Search results for: unplanned pregnancy

Authors: Alejandra Sierra, Maria de los Angeles Covarrubias, Guillermo Julian Gonzalez, Noe Alfaro

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The objective of this study was to identify the cultural dimensions of the terms unplanned pregnancy and unwanted pregnancy built by adolescent women, through the focus of the social representations. Two associative methods were used: free listings and the paired comparison. 72 female students between the ages of 15 and 19 were interviewed, from the downtown area of Leon Guanajuato, Mexico. Words related to inducer terms were classified into five thematic categories: facilitators, consequences, reactions, expectations, and lexicon. The results showed that the social representations of unplanned pregnancy highlighted elements related to economic difficulties and negative emotional aspects, while unwanted pregnancy was associated with negative emotional aspects such as anger, anxiety, and sadness. The meanings each person attributes to terms related to pregnancy are culturally constructed and differ between populations; therefore, more attention should be paid to understanding the cultural meanings and attitudes of people in fertility decision-making, including also the views of adolescent men and other types of population, stratified by age groups and social conditions.

Keywords: adolescent, qualitative research, unplanned pregnancy, unwanted pregnancy

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Authors: Anthony Idowu Ajayi, Ezebunwa Ethelbert Nwokocha, Wilson Akpan, Oladele Vincent Adeniyi

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Studies on emergency contraception (EC) mostly utilise quantitative methods and focus on medically approved drugs for the prevention of unwanted pregnancies. This methodological bias necessarily obscures insider perspectives on sexual behaviour, particularly on why specific methods are utilized by women who seek to prevent unplanned pregnancies. In order to privilege this perspective, with a view to further enriching the discourse and policy on the prevention and management of unplanned pregnancies, this paper brings together the findings from several focus groups and in-depth interviews conducted amongst unmarried female undergraduate students in two Nigerian universities. The study found that while the research participants had good knowledge of the consequences of unprotected sexual intercourses - with abstinence and condom widely used - participants’ willingness to rely only on medically sound measures to prevent unwanted pregnancies was not always mediated by such knowledge. Some of the methods favored by participants appeared to be those commonly associated with people of low socio-economic status in the society where the study was conducted. Medically unsafe concoctions, some outright dangerous, were widely believed to be efficacious in preventing unwanted pregnancy. Furthermore, respondents’ narratives about their sexual behaviour revealed that inadequate sex education, socio-economic pressures, and misconceptions about the efficacy of “crude” emergency contraception methods were all interrelated. The paper therefore suggests that these different facets of the unplanned pregnancy problem should be the focus of intervention.

Keywords: unplanned pregnancy, unsafe abortion, emergency contraception, concoctions

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Authors: Maria Cristina B. Cabanag, Elijinese Marie S. Culangen

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Pregnancy is a period in a woman's life wherein the body may undergo different physiological changes. These changes can be attributed to the interplay of hormones in the body but can mask a more sinister type of disease such as malignancy on rare occasions. Colorectal cancer (CRC) in pregnancy is an epidemiologically rare disease worldwide. To our knowledge, no available studies were reported in the Philippines at the time of this writing, posing a dilemma for its appropriate diagnosis and management. Signs and symptoms of colorectal malignancy may camouflage a normal pregnancy and, when overlooked, impedes an appropriate approach. This case of a 38-year-old elderly primigravid who presented with hematochezia on her 25th week of gestation. She was diagnosed with rectal adenocarcinoma later in pregnancy which warranted a predicament regarding her appropriate care and management. This paper explores the repertoire of the different diagnostic and treatment approaches to colorectal cancer in the second trimester of pregnancy, with the least possible maternal and fetal hazards.

Keywords: cancer in pregnancy, chemotherapy in pregnancy, colorectal cancer, hematochezia in pregnancy

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Authors: Abdulnasir Hossen, Alaa Barhoum, Deepali Jaju, V. Gowri, L. Al-Kharusi, M. Hassan, K. Al-Hashmi

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Preeclampsia is a pregnancy disorder associated with increase in blood pressure and excess amount of protein in the urine. HRV analysis has been used by many researchers to identify preeclamptic pregnancy from normal pregnancy. A study in this regard to identify preeclamptic pregnancy in Oman from normal pregnant was conducted on 40 subjects (20 patients and 20 normal). The subjects were collected from two hospitals in Oman. A Fast Fourier transform (FFT) spectral analysis has shown that patients with preeclamptic pregnancy have a reduction in the power of the HF band and an increase in the power of the LF band of HRV compared with subjects with normal pregnancy. The accuracy of identification obtained was 80%.

Keywords: preelampsia, pregnancy hypertension, normal pregnant, FFT, spectral analysis, HRV

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Authors: Sumi Manjipparambil Surendran, Subrata Majumdar

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Aim: The aim of the study is to find out if low PAPP-A (Pregnancy-Associated Plasma Protein A) levels in the first trimester are associated with adverse obstetric outcome. Methods: A retrospective study was carried out on 114 singleton pregnancies having undergone combined test screening. Results: There is statistically significant increased incidence of low birth weight infants in the low PAPP-A group. However, significant association was not found in the incidence of pre-eclampsia, miscarriage, and placental abruption. Conclusion: Low PAPP-A in the first trimester is associated with fetal growth restriction. Recommendation: Women with low PAPP-A levels in first trimester pregnancy screening require consultant-led care and serial growth scans.

Keywords: pregnancy, pregnancy-associated plasma protein A, PAPP-A, fetal growth restriction, trimester

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Authors: Thomas Adi Purnomo Sidhi

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The importance of designing a pregnancy interactive information design for a mobile application is felt in order to assist pregnant women to get an easy access of highly credible pregnancy-related information on which often fail to be fulfilled, while it has been a very critical one. Thus, an observation of needs assessment for designing a pregnancy interactive information system design for a mobile application at iOS becomes current objective study. A comparative study of the top five pregnancy interactive information design available at the Apple Store conducted in order to fulfill it. Whilst, an observation of user experiences included for deeper analyzes. Moreover, a literature study conducted to support the arguments that being provided in the current study. The findings, surprisingly, also reveal the advantages of local wisdom in pregnancy that never been attached to those top five applications before.

Keywords: information system design, interactive design, local wisdom, pregnancy

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Authors: Daniela F. Maluf, Fernanda Roters, Luma C. F. Silva

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The goal of this work is to report the main dermatological alterations occurring during pregnancy and actual cosmetic protocols available and recommended for safe use. Throughout pregnancy, woman's body undergoes many transformations such as hormonal changes and weight gain. These alterations can result in undesirable skin aspects that end up affecting the future mother's life. The main complaints of pregnant women involve melasma advent, varicose veins, edema, and natural skin aging. Even if most of the time is recommended to wait for the birth to use cosmetics, there are some alternatives to prevent and to treat these alterations during pregnancy. For all these cases, there is a need to update information about safety and efficacy of new actives and technologies in cosmetic products. The purpose of this study was to conduct a literature review about the main skin alterations during pregnancy and actual recommended treatments, according to the current legislation.

Keywords: pregnancy, cosmetic, treatment, physiological changes

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Authors: Benyapa Thitimapong, Najwa Niyomdecha

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This qualitative descriptive research aimed to explore the self-care experiences during pregnancy of Muslim adolescents. Twenty participants were first-time Muslim mothers who had pregnancy experienceห under 20 years of age in three Southern border provinces of Thailand. Participants were selected by purposive sampling with inclusion criteria. Data were collected from the in-depth interview and analyzed using content analysis. The findings revealed that Muslim pregnant adolescents take care of themselves in the context of combining self-care in an Islamic way and conventional medicine. There are 2 subthemes: 1) antenatal care with Tok Bidan and 2) health promotion during pregnancy. The finding will help to understand self-care during pregnancy of Muslim adolescents among three Southern border provinces and can apply to nurse educators as a guide to educate and manage an appropriate self-care program for Muslim pregnant adolescents based on cultural diversity.

Keywords: adolescents, muslim, pregnancy, selfcare

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Authors: M. Elder, L. Beech, A. Mackie

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Heterotopic pregnancy is an uncommon and potentially life-threatening condition in which there is simultaneous occurrence of intrauterine and ectopic pregnancies. It has an incidence of approximately 1:3900 pregnancies, occurring in only 1:30000 spontaneous pregnancies. This study presents a rare case of spontaneous heterotopic pregnancy in a 34-year-old primiparous woman who was brought in by ambulance to the emergency department following collapse at 20+1 weeks gestation after normal first trimester screening and morphology scan. She was hemodynamically unstable and fetal heart rate was 60bpm. Initial resuscitation included transfusion of 2 units packed red blood cells and 1g intravenous tranexamic acid. Bedside ultrasound revealed evidence of approximately 1000ml clot in the right upper quadrant. She underwent a diagnostic laparoscopy and washout, which proceeded to a midline exploratory laparotomy. This revealed a 2.6L hemoperitoneum and query right ectopic pregnancy with calcified areas and clot, with no other cause of bleeding identified. Right salpingectomy was performed, and pathology later confirmed ectopic pregnancy. The intrauterine pregnancy had no complications, and she delivered a healthy full-term baby. This case demonstrates that ultrasound confirmation of intrauterine pregnancy does not exclude coexisting ectopic pregnancy. Heterotopic pregnancy should be considered in any pregnant woman presenting with abdominal pain or signs of hemorrhagic shock, as prompt diagnosis and treatment is essential to minimize foetal and maternal morbidity and mortality.

Keywords: ectopic pregnancy, hemorrhagic shock, salpingectomy, spontaneous heterotopic pregnancy

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Authors: Nurul Imansari

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The study object in this research is 'pregnancy and women’s subjectivity represented in Ali’s Brick Lane, Cusk’s Arlington Park, and McGregor’s If Nobody Speaks of Remarkable Things'. Pregnancy is invested with both figurative and literal significance in the novels. Being a symbol of domesticity of the woman in the novels, pregnancy conveys the relationship of the women due to their role as a mother and wife in a family and their subjectivity as a woman. The aim of this study is to examine to what extent pregnancy affects the subjectivity of woman in Ali’s 'Brick Lane', Cusk’s 'Arlington Park', and McGregor’s 'If Nobody Speaks of Remarkable Things'. It also discusses on how pregnancy can be seen as a symbolic sense and the things that symbolise it. The study uses theoretical ideas of female subjectivity proposed by Julia Kristeva. She stated that in patriarchal culture, the meaning of a woman is always being reduced to the function of reproduction. She has emphasized a new discourse about pregnancy that recognizes the importance of maternal function in the development of subjectivity and in culture. The result shows that the three novels represent pregnancy as something which can affect women’s subjectivity but the way in representing the pregnancy are different from each other. Kristeva’s idea about pregnancy and women’s subjectivity can be applied in both Cusk’s Arlington Park, and McGregor’s If Nobody Speaks of Remarkable Things as the characters in the texts come from the same background as her. However, it can hardly be applied to Ali’s Brick Lane because this idea can justify the women to choose their own way and South Asian culture still bound to the strong patriarchal system.

Keywords: culture, pregnancy, subjectivity, women

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Authors: Shivani Thakur, Jasmin Dominguez Cervantes, Ahmed Zabiba, Fatima Zabiba, Sandhini Agarwal, Kamalpreet Kaur, Hussein Maatouk, Shae Chand, Omar Madriz, Tiffany Huang, Saloni Bansal

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Contraceptives are an effective public health achievement, allowing for family planning and reducing the risk of sexually transmitted diseases (STDs). California’s rural Central Valley has high rates of teenage pregnancy and STDs. Factors affecting contraceptive usage here may include religious concerns, financial issues, and regional variations in the accessibility and availability of contraceptives. The increasing population and diversity of the Central Valley make the understanding of the determinants of unintended pregnancy and STDs increasingly nuanced. Patients in California’s Central Valley were surveyed at 6 surgical clinics to assess attitudes toward contraceptives. The questionnaire consisted of demographics and 14 Likert-scale statements investigating patients’ feelings regarding contraceptives. Parametric and non-parametric analysis was performed on the Likert statements. A correlation matrix for the Likert-scale statements was used to evaluate the strength of the relationship between each question. 76 patients aged 18-75 years completed the questionnaire. 90% of the participants were female, 76% Hispanic, 36% married, 44% with an income range between 30-60K, and 83% were between childbearing ages. 60% of participants stated they are currently using or had used some type of contraceptive. 25% of participants had at least one unplanned pregnancy. The most common type of contraceptives used were oral contraceptives(28%) and condoms(38%). The top reasons for patients’ contraceptive usage were: prevention of pregnancy (72%), safe sex/prevention of STDs (32%), and regulation of menstrual cycle (19%). Further analysis of Likert responses revealed that contraception usage increased due to approval of contraceptives (x̄=3.98, σ =1.02); partner approval of contraceptives (x̄=3.875, σ =1.16); and reduced anxiety about pregnancy (x̄=3.875, σ =1.23). Younger females (18-34 years old) agreed more with the statement that the cost of contraceptive supplies is too expensive than older females (35-75 years old), (x̄=3.2, σ = 1.4 vs x̄=2.8, σ =1.3, p<0.05). Younger females (44%) were also more likely to use short-acting contraceptive methods (oral and male condoms) compared to older females (64%) who use long-acting methods (implants/ intrauterine devices). 51% of Hispanic females were using some type of contraceptive. Of those Hispanic females who do not use contraceptives, 33% stated having no children, and all plan to have at least one child in the future. 35% of participants had a bachelor's degree. Those with bachelor’s degrees were more likely to use contraceptives, 58% vs 51%, p<0.05, and less likely to have unplanned pregnancy, 50% vs. 12%, p<0.01. There is increasing use and awareness among patients in rural settings concerning contraceptives. Our finding shows that younger women and women with higher educational attainment tend to have more positive attitudes towards the use of contraceptives. This work gives physicians an understanding of patients’ concerns about contraceptive methods and offers insight into culturally competent intervention programs that respect individual values.

Keywords: contraceptives, public health, rural california, women of child baring age

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Authors: Edit Xhajanka, Gresa Baboci, Irene Malagnino, Mimoza Canga, Vito Antonio Malagnino

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Purpose: This study aimed at identifying dental caries increment or reduction, based on factors such as smoking, the scaling of teeth, BMI before and during pregnancy, carbohydrates consumption in relation to childbirth. Material and method: In this observational study, the sample included a total of 98 pregnant women and their age class was 18-45 years old, with a median age of 31.5 years. The setting of the participants resides in Vlora –Albania. Moreover, 64.4% were from the city and 35.6% were from the nearby villages. The study was conducted in the time period January 2018 –June 2021. Body mass index (BMI) was calculated using the standard formula (kg/m²). Maternal pre, during and post-pregnancy BMI was collected by using a validated questionnaire. Statistical analysis was performed using IBM SPSS Statistics 23.0. The significance level (α) was set at 0.05, whereas P-value and analysis of variance (ANOVA) were used to analyze the data. Results: Based on the data analysis, 44.4% of the sample declared that they did smoke before pregnancy and 55.6% not smoked during their pregnancy. As a result, no association was found between smoking and length of pregnancy P=0.95. There is also a strong relation (P=0.000) between the number of teeth with caries before pregnancy and the number of teeth with caries during pregnancy. There is a significant relationship between the scaling of teeth and childbirth, P=0.05. BMI before and during pregnancy in relation to carbohydrates consumption have a significant correlation P=0.004 and P=0.002. The values of BMI before and during pregnancy in relation to childbirth have a strong correlation: P=0.043 and P=0.040, respectively. As a result, obesity was associated with preterm birth. The percentage of children born during 34-36 weeks of pregnancy was 69%, and children born during 32-34 weeks of pregnancy were 31%. CONCLUSION: There was a positive association between dental caries experience, BMI and carbohydrates consumption. Obesity in pregnancy is increasing worldwide; that is why this study suggests the importance of an appropriate weight before and during pregnancy.

Keywords: BMI, dental caries, pregnancy, scaling, smoking

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Authors: Hui-Yen Lee, Hsiu-Yun Wei, Guey-Jen Lin, Pi-Yueh Lee Lee

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Background: Unplanned hospital readmissions increase healthcare costs and have been considered a marker of poor healthcare performance. The elderly face a higher risk of unplanned readmission due to elderly-specific characteristics such as deteriorating body functions and the relatively high incidence of complications after treatment of acute diseases. Purpose: The aim of this study was exploring the factors that relate to the unplanned readmission of elderly within 14 days of discharge at our hospital in southern Taiwan. Methods: We retrospectively reviewed the medical records of patients aged ≥65 years who had been re-admitted between January 2018 and December 2018.The Charlson Comorbidity score was calculated using previous used method. Related factors that affected the rate of unplanned readmission within 14 days of discharge were screened and analyzed using the chi-squared test and logistic regression analysis. Results: This study enrolled 829 subjects aged more than 65 years. The numbers of unplanned readmission patients within 14 days were 318 cases, while those did not belong to the unplanned readmission were 511 cases. In 2018, the rate of elderly patients in unplanned 14 days readmissions was 38.4%. The majority patients were females (166 cases, 52.2%), with an average age of 77.6 ± 7.90 years (65-98). The average value of Charlson Comorbidity score was 4.42±2.76. Using logistic regression analysis, we found that the gastric or peptic ulcer (OR=1.917 , P< 0.002), diabetes (OR= 0.722, P< 0.043), hemiplegia (OR= 2.292, P< 0.015), metastatic solid tumor (OR= 2.204, P< 0.025), hypertension (OR= 0.696, P< 0.044), and skin ulcer/cellulitis (OR= 2.747, P< 0.022) have significantly higher risk of 14-day readmissions. Conclusion: The results of the present study may assist the healthcare teams to understand the factors that may affect unplanned readmission in the elderly. We recommend that these teams give efficient approach in their medical practice, provide timely health education for elderly, and integrative healthcare for chronic diseases in order to reduce unplanned readmissions.

Keywords: unplanning readmission, elderly, Charlson comorbidity score, logistic regression analysis

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Authors: Udomporn Yingpaisuk, Premwadee Karuhadej

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The purposed of this research was to study the eating habit of teenage pregnancy and its relationship to the knowledge of nutrition during pregnancy. The 100 samples were derived from simple random sampling technique of the teenage pregnancy in Bangkae District. The questionnaire was used to collect data with the reliability of 0.8. The data were analyzed by SPSS for Windows with multiple regression technique. Percentage, mean and the relationship of knowledge of eating and eating behavior were obtained. The research results revealed that their knowledge in nutrition was at the average of 4.07 and their eating habit that they mentioned most was to refrain from alcohol and caffeine at 82% and the knowledge in nutrition influenced their eating habits at 54% with the statistically significant level of 0.001.

Keywords: teenage pregnancy, knowledge of eating, eating behavior, alcohol, caffeine

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Authors: V. Jamuna, A. K. Chakravarty, C. S. Patil, Vijay Kumar, M. A. Mir, Rakesh Kumar

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Intense selection of buffaloes for milk production at organized herds of the country without giving due attention to fertility traits viz. pregnancy rate has lead to deterioration in their performances. Aim of study is to develop an optimum model for predicting pregnancy rate and to assess the level of pregnancy rate with respect to milk production Murrah buffaloes. Data pertaining to 1224 lactation records of Murrah buffaloes spread over a period 21 years were analyzed and it was observed that pregnancy rate depicted negative phenotypic association with lactation milk yield (-0.08 ± 0.04). For developing optimum model for pregnancy rate in Murrah buffaloes seven simple and multiple regression models were developed. Among the seven models, model II having only Service period as an independent reproduction variable, was found to be the best prediction model, based on the four statistical criterions (high coefficient of determination (R 2), low mean sum of squares due to error (MSSe), conceptual predictive (CP) value, and Bayesian information criterion (BIC). For standardizing the level of fertility with milk production, pregnancy rate was classified into seven classes with the increment of 10% in all parities, life time and their corresponding average pregnancy rate in relation to the average lactation milk yield (MY).It was observed that to achieve around 2000 kg MY which can be considered optimum for Indian Murrah buffaloes, level of pregnancy rate should be in between 30-50%.

Keywords: life time, pregnancy rate, production, service period, standardization

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Authors: Sihana Ahmeti Lika, Merita Dauti, Ledjan Malaj

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The objective of this study is to analyze the prophylactic usage of low molecular weight heparine (LMWH) along pregnancy and the correlation between their usage and month/week of pregnancy, in the Department of Gynecology and Obstetrics, at Clinical Hospital in Tetovo. A retrospective study was undertaken during 01 January–31 December 2012. Over of one year, the total number of patients was 4636. Among the 1447 (32.21%) pregnant women, 298 (20.59%) of them were prescribed LMWH. The majority of patients given LMWH, 119 (39.93%) were diagnosed hypercoagulable. The age group with the highest attendance was 25-35, 141 patients (47.32%). For 195 (65.44%) patients, this was their first pregnancy. Earliest stage of using LMWH was the second month of pregnancy 4 (1.34%) cases. The most common patients, were 70 women along the seventh month (23.49%), followed by 68 in the ninth month of pregnancy (22.81%). Women in the 28th gestational week, were found to be the most affected, a total of 55 (78.57%) were in that week. Clexane 2000 and Fraxiparine 0.3 were the most common for which low molecular weight heparine was prescribed. The number of patients which received Clexane 2000 was 84 (28.19%), followed by those with Fraxiparine 0.3 81 (27.18%). The administration of LMWH is associated with long hospitalization (median 14,6 days).

Keywords: hypercoagulable state, low moleculare weight heparine, month of pregnancy, pregnant women

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Authors: Xuan Hua Huang, Shu Fen Wu, Yi Ting Huang, Pi Yueh Lee

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Background: In Taiwan, the Taiwan healthcare care Indicator Series regards the rate of hospital readmission as an important indicator of healthcare quality. Unplanned readmission not only effects patient’s condition but also increase healthcare utilization rate and healthcare costs. Purpose: The purpose of this study was explored the effects of adult unplanned readmission within 14 days of discharge at a regional teaching hospital in South Taiwan. Methods: The retrospectively review design was used. A total 495 participants of unplanned readmissions and 878 of non-readmissions within 14 days recruited from a regional teaching hospital in Southern Taiwan. The instruments used included the Charlson Comorbidity Index, and demographic characteristics, and disease-related variables. Statistical analyses were performed with SPSS version 22.0. The descriptive statistics were used (means, standard deviations, and percentage) and the inferential statistics were used T-test, Chi-square test and Logistic regression. Results: The unplanned readmissions within 14 days rate was 36%. The majorities were 268 males (54.1%), aged >65 were 318 (64.2%), and mean age was 68.8±14.65 years (23-98years). The mean score for the comorbidities was 3.77±2.73. The top three diagnosed of the readmission were digestive diseases (32.7%), respiratory diseases (15.2%), and genitourinary diseases (10.5%). There were significant relationships among the gender, age, marriage, comorbidity status, and discharge planning services (χ2: 3.816-16.474, p: 0.051~0.000). Logistic regression analysis showed that old age (OR = 1.012, 95% CI: 1.003, 1.021), had the multi-morbidity (OR = 0.712~4.040, 95% CI: 0.559~8.522), had been consult with discharge planning services (OR = 1.696, 95% CI: 1.105, 2.061) have a higher risk of readmission. Conclusions: This study finds that multi-morbidity was independent risk factor for unplanned readmissions at 14 days, recommended that the interventional treatment of the medical team be provided to provide integrated care for multi-morbidity to improve the patient's self-care ability and reduce the 14-day unplanned readmission rate.

Keywords: unplanned readmission, comorbidities, Charlson comorbidity index, logistic regression

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Authors: Olga Plaza, Katarzyna Kosinska-Kaczynska, Stepan Feduniw, Dominika Pazdzior, Kinga Zebrowska, Katarzyna Kwiatkowska

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Introduction: The main causes of depression among pregnant women remain unclear. However, it is clear that pregnancy carries a higher risk of depression occurrence. Left untreated, prenatal depression can be a cause of serious both maternal and neonatal complications. Aim of the study: The aim of the study was to define potential risk factors of prenatal depression and to assess the frequency of its occurrence among pregnant women. Material and Methods: A prospective cross-sectional study was performed among 346 women. The self- composed questionnaire consisting of 46 questions, was distributed via the Internet between November 2017 and March 2018. The questionnaire contained the Edinburgh Postnatal Depression Scale (EPDS), in which the results of 13 and more points (out of 30) suggested possible prenatal depression. Statistical analysis was performed with Chi2 Pearson. P value < 0.05 was considered significant. Results: 37.57% (n=130) of women had a score of 13 or more points. Women with depressive symptoms (DS) reported lack of support from the partner (46.9% vs. 16.2%; p < 0.001) as well as other family members (40.8% vs. 14.4%; p < 0.001), current pregnancy being unplanned (21.5% vs. 12.5%; p=0.014) and low socio-economic status (10% vs. 0.9%; p < 0.001). Both early and advanced maternal age seemed to play a role in occurrence of DS: in women aged 17-24 40.8% declared symptoms (vs 28.7%; p < 0.01), in mothers aged ≥37 6.2% did (vs 0.5%; p < 0.001). Smoking during pregnancy was also more frequent among patients with DS (31.5% vs. 18.1%; p=0.004). Previous diagnosis of depression or other mood disorders significantly increased a chance of DS occurrence (respectively- 17.7% vs. 4.6%; p < 0.001 and 49.2% vs. 25%; p<0.001). Parental diagnosis of mood disorders and other mental disorders was also more frequent in this group of patients (respectively- 24.6% vs. 15.7%; p= 0.026 and 26.4% vs. 9.7%; p < 0.001). Only 23.8% of women with DS sought help from healthcare professionals, with 21.5% receiving pharmacological treatment. Conclusions: Pregnant women often report having DS. Evaluation of risk factors of DS and possible prenatal depression is essential in proper screening for depression among pregnant women.

Keywords: obstetrics, polish women, prenatal care, prenatal depression, risk factors

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Authors: Rim Frikha, Nouha Bouayed, Afifa Sellami, Nozha Chakroun, Salima Daoud, Leila Keskes, Tarek Rebai

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Introduction: Recurrent pregnancy loss (RPL) defined as two or more pregnancy losses, is a serious clinical problem. Methylene-tetrahydro-folate-reductase (MTHFR) polymorphisms, commonly the variant C677T is recognized as an inherited thrombophilia which might affect embryonic development and pregnancy success and cause pregnancy complications as RPL. Material and Methods DNA was extracted from peripheral blood samples and PCR-RFLP was performed for the molecular diagnosis of the C677T MTHFR polymorphism among 70 patients (35 couples) with more than 2 fetal losses. Aims and Objective: The aim of this study is to determine the frequency of MTHFR C677T among Tunisian couples with RPL and to critically analyze the available literature on the importance of MTHFR polymorphism testing in the management of RPL. Result and comments: No C677T mutation was detected in the carriers of RPL. This result would be related to sample size and to different criteria (number of abortion), - The association between MTHFR polymorphisms and pregnancy complications has been reported but with controversial results. - A lack of evidence for MTHFR polymorphism testing previously recommended by ACMG (American College of Medical medicine). Our study highlights the importance of screening of MTHFR polymorphism since the real impact of such thrombotic molecular defect on the pregnancy outcome is evident. - Folic supplementation of these patients during pregnancy can prevent such complications and lead to a successful pregnancy outcome.

Keywords: methylenetetrahydrofolate reductase, C677T, recurrent pregnancy loss, genetic testing

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Authors: O. S. Asaolu, A. Bolorunduro

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Background: Unwanted, mistimed and unintended pregnancy is an important public health issue and the most common cause of maternal mortality in developing countries. Unintended pregnancy is a potential hazard for every sexually active woman as it most times ends in unsafe abortion. The study aimed at assessing the pre-conception contraceptive use, prevalence of unintended pregnancies and the non-contraceptive factors associated with unintended pregnancy amongst currently married women in Osun state. Methodology: A descriptive cross-sectional study among randomly selected 341 currently married pregnant women attending antenatal clinics in Ilesa town of Osun state was conducted in 5 health facilities. A random selection of 5 of the 22 health facilities in the state was done. Data was collected through a self-administered questionnaire and all completed questionnaires were analyzed with SPSS. Result: About two-fifth of the currently pregnant women (40%) who has never used an FP method reported that their current pregnancy was unintended. The results indicate that age of women, age at first sex, substance use, total children ever born of children, religion, and extramarital affairs were key predictors of unintended pregnancy. Women who have higher parity are more likely to experience unintended pregnancy compared to women with lower parity (odds ratio, 0.25). Furthermore, those women who don’t engage in extra marital affairs were less likely to experience unintended pregnancy (odds ratio, 0.3) compared to those who do not. Contribution to knowledge: The predicted probability, using logistic regression, has shown that women who engage in extramarital affairs and women with high parity are more likely to have unintended pregnancy. Conclusion: Behaviour change programs should aim to reduce unintended pregnancy by focusing mostly on identified factors so that the need for abortion is decreased and the overall well-being of the family is maintained and enhanced.

Keywords: unintended pregnancy, factors, pregnant women, Nigeria

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Authors: Botshelo Rachel Sebola

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Unintended pregnancy often results in pregnancy termination. Most countries have legalised the termination of a pregnancy and pregnant adolescents can visit designated clinics without their parents’ consent. In most African and Asian countries, certain cultural practices are performed following any form of childbirth, including abortion, and such practices are ingrained in societies. The aim of this paper was to understand how women who terminated a pregnancy during adolescence coped by embracing cultural practices. A descriptive multiple case study design was adopted for the study. In-depth, semi-structured interviews and reflective diaries were used for data collection. Thirteen women aged 25 to 35 who had terminated a pregnancy in adolescence participated in the study. Three women kept their soiled sanitary pads, burned them to ash and waited for the rainy season to scatter the ash in a flowing stream. This ritual was performed to appease the ancestors, ask them for forgiveness and as a send-off for the aborted foetus. Five women secretly consulted Sangoma (traditional healers) to perform certain rituals. Three women isolated themselves to perform herbal cleansings, and the last two chose not to engage in any sexual activity for one year, which led to the loss of their partners. This study offers a unique contribution to understanding the solitary journey of women who terminated a pregnancy. The study challenges healthcare professionals who work in clinics that offer pregnancy termination services to look beyond releasing the foetus to advocating and providing women with the necessary care and support in performing cultural practices.

Keywords: adolescence, cultural practices, case study, pregnancy

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Authors: Anne Nicole Fuentes

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A 29 year old Gravida 1 Para 0 who presented at the hospital with a 5-week history of amenorrhea, abdominal pain and vaginal bleeding. Transvaginal ultrasound revealed 3 pathologic findings : Tuboovarian complex on the right adnexa, a complex mass indicative of an unruptured ectopic pregnancy and right ovarian new growth probably endometrioma. Pelvic laparotomy was done and histopathologic finding revealed tubal pregnancy, right and mature cystic teratoma of the right ovary. This case report demonstrates the importance of considering the coexistence of different gynecologic pathologies in the same patient and clinical importance of an accurate diagnostic evaluation.

Keywords: mature cystic teratoma, ectopic pregnancy, Tuboovarian abscess, bHCG

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Authors: Botshelo Rachel Sebola

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Unintended pregnancy often results in pregnancy termination. Most countries have legalised the termination of a pregnancy, and pregnant adolescents can visit designated clinics without their parents’ consent. In most African and Asian countries, certain cultural practices are performed following any form of childbirth, including abortion, and such practices are ingrained in societies. The aim of this paper was to understand how women who terminated a pregnancy during adolescence coped by embracing cultural practices. A descriptive multiple case study design was adopted for the study. In-depth, semi-structured interviews and reflective diaries were used for data collection. 13 women aged 20 to 35 years who had terminated a pregnancy in adolescence participated in the study. Three women kept their soiled sanitary pads, burned them to ash and waited for the rainy season to scatter the ash in a flowing stream. This ritual was performed to appease the ancestors, ask them for forgiveness and as a send-off for the aborted foetus. Five women secretly consulted Sangoma (traditional healers) to perform certain rituals. Three women isolated themselves to perform herbal cleansings, and the last two chose not to engage in any sexual activity for one year, which led to the loss of their partners. This study offers a unique contribution to understanding the solitary journey of women who terminate a pregnancy. The study challenges healthcare professionals who work in clinics that offer pregnancy termination services to look beyond releasing the foetus to advocating and providing women with the necessary care and support in performing cultural practices.

Keywords: adolescence, culture, case study, pregnancy

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Authors: Olivier Mulisya, Guelord Barasima, Henry Mark Lugobe, Philémon Matumo, Bienfait Mumbere Vahwere, Hilaire Mutuka, Zawadi Léocadie, Wesley Lumika

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Abdominal pregnancy is defined as pregnancy anywhere within the peritoneal cavity, exclusive of tubal, ovarian, or broad ligament locations. It is a rare form of ectopic pregnancy with high morbidity and mortality for both the mother and the fetus. Diagnosis can be frequently missed in most poor-resource settings because of poor antenatal coverage, low socioeconomic status in most of the patients as well as lack of adequate medical resources. Clinical diagnosis can be very difficult and an ultrasound scan is very helpful during the early stages of gestation but can also be disappointing in the later stages. We report a case of a 25-year-old woman with severe abdominal pain not amended with any medication. A clinical picture of shock lead to an emergency laparotomy which confirmed the diagnosis of abdominal pregnancy. The ministry of health in developing countries should make an effort to make routine early ultrasounds accessible to pregnant women, and obstetricians should keep in mind the possibility of ectopic pregnancy, irrespective of the gestational age.

Keywords: abdominal pregnancy, live new bron, ultrasound imaging, abdominal pain

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Authors: Aleme Mekuria, Samuel Mathewos

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Background: Teenage pregnancy has long been a worldwide social, economic and educational concern for the developed, developing and underdeveloped countries. Studies on adolescent sexuality and pregnancy are very limited in our country. Therefore, this study aims at assessing the prevalence of teenage pregnancy and its determinants among school adolescents of Arba Minch town. Methods: Institution- based, cross-sectional study was conducted from 20-30 March 2014. Systematic sampling technique was used to select a total of 578 students from four schools of the town. Data were collected by trained data collectors using a pre-tested, self-administered structured questionnaire. The analysis was made using the software SPSS version 20.0 statistical packages. Multivariate logistic regression was used to identify the predictors of teenage pregnancy. Results: The prevalence of teenage pregnancy among school adolescents of Arba Minch town was 7.7%. Being grade11(AOR=4.6;95%CI:1.4,9.3) and grade12 student (AOR=5.8;95% CI:1.3,14.4), not knowing the correct time to take emergency contraceptives(AOR=3.3;95%CI:1.4,7.4), substance use(AOR=3.1;95%CI:1.1,8.8), living with either of biological parents (AOR=3.3;95%CI:1.1,8.7) and poor parent-daughter interaction (AOR=3.1;95%CI:1.1,8.7) were found to be significant predictors of teenage pregnancy. Conclusion: This study revealed a high level of teenage pregnancy among school adolescents of Arba Minch town. A significant number of adolescent female school students were at risk of facing the challenges of teenage pregnancy in the study area. School-based reproductive health education and strong parent-daughter relationships should be strengthened.

Keywords: adolescent, Arba minch, risk factors, school, southern Ethiopia, teenage pregnancy

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Authors: Edson Ephraim Sanga

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This paper stems to explore possible places used for recreation in unplanned settlements in order to avail knowledge on how to create and shape urban spaces essential for recreation and leisure. The context of unplanned settlements is spatially characterized compactness and congestions of buildings developed by residents without professional inputs. These characteristics surpass greenery landscapes such as parks and squares essential for health, happiness and wellbeing. The lack of recreational greenery landscape arises a question on how possible can recreation take places in the settlements? This study used qualitative methods mainly observation and in-depth interview to explore the recreational situation in Manzese informal settlements as an instrumental case and found that ordinary spaces are re-configured into recreational spaces and used as ‘parks’ and ‘squares’ in the settlements. The spaces are diverse and complex as they possess different spatial characteristics based on their physical attributes and the way they are used and interpreted by respective users. This paper argues that the re-configuration processes of ordinary spaces should not be taken for granted because they portray the appropriation of spaces from quotidian dimensions in a particular context.

Keywords: ordinary spaces, recreation, unplanned settlement, urban spaces

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Authors: Katarzyna Kwiatkowska, Izabela Walasik, Katarzyna Kosińska-Kaczyńska, Olga Płaza, Kinga Żebrowska

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Introduction Adequate physical activity of a pregnant woman has been proven to decrease the risk of pregnancy complications. The knowledge of women regarding physical exercise in pregnancy is a part of conscious motherhood, while a lack of it may lead to not taking up any form of physical activity during pregnancy. Aim: The aim of the study was to assess the knowledge and experience of women regarding physical activity during their latest pregnancy. Material and methodology: An anonymous questionnaire, consisting of 57 questions, was completed electronically in 2018 by women who gave birth at least once. The respondents were qualified as 'physically active during pregnancy' if they performed physical exercises such as regular walks, marching, jogging, working out at a gym, swimming, yoga, pilates, fitness, exercise-ball workouts or home gymnastics. Results: The study group consisted of 9345 women. 52% of them performed exercises during pregnancy. The main reasons for the lack of physical activity were: lack of interest in physical activity (45%), lack of energy (40%), lack of knowledge regarding proper exercise during pregnancy (34%), lack of time (27%) and medical contraindications (25%). Non-active respondents suffered from gestational hypertension (6,7% vs 9,2%; p<00,1) and gave birth prematurely (11% vs 15%; p < 001) to newborns with a lower birth weight significantly more often ( < 2500g vs > 2500g; p < 0,001). Physically active women reported suffering from pregnancy-related ailments such as fatigue, back pain or constipation significantly less often. 22% of all respondents were unable to identify reliable sources of information regarding exercise during pregnancy. A majority of the exercising women used the Internet to obtain gain information on physical activity during pregnancy (69,1%). 4% of women thought that exercising during pregnancy is forbidden, while 20% thought it is not allowed in the 3rd trimester. Physically active women had vaginal delivery more often (61% vs 55%; p < 0,05). Episiotomy was performed most often on non-active primiparous respondents (77,5% vs 71% active primiparous, p < 0,001). 13% of women felt discriminated due to their physical activity during pregnancy. 22% of respondents’ physical activity was not accepted by their environment. 39,1% of the women were told by others to stop physical exercise because it was bad for the baby’s health. Conclusion: The knowledge of Polish women regarding proper physical activity during pregnancy is insufficient, which may influence a lack of will to initiate such activity among pregnant women. Physical activity of a pregnant woman may have an impact on the course of pregnancy and birth.

Keywords: childbirth, discrimination, physical activity, pregnancy

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Authors: Hacer Kobya Bulut, Ilknur Kahriman, Birsel C. Demirbag

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Introduction and Purpose: The lives of children with cancer are affected by long term hospitalizations in a negative way due to complications arising from diagnosis or treatment. However, the children's parents are known to have difficulties in meeting their children’s needs and providing home care after cancer treatment or during remission process. Supporting these children and their parents by giving a planned discharge training starting from the hospital and home care leads to reducing hospital applications, hospitalizations, hospital costs, shortening the length of hospital stay and increasing the satisfaction of the children with cancer and their families. This study was conducted to investigate the status of children and their parents' unplanned application to hospital and re-hospitalization. Methods: The study was carried out with 65 children with hematological malignancy in 0-17 age group and their families in a hematology clinic and polyclinic of a university hospital in Trabzon. Data were collected with survey methodology between August-November, 2015 through face to face interview using numbers, percentage and chi-square test in the evaluation. Findings: Most of the children were leukemia (90.8%) and 49.2% had been ill over 13 months. Few of the parents (32.3%) stated that they had received discharge and home care training (24.6%) but most of them (69.2%) found themselves enough in providing home care. Very few parents (6.2%) received home care training after their children being discharged and the majority of parents (61.5%) faced difficulties in home care and had no one to call around them. The parents expressed that in providing care to their children with hematological malignance, they faced difficulty in feeding them (74.6%), explaining their disease (50.0%), giving their oral medication (47.5%), providing hygiene (43.5%) and providing oral care (39.3%). The question ‘What are the emergency situations in which you have to bring your children to a doctor immediately?' was replied as fever (89.2%), severe nausea and vomiting (87.7%), hemorrhage (86.2%) and pain (81.5%). The study showed that 50.8% of the children had unplanned applications to hospitals and 33.8% of them identified as unplanned hospitalization and the first causes of this were fever and pain. The study showed that the frequency of applications (%78.8) and hospitalizations (%81.8) was higher for boys and a statistically significant difference was found between gender and unplanned applications (X=4.779; p=0.02). Applications (48.5%) and hospitalizations (40.9%) were found lower for the parents who had received hospital discharge training, and a significant difference was determined between receiving training and unplanned hospitalizations (X=8.021; p=0.00). Similarly, applications (30.3%) and hospitalizations (40.9%) was found lower for the ones who had received home care training, and a significant difference was determined between receiving home care training and unplanned hospitalizations (X=4.758; p=0.02). Conclusion: It was found out that caregivers of children with cancer did not receive training related to home care and complications about treatment after discharging from hospital, so they faced difficulties in providing home care and this led to an increase in unplanned hospital applications and hospitalizations.

Keywords: cancer, children, unplanned application, unplanned hospitalization

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Authors: Hanan Azzam1, Nashwa Abousamra1, Amany Mansour1, Yaser Abd El-dayem2, , Solafa Elsharawy1

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Background: Inherited thrombophilias are a heterogenous group of conditions which have been implicated in a variety of pregnancy complications. More recently, deficiency of protein Z (PZ) has been liked to pregnancy complications, including preterm delivery. Aim: We designed this study to evaluate the association of inherited thrombophilias including [Protein C (PC), Protein S (PS), Anti thrombin III (ATIII) deficiency and activated protein C (APC) resistance] and protein Z deficiency with a variety of pregnancy complications. Patients and Methods: 60 women with different pregnancy complications, including 20 patients with preeclampsia, 20 patients with intrauterine growth resistance (IUGR), and 20 patients with intrauterine fetal death (IUFD), in addition to 30 healthy pregnant women were recruited for the present study. PC and free PS antigen, ATIII activity, modified functional APC-resistance, and PZ levels were determined. Results: There was no significant association between inherited thrombophilias and complicated pregnancies as regards PC deficiency (p=1.0), AT III and PS deficiency (p=0.312), and APC-resistance (P=0.083). PZ was significantly associated with complicated pregnancies (p=0.012). Patients with protein Z levels below 1.5 µg/ml were considered deficient. Accordingly, we demonstrated protein Z deficiency in 30% of complicated pregnancies (RR 6.0, 95% CI 1.29-27.90;p=0.022), 20% of preeclampsia (RR 3.5, 95% CI 0.57 – 21.28; P = 0.174), 40% of IUGR (RR 9.3 95% CI 1.72-50.61; P = 0.010) and 30% of IUFD (RR 6, 95% CI 1.07 – 33.64; P = 0.042). Conclusions: These findings indicate the absence of association of inherited thrombophilias, including PC, PS, AT III deficiency, and APC resistance with pregnancy complications. However, PZ deficiency is associated with increased risk of pregnancy complications, especially intrauterine growth restriction and intrauterine fetal death.

Keywords: protein C, protein S, thrombophelia, pregnancy, protein Z

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Authors: Salina Yahya Saddik

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The present study is designed to demonstrate the Ovarian Surface Epithelial cells (OSE) Estrogen Receptor α (ERα) and Progesterone Receptor (PR) during pregnancy and estrous cycle in rat. Moreover, determination of the levels of plasma progesterone, estradiol, FSH and LH were also made. The levels of plasma progesterone, estradiol, FSH and LH concentrations were determined on days 7 (n=5), 14 (n=5), and 21(n=5) of pregnancy in three groups of rats and during the estrous cycle (n=5) using ELISA kit. Immunohistochemical method for PR and ERα expression was also made on the ovary. During pregnancy, FSH and LH remained low except at term when LH levels began to increase from 16 ng/ml to 47 ng/ml. Progesterone levels significantly exceeded estradiol values in all pregnant rats with a peak value of 202 ng/ml on day 14. Elevated progesterone levels were associated negatively with LH and estradiol levels during pregnancy. The levels of estradiol surged significantly on day 21. Immunohistochemistry of the ovary showed low levels of OSE cells staining positive for ERα expression. ERα positive cells were absent on day 7 and 14 of pregnancy, only day 21 recorded a very low percentage of immunostaining (0.5%) within the nuclei of OSE cells. On the contrary, immunostaining of PR was not observed within the nuclei of OSE cells in all groups of study. In conclusions, these results may suggest that progesterone effect during pregnancy seems to be overriding the positive effect of estrogens on OSE cells. High progesterone levels may have a direct negative effect on gonadotropin production and thereby it might inhibit events leading to both follicular development and OSE proliferation. Understanding the factors affecting OSE proliferation may help elucidating the mechanism(s) of assisted diseases such as ovarian cancer.

Keywords: ovarian surface, pregnancy, gonadotropins, steroids

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