Analysis of Cardiac Functional Status and Factors Influencing Adverse Pregnancy Outcomes in Pregnant Women with Combined Heart Disease

Objective:To investigate the cardiac function of pregnant women with complicated heart disease during pregnancy and the factors influencing the adverse pregnancy outcome.Methods:A total of 162 cases of pregnant women with complicated heart disease admitted to the Beijing Anzhen Hospital from October 2021 to December 2023 were selected to compare the occurrence of adverse pregnancy outcomes in pregnant women with complicated heart disease at different levels of cardiac function and to analyze the single and multi factors leading to adverse pregnancy outcomes in pregnant women with complicated heart disease.Results:Among 162 pregnant women with combined heart disease in pregnancy,the highest percentage of heart disease type was congenital heart disease(80/49.38%),and the lowest percentage was other(9/5.56%);the overall incidence of adverse pregnancy outcomes in pregnant women with combined heart disease in pregnancy with cardiac function grades of 3–4 cardiac function(30/68.18%)was higher than that in pregnant women with combined heart disease in cardiac function grades of 1–2(40/33.90%)(P=0.000);age,marital status,hypertension,and past history of all pregnant women were not statistically significant(P>0.05);gestational age,type of heart disease,and cardiac function grading were statistically significant(P<0.05),and these factors were all independent risk factors for adverse pregnancy resolution in pregnant women with combined heart disease(P<0.05).Conclusion:The overall incidence of adverse pregnancy outcomes was higher in pregnant women with heart disease than in those with heart disease grades 1–2,and the number of pregnancies,the type of heart disease,and heart function grades were all independent risk factors for adverse pregnancy outcomes in pregnant women with heart disease.

Adverse Pregnancy Outcomes Following Cryotherapy, Thermal Ablation, and Loop Electrosurgical Excision Procedure for Cervical Treatments among Reproductive Age Women in Zambia

Background: Cervical Intraepithelial neoplasia treatments have become essential interventions to manage cervical lesions. Most recipients are women of reproductive age who, as reported in the literature, may be at risk of adverse pregnancy outcomes. This study investigated the risk of abortions, prematurity, stillbirths, and prolonged labor among reproductive-age women following Cryotherapy, Thermal ablation, and Loop Electrosurgical Excision Procedure treatments in Zambia. Methods: This cross-sectional study analyzed records of 8000 women aged 15 - 49 years at the Adult Infectious Disease Control Centre using records between January 2010 and December 2020. Women constituting the treatment group were all respondents treated by cryotherapy, thermal ablation, and LEEP, while the control group were VIA negative women. Women from both groups were invited to answer a phone survey. Data were analyzed using Stata version 16;descriptive analysis estimated the prevalence and obtained the frequency distribution of abortion, prematurity, prolonged labor and fresh stillbiths. Chi-square and Fisher’s exact test established the associations of CIN and APOs at 95% Confidence intervals. Univariate and multivariable binary logistic regression estimated the odds of adverse pregnancy outcomes across the three treatments. Results: Adverse pregnancy outcomes were more prevalent in the treatment group (39.2%) compared to the untreated group (16.9%). Across the two groups, normal outcomes were lower in the treated (42.3% vs 57.7%). The treated group accounted for the majority of abortions (74.5% vs 25.5%) and prolonged labor (72.5% vs 27.5%), while the untreated group accounted for higher proportions of stillbirths (66.7% vs 33.3%) and prematurity (53% vs 47%). Adverse pregnancy outcomes were five and two times more likely in women treated with thermal ablation (aOR = 5.05, 95% CI = 4.01 - 6.36, p Conclusion: Cervical treatment among Zambian women increases the risk of abortion and prolongs labor. Therefore, caution should be taken when administered to those of reproductive age. Vigilant monitoring should be maintained during pregnancy, delivery, and postpartum to improve maternal and neonatal health.

Birth outcomes and pregnancy complications of women with uterine leiomyoma—a population-based case-control study

Objective Uterine leiomyoma is not a rare pathological condition in pregnant women;thus the aim of the study was to evaluate the recent progress in the treatment of these pregnant women on the basis of the association of leiomyoma in pregnancy (LP) with pregnancy complications and birth outcomes including structural birth defects, i.e. congenital abnormalities (CA) in the offspring. Design Cases with CA and matched controls without CA in the population-based Hungarian Case-Control Surveillan- ce System of Congenital Abnormalities (HCC SCA) were evaluated. Only women with prospectively and medically recorded LP in prenatal maternity logbook and medically recorded birth outcomes (gestational age, birth weight, CA) were included to the study. Setting the HCCSCA, 1980-1996 contained 22,843 cases with CA and 38,151 matched controls without CA. Population Hungarian pregnant women and their informative offspring: live births, stillbirths and prenatally diagnosed malformed fetuses. Methods Comparison of birth outcomes of ca- ses with matched controls and pregnancy com- plications of pregnant women with or without LP. Main outcome measures Pregnancy complications, mean gestational age at delivery and birth weight, rate of preterm birth, low birthweight, CA. Results A total of 34 (0.15%) cases had mothers with LP compared to 71 (0.19%) controls. There was a higher incidence of threatened abortion, placental disorders, mainly abruption placentae and anaemia in mothers with LP. There was no significantly higher rate of preterm birth in the newborns of women with LP but their mean birth weight was higher and it associated with a higher rate of large birthweight newborns. A higher risk of total CA was not found in cases born to mothers with LP (adjusted OR with 95% CI = 0.7, 0.5-1.1), the spe- cified groups of CAs were also assessed versus controls, but a higher occurrence of women with LP was not revealed in any CA group. Con- clusions Women with LP have a higher risk of threatened abortion, placental disorders and anaemia, but a higher rate of adverse birth outcomes including CAs was not found in their offspring.

Placental pathologies and fetal outcome in pregnant women with COVID-19: A retrospective study

Objective:To describe histopathologic findings in the placentas in women with coronavirus disease 2019(COVID-19)during pregnancy.Methods:In a cross-sectional study,38 pregnant women with COVID-19 and undergoing delivery between March 2020 and January 2022,were included.The patients had positive polymerase chain reaction(PCR)test for SARS-CoV-2 infection and the placentas after delivery were sent for histopathologic evaluation based on the Amsterdam Placental Workshop Group Consensus Statement and assessed by two pathologists.Results:Our results showed that maternal vascular malperfusion was the most common and was present in 17 cases(44.7%).These features included accelerated villous maturation(36.8%)distal villous hypoplasia(5.3%),placental infarction(5.3%)and intervillous fibrin deposition(10.5%).Other pathologic findings included focal calcification(10.5%),intravillous congestion and hemorrhage(10.5%),sub-chorionic hemorrhage(5.3%),acute villitis,chronic histiocytic intervillositis and delayed villous maturation each in one case(2.6%).Twelve out of 38 cases showed no significant pathologic changes.Fetal outcomes included neonatal intensive care unit admission rate of 13.2%,dyspnea 31.6%,newborn’s anosmia 7.9%,intrauterine fetal demise 2.6%,asphyxia 2.6%and neonate COVID infection 5.3%.Conclusions:Microvasculopathy,as a sign of maternal vascular malperfusion,is a common finding in placentas from SARS-CoV-2 positive pregnant women in the present study.Further studies with larger sample sizes and comparative studies between COVID-19 positive and negative,as well as information from patient follow-up are suggested.

Retrospective Analysis of Clinical Characteristics and Neonatal Outcomes of Pregnant Women with SARS-COV-2 Infection

This retrospective study aimed to investigate the clinical characteristics and neonatal outcomes of pregnant women with SARS-COV-2 in Wuhan Children's Hospital and further suggested a possible management strategy for infected pregnant women under epidemic situation.In this study,8 pregnant women with SARS-COV-2 who were admitted into Wuhan Children's Hospital,China from February 1,2020 to March 30,2020 and the clinical features,laboratory data,maternal and neonatal outcomes were analyzed.The mean age of the women at the time of admission was 30.6 years.The mean gestational age of the women was 37 weeks±4 days,and one woman presented with dichorionic diamniotic(DCDA)twin pregnancy.Except for one woman who was febrile,others had no typical clinical symptoms.For all pregnant women,the count of white blood cells and lymphocytes appeared normal,but 6 had a lower percentage of lymphocytes.C-reactive protein(CRP)levels were normal for all the women.One neonate was tested positive for the coronavirus IgG and IgM antibodies.The clinical symptoms of the pregnant women with SARS-COV-2 were mild,and the laboratory data showed similar characteristics to those of non-infected pregnant women.Since one neonate was tested positive for coronavirus,there is a possibility of vertical transmission of SARS-CoV-2.Prompt and efficient screening,triage,and isolation of pregnant women are ffective management strategies to reduce nosocomial infection during the SARS-COV-2 epidemic.

Lyell Syndrome with Fatal Outcome in Two Pregnant Women Receiving Antiretroviral Therapy in Guinea Conakry

An old woman, 28 years old, weighing 74 kg was referred for skin detachment associated with bubbles and mucosal erosions. This clinical picture had occurred 15 days after the institution of a triple combination: AZT (300 mg) + 3TC (150 mg) and nevirapine (200 mg), during a pregnancy of 20-week gestation. The woman was in her third gestation. The second case is aged 26, weighing 65 kg. This clinical picture had occurred 20 days after the administration of a triple therapy combination: AZT (300 mg) + 3TC (150 mg) and nevirapine (200 mg), during a pregnancy of 32-week gestation. It was the fourth gestation. The birth of a stillborn had occurred the day before his admission into our service. The diagnosis of Toxic Epidermal Necrolysis with nevirapine was selected on the basis of the clinical and anamnestic arguments. The biological tests showed the following results: transaminases (ALT and AST) were within normal limits, blood glucose, and urea > 10 mmol/l. The evolution was marked by the patient death to Day 9 (D9) and at D2 of hospitalization. Discussion: NET and the SJS have been reported in pregnant women as potentially dangerous complications that are often associated with suspected drugs. Among these drugs, antiretroviral drugs, prescribed to pregnant women to prevent mother to child transmission of HIV are often reported. Our case is an illustration of the problem of HIV management in pregnant women. It also focuses on the association between pregnancy and Toxic Epidermal Necrolysis. Nevirapine is an effective drug in the regimens proposed in the management of HIV patients in limited resources countries. But the high frequency of toxidermia with this drug should lead to its replacement by other antiretrovirals least providers of toxidermia as anti proteases in the context of PMTCT programs.

Survey on Pre-pregnancy Health Knowledge and Service Demands among Un-pregnant Married Women

Objective To understand the pre-pregnancy health knowledge and service needs among un-pregnant married women in Shanghai. Methods A total of 968 newly-married un-pregnant women in Changqiao, Lingyun sub-districts and Huajing town of Xuhui district, Shanghai, were recruited and interviewed by structured questionnaire to collect the information on pre-pregnancy health knowledge and service demands. Results 1） Newly-married women thought the contraceptive methods suitable for them was male condom（84.4%）, followed by oral contraceptives（54%）, emergent contraceptive（52.5%） and contraceptive suppository （48.3%）. 2） The score of pre-pregnancy health knowledge was 54.7±14.5 among the subjects. The participants with junior college or a bachelor had more knowledge than those with junior or senior high school, and those who were engaged in medicine /education/science field had higher score. 3） They had higher knowing rate on the common knowledge, and the rate was above 80%. But the knowing rate on the knowledge of birth defect was low, and all below 50%. 4）A proportion of 52. 7% of the respondents knew that there was a station for reproductive health service in their communities, but only 45.5% received the service from the station, 87.0% thought they had insufficient or scarce knowledge, 73.6% planned to consult before pregnancy training courses on preparing pregnancy. and 63.6% were willing to attend the Conclusion The participants had certain pre-pregnancy health knowledge, but still need being improved,＂ in addition, they had higher needs on knowledge and service of birth defect prevention, at the same time they can＇t make full use of the existing reproductive health institution.

Women’s Motivation and Associated Factors for Herbal Medicine Use during Pregnancy and Childbirth: A Systematic Review

Background: Herbal medicines use has prevailed over the past decades in both low-middle-income and high-income countries over the years. The use among women has increased with increased risks of ill-health. There is extensive literature on herbal medicine use among women in pre/pregnancy, labour, and the postpartum periods. Therefore, this study aimed to understand women’s purposes, experiences, and motivation for using herbal medicines during pregnancy, childbirth and postpartum, and the experiences associated with the use. Methods: Four critical databases were predetermined and searched: CINAHL, Medline, Web of Science, and EMBASE. These databases were chosen for their comprehensiveness and relevance to the review aims. We considered peer-reviewed published articles from January 2000 to December 2018. We chose these databases because we found that they are dominant in the medical and healthcare-related literature. All references were pooled to Endnote reference management software for screening. Quality appraisal of articles was conducted using the Mixed-Method Assessment Tool (MMAT). Content analysis approach was used to extra the data from the articles. Globally, twenty-one articles met the inclusion criteria, and thus, formed the dataset for this review. Results: Most articles (n = 10, 47.6%) reported solely HM uses on only pregnancy whiles the rest evaluated HM uses in labour, pre-pregnancy, and the postpartum periods. The results have shown that the majority of women received information about HM from friends, family, the “black markets,” and drug outlets. Overall, the results were presented in seven broad themes: 1) sociodemographic characteristics of HM users, 2) perceived threat of health problem, 3) sources and quality of the information received, 4) susceptibility to health complications, 5) potential limitations to the use of HM, 6) the motivation for HM utilization, 7) concerns on the combined use of herbal and allopathic medicines. Conclusion: The study recommends the further research into the toxicity of herbal products, to ensure that accurate information can be provided to women before use.

Covid-19 in Pregnancy: Cases of Women Managed in the City of Douala-Cameroon

Introduction: The SARS-COV-2 virus has been responsible for a health crisis in pregnancy, causing severe acute respiratory distress syndrome. Materno-foetal complications can be observed. Taking into account the materno-foetal risks associated with COVID-19 infection in pregnant women and the low sample size of the first publication in Cameroon, we considered it necessary to conduct an in-depth study on the maternal and foetal prognosis of this condition in pregnant women in three hospitals in Douala. Materials and Methods: We conducted a cross-sectional survey with retrospective data collection in the three state tertiary and reference hospitals in Douala (DGOPH, DGH and DLH) from November 1, 2021 to April 30 2022 after obtaining ethical and administrative clearances. All records of COVID-19 pregnant women confirmed by reverse transcription polymerase chain reaction (RT PCR) or COVID-19 rapid diagnostic test (COVID RDT) were included. The survey form contained socio-demographic data, clinical and para-clinical characteristics, management and materno-foetal outcome. SPSS.26 and Microsoft Excel 2016 software were used to analyze the data, and a logistic regression model was used to look for associations between the variables. Results: We found in total 96 files that met our inclusion criteria. The most represented sector of activity was the unemployed (44.46%). Patients with a secondary level of education constituted the majority with 47% (45). The main comorbidity found was diabetes (27.2%). The most frequent symptom was fever, found in 87 patients (90.1%). In our series, a chest CT scan was performed in 50 patients. Caesarean section was the most common mode of delivery (58.3%). We recorded 15.6% of maternal deaths, mainly in patients admitted to intensive care. Factors associated with maternal death were: Maternal diabetes, high LDH and D-dimer levels, and 75% lung involvement on chest CT scan. Oxygen saturation > 94% on admission was a protective factor. Regarding fetal and neonatal outcomes, we registered 30.2% cases of prematurity, 32.3% cases of respiratory distress at birth and 24% neonatal deaths. Factors associated with neonatal death were temperature ≥ 38.5°C. Conclusion: At the end of the study, we can conclude that in pregnant women with COVID-19, fever is the main symptom, 1/3 are admitted to intensive care and caesarean section is the most common mode of delivery. The maternal death rate remains high, especially in diabetic patients admitted to intensive care with altered biological parameters. Fetal complications include prematurity and death.

Relation Ship of Maternal Haemoglobin Concentration Measured in Labour with Neonatal Outcome among Sudanese Women

Objective: Data showed that maternal anaemia during pregnancy negatively affects maternal/fetal outcomes. We here attempted to re-confirm this in this specific region of Sudan, with special reference to fetal/neonatal outcome. Methodology: This cross-sectional observational study was carried out at Omdurman Maternity and Khartoum North Teaching Hospitals-Sudan from March 2018 to March 2019, with 246 pregnant women presented in labour enrolled. Maternal characteristics, haemoglobin (Hb) measured after labour initiation and fetal/neonatal outcomes were analyzed. Results: When maternal anemia was defined as Hb less than 10.0 g/dL, 80 (32.5%) had anemia and 166 had not. Anemic women (Hb;8.3 ± 0.31), compared with non-anemic women (Hb;11.4 ± 0.61), were significantly more likely to have low birth weight (LBW) infants (40% vs. 15.7%) and still birth (12.5% vs. 4.8%). There was a correlation between hemoglobin concentration and the followings: LBW, respiratory distress syndrome, neonatal nursery admission, still birth, early neonatal death, and low Apgar score. Conclusions: Maternal aneamia negatively affected fetal/neonatal outcomes. This data may be useful to make health policy in this area.

Pregnancy outcomes and risk factors for low birth weight and preterm delivery among HIV-infected pregnant women in Guangxi, China

Background Six provinces in China accounted for 70%-80% of all reported HIV/AIDS cases in the country in 2009 and five provinces accounted for 78% of all reported mother-to-child transmission （MTCT） of HIV cases. Because Guangxi belonged to both groups, the Prevention of Mother-to-Child Transmission （PMTCT） Plus program was established there to understand better low birth weight （LBW） and preterm delivery （PD） birth outcomes and their associated risk factors better. Methods Pregnancy outcomes were examined among HIV-infected pregnant women who enrolled in the PMTCT Plus program from June 2006 to February 2009 in Guangxi, China. Multivariate Logistic regression analysis was used to explore the risk factors associated with LBW （〈2500 g） and PD （gestational age 〈37 weeks）. Results The prevalence of LBW and PD among 194 HIV-positive mothers was 19.6% （38/194） and 9.8% （19/194）, respectively. Multivariate Logistic regression analysis showed that CD4 cell count 〈100 cell/IJI （multivariate-adjusted odds ratio （AOR） 5.52; 95% Cl 1.11-25.55） and CD4 cell count 100-199 cells/IJI （AOR3.40; 95% Cl 1.03-11.25, compared to CD4 cell count 〉350 cells/IJI）, gestational age 〈37 weeks （AOR 4.38; 95% Cl 1.29-14.82, compared to 〉37 weeks）, maternal weight 〈45 kg （AOR 5.64; 95% Cl 1.09-29.07） and maternal weight 45-54 kg （AOR 3.55; 95% CI 1.31-9.60, compared to 〉55 kg） at enrollment, and H IV RNA 〉100 000 copies/ml at enrollment （AOR 4.22; 95% CI 1.24-14.32） and 20 000-99 999 （AOR 2.77; 95% Cl 1.01-7.77, compared to 〈20 000 copies/ml） were associated with a higher risk of LBW. For PD, only maternal injection drug use as the route of HIV transmission （AOR 5.30; 95% Cl 1.33-21.14, compared to those infected with HIV through sexual transmission） was significantly associated with a higher risk of PD. Conclusions Lower CD4 cell count and higher HIV RNA viral load at enrollment were associated with LBW. Optimal antenatal care, including earlier antenatal screening and HIV diagnosis, is critical to earlier PMTCT prophylaxis and/or HIV treatment to prevent transmission of HIV to the infant and also to prevent LBW pregnancy outcomes.

A possible association between cervical erosion in pregnant women and congenital abnormalities in their children-a population-based case-control study

Objective to study the possible association between erosion of cervix in pregnant women (ECP) and structural birth defects, i.e. congenital abnormalities (CA) in their offspring. Study design: Comparison of cases with CA and all matched controls without any CA born to wo- men with prospectively and medical record ECP in the population-based large data set of the Hungarian Case-Control Surveillance of Congenital Abnormalities (HCCSCA). Results: HCC- SCA contained 22,843 cases and 38,151 matched controls, the informative offspring of 40 (0.18%) case mothers and the newborns of 25 control mothers (0.07%) with ECP were compared and the higher risk for total CA (adjusted OR with 95% CI: 2.7, 1.6-4.4) was found explained by the higher risk of 9 cases with hypospadias (OR with 95% CI: 4.5, 2.1-9.7) and 10 cases with car-diovascular CAs (OR with 95% CI: 3.4, 1.6-7.1), particularly with conotruncal CAs. Conclusions: An unexpected possible association of ECP with higher risk for hypospadias and conotrun-cal cardiovascular CAs was found and these findings are considered as signals that need confirmation or

Liver injury associated with drug intake during pregnancy

Drug use during pregnancy is not common.Drug-induced liver injury(DILI)is a potential complication that is rare but can adversely affect both the mother and the fetus.Although many drugs can directly cause hepatotoxicity,idiosyncratic liver injury is common in pregnancy.Underreporting of adverse drug reactions,lack of adequate literature regarding drug safety in pregnancy,and the inherent difficulty in diagnosing DILI during pregnancy make the management of this condition challenging.This review attempts to describe the existing literature regarding DILI in pregnancy,which is mainly in the form of case reports;several studies have looked at the safety of antithyroid drugs,antiretroviral drugs,and paracetamol,which have an indication for use in pregnancy;the relevant data from these studies with regard to DILI has been presented.In addition,the review describes the diagnosis of DILI,grading the disease severity,assessment of causality linking the drug to the adverse event,regulatory guidelines for evaluating the potential of drugs to cause liver injury,efforts to ensure better participation of women in clinical trials and studies in pregnant women population in particular,and the challenges involved in generating adequate research evidence.The establishment of DILI registries in various countries is an encouraging development;however,there is a need for promoting active,spontaneous reporting of adverse events during pregnancy to ensure rapid generation of evidence regarding the safety of a drug in pregnant women.

Corona Virus Disease among Pregnant Women: A Systematic Scoping Review

Corona Virus Disease 2019 (COVID-19) is a deadly respiratory viral disease that started in China in the year 2019 before spreading to the world. It affects everybody regardless of race, religion, social economic status or age. However, literature indicates that people with compromised immune status are at a higher risk of contracting viral infections. During pregnancy, the immune status of the woman is suppressed because it acts to protect both the mother and her unborn baby. The purpose of this study was to provide an overview of available evidence on the risk of contracting COVID-19 and COVID-19 infection prevention among pregnant women. Relevant and recent articles were identified from various databases. Article selection was aligned to the study questions. Articles that were related to study objectives were included and those not related to study objectives were excluded. A narrative report was produced and results were described according to study objectives. Approximately 8 data sources were included and most of the reviewed articles indicated that pregnant women are at a higher risk of getting COVID-19. The reviews further indicated that pregnant women can be prevented from this deadly virus by providing community antenatal services instead of visiting the health facilities. If a pregnant woman develops symptoms of respiratory infection, it is advisable to seek immediate diagnosis to rule out COVID-19 and get appropriate management to avoid complications. The selected studies’ quality was appraised through Mixed Methods Appraisal Tool (MMAT) version 2018. Knowledge on the risk of COVID-19 infection among pregnant women will help health workers especially midwives who take care of pregnant women to design confidently and put into action preventive programs to address health needs of pregnant women who are at a higher risk of contracting COVI-19 as compared to other people in the general population. This also will assist health workers to provide appropriate care to pregnant women on the basis of their COVID-19 infection risk status at health facility and community levels. This study review is also creating more awareness on the risk of COVID-19 to pregnant women even in communities. It serves as evidence to guide health policymakers to put emphasis on addressing the preventive measure of this greatly vulnerable group of population. To prevent COVID-19 infection during pregnancy, pregnant women should strictly follow the laid down measures of prevention by World Health Organisation (WHO) and their local health authorities.

Problems of Rational Therapy for Epilepsy during Pregnancy

Epilepsy is one of the most frequent neurological disorders. In these circumstances, more than 25% of the patients are women of reproductive age. The aim of our research was to analyze the effectiveness and safety of antiepileptic therapy in women with epilepsy during pregnancy and to analyze the pregnancies’ outcomes. We included in our research 121 pregnancies of 101 women aged at the moment of childbearing about 26.9 ± 4.57 years old. Idiopathic forms of epilepsy were predominant among all causes—47.1% (р < 0.01). Of all cases, 65.4% remained seizure-free from generalized tonic-clonic seizures (GTCS), including 69.6% of all idiopathic epilepsy cases and 68.6% among symptomatic ones. The antiepileptic drugs (AED) dosages were exceeding teratogenic level at the moment of conception in 54.7% of the cases. Worse control of epileptic seizures was associated with Benzobarbital (66.7%) and Lamotrigine (50.0%). Women with epilepsy did not receive specialized neurological therapy before conception in most cases, which leaded to the usage of AED teratogenic doses and less effectiveness of AED during pregnancy. It is necessary to plan the pregnancy and prescribe rational treatment for epilepsy starting at the stage of planning and during gestation in order to obtain a better seizures control and to decrease congenital disorders risk in fetus.

Missed Opportunities for Intermittent Preventive Treatment among Pregnant Women, in a Secondary Health Facility, Cross River State, Nigeria

The study determined the magnitude and contributory factors for missed opportunities for the administration of IPTp （intermittent preventive treatment for malaria prevention）, during pregnancy among pregnant women attending a secondary health facility in Calabar. This study was a descriptive survey. Exit interviews were carried out on all pregnant and post natal women who attended the antenatal clinic of a secondary health facility for two weeks in November 2008. Data were analyzed using descriptive and inferential statistics. The mean age of respondents was 27.0 ± 5.4, mean parity was 2.4 ± 1.5, mean clinic attendance 4.9 ± 4.0 while mean gestational age at booking was 18.6± 7.7. The prevalence of missed opportunity among the pregnant women was 59.1% for IPTpl ＆ 56.0% for IPTp2; among pregnant PLWHA （people living with HIV/AIDS）, it was 100% for IPTp3, 70% for IPTp2 ＆ 80.0% for IPTpl. Factors accountable for missed opportunity include non-availability of SP （sulfadoxine-pyrimethamine）, lack of supervision, failure to prescribe medication, late booking and lack of knowledge. More women significantly received IPTp2 compared to IPTpl （P = 0.001）. Discussion： The findings establish the need for making SP available in the ANC （antenatal clinic）, educating health workers about current schedule and procedures for administration and early mobilization of pregnant mothers for ANC.

Prevalence and factors associated with non-adherence to therapy among partners of pregnant women with syphilis in a city of northeastern Brazil

BACKGROUND One of the main difficulties faced in the prevention of the vertical transmission of syphilis is the inadequate treatment of pregnant women and their partners.The disease causes serious repercussions in infected newborns.AIM To evaluate the prevalence and factors associated with the therapeutic adhesion among partners of pregnant women with syphilis in a county in Northeastern Brazil.METHODS This is a descriptive,analytic,quantitative,cross-sectional study that was carried out through interviews with 46 pregnant women diagnosed with syphilis between 2017 and 2018 as well as with their partners.The interviews aimed at collecting data regarding sociodemographic characteristics,obstetric variables and information about syphilis,and partners’related variables.RESULTS Our results showed that 73.91%of the partners did not undergo appropriate treatments,and obtaining negative results in syphilis tests was the main reason for the absence of therapies.The following factors were significantly associated with the lack of treatment among partners:Being a partner that is not the current mate of the pregnant woman,having a level of schooling inferior to 8 years[oddsratio(OR)=10.28],and the pregnant woman undergoing up to two syphilis tests during the prenatal care(OR=8.6).The study found a higher odds of absent treatment among partners if the pregnant woman is not white(OR=13.88)or if the partner has less than 8 years of schooling(OR=21.00)or has a monthly income of less than half the minimum wage(OR=13.93).CONCLUSION The findings of this study show a high prevalence of partners that are not adequately treated for syphilis,a phenomenon that is strongly associated with socioeconomic factors.

Analysis of Factors Influencing the Cumulative Pregnancy Outcome of In Vitro Fertilization-Embryo Transfer in Women Aged 35 Years and Older with Normal Ovarian Reserve

Background:To investigate the factors associating with the cumulative clinical pregnancy outcome of in vitro fertilization-embryo transfer(IVF-ET)in women aged 35 years and older with normal ovarian reserve.Methods:A total of 358 patients undergoing IVF-ET at the Department of Reproductive Medicine,the First Affiliated Hospital of Xinjiang Medical University between January 2014 and June 2016 were analyzed by the Kaplan-Meier method and Cox proportional hazards model.Results:The probability of pregnancy in women 35-37 years of age and 38-40 years of age was 75.9%(95%confidence interval[CI]:75.1%-76.7%)and 66.9%(95%CI:65.6%-68.2%),respectively,and it was 37.8%(95%CI:34.7%-41.1%)in women aged 40 years and older.Univariate analysis(hazard ratio[HR]:2.50,95%CI:1.647-3.774)and multivariate analysis(HR:2.17,95%CI:1.427-3.268)showed a correlation between the number of retrieved oocytes and successful pregnancy.Conclusions:The number of retrieved oocytes plays a key role in the pregnancy outcome of women aged 35 years and older with normal ovarian reserve.We recommend the number of retrieved oocytes be increased for women aged 35 years and older with normal ovarian reserve.

Antenatal care positive responses to pregnant women in preventing and controlling malaria in pregnancy:the sub-Saharan African perspective

Background The response to antenatal care(ANC)for maternal and offspring outcomes,especially in pregnant women has been thoroughly studied.However,despite the number of interventional studies on the treatment of sulfadoxine-pyrimethamine combination(IPTp-SP)uptake,the point in point cases of the positive responses of ANC in improving health conditions of pregnant women are not found in the literature.Data sources This review collected ANC responses to the positive health outcomes for pregnant women with malaria,the challenges faced regarding IPTp-SP uptake during ANC visits and the role of ANC in preventing and controlling malaria in sub-Saharan Africa.It elucidated ANC and uptake of optimal intermitent preventive IPTp-SP and further described ANC as a tool for heterogeneity for malaria prevention.Results ANC is seen as a microscope to malaria in pregnacy,maternal iron deficiency and anemia checkpoints,ANC and malaria treatment strategies,and ANC and the use of insecticide treated nets(ITN).The review further discussed ANC attendance influencing factors,limitations to ANC implications and the prospects in ANC visits on preventing malaria in pregnancy.Conclusions A declining trend of malaria transmission in Africa has been observed in recent years.However,the burden of malaria in pregnancy remains a health concern.The rate of SP resistance,low uptake of IPTp-SP,low LLINs distribution,late gestational ANC visits and low turnaround for optimal ANC visits for first time mothers’aggrevated the malaria-endemic settings among pregnant women in sub-Saharan Africa.

Impact of COVID-19 infection during pregnancy on maternal and fetal outcomes

Objectives:The objective of this study is to assess the impact of coronavirus disease 2019(COVID-19)infection during pregnancy on maternal and fetal outcome in relation to gestational age.Methods:This retrospective study was conducted between May 2020 and July 2021.Sixty-five women infected with severe acute respiratory syndrome coronavirus 2(SARS-CoV-2)and hospitalized at a quarantine hospital were included.Thirty-four women received prenatal care at the hospital until delivery,while 31 dropped out from the study due to COVID-19 recovery and discharge before delivery.Results:COVID-19 was found in 83%of the pregnant women after 20 weeks of pregnancy.The most common symptoms were cough and fever.Medical complications included severe pneumonia and thrombosis.The maternal mortality rate was 9.2%.Premature rupture of membranes and severe hypertension during labor affected nearly 9%of the pregnant women who completed prenatal care until delivery at the hospital.Preterm labor occurred at a rate of 38.2%.There were seven(20.8%)stillbirths and two cases of infant mortality.Conclusion:Hospitalized pregnant women who have coronavirus infection,lymphopenia,and a high C-reactive protein level were at a higher risk of developing severe illness,which can lead to maternal and neonatal complications.