Search results for: ectopic pregnancy

Authors: Leoba Nyathi, Augustine K. Tugli, Takalani G. Tshitangano

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Use of health care services is an effective way of improving maternal and child health outcomes, especially in the rural areas. The study aimed to find out the perceptions of women on factors that affect the utilisation of antenatal care services (ANC) in Mangwe Rural District, Zimbabwe. The study was conducted in Mabunga village which is situated in Mangwe Rural District, Matabeleland South Province, Zimbabwe. A qualitative approach using explorative and descriptive design was adopted for the study. A sample of ten women were chosen from the target population by means of convenience sampling and data was collected through semi-structured interviews. Interviews and discussions were audio-taped, transcribed and coded into themes and subthemes. The study results showed that access factors, socio-cultural factors, demographic factors, quality of care and knowledge about antenatal care services were the major factors affecting utilisation of ANC services in Mangwe Rural District. It was discovered that the geographical location of the village to the health care centres has a great impact on utilisation of services. All the women did not initiate ANC services as recommended and they also did not adhere to the number of times they were supposed to visit the health care centres. The findings concluded that women have the knowledge about ANC and they all attended at least once during their last pregnancy. However, inconsistencies in attendance were shown due to access, socio-cultural and demographic factors.

Keywords: antenatal care services, women, utilisation, affect, factors, perceptions

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Authors: Calvin Chiu, Samar Saade Needham

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The factors associated with the development of major depressive disorder (MDD) have been an ongoing area of concern within the field of psychopathology. Among parents, the rise in stress factors for individuals receiving less social support contributes to an increase in MDD cases. Understanding the causal aspects of MDD through the interworking of stress development within social support disparities provides critical insights into preventive measures for depressive symptoms. The present study seeks to assess the impact of social support on stress formation within MDD. Such that single parents lacking social support prompt an increase in stress formation, which proliferates the progression of MDD. Participants in this study were 450 ethnic minority mothers and fathers experiencing health inequities during pregnancy and early childhood. Perceived stress, social support, and depression are assessed by multi-item questionnaires that produce score ranges for general findings. Results indicated that lower social support scores resulted in higher depression scores, and higher perceived stress scores produced higher depression scores. Furthermore, single parents reported higher depression scores. These findings overlap with studies on paternal depression and suggest that MDD is a product of stress accumulation due to declining social support systems. Future studies may specify effective social support systems for decreasing stress accumulation in MDD formation in preventive strategies.

Keywords: major depressive disorder, stress formation, cognitive-behavioral outcomes, deficit-based behaviors

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Authors: Nia McRae, Robert Wright, Ghalib Bello

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Introduction: Postpartum depression is a prevalent mood disorder that is detrimental to the mental and physical health of mothers and their newborns. Lead (Pb) is a toxic metal that is associated with hormonal imbalance and mental impairments. The hormone changes that accompany pregnancy and childbirth may be exacerbated by Pb and increase new mothers’ susceptibility to postpartum depression. To the best of the author’s knowledge, this is the only study that investigates the association between prenatal Pb exposure and postpartum depression. Identifying risk factors can contribute to improved prevention and treatment strategies for postpartum depression. Methods: Data was derived from the Programming Research in Obesity, Growth, Environment and Social Stress (PROGRESS) study which is an ongoing longitudinal birth cohort. Postpartum depression was identified by a score of 13 or above on the 10-Item Edinburg Postnatal Depression Scale (EPDS) 6-months and 12-months postpartum. Pb was measured in the blood (BPb) in the second and third trimester and in the tibia and patella 1-month postpartum. Quantile regression models were used to assess the relationship between BPb and postpartum depression. Results: BPb in the second trimester was negatively associated with the 80th percentile of depression 6-months postpartum (β: -0.26; 95% CI: -0.51, -0.01). No significant association was found between BPb in the third trimester and depression 6-months postpartum. BPb in the third trimester exhibited an inverse relationship with the 60th percentile (β: -0.23; 95% CI: -0.41, -0.06), 70th percentile (β: -0.31; 95% CI: -0.52, -0.10), and 90th percentile of depression 12-months postpartum (β: -0.36; 95% CI: -0.69, -0.03). There was no significant association between BPb in the second trimester and depression 12-months postpartum. Bone Pb concentrations were not significantly associated with postpartum depression. Conclusion: The negative association between BPb and postpartum depression may support research which demonstrates lead is a nontherapeutic stimulant. Further research is needed to verify these results and identify effect modifiers.

Keywords: depression, lead, postpartum, prenatal

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Authors: Fariha Qureshi, Mohammad Tahir

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Epidemiological evidences indicated that arsenic contamination in drinking water increased the incidence of spontaneous abortion, stillbirth and premature babies in pregnant women. This study was designed to investigate the protective role of vitamin C&E against sodium arsenate induced fetal toxicity in albino mice. Twenty-four pregnant albino mice of BALB/c strain were randomly divided into 4 groups having 6 animals in each. Group A1 served as control and was injected with 0.1ml/kg/day distilled water I/P for 18 days. Groups A2,A3 & A4 received single I/P injection of sodium arsenate 35mg/kg on 8th gestational day, whereas groups A3 and A4 were also given Vitamin C and E by I/P injection, 9 mg/kg/day and 15 mg/kg/day respectively, starting from 8th GD and continued for the rest of the pregnancy period. The early implantation sites, fetal resorptions, weight of live fetuses and crown rump length were recorded. Gross morphological examination was carried out for malformations. Fetal kidneys were extracted for histological and micrometric analysis. Group A2 exhibited an increased incidence of abortion, fetal resorptions, significant decrease in number of litter and fetal weight; the difference of means was statistically significant among the groups (p<0.000). In group A2 fetal kidneys presented glomerulonephritis with acute tubular necrotic changes and interstitial fibrosis. Groups A3&A4 showed statistically significant improvement in these parameters. The results revealed the antioxidant potential of Vitamin C and E in protecting against arsenic induced fetal toxicity in mice.

Keywords: fetal toxicity, fetal resorptions, interstitial fibrosis, tocopherol

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Authors: M. Moiz

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Family planning has been known and accepted as a key tool to decrease fertility, provides birth spacing and plays a vital role to attain better outcomes for maternal and child health. Pakistan initiated various family planning programs to preserve maternal and child health for six decades. However, less contraceptive use leading to high fertility and low birth spacing is ultimately a risk for increasing morbidity and mortality. As an outcome of 2012 London Summit on Family Planning where 20 countries including Pakistan made its commitment to increase contraceptive prevalence rate by 55% and provide a universal access to reproductive health to protect human rights of women and ensure safe, choice informed and affordable contraceptives throughout the country. This paper will assess some of the factors of service delivery, coverage and the role of Ministry of Health and Population Welfare Department in providing Family Planning services and how it can be improved in Pakistan. In view of Pakistan Demographic Health Survey 2017-18, there are total nine million potential users of contraceptives and one third among them never used with unmet need while every fifth pregnancy ends into abortion indicates need for Family Planning services. In order to explain this concern, a comprehensive analysis has been done on role of governance in implementing family planning policy and its limitations are discussed. Moreover, this paper highlights policy options and recommendations for improving service provision through public and private sector in creating demand for Family Planning services in Pakistan.

Keywords: contraceptive prevalence rate, family planning, maternal and child health, policy options

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Authors: Gerald H. Artisen, Miah Joy O Awing, Elydia O. Ayat, Rachel L. Ayangwa, Zeah D. Baggas, Aspen S. Baguiyac, Delight D. Baguiyac, Kristine G. Bakidan, Nemesis B. Bakidan, Ketly B. Balanggao, Rhea G. Bala-Is, Hope Lulet A. Lomioan

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The study investigated the prevalence and risk factors associated with postpartum depression among mothers in the Pasil, Kalinga, contributing to a better understanding of the mental health challenges faced by this specific population. This research utilized a cross-sectional descriptive study to assess postpartum depression prevalence and identify contributing factors in Pasil, utilizing a quantitative approach and collecting data on sociodemographic characteristics, obstetric data, and the Edinburgh Postnatal Depression Scale. The study concluded that probable depression can be seen among mothers in the Pasil, which resulted in a risk of suicidality with a percentage of 40.08. Additionally, most of the respondents are aged 28–32, married, have a college degree, are unemployed, have a monthly income of 1,000–5,000, are female, have hypertension, gave birth naturally, have two children, have a planned pregnancy, and are currently breastfeeding. Lastly, the study found that mothers in Pasil who have unplanned pregnancies under obstetric factors are at high risk of developing postpartum depression, with a p-value below the 0.05 level. The study recommends barangay health professionals develop initiatives to inform aspiring mothers about postpartum depression (PPD) and resources to help them adjust to motherhood. It also recommends frequent check-ins with new mothers to identify special healthcare needs. Programs should be independently funded by LGUs, and support from family and relatives is recommended to prevent PPD.

Keywords: maternal health, postpartum depression, mothers, Pasil

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Authors: Sajia Islam, T. Tahsina, S. Raihana, M. M. Rahman, Q. S. Rahman, T. M. Huda, S. E. Arifeen, M. J. Dibley

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Early neonatal sepsis accounts for more than two-thirds of all deaths in the first year of life. This study assessed the counseling during antenatal, perinatal, post natal periods and its association with possible sepsis in rural Bangladesh. Method: Data were collected from a large community-based trial in Bangladesh where pregnant women were enrolled from 2013-2015 covering 29,497 newborns. Sepsis was defined using neonatal danger signs reported by 'The Young-Infants Clinical Science Study Group. 'Result: Signs of sepsis was found among 15% of the neonates. Neonatal sepsis was higher among those who did not receive advice on TT vaccinations (15.4% vs. 11%, p < 0.05) and danger signs (14.8% vs. 12.8%, p < 0.05) during pregnancy. Advice on delivering in well-lit place was significantly associated with lower incidence of sepsis (12.7% vs. 14.8% p < 0.05). Sepsis was lower among neonates whose mothers were counseled on immediate newborn care for bathing after 3 days of delivery (13.4% vs. 15.2% p=0), breastfeeding within 1hr of birth (13.82 % vs. 15.28% p=0), apply nothing on the cord (11.54 vs. 15.06 p=0), immediate drying of child (12.62% vs. 14.89%, p=0). Neonatal sepsis was lower among children whose mothers received 2-4 advice [OR=0.91(95% CI: 0.85-0.97)] compared to neonates whose mothers received only 1 or none. Overall, children to mothers who received ≥ 5 advice had lowest incidence of sepsis [OR=0.83 (95% CI: 0.71-0.97)] Conclusion: Advice on antenatal, prenatal and post natal is significantly reduced with early newborn sepsis. Further research is required to identify specific type of counseling messages that translate into practices and reduce pathways towards early-newborn morbidities.

Keywords: ante natal care, counseling, neonatal sepsis, post natal care

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Authors: Mila Radovanovic, Jovana Jestrovic, Ivana Mihic

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Deciding whether to have a child is a complex psychological process, and the child's birth is an everlasting change in the life of the family. Researchers from all over the world have been recognized the importance of the motivation for parenthood in latter family life, but there is no very clear picture of factors which make the difference in this motivation. One of these factors can be the method of conception and results of the earlier studies are different- some showed the differences, but the others did not. The aim of this study was to determine the type and intensity of motivation for parenting among women in Serbia and to examine whether there are differences in motivation depend on the method of conception. The total sample consisted of 94 women- 57 pregnant women who conceive naturally and the same number of women in the process of in vitro fertilization, who still haven’t known the final result of the process- are they pregnant or no. The Child Study Inventory, which estimates four types of motivation for parenthood- altruistic, instrumental, narcissistic and fatalistic-was used for this purpose. Multivariate analysis of variance was used to answer the main question of the study. The results indicate that there is no statistically significant difference between the two groups of women, while the most common is the altruistic motivation that emphasizes the psychological value of the child, and sees the motivation for parenting as a desire to give love to the child. The results are encouraging because altruistic motivation is intrinsic one and the protective factor for latter family relations and care about child and sensitivity of parents. Altruistic motivation is showed like a good predictor in developing stable emotional relationship between mother and her baby but also is correlated with the higher satisfaction with marriage.

Keywords: development of parental role, in vitro fertilization, motivation for parenthood, pregnancy

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Authors: Esra Güney, Tuba Uçar

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Aim: This study has been conducted for the purpose of determining the effects of fetal movement counting on antenatal maternal attachment. Material and Method: This research was conducted on the basis of the real test model with the pre-test /post-test control groups. The study population consists of pregnant women registered in the six different Family Health Centers located in the central Malatya districts of Yeşilyurt and Battalgazi. When power analysis is done, the sample size was calculated for each group of at least 55 pregnant women (55 tests, 55 controls). The data were collected by using Personal Information Form and MAAS (Maternal Antenatal Attachment Scale) between July 2015-June 2016. Fetal movement counting training was given to pregnant women by researchers in the experimental group after the pre-test data collection. No intervention was applied to the control group. Post-test data for both groups were collected after four weeks. Data were evaluated with percentage, chi-square arithmetic average, chi-square test and as for the dependent and independent group’s t test. Result: In the MAAS, the pre-test average of total scores in the experimental group is 70.78±6.78, control group is also 71.58±7.54 and so there was no significant difference in mean scores between the two groups (p>0.05). MAAS post-test average of total scores in the experimental group is 78.41±6.65, control group is also is 72.25±7.16 and so the mean scores between groups were found to have statistically significant difference (p<0.05). Conclusion: It was determined that fetal movement counting increases the maternal antenatal attachments.

Keywords: antenatal maternal attachment, fetal movement counting, pregnancy, midwifery

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Authors: Ramazan F. Akkoc, Elif Erdem, Nalan Kaya, Gonca Ozan, D. Özlem Dabak, Enver Ozan

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Maternal tobacco smoke exposure is known to cause growth retardation in the neonatal skeletal system. Alpha lipoic acid, a natural antioxidant found in some foods, limits the activities of osteoclasts and supports the osteoblast's bone formation mechanism. In this study, it was aimed to investigate the effects of alpha lipoic acid (ALA) on the height, long bones and tail lengths of pups exposed to maternal tobacco smoke. The rats were divided into four groups: 1) control group, 2) tobacco smoke group, 3) tobacco smoke + ALA group, and 4) ALA group. Rats in the group 2 (tobacco smoke), group 3 (tobacco smoke + ALA) were exposed to tobacco smoke twice a day for one hour starting from eight weeks before mating and during pregnancy. In addition to tobacco smoke, 20 mg/kg of alpha lipoic acid was administered via oral gavage to the rats in the group 3 (tobacco smoke + ALA). Only alpha lipoic acid was administered to the rats in the group 4. On day 21 postpartum, the height and tail lengths of the pups in all groups were measured, and the length of the extremity long bones was measured after decapitation. All morphometric measurements performed in group 2 (tobacco smoke) showed a significant decrease compared to group 1 (control), while all measurements in group 3 (tobacco smoke + ALA) showed a significant increase compared to group 2 (tobacco smoke). It has been shown that ALA has a protective effect against the regression of height, long bones and tail lengths of pups exposed to maternal tobacco smoke.

Keywords: alpha lipoic acid, bone, morphometry, rat, tobacco smoke

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Authors: Maria Magdy Danial Riad

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The objective of this study was to investigate the effect of different protein sources with different degradability ratios during late gestation of ewes on colostrum composition and its IgG concentration, body weight change of dams, and birth weight of their lambs. Objectives: 35 multiparous native crossbred ewes (BW= 59±2.5kg) were randomly allocated to five dietary treatments (7 ewes / treatment) for 2 months prior to lambing. Methods: Experimental diets were isonitrogenous (12.27% CP) and isocaloric (2.22 Mcal ME/kg DM). In diet I (the control), solvent extract soybeans (SESM 33% RUP of CP), II feed grade urea (FGU 31% RUP), III slow release urea (SRU 31% RUP). As sources of undegradable protein, extruded expeller SBM-EESM 40 (37% RUP) and extruded expeller SBM-EESM 60 (41% RUP) were used in groups IV and V, respectively. Results showed no significant effect on feed intake, crude protein (CP), metabolizable energy (ME), and body condition score (BCS). Ewes fed the 37% RUP diet gained more (p<0.05) weight compared with ewes fed the 31% RUP diet (5.62 vs. 2.5kg). Ewes in EESM 60 had the highest levels of fat, protein, total solid, solid not fat, and immunoglobulin and the lowest in urea N content (P< 0.05) in colostrum during the first 24hrs after lambing. Conclusions: Protein source and RUP levels in ewes’ diets had no significant effect (P< 0.05) on lambs’ birth weight and ewes' blood biochemical parameters. Increasing the RUP content of diet during late gestation resulted in an increase in colostrum constituents and its IgG level but had no effect on ewes’ performance and their lambs’ outcome.

Keywords: colostrum, ewes, lambs output, pregnancy, undegradable protein

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Authors: Joselyne Rugema, Innocent Twagirayezu, Aimable Nkurunziza, Alice Nyirazigama, Vedaste Bagweneza, Belancilla Nikuze

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Introduction: Burn injuries among children are associated with major complications. Early health care seeking and appropriate management are crucial in saving lives and preventing complications. Objective: To assess home-based management practices and health seeking behaviors among caregivers of children admitted with burn injuries at selected hospitals in Rwanda. Methods: A cross-sectional descriptive study was conducted among caregivers of children admitted with burn injuries at three hospitals in Kigali. A semi-structured questionnaire was used to collect the data that were analyzed using SPSS version 25. Statistical software Results: Most of the children with burn injuries had median age of 36 months, and 89.9% had second-degree burns. 92.4% of burns happened at home and 63.3% were scalds. Only 18% of the caregivers seek care immediately after children’s burn injuries. About 2.5% reported not seeking any care after burn injuries and 3.8% sought care from traditional healers. 65.9% of the participants used wrong practices before seeking care such as applying honey, cooking oil and urine to the burn injuries. Transportation difficulties before consulting health facilities were the main reported faced barriers to success health care (86.1%). Conclusion: Immediate health seeking behavior was low. Wrong practices including application of harmful products to burn injuries are common in the community. There is a need for community based interventions to prevent burn injuries at home and to empower the community with appropriate actions to take after injuries.

Keywords: adolescent pregnancy, qualitative design, childbearing, teenage mothers

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Authors: Komathy Thiagarajan, Mohd. Azizuddin Mohd. Yussof, Hasnoorina Husin, Noor Azreena Abd Aziz, Faezah Shekh Abdullah, Abdul Wahaf Abdul Wahid

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Polycystic Ovary Syndrome (PCOS) presents with a plethora of clinical features owing to the multifaceted underlying pathophysiology. This study was conducted to determine the clinical features unique to the sub fertile women attending the Sub fertility Clinic of the National Population and Family Development Board (NPFDB) so that a more holistic approach can be adopted to further enhance the pregnancy outcome in those women. This was a case-control study conducted over a span of three years (from January 2014 until December 2016), whereby women who fulfilled the Rotterdam Criteria 2004 were classified as PCOS (n=79) and women who did not fulfill the Rotterdam Criteria were classified as controls (n=88). The mean age of the women was 30.1 years and the mean duration of marriage was 3.93 years. The majority of women suffered from primary sub fertility (82.6%). The median age was lower among PCOS women (29.0 years) compared to the controls (30.0 years), p<0.05. The majority of PCOS women (43.0%) were obese (BMI > 30 kg/m2) compared to only 19.3% who were obese in the control group, p<0.05. Hypertension was present in 59.5% of PCOS women and only in 36.4% of the control group, p<0.05. There were significantly more women who presented with hirsutism in PCOS group (27.8%) as compared to the control group (5.7%), p<0.05. The findings of this study elucidate that the clinical features of significance among sub fertile women suffering from PCOS, if detected early, are amenable to lifestyle modifications and timely interventions can potentially improve the fertility outcomes in this group of women.

Keywords: clinical features, fertility, lifestyle modification, PCOS

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Authors: Ilim Moses Msughter

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The study was carried out to examine the availability of Ante-natal care services and the socio-cultural factors affecting the utilization of these services in Dutsin-Ma Local Government Area of Katsina State. Four specific objectives were outlined as thus to examine the availability of antenatal care services in Dutsin-Ma local government area, to identify the socio-cultural factors affecting the utilisation of ante-natal care services, to ascertain the challenges affecting utilisation of ante-natal care services and suggest strategies to improve efficiency in ante-natal service delivery and utilisation of same services. Data were collected from 110 respondents using a questionnaire and through the use of the interview. Data were analysed quantitatively and qualitatively. The findings revealed that ante-natal care services are available in the study area, but access to such services is hindered by several factors, which include religious and traditional beliefs, cost of services and poor attitudes of health care workers which has an adverse effect on people’s desire to visit ante-natal centres. The study recommended that Traditional Birth Attendants (TBA) need to be trained on how to handle pregnancy-related complications. It is also recommended that essential ante-natal drugs and services should be subsidised or made free by the government, and this must be closely monitored to ensure efficiency. Finally, human relation training should be organised for nurses and midwives to improve their attitudes towards patients during ante-natal visits.

Keywords: utilisation, religion, traditional birth attendant, ante-natal

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Authors: S. H. Atef

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Background: The most common chromosomal abnormalities identified at birth are aneuploidies of chromosome 21, 18, 13, X and Y. Prenatal diagnosis of fetal aneuploidies is routinely done by traditional cytogenetic culture, a major drawback of this technique is the long period of time required to reach a diagnosis. In this study, we evaluated the QF-PCR as a rapid technique for prenatal diagnosis of common aneuploidies. Method:This work was carried out on Sixty amniotic fluid samples taken from patients with one or more of the following indications: Advanced maternal age (3 case), abnormal biochemical markers (6 cases), abnormal ultrasound (12 cases) or previous history of abnormal child (39 cases).Each sample was tested by QF-PCR and traditional cytogenetic. Aneuploidy screenings were performed amplifying four STRs on chromosomes 21, 18, 13, two pseudoautosomal,one X linked, as well as the AMXY and SRY; markers were distributed in two multiplex QFPCR assays (S1 and S2) in order to reduce the risk of sample mishandling. Results: All the QF-PCR results were successful, while there was two culture failures, only one of them was repeated. No discrepancy was seen between the results of both techniques. Fifty six samples showed normal patterns, three sample showed trisomy 21, successfully detected by both techniques and one sample showed normal pattern by QF-PCR but could not be compared to the cytogenetics due to culture failure, the pregnancy outcome of this case was a normal baby. Conclusion: Our study concluded that QF-PCR is a reliable technique for prenatal diagnosis of the common chromosomal aneuploidies. It has the advantages over the cytogenetic culture of being faster with the results appearing within 24-48 hours, simpler, doesn't need a highly qualified staff, less prone to failure and more cost effective.

Keywords: QF-PCR, traditional cytogenetic fetal aneuploidies, trisomy 21, prenatal diagnosis

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Authors: E. M. Vieira, C. S. Vieira, L. P. Bonifácio, L. M. de Oliveira Ciabati, A. C. A. Franzon, F. S. Zaratini, J. A. C. Sanchez, M. S. Andrade, J. P. Dias de Souza

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The quality of prenatal care is key to reduce maternal morbidity and mortality. Communication between the health service and users can stimulate prevention and care. M-health has been an important and low cost strategy to health education. The PRENACEL programme (prenatal in the cell phone) was developed. It consists of a programme of information via SMS from the 20^th week of pregnancy up to 12^th week after delivery. Messages were about prenatal care, birth, contraception and breastfeeding. Communication of the pregnant woman asking questions about their health was possible. The objective of this study was to evaluate the implementation of PRENACEL as a useful complement to the standard prenatal care. Twenty health clinics were selected and randomized by cluster, 10 as the intervention group and 10 as the control group. In the intervention group, women and their partner were invited to participate. The control group received the standard prenatal care. All women were interviewed in the immediate post-partum and in the 12^th and 24^th week post-partum. Most women were married, had more than 8 years of schooling and visit the clinic more than 6 times during prenatal care. The intervention group presented lowest percentage of higher economic participants (5.6%), less single mothers and no drug user. It also presented more prenatal care visits than the control group and it was less likely to present Severe Acute Maternal Mortality when compared to control group as well as higher percentage of partners (75.4%) was present at the birth compared to control group. Although the study is still being carried out, preliminary data are showing positive results of the compliance of women to prenatal care.

Keywords: cellphone, health technology, prenatal care, prevention

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Authors: Khitam Ibrahem Shlash Mohammad

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Background: Postnatal depression is a focus of considerable research attention, but little is known about the pattern of stress across this period. Objective: to investigate the prevalence of stress after childbirth for Jordanian women and identify associated risk factors. Method: Design: A descriptive cross-sectional study. Participants were recruited six to eight weeks postpartum, provided personal, social and obstetric information, and completed the stress subscale of Depression Anxiety and Stress Scale (DASS-S), the Maternity Social Support Scale (MSSS), and Perceived Self-Efficacy Scale (PSES). Setting: maternal and child health care clinics in four health care centres in Maan city in Southern Jordan. Participants: Arabic speaking women (n = 324) between the ages of 18 and 45 years, six to eight weeks postpartum, primiparous or multiparous at low risk for obstetric complications. Data collection took place between October 2015 and January 2016. Ethical clearance was obtained prior to data collection. Results: The prevalence of postpartum stress among Jordanian women was 39.8 %. A regression analysis revealed that occupation, low social support, financial problems, difficult marital relationships, difficult relationship with family-in-law, giving birth to a female baby, difficult childbirth, and low self-efficacy were associated with postpartum stress. Conclusions and implications for practice: Jordanian women need support during pregnancy, during and after childbirth. Postpartum emotional support and assessment of symptoms of stress need to be incorporated into routine practice. The opportunity for open discussion along with increased awareness and clarification of common misconceptions about postpartum stress is necessary.

Keywords: prevalence, postpartum, stress, Jordanian women

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Authors: Aarati Susan Mathew, Radhika Narendra Patel, Jiji Mathew

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A retrospective study conducted at Christian Medical College (CMC) Teaching Hospital, Vellore, India on 14th August 2014 to assess the accuracy of clinically estimated foetal weight upon labour admission. Estimating foetal weight is a crucial factor in assessing maternal and foetal complications during and after labour. Medical notes of ninety-eight postnatal women who fulfilled the inclusion criteria were studied to evaluate the correlation between their recorded Estimated Foetal Weight (EFW) on admission and actual birth weight (ABW) of the newborn after delivery. Data concerning maternal and foetal demographics was also noted. Accuracy was determined by absolute percentage error and proportion of estimates within 10% of ABW. Actual birth weights ranged from 950-4080g. A strong positive correlation between EFW and ABW (r=0.904) was noted. Term deliveries (≥40 weeks) in the normal weight range (2500-4000g) had a 59.5% estimation accuracy (n=74) compared to pre-term (<40 weeks) with an estimation accuracy of 0% (n=2). Out of the term deliveries, macrosomic babies (>4000g) were underestimated by 25% (n=3) and low birthweight (LBW) babies were overestimated by 12.7% (n=9). Registrars who estimated foetal weight were accurate in babies within normal weight ranges. However, there needs to be an improvement in predicting weight of macrosomic and LBW foetuses. We have suggested the use of an amended version of the Johnson’s formula for the Indian population for improvement and a need to re-audit once implemented.

Keywords: clinical palpation, estimated foetal weight, pregnancy, India, Johnson’s formula

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Authors: A. G. Miah, U. Salma, K. Schellander

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Relaxin was first described in 1926 by Frederick Hisaw. Previously it was considered as only the hormone of pregnant mammals due to its important roles in pregnancy and parturition. From the last decade, the physiological role of relaxin in male reproduction has been given experimental attention, and the results have made it clear that relaxin can no longer be considered strictly as only the hormone of female reproduction. The accessory glands (specially, the prostate glands) of the male reproductive system are the source of seminal relaxin, which is secreted into the seminal plasma and saturated with spermatozoa just after ejaculation. Several studies have reported that relaxin has important roles in improving motility in human sperm. Thereafter, the growing interest on relaxin has intensified efforts to investigate the role of relaxin in other sperm physiological phenomena like, capacitation, acrosome reaction, and their mediating factors associated with successful fertilization. Therefore, this review aims to provide up-to-date information about the physiological roles of relaxin in sperm motility, capacitation, acrosome reaction, and their mediating factors, such as, utilization of glucose, cholesterol efflux, Ca2+-influx, intracellular cAMP and protein tyrosine phosphorylation. Some studies have shown relaxin to increase the percentage of progressive motility and induce capacitation and acrosome reaction through increasing the utilization of glucose and mediating the cholesterol efflux, Ca2+-influx, intracellular cAMP and protein tyrosine phosphorylation. Thus, the review suggests that the supplementation of relaxin into the capacitating medium may contribute the possible beneficial roles in fresh and cryopreserved spermatozoal prefertilization events.

Keywords: relaxin, physiological roles, prefertilizing activities, spermatozoa

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Authors: Doctor Akanle Florence Foluso

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Access to health care and people’s ability to having a responsible, satisfying and safe sexual life is clearly a defined human right of people with hearing impairment and others with disabilities this paper looks at disability and sexuality: a human right approach to sexual and reproductive health of the hearing impaired adolescents in developing countries. This paper investigates the extent to which the hearing impaired has a satisfying, safe sexual life and whether their human right in regards to information education is violated. The study population consists of all hearing impaired adolescents and young adults aged 10-24 years who are currently enrolled in the primary and secondary schools in Nigeria. A sample of 389 hearing impaired adolescents was selected, an adapted version of the illustrative questionnaire for interview – survey by Johncleland was used to collect the data. A correlation of 0.80 was obtained at p<0.05 level of significance. Teachers in the schools of the deaf who used sign language were used in the administration of the questionnaire. The data generated were analyzed using Frequency Counts, Percentages, Means and Standard Deviation to give a Summary on responses on access to information, education, voluntary testing and counselling and other reproductive services. This is to investigate if the sexual and reproductive right violated or protected. Findings show that a gap exists in the level of knowledge of SRH services, voluntary counselling because more than half the respondents are not aware of these services in their community. Access to information, education and health services are rights denied the hearing impaired. So their SRH rights are violated.

Keywords: sexual right diability, family planning, pregnancy, diability

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Authors: Ahmed A. Abd El Rahim, Mohamed M. M. Essa, Magdy M. A. Shabana, Said A. Mohamed, Mohamed Ibrahim Mabrouk

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Background: Sacroiliac joint (SIJ) dysfunction is considered the main cause of pregnancy-related back pain, which may continue to persist postnatally. Myofascial release technique (MFR) is an application of low-intensity, prolonged stretch to myofascial structures to improve function by increasing the sliding properties of restricted myofascial tissues. Purpose: This study was designed to investigate the effect of MFR on postnatal SIJ hypo-mobility. Materials and Methods: Fifty postnatal women complaining of SIJ hypo-mobility participated in this study. Their ages ranged from 26 to 35 yrs., and their body mass index (BMI) didn`t exceed 30 kg/m2. They were randomly assigned to two equal groups, group A (Gr. A) and group B (Gr. B). Both groups received three sessions per week for eight successive weeks. Gr. A received a traditional physical therapy program, while Gr. B received a traditional physical therapy program in addition to MFR. Doppler imaging of vibration was utilized to measure SIJ mobility pre- and post-intervention, and an electronic digital goniometer was used to measure back flexion and extension Range of motion. Results: Findings revealed a statistical improvement in post-intervention values of SIJ mobility in addition to trunk flexion and extension ROM in Gr. B compared to Gr. A (P<0.001). Conclusion: Adding MFR to traditional physical therapy programs is highly recommended in the treatment of SIJ hypo-mobility in postnatal women.

Keywords: sacroiliac hypo-mobility, sacroiliac dysfunction, myofascial release technique, traditional physical therapy, postnatal

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Authors: Mya Achike

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Background and Significance: Perinatal mental illness covers a wide range of conditions and has a huge influence on maternal-child health. Issues and challenges with perinatal mental health have been associated with poor pregnancy, birth, and postpartum outcomes. It is estimated that one out of five new and expectant mothers experience some degree of perinatal mental illness, which makes this a hugely significant health outcome. Certain factors increase the maternal risk for mental illness. Challenges related to poverty, migration, extreme stress, exposure to violence, emergency and conflict situations, natural disasters, and pandemics can exacerbate mental health disorders. It is widely expected that perinatal mental health is being negatively affected during the present COVID-19 pandemic. Methods: A review of studies that reported a measurement tool to assess perinatal mental health outcomes during the COVID-19 pandemic was conducted following PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. PubMed, CINAHL, and Google Scholar were used to search for peer-reviewed studies published after late 2019, in accordance with the emergence of the virus. The search resulted in the inclusion of ten studies. Approach to measure health outcome: The main approach to measure perinatal mental illness is the use of self-administered, validated questionnaires, usually in the clinical setting. Summary: Widespread use of these tools has afforded the clinical and research communities the ability to identify and support women who may be suffering from mental illness disorders during a pandemic. More research is needed to validate tools in other vulnerable, perinatal populations.

Keywords: mental health during covid, perinatal mental health, perinatal mental health measurement tools, perinatal mental health tools

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Authors: S. Shafiee Ardestani, A. Najafi, N. Valizadeh, E. Payani, H. Karimian

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Objectives: Treatment of mild traumatic brain injury in emergency ward patients with any type of traumatic intracranial hemorrhage is flexible. The aim of this study is to assess the clinical outcomes of mild traumatic brain injury patients who had acute traumatic intracranial hemorrhage on initial emergency ward neuroimaging. Materials-Methods: From March 2011 to November 2012 in a retrospective cohort study we enrolled emergency ward patients with mild traumatic brain injury with Glasgow Coma Scale (GCS) scores of 14 or 15 and who had stable vital signs. Patients who had any type of intracranial hemorrhage on first head CT and repeat head CT within 24 hours were included. Patients with initial GCS < 14, injury > 24 hours old, pregnancy, concomitant non-minor injuries, and coagulopathy were excluded. Primary endpoints were neurosurgical procedures and/or death and for discharged patients, return to the emergency ward during one week. Results: Among 755 patients who were referred to the emergency ward and underwent two head CTs during first 24 hours, 302 (40%) were included. The median interval between CT scans was 6 hours (ranging 4 to 8 hours). Consequently, 135 (45%) patients had subarachnoid hemorrhage, 124 (41%) patients had subdural hemorrhage, 15 (5%) patients had epidural hemorrhage, 28 (9%) patients had cerebral contusions, and 54 (18%) patients had intra-parenchymal hemorrhage. Six of 302 patients died within 15 days of injury. 200 patients (66%) have been discharged from the emergency ward, 25 (12%) of whom returned to the emergency ward after one week. Conclusion: Discharge of the head trauma patients after a repeat head CT and brief period of observation in the emergency ward lead to early discharge of mild traumatic brain injury patients with traumatic ICH without adverse events.

Keywords: clinical outcomes, emergency ward, mild traumatic intracranial hemorrhage, Glasgow Coma Scale (GCS)

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Authors: Hagos Abraham, Solomon Gizaw, Mengistu Urge

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A sound breeding objective is the basis for genetic improvement in overall economic merit of farm animals. Begait goat is one of the identified breeds in Ethiopia, which is a multipurpose breed as it serves as source of cash income and source of food (meat and milk). Despite its importance, no formal breeding objectives exist for Begait goat. The objective of the present study was to identify breeding objectives for the breed through two approaches: using own-flock ranking experiment and developing deterministic bio-economic models as a preliminary step towards designing sustainable breeding programs for the breed. In the own-flock ranking experiment, a total of forty five households were visited at their homesteads and were asked to select, with reasons, the first best, second best, third best and the most inferior does from their own flock. Age, previous reproduction and production information of the identified animals were inquired; live body weight and some linear body measurements were taken. The bio-economic model included performance traits (weights, daily weight gain, kidding interval, litter size, milk yield, kid mortality, pregnancy and replacement rates) and economic (revenue and costs) parameters. It was observed that there was close agreement between the farmers’ ranking and bio-economic model results. In general, the results of the present study indicated that Begait goat owners could improve performance of their goats and profitability of their farms by selecting for litter size, six month weight, pre-weaning kid survival rate and milk yield.

Keywords: bio-economic model, economic parameters, own-flock ranking, performance traits

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Authors: Theresia F. Mrema, Innocent Semali

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Food insecurity to pregnant women seriously impedes efforts to reduce maternal mortality in resource poor countries. This study was carried out to assess determinants food insecurity among pregnant women in urban areas. A cross sectional study design was used to collect data for the period of two weeks. A structured questionnaire with both closed and open ended questions was used to interview a total of 225 randomly selected pregnant women who attend the three randomly selected antenatal care clinics in Temeke Municipal council. The food insecurity was measured using a modified version of the USDA’s core food security module which consists of 15questions. Logistic regression analysis was used to obtain strength of association between dependent and independent variables. Among 225 pregnant women attending antenatal care (ANC) interviewed 55.1% were food insecure. Food insecurity declined with increasing household wealth, it was also significantly low among those with less than three children compared with having more. Low level of food insecurity was associated with having Secondary education (Adjusted OR=0.24; 95%CI, 0.12–0.48), College Education (OR=0.156; 95%CI, 0.05-0.46), paid employment (OR=0.322; 95%CI, 0.11-0.96) and high income (OR=0.031; 95%CI, 0.01–0.07). Also, having head of the household with secondary education (OR=0.51; 95%CI, 0.07-0.32) college education (OR=0.04; 95%CI, 0.01-0.13) and paid employment (OR=0.225; 95%CI, 0.12-0.42). Food insecurity is a significant problem among pregnant women in Temeke Municipal which might significantly affect health of the pregnant woman and foetus due to higher maternal malnutrition which increases risk of miscarriage, maternal and infant mortality, and poor pregnancy outcomes. The study suggests a multi-sectoral approach in order to address this problem.

Keywords: food security, nutrition, pregnant women, urban settings

Procedia PDF Downloads 355

Authors: Mindy A. Brown, Emma E. Reardon, Jennifer Isenhour, Sheila E. Crowell, K. Lee Raby, Elisabeth Conradt

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The positive impact of maternal sensitivity on infant social and emotional development is well-known, as is the notion that stress may impair a mother’s ability to provide sensitive care for her infant. However, individual differences in susceptibility to parenting-related stress are less understood. This study explores how chronic prenatal stress moderates the effect of acute stressors on maternal sensitivity. Data were gathered from 110 mothers and their 7-month-old infants. Mothers were exposed to either an acute stress task or a control task, after which they engaged in the still-face paradigm, a face-to-face interaction where maternal sensitivity was measured. Chronic maternal stress was assessed using the UCLA Life Stress Interview during the third trimester of pregnancy. The results revealed that among mothers exposed to the stress condition, those with higher chronic stress levels in the previous six months displayed significantly lower sensitivity during the still-face paradigm compared to those with lower chronic stress. Notably, past stress levels had no effect on maternal sensitivity in the control condition. These findings suggest a moderating effect of chronic stress on maternal caregiving behavior, with higher prenatal stress diminishing a mother’s ability to cope with acute parenting-related stressors in the present. The mechanisms behind this may involve changes in stress reactivity pathways, such as the hypothalamic-pituitary-adrenal (HPA) axis or altered emotion regulation strategies developed in response to chronic stress. Understanding these pathways could guide targeted interventions for mothers who may be more vulnerable to stress, improving caregiving outcomes.

Keywords: acute stress, maternal stress, prenatal stress, still-face paradigm

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Authors: A. Goma Amira, U. E. Mahrous

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Measuring the effect of perinatal lead exposure on learning ability of offspring is considered as a sensitive and selective index for providing an early marker for central nervous system damage produced by this toxic metal. A total of 35 Sprague-Dawley adult rats were used to investigate the effect of lead acetate toxicity on behavioral patterns of adult female rats and learning ability of offspring. Rats were allotted into 4 groups, group one received 1g/l lead acetate (n=10), group two received 1.5g/l lead acetate (n=10), group three received 2g/l lead acetate in drinking water (n=10), and control group did not receive lead acetate (n=5) from 8th day of pregnancy till weaning of pups. The obtained results revealed a dose-dependent increase in the feeding time, drinking frequency, licking frequency, scratching frequency, licking litters, nest building, and retrieving frequencies, while standing time increased significantly in rats treated with 1.5g/l lead acetate than other treated groups and control. On the contrary, lying time decreased gradually in a dose-dependent manner. Moreover, movement activities were higher in rats treated with 1g/l lead acetate than other treated groups and control. Furthermore, time spent in closed arms was significantly lower in rats given 2g/l lead acetate than other treated groups, while they spent significantly much time spent in open arms than other treated groups which could be attributed to occurrence of adaptation. Furthermore, number of entries in open arms was-dose dependent. However, the ratio between open/closed arms revealed a significant decrease in rats treated with 2g/l lead acetate than the control group.

Keywords: lead toxicity, rats, learning ability, behavior

Procedia PDF Downloads 379

Authors: Jin Liang, Q. Li, Yue Qi, Liying Wang, Wenhua Yu, Xun Liu

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Fertility is very important for women. The gender role of women gives them the fertility ability. Giving birth to a boy or a girl might have effect on the mother’s life in the past in China. However, with the shifting of traditional attitudes and views, the women's social status and living situation have been transformed. Although the pregnancy and childbirth can still bring them a major impact on their lives, the form and content of the impact have changed. So we investigated the rural women of Hebei province after birth to reflect their living situation changes before and after birth and the differences of their living situation from women in the past by using a self-made rural women life situation change questionnaire, the index of well-being, and the index of general effect questionnaire. It has shown that women’s living situation after babybirth in Hebei province is well in general, and their mind and body, as well as their interpersonal relationships and social status, were all enhanced. The women’s living situation after babybirth was positively related to and could anticipate subjective happiness, and specifically, the rural women’s mind and body, their interpersonal relationship and social status in rural women life situation change questionnaire are the main predicted factors to subjective happiness. Furthermore, the women’s self-identification on female roles was influenced by the children’s gender. Specifically, women with only one daughter had highest self-identification on female roles, consisting with their families' concept about children’s gender, which indicated family values have a great effect on women’s self-identification on female roles in rural. Moreover, the women’s living situation and subjective happiness are both impacted by home incomes.

Keywords: rural women, parturition, well-being, life quality

Procedia PDF Downloads 233

Authors: Luh Eka Suryani, Purhadi

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Poisson regression is a non-linear regression model with response variable in the form of count data that follows Poisson distribution. Modeling for a pair of count data that show high correlation can be analyzed by Poisson Bivariate Regression. Data, the number of infant mortality and maternal mortality, are count data that can be analyzed by Poisson Bivariate Regression. The Poisson regression assumption is an equidispersion where the mean and variance values are equal. However, the actual count data has a variance value which can be greater or less than the mean value (overdispersion and underdispersion). Violations of this assumption can be overcome by applying Generalized Poisson Regression. Characteristics of each regency can affect the number of cases occurred. This issue can be overcome by spatial analysis called geographically weighted regression. This study analyzes the number of infant mortality and maternal mortality based on conditions in East Java in 2016 using Geographically Weighted Bivariate Generalized Poisson Regression (GWBGPR) method. Modeling is done with adaptive bisquare Kernel weighting which produces 3 regency groups based on infant mortality rate and 5 regency groups based on maternal mortality rate. Variables that significantly influence the number of infant and maternal mortality are the percentages of pregnant women visit health workers at least 4 times during pregnancy, pregnant women get Fe3 tablets, obstetric complication handled, clean household and healthy behavior, and married women with the first marriage age under 18 years.

Keywords: adaptive bisquare kernel, GWBGPR, infant mortality, maternal mortality, overdispersion

Procedia PDF Downloads 159

Authors: Lea Stein, Sabine Rösner, Alessandra Lo Giudice, Beate Ditzen, Tewes Wischmann

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For many couples bearing children is a consistent life goal; however, it cannot always be fulfilled. Undergoing infertility treatment does not guarantee pregnancies and live births. Couples have to deal with miscarriages and sometimes even discontinue infertility treatment. Significant medical predictors for the outcome of infertility treatment have yet to be fully identified. To further our understanding, a cross-sectional five-year follow-up survey was undertaken, in which 95 women and 82 men that have been treated at the Women’s Hospital of Heidelberg University participated. Binary logistic regressions, parametric and non-parametric methods were used for our sample to determine the relevance of biological (infertility diagnoses, maternal and paternal age) and lifestyle factors (smoking, drinking, over- and underweight) on the outcome of infertility treatment (clinical pregnancy, live birth, miscarriage, dropout rate). During infertility treatment, 72.6% of couples became pregnant and 69.5% were able to give birth. Suffering from miscarriages 27.5% of couples and 20.5% decided to discontinue an unsuccessful fertility treatment. The binary logistic regression models for clinical pregnancies, live births and dropouts were statistically significant for the maternal age, whereas the paternal age in addition to maternal and paternal BMI, smoking, infertility diagnoses and infections, showed no significant predicting effect on any of the outcome variables. The results confirm an effect of maternal age on infertility treatment, whereas the relevance of other medical predictors remains unclear. Further investigations should be considered to increase our knowledge of medical predictors.

Keywords: advanced maternal age, assisted reproductive technology, female factor, male factor, medical predictors, infertility treatment, reproductive medicine

Procedia PDF Downloads 109