conclusion: Coronavirus disease 2019 vaccination is considered safe during pregnancy. While some studies have identified potential associations with certain conditions, the overall benefits of vaccination outweigh the risks. Continued monitoring of the safety and effectiveness of COVID-19 vaccines during pregnancy is recommended. Pregnant women should consult healthcare providers to make informed decisions regarding vaccination.Contribution: The findings of this review may assist in alleviating anxiety and reducing vaccine hesitancy among pregnant women.

Evaluation of Neonatal and Maternal Outcomes in Pregnant Women with COVID-19 in Southern Iran: A Case-Control Study

Background: Pregnant women and their fetuses are considered high-risk populations during pandemics, including coronavirus disease 2019 (COVID-19). Objectives: This study aims to evaluate maternal and neonatal outcomes among pregnant women infected with COVID-19. Methods: This descriptive, analytical, retrospective case-control study included COVID-19-infected pregnant women referred to hospitals affiliated with Shiraz University of Medical Sciences in southern Iran from March 2021 to March 2022. Data were collected using a pre-designed checklist covering demographic information and maternal and neonatal outcomes. Analyses were performed using SPSS version 25, with the significance level set at P < 0.05. Results: Significant differences were observed in maternal and neonatal outcomes for variables such as vaginal bleeding, fetal distress, premature birth, intrauterine death, ICU admission, low birth weight, and NICU admission (P < 0.05). Although neonatal transient tachypnea and pneumonia were more than twice as common in infants of COVID-19-infected mothers compared to controls, these findings were not statistically significant (P > 0.05). Similarly, abnormal lung X-rays, thrombocytopenia, and positive CRP were slightly more frequent in infants born to COVID-19-infected mothers, but these differences did not reach statistical significance (P > 0.05). Conclusions: The study highlights the increased risks of adverse short-term and long-term maternal and neonatal outcomes associated with COVID-19 during pregnancy. Prioritizing pregnancy-specific interventions is crucial in pandemic management to mitigate these risks and improve outcomes for both mothers and their infants.

Management guidelines for pregnant women living with epilepsy: An integrative literature review

Background: Epilepsy affects more than 50 million people worldwide, with a significant number of safety-related concerns arising in pregnant women. Precise management needs to include a vast array of stepwise protocols; however, no studies have been conducted to compare current South African guidelines to international norms.Aim: The aim of this integrative literature review was to identify discrepancies, if any, in the current protocols for treating pregnant women with epilepsy within the public sector of South Africa when measured against global standards.Method: An integrative literature review was conducted using the Whittemore and Knafl method. The following databases and search engines were used: PubMed, EBSCOhost, Science Direct, Medscape, African Journals Online, Cochrane Library, Google scholar, Google and MedlinePlus. The study included qualitative literature from all levels of evidence from 2006 to 2023. The data were evaluated using the PRISMA flow chart and analysed using the Cooper method. On completion of critical appraisal, 22 articles met the inclusion criteria and were analysed thematically.Results: The review identified several areas that can be enhanced to improve patient management and outcomes such as therapeutic drug monitoring and targeted dosing, folic acid supplementation, the use of antepartum vitamin K, high-resolution ultrasounds, elimination of sodium valproate in women of childbearing potential, monotherapy and endorsing frequent obstetrician visits.Conclusion: The study validated many differences between guidelines used in South Africa and internationally. Some of the prominent findings included areas focused on patient medication, screening, physician visits and pharmacovigilance.Contribution: The findings can be used to enhance and provide evidence-based recommendations in the areas that are not well developed within the current guidelines.

General practitioners’ barriers to cross-sectoral collaboration on pregnant women with vulnerabilities: a cross-sectional survey in Danish general practice

Background Pregnancy vulnerability contributes to poor perinatal mental health. Proper cross-sectoral collaboration may mitigate perinatal mental health problems. General practitioners (GPs) often face barriers when assessing pregnancy vulnerability, but little is known about GPs’ perceived barriers to the cross-sectoral collaboration on vulnerable pregnant women. Objective To explore GPs’ barriers to cross-sectoral collaboration on pregnant women with vulnerabilities, and how barriers are associated with the organization of antenatal care (ANC) and general practice characteristics. Design, setting and subjects A cross-sectional questionnaire study among Danish GPs (n = 3465). Main outcome measures Descriptive statistics according to the Theoretical Domains Framework describes the barriers to collaboration. Analytical statistics with ordered logistic regression models demonstrate associations between selected barriers (the main outcome measures) and organization of ANC, GP and practice, characteristics. Results A total of 760 GPs (22%) participated. Perceived GP barriers to collaboration were lacking knowledge of ANC levels relevant to vulnerable pregnant women, insufficient information on vulnerability indicators from collaborating parties, heavy workload and insufficient remuneration for collaborative meetings. Being young were associated with insufficient GP knowledge of ANC levels. Old age was associated with less likelihood of experiencing heavy workload as a barrier. Conclusions Barriers to collaboration on vulnerable pregnant women were associated with some GP-organizational characteristics including low experience in collaborating with partners in ANC, and GP characteristics, such as age. Reducing general practice workload, e.g. by reorganizing priority areas, releasing more time to vulnerable patients, and improving cross-sectoral information sharing on vulnerability might improve collaboration on vulnerable pregnant women.

Malaria pervasiveness in Sub-Saharan Africa: Overcoming the scuffle.

Malaria has posed a momentous health and economic burden to the Sub-Saharan African region. The Sub-Saharan African region accounts for more than 90% of global malaria-related mortality and morbidity. Pregnant women and children under 5 years old are the most vulnerable. Mosquitoes transmit the plasmodium which is the parasite responsible for malaria. The climatic conditions, poverty, and poor healthcare system of the Sub-Saharan African region are some factors fueling this menace. There have been concerted efforts to annihilate malaria but the scuffle has been a tedious one. Malarial eradication campaigns have been focused on mosquito control through the use of insecticide-treated bed nets, use of indoor insecticide sprays, and use of larvicides. The use of artemisinin in combination with other drugs has been effective to some extent. Despite the aforementioned strategies, the pervasiveness of malaria infection in the Sub-Saharan African region is worrisome. Thus, strengthening the already existing control measures, finding novel measures through intensive research, and embracing malaria vaccination could help accelerate the overcoming of this scuffle. In this review, we utilized relevant published data from various databases to reexamine the factors fueling malaria pervasiveness in this region and spelled out point-by-point intervention protocols to end malaria scuffle.

Indigenous Practices of Women during Pregnancy, Labour and Puerperium among Cultural Groupings at Selected Hospitals in Limpopo Province, South Africa

Indigenous practices are performances that occur naturally in a region. Most women believe in Indigenous practices because of their cultures and social structure. In South Africa, regardless of the availability and accessibility of maternal and child health services, 50% of women still consult traditional birth attendants as their first choice during pregnancy, labour, delivery and postnatal care. A qualitative research approach was applied with an explorative and descriptive design to explore the Indigenous practices of women during pregnancy, labour and puerperium among cultural groupings. Non-probability purposive sampling was used to select 25 participants and data was collected through semi-structured interviews with a guide until data saturation was reached. Data was analysed using tech’s open coding method. The study showed most women use Indigenous practices for protection against witchcraft and a fear of caesarean section. This study will help pregnant women to be aware of the harmful Indigenous practices that can affect their own health and that of their baby. It will also help nurses provide holistic nursing care, taking into consideration pregnant women’s cultures and beliefs. The study recommends that nursing education include Indigenous practices in the curriculum so that healthcare practitioners know about them. This could reduce maternal and child morbidity and mortality.

Comparison of chromosomal microarray and karyotyping in prenatal diagnosis using 491 amniotic fluid samples.

This study was aimed to investigate the performance of chromosomal microarray analysis (CMA) in prenatal diagnosis compared with traditional karyotyping analysis. Both CMA and karyotyping analyses were performed to detect the karyotypes in the amniotic fluid of 491 pregnant women who got prenatal diagnosis at the Center of Prenatal Diagnosis of Shangrao (China) during January 2019 to April 2021. After excluding 2 samples in the CMA analysis and 2 samples in the karyotyping analysis which were failed in detection, the remaining 487 amniotic fluid samples were detected. Both CMA and karyotyping analyses identified 22 cases of aneuploidy chromosome abnormalities, including trisomy 21 (10 cases), trisomy 18 (4 cases), sex chromosome abnormality (5 cases), and other chromosome abnormalities (3 cases). In addition, CMA and karyotyping analyses found 8 cases of fetal chromosomal imbalance. Interestingly, abnormal results were detected by CMA analysis in 10 cases whose results were normal by karyotype analysis. Furthermore, 23 cases of copy number variation (CNVs) with variation of unknown clinical significance (VOUS) were detected by CMA, which accounted for 4.68% (23/491) in all cases. However, CMA was not able to accurately identify some complex karyotypes and mixed chimeras, including 2 cases of chimeras, 4 cases of balanced translocations, 4 cases of pericentric inversions, and 8 cases of other chromosome polymorphisms, indicating karyotyping analysis was superior to detect these chromosome abnormalities compared with CMA analysis. CMA was better in detecting the fracture sites, microduplication and microdeletion with definite pathogenicity, and CNVs with VOUS compared with karyotype analysis.

Comprehensive Monitoring System for High-Risk Pregnancies

Prenatal care protects the Health of both mother and baby, influencing the development and well-being of the mother-child duo. Risks during pregnancy, such as preeclampsia or gestational diabetes, can have long-term effects on the mother’s Health. Effective monitoring of pregnancy risks is essential for improving health outcomes. Therefore, we propose the development of an integrated high-risk pregnancy monitoring mobile application incorporating IoT sensors (smartwatches) to monitor critical biomedical variables. This allows healthcare professionals to collect and analyze data, reducing prenatal risks and improving maternal and fetal health outcomes. Functional and non-functional requirements were gathered and refined through continuous support and iterative meetings with an experienced gynecologist. We identified multiple functional requirements through user stories. Non-functional requirements were also collected to design the proposed architecture and comply with current legislation, prioritizing the security and privacy of biomedical data. We conducted Load tests on the proposed architecture, verifying the system’s quality attributes. Additionally, we carried out usability tests through interviews with a sample of ten pregnant women. Participants found the application intuitive and essential for monitoring their Health, and it could provide a constant source of confidence throughout their pregnancy. The proposed system could be a valuable tool for high-risk pregnancy monitoring. However, large and intensive clinical trials are essential to validate its effectiveness in real-life scenarios.

The relationship between maternal health during pregnancy and infant kidney development: a prospective cohort study.

The significance of intergenerational impacts on fetal and infant kidney development and function remains to be fully understood. This is particularly relevant for certain populations, for example the Indigenous Australians since their risk of developing chronic kidney disease (CKD) is twice that of non-Indigenous Australians. The aim of this study was to assess the impact of maternal health and kidney size and function on infant kidney development. This study was open to all pregnant women receiving antenatal care at Townsville University Hospital, Australia. It presents data from a larger, ongoing prospective, longitudinal cohort study which commenced August 2019, involving mother-infant dyads. This manuscript reports on term mother-infants' dyads from singleton pregnancies. Ultrasound was used to measure renal parenchymal thickness, a surrogate for nephron number, of the mother and their newborn. Kidney function was assessed using serum cystatin C and creatinine. Analysis was conducted on 80 mother-infant dyads, 17 Indigenous and 63 non-Indigenous. Multivariate regression modeling showed maternal renal parenchymal thickness (ß = 0.31, p = 0.004), smoking (ß = -0.70, p = 0.022) and maternal serum cystatin C (ß = -0.34, p = 0.014) significantly predicted newborn renal parenchymal thickness. No significant differences were found between the maternal and newborn renal parenchymal thickness and function between Indigenous and non-Indigenous participants. Our study suggests thatmaternal kidney size and function has a significant intergenerational effect on kidney development of their infants. Newborn renal parenchymal thickness was positively associated with maternal renal parenchymal thickness and negatively associated with smoking and maternal serum cystatin C.

Arterial hypertension in pregnant women – diagnosis and features of therapy

Hypertension in pregnancy is one of the most common pathology in the structure of extragenital deseases in pregnant women. Cardiovascular diseases, including strokes, account for approximately half of all cases of maternal mortality. In addition, hypertension and its complications are significant cause of fetal and infant mortality. The prevalence of this pathology increase over the past few decades. Hypertension and its complications significantly worsen the prognosis for both the mother and the fetus and newborn. Hypertension in pregnancy also causes the cardiovascular pathology in the future. Early diagnosis and adequate therapy of hypertension at all stages of preparation and the pregnancy can significantly improve the prognosis for the mother and fetus/newborn, as well as prevent possible cardiovascular diseases and complications in women in the future.

Fear of childbirth among Chinese women in the third trimester and mode of delivery

ABSTRACT Aims Findings from studies of the influence of fear of childbirth on mode of delivery in women are equivocal. This study used the 2021 Science Database of People Mental Health to investigate the trend of caesarean sections in the Chinese population and its relationship with the fear of childbirth. Methods A total of 1,894 Chinese women were included in the study. We performed a hierarchical regression analysis to control sociodemographic and obstetric information, depression, anxiety, and fear of childbirth in pregnant women. Restricted cubic spline analysis was applied to determine the association between fear of childbirth and caesarean sections. Results The total prevalence of caesarean sections was 54.49%. The final regression analysis explained 58.7% of the variance in the mode of delivery. After controlling for confounders, fear of childbirth was a risk factor for caesarean sections in pregnant women (OR = 1.108, 95% CI: 1.093 ~ 1.124). Furthermore, the RCS analysis showed a non-linear correlation between fear of childbirth and mode of delivery (non-linear p < 0.001), and a stronger impact was found in the relation between fear of childbirth and mode of delivery in multiparous women than in primiparous women. Conclusions Mild or high-level fear of childbirth during the third trimester was associated with an increased number of caesarean sections, especially in multiparous women. These results suggested that healthcare professionals should underscore the importance of fear of childbirth screening and implement targeted interventions for affected women.

Effective Antifungal Compounds of Lactococcus lactic Against Vulvovaginal Candidiasis for Women in Thi-Qar Governorate

Abstract One hundred and fifty-four samples were collected from Bint Al-Huda Teaching Hospital in Thi-Qar Governorate divided to 104 women infected urinary tract infection (UTI) and 50 healthy women as control group. Vulvovaginal Candidiasis (VVC) is the most opportunistic yeast infection produced by species of Candida in both pregnant and non-pregnant women were examined in this study. Lactococcus lactic (ATCC 11454) extracted and chemical compounds identified by Gas Chromatography, the extract of L. lactic inhibited all Candida isolates in agar well diffusion assay and the inhibition zone, it were (12, 11, 11, 11, 10 mm) for C. albicans, C. dublniesis, C. glabrata C. krusei and C. parapsilosis respectively, while minimum inhibiter concentration were (64, 128, 128, 128, 128μg/ml) for C. albicans, C. dublniesis, C. glabrata C. krusei and C. parapsilosis respectively, the chemical compounds of L. lactic unable inhibit efflux pump of all clinical Candida isolates after treated with (40, 20, 10, 5 mg/ml) of ethidium bromideOne hundred and fifty-four samples were collected from Bint Al-Huda Teaching Hospital in Thi-Qar Governorate divided to 104 women infected urinary tract infection (UTI) and 50 healthy women as control group. Vulvovaginal Candidiasis (VVC) is the most opportunistic yeast infection produced by species of Candida in both pregnant and non-pregnant women were examined in this study. Lactococcus lactic (ATCC 11454) extracted and chemical compounds identified by Gas Chromatography, the extract of L. lactic inhibited all Candida isolates in agar well diffusion assay and the inhibition zone,

Differences in second trimester risk estimates for trisomy 21 between Maglumi X3/Preaccu and Immulite/Prisca systems

Abstract Objectives Maternal serum alpha-fetoprotein (AFP), human chorionic gonadotropin (HCG) or free βHCG, and unconjugated estriol (uE3) concentrations are used to screen trisomy 21 in the second trimester. The performance of different analytical platforms has an impact on individual risk estimates. The aim of this study is to compare the multiple of median (MoM) values and risk estimates generated by Maglumi X3 analyzer/Preaccu software with the Immulite 2000 XPi device/Prisca software. Methods 164 pregnant women (including 20 pregnants with risk estimates above ≥1 in 250 for trisomy 21) analyzed with both platforms. Results Passing–Bablok indicated proportional bias (0.75 [95 % CI 0.70 to 0.82]) between AFP MoMs and both systematic (−0.20 [95 % CI –0.33 to −0.05]) and proportional (1.25 [95 % CI 1.06 to 1.44]) differences between the HCG/free βHCG MoMs, respectively. No significant differences (p=0.070) were present between calculated individual risks by both of the programmes (estimated median risk with Immulite/Prisca system was 1 in 1890 and 1 in 1220 with Maglumi X3/Preaccu system). The triple test result for three pregnant women was negative with the Prisca program, it was positive with the Preaccu. Conclusions Second trimester screening performance of Maglumi X3/Preaccu system achieves comparable performance. Determining regional median values before using will provide more accurate and reliable results.

Comparing models that integrate obstetric care and WIC on improved program enrollment during pregnancy: a protocol for a randomized controlled trial

BackgroundLow-income, rural pregnant women are at disproportionate risk for adverse pregnancy outcomes as well as future cardiovascular risk. Currently, less than half of eligible women enroll in the Women, Infants, and Children’s (WIC) Program. This study aims to evaluate whether integrating clinical care and social care may advance health equity and reduce health disparities by directly linking women receiving obstetric care to the Special Supplemental Nutrition Program for WIC and/or a Registered Dietitian/Nutritionist (RDN).MethodsThis pragmatic study is situated in real-world care and utilizes a randomized controlled trial design. A total of 240 low-income, rural, pregnant patients will be recruited from Geisinger (Pennsylvania, USA) obstetric clinics and randomized to receive one of four models: (1) Clinic; (2) Clinic-WIC; (3) Clinic-RDN, or (4) Clinic-WIC-RDN. Participants provide consent for electronic referrals that directly link their contact information from the electronic health record to WIC and/or RDN. Patients in the Clinic model receive standard prenatal care, which includes provision of basic information about WIC. The Clinic-WIC model includes a clinical decision alert to queue clinical staff to ask about WIC interest and place a referral to WIC using a social health access referral platform. In turn, WIC staff contact the pregnant woman about enrollment. The Clinic-RDN model includes a referral to an RDN for telehealth counseling to promote heart healthy eating and food resource management. The Clinic-WIC-RDN model includes referrals to both WIC and RDN. The primary outcome is difference in WIC enrollment between the Clinic and Clinic-RDN models versus the Clinic-WIC and Clinic-WIC-RDN arms at 6-months post-baseline. Secondary endpoints include WIC retention and adherence, change in participant behavior, skills, and food security, preterm delivery, birthweight, and maternal and child health outcomes. Implementation outcome measures include acceptability, appropriateness, and feasibility from the perspective of clinic and WIC staff.DiscussionStudy findings will inform system models that integrate clinic care and social care to improve health equity among a high-risk population. Specifically, these findings will advance implementation of strategies to increase enrollment in a widely available but underutilized food provision program during pregnancy.Trial registrationClinicalTrials.gov identifier (NCT06311799). Registered 3/13/2024.

Prevalence of urinary tract infections among pregnant women in Iraq: meta-analysis study

Prevalence of urinary tract infections among pregnant women in Iraq: meta-analysis study

Assessment of Renal Function in Women with Preeclampsia by Measuring of Serum Cystatin C Level

Abstract Background: Preeclampsia (PE) is a major health problem that increases the risk of renal impairment during pregnancy. Studies have described the utility of Cystatin C as a better indicator of kidney function during pregnancy compared to urea, creatinine, or uric acid. Objective: The objective of the study was to evaluate cystatin C as a diagnostic tool for renal impairment in women with severe PE and compare it to standard renal function tests. Patients and Methods: A case–control study was conducted at Al Yarmouk Teaching Hospital, Bagdad. From March 1, 2022, to September 1, 2022, 94 3rd-trimester pregnant women with newly diagnosed or a history of PE were included in the study and interviewed and subsequently divided into three groups. The GraphPad Prism Software was used for data analysis and graphical presentations in addition to SPSS version 28; 0.05 was selected as a cutoff point for statistical significance. Results: The mean of cystatin C for control 0.39 ± 0.15 was significantly lower than for severe PE 1.12 ± 0.53, P &lt; 0.001. The mean cystatin C for mild PE 0.52 ± 0.13 was considerably lower than for severe PE 1.12 ± 0.53, P &lt; 0.001. Conclusions: Patients with severe PE had higher serum cystatin C than patients with mild PE and healthy normotensive pregnant females. Serum cystatin C at a cutoff value of &gt;0.61 had higher diagnostic accuracy than the other standard kidney tests (urea, creatinine, and uric acid), with a sensitivity and specificity of 90.32% and 93.75%, respectively.

Screening of pregnant women for foetal neonatal alloimmune thrombocytopenia: A cost-utility analysis.

Foetal and neonatal alloimmune thrombocytopenia (FNAIT) results from maternal platelet-directed antibodies and can result in severe intracranial haemorrhage (ICH) in foetuses and newborns. Screening for human platelet antigen-1a (HPA-1a)-directed antibodies during pregnancy could allow timely intervention with antenatal treatment and prevent ICH. We assessed the cost effectiveness of HPA-1a typing and anti-HPA-1a-screening as part of the prenatal screening programme. Different HPA-1a screening scenarios were tested in a decision analysis model and assessed for diagnostic, treatment, intervention and lifetime costs and prevention effects compared to the current situation without screening in the Netherlands. Model parameters were based on available data, literature and expert opinions. One-way sensitivity analysis and probabilistic sensitivity analysis were performed. Adding screening for anti-HPA-1a antibodies to the current antenatal screening programme of the Netherlands will lead to an additional cost of €4.7 million per year and a gain of 226 quality-adjusted life years (QALYs) per year, indicating an incremental cost-effectiveness ratio (ICER) of €20,782 per QALY gained. One-way sensitivity analysis showed that the uncertainty around the incidence of ICH, lifetime costs of disabled children and the probability of having antibody quantitation >3.0 IU/mL at 20 weeks had the highest effect on the ICER. Antenatal anti-HPA-1a screening might be cost effective. To obtain more knowledge and thereby to improve risk stratification, a pilot screening programme is warranted.