Obstetrics and Gynecology International最新文献

Background: Women's and children's health is a crucial public health concern that epitomizes the universal platform for Sustainable Development Goals (SDGs). Appropriate and timely care during pregnancy can improve maternal and child health.

Objectives: The present study aimed at determining the magnitude and determinants of antenatal care services' utilization in Kandahar city.

Methods: A community-based cross-sectional study involving 850 women with at least one delivery in the last 2 years was carried out in Kandahar city from January to February 2021. Questionnaires to record information on sociodemographic, reproductive, and antenatal care- (ANC-) related characteristics were administered. Data were analyzed using SPSS 21.00 statistical software. We used descriptive statistics such as frequency and percentages to present the data. Determinants of antenatal care services' utilization were determined using a multivariable logistic regression model.

Results: Among all study participants, 589 (69.3%, 95% confidence interval (CI) = 66.0%-72.4%) of study participants utilized antenatal care services at least once. However, only 22% of the women were utilizing the recommended ≥4 ANC visits. Factors that remained significantly associated with antenatal care services' utilization in multivariable analysis included women's educational status (adjusted odds ratio (AOR) = 2.0, 95% CI: 1.0-4.3), pregnancy intention (AOR = 2.1, 95% CI: 1.1-3.4), and place of residence (AOR = 1.7, 95% CI: 1.1-2.6).

Conclusion: This study has found high rates (vs. the national level) of antenatal care services' utilization among women who had at least one delivery in the last 2 years. However, the rate of recommended ≥4 ANC visits was low. Factors determining antenatal care utilization such as educational status of the mother, pregnancy intention, and place of residence hold the key to address the issue of ANC services lower utilization and consequently improve maternal and fetal health.

Introduction: The objective of this study was to investigate the impact of socioeconomic determinants on the quality of life of Moroccan women with breast cancer two years after their diagnosis who are followed up at the National Institute of Oncology (INO) in Rabat.

Methods: This is a cross-sectional study that was conducted between May 2019 and September 2020. The sample size was 304 women. Data were collected using the EORTC QLQ-C30 and EORTC QLQ-BR 23 questionnaires in the Moroccan dialect.

Results: The mean age of participants was 53.5 ± 12.4 years, where the majority resided in urban areas and more than half were illiterate. Moreover, three-quarters of the survivors were not working, and almost all have basic medical coverage. Nearly one-third of the respondents had experienced discrimination from those around them, and nearly half attributed the decrease in income to their state of health. In addition, 38.2 percent of participants stated that they had great difficulty living on their monthly income after the illness, whereas more than half of the survivors had a good quality of life in terms of overall health (GHS/QOL). Besides, social function obtained the highest score, while emotional function obtained the lowest score. Furthermore, financial difficulty was the most distressing symptom. Indeed, income adjustment after the disease, discrimination, distance between home and treatment center, professional status, and medical coverage were correlated with GHS/QOL. Regression analysis revealed that income adjustment after illness and discrimination were significant predictors of GHS/QOL.

Conclusion: The data suggest establishing a financial support program and the development of education and awareness-raising policies to combat discrimination.

Background. Fetal bowel could pass meconium, a green viscous fluid, before or during labour and most intrauterine passage of meconium is associated with several fetomaternal factors that lead to increased risk of perinatal morbidity and mortality. Given that there is a paucity of data, this study was conducted to assess the proportion and associated factors of meconium-stained amniotic fluid (MSAF) in women who came for labour and delivery service in a tertiary hospital.

Methods: A cross-sectional study was conducted from 1 June to 31 August 2018 among 606 labouring mothers at Felege Hiwot Referral Hospital, northwest Ethiopia. Study participants were selected using a systematic random sampling technique. Data were collected using an interviewer-administered pretested questionnaire and data checklist. Factors associated with MSAF were explored using multivariable logistic regression analysis.

Results: MSAF occurred in 24.6% (149/606) of pregnancies. Nonreassuring fetal heart rate patterns (Adjusted Odds Ratio [AOR]: 21.9, 95% Confidence interval [95% CI]: 10.96-43.83), postterm pregnancy (AOR: 4.54, 95% CI: 2.24-9.20), duration of labour more than 15 hours (AOR: 2.83, 95% CI: 1.76-4.53), pregnancy-induced hypertension (AOR: 2.43, 95% CI: 1.45-4.05), oligohydramnios (AOR: 2.53, 95% CI: 1.25-5.12), interpregnancy interval less than 2 years (AOR: 2.24, 95% CI: 1.12-4.51), and monthly family income less than 5000 Ethiopian Birr (185 USD) (AOR: 2.03, 95% CI: 1.18-3.51) were significantly associated with MSAF.

Conclusions: In this study, the proportion of MSAF was at 24.6% which was higher than a previous report in Ethiopia. Nonreassuring fetal heart rate pattern, postterm pregnancy, duration of labour more than 15 hours, pregnancy-induced hypertension, oligohydramnios, interpregnancy interval less than 2 years, and monthly family income less than 5000 Ethiopian Birr were factors associated with an increased risk for MSAF. Therefore, interventions aimed at detecting MSAF early should consider these factors.

Background: A postnatal care given after childbirth is a critical care to promote health and to prevent complications of the mother and newborn. However, utilization of this service is low in Ethiopia, and little is known about its coverage and determinants. Thus, this study aimed to assess the prevalence of early postnatal-care service utilization and its associated factors among mothers in Hawassa Zuria district, Sidama Regional State, Ethiopia.

Methods: A cross-sectional study was conducted from 20 February to 20 March 2020 in Hawassa Zuria District among randomly selected 320 mothers. Data were collected by using interviewer-administered structured questionnaires. Data entered were into Epi data version 3.1 and exported to SPSS version 26 for analysis. Descriptive, bivariable, and multivariable logistic regression analysis with odds ratio and 95% confidence interval were conducted. A P value <0.05 was considered a statistically significant association. Finally, the results were presented by texts, tables, and figures.

Result: The prevalence of early postnatal-care service utilization was 29.7% (95% CI = 24.7, 35.5). Age below 25 years [AOR = 3.2 (95% CI = 1.37, 7.48)], having planned and supported pregnancy for last birth [AOR = 2.2 (95% CI = 1.13, 4.38)], having information about obstetric danger signs [AOR = 2.1 (95% CI = 1.25, 3.78)], and having positive attitude on use postnatal services [AOR = 3.5 (95% CI = 1.94, 6.32)] were factors associated with early postnatal-care utilization.

Conclusion: The finding revealed that early postnatal-care utilization in the study area was low. Strengthening family planning services, giving information on obstetrics danger signs, and creating awareness about postnatal care will improve uptake of the service in a timely manner.

Background: Methamphetamine abuse has been a significant problem in Thailand. The methamphetamine abuse problem also affects pregnant women. The study of pregnancy outcomes among methamphetamine users during pregnancy is currently limited.

Objective: To determine maternal and neonatal complications among methamphetamine-abusing parturients. Materials and method. This historical cohort study was conducted at Bhumibol Adulyadej Hospital (BAH), Bangkok, Thailand, between January 2017 and December 2019. The total number of women was 206 who were equally divided into a study and control group. Pregnant women who tested positive for methamphetamine in urine tests during the intrapartum period were compared to the control group with no history of drug abuse.

Results: Maternal outcomes: gestational hypertension was found to be significantly increased in the study group compared to the control group at 14.6 vs. 1.0% (OR 17.4, 95%CI 2.5-134.3). Preeclampsia with and without severe features were found at higher rates in the study group without statistical significance. There were no eclamptic cases in this study. Neonatal outcomes: preterm birth rate of pregnant women who have tested positive in their urine methamphetamine test was significantly higher than in the control group (33.3%, 11.7%, OR 3.7, 95%CI 1.8-7.7). Average birth weight in the study and control group was 2779.1 ± 486.7 and 3049.5 ± 510 gm, respectively (p value < 0.001). Low APGAR score rates of both groups also had no significant difference.

Conclusion: Methamphetamine use during pregnancy increased both maternal and neonatal complications in terms of gestational hypertension, preterm birth, and average birth weight.

Objectives: To compare serum uric acid levels with disease severity and perinatal outcome among preeclamptic and normal pregnant women.

Materials and methods: This was a case-control study carried out in Federal Medical Centre, Umuahia, Nigeria. Consenting pregnant women were consecutively recruited into two groups comprising pregnant women diagnosed with preeclampsia and normotensive nonproteinuric pregnant women. Exclusion criteria included pregnant women who were current smokers, took alcohol, and diagnosed with multiple gestation, diabetes mellitus, or renal failure. Associations between categorical variables such as preeclampsia severity and perinatal outcomes were done using logistic regression while means of continuous variables such as serum uric acid were compared using Student's t-test. Data were presented using odds ratios (ORs) with 95% confidence intervals (95% CI) and a statistical significance level set at P value ˂ 0.05. Data analysis was done using Statistical Package for Social Sciences version 22.

Results: One hundred and two participants were finally analysed. Fifty-one participants were recruited in each arm. Women with preeclampsia had significantly high serum uric acid level versus controls (6.08 ± 0.49 mg/dL vs. 5.20 ± 0.19; P < 0.001). Women with elevated serum uric acid levels (˃6 mg/dL) were found to be 4 times more likely to have severe preeclampsia (P=0.022, OR = 4.00, 95% CI = 1.225-13.056), 66 times more likely to have APGAR score ˂7 in the first minute (P < 0.001, OR = 66.00, 95% CI = 6.991-623.128), and 3 times more likely to have lower birth weight (P=0.038, OR = 3.400, 95% CI = 1.073-10.775) than those with normal serum uric acid levels.

Conclusions: The mean serum uric acid level in a preeclamptic is higher than that of normal pregnant control, and higher levels are associated with severity of the disease and significantly associated with poorer perinatal outcome.

Background: Postnatal care is one of the key strategies to reduce maternal and newborn morbidity and mortality. Early postnatal visit is especially the most critical time for survival of mothers and newborns, particularly through early detection and management of postpartum complication. Despite the benefits, most mothers and newborns do not receive postnatal care services from health care providers during the critical first few days after delivery.

Objective: The aim of this study was to assess utilization of early postnatal care service and associated factors among women who gave birth in the last six months in Wonago District, Gedeo Zone, Southern Ethiopia.

Methods: A community-based cross-sectional study design was employed at Wonago District. A total of 612 mothers who gave birth in the last six months were selected by simple random sampling technique. Pretested structured questionnaire was used for data collection. Data were entered into EpiData version 3.1 and then exported into SPSS version 20 for analysis. Principal component analysis (PCA) and bivariate and multivariate logistic regression were used.

Result: In this study, 13.7% of mothers utilized early postnatal care. Educational status of mothers (AOR = 3.7 : 95 CI; 1.3-10.7), place of delivery (AOR: 1.8 : 95 CI; 1.03-3.2), ANC attendance (AOR = 3.4 : 95 CI; 1.1-10.09), development of complication after delivery (AOR: 7.8 : 95 CI; 3.7-16.2), and previous history of postnatal care utilization (AOR: 2.1 : 95 CI; 1.13-3.9) were found to be associated with early postnatal care service utilization. Conclusion and Recommendations. Educational status of mothers, ANC attendance, place of delivery, delivery complication while giving recent birth, and past history of postnatal care utilization were significant predictors for early postnatal care utilization. Considering this, empowering women with education and overall strengthening of health facility to improve maternal health service utilization are necessary measures to be done at different levels to enhance early postnatal care utilization during this critical time.

Background: Men have a special role to play in promoting maternal and child health during pregnancy, childbirth, and postpartum period. The health of women also requires the participation and cooperation of men. The aim of this study is to compare the effect of virtual and face-to-face childbirth preparation training for spouses of the primiparous women on the pregnancy experience, fear of childbirth (FOC), and mother- and father-infant attachment.

Methods: The primiparous women attending the prenatal clinics of Lolagar Hospital and Azadi and Tehransar health centers of Tehran along with their husbands will be studied. The inclusion criteria for the women's husbands are the first experience of becoming a father, being at least 18 years of age, and the ability to read and write. The exclusion criteria for women's husbands are the history of physical/mental illness; being a smoker; and consuming alcohol, drugs, or psychotropic substances. The participants will be selected by the convenience sampling method and will be divided into three groups of study A, study B, and control. Spouses in study groups A and B will receive childbirth training through virtual and face-to-face methods with similar content, respectively. The control group only receives ordinary prenatal care. At the 18-20 weeks of gestation, demographic information, pregnancy experience scale (PES), and version A of Wijma delivery expectancy/experience questionnaire (WDEQ-A) will be completed. At 37-38 weeks of gestation, the PES and WDEQ-A questionnaires will be completed again and maternal postnatal attachment scale (MPAS) and postnatal paternal-infant attachment questionnaire (PPAQ) will be completed by the parents 12 weeks after the delivery. Discussion. Improving the experience of pregnancy, especially reducing the FOC and creating a positive attitude towards it, is a vital strategy to promote vaginal childbirth and reduce the number of cesarean sections requested by women. Achieving this will reduce the cost of health care and improve the quality of life during pregnancy, after childbirth, and during the growth and development of infants. Ethics and Dissemination. This research has been funded by the Iran University of Medical Sciences, approved by the Thailand Registry of Clinical Trials, and will commence in May 2020. Results will be disseminated through peer-reviewed journals and shared with the academic and medical community to pregnancy and childbirth outcomes. This trial is registered with TCTR20200515011.

Acne vulgaris ranks among the most common dermatologic conditions encountered during adolescence up to adulthood. For moderate to severe cases of acne, isotretinoin is indicated as it is considered the most efficacious medication against acne. However, isotretinoin use is known to have its side effects and most importantly is the drug's teratogenic potential. As a response, programs such as the Retinoid Pregnancy Prevention Program (PPP), System to Manage Accutane-Related Teratogenicity (SMART), and iPLEDGE were put into action as attempts to promote awareness on isotretinoin's teratogenicity and reduce the incidence of exposed pregnancies. Such programs are lacking in Saudi Arabia. This study aimed, therefore, to evaluate the awareness of women of childbearing age in Makkah Province, Saudi Arabia, with regards to the side effects of the medication, specifically its teratogenicity. This study also intended to assess the compliance of both doctors and patients with the recommendations and precautions associated with isotretinoin. A cross-sectional study was conducted on 766 women participants using a previously validated questionnaire. Results showed that majority of the respondents (91%) are generally aware of the side effects of isotretinoin use, particularly its teratogenicity. However, lapses have been identified with regards to the compliance of both the treating physician and the patient. Three-fourths of sexually active women did not use any form of contraception while being on isotretinoin treatment. Two-thirds of the study participants responded that they were not issued approval forms indicating their understanding of the side effects of isotretinoin and the importance of compliance to the treating physician's instructions; 11.5% claimed that their doctors did not perform any blood tests; and 67.7% claimed that no pregnancy test was performed at any time during the treatment. These findings strongly suggest a need for improvement when it comes to compliance of both doctors and patients. It is recommended that doctor-patient communication be more comprehensive and more efforts should be made to follow international guidelines in that regard.