Introduction: Herbal medicine is described by the World Health Organization (WHO) as plant-derived compounds, either raw or processed, that are thought to have therapeutic advantages. Herbal medication is becoming more and more popular worldwide, particularly during pregnancy. The WHO estimates that 80% of people utilize herbal remedies. In Ethiopia, grandmothers and grandfathers frequently use herbal medicine at home to treat common health issues. Instead of using medically proven treatments during their pregnancy, the majority of expectant mothers trust herbal remedies. Objective: The aim of this study was to assess the magnitude and associated factors of herbal medicine use during pregnancy among women attending antenatal care in public health institutions of central Tigray, northern Ethiopia. Methods: Facility-based cross-sectional study was conducted from March 01 to May 15, 2020. Data were collected using a structured and pretested questionnaire. Data were entered into Epi-data manager version 7.2.5 and analyzed using SPSS version 23. Both binary and multivariate logistic regression analyses were carried out to assess the associated factors. Variables with p value less the 0.2 in bivariate analysis were transferred to multivariate analysis, and variables with p value ≤ 0.05 were considered as significant. Result: Out of the total 333 respondents, making a response rate of 100%, 176 (52.9%) used herbal medicine during current pregnancy. The most common medicines used during pregnancy were garlic (59.4%) and ginger (51.7%). Occupation that is housewife had educational status (AOR = 11.816, 95% CI 1.848-35.535), illiterate (AOR = 1.886, 95% CI 1.586-2.241), residency/rural (AOR = 2.905, 95% CI 1.173-7.197), and average monthly income less than 500 Ethiopian birrs (AOR = 7.621, 95% CI 2.691-21.585) were factors that are significantly associated with the use of herbal medicine during pregnancy. Conclusion and Recommendation: Based on our results, herbal medicine use during pregnancy is highly practiced in this study, and occupation, residency, educational status, and average monthly income were the significantly associated factors of herbal medicine use during pregnancy. There is a need to educate and counsel pregnant women on the harmful effects of herbal medicine use during pregnancy by the health care personnel and health extension worker.
导言:世界卫生组织(WHO)将草药描述为植物提取的化合物,无论是未加工的还是加工过的,都被认为具有治疗优势。草药在全世界越来越受欢迎,尤其是在怀孕期间。世卫组织估计,80% 的人使用草药疗法。在埃塞俄比亚,祖母和祖父经常在家里使用草药来治疗常见的健康问题。大多数准妈妈在怀孕期间不使用经过医学验证的治疗方法,而是相信草药疗法。研究目的本研究旨在评估埃塞俄比亚北部提格雷中部公共医疗机构中接受产前检查的妇女在怀孕期间使用草药的程度和相关因素。研究方法于 2020 年 3 月 1 日至 5 月 15 日开展了基于医疗机构的横断面研究。采用结构化的预试问卷收集数据。数据输入 Epi-data 管理器 7.2.5 版,并使用 SPSS 23 版进行分析。对相关因素进行了二元和多元逻辑回归分析。二元分析中 P 值小于 0.2 的变量转入多元分析,P 值小于 0.05 的变量被视为显著变量。结果在 333 名受访者中,有 176 人(52.9%)在怀孕期间使用过中草药,回复率为 100%。孕期最常用的药物是大蒜(59.4%)和生姜(51.7%)。家庭主妇职业、受教育程度(AOR = 11.816,95% CI 1.848-35.535)、文盲(AOR = 1.886,95% CI 1.586-2.241)、居住地/农村(AOR = 2.905,95% CI 1.173-7.197)和平均月收入低于 500 埃塞俄比亚比尔(AOR = 7.621,95% CI 2.691-21.585)是与孕期使用草药显著相关的因素。结论与建议:根据我们的研究结果,在本研究中,孕期使用中草药的比例很高,而职业、居住地、教育状况和平均月收入是与孕期使用中草药显著相关的因素。医护人员和卫生推广人员有必要就孕期使用中草药的有害影响对孕妇进行教育和咨询。
{"title":"Magnitude and Associated Factors of Herbal Medicine Use During Pregnancy Among Women Attending Antenatal Care in Public Health Institutions of Central Tigray, Northern Ethiopia (2020): Facility-Based Cross-Sectional Study.","authors":"Hailemikael Gebrekidan, Gebregziabher Kidanemariam","doi":"10.1155/2024/9932851","DOIUrl":"10.1155/2024/9932851","url":null,"abstract":"<p><p><b>Introduction:</b> Herbal medicine is described by the World Health Organization (WHO) as plant-derived compounds, either raw or processed, that are thought to have therapeutic advantages. Herbal medication is becoming more and more popular worldwide, particularly during pregnancy. The WHO estimates that 80% of people utilize herbal remedies. In Ethiopia, grandmothers and grandfathers frequently use herbal medicine at home to treat common health issues. Instead of using medically proven treatments during their pregnancy, the majority of expectant mothers trust herbal remedies. <b>Objective:</b> The aim of this study was to assess the magnitude and associated factors of herbal medicine use during pregnancy among women attending antenatal care in public health institutions of central Tigray, northern Ethiopia. <b>Methods:</b> Facility-based cross-sectional study was conducted from March 01 to May 15, 2020. Data were collected using a structured and pretested questionnaire. Data were entered into Epi-data manager version 7.2.5 and analyzed using SPSS version 23. Both binary and multivariate logistic regression analyses were carried out to assess the associated factors. Variables with <i>p</i> value less the 0.2 in bivariate analysis were transferred to multivariate analysis, and variables with <i>p</i> value ≤ 0.05 were considered as significant. <b>Result</b>: Out of the total 333 respondents, making a response rate of 100%, 176 (52.9%) used herbal medicine during current pregnancy. The most common medicines used during pregnancy were garlic (59.4%) and ginger (51.7%). Occupation that is housewife had educational status (AOR = 11.816, 95% CI 1.848-35.535), illiterate (AOR = 1.886, 95% CI 1.586-2.241), residency/rural (AOR = 2.905, 95% CI 1.173-7.197), and average monthly income less than 500 Ethiopian birrs (AOR = 7.621, 95% CI 2.691-21.585) were factors that are significantly associated with the use of herbal medicine during pregnancy. <b>Conclusion and Recommendation:</b> Based on our results, herbal medicine use during pregnancy is highly practiced in this study, and occupation, residency, educational status, and average monthly income were the significantly associated factors of herbal medicine use during pregnancy. There is a need to educate and counsel pregnant women on the harmful effects of herbal medicine use during pregnancy by the health care personnel and health extension worker.</p>","PeriodicalId":47062,"journal":{"name":"Journal of Pregnancy","volume":null,"pages":null},"PeriodicalIF":3.2,"publicationDate":"2024-10-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11511591/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142510280","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-10-17eCollection Date: 2024-01-01DOI: 10.1155/2024/8895971
Suada Suleiman Ibrahim, Yarine Fajardo Tornes, Musa Kayondo, Fidel Kasereka Tsongo, Godfrey Rwambuka Mugyenyi, Joseph Ngonzi, Henry Mark Lugobe, Julius Sebikali Mugisha, Leevan Tibaijuka
Background: Hypertensive disorders of pregnancy (HDP) are associated with placental insufficiency and adverse perinatal outcomes-over half (58.9%) of women with HDP at Mbarara Regional Referral Hospital (MRRH) have adverse perinatal outcomes. The cerebroplacental ratio (CPR) is an important predictor and prevents approximately 30% of these adverse perinatal outcomes. We determined the prevalence and factors associated with abnormal CPR among women with HDP at MRRH. Methods: We conducted a cross-sectional study from December 2022 to May 2023 at the high-risk obstetrics unit of MRRH. We consecutively enrolled all women with hypertensive disorders and gestational ages ≥ 26 weeks and performed obstetric Doppler studies to document the pulsatility index (PI) of the umbilical artery (UA) and middle cerebral artery (MCA) and then calculated the CPR as a ratio of the MCA-PI and UA-PI. The prevalence of women with an abnormal CPR ≤ 1.0 was expressed as a percentage. We used robust modified Poisson regression analysis to determine the factors associated with abnormal CPR. Results: We enrolled 128 women with hypertensive disorders in pregnancy, with a mean age of 28.8 ± 6.3 years. Of these, 67 (52.3%) had abnormal CPR. The factors associated with abnormal CPR were severe pre-eclampsia (adjusted prevalence ratio (aPR): 5.0, 95% CI: 1.28, 29.14) and eclampsia (aPR: 5.27, 95% CI: 1.11, 34.27). Conclusion: On average, half of the women with hypertensive disorders have abnormal CPR. Women with severe pre-eclampsia or eclampsia are more likely to have abnormal CPR. Obstetric Doppler studies with CPR may be warranted for all pregnant women with severe pre-eclampsia and eclampsia. We recommend further research to assess perinatal outcomes among those with and without abnormal CPR to profile women with HDP at increased risk of adverse perinatal outcomes.
{"title":"Prevalence and Factors Associated With Abnormal Cerebroplacental Ratio Among Women With Hypertensive Disorders of Pregnancy at a Tertiary Referral Hospital in Southwestern Uganda.","authors":"Suada Suleiman Ibrahim, Yarine Fajardo Tornes, Musa Kayondo, Fidel Kasereka Tsongo, Godfrey Rwambuka Mugyenyi, Joseph Ngonzi, Henry Mark Lugobe, Julius Sebikali Mugisha, Leevan Tibaijuka","doi":"10.1155/2024/8895971","DOIUrl":"https://doi.org/10.1155/2024/8895971","url":null,"abstract":"<p><p><b>Background:</b> Hypertensive disorders of pregnancy (HDP) are associated with placental insufficiency and adverse perinatal outcomes-over half (58.9%) of women with HDP at Mbarara Regional Referral Hospital (MRRH) have adverse perinatal outcomes. The cerebroplacental ratio (CPR) is an important predictor and prevents approximately 30% of these adverse perinatal outcomes. We determined the prevalence and factors associated with abnormal CPR among women with HDP at MRRH. <b>Methods:</b> We conducted a cross-sectional study from December 2022 to May 2023 at the high-risk obstetrics unit of MRRH. We consecutively enrolled all women with hypertensive disorders and gestational ages ≥ 26 weeks and performed obstetric Doppler studies to document the pulsatility index (PI) of the umbilical artery (UA) and middle cerebral artery (MCA) and then calculated the CPR as a ratio of the MCA-PI and UA-PI. The prevalence of women with an abnormal CPR ≤ 1.0 was expressed as a percentage. We used robust modified Poisson regression analysis to determine the factors associated with abnormal CPR. <b>Results:</b> We enrolled 128 women with hypertensive disorders in pregnancy, with a mean age of 28.8 ± 6.3 years. Of these, 67 (52.3%) had abnormal CPR. The factors associated with abnormal CPR were severe pre-eclampsia (adjusted prevalence ratio (aPR): 5.0, 95% CI: 1.28, 29.14) and eclampsia (aPR: 5.27, 95% CI: 1.11, 34.27). <b>Conclusion</b>: On average, half of the women with hypertensive disorders have abnormal CPR. Women with severe pre-eclampsia or eclampsia are more likely to have abnormal CPR. Obstetric Doppler studies with CPR may be warranted for all pregnant women with severe pre-eclampsia and eclampsia. We recommend further research to assess perinatal outcomes among those with and without abnormal CPR to profile women with HDP at increased risk of adverse perinatal outcomes.</p>","PeriodicalId":47062,"journal":{"name":"Journal of Pregnancy","volume":null,"pages":null},"PeriodicalIF":3.2,"publicationDate":"2024-10-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11502126/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142510281","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-10-16eCollection Date: 2024-01-01DOI: 10.1155/2024/9779831
Luis Carlos Franco, Sandra M Buitrago, Isabel Arbelaez, Laura F Pinto, Daniela Blanco, María C Pizarro, Laura Santamaria, Catalina Trillos
Background: There are limitations to predicting perinatal asphyxia, as current tools rely almost entirely on fetal cardiotocography (CTG). The fetal lack of responsiveness scale (FLORS) is a new diagnostic alternative based on the physiological phenomena associated with fetal hypoxia. Objectives: The objective of this study was to develop, validate, and assess the diagnostic accuracy of the FLORS for predicting severe perinatal hypoxia (SPH). Study Design: A two-phase retrospective observational cross-sectional analytical study was conducted. Phase 1 involved the formulation and retrospective validation of the FLORS. A total of 366 fetal CTG records were evaluated twice by seven readers. Phase 2 was a collaborative, retrospective, multicenter diagnostic test study that included 37 SPH and 366 non-SPH cases. Results: Phase 1: A numeric, physiology-based scale was developed and refined based on expert opinions. The median time to apply the scale per reading was 38 s. Cronbach's alpha, which is a reliability measure, was significant (p = 0.784). The kappa index for test-retest agreement was moderate to reasonable, with a median value of 0.642. For interobserver agreement, the kappa index per variable was as follows: baseline, 0.669; accelerations, 0.658; variability, 0.467; late/variable decelerations, 0.638; slow response decelerations, 0.617; and trend to change, 0.423. Phase 2, including 37 SPH and 366 non-SPH cases, showed a sensitivity of 62.2% and specificity of 75.4% for the 2-point score, whereas the 3-point score had a sensitivity of 35.1% and specificity of 89.9%. The area under the curve (AUC) was significant at 0.73 (CI 0.645-0.818). Conclusions: FLORS demonstrated significant internal consistency and observer agreement, with a promising sensitivity-specificity balance and significant AUC. Further research is needed to assess its impact on perinatal hypoxia and cesarean delivery.
{"title":"Development, Validation, and Diagnostic Accuracy of the Fetal Lack of Responsiveness Scale for Diagnosis of Severe Perinatal Hypoxia.","authors":"Luis Carlos Franco, Sandra M Buitrago, Isabel Arbelaez, Laura F Pinto, Daniela Blanco, María C Pizarro, Laura Santamaria, Catalina Trillos","doi":"10.1155/2024/9779831","DOIUrl":"https://doi.org/10.1155/2024/9779831","url":null,"abstract":"<p><p><b>Background:</b> There are limitations to predicting perinatal asphyxia, as current tools rely almost entirely on fetal cardiotocography (CTG). The fetal lack of responsiveness scale (FLORS) is a new diagnostic alternative based on the physiological phenomena associated with fetal hypoxia. <b>Objectives:</b> The objective of this study was to develop, validate, and assess the diagnostic accuracy of the FLORS for predicting severe perinatal hypoxia (SPH). <b>Study Design:</b> A two-phase retrospective observational cross-sectional analytical study was conducted. Phase 1 involved the formulation and retrospective validation of the FLORS. A total of 366 fetal CTG records were evaluated twice by seven readers. Phase 2 was a collaborative, retrospective, multicenter diagnostic test study that included 37 SPH and 366 non-SPH cases. <b>Results:</b> Phase 1: A numeric, physiology-based scale was developed and refined based on expert opinions. The median time to apply the scale per reading was 38 s. Cronbach's alpha, which is a reliability measure, was significant (<i>p</i> = 0.784). The kappa index for test-retest agreement was moderate to reasonable, with a median value of 0.642. For interobserver agreement, the kappa index per variable was as follows: baseline, 0.669; accelerations, 0.658; variability, 0.467; late/variable decelerations, 0.638; slow response decelerations, 0.617; and trend to change, 0.423. Phase 2, including 37 SPH and 366 non-SPH cases, showed a sensitivity of 62.2% and specificity of 75.4% for the 2-point score, whereas the 3-point score had a sensitivity of 35.1% and specificity of 89.9%. The area under the curve (AUC) was significant at 0.73 (CI 0.645-0.818). <b>Conclusions:</b> FLORS demonstrated significant internal consistency and observer agreement, with a promising sensitivity-specificity balance and significant AUC. Further research is needed to assess its impact on perinatal hypoxia and cesarean delivery.</p>","PeriodicalId":47062,"journal":{"name":"Journal of Pregnancy","volume":null,"pages":null},"PeriodicalIF":3.2,"publicationDate":"2024-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11498997/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142510279","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-09-21eCollection Date: 2024-01-01DOI: 10.1155/2024/4040825
Christina Gjestvang, Lene Annette Hagen Haakstad
Background: Accessible health information during pregnancy is important to positively affect maternal and fetal health. However, the quality and accuracy of health information can greatly vary across numerous sources. This narrative review is aimed at summarizing the literature on pregnant individuals' information sources and how these sources influence their habits toward GWG, PA, and nutrition. Such data will highlight preferences and needs, reveal challenges, and identify opportunities for improvement. Methods: We searched PubMed for studies published in the last decade. Out of 299 studies initially identified, 20 (16 quantitative and four qualitative) met the eligibility criteria (investigating information sources and their influence on health habits toward GWG, PA, nutrition, pregnant participants, adequate data reporting, and being available in full text). Results: Primary sources of health information varied. The Internet (26%-97%) and healthcare providers (HCPs) (14%-74%) predominated, followed by family/friends (12%71%), books/magazines (49%-65%), and guidelines/brochures (25%-53%). Despite the widespread use of the Internet, HCPs were considered the most reliable source. The use of the Internet to retrieve health information was reported to be 2-4 h a week, and < 50% discussed the online information with their HCP. The Internet was also used as a supplementary resource on topics raised by HCPs. Regarding the influence on health habits, the Internet, HCPs, media, and family positively influenced GWG and promoted adherence to recommended guidelines (OR = 0.55-15.5). Only one study showed a positive association between Internet use and PA level. The Internet, media, HCPs, and information brochures were associated with better adherence to nutritional recommendations. Conclusions: Pregnant individuals relied on the Internet and HCP, with a preference for the Internet despite trust in midwives. Several sources of health information were positively associated with adherence to GWG and nutrition recommendations. Improving the quality of online information should be a priority for policymakers and health authorities.
{"title":"Navigating Pregnancy: Information Sources and Lifestyle Behavior Choices-A Narrative Review.","authors":"Christina Gjestvang, Lene Annette Hagen Haakstad","doi":"10.1155/2024/4040825","DOIUrl":"https://doi.org/10.1155/2024/4040825","url":null,"abstract":"<p><p><b>Background:</b> Accessible health information during pregnancy is important to positively affect maternal and fetal health. However, the quality and accuracy of health information can greatly vary across numerous sources. This narrative review is aimed at summarizing the literature on pregnant individuals' information sources and how these sources influence their habits toward GWG, PA, and nutrition. Such data will highlight preferences and needs, reveal challenges, and identify opportunities for improvement. <b>Methods:</b> We searched PubMed for studies published in the last decade. Out of 299 studies initially identified, 20 (16 quantitative and four qualitative) met the eligibility criteria (investigating information sources and their influence on health habits toward GWG, PA, nutrition, pregnant participants, adequate data reporting, and being available in full text). <b>Results:</b> Primary sources of health information varied. The Internet (26%-97%) and healthcare providers (HCPs) (14%-74%) predominated, followed by family/friends (12%71%), books/magazines (49%-65%), and guidelines/brochures (25%-53%). Despite the widespread use of the Internet, HCPs were considered the most reliable source. The use of the Internet to retrieve health information was reported to be 2-4 h a week, and < 50% discussed the online information with their HCP. The Internet was also used as a supplementary resource on topics raised by HCPs. Regarding the influence on health habits, the Internet, HCPs, media, and family positively influenced GWG and promoted adherence to recommended guidelines (OR = 0.55-15.5). Only one study showed a positive association between Internet use and PA level. The Internet, media, HCPs, and information brochures were associated with better adherence to nutritional recommendations. <b>Conclusions:</b> Pregnant individuals relied on the Internet and HCP, with a preference for the Internet despite trust in midwives. Several sources of health information were positively associated with adherence to GWG and nutrition recommendations. Improving the quality of online information should be a priority for policymakers and health authorities.</p>","PeriodicalId":47062,"journal":{"name":"Journal of Pregnancy","volume":null,"pages":null},"PeriodicalIF":3.2,"publicationDate":"2024-09-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11438513/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142336851","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background: Uteroplacental insufficiency in fetuses with growth restriction (FGR) leads to chronic hypoxia and stress, predominantly affecting the adrenal glands. However, the mechanisms of impact remain unclear. Objectives: This study is aimed at comparing the Doppler indices of the adrenal artery and the adrenal gland sizes between FGR and those with normal growth. Materials and Methods: A multicenter, cross-sectional study was conducted from February to December 2023. We compared 34 FGR to 34 with normal growth in terms of inferior adrenal artery (IAA) Doppler indices and adrenal gland volumes. Results: The IAA peak systolic velocity (PSV) in the FGR group was 14.9 ± 2.9 cm/s compared to 13.5 ± 2.0 cm/s in the normal group, with a mean difference of 1.4 cm/s (95% confidence interval [CI]: 0.27-2.65; p value = 0.017). There were no significant differences between groups in terms of IAA pulsatility index (PI), resistance index (RI), or systolic/diastolic (S/D), with p values of 0.438, 0.441, and 0.658, respectively. The volumes of the corrected whole adrenal gland and the corrected neocortex were significantly larger in the FGR group, with p values of 0.031 and 0.020, respectively. Conclusion: Both increased IAA PSV and enlarged volumes of the corrected whole adrenal gland and neocortex were found in fetuses with FGR, suggesting significant adrenal gland adaptation in response to chronic intrauterine stress.
{"title":"The Impact of Fetal Growth Restriction on Prenatal 2D Ultrasound and Doppler Study of the Fetal Adrenal Gland.","authors":"Suphawan Pattamathamakul, Chatuporn Duangkum, Sukanya Chaiyarach, Kiattisak Kongwattanakul, Piyamas Saksiriwuttho, Ratana Komwilaisak, Sathida Chantanavilai, Manasicha Pongsamakthai, Prapassara Sirikarn","doi":"10.1155/2024/9968509","DOIUrl":"10.1155/2024/9968509","url":null,"abstract":"<p><p><b>Background:</b> Uteroplacental insufficiency in fetuses with growth restriction (FGR) leads to chronic hypoxia and stress, predominantly affecting the adrenal glands. However, the mechanisms of impact remain unclear. <b>Objectives:</b> This study is aimed at comparing the Doppler indices of the adrenal artery and the adrenal gland sizes between FGR and those with normal growth. <b>Materials and Methods:</b> A multicenter, cross-sectional study was conducted from February to December 2023. We compared 34 FGR to 34 with normal growth in terms of inferior adrenal artery (IAA) Doppler indices and adrenal gland volumes. <b>Results:</b> The IAA peak systolic velocity (PSV) in the FGR group was 14.9 ± 2.9 cm/s compared to 13.5 ± 2.0 cm/s in the normal group, with a mean difference of 1.4 cm/s (95% confidence interval [CI]: 0.27-2.65; <i>p</i> value = 0.017). There were no significant differences between groups in terms of IAA pulsatility index (PI), resistance index (RI), or systolic/diastolic (S/D), with <i>p</i> values of 0.438, 0.441, and 0.658, respectively. The volumes of the corrected whole adrenal gland and the corrected neocortex were significantly larger in the FGR group, with <i>p</i> values of 0.031 and 0.020, respectively. <b>Conclusion:</b> Both increased IAA PSV and enlarged volumes of the corrected whole adrenal gland and neocortex were found in fetuses with FGR, suggesting significant adrenal gland adaptation in response to chronic intrauterine stress.</p>","PeriodicalId":47062,"journal":{"name":"Journal of Pregnancy","volume":null,"pages":null},"PeriodicalIF":3.2,"publicationDate":"2024-08-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11377111/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142141394","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-08-06eCollection Date: 2024-01-01DOI: 10.1155/2024/1177119
Leyla Sero, Nilufer Okur, Duygu Tunçel, Mehmet Nur Talay, Mustafa Fırat Aydın, Suleyman Cemil Oglak
Background: The novel coronavirus disease 2019 (COVID-19) was more devastating in people with comorbidities such as advanced age and immunodeficiency. Another group affected by COVID-19 was pregnant women. Immunological changes during pregnancy and conditions such as gestational diabetes and pre-eclampsia that occur during pregnancy also have effects on the fetus. The aim of this study was to analyze the effects of PCR-proven COVID-19 infection during pregnancy on fetus and newborn. Methods: Between December 2019 and October 2021, data from pregnant women with COVID-19 symptoms or a history of contact with people with COVID-19, infected with PCR-proven COVID-19 virus, were analyzed retrospectively. Clinical and laboratory data of pregnant women were analyzed. Death data associated with COVID-19 were evaluated. Clinical and laboratory findings of newborns related to COVID-19 and mortality data related to COVID-19 were recorded. The study received approval from the Gazi Yasargil Training and Research Hospital ethics committee (09.07.2021/853). Results: We evaluated 327 pregnant women who were followed up in our hospital and whose deliveries ended in live birth, stillbirth, miscarriage, or curettage. One hundred eighty-five (56.6%) of the pregnant women had at least one COVID-19-related symptom. We evaluated the data of 306 live births, 21 intrauterine fetal deaths, and 13 postnatal deaths. Among the postnatal deaths, five infants succumbed directly due to COVID-19 infection. A total of 23 live-born babies (7.5%) were classified as small for gestational age (SGA), while 80 babies (26.1%) were born before 37 weeks of gestation, and 32 babies (10.4%) were born before 32 weeks. Cord blood gas analysis revealed that 19 infants (6.3%) had pH < 7 and base excess (BE) < -12. The rate of perinatal asphyxia was significantly higher in babies born to mothers who did not survive (p = 0.027). A considerable number of infants, 119 (40.3%), were admitted to the neonatal intensive care unit (NICU). Among the seven infants with positive PCR results admitted to the NICU, five (4.2%) did not survive. Conclusion: While COVID-19 infection in pregnancy seriously affects mortality and morbidity in pregnant women, it also causes mortality and morbidity on the fetus.
{"title":"Retrospective Analysis of the Impact of SARS-CoV-2 (COVID-19) on Pregnancy and Neonatal Outcomes.","authors":"Leyla Sero, Nilufer Okur, Duygu Tunçel, Mehmet Nur Talay, Mustafa Fırat Aydın, Suleyman Cemil Oglak","doi":"10.1155/2024/1177119","DOIUrl":"10.1155/2024/1177119","url":null,"abstract":"<p><p><b>Background:</b> The novel coronavirus disease 2019 (COVID-19) was more devastating in people with comorbidities such as advanced age and immunodeficiency. Another group affected by COVID-19 was pregnant women. Immunological changes during pregnancy and conditions such as gestational diabetes and pre-eclampsia that occur during pregnancy also have effects on the fetus. The aim of this study was to analyze the effects of PCR-proven COVID-19 infection during pregnancy on fetus and newborn. <b>Methods:</b> Between December 2019 and October 2021, data from pregnant women with COVID-19 symptoms or a history of contact with people with COVID-19, infected with PCR-proven COVID-19 virus, were analyzed retrospectively. Clinical and laboratory data of pregnant women were analyzed. Death data associated with COVID-19 were evaluated. Clinical and laboratory findings of newborns related to COVID-19 and mortality data related to COVID-19 were recorded. The study received approval from the Gazi Yasargil Training and Research Hospital ethics committee (09.07.2021/853). <b>Results:</b> We evaluated 327 pregnant women who were followed up in our hospital and whose deliveries ended in live birth, stillbirth, miscarriage, or curettage. One hundred eighty-five (56.6%) of the pregnant women had at least one COVID-19-related symptom. We evaluated the data of 306 live births, 21 intrauterine fetal deaths, and 13 postnatal deaths. Among the postnatal deaths, five infants succumbed directly due to COVID-19 infection. A total of 23 live-born babies (7.5%) were classified as small for gestational age (SGA), while 80 babies (26.1%) were born before 37 weeks of gestation, and 32 babies (10.4%) were born before 32 weeks. Cord blood gas analysis revealed that 19 infants (6.3%) had pH < 7 and base excess (BE) < -12. The rate of perinatal asphyxia was significantly higher in babies born to mothers who did not survive (<i>p</i> = 0.027). A considerable number of infants, 119 (40.3%), were admitted to the neonatal intensive care unit (NICU). Among the seven infants with positive PCR results admitted to the NICU, five (4.2%) did not survive. <b>Conclusion:</b> While COVID-19 infection in pregnancy seriously affects mortality and morbidity in pregnant women, it also causes mortality and morbidity on the fetus.</p>","PeriodicalId":47062,"journal":{"name":"Journal of Pregnancy","volume":null,"pages":null},"PeriodicalIF":3.2,"publicationDate":"2024-08-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11321895/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141976876","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-06-25eCollection Date: 2024-01-01DOI: 10.1155/2024/7713590
Khanisyah Erza Gumilar, Khairunnisa Binti Abd Rauf, Muhammad Ilham Aldika Akbar, Nareswari Cininta Imanadha, Susetyo Atmojo, Alisia Yuana Putri, Erry Gumilar Dachlan, Gus Dekker
Preeclampsia and peripartum cardiomyopathy (PPCM) are significant obstetric problems that can arise during or after pregnancy. Both are known to be causes of maternal mortality and morbidity. Several recent studies have suggested a link between preeclampsia and the pathophysiology of PPCM. However, the common thread that connects the two has yet to be thoroughly and fully articulated. Here, we investigate the complex dynamics of preeclampsia and PPCM in this review. Our analysis focuses mainly on inflammatory and immunological responses, endothelial dysfunction as a shared pathway, and potential genetic predisposition to both diseases. To begin, we will look at how excessive inflammatory and immunological responses can lead to clinical symptoms of both illnesses, emphasizing the role of proinflammatory cytokines and immune cells in modifying vascular and tissue responses. Second, we consider endothelial dysfunction to be a crucial point at which endothelial damage and activation contribute to pathogenesis through increased vascular permeability, vascular dysfunction, and thrombus formation. Finally, we examine recent information suggesting genetic predispositions to preeclampsia and PPCM, such as genetic variants in genes involved in the management of blood pressure, the inflammatory response, and heart structural integrity. With this synergistic study, we seek to encourage more research and creative therapy solutions by emphasizing the need for an interdisciplinary approach to understanding and managing the connection between preeclampsia and PPCM.
{"title":"Connecting the Dots: Exploring the Interplay Between Preeclampsia and Peripartum Cardiomyopathy.","authors":"Khanisyah Erza Gumilar, Khairunnisa Binti Abd Rauf, Muhammad Ilham Aldika Akbar, Nareswari Cininta Imanadha, Susetyo Atmojo, Alisia Yuana Putri, Erry Gumilar Dachlan, Gus Dekker","doi":"10.1155/2024/7713590","DOIUrl":"10.1155/2024/7713590","url":null,"abstract":"<p><p>Preeclampsia and peripartum cardiomyopathy (PPCM) are significant obstetric problems that can arise during or after pregnancy. Both are known to be causes of maternal mortality and morbidity. Several recent studies have suggested a link between preeclampsia and the pathophysiology of PPCM. However, the common thread that connects the two has yet to be thoroughly and fully articulated. Here, we investigate the complex dynamics of preeclampsia and PPCM in this review. Our analysis focuses mainly on inflammatory and immunological responses, endothelial dysfunction as a shared pathway, and potential genetic predisposition to both diseases. To begin, we will look at how excessive inflammatory and immunological responses can lead to clinical symptoms of both illnesses, emphasizing the role of proinflammatory cytokines and immune cells in modifying vascular and tissue responses. Second, we consider endothelial dysfunction to be a crucial point at which endothelial damage and activation contribute to pathogenesis through increased vascular permeability, vascular dysfunction, and thrombus formation. Finally, we examine recent information suggesting genetic predispositions to preeclampsia and PPCM, such as genetic variants in genes involved in the management of blood pressure, the inflammatory response, and heart structural integrity. With this synergistic study, we seek to encourage more research and creative therapy solutions by emphasizing the need for an interdisciplinary approach to understanding and managing the connection between preeclampsia and PPCM.</p>","PeriodicalId":47062,"journal":{"name":"Journal of Pregnancy","volume":null,"pages":null},"PeriodicalIF":3.2,"publicationDate":"2024-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11219213/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141493837","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Congenital Zika syndrome (CZS) is a major concern in India and highlights the multifaceted challenges posed by the Zika virus (ZIKV). The alarming increase in CZS cases in India, a condition that has serious effects on both public health and newborns, has raised concerns. This review highlights the importance of raising concern and awareness and taking preventive measures by studying the epidemiology, clinical symptoms, and potential long-term consequences of CZS. The review also contributes to worldwide research and information sharing to improve the understanding and prevention of CZS. As India deals with the changing nature of CZS, this thorough review is an important tool for policymakers, health workers, and researchers to understand what is happening now, plan for what to do in the future, and work together as a team, using medical knowledge, community involvement, and study projects to protect newborns' health and reduce the public health impact of these syndromes.
{"title":"Serious Concern of Congenital Zika Syndrome (CZS) in India: A Narrative Review.","authors":"Maneesh Kumar, Suman Kumar, Ratnesh Kumar, Mithilesh Kumar Jha, Shashank Nand Tiwari, Pratima Gupta","doi":"10.1155/2024/1758662","DOIUrl":"10.1155/2024/1758662","url":null,"abstract":"<p><p>Congenital Zika syndrome (CZS) is a major concern in India and highlights the multifaceted challenges posed by the Zika virus (ZIKV). The alarming increase in CZS cases in India, a condition that has serious effects on both public health and newborns, has raised concerns. This review highlights the importance of raising concern and awareness and taking preventive measures by studying the epidemiology, clinical symptoms, and potential long-term consequences of CZS. The review also contributes to worldwide research and information sharing to improve the understanding and prevention of CZS. As India deals with the changing nature of CZS, this thorough review is an important tool for policymakers, health workers, and researchers to understand what is happening now, plan for what to do in the future, and work together as a team, using medical knowledge, community involvement, and study projects to protect newborns' health and reduce the public health impact of these syndromes.</p>","PeriodicalId":47062,"journal":{"name":"Journal of Pregnancy","volume":null,"pages":null},"PeriodicalIF":3.2,"publicationDate":"2024-06-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11221965/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141500162","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-06-12eCollection Date: 2024-01-01DOI: 10.1155/2024/9910316
Ahmet Yalınkaya, Süleyman Cemil Oğlak
Background: This study is aimed at evaluating the conservative surgical treatment of patients with placenta accreta spectrum (PAS) disorder and at presenting the experience of a single surgeon. Materials and Methods: This retrospective study included 245 patients with placenta previa accompanied by PAS disorders operated at a university hospital between June 2013 and December 2023. The diagnosis of PAS was made by a single perinatologist using a combination of transvaginal and transabdominal ultrasonography. All patients were operated with conservative surgical technique by the same surgeon. The demographic and clinical characteristics of the patients, the anesthesia and incision types used, and the details of the surgical technique were evaluated. Results: Of the patients, 165 were operated on at the scheduled time, 80 were operated on under emergency conditions, and 232 (94.69%) of them were operated on under spinal anesthesia. All patients were operated on with a Pfannenstiel incision followed by a transverse incision to the upper border of the placenta to enter into the uterus. An average of 0.52 units of red blood cells per patient was transfused to all patients. Spontaneous intra-abdominal bleeding developed in five patients, and surgical complications occurred in eight patients. No cesarean hysterectomy was performed, and no maternal mortality was detected in any of the cases. The mean time duration of surgery was 54.44 ± 11.37 (30-90) min, and the mean length of hospital stay was 1.71 ± 1.30 (1-9) days. Conclusions: We recommend this procedure as a novel technique and a robust and safe alternative to peripartum hysterectomy and other conservative surgical management procedures for cases with complete PP accompanied with PAS. This technique preserves the uterus as well as reduces blood loss, and transfusion requirement, and thus maternal morbidity and mortality in PAS cases.
{"title":"A Novel Approach for Conservative Management of Placenta Accreta Spectrum Disorder Cases: Experience of a Single Surgeon: PAS Disorders and Conservative Management.","authors":"Ahmet Yalınkaya, Süleyman Cemil Oğlak","doi":"10.1155/2024/9910316","DOIUrl":"10.1155/2024/9910316","url":null,"abstract":"<p><p><b>Background:</b> This study is aimed at evaluating the conservative surgical treatment of patients with placenta accreta spectrum (PAS) disorder and at presenting the experience of a single surgeon. <b>Materials and Methods:</b> This retrospective study included 245 patients with placenta previa accompanied by PAS disorders operated at a university hospital between June 2013 and December 2023. The diagnosis of PAS was made by a single perinatologist using a combination of transvaginal and transabdominal ultrasonography. All patients were operated with conservative surgical technique by the same surgeon. The demographic and clinical characteristics of the patients, the anesthesia and incision types used, and the details of the surgical technique were evaluated. <b>Results:</b> Of the patients, 165 were operated on at the scheduled time, 80 were operated on under emergency conditions, and 232 (94.69%) of them were operated on under spinal anesthesia. All patients were operated on with a Pfannenstiel incision followed by a transverse incision to the upper border of the placenta to enter into the uterus. An average of 0.52 units of red blood cells per patient was transfused to all patients. Spontaneous intra-abdominal bleeding developed in five patients, and surgical complications occurred in eight patients. No cesarean hysterectomy was performed, and no maternal mortality was detected in any of the cases. The mean time duration of surgery was 54.44 ± 11.37 (30-90) min, and the mean length of hospital stay was 1.71 ± 1.30 (1-9) days. <b>Conclusions:</b> We recommend this procedure as a novel technique and a robust and safe alternative to peripartum hysterectomy and other conservative surgical management procedures for cases with complete PP accompanied with PAS. This technique preserves the uterus as well as reduces blood loss, and transfusion requirement, and thus maternal morbidity and mortality in PAS cases.</p>","PeriodicalId":47062,"journal":{"name":"Journal of Pregnancy","volume":null,"pages":null},"PeriodicalIF":3.2,"publicationDate":"2024-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11221975/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141499273","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-06-06eCollection Date: 2024-01-01DOI: 10.1155/2024/8915166
Ricardo Rohweder, Natálya G Pereira, Bruna H Micheletti, Jéssica Mosello, Júlia R M Campos, Matheus G Pereira, Cristina N Santos, Natália L Simões, Regina L B Matielo, Lisandra S Bernardes, Maria L R Oppermann, Maria C O Wender, Angela Lupattelli, Hedvig Nordeng, Lavinia Schuler-Faccini
There is limited evidence about the use of medications among pregnant women with COVID-19, as well as risk factors for hospitalization due to COVID-19 in pregnancy. We aimed to describe the use of medications among SARS-CoV-2-positive pregnant women at the time around infection and identify predictors for hospitalization due to COVID-19 in two hospitals in Brazil. This is a hospital record-based study among pregnant women with positive SARS-CoV-2 tests between March 2020 and August 2022 from two Brazilian hospitals. Characteristics of sociodemographic, obstetrical, and COVID-19 symptoms were extracted retrospectively. The prevalence use of medications was based on self-reported use, and this was administered at the hospital. Logistic regression was used to estimate predictors of hospitalization due to COVID-19. There were 278 pregnant women included in the study, of which 41 (14.7%) required hospitalization due to COVID-19. The remaining 237 (85.3%) had mild symptoms or were asymptomatic. Most of the women had the infection in the third trimester (n = 149; 53.6%). The most prevalent medications used across all trimesters were analgesics (2.4% to 20.0%), antibacterials (15.0% to 23.1%), and corticosteroids (7.2% to 10.4%). Pre- or gestational hypertensive disorder (odds ratio (OR) 4.94, 95% confidence interval (CI) 1.65, 14.87) and having at least one dose of vaccine against SARS-CoV-2 (OR 0.13, 95% CI 0.04, 0.39) were associated with hospitalization due to COVID-19. Analgesics, antibacterials, and corticosteroids were the most frequently used medications among pregnant women with COVID-19. Women with hypertensive disorders have almost a five-fold increased risk of hospitalization due to COVID-19. Vaccination was the strongest protective factor for severe COVID-19. The COVID-19 vaccination among pregnant women should be promoted, and pregnant women diagnosed with COVID-19 who have hypertensive disorders should be closely monitored.
{"title":"Medication Use Among Pregnant Women With SARS-CoV-2 Infection and Risk of Hospitalization-A Study in Two Brazilian Hospitals.","authors":"Ricardo Rohweder, Natálya G Pereira, Bruna H Micheletti, Jéssica Mosello, Júlia R M Campos, Matheus G Pereira, Cristina N Santos, Natália L Simões, Regina L B Matielo, Lisandra S Bernardes, Maria L R Oppermann, Maria C O Wender, Angela Lupattelli, Hedvig Nordeng, Lavinia Schuler-Faccini","doi":"10.1155/2024/8915166","DOIUrl":"10.1155/2024/8915166","url":null,"abstract":"<p><p>There is limited evidence about the use of medications among pregnant women with COVID-19, as well as risk factors for hospitalization due to COVID-19 in pregnancy. We aimed to describe the use of medications among SARS-CoV-2-positive pregnant women at the time around infection and identify predictors for hospitalization due to COVID-19 in two hospitals in Brazil. This is a hospital record-based study among pregnant women with positive SARS-CoV-2 tests between March 2020 and August 2022 from two Brazilian hospitals. Characteristics of sociodemographic, obstetrical, and COVID-19 symptoms were extracted retrospectively. The prevalence use of medications was based on self-reported use, and this was administered at the hospital. Logistic regression was used to estimate predictors of hospitalization due to COVID-19. There were 278 pregnant women included in the study, of which 41 (14.7%) required hospitalization due to COVID-19. The remaining 237 (85.3%) had mild symptoms or were asymptomatic. Most of the women had the infection in the third trimester (<i>n</i> = 149; 53.6%). The most prevalent medications used across all trimesters were analgesics (2.4% to 20.0%), antibacterials (15.0% to 23.1%), and corticosteroids (7.2% to 10.4%). Pre- or gestational hypertensive disorder (odds ratio (OR) 4.94, 95% confidence interval (CI) 1.65, 14.87) and having at least one dose of vaccine against SARS-CoV-2 (OR 0.13, 95% CI 0.04, 0.39) were associated with hospitalization due to COVID-19. Analgesics, antibacterials, and corticosteroids were the most frequently used medications among pregnant women with COVID-19. Women with hypertensive disorders have almost a five-fold increased risk of hospitalization due to COVID-19. Vaccination was the strongest protective factor for severe COVID-19. The COVID-19 vaccination among pregnant women should be promoted, and pregnant women diagnosed with COVID-19 who have hypertensive disorders should be closely monitored.</p>","PeriodicalId":47062,"journal":{"name":"Journal of Pregnancy","volume":null,"pages":null},"PeriodicalIF":3.2,"publicationDate":"2024-06-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11254464/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141634959","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}