Search results for: pregnancy complication

Authors: Demmiele Matu Kiiza, Constantine Steven Labongo Loum, Julaina Obika Asinasi

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Background: The use of traditional medicine in Uganda forms the preliminary therapeutic approaches among many people. Traditional medicines have been used in Uganda for many years, not only for the management of pregnancy-related complications but also for the management of other physical and psychological illnesses. Traditional medicines are always considered the first line of treatment by a considerable number of people. This study, therefore, sought to explore the lived experiences of pregnant women by assessing their perceptions of the transitional use of traditional medicine. Methods: Ethnography was used to capture data from an emic perspective. The ethnographic approach involved visiting a few selected pregnant women to observe and participate in the identification of traditional medicines. The ethnographic fieldwork was carried out within a period of three months. In-depth interviews were carried out and audio recorded and later transcribed verbatim. Data was thereafter analyzed thematically. The thematic analysis involved identifying statements made by research participants by transcribing audio and reading through field notes, coding was done, and themes were generated according to commonly mentioned experiences of using traditional medicine. Results: The findings revealed that women performed a ritual of ‘cutting the cord’ by making a small horizontal incision on the belly across the linea Nigra (also known as a pregnancy line) at around six months of pregnancy to avoid producing a baby with an umbilical cord tied around the baby’s neck. They also used crushed egg shells, crushed snail shells and herbs such as pawpaw roots, Entarahompo (crassocephalum vitelline), Ekyoganyanja (Erlangea tomentose), to manage Omushohokye (a term used by the study participants to refer to a situation where women pass out too much water when giving birth, producing a child with mold and oozing out of a milky liquid through the breasts before giving births); prepare for safe delivery and also to manage pregnancy-related complications. The study recommends the implementation of a traditional medicine use policy using a bottom-up approach. Designing and implementing of culturally sensitive maternal healthcare intervention programs and involving village health teams and the elderly in health education.

Keywords: traditional medicine, pregnant women, uganda, perceptions

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Authors: Cynthia Zgheib, Yonna Sacre

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Pregnancy, this particular moment in the life of a woman, requires monitoring of eating behavior changes. However, the food choices during pregnancy should be varied and healthy, including the consumption of different food groups. Nutritional status is the process of acquisition and consumption of food. Therefore, a varied diet is associated with good nutritional status. This is why the nutrition education is a strategy commonly applied to improve maternal nutrition during pregnancy. Thus, it is crucial to assess 'The eating behavior and nutritional status of pregnant women living in Keserwan Lebanon.' In order to evaluate the association of different persona, socioeconomic and sociodemographic factors with the eating behavior and nutrition in the concerned study category, a cross-sectional descriptive study was conducted on a sample of 150 pregnant women aging between 18 and 40 years randomly selected from the hospitals and clinics located in Keserwan area and equally distributed between different cities and villages of the area according to altitude. The purpose of this study was to evaluate the eating behavior of the concerned population and to compare it to the recommendation of the food guide pyramid, their level of food awareness and finally to analyze their blood tests in order to detect any nutrients deficiency that they may face during the course of their pregnancy. Sociodemographic, lifestyle, eating behaviour, health, eating patterns, awareness, and food frequency questionnaire (FFQ) were collected through a validated questionnaire specifically adapted for the purpose of the study. Statistical analysis was carried out, and multivariate models were used in order to evaluate the association between several independent variables and the eating behaviour and nutritional status of Lebanese pregnant women The final analysis has shown that 48.7% of pregnant women were aged between 30 and 40 years old, 56% had a normal BMI between 18.5 and 24.9, thus age affects the eating behavior, so the older are the pregnant women, and the healthier is their eating behavior. In fact, 80.7% had acceptable food behavior which is based on an equilibrium between both quantity and quality of food, although the recommended foods are foods found in the food pyramid and available in the Lebanese diet. In addition, 68% had an acceptable level of awareness concerning the health importance of good eating habits, therefore, it is positively affecting their food choices. Moreover, 50 % have an acceptable nutritional status which is confirmed by their biological tests. Future governmental or national studies and programs could be settled aiming to increase the awareness about the good eating behaviors and nutritional status of Lebanese pregnant women.

Keywords: eating behavior, nutritional status, level of awareness, pregnant woman

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Authors: Sudha Summarwar, Sudesh Agarwal, Deepali Lall, Nalini Kataria, Jyotsana Pandey

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Assessment of antioxidant status is an effective tool to appraise the presence of oxidative stress. A combination of assays can be used to evaluate the antioxidant status like serum catalase (CAT), superoxide dismutase (SOD) and monoamine oxidase (MAO). In human medicine pregnancy is known to be associated with oxidative stress. Oxidative stress produces harmful effects to the developing foetus. Several metabolic changes occur in the maternal body to meet the demand of energy of developing foetus. Due to these changes susceptibility of maternal body increases to oxidative stress. There is paucity of research work on this aspect in nondescript goats. Therefore, the present study was intended to appraise the oxidative stress in pregnant and non-pregnant non-descript goat. Blood samples were collected for serum separation in otherwise healthy pregnant and non-pregnant nondescript goats. Mean values of serum CAT, SOD and MAO were found on a higher side (p≤0.05) with serum SOD values showing a rise of 2.5 times higher than the control healthy value. Correlations among all the three parameters were found to be highly significant (p≤0.01) especially greatest in youngest group of pregnant animals. Illustration of result enlightened the veracity of bumped up production of free radicals in pregnant animals. Technical savoir-faire of oxidative stress supervision is essential for upholding of health status of foetus. The upshot of present study undoubtedly implied the development of oxidative stress in pregnant goats on the basis of altered antioxidant status. These findings conclude that initially the oxidative stress due to pregnancy is critically combated by the intricate defensive mechanism of natural antioxidant system of the body. It appears that this imbalance between oxidant and antioxidant must be checked in time to prevent cellular damage by regularly appraising the antioxidant status through laboratory methods.

Keywords: antioxidant, oxidative stress, pregnancy, serum catalase

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Authors: Madeleine Elder, Aye Htun

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Background: Myiasis is the parasitic infestation of body tissues by fly larvae. It predominantly occurs in poor socioeconomic regions of tropical and subtropical countries where it is associated with poor hygiene and sanitation. Cutaneous and wound myiasis are the most common presentations whereas urogenital myiasis is rare, with few reported cases. Case: a 26-year-old primiparous woman with a low-risk pregnancy presented to the emergency department at 37+3-weeks’ gestation after passing a 2cm black larva during micturition, with 2 weeks of mild vulvar pruritus and dysuria. She had travelled to India 9-months prior. Examination of the external genitalia showed small white larvae over the vulva and anus and a mildly inflamed introitus. Speculum examination showed infiltration into the vagina and heavy white discharge. High vaginal swab reported Candida albicans. Urine microscopy reported bacteriuria with Enterobacter cloacae. Urine parasite examination showed myiasis caused by Clogmia albipunctata species of fly larvae from the family Psychodidae. Renal tract ultrasound and inflammatory markers were normal. Infectious diseases, urology and paediatric teams were consulted. The woman received treatment for her urinary tract infection (which was likely precipitated by bladder irritation from local parasite infestation) and vaginal candidiasis. She underwent daily physical removal of parasites with cleaning, speculum examination and removal, and hydration to promote bladder emptying. Due to the risk of neonatal exposure, aspiration pneumonitis and facial infestation, the woman was steroid covered and proceeded to have an elective caesarean section at 38+3-weeks’ gestation, with delivery of a healthy infant. She then proceeded to have a rigid cystoscopy and washout, which was unremarkable. Placenta histopathology revealed focal eosinophilia in keeping with the history of maternal parasites. Conclusion: Urogenital myiasis is very rare, especially in the developed world where it is seen in returned travellers. Treatment may include systemic therapy with ivermectin and physical removal of parasites. During pregnancy, physical removal is considered the safest treatment option, and discussion around the timing and mode of delivery should consider the risk of harm to the foetus.

Keywords: urogenital myiasis, parasitic infection, infection in pregnancy, returned traveller

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Authors: Kadhim Alabady

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Background: Mental illnesses after childbirth are common. After childbirth, women may experience a variety of postpartum complications such as developing depression during pregnancy and after childbirth. Postpartum depression might increases the risk of developing major depression in the future. The most common is postnatal depression also known as postpartum depression that is believed to affect between 10% – 15% of mothers and the most serious, puerperal psychosis (affecting less than 1%). Purpose: This research simply applies the predictions to the population of Dubai, without any adjustment for local conditions. It is intended to help stakeholders to discuss the scale of the issue locally. Method: Applying the above rates of postnatal depression prevalence (10%–15%) to the number of total live births in Dubai 2014. Setting: Birth registry for Dubai 2011/14. Key findings: it is estimated there would be approximately 2,928–4,392 mothers suffering from postnatal depression in 2014 of which 858–1,287 were nationals and 2,070–3,105 were non–nationals. These figures are likely to fluctuate depending on the number of mothers who have twin births, and these estimates of the level of postnatal depression do not take into account related factors such as the age of the mother and education. Recommendations: To establish mother-infant psychiatric care to target women suffering from depression during pregnancy and puerperium.

Keywords: post natal depression, women, mental health, birth

Procedia PDF Downloads 135

Authors: A. Abiodun, G. George, B. Longo-Mbenza, E. Blanco-Blanco

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Objective: To determine the prevalence and determinants of iron-deficiency anaemia in pregnant Xhosa women practising geophagia. Methods: This cross-sectional study was conducted among pregnant Xhosa women from rural areas of Mthatha, South Africa, according to socio-demographic, geophagia, haematologic and iron metabolism profiles using univariate and multivariate analyses. Anaemia was defined by haemoglobin <11 g/dL and iron deficiency was defined by serum ferritin < 12 ug/L. Results: Out of 210 pregnant women (mean age =23±5.3 for geophagic and 25.6±5.3 for non-geophagic), 51.4% (n = 108) had iron deficiency anaemia (50.9% geophagic and 49.1% non-geophagic). After adjusting for confounders, only geophagia (OR=2.1 95% CI 1.1-4.2; P=0.029) and mean corpuscular haemoglobin concentration categories (< 30.5 g/dL with OR=16.6 95% CI 6.8-40.2; P < 0.0001; 30.5-31.5 g/dL with OR=2.9 95% CI 1.4-6.1; P=0.006; and ≥ 31.5 g/dL with OR=1) were identified as the most important significant and independent determinants of iron deficiency anaemia. Conclusion: The study results point to the potential harm geophagia can cause in pregnant women. The prevalence of iron deficiency anaemia is unacceptably high. Geophagic behaviour, low MCHC presented as particular risk factors of iron deficiency anaemia in this study. Education and counselling about appropriate diet during pregnancy and prevention of geophagic behaviour (and health consequences) are needed among pregnant Xhosa women.

Keywords: geophagia, pregnancy, iron deficiency anaemia, Xhosa

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Authors: Anthony J. Kondracki, Bonzo Reddick, Jennifer L. Barkin

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Background: Many pregnancies in the United States are affected each year with the most common sexually transmitted infections (STIs), including Chlamydia trachomatis (CT), Neisseria gonorrhoeae (NG), and Treponema pallidum (TP, syphilis), and the rate of congenital syphilis has reached a 20-year high. We sought to estimate the prevalence of CT, NG, and TP in pregnancy and the risk of preterm birth (PTB) (<37 weeks gestation) and low birthweight (LBW) (<2500g) deliveries according to utilization of prenatal care (PNC) during the COVID-19 pandemic. Methods: This study was based on the 2020 National Center for Health Statistics (NCHS) Natality File restricted to singleton births (N=3,512,858). We estimated the prevalence of CT, NG, TP, PTBand LBW across timing and the number of prenatal care (PNC) visits attended. In multivariable logistic regression models, adjusted odds ratios of PTB and LBW were assessed according to STIs and PNC status. E-values, based on effect size estimates and the lower bound of the 95% confidence intervals (CIs) of the association, examined the potential impact of unmeasured confounding. Results: CT (1.8%) was most prevalent in pregnancy, followed by NG (0.3%) and TP (0.1%). The strongest predictors of PTB and LBW were maternal NG (12.2% and 12.1%, respectively), late initiation/no PNC (8.5% and 7.6%, respectively), and ≤10 prenatal visits (13.1% and 10.3%, respectively). The odds of PTB and LBW were 2.5- to 3-fold greater for each STI in women who received ≤10 compared to >10 prenatal visits. E-values demonstrated the minimum strength of potential unmeasured confounding necessary to explain away observed associations. Conclusions: Timely initiation and receipt of recommended number of prenatal visits benefits screening and treatment of all women for STIs, including NG to substantially reduce infant morbidity and mortality related to PTB and LBW among infants born during the COVID-19 pandemic.

Keywords: COVID-19 pandemic, sexually transmitted infections, preterm birth, low birthweight, prenatal care

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Authors: Abdelfatah Elsenosy, Mahmoud Ebrahim

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Background: Distal radius fractures are commonly encountered in orthopedic practice, especially in elderly patients. A number of clinical papers have supported the idea that anatomic restoration of the distal end of the radius is essential to gain superior results. Aim and objectives: The aim of the study is to systematically review the literature for the management of distal end radius in elderly persons (conservative treatment versus percutaneous wire fixation) as regards radiological and functional outcomes. Subjects and methods: Studies were identified from the Medline, Cochrane, EMBASE, and Google Scholar databases were searched until 2019 using combinations of the following search terms: distal radius fracture, conservative treatment, non-operative treatment, and nonsurgical treatment, surgical treatment, operative, elderly, and older. Reference lists of relevant studies were manually searched. Results: There was no statistical significance difference between CI and PKF groups’ frequency of complication in all of the selected studies. Based on the results, we recommend more analysis regarding every parameter of the radiographic and functional results and specific complications related to each fixation need to be accomplished, which requires more Randomized controlled trials (RCTs) with high quality. Conclusion: Surgical treatment seems to be more effective distal radius fracture compared with conservative treatment when the radiographic outcomes were analyzed, and no significant differences were detected in the functional outcomes and complication rate.

Keywords: radius, fracture, surgical, RCTs, conservative, radiographic, outcomes, orthopedic

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Authors: Blanca Fatela Cantillo, Silvia Iglesias Cerrato, Guadalupe Garrido Ceca

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Purpose: Bleb dysfunction is a late complication following glaucoma filtration surgery. We describe our surgical technique for excision and reconstruction of a hypertrophic bleb complication using bovine pericardium patch graft (Tutopatch®) and amniotic membrane. Material and methods: The case report presents a hypertrophic bleb over the cornea with good intraocular pressure control. The hanging bleb without leak caused dysesthesia and high irregular astigmatism. Bleb reconstruction involved the excision of corneal fibrous material and avascular conjunctiva, preserving the original scleral and tennon. Bovine pericardium patch graft (Tutopatch®) was sited over these with fixed sutures, reinforcing the underlying scleral, and the conjunctiva advanced. The superior epithelium corneal defect was covered using an amniotic membrane. Conclusion: Repair of bleb dysfunction with varied techniques has been reported, including conjunctival advancement, use of scleral patch graft, dural patch graft, or pericardium. Additional use of amniotic membrane promotes epithelialization and exhibits anti-fibrotic and anti-inflammatory features. Reconstruction with bovine pericardium patch graft and amniotic membrane resulted in pain relief, visual rehabilitation, and good aesthetic results, with preservation of bleb function.

Keywords: reconstruction, hypertrophic bleb, bovine pericardium, amniotic membrane, dysesthesia of the bleb

Procedia PDF Downloads 57

Authors: Pierre Mintom, Ebai Patricia, Merlin Dasse, Marlyse Chantal Nyangon Ndongo, Aicha Aretouyap Kouotou, Felix Essiben, Christine Fernande Nyangono Biyegue

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Background: The death of women during and after pregnancy remains a major concern in public health policy in Cameroon. Among the causes of this mortality is eclampsia which is a consequence of the Pre-eclampsia characterized by the double burden of pregnancy-induced hypertension and albuminuria in pregnant women. Objective: To determine the various factors associated with the pre-eclampsia in pregnant women of Foumban. Methodology: A cross-sectional and analytical study was carried out during the period from July to August 2020 and supplemented by another study carried out from August 05 to September 05, 2022, at the Foumban district hospital. A questionnaire was administered to pregnant women. It focused on socio-demographic parameters, the state nutritional, health status, and maternal parameters. Blood pressure was taken using an electronic blood pressure monitor, and urinary albumin was measuring using urine dipstick. Pre-eclampsia was defined by three types of double burden: double burden systolic hypertension–hyperalbuminuria (SHH), defined for SBP≥140 mmHg and hyperalbuminuria ≥1+ on urine dipstick, double burden diastolic hypertension–hyperalbuminuria (DHH), defined for PAD≥90 mmHg and hyperalbuminuria ≥1+ on the urine dipstick, and the double burden systolodiastolic arterial hypertension– hyperalbuminuria (SDHH), defined for SBP ≥ 140mmHg, PAD≥90 mmHg and hyperalbuminuria ≥1+ on urine dipstick. IBM SPSS Software was used for statistical analysis. Results: The results of this study show that the prevalence of pre-eclampsia was 17.3% for the double burden SHH, 19.9% for the double burden DHH and 14.1% for double burden SDHH. Associated factors with pre-eclampsia according to the three types of double burden were marital status (P<0.05), religion (P<0.05), history of hypertension before pregnancy (P<0.05). Associated factors for the double burden of DHH and SDHH were the nutritional status before the pregnancy (P<0.05) and the number of prenatal consultations (P<0.05). In terms of food groups, regular consumption of spices significantly increased the risk of pre-eclampsia by 5.318, 6.277 and 11.271 times respectively for the SHH, DHH and SDHH double burdens, while regular consumption of sweets regular consumption of sweets increased by 2.42 times and 2.053 times respectively the double DHH and SDHH burdens respectively. Conclusion: Our study made it possible to redefine pre-eclampsia by considering the subtypes of hypertension. Certain socio-demographic parameters and certain dietary habits influence the occurrence of pre-eclampsia characterized by the double burden Hypertension-hyperalbuminuria in pregnant women, which may later lead to the occurrence of eclampsia. Moreover, albuminemia could be a good predicitive factor of pre-eclampsia and could be explored.

Keywords: hypertension, hyperalbuminuria, pregnant women, foumban

Procedia PDF Downloads 37

Authors: Lisnawati Hutagalung

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Background: Low birth weight (LBW) is one cause of newborn death. Babies with low birth weight tend to have slower cognitive development, growth retardation, more at risk of infectious disease event at risk of death. Objective: Identifying risk factors and dominant factors that influence the incidence of LBW in Indonesia. Method: This research used some database of public health such as Google Scholar, UGM journals, UI journals and UNAND journals in 2012-2015. Data were filtered using keywords ‘Risk Factors’ AND ‘Cause LBW’ with amounts 2757 study. The filtrate obtained 5 public health research that meets the criteria. Results: Risk factors associated with LBW, among other environment factors (exposure to cigarette smoke and residence), social demographics (age and socio-economic) and maternal factors (anemia, placental abnormal, nutritional status of mothers, examinations antenatal, preeclampsia, parity, and complications in pregnancy). Anemia and nutritional status become the dominant factor affecting LBW. Conclusions: The risk factors that affect LBW, most commonly found in the maternal factors. The dominant factors are a big effect on LBW is anemia and nutritional status of the mother during pregnancy.

Keywords: low birth weight, anemia, nutritional status, the dominant factor

Procedia PDF Downloads 327

Authors: Tessa Sellis, Marike A. Wierda, Elke Tichelman, Mirjam T. Van Lohuizen, Marjolein Berger, François Schellevis, Claudi Bockting, Lilian Peters, Huib Burger

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Introduction: Most women develop a healthy bond with their children, however, adequate mother-to-infant bonding cannot be taken for granted. Mother-to-infant bonding refers to the feelings and emotions experienced by the mother towards her child. It is an ongoing process that starts during pregnancy and develops during the first year postpartum and likely throughout early childhood. The prevalence of inadequate bonding ranges from 7 to 11% in the first weeks postpartum. An impaired mother-to-infant bond can cause long-term complications for both mother and child. Very little research has been conducted on the direct relationship between the personality of the mother and mother-to-infant bonding. This study explores the associations between maternal personality and postnatal mother-to-infant bonding. The main hypothesis is that there is a relationship between neuroticism and mother-to-infant bonding. Methods: Data for this study were used from the Pregnancy Anxiety and Depression Study (2010-2014), which examined symptoms of and risk factors for anxiety or depression during pregnancy and the first year postpartum of 6220 pregnant women who received primary, secondary or tertiary care in the Netherlands. The study was expanded in 2015 to investigate postnatal mother-to-infant bonding. For the current research 3836 participants were included. During the first trimester of gestation, baseline characteristics, as well as personality, were measured through online questionnaires. Personality was measured by the NEO Five Factor Inventory (NEO-FFI), which covers the big five of personality (neuroticism, extraversion, openness, altruism and conscientiousness). Mother-to-infant bonding was measured postpartum by the Postpartum Bonding Questionnaire (PBQ). Univariate linear regression analysis was performed to estimate the associations. Results: 5% of the PBQ-respondents reported impaired bonding. A statistically significant association was found between neuroticism and mother-to-infant bonding (p < .001): mothers scoring higher on neuroticism, reported a lower score on mother-to-infant bonding. In addition, a positive correlation was found between the personality traits extraversion (b: -.081), openness (b: -.014), altruism (b: -.067), conscientiousness (b: -.060) and mother-to-infant bonding. Discussion: This study is one of the first to demonstrate a direct association between the personality of the mother and mother-to-infant bonding. A statistically significant relationship has been found between neuroticism and mother-to-infant bonding, however, the percentage of variance predictable by a personality dimension is very small. This study has examined one part of the multi-factorial topic of mother-to-infant bonding and offers more insight into the rarely investigated and complex matter of mother-to-infant bonding. For midwives, it is important recognize the risks for impaired bonding and subsequently improve policy for women at risk.

Keywords: mother-to-infant bonding, personality, postpartum, pregnancy

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Authors: Mirzashahi Babak, Mansouri Pejman, Najafi Arvin, Farzan Mahmoud

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Introduction: There are several surgical treatment choices for cervical spondylotic myelopathy (CSM). The aim of this study is to evaluate clinical outcomes and surgical complications in patients with cervical disk degeneration (CDD) undergoing either anterior cervical discectomy with or without fusion or cervical laminectomy and fusion. Methods: This prospective case series study included 45 consecutive patients with cervical spondylotic myelopathy between January 2010 and November 2014. There were 28 males and 17 females, with a mean age of 47 (range 37-68) years. The mean clinical follow-up was 14 months (range 3-24 months). The Neck Disability Index (NDI), visual analog scale (VAS) neck and arm pain, Short Form-36 (SF-36) were used as the functional outcome measurements. All of the complications in our patients were recorded. Results: In our study group, 26 patients underwent only one or two level anterior cervical discectomy. Ten patients underwent anterior cervical discectomy and fusion (ACDF) and nine cases underwent posterior laminectomy and fusion. We have found a statistically significant improvement between mean preoperative (29, range 19-43) and postoperative (7, range 0-12) NDI scores following surgery (P < 0.05). Also, there was a statistically significant difference between pre and post-operative VAS and SF-36 score (p < 0.05). There was a 7% overall complication rate (n = 3). The only complication in our patients was surgical site cellulitis which has been managed with oral antibiotic therapy. Conclusion: Both anterior cervical discectomy with or without fusion or posterior laminectomy and fusion are safe and efficacious treatment options for the management of CSM. The clinical outcomes seem to be fairly reproducible.

Keywords: cervical, myelopathy, discectomy, fusion, laminectomy

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Authors: Galila Aisyah Latif Amini, Husnul Khatimah, Citra Amelia

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Smoking among women is of particular concern for the maternal and child health community due to the strong association between prenatal smoking and adverse birth outcomes. Pregnancy is perceived to be a unique reason for smoking cessation, as motivation to care for the unborn fetus. This study aimed to find out the determinants of smoking cessation among pregnant women. Method that we use in this study is systematic review. We identified relevant studies by searching on science database online through SAGE journals, Proquest, Scopus, Emerald, JSTOR, and Springerlink. Journals were screened by title and abstract according to the research topic then filtered using the criteria exclusion and inclusion. And then we did critical appraisal. The results of the four studies reviewed were found that the determinant of smoking cessation are parity, the level of education, socioeconomic status, household SHS exposure, smoking habits of both parents, partner smoking status, psychological factors, antenatal care, intervention for health care provider, age smoking duration. The factor most strongly associated with smoking cessation is parity (OR 2,55; Cl 2,34-2,77). The results of this study are expected to give advice for developing future smoking cessation and relapse prevention programs.

Keywords: pregnancy, smoking cessation, tobacco use cessation, smoking

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Authors: Amy Kless, Peter Reuter

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The purpose of this study was to explore the association between the teachings of religious doctrine on the use of contraceptives and its influence on the behavior of female college students. The religious doctrine of both Christian and non-Christian religions states that sexual intercourse shall only take place between people that are married. Additionally, the teachings of most Christian and non-Christian religions prohibit the use of contraceptives during sexual intercourse. Being away from home for the first time, students that grew up in religious households may stop attending church services or stop practicing religion entirety. The college years are also a time for sexual exploration. The desire for sexual exploration leaves many students, both religious and non-religious, with having to choose between abstaining from sexual intercourse or using a form of contraceptive to prevent pregnancy. Of 1,130 female students anonymously surveyed at a southern university between Spring 2016 and Fall 2020, 50% reported having religious beliefs. Less than 50% of the students who reported having religious beliefs attend church services on a regular basis. Nearly 75% of the same students reported having participated in sexual intercourse with close to 60% utilizing some form of contraceptive to prevent pregnancy. The data suggest that female college students do not follow religious teachings on abstinence from premarital sex or the ban on the use of contraceptives.

Keywords: contraceptives, females, intercourse, religion

Procedia PDF Downloads 238

Authors: O. O. Leigh, L. C. Agbugba, A. O. Oyewunmi, A. E. Ibiam, A. Hassan

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Accuracy of insemination timing is a key determinant of high pregnancy rates in livestock breeding stations. The estrous detector probes are a recent introduction into the Nigerian livestock farming sector. Many of these probes are species-labeled and they measure changes in the vaginal mucus resistivity (VMR) during the stages of the estrous cycle. With respect to size and shaft conformation, the Draminski® swine estrous detector probe (sEDP) is quite similar to the bovine estrous detector probe. We investigated the reliability of the sEDP at insemination time on two farms designated as FM A and FM B. Cows (Bunaji, n=20 per farm) were evaluated for VMR at 16th h post standard OvSynch protocol, with concurrent insemination on FM B only. The difference in the mean VMR between FM A (221 ± 24.36) Ohms and FM B (254 ± 35.59) Ohms was not significant (p > 0.05). Sixteen cows (80%) at FM B were later (day 70) confirmed pregnant via rectal palpation and calved at term. These findings suggest consistency in VMR evaluated with sEDP at insemination as well as a high predictability for VMR associated with good pregnancy rates in dairy cattle. We conclude that Draminski® swine estrous detector probe is reliable in determining time of insemination in cattle breeding stations.

Keywords: dairy cattle, insemination, swine estrous probe, vaginal mucus resistivity

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Authors: Ghada E. Esheba, Ghufran Kheshaifaty, Kholoud Al-Harbi, Wafa'a Al-Harbi, Ala'a Al-Orabi, Moayad Turkistani

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Krukenberg tumor is a rare metastatic ovarian carcinoma that usually occurs in female between 30 - 40 year old and rarely seen after menopause. Stomach is the most common primary site. Histopathological features of krukenberg tumors appear as diffuse stromal proliferation, mucus-production, and numerous signet-cells and these tumors spread mostly by lymphatic route. Treatment and prognostic factors are not well established. This study describes a 34 year old female with a unilateral ovarian mass discovered accidentally during cesarean section delivery and it was misdiagnosed as luteoma of pregnancy, but histopathological examination showed a diffuse infiltration of the ovary and omentum by signet ring cells. These findings were not correlated with luteoma of pregnancy or any other types of primary ovarian tumors like surface epithelial tumor, sex cord stromal tumor or germ cell tumor. However, after the analysis of immunohistochemical results (negative CK7, positive CK20 and CDX-2), the finding was the diagnostic of metastatic krukenberg tumor. Two weeks later, the patient was evaluated and a large gastric tumor was found in her stomach and she underwent gastrectomy.

Keywords: CK7, CK20, CDX-2, Krukenburg tumor, metastatic ovarian tumor

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Authors: Seham Alsaif, Susan Wray

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Obesity is a worldwide disorder influencing women’s health and childbearing. There is a close relation between obesity and pregnancy related complications. Dyslipidemia and adipokine dysregulation are core environmental changes that may mechanistically link these complications with obesity in pregnant women. We have previously found that visfatin has a relaxant effect on mouse, rat and human myometrial contractility. We hypothesised that visfatin inhibits mouse myometrial contractility through the NAD+ pathway. This study was designed to examine the mechanism of action of visfatin on myometrial contractility. To examine the NAD+ pathway, FK866 which is a potent inhibitor of NAD+ biosynthesis was used. Methods: Myometrial strips from term pregnant mice were dissected, superfused with physiological saline and the effects of visfatin (10nM) on oxytocin-induced contractions (0.5nM) alone and after the infusion of FK866 (10uM) were studied. After regular contractions were established, contractility was examined for control (100%) and test response at 37 °C for 10 min each. Results: FK866 was found to inhibit the effect of visfatin on myometrial contractility (the AUC increased from 89±2% of control, P=0.0009 for visfatin alone to 97±4% of control, P>0.05 for visfatin combined with FK866, n=8). In conclusion, NAD+ pathway appears to be involved in the mechanism of action of visfatin on mouse myometrium. This could have a role in making new targets to prevent obesity-related complications.

Keywords: myometrium, obesity, oxytocin, pregnancy, visfatin

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Authors: L. Kolatorova, J. Vitku, K. Adamcova, M. Simkova, M. Hill, A. Parizek, M. Duskova

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Endocrine disruptors (EDs) are substances leaching from various industrial products, which are able to interfere with the endocrine system. Their harmful effects on human health are generally well-known, and exposure during fetal development may have lasting effects. Fetal exposure and transplacental transport of bisphenol A (BPA) have been recently studied; however, less is known about alternatives such as bisphenol S (BPS), bisphenol F (BPF) and bisphenol AF (BPAF), which have started to appear in consumer products. The human organism is usually exposed to the mixture of EDs, out of which parabens are otherwise known to transfer placenta. The usage of many cosmetic, pharmaceutical and consumer products during the pregnancy that may contain parabens and bisphenols has led to the need for investigation. The aim of the study was to investigate the transplacental transport of BPA, its alternatives, and parabens, and to study their relation to fetal steroidogenesis. BPA, BPS, BPF, BPAF, methylparaben, ethylparaben, propylparaben, butylparaben, benzylparaben and 15 steroids including estrogens, corticoids, androgens and immunomodulatory ones were determined in 27 maternal (37th week of gestation) and cord plasma samples using liquid chromatography - tandem mass spectrometry methods. The statistical evaluation of the results showed significantly higher levels of BPA (p=0.0455) in cord plasma compared to maternal plasma. The results from multiple regression models investigated that in cord plasma, methylparaben, propylparaben and the sum of all measured parabens were inversely associated with testosterone levels. To our best knowledge, this study is the first attempt to determine the levels of alternative bisphenols in the maternal and cord blood, and also the first study reporting the simultaneous detection of bisphenols, parabens, and steroids in these biological fluids. Our study confirmed the transplacental transport of BPA, with likely accumulation in the fetal compartment. The negative association of cord blood parabens and testosterone levels highlights their possible risks, especially for the development of male fetuses. Acknowledgements: This work was supported by the project MH CR 17-30528 A from the Czech Health Research Council, MH CZ - DRO (Institute of Endocrinology - EÚ, 00023761) and by the MEYS CR (OP RDE, Excellent research - ENDO.CZ).

Keywords: bisphenol, endocrine disruptor, paraben, pregnancy, steroid

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Authors: Pushp Lata Sankhwar

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INTRODUCTION: Maternal Hypothyroidism is the most frequent endocrine disorder in pregnancy and varies from 2.5% in the west to 11.0% in India. Maternal Hypothyroidism can have detrimental maternal effects like increased risk of preterm labor, PPROM leading to increased maternal morbidity and also on the neonate in the form of prematurity and its complications, prolonged hospital stay, neurological developmental problems, delayed milestones and mental retardation etc. Henceforth, the study was planned to evaluate the role of Hypothyroidism in preterm labor and its effect on neonates. AIMS AND OBJECTIVES: To Correlate Overt Hypothyroidism, Subclinical Hypothyroidism and Isolated Hypothyroxinemia With Preterm Labor and the neonatal outcome. Material and Methods: A case-control study of singleton pregnancy was performed over a year, in which a total of 500 patients presenting in the emergency with preterm labor were enrolled. The thyroid profile of these patients was sent at the time of admission, on the basis of which they were divided into Cases – Hypothyroidic mothers and Controls – Euthyroid mothers. The cases were further divided into subclinical, overt Hypothyroidism and isolated hypothyroxinemia. The neonatal outcome of these groups was also compared on the basis of the incidence and severity of neonatal morbidity, neonatal respiratory distress, the incidence of neonatal Hypothyroidism and early complications. The feto-maternal data was collected and analysed. RESULTS: In the study, a total of 500 antenatal patients with a history of preterm labor were enrolled, out of which 67 (13.8%) patients were found to be hypothyroid. The majority of the mothers had Subclinical Hypothyroidism (12.2%), followed by Overt Hypothyroidism seen in 1% of the mothers and isolated hypothyroxinemia in 0.6% of cases. The neonates of hypothyroid mothers had higher levels of cord blood TSH, and the mean cord blood TSH levels were highest in the case of neonates of mothers with Overt Hypothyroidism. The need for resuscitation of the neonates at the time of birth was higher in the case of neonates of hypothyroid mothers, especially with Subclinical Hypothyroidism. Also, it was found that the requirement of oxygen therapy in the form of oxygen by nasal prongs, oxygen by a hood, CPAP, CPAP along with surfactant therapy and mechanical ventilation along with surfactant therapy was significantly higher in the case of neonates of hypothyroid mothers. CONCLUSION: The results of our study imply that uncontrolled and untreated maternal Hypothyroidism may also lead to preterm delivery. The neonates of mothers with Hypothyroidism have higher cord blood TSH levels. The study also shows that there is an increased incidence and severity of respiratory distress in the neonates of hypothyroid mothers with untreated subclinical Hypothyroidism. Hence, we propose that routine screening for thyroid dysfunction in pregnant women should be done to prevent thyroid-related feto-maternal complications.

Keywords: high-risk pregnancy, thyroid, dysfunction, hypothyroidism, Preterm labor

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Authors: Wid Kattan, Rahaf Albarraq

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Background: Tokophobia is a pathological fear of pregnancy that can lead to the avoidance of childbirth. It is classified as primary or secondary. This report describes a patient with tokophobia, as well as her presentation, risk factors, comorbidities, and treatment. Case Presentation: A 43-year-old Saudi woman experienced tokophobia upon becoming pregnant for the fifth time. She was assessed in two clinical interviews by a consultant psychiatrist specializing in women’s mental health. In addition, she completed several questionnaires for assessment of different aspects of her mental health: overall depression, perinatal depression, generalized anxiety, maternal functioning, and fear of childbirth (FOC). Several risk factors and comorbidities that may have contributed to the development of tokophobia in this patient were discussed, including traumatic experiences in previous deliveries, the unplanned nature of the pregnancy, perinatal depression, and pronounced symptoms of anxiety. A collaborative decision to perform a C-section was made, in line with obstetric guidelines and good mental health practice. Full symptomatic recovery was achieved immediately after delivery. Conclusions: We hope to increase clinical awareness of the assessment and management of tokophobia, which is a relatively new concept and, as yet, understudied.

Keywords: tokophobia, fear of childbirth, mental health, anxiety, case report, depression, fear of delivery, psychiatry, cesarean section, perinatal depression

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Authors: Allyne Topaz

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Intraoral dehiscence compromises free fibula flaps following mandibular reconstruction. Salivary contamination risks thrombosis of microvascular anastomosis and hardware infection. The superficial temporal artery islandized flap (STAIF) offers an efficient, non-microsurgical reconstructive option for regaining intraoral competency for a time sensitive complication. Methods: The STAIF flap is based on the superficial temporal artery coursing along the anterior hairline. The flap is mapped with assistance of the doppler probe. The width of the skin paddle is taken based on the ability to close the donor site. The flap is taken down to the level of the zygomatic arch and tunneled into the mouth. Results: We present a case of a patient who underwent mandibular reconstruction with a free fibula flap after a traumatic shotgun wound. The patient developed repeated intraoral dehiscence following failed local buccal and floor of mouth flaps leading to salivary contamination of the flap and hardware. The intraoral dehiscence was successfully salvaged on the third attempt with a STAIF flap. Conclusions: Intraoral dehiscence creates a complication requiring urgent attention to prevent loss of free fibula flap after mandibular reconstruction. The STAIF is a non-microsurgical option for restoring intraoral competency. This robust, axially vascularized skin paddle may be split for intra- and extra-oral coverage, as needed and can be an important tool in the reconstructive armamentarium.

Keywords: free fibula flap, intraoral dehiscence, mandibular reconstruction, superficial temporal artery islandized flap

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Authors: Abdurraouf O. Gaja, Salah Y. A. Al-Dahash, Guru Solmon Raju, Chikara Kubota

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Corpus luteum cross sectional (by ultrasonography) and plasma progesterone (by DELFIA) were estimated in early pregnant and non pregnant cows on days 14th and 20th to 23rd post insemination. On day 14th, corpus luteum sectional area was 348.43 mm2 in pregnant and 387.84mm2 in non pregnant cows. Within days 20th to 23rd, corpus luteum sectional area ranged between 342.06 and 367.90 mm2 in pregnant and between 193.85 and 270.69 mm2 in non pregnant cows. Plasma progesterone level was 2.43 ng/ml in pregnant and 2.46 ng/ml in non pregnant cows on day 14th, while during days 20th to 23rd the level ranged between 2.47 and 2,84 ng/ml in pregnant and between 0.53 and 1.17 ng/ml in non pregnant cows. Results of both luteal tissue areas as well as plasma progesterone levels were highly significantly deferent (P<0.01) between pregnant and non pregnant cows during days 20th to 23rd, but there were no significant differences on day 14th. The correlation between CL cross-sectional area and plasma progesterone level was 0.4 in pregnant cows and 0.99 in non pregnant cow. It is clear, from this study, that ultrasonic assessment of corpora lutea is a viable alternative to determine plasma progesterone levels for early pregnancy diagnosis in cows.

Keywords: progesterone, ultrasonography, corpus luteum, pregnancy diagnosis, cow

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Authors: K. Hinde, R. Bookun, P. Tran

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Percutaneous CT guided biopsies provide a fast, minimally invasive, cost effective and safe method for obtaining tissue for histopathology and culture. Standards for diagnostic yield vary depending on whether the tissue is being obtained for histopathology or culture. We present a retrospective audit from Western Health in Melbourne Australia over a 12-month period which aimed to determine the diagnostic yield, technical success and complication rate for CT guided bone biopsies and identify factors affecting these results. The digital imaging storage program (Synapse Picture Archiving and Communication System – Fujifilm Australia) was analysed with key word searches from October 2015 to October 2016. Nineteen CT guided bone biopsies were performed during this time. The most common referring unit was oncology, work up imaging included CT, MRI, bone scan and PET scan. The complication rate was 0%, overall diagnostic yield was 74% with a technical success of 95%. When performing biopsies for histologic analysis diagnostic yield was 85% and when performing biopsies for bacterial culture diagnostic yield was 60%. There was no significant relationship identified between size of lesion, distance of lesion to skin, lesion appearance on CT, the number of samples taken or gauge of needle to diagnostic yield or technical success. CT guided bone biopsy at Western Health meets the standard reported at other major clinical centres for technical success and safety. It is a useful investigation in identification of primary malignancy in distal bone metastases.

Keywords: bone biopsy, computed tomography, core biopsy, histopathology

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Authors: Umran Erciyes, Filiz Okumus

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The purpose of this study was the determination of factors which impact the pregnancy, birth experience and the opinions regarding the delivery type of the puerperants, after vaginal birth. This descriptive study includes 349 patients who gave births with normal birth in one of the hospital in İstanbul in May- November 2014. After birth, we interview with these women face to face. The descriptive information form and Perception of Birth Scale were used as data collection tool. SPSS (Statistical Package for the Social Sciences) was used for statistical analysis. The average age of patients was 27.13, and the average score was 76.93±20.22. The patients are primary school graduate, and they do not have a job. They expressed an income outcome equality. More than half of women did not get educated before birth. Among educated patients, few women got educated overcoming the pain during labor process. As the time spent in the hospital for the birth increases, the birth perception of mothers is affected negatively. %86.8 of participants gave assisted delivery. Spontaneous vaginal birth has positive effects on birth perception. Establishing a vascular access, induction of labor performing enema, restriction of orally intake and movement, fundal pressure, episiotomy, nor to perform skin to skin contact with the baby after birth has adverse effects on the birth perceptions.

Keywords: antenatal care, birth experience, perception of birth, vaginal birth

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Authors: Maria Francesca Maunes

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Life is never the same when an adolescent becomes a teenage parent. Living in a developing country with the highest rate of teenage pregnancy in the Asia-Pacific region, it is necessary to address the psychological well-being of Filipino teenage parents and be put into consideration. Thus, this quantitative study used both descriptive statistics and quantitative techniques on a total of 70 participants, consisting of 32 teenage fathers and 38 teenage mothers to describe the level of psychological well-being among teenage parents according to the six domains of Ryff’s eudaimonic well-being—autonomy, environmental mastery, personal growth, positive relations with others, purpose in life, and self-acceptance, and to determine the difference between the psychological well-being of teenage fathers and teenage mothers. Results show that there is no significant difference in the overall psychological well-being between the two groups of participants, yet, when compared by each domain, it is found that there is a significant difference between their purpose in life. While both teenage fathers and teenage mothers are high scorers across all the domains, this does not serve as an assurance that the sustained increase in the number of teenage pregnancies in the Philippines does not anymore pose as a national issue. This could only signify that despite dire circumstances, Filipino teenage parents are able to continue make meaning in their lives and strive to keep living in comfort and contentment, not only for themselves but for their children as well. Additional findings as well as its implications are further discussed. Recommendations and suggestions for further study are presented.

Keywords: adolescence, adolescent psychology, eudaimonic psychological well-being, positive psychology, teenage fathers, teenage mothers, teenage parents, teenage pregnancy in the Philippines

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Authors: Boshra Mozaffar, Iskandar Idris

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Taste change is a common complication after Bariatric surgery (BS). However, the cause of this is still not clear. Since zinc is important fortaste perception, zinc deficiency, which is common after BS, may play an important role for taste change after BS. In this review, we aimto collate evidence relating to taste change and zinc deficiencyin relation to BS; effects of zinc replacement on taste perception in general and thereafter discuss the possible role of zinc deficiency to induce taste change after BS. A literature search was conducted, using four electronic bibliographical databases—EMBASE, PubMed, AMED and MEDLINE. We identified all available and relevant articles published before 30th February 2021.In total, 33 studies were included. The total number of participants analysed was N= 3264. We showed that taste change is a frequent complication after BS, especially after Roux-en-Y gastric bypass RYGBP comparing to other types of procedures. Patients' taste sensitivity differs among studies, but the most important decline in taste preference was observed for sweet food. Twelve studies investigating zinc deficiency following BS showed a significant decrease in zinc levels at six months after surgery. Supplementation with 45–50 mg of zinc sulphate was effective in improving taste, except in cancer patients, who showed no improvement in taste following zinc supplementation. Zinc deficiency appears to be associated with taste change after BS. Supplementation with much higher levels of zinc, at 45–50 mg, was effective in taste change treatment for many cases of taste disorder. The currently recommended levels of zinc replacements currently prescribed to patients following BS were not effective for avoiding zinc deficiency after BS—and thus not effective for averting taste change. It is therefore suggested that taste change following BS is closely related to zinc deficiency induced by the surgery.

Keywords: taste change, taste disorder, bariatric surgery, zinc, zinc sulphate or Zn, deficiency, supplementation, and micro-nutrient deficiencies

Procedia PDF Downloads 154

Authors: Ya-Ping Chang

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Starting from the early stages of pregnancy, parents begin to form hopes and dreams about the future of their child. They will think about the appearance and personality of their child and may even develop many expectations. The patient in this study experienced a successful pregnancy following multiple attempts at artificial insemination. However, due to arrested embryonic development, and based on the physician’s evaluation, a caesarean section was performed at week 25. However, the baby suffered from infections and subsequently died from multiple organ failures. This study collected and analyzed objective and subjective data through observation, interviews, recording, and interactions with the patient. The following nursing issues of the patient were identified: anxiety, anticipatory grief, and adjustment disorder. The psychology of caring as proposed in Watson’s theory was applied to address these nursing issues. Comprehensive and continuous care was provided to the patient on the basis of mutual trust and individual nursing guidelines in order to alleviate the patient’s anxiety, help her to cope with grief, and prepare her for the eventual death of her child. The author helped the patient to say goodbye to her child and accept the child’s death calmly, such that she had no regrets about the experience. This nursing experience may serve as a reference to nurses managing similar cases in the future.

Keywords: dying baby, mother, grief, Watson’s theory

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Authors: Aboozar Dehghan, S. Sharifi, S. A. Dehghan, Ali Aliabadi, Arash Esfandiari

Abstract:

Ultrasonography is a safe, available and particular method in diagnostic imaging science. In ultrasonography most of body soft tissue imaged in B mode display. Iranian Qashqaeian sheep is an old and domestic breed in Zagros mountain area in central plateau of Iran. Population of this breed in Fars state (study location) is 250000 animals. Gestation age detection in sheep was performed by ultarasonography in Kivircik breed in 2010 in turkey. In this study 5 adult, clinically healthy, Iranian ewes and 1 Iranian ram were selected. We measured biparital diameter that thickened part of fetal skull include (BPD), trunk diameter (TD), fetal heart diameter(FHD), intercostals space of fetus (ICS) and fetal heart rate per minute (FHR) weekly after day 60 after pregnancy. Inguinal area in both sides shaved and cleaned by alcohol 70 degree and covered by enough copulating gel. Trans abdominal Ultarasonography was performed by a convex multi frequency transducer with 2.5-5 MHz frequency. Data were collected and analyzed by on way Annova method in Spss15 software. Mean of BPD, TD, FHD and ICS in day 60 were 14.58, 25.92, 3.53, 2.3mm. FHR can measure on day 109 to 150. TD after day 109 cannot displayed in 1 frame in scanning. Ultrasonography in sheep pregnancy is a particular method. Using this study can help in theriogeniologic disease that affected fetal growth. Differentiating between various sheep breed is a functional result of this study.

Keywords: qashqaeian sheep, fetometry, ultrasonography

Procedia PDF Downloads 522

Authors: Fernanda Piculo, Giovana Vesentini, Gabriela Marini, Debora Cristina Damasceno, Angelica Mercia Pascon Barbosa, Marilza Vieira Cunha Rudge

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Introduction: Women with previous gestational diabetes mellitus (GDM) were significantly more likely to have urinary incontinence (UI) and pelvic floor muscle dysfunction compared to non-diabetic women two years after a cesarean section. Additional results demonstrated that induced diabetes causes detrimental effects on pregnant rat urethral muscle. These results indicate the need for exploration of the mechanistic role of a recovery factor in female UI. Chemokine ligand 7 (CCL7) was significantly over expressed in rat serum, urethral and vaginal tissues immediately following induction of stress UI in a rat model simulating birth trauma. CCL7 over expression has shown potency for stimulating targeted stem cell migration and provide a translational link (clinical measurement) which further provide opportunities for treatment. The aim of this study was to investigate the CCL7 levels profile in diabetic pregnant women with urinary incontinence during pregnancy over the first year postpartum. Methods: This study was conducted in the Perinatal Diabetes Research Center of the Botucatu Medical School/UNESP, and was approved by the Research Ethics Committee of the Institution (CAAE: 20639813.0.0000.5411). The diagnosis of GDM was established between 24th and 28th gestational weeks, by the 75 g-OGTT test according to ADA’s criteria. Urinary incontinence was defined according to the International Continence Society and the CCL7 levels was measured by ELISA (R&D Systems, Catalog Number DCC700). Two hundred twelve women were classified into four study groups: normoglycemic continent (NC), normoglycemic incontinent (NI), diabetic continent (DC) and diabetic incontinent (DI). They were evaluated at six-time-points: 12-18, 24-28 and 34-38 gestational weeks, 24-48 hours, 6 weeks and 6-12 months postpartum. Results: At 12-18 weeks, it was possible to consider only two groups, continent and incontinent, because at this early gestational period has not yet been the diagnosis of GDM. The group with GDM and UI (DI group) showed lower levels of CCL7 in all time points during pregnancy and postpartum, compared to normoglycemic groups (NC and NI), indicating that these women have not recovered from child birth induced UI during the 6-12 months postpartum compared to their controls, and that the progression of UI and/or lack of recovery throughout the first postpartum year can be related with lower levels of CCL7. Instead, serum CCL7 was significantly increased in the NC group. Taken together, these findings of overexpression of CCL7 in the NC group and decreased levels in the DI group, could confirm that diabetes delays the recovery from child birth induced UI, and that CCL7 could potentially be used as a serum marker of injury. Conclusion: This study demonstrates lower levels of CCL7 in the DI group during pregnancy and postpartum and suggests that the progression of UI in diabetic women and/or lack of recovery throughout the first postpartum year can be related with low levels of CCL7. This provides a translational potential where CCL7 measurement could be used as a surrogate for injury after delivery. Successful controlled CCL7 mediated stem cell homing to the lower urinary tract could one day introduce the potential for non-operative treatment or prevention of stress urinary incontinence.

Keywords: CCL7, gestational diabetes, pregnancy, urinary incontinence

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