Women In Third Trimester Of Pregnancy Research Articles

Factors Affecting The Incidence of Anemia in Third-Trimester Pregnant Women at Purwoharjo Primary Health Center, Pemalang District

AbstractIntroduction: Anemia in pregnancy occurs due to a lack of nutritional intake to meet the needs of the mother and fetus. According to Riskesdas, the prevalence of anemia in Indonesia is 48.9%. Anemia in pregnancy can occur due to various factors. The most common anemia in pregnancy is iron deficiency anemia which is caused by a lack of nutritional intake and foods that contain iron.Methods: This research uses a quantitative approach with descriptive observational, the sample was pregnant women in the third trimester, who had Hb levels <11 gr/dl and underwent ANC at Purwoharjo Primary Health Center. This research was conducted in August-October 2023 with a total of 62 respondents, analysis used univariate analysis.Results: The prevalence of anemia in third-trimester pregnant women at the Purwoharjo Primary Health Center is 43%. Various factors influence the incidence of anemia in pregnant women in the third trimester at Purwoharjo Primary Health Center.Conclusion: The prevalence of third-trimester pregnancy anemia at the Purwoharjo Primary Health Center is 43%, and the most influencing factors are nutritional status (61.3%) and non-compliance with iron supplement consumption (53.2%). Health officials have also made various efforts to reduce the incidence of anemia

Verification of bile acid determination method and establishing reference intervals for biochemical and haematological parameters in third-trimester pregnant women.

The aims of this study were to verify the bile acids (BA) method and to establish reference intervals (RIs) for bile acids (BA) and biochemical and haematological parameters in Croatian pregnant women. BA spectrophotometric method verification was performed on Siemens Atellica Solution CH 930 automated analyser using Sentinel reagent. Stability, precision, trueness, linearity, and RIs, as well as lipemia interference were tested according to CLSI guidelines. BA, biochemical, and haematological parameters were measured in serum (BA, biochemical) and whole blood (haematological) samples of fasting healthy third-trimester pregnant women from Croatia (n=121). The establishment of the RIs was done a priori according to the CLSI EP28-A3C:2010 guideline. Selected reference individuals' data were analysed using parametric, non-parametric, and robust methods. Stability study showed that BA are stable in serum samples for 2days at 20 °C, 14days at 4-8 °C, and 22days at-20 °C. The precision study and adult RIs verification met the criteria. Linearity was verified for the concentration range of 3.5-172.1 μmol/L whereas the lipemia interference test showed a positive bias (%) in BA concentration. The determined reference limits generally exhibited better precision for haematological parameters, being lower than the upper recommended value 0.2, unlike biochemical parameters. Haematological parameters showed notable differences between pregnant and non-pregnant women, while many biochemical parameters' RIs remained similar. Only ALT and GGT showed lower non-comparable RI upper limits in the population pregnant women. Spectrophotometric BA method showed satisfactory performance and all examined parameters were within the set criteria. Moreover, RIs for key biochemical and haematological parameters, including BAs, have been established for the first time in the population of Croatian pregnant women.

Sleep Quality among Pregnant Women during COVID-19 Pandemic: A Short Report


 
 
 
 Background and Objective: During the coronavirus disease 2019 (COVID-19) pandemic, one of the vulnerable groups was pregnant women. This study aimed to determine sleep quality in pregnant women in the third trimester of pregnancy referred to Ibn Sina Health Center in Tabriz, Iran.
 Materials and Methods: We performed a cross-sectional study among third-trimester pregnant women in May 2021. To study sleeping habits, we used the Pittsburgh Sleep Quality Questionnaire (PSQI), which had acceptable reliability and validity in Persian to evaluate sleep quality. Participants filled out the questionnaires with the help of healthcare providers in the health center.
 Results: A total of 176 pregnant women participated in this study. The mean and standard deviation (SD) of partici- pants’ age was 25.9 ± 1.2 years. This study showed that the mean of sleep quality in the third trimester was 9.97 ± 1.81 and the majority of pregnant women (87.79%) had poor sleep quality.
 Conclusion: The findings of the current study demonstrated that most pregnant women during COVID-19 had poor sleep quality. Finding ways to improve their sleep quality is important
 
 
 

Small group classes with pregnancy cadres (kekasih) can improve knowledge and attitudes about exclusive breastfeeding among third-trimester pregnant women on the remote Island of Enggano, Bengkulu Province

<p><strong><em>Background</em></strong><em>: One of the government programs that focuses on the first 1000 days of life is exclusive breastfeeding for infants aged 0-6 months, but there is often a failure of exclusive breastfeeding at the age of 0-3 days due to pre-lactal feeding, so education during pregnancy is needed to improve the knowledge and attitudes of pregnant women through KEKASIH (Small Group of Cadres with Pregnant Women) classes. </em><strong><em>Objectives</em></strong><strong><em>:</em></strong><em> This study aims to determine the effectiveness of KEKASIH classes on knowledge and attitudes of pregnant women trimester III in remote areas of Enggano Island, Bengkulu Province in 2023.</em></p><p><strong><em>Methods:</em></strong><em> Quasi-experimental research design with pre- and post-test and control group. Intervention in the form of KEKASIH class, which is a modified class for pregnant women divided into small groups with cadres as facilitators. Independent variables were KEKASIH class, dependent variables were knowledge and attitude. External variables are age, parity, education, distance of pregnancy, employment. The sample was trimester III pregnant women a total of 50 people consisting of the treatrimesterent group is pregnant women in KEKASIH class, the control group is pregnant women who receive conventional health promotion.</em></p><p><strong><em>Results:</em></strong><em>The results of the study showed that there was a difference in the mean knowledge score before and after exclusive breastfeeding education through KEKASIH class from 27.36 to 49.04, p=0.00. There is no difference in the mean attitude score before and after exclusive breastfeeding education in the control group from 28.16 to 28.96 p=0.00.</em></p><p><strong><em>Conclusions:</em></strong><em> KEKASIH Class is more effective in improving mothers' knowledge and attitudes about exclusive breastfeeding with a value of p=00. Educational factors affect mothers' knowledge, but gestational distance and parity affect mothers' attitudes about exclusive breastfeeding.</em></p>

Evaluation of Fetal Breathing-Related Nasal Fluid Flow Doppler in the Third Trimester in Pregnant Women with Fetal Growth Restriction: Preliminary Observations.

To investigate the fetal breathing-related nasal fluid flow Doppler waveforms as an indicator of fetal respiratory function in fetuses diagnosed with fetal growth restriction (FGR) in the third trimester. This prospective, non-interventional case-control study was conducted on 96 pregnant women, including 23 pregnant women diagnosed with FGR in the third trimester as the FGR group and 73 healthy pregnant women with fetuses appropriate for gestational age (AGA) as the control group. Fetal breathing-related nasal fluid flow Doppler was examined in the fetuses of the participants. Inspiration and expiration duration, inspiration and expiration peak velocity, total breathing duration, and number of fetal breaths per minute were calculated. Both groups were similar in terms of the duration of inspiration, duration of expiration, and total breathing duration (p=0.463, p=0.711, p=0.520, respectively). Peak inspiratory velocity and peak expiratory velocity were significantly lower in the FGR group than in the control group, and the number of fetal breaths per minute was similar in both groups (p=0.027, p=0.012, p=0.768, respectively). When participants were regrouped into those whose newborn was admitted to the neonatal intensive care unit (NICU) after birth and those who were not, all fetal nasal fluid flow Doppler parameters were similar in both groups. Although the number of participants was too small to draw a definitive conclusion, FGR appears to be associated with a decrease in peak inspiratory and expiratory velocity. The clinical significance of changes in fetal breathing-related nasal fluid flow Doppler parameters in FGR is as yet unclear, and their use in clinical follow-up and predicting unfavorable perinatal outcomes are the subjects of future research.

Effects of osteopathic manipulative treatment on maternal-fetal hemodynamics in third trimester pregnant women: A prospective study.

To evaluate the maternal-fetal hemodynamic effects after osteopathic manipulative treatment by measuring vital signs and Doppler velocimetry in third-trimester pregnant women. This is a prospective study with pregnant women undergoing outpatient follow-up and hospitalized in a ward at Instituto Fernandes Figueira/Fiocruz, between August 2021 to August 2022, during the SARS-CoV-2 pandemic. This study was registered in REBEC under Register Number RBR-9q7kvg and approved by the ethics committee under number 32216620.0.0000.5269. The study population was composed of 51 pregnant women between 28 and 40 weeks of gestation, over 18 years of age, allocated in a single group. Pregnancies with multiple fetuses, malformations, premature rupture of the membrane, and active labor were excluded. The procedures evaluated maternal-fetal hemodynamics using three consecutive measures of ultrasound examination with Doppler velocimetry, and three maternal vital signs measured by an electronic blood pressure monitor. Most vital signs changed after osteopathic treatment. However, only the systolic blood pressure (109.92 ±14.42 to 110.71±12.8, p = 0.033), diastolic blood pressure (79.8±11.54 to 77.57±9.44, p = 0.018) and heart rate (87.59±11.93 to 81.12±10.26, p = 0.000) in the sitting position, systolic blood pressure (110.75±13.26 to 108.59±13.07; p = 0.034) in the supine, and heart rate (83.22±11.29 to 80.39±11.0; p = 0.013) in left lateral decubitus reached statistical significance. The oximetry measures (98.55±0.64 to 98.67±0.68; p = 0.098) stayed stable during all three positions. All artery values remained stable after treatment, and no statistically significant difference was recorded in the artery results. Responses to osteopathic treatment in women in the third trimester of pregnancy did not affect uteroplacental and fetoplacental circulation. However, some maternal vital signs had statistically significant results, with a decrease in diastolic blood pressure and heart rate, and an increase in systolic blood pressure in the sitting position, a decrease of heart rate in the left lateral decubitus position, and systolic blood pressure in the supine position. All the results observed were maintained in the normal parameters. The study responses attest to the safety of using the osteopathic manipulative treatment for the fetus and for pregnant women with comorbidities.

Evaluation of Fibrinogen Level and Platelet Count among the Apparently Healthy Pregnant Women at 3rd Trimester

Background: Different physiological changes affect normal coagulation and fibrinolytic system during pregnancy. Hemostatic abnormalities are often associated with various complications of pregnancy. Objectives: This study was aimed to evaluate the fibrinogen level and platelet count among pregnant women at third (3rd) trimester as compared to non-pregnant healthy women. Methods: This cross-sectional study was conducted at the Department of Physiology, Rajshahi Medical College (RMC), Rajshahi, Bangladesh, from July 2016 to June 2017 on 60 healthy women, out of them 30 were apparently healthy pregnant women of third trimester in the age group of 20-35 years (cases), and 30 were age matched non-pregnant healthy women (controls). Their detailed case history was taken and relevant clinical examinations were done. Plasma fibrinogen level and platelet count were measured using auto analyzer. Data were analyzed and compared by statistical test. Results: The mean±SD age of the pregnant women was 27.27±3.72 years and that was 27.13±4.01 years in non-pregnant healthy women. The maximum (40.0%) study women were in 26-30 years age group followed by 38.3% was in 20-25 years age group and 21.7% was in 31-35 years age group. Most of the cases were primipara [22(36.66%)] and majority women in the control group were multiparous [17(28.33%)]. Mean±SD body mass index (BMI), pulse rate, systolic blood pressure (SBP), and diastolic blood pressure (DBP) were nearly similar between the groups. Plasma fibrinogen level was significantly high (p<0.001) and platelet count was relatively low among women at 3rd trimester of pregnancy in comparison to non-pregnant healthy women. Conclusion: Plasma fibrinogen level is significantly high and platelet count is relatively low at 3rd trimester of pregnancy. Coagulation parameters are altered in a balanced way during normal 3rd trimester pregnancy.

Asuhan Kebidanan Komplementer Penanganan Nyeri Pinggang Pada Ibu Hamil Trimester III

Pain is a very common problem in pregnancy, especially in the third trimester of pregnancy. The phenomenon of back pain during pregnancy is one of the most frequently reported complaints among pregnant women, varying from 50% to 70%, based on previous studies in various countries. This study aimed to treat low back pain in the third trimester, in pregnant women, by complementary midwifery care standards. The method used is descriptive, namely describing or describing complementary midwifery care for pregnant women with low back pain problems, with a case study approach. The process of collecting data using direct interviews with patients and families, home visits, performing physical examinations, observing, and making discussions using related journals or books. The results after 3 visits of complementary midwifery care in patients with low back pain (waist) in third-trimester pregnant women resolved the problem and the intervention was stopped. Problems that occur in patients can be resolved and the intervention is stopped.

Paritas, Age, and Education Are Associated with the Level of Anxiety in Facing the Childbirth Period in PMB Komang Seni Rahayu, A.Md.Keb

Pregnancy-related anxiety is a condition that arises from the subjective experience of unsettling mental tension as a general reaction and the inability to deal with issues or feelings of insecurity that affect pregnant women and are related to the mother's concern for the welfare of herself and her fetus. The pregnant woman's age, education level, and prior pregnancies and deliveries are risk factors that contribute to anxiety in pregnant women. Particularly throughout the third trimester of pregnancy up until delivery, anxiety can strike pregnant women. Pregnant women experience anxiety during this time, including worry about having a healthy baby or worrying about the discomfort they are experiencing. These diseases can raise the risk of bleeding wounds and uterine atony, while also raising the likelihood of preterm birth and low birth weight in babies. This study's main goal was to find out how third-trimester pregnant women at PMB Komang Seni Rahayu, A.Md.Keb related to parity, age, and education. This study is quantitative and cross-sectional in nature. A questionnaire that was distributed to a specified group of respondents was used to collect data using the purposive sampling technique. 32 samples total were used in this study. Both univariate and bivariate data analysis are used in this study. Results of the correlations statistical test (= 0.05). The findings revealed a correlation between parity, age, and education with the degree of anxiety associated with giving birth in third-trimester pregnant women at PMB Komang Seni Rahayu, A.Md.Keb, with a significance of p = 0.139 at parity, age with p = 0.005, and level of education with 0.628.
 
 Keywords : Characteristics, Pregnant Women, Anxiety

Effect of Dzikir (Religious Chanting) Therapy on The Anxiety Level of Third-Trimester Pregnant Women Facing Labor

ABSTRACT Anxiety in the third trimester of pregnancy is often related to impending labor and childbirth. In Indonesia, 28.7% of pregnant women in the third trimester experienced anxiety. The negative impact of anxiety during pregnancy includes the risk of miscarriage and fetal abnormalities. Non-pharmacological therapies based on Islam, such as dzikir (religious chanting) therapy, have been developed. To determine the effect of dzikir (religious chanting) therapy on the anxiety level of third-trimester pregnant women facing labor in the working area of Bandar Negeri Suoh Primary Health Care in the year 2023. This research was quantitative in design and employed a pre-experimental design with a one-group pretest and posttest design. The population of this study consisted of third-trimester pregnant women in the working area of Bandar Negeri Suoh Primary Health Care in July. The total was 35 people, with 30 people as the sample. The sampling technique used is purposive sampling. Moreover, the data analysis involved univariate and bivariate analyses with the Wilcoxon test.The results of this r esearch showed that the average anxiety level of third-trimester pregnant women facing labor before undergoing dzikir (religious chanting) therapy was 21.4, and after undergoing dzikir (religious chanting) therapy, it decreased to 10.7. Bivariate analysis revealed that there was an effect of dzikir (religious chanting) therapy on the anxiety level of third-trimester pregnant women facing labor, with a p-value of 0.000. An effect of dzikir (religious chanting) therapy on the anxiety level of third-trimester pregnant women facing labor in the working area of Bandar Negeri Suoh Primary Health Care in the year 2023. Keywords: Anxiety, The Dzikir (Religious Chanting) Therapy, Pregnant Women

Isolation of serum-derived placental/amnio-chorionic extracellular vesicles across pregnancy by immunoaffinity using PLAP and HLA-G.

Circulating extracellular vesicles of placental/amniochorionic origin carry placental/amniochorionic proteins and nucleic acids with the potential to facilitate non-invasive diagnosis of pregnancy-related disorders. The study reports an improvised method for the enriched isolation of extracellular vesicles of placental/amniochorionic origin using the two markers, PLAP and HLA-G. Extracellular vesicles (EVs) are membrane-bound nanovesicles secreted from the cells into extracellular space and body fluids. They are considered 'fingerprints of parent cells', which can reflect their physiological and functional states. During pregnancy, EVs are produced by the syncytiotrophoblasts and extravillous trophoblasts and are released into the maternal bloodstream. In the present study, placental alkaline phosphatase (PLAP)-specific extracellular vesicles were isolated from maternal serum-derived EVs (SDE) across pregnancy. Transmission electron microscopy and dynamic light scattering analysis showed that the isolated EVs exhibited a spherical morphology with ~30-150 nm size range. Nanoparticle tracking analysis indicated that the concentration of PLAP+ serum-derived EVs (PLAP+-SDE) increased across the gestation. PLAP+-SDE contained DNA with LINE1 promoter methylation pattern. C19 miRNA cluster miRNAs (miR 515-5p, 519e and 520f) were present in PLAP+-SDE along with other miRNAs (miR-133-3p, miR210-3p and miR-223-3p). PLAP+-SDE confirmed the presence of EV markers (CD63 and CD9), along with placental proteins (PLAP and cullin 7). A modified novel strategy to extract an enriched population of circulating placental/amniochorionic EVs was devised employing an additional marker of extravillous trophoblasts, human leukocyte antigen G (HLA-G), along with PLAP. The isolated pooled placental/amniochorionic (PLAP+&HLA-G+) serum-derived EVs (PP-SDE) showed ~two-fold increased protein levels of HLA-G in the third-trimester pregnant women compared to the non-pregnant controls. Future studies will be focused on validation of this novel strategy to isolate an enriched population of placental/amniochorionic EVs to facilitate a better understanding of placental physiology and pathophysiology.

Comparison of the Effectiveness of Kencur Warm Water Soaking with Salt Warm Water Against Leg Edema of Third Trimester Pregnant Women in the Working Area of Rawang Health Center, Indonesia

Leg edema is a common complaint in third trimester pregnant women. It is believed that soaking in kencur warm water and salt warm water can help overcome this. Comparing the effectiveness of soaking in warm kencur water with warm salt water on leg edema in third trimester pregnant women. Quasi-experimental research with a pretest-posttest design with the control group. A total of 60 third trimester pregnant women were divided into two groups: the kencur warm water immersion group (n=30) and the salt warm water immersion group (n=30). The intervention was carried out for 15 minutes, twice a day for 3 days. Leg edema was measured using a measuring tape before and after the intervention. There was a significant reduction in leg edema in both groups after intervention (p<0.05). The reduction in leg edema in the kencur warm water immersion group was greater than in the salt warm water immersion group (p<0.05). Kencur warm water soaks are more effective than salt warm water soaks in reducing leg edema in third-trimester pregnant women.

Knowledge Overview of Thirdtrimester Pregnant Women and Women in Labor about the Rebozo Technique

One of the efforts that can be made to reduce pain, prolonged labor (congestion) and prepare the mother for childbirth is through the rebozo technique. The rebozo technique is a non-pharmacological method without the use of drugs to help reduce pain during labor. Objective: To determine the knowledge of third-trimester pregnant women and women giving birth regarding the Rebozo technique. Method: The method used in this research is descriptive method. The researcher's research sampling technique used a total sampling technique. This research was conducted on 12 – 19 May 2023, the sample size was 35 people. The research instrument used a questionnaire. Results: This research used univariate analysis using frequency distribution to provide an overview of the respondents characteristics. Respondents knowledge about the definition of rebozo was 26 (74.3%) respondents had poor knowledge, 29 (82.9%) respondents had moderate knowledge about the benefits of rebozo, 30 (85.7%) respondents had poor knowledge about the rebozo technique, and 29 respondents had poor knowledge about rebozo contraindications ( 82.9%) respondents had moderate knowledge. Then regarding respondents' general knowledge regarding rebozo, 28 (80%) respondents had poor knowledge. Conclusions: Description of the knowledge of third-trimester pregnant women and women giving birth regarding the Rebozo technique at PMB Utin Mulia Pontianak in 2023. Based on the result, it can be concluded that the majority of respondents, namely 28 (80%) respondents, have poor knowledge. The existence of research on rebozo can be used as evaluation material and input for every health care provider as well as further increasing information and learning about rebozo in hospitals, health centers or in private or private clinics.

The Effect of Endorphin Massage on Reducing Anxiety in Third-Trimester Pregnant Women in Purwakarta Regency, Indonesia

Anxiety is an emotion commonly experienced by pregnant women, especially in the third-trimester. Anxiety can disrupt the physical and mental health of pregnant women and can have a negative impact on fetal development. Endorphin massage is a therapy that can be used to reduce anxiety in pregnant women. This study aims to determine the effect of endorphin massage in reducing anxiety in third-trimester pregnant women in Purwakarta Regency, Indonesia. This research uses a quasi-experimental research design with a pre-test and post-test approach. The research sample consisted of 60 third-trimester pregnant women who were divided into two groups, namely the treatment group (30 people) and the control group (30 people). The treatment group received endorphin massage therapy for 30 minutes 10 times, while the control group received no therapy. Anxiety data was measured using the state-trait anxiety inventory (STAI) questionnaire. The results showed that there was a significant difference in anxiety between the treatment group and the control group after receiving therapy (p < 0.05). Anxiety in the treatment group decreased significantly after receiving therapy, while anxiety in the control group did not change. Based on the results of this study, it can be concluded that endorphin massage is effective in reducing anxiety in third-trimester pregnant women.

Circulating sex hormones in women with severe anxiety during pregnancy

Introduction. Anxiety, mood- and stress-related behaviors are regulated by sex hormones in pregnant and non-pregnant women. Very scarce information exists about the role of sex steroids in pregnant women displaying high levels of anxiety. Objective. To determine sex hormones serum levels in pregnant women exhibiting high levels of anxiety symptoms. Method. The Hamilton Anxiety Rating Scale (HARS/ HAM-A) was used to assess the intensity of anxiety symptoms in third-trimester pregnant women. Two groups were included in the study, pregnant women exhibiting severe anxiety (ANX; HARS scores ≥ 25; n = 101) and healthy control subjects (CTRL; n = 40) displaying lower scores for anxiety (HARS scores ≤ 7). Estradiol (E2), progesterone (P4), and testosterone (T) serum levels were measured using a standard chemiluminescent immunoassay. Bivariate and partial correlations were performed to detect significant associations between groups, clinical measures, biochemical data, and HARS scores. Results. The anxiety group (ANX) showed an increase in E2 and T serum levels (p () .001) compared to CTRL. Conversely, significantly lower P4 levels were found in the symptomatic group (p () .001) as compared to the CTRL hormone values. The P4:E2 index was significantly reduced in pregnant women with high levels of anxiety (p () .001). Negative correlations between anxiety (HARS) scores, P4 serum levels (p = .02), and P4:E2 ratio (p = .04) were found in the symptomatic group. Conversely, T serum levels displayed a positive association (p = .001) with high levels of anxiety symptoms in the same group, after adjusting our data by clinical confounders. Discussion and conclusion. Serum levels of sex-steroid hormones are altered in pregnant women exhibiting severe anxiety.

The Effect of Ginger Compress on Back Pain in Pregnant Women in the Work Area of X Health Center, Cianjur Regency, Indonesia

Back pain is one of the disorders often experienced by pregnant women. The research results show that the prevalence of back pain in pregnant women in Indonesia reaches 60-80%. One non-pharmacological therapy that can be used to treat back pain in pregnant women is a ginger compress. This study aims to determine the effect of ginger compresses on back pain in third-trimester pregnant women in the working area of X Health Center, Cianjur Regency, Indonesia. This study used a quasi-experimental design with a two-group pretest-posttest design. The research population was pregnant women in the third trimester who experienced back pain. The sample size was 60 people, who were divided into two groups, namely the intervention group (30 people) and the control group (30 people). The intervention group was given a ginger compress for 15 minutes, 3 times a day, for 3 days. The control group was given warm water compresses for 15 minutes, 3 times a day, for 3 days. The results of the study showed that the average value of back pain in the intervention group before the intervention was 4.68 (moderate pain scale) and after the intervention was 2.91 (mild pain scale). The average value of back pain in the control group before the intervention was 4.75 (moderate pain scale), and after the intervention, it was 3.88 (moderate pain scale). The Wilcoxon test showed that ginger compresses reduced back pain in third-trimester pregnant women (p=0.000). The conclusion of this study is that ginger compresses have an effect on reducing back pain in third-trimester pregnant women.

Effectiveness of Counseling in Increasing Mothers' Behavior (Knowledge and Attitudes) Regarding Post-Placental IUD Selection to Realize the SDG Goals of Good Health and Well-Being

Background: The low coverage of post-placenta IUDs is due to the non-optimal family planning counseling for third-trimester pregnant women. Aims: This study aims to analyze the effectiveness of ABPK and SKB counseling in increasing mothers' knowledge and attitudes about choosing a post-placenta IUD at Tawangrejo Health Center, Madiun City. Methods: This type of research is quasi quasi-experimental nonequivalent control group design. Data were analyzed using Marginal Homogeneity, Mann-Whitney, Mc Nemar, and Chi-Square. Results: The results showed that the Marginal Homogeneity test in the experimental group (SKB) obtained an increase in knowledge with a p-value of 0.000 (<0.05) and the control group (ABPK) obtained an increase in knowledge with a p-value of 0.000 (<0.05) so that it can be interpreted both effective in increasing the mother's knowledge about the selection of the Post Placenta IUD at the Tawangrejo Health Center. The result of the McNemar test on the attitude of the ABPK group was 0.227 (> 0.05) and the attitude of the SKB group was 0.146 (> 0.05) so it can be interpreted that both were not effective in increasing the attitude of mothers about the selection of the Post Placenta IUD at the Tawangrejo Health Center. The results of the Mann-Whitney test on knowledge after ABPK with knowledge after LCS show a p-value of 0.02 the mean rank at ABPK is 23 and the mean rank SKB is 28 meaning that there is a difference between ABPK counseling and SKB counseling in improving mothers' attitudes about choosing the Post Placenta IUD and counseling SKB is more effective. Conclusion: The conclusion of SKB counseling is more effective in increasing the mother's knowledge about the selection of the Post Placenta IUD at the Tawangrejo Health Center. Suggestions to further improve SKB counseling in Post Placenta IUD family planning services.

THE EFFECTIVENESS OF ANTENATAL HYPNOTHERAPY ON ANXIETY IN FACING THE CHILDBIRTH PROCESS

The Maternal Mortality Rate (MMR) in Indonesia is still around 305 per 100,000 Live Births, which has not yet reached the set target of 183 per 100,000 LB in 2024. One of the causes of this high rate is attributed to the anxiety experienced during pregnancy, reaching 373,000 cases. Antenatal hypnotherapy is an effort aimed at reducing maternal anxiety with the goal of preparing for a normal pregnancy and facilitating the labor process. Hypnotherapy in Antenatal care focuses on providing comfort to mothers by inducing deep relaxation. The purpose of this study is to determine the effectiveness of antenatal hypnotherapy in reducing anxiety during the labor process at PMB Pera Medan. The research employed a quantitative approach with a Quasi-Experimental Design (pseudo-experiment). The study utilized a One Group Pre-Test and Post-Test design. The population consisted of all third-trimester pregnant women at PMB Pera Medan, totaling 61 pregnant women, with a sample size of 16 selected through purposive sampling. The research findings indicate that the average anxiety level among third-trimester pregnant women at the Independent Practice of Midwife Pera Medan before receiving antenatal hypnotherapy was 30.1875 (moderate anxiety), which decreased to 13.8750 (mild anxiety) after receiving antenatal hypnotherapy. There is a significant influence of antenatal hypnotherapy on reducing anxiety during labor at PMB Pera Medan with a p-value of 0.000 < 0.05. Therefore, it is advisable to continue antenatal hypnotherapy classes for pregnant women during each ANC visit and at home to reduce anxiety, thereby facilitating a normal labor process.

Nutrient density of Bangladeshi foods and its application in planning diet for pregnant women.

Nutrient profiling is a method that classifies foods based on their nutrient content and identifies foods that are high in micronutrients both across and within food groups. This study aimed to identify foods that are rich sources of the seven micronutrients (iron, zinc, calcium, thiamine, riboflavin, vitamin A, and vitamin B12) of public health concern for the Bangladeshi population.. This study developed a metric termed "naturally nutrient-rich score 7 (NNR7)" specifically for third-trimester pregnant women to identify nutrient-dense foods. Further, it computed the nutrient adequacy score (NAS) of the top NNR7-scored foods for seven micronutrients to assess the extent (percent) to which foods can meet pregnant women's recommended dietary allowances (RDA). A linear programming technique was then used to construct a nutrient-adequate model diet for third-trimester pregnant women using the top ten NNR7-scored foods. According to the NNR7, food groups such as leafy vegetables, fish, meat, poultry and eggs, and vegetables are the richest sources of the problem micronutrients. Mutton liver (916.7%), soybean (39.3%), lamb liver (2160%) and duck liver (50.0%) were found to fulfill the highest percentage of the RDA of vitamin A, zinc, vitamin B12, and iron, respectively. In the formulated nutrient-adequate diets for pregnant women, rice, potato, brown wheat flour, and soya oil were universal to all three diets and Bengal gram, orange, Ganges River sprat, and duck liver were the most common ones. The study findings highlight the need for the consumption of foods such as leafy vegetables, fish, meat, poultry, eggs, pulses and vegetables to increase the intake of problematic micronutrients. Planning a nutrient-adequate diet for pregnant women using linear programming can be an alternative approach to optimize and shape food choices to meet their nutritional requirements.

EVALUATION OF LIPID AND THYROID STATUS IN PREGNANCY AND ITS EFFECT ON NEONATAL OUTCOME

Objective: Maternal nutritional status is essential for the achievement of maternal and fetal growth. Blood lipid concentrations have been associated with adverse pregnancy outcomes such as gestational diabetes, pregnancy-induced hypertension, and high birth weight. As blood lipids are not routinely measured during pregnancy, there is limited information on what is considered normal during pregnancy. In early pregnancy, there is an increase in fat buildup associated with increased fat concentration in blood, lipoprotein, and apolipoprotein in plasma increased significantly during pregnancy. This study was aimed at the analysis of lipid profile and thyroid profile in second- and third-trimester pregnant women, with the incidence of hypertension and their possible effect on neonatal outcome. Methods: Blood samples were collected from the Beri Maternity Hospital, Amritsar, and were analyzed for biochemical investigation, namely lipid profile and thyroid profile. Results: The levels of total cholesterol, triglycerides, high-density lipoprotein (HDL), low-density lipoprotein (LDL), and very LDL have been significantly increased in third-trimester pregnant women as compared to second-trimester pregnant women. However, the level of HDL diminished in the third trimester as compared to the second trimester. Thyroid-stimulating hormone (TSH) levels increased in third-trimester pregnant women. Conclusion: Our findings highlighted the importance of maternal lipid metabolism in preventing pregnancy complications and adverse birth outcomes as human gestation is associated with an “atherogenic” lipid profile which could act as a potential risk factor for pre-eclampsia and endothelial cell dysfunction if further enhanced than the normal limits. Increased blood lipid concentrations during pregnancy are altered by maternal body mass index. This study will help in understanding baseline lipid parameters in the second and third trimesters among pregnant women. Excessive dietary nutrition intake and inadequate physical activity during pregnancy may be important contributors of dyslipidemia which can lead to complications.