Serum Calcium Ionised Rate and Materno-Perinatal Prognosis in Arterial Hypertension in Pregnancy at the Reference General Hospital of Panzi

Hypertensive disorders of pregnancy are among the leading causes of severe maternal morbidity and mortality, particularly in developing countries. Hypertensive disorders of pregnancy are among the leading causes of severe maternal morbidity and mortality, particularly in developing countries, maternal hypocalcaemia being a factor favouring the onset of arterial hypertension during pregnancy. The aim was to determine the maternal and perinatal prognosis of patients with hypertensive disorders of pregnancy as a function of serum ionised calcium levels. Material and Methods: A cross-sectional analytical study of 114 patients with arterial hypertension during pregnancy or during pregnancy or in the postpartum period at the HGR/Panzi from 1 January 2021 to 30 June 2022, text was entered using Microsoft Office Word 2010 and the tables were analysed using Excel 2010. The data was analysed using SPSS version 20.0 and Stata 14.0. The associations of the variables were calculated using Pearson's chi-square test, with a significance threshold set at a value of p < 0.05. Study of risk factors, Odds ratios and their confidence intervals were estimated in a univariate analysis. The most determining factors were identified by multivariate analysis using the Forward conditional logistic regression model. Results: The mean gestational age was 34.43 ± 4.327 amenorheas weeks, 46.6% of patients had a vaginal delivery, 66.65% of which were indicated for maternal prognosis, maternal complications were associated with maternal hypocalcaemia in 81, 82% (P = 0.043) and an OR = 3.255 (P = 0.0158) threefold risk that the patient presenting with a complication is likely to be in a state of hypocalcaemia at 95% confidence index, and fetal prognosis was not significantly related to maternal calcaemia. Conclusion: Maternal hypocalcaemia is one of the factors that can influence maternal-foetal complications maternal-fetal complications, early management and prevention of this pathology is pathology is important to reduce maternal-fetal morbidity and mortality.

Prevalence and Adverse Pregnancy Outcomes Associated with Maternal Obesity in the Bamenda Regional Hospital

Introduction: Obesity is one of the most common problems of reproductive age women and has been associated with diverse adverse pregnancy outcomes. Its prevalence in pregnancy is estimated at 14% in Cameroon. Objective: The main objective of this study was to determine the adverse pregnancy outcomes associated with obesity in the Regional Hospital Bamenda. Methodology: This was a hospital-based cross-sectional study. We recruited 283 participants and their BMIs were used to classify them as underweight ( - 24.9), overweight (25 - 29.9) and obese (≥30). Ethical clearance, administrative authorisation and consent of participants were obtained. Data was collected using a pretested questionnaire. We collected data on sociodemographic characteristics, anthropometric characteristics, and adverse pregnancy outcomes. Data was analysed using Microsoft Excel version 2010. Fisher’s test was used to determine relative risk on bivariate logistic regression. P-values < 0.05 were considered statistically significant. Results: Most participants were in the age group 20 - 34 years, and were multigravida and multipara. The prevalence of maternal obesity was 31.4%. Obesity was associated with an increased risk of hypertensive disorders [RR: 7.7, 95% CI (2.13 - 42.39), p = 0.0003], caesarean section [RR: 2.9, 95% CI (1.11 - 4.01), p = 0.017] and macrosomia [RR: 7.3, 95% CI (3.03 - 19.61), p Conclusion: Maternal obesity is associated with hypertensive disorders, caesarean section and macrosomia.

Maternal diaphragmatic hernia in pregnancy:A systematic review with a treatment algorithm

BACKGROUND Diaphragmatic hernia(DH)is extremely rarely described during pregnancy.Due to the rarity,there is no diagnostic or treatment algorithm for DH in pregnancy.AIM To summarize and define the most appropriate diagnostic methods and therapeutic options for DH in pregnancy based on scarce literature.METHODS Literature search of English-,German-,Spanish-,and Italian-language articles were performed using PubMed(1946–2021),PubMed Central(1900–2021),and Google Scholar.The PRISMA protocol was followed.The search terms included:Maternal diaphragmatic hernia,congenital hernia,pregnancy,cardiovascular collapse,mediastinal shift,abdominal pain in pregnancy,hyperemesis,diaphragmatic rupture during labor,puerperium,hernie diaphragmatique maternelle,hernia diafragmática congenital.Additional studies were identified by reviewing reference lists of retrieved studies.Demographic,imaging,surgical,and obstetric data were obtained.RESULTS One hundred and fifty-eight cases were collected.The average maternal age increased across observed periods.The proportion of congenital hernias increased,while the other types appeared stationary.Most DHs were left-sided(83.8%).The median number of herniated organs declined across observed periods.A working diagnosis was correct in 50%.DH type did not correlate to maternal or neonatal outcomes.Laparoscopic access increased while thoracotomy varied across periods.Presentation of less than 3 days carried a significant risk of strangulation in pregnancy.CONCLUSION The clinical presentation of DH is easily confused with common chest conditions,delaying the diagnosis,and increasing maternal and fetal mortality.Symptomatic DH should be included in the differential diagnosis of pregnant women with abdominal pain associated with dyspnea and chest pain,especially when followed by collapse.Early diagnosis and immediate intervention lead to excellent maternal and fetal outcomes.A proposed algorithm helps manage pregnant women with maternal DH.Strangulated DH requires an emergent operation,while delivery should be based on obstetric indications.

Effects of Maternal Death on Children Living in the Sagnarigu Municipality

Introduction: The greatest effect of maternal mortality is renowned in children aged 2 - 5 months whose mothers had died. Children whose mothers died due to maternal complications were likely to record a higher mortality in infancy compared to children of surviving mothers. Motherless children mostly suffer a lot due to lack of day-to-day care, isolation, lack of motivation as well as economic cost associated with mother’s death. Thus, the purpose of this study was to ascertain the lives of children whose mothers passed away during childbirth at the Sagnarigu Municipality. Methods: This quantitative cross-sectional study was carried out at the Sagnarigu Municipal. The study recruited 297 respondents. To assess the effects of maternal death on the lives of children, families that experienced maternal death were assessed. The number of pregnancies experienced by the deceased woman, pregnancy-related complaints experienced, determinants of maternal death, number of children alive, and their standard of living were assessed with the aid of a structured questionnaire. Results: The data showed that negligence, illiteracy, poor road access, poverty, ignorance, delays in recognizing the problem, delays in making appropriate decisions, delays in the health facility, delays in giving the appropriate treatments, and traditional beliefs were some of the factors that led to maternal death in the Sagnarigu Municipality. Conclusion: The study concluded that determinants of maternal death in the Sagnarigu Municipal included the following;negligence, illiteracy, poverty, and delays in recognizing the problem. The study findings also demonstrated that the effects of maternal death on children are diverse and cut across different areas of a child’s life including livelihood sustenance, healthcare, education, and emotional and psychological development.

Expression and clinical significance of short-chain fatty acids in patients with intrahepatic cholestasis of pregnancy

BACKGROUND Intrahepatic cholestasis of pregnancy(ICP)is a pregnancy-specific liver condition that typically arises in the middle and late stages of pregnancy.Short-chain fatty acids(SCFAs),prominent metabolites of the gut microbiota,have significant connections with various pregnancy complications,and some SCFAs hold potential for treating such complications.However,the metabolic profile of SCFAs in patients with ICP remains unclear.AIM To investigate the metabolic profiles and differences in SCFAs present in the maternal and cord blood of patients with ICP and determine the clinical significance of these findings.METHODS Maternal serum and cord blood samples were collected from both patients with ICP(ICP group)and normal pregnant women(NP group).Targeted metabolomics was used to assess the SCFA levels in these samples.RESULTS Significant differences in maternal SCFAs were observed between the ICP and NP groups.Most SCFAs exhibited a consistent declining trend in cord blood samples from the ICP group,mirroring the pattern seen in maternal serum.Correlation analysis revealed a positive correlation between maternal serum SCFAs and cord blood SCFAs[r(Pearson)=0.88,P=7.93e-95].In both maternal serum and cord blood,acetic and caproic acids were identified as key metabolites contributing to the differences in SCFAs between the two groups(variable importance for the projection>1).Receiver operating characteristic analysis demonstrated that multiple SCFAs in maternal blood have excellent diagnostic capabilities for ICP,with caproic acid exhibiting the highest diagnostic efficacy(area under the curve=0.97).CONCLUSION Compared with the NP group,significant alterations were observed in the SCFAs of maternal serum and cord blood in the ICP group,although they displayed distinct patterns of change.Furthermore,the SCFA levels in maternal serum and cord blood were significantly positively correlated.Notably,certain maternal serum SCFAs,specifically caproic and acetic acids,demonstrated excellent diagnostic efficiency for ICP.

Evaluation of Spontaneous Fertility after Medical Treatment of Tubal Ectopic Pregnancy in Two Hospitals in the City of Yaounde

Background: Ectopic pregnancy is a major cause of maternal morbidity and mortality, estimated to occur in 1% - 2% of pregnancies worldwide. This condition also has an adverse effect on the fertility prospects of women who experience it. Objective: To determine the outcomes of subsequent spontaneous fertility after medical treatment of patients with methotrexate (MTX) in patients with ectopic pregnancy at two university teaching hospitals of Yaounde. Methodology: We carried out a cross-sectional study with retrospective data collection in two university teaching hospitals of Yaounde during a six years period from 1st January 2015 to 31st May 2021. Seventy records of patients who had medical treatment for ectopic pregnancy were included in this study. Statistical analysis was performed using SPSS. 23. The Chi-2 statistical test was used to compare qualitative variables. Binary logistic regression method was performed to identify independent risk factors associated with infertility after medical treatment of tubal ectopic pregnancy (TEP). The significance level was set at 0.05. Results: The mean age in our study population was 27.8 ± 3.8 years. According to the past medical history, 52.9% had a pelvic inflammatory disease (PID) and the most frequently germ found was C. trachomatis (47.1%). Almost 15% of our study population had previous surgery for EP. The median Fernandez score was 11 with a minimum score of 4 and a maximum score of 13. The route of administration of methotrexate was intramuscular in all our patients, and the single-dose protocol was used most frequently (58.6%). After medical treatment of the EP, we found a spontaneous conception rate of 58.6%. After multivariate analysis, we were unable to confirm that there was an association between a history of sexually transmitted infections (STIs) and fertility prognosis. Conclusion: The spontaneous fertility rate after medical management of EP was 58.6%, of which 73.2% were term pregnancies and 14.6% were recurrent ectopic pregnancies.

International Outcomes of COVID-19 during Pregnancy and a Literature Review on Maternal and Neonatal Outcomes

Since the first report of COVID-19 in December 2019, our knowledge and treatment modalities have evolved at great pace understanding its impact on the maternal and neonatal outcomes. Whilst pregnant patients are not more susceptible to acquiring the infection as compared to the general population, they may be at higher risk of developing severe symptoms given the physiological changes, relative immune-compromised state of pregnancy, and their neonates at risk of consequent iatrogenic preterm deliveries. Our review article discusses outcomes of pregnant women and neonates with COVID-19 from several countries including the UK, USA, France, Italy and China and provides a narrative review of literature from November 2019 till December 2020.

Maternal mental disorders in pregnancy and the puerperium and risks to infant health

Prenatal and postnatal period presents the highest prevalence of mental disorders in women's lives and depression is the most frequent one,affecting approximately one in every five mothers.The aggravating factor here is that during this period psychiatric symptoms affect not only women's health and well-being but may also interfere in the infant's intra and extra-uterine development.Although the causes of the relationship between maternal mental disorders and possible risks to a child's health and development remain unknown,it is suspected that these risks may be related to the use of psychotropic drugs during pregnancy,to substance abuse and the mother's lifestyle.Moreover,after delivery,maternal mental disorders may also impair the ties of affection(bonding) with the newborn and the ma-ternal capacity of caring in the post-partum period thus increasing the risk for infant infection and malnutrition,impaired child growth that is expressed in low weight and height for age,and even behavioral problems and vulnerability to presenting mental disorders in adulthood.Generally speaking,research on this theme can be divided into the type of mental disorder analyzed: studies that research minor mental disorders during pregnancy such as depression and anxiety find an association between these maternal disorders and obstetric complications such as prematurity and low birth weight,whereas studies that evaluate severe maternal mental disorders such as schizophrenia and bipolar disorder have found not only an association with general obstetric complications as well as with congenital malformations and perinatal mortality.Therefore,the success of infant growth care programs also depends on the mother's mental well being.Such findings have led to the need for new public policies in the field of maternal-infant care geared toward the population of mothers.However,more research is necessary so as to confirm the association between all factors with greater scientific rigor.

Improving Maternal Mortality: Comprehensive Reporting for All Pregnancy Outcomes

Objective: To demonstrate the impact of inadequate standardization and population coverage on the ability to measure and improve maternal mortality in the United States. Data Sources: The CDC Wonder system for the years 2000-2015 using the following definitions of maternal mortality and associated ICD-CM-10 codes: 1) Maternal deaths up to 42 days after delivery (A34, O00-O99, except O96-O97);2) Maternal deaths within one year after delivery (A34, O00-O99, except O97);3) All maternal deaths (A34, O00-O99). Study Design: For each year between 2000-2015, we provided maternal deaths, live births, and calculated maternal mortality ratios (MDR). For deaths within 42 days, we also calculated adjusted mortality ratios (ADR). Principal Findings: Maternal mortality comparisons which utilize inconsistent definitions and apply non-validated statistical adjustments produce specious results. Conclusions: Variation and inconsistency in definitions, coding, and other reporting anomalies render the current aggregated vital statistics on maternal mortality inadequate for accurate trending and service impact studies. The definition of maternal mortality must be expanded to all outcomes of pregnancy: births, induced abortions, and natural fetal losses.

Adverse pregnancy outcomes in extremely maternal age

Objective: To study the adverse outcome in pregnant women ≤ 16 and ≥ 40 years. Study Design: A total of 1100 cases, 1061 cases of pregnant women ≤ 16 years, 20 - 29 and ≥ 40 years with completed charts between 1st January, 2006 to 31st December, 2010, were enrolled in this study. The patient data includeing demographic data, hospital course, maternal laboratory investigations, maternal complications, placental complications and neonatal outcomes were recorded. SPSS version 14, one-way Anowa, Chi-square and analysis of varience were used to compare the data among two and three groups. Results: Anemia, underlying medical diseases including heart, thyroid and pulmonary diseases, obstetric complications including severe pre-eclampsia and gestational diabetes mellitus, placenta previa and preterm labour;medical administrations including magnesium sulfate, dexamethasone and bricanyl, outcome of deliveries and neonatal outcomes, were different with statistical significance between the 3 groups of pregnant women. Conclusion: Adverse maternal and neonatal outcomes were mostly found in the pregnant women ≤ 16 and ≥ 40 years. Education of contraception, safe sex and effective care during pregnancy of both extremely maternal age groups should be implemented to reduce those poor outcomes.

Maternal alcohol consumption during pregnancy and the risk of childhood acute leukemia:a meta-analysis

Objective： The authors used a meta-analytic technique to quantify the evidence of an association between ma- ternal alcohol consumption during pregnancy and childhood acute leukemia （AL）, which provided a basis for the prevention of childhood AL. Methods： Relevant literatures of maternal alcohol consumption during pregnancy were comprehensively searched and screened. Subgroup meta-analysis was conducted according to the type of leukemia. Results of research data of maternal alcohol consumption during pregnancy were tested for heterogeneity. Combined OR values and 95% CIs were statistically calculated with RevMan 4.2 software; Funnel plots were applied to conduct bias analysis for those included litera- tures. Results： Ten related literatures were included after data screening, 4593 cases in AL group and 6157 cases in control group respectively. According to heterogeneity test result （X2 = 16.26, P 〈 0.05）, the combined OR values and 95% CI were calculated with random effects model, which were 1.02 （0.92-1.14）, Z = 0.41, P = 0.68 〉 0.05, indicating that there was no significant difference between maternal alcohol consumption during pregnancy and the risk of childhood acute leukemia （AL）. Subgroup analysis： for the association between maternal alcohol consumption during pregnancy and childhood acute lympho- blastic leukemia （ALL）, the combined OR value and 95% CI were 0.92 （0.84-1.00）, Z = 1.92, P = 0.05, indicating that there was significant difference between two groups; for the association between maternal alcohol consumption during pregnancy and childhood acute non-lymphoblastic leukemia （ANLL）, the combined OR values and 95% CI were 0.82 （0.61-1.11）, Z = 1.30, P = 0.19 〉 0.05, indicating that there was no significant difference between two groups. Conclusion： Maternal alcohol consumption during pregnancy is a risk factor in childhood ALL, but not in childhood ANLL.

Efficacy of Danshen Injection Combined with Phosphocreatine Disodium in Treating Frequent Premature Contractions during Pregnancy and Its Effects on Maternal and Infant Outcomes

[Objectives]To explore the efficacy of Danshen Injection combined with phosphocreatine disodium in treating frequent premature contractions during pregnancy and its effect on maternal and infant outcomes.[Methods]A total of 200 pregnant women with normal pregnancy and frequent premature contractions who were treated in the outpatient department of internal medicine in Women and Children's Hospital of Hubei Province and Xinzhou District People's Hospital of Wuhan Central Hospital during September 2015 and October 2018 were selected and randomly divided into the control group and observation group,100 cases for each group.The observation group was treated with Danshen Injection combined with phosphocreatine disodium,and the control group was treated with phosphocreatine disodium alone.The course of treatment in both groups was one week.During the treatment,the changes of heart rate,heart rhythm,electrocardiogram and 24-h dynamic electrocardiogram(DCG)of both groups were observed.[Results]After treatment,the clinical efficacy of the observation group was better than that of the control group,and the difference was statistically significant(P<0.01).There were no adverse drug reactions in both groups.However,in the control group,non-sustained ventricular tachycardia(NSVT)was found in 24-h dynamic electrocardiogram(DCG)of 2 pregnant women with premature ventricular contraction.The pregnancy process was smooth,with full-term natural delivery and no fetal malformation.There was no significant difference in gestational age and neonatal weight between the two groups(P>0.05).However,there was a statistically significant difference in Apgar score between the two groups(P<0.05).During the 6-month postpartum follow-up,the mother and child were unharmed,and examination of repeated electrocardiograms showed that the conditions were normal.[Conclusions]Danshen Injection combined with phosphocreatine disodium has better efficacy in the treatment of frequent premature contractions during pregnancy and the maternal and infant outcomes than the treatment with phosphocreatine disodium alone,and it has good safety and can prevent premature contractions from progressing to tachyarrhythmias.

Negative Effects of Maternal Smoking on Pregnancy and the Fetus in Relation to Elevated Levels of Erythropoetin in Umbilical Cord Plasma

Introduction: Based on many scientific research studies, there has been demonstrated a relation between smoking of pregnant women and its negative effects on pregnancy, intrauterine fetal growth, postnatal newborn condition, and development. The aim of our study is to highlight the adverse effects of cigarette use during pregnancy and to evaluate the effect of maternal smoking on the levels of erythropoietin (EPO) in umbilical cord plasma. Our aim was to show an effect of maternal smoking by determining carboxyhemoglobin (COHb) levels in maternal blood, too. Design: Prospective analysis. Setting: Department of Gynecology and Obstetrics, Jessenius Faculty of Medicine, Comenius University, Martin, Slovak Republic. Methods: Our study included 174 newborns. Mothers were divided into group of smokers (n = 67) and non-smokers (n = 107). This prospective study was realized from February 2012 to November 2013 at the Department of Gynecology and Obstetrics, Jessenius Faculty of Medicine in Martin, Slovak Republic. Patients signed a written informed consent and completed a questionnaire that involved medical history, and data of their smoking habits. EPO levels were measured in 174 samples of umbilical cord plasma. Infants were born spontaneously at term. Results: We observed significantly higher EPO levels in umbilical cord plasma in children born to smokers in contrast to non-smokers’ (children of non-smoking mothers: 19 ± 8 mIU/mL;children of smokers: 61 ± 33 mIU/mL, p < 0.01). The COHb levels were significantly higher in smokers (non-smokers: 0.8% ± 0.4%;smokers: 3.6% ± 1.1%, p < 0.001). Conclusion: Smoking during pregnancy is associated with elevated EPO concentrations in umbilical cord plasma at the time of birth. Based on the results of our study, we would like to support women planning pregnancy and pregnant women to quit smoking. Closer surveillance is recommended in smoking pregnant women, particularly because of the risk of placental insufficiency and fetal growth retardation.

Clinical Manifestations and Maternal and Infant Outcomes of Pregnancy Complicated with Thrombocytopenia

Objective:To explore the clinical manifestations as well as maternal and infant outcomes of pregnancy complicated with thrombocytopenia.Methods:A total of 478 pregnant women with thrombocytopenia,treated in Shaanxi Provincial People's Hospital from July 2019 to June 2021,were selected as the research group,while 200 nonnal pregnant women,treated during the same period,were selected as the control group to analyze gestational thrombocytopenia(GT),idiopathic thrombocytopenic purpura(ITP),pregnancy-induced hypertension(PIH),adverse maternal and infant outcomes,etc.Results:Among the 478 patients in the research group,the main causes of pregnancy complicated with thrombocytopenia were GT,ITP,and PIH,accounting for 75.51%,6.49%,and 8.79%,respectively,while other causes accounted for 9.21%.There was no significant difference between the research group and the control group in the amoxmt of intrapartum bleeding,premature delivery,stillbirth,thrombocytopenia,and neonatal asphyxia,but there was significant difference in the mode of delivery(P<0.05)・Conclusion:The traditional indexes of coagulation function are not abnormal with decreased platelets in pregnant women with thrombocytopenia,but the indexes of thromboelasticity are abnormal and can reflect the changes of coagulation function.The cesarean section rate of patients with thrombocytopenia in pregnancy increases with the decrease of platelet count,but the mode of delivery should be determined in consideration of specific conditions.

Intermittent Preventive Treatment in Pregnancy with Sulphadoxine-Pyrimethamine Does Not Have Effect on Maternal Hemoglobin at Delivery and Birth Weight in Kisangani, Democratic Republic of Congo

Background: The consequences of malaria during pregnancy are different regarding local conditions of malaria transmission. In stable malaria areas, the main complications are maternal anaemia and fetal growth restriction. This study aims to determine if pregnancy-associated malaria is associated with the risk of the above-mentioned complications and to determine if IPTp-sp reduces them in Kisangani. Methods: It is a cross-sectional analytical study conducted in parturients, in 6 medical facilities of Kisangani, from January 1st to September 30th, 2017. At delivery we measured their hemoglobin, we performed the thick blood smear of their peripheral blood and placental apposition;and we weighed their newborns at birth. Results: Risk of anaemia at delivery increased with malaria access during pregnancy (p = 0.0056;OR: 1.4221, 95% CI: 1.0851 - 1.8638) and peripheral parasitaemia at delivery (p = 0.0000;OR: 6.3855, 95% CI: 4.5552 - 8.9512). LBW increased with peripheral parasitaemia at delivery (p = 0.0000;OR: 3.5299, 95% CI: 2.4424 - 5.1015) and placental parasitaemia (p = 0.0000;OR: 18.3247, 95% CI: 12.5141 - 26.8332). IPTp-sp did not have effect on maternal hemoglobin at delivery (p = 0.1546;OR: 0.7553, IC à 95%: 0.4414 - 1.2923) and the birth weight (p = 0.1225;OR: 0.6638, IC à 95%: 0.3375 - 1.3056). Conclusion: In Kisangani, pregnancy-associated malaria is associated with maternal anaemia at delivery and LBW. IPTp-sp does not reduce the risk of these complications. Therefore, studies evaluating IPTp alternatives are required in malaria endemic areas.

Obstetric Outcomes in Advanced Maternal Age among Women at King Abdulaziz University Hospital

Background: Advanced maternal age, over 35 years, is a well-known risk factor for poor pregnancy outcomes. It is commonly associated with various pregnancy complications, such as spontaneous miscarriage, preeclampsia/ toxemia, gestational diabetes mellitus, preterm labor, stillbirth, chromosomal abnormalities, and cesarean delivery. Objectives: This study assessed obstetric and neonatal complications associated with advanced maternal age. Methods: We reviewed the medical records of 199 pregnant women over 35 years old at King Abdulaziz University Hospital in Jeddah, Saudi Arabia, from January to June 2022. We gathered data on age, nationality, number of antenatal visits, results of ultrasound scans for dating and viability, nuchal translucency and anatomy surveys, medications and multivitamins taken during pregnancy, smoking status, pregnancy, and fetal complications, and mode of delivery. Results: The prevalence of obstetric complications was 71.4% (preeclampsia/toxemia, 4.5%;antepartum hemorrhage, 4%;postpartum hemorrhage, 1%;and gestational diabetes, 23.1%). The most frequent complication was preterm labor between 34 and 36 weeks (48%), and only 12.6% of all deliveries were associated with fetal and neonatal complications such as congenital anomalies and neonatal jaundice. The prevalence of anemia during pregnancy was 10.1%, 21.1%, and 28.6% in the first, second, and third trimesters, respectively, and pregnancies complicated with antepartum or postpartum hemorrhage were associated with higher rates of anemia in the second trimester. A significant relationship was found between mean maternal age (38.84 ± 2.75 years) and the development of maternal complications (p < 0.05). Newborns with neonatal complications were much more likely to be born to mothers with a history of antepartum hemorrhage and anemia in the second trimester. Conclusion: Our findings confirm that pregnancy at an advanced maternal age is associated with increased overall maternal complications. The most frequent complication was preterm labor (48%). Other complications, such as preeclampsia/toxemia, antepartum hemorrhage, postpartum hemorrhage, gestational diabetes, and anemia, were less frequent in the sample we reviewed.

Maternal and Foetal Outcome among Pregnant Women Infected with COVID-19 in Three Referral Hospitals in Cameroon

Introduction: Pregnancy is generally known to be an immune compromised state, thus placing pregnant women at risk of SARS-COV-2 infection. We therefore carried out this study to assess the maternal and foetal outcomes among pregnant women infected with COVID-19 in three referral hospitals in Cameroon. Methodology: This was a hospital-based retrospective case control study covering a two-year period. Data collection was done over a duration of four months at the Yaoundé Central Hospital, Douala Gynaeco-Obstetric and Paediatric Hospital and the Bamenda Regional Hospital. Cases were pregnant women who gave birth after a confirmed COVID-19 infection, matched 1:2 by age (±1 year) and parity (±1) to pregnant women not infected by COVID-19, who gave birth at the three hospitals within the same period. Results: The rate of caesarean section delivery among our cases was 52.4% as compared to 44.3% among controls (OR, 1.38, 95% CI, 0.74 - 2.60, P = 0.296). Maternal mortality rate in our cases was at 8.2% as compared to 6.6% in controls (OR, 1.60, 95% CI, 0.50 - 5.12, P = 0.422). The rate of preterm delivery in our cases was 24.6% as compared to 11.5% in the control group (OR, 2.39, 95% CI, 1.05 - 5.42, P = 0.025). Perinatal death rate in our study was recorded at 8.2% as compared to 3.4% in the controls (OR, 2.63, 95% CI, 0.68 - 10.18, PS = 0.162) Conclusion: Pregnant women infected with COVID-19 were found to have higher risks of preterm delivery and acute foetal distress as compared to pregnant women who were not infected. Caesarean section deliveries, maternal and foetal mortality were higher in COVID-19 infected pregnant women as compared to those not though these findings were not statistically significant.

Maternal Vascular Dysfunction in Congenital Heart Defects

Background:Research on fetal congenital heart defect(CHD)mostly focuses on etiology and mechanisms.However,studies on maternal complications or pathophysiology are limited.Our objective was to determine whether vascular dysfunction exists in pregnant women carrying a fetus with congenital heart defects.Methods:We conducted a case-control study.27 cases of pregnant women carrying a fetus with major CHD admitted to our hospital for delivery between April 2021 and August 2022 were selected.Every case was matched with about 2 pregnant complication-free controls without fetal abnormalities.The proangiogenic and anti-angiogenic factors and pregnancy outcomes were compared.Results:The proangiogenic factors include vascular endothelial growth factor(VEGF)and placental growth factor(PlGF).The anti-angiogenic factors involve soluble fms-like tyrosine kinase 1(sFlt-1)and soluble endoglin(sEng).No differences were found in maternal plasma concentrations of PlGF,VEGF,and sFlt-1 between case-control groups when analyzed at 36 weeks≤gestational age(GA)<39 weeks and 39 weeks≤GA≤41 weeks.The concentrations of sEng in maternal plasma in the fetal CHD group were significantly higher than those in the control group:0.60(0.77)vs.0.32(0.26)ng/ml at 36 weeks≤GA<39 weeks,p=0.001 and 0.75(0.55)vs.0.28(0.27)ng/ml at 39 weeks≤GA≤41 weeks,p<0.001.Conclusion:Vascular dysfunction exists in pregnant women with fetal congenital heart defects,manifesting significantly elevated sEng concentration at delivery.

Pregnancy Outcomes at Kasungu Maternity Ward in Central Malawi—A Review of Maternity Ward Register

Health care services during pregnancy and childbirth and after delivery are important for the survival and wellbeing of both the mother and the infant. The pregnancy outcomes at Kasungu District Hospital Maternity Ward have not been documented. Additionally, MDHS does not capture data regarding, prematurity, APGAR scores, and causes of maternal deaths and causes of neonatal deaths. Using Kasungu District Hospital Maternity Ward register, we aimed to describe the pregnancy outcomes at Kasungu Maternity Ward. From March 2016 to February 2017, data were available for 10,842 deliveries. The calculated Perinatal Mortality Rate (PMR) was about 77/1000 births and the Maternal Mortality Ratio (MMR) was 318 deaths per 100,000 live births. The Spontaneous Vertex Delivery (SVD) rate was 86% and the caesarean section rate was 10%. 1734 (16%) of all deliveries were premature borne between 28 and 36 gestation weeks. 1182 (11%) deliveries had missing APGAR scores and 81 neonates were born with 5 min Apgar scores less than 7. Adverse pregnancy outcomes occur at Kasungu Hospital Maternity Ward. More effort and resources are needed to decrease their occurrence.

Ectopic Pregnancy Combined with Intra-Uterine Pregnancy with a Full-Term Live Baby: A Case Report and Review of Literature

Heterotopic pregnancy is no more a medical breakthrough. It combines intrauterine pregnancy and extra-uterine pregnancy regardless of location. We report a case of intra-uterine pregnancy associated with a ruptured abdominal ectopic pregnancy located on the pelvic colon in a 29-year-old patient, third gestation, primigravida, having a live baby and a prior history of two abortions. She has blood group O negative of Rhesus. It has been diagnosed at the stage of the rupture of ectopic pregnancy. An emergency laparotomy performed under blood transfusion has revealed heavy hemoperitoneum (1100 ml), a ruptured abdominal extra-uterine localized on the pelvic under blood transfusion and a bulging uterus. We have proceeded with the aspiration of hemoperitoneum, the ablation of the extra-uterine pregnancy and the hemostasis of the section part. The post-operative follow-up has been easy. The intra-uterine pregnancy has developed normally and has given birth to a full-term live, and healthy baby.