Periconceptional folic acid usage and its associated factors in eastern Sudan: A cross-sectional study.

BACKGROUND: Several countries poorly adhere to the World Health Organization's recommendation of folic acid supplementation in the periconceptional period, especially in limited-resource settings. OBJECTIVE: The objective of this study was to investigate the prevalence of and the factors associated with folic acid usage in the periconceptional period among pregnant women at Gadarif Maternity Hospital in eastern Sudan. STUDY DESIGN: This is a cross-sectional study. METHODS: This study was conducted in eastern Sudan from April to September 2022. A total of 720 pregnant women in their first trimester were enrolled. The sociodemographic characteristics and clinical and obstetrical data of pregnant women in their first trimester were assessed using a face-to-face questionnaire. In addition, multivariate regression analysis was performed. RESULTS: In this study, the median (interquartile range) of the age and gravidity of the enrolled women was 26.3 (24.14-29.52) years and 2 (1-4), respectively. Of these 720 women, 423 (58.8%) used folic acid during the periconceptional period, while 27 (3.7%) women used folic acid in the preconceptional period. None of the investigated factors (age, residence, education, employment, body mass index, or gravidity) were associated with periconceptional use of folic acid. CONCLUSION: The study revealed a low prevalence of folic acid usage in preconceptional period among pregnant women in eastern Sudan. Additional efforts are needed to promote folic acid usage in the preconceptional period as well as in the first trimester.

Women's Knowledge, Attitudes, and Practice About Female Genital Cosmetic Surgery: A Cross-Sectional Study in Saudi Arabia.

Introduction Vulvoplasty, or female genital cosmetic surgery (FGCS), refers to any surgical alteration of the vaginal or labial anatomy for aesthetic or medical reasons. It aims to restore or enhance the female genitals and can involve multiple procedures such as labiaplasty, clitoral unhooding, monsplasty, vaginoplasty, hymenoplasty, G-spot augmentation, frenuloplasty, perineoplasty, fat injections, or a combination of these. Labiaplasty is currently the most popular procedure among patients. Since the public is exploring FGCS benefits in the media, it can be foreseen that it will soon gain popularity among the population of Saudi Arabia. As a result, the purpose of this study is to assess women's attitudes and knowledge towards genital cosmetic surgeries in Saudi Arabia.  Methods This correlational cross-sectional survey was conducted in Saudi Arabia among women aged 18 years and above, using an online self-structured questionnaire distributed from April 2023 to October 2023. The sample size of 594 respondents was determined based on a minimum requirement of 500 participants, with a confidence level of 95% and a study power of 95%. A convenient sampling method was employed to select participants, and data collection was carried out through a self-administered online questionnaire distributed via various social media platforms. The survey was self-structured, and Cronbach's alpha values for all sections were greater than 0.7. These sections include demographic characteristics, sexual life and obstetric history, and women's knowledge, practices, and attitudes toward FGCS. Descriptive analysis, chi-square test, and t-test were used for data analysis using SPSS software.  Results A total of 589 eligible women were included in the study; 284 (48.2%) were from the central region, and ages ranged from 18 to 65 years, with a mean age of 33.5 years. A total of 401 (68.1%) were married, 366 (62.1%) had a bachelor degree. Two hundred and ninety-one (49.4%) participants heard about FGCS, 165 (28%) knew that it involves surgical procedures to change the appearance of the female genitalia, 144 (24.4%) said it is also known as vaginal rejuvenation or designer vagina surgery and 200 (34%) knew it can involve procedures such as labiaplasty, clitoral hood reduction, or vaginal tightening, while 190 (32.3%) reported it is sometimes done for aesthetic reasons but may also be done for medical reasons. Only 45 (7.6%) had undergone FGCS, but 112 (19%) confirmed they consider undergoing FGCS for themselves. Four hundred and ninety-eight (84.6%) participants thought that it's important to have access to support services, such as counseling or peer support, 471 (80%) expressed that it's important that healthcare providers in Saudi Arabia are knowledgeable about FGCS, 425 (72.2%) were concerned about the potential risks and complications of FGCS. Conclusion In conclusion, the current study revealed that nearly one out of five women were knowledgeable about FGCS, mainly about the nature and types of the procedure. Higher knowledge levels about FGCS were associated with younger age, higher educational levels, and women who were more likely to consider undergoing FGCS in the future.

Membrane Sweeping to Induce Labor in Post-term Pregnant Women: Success Rate and Outcomes.

Introduction Membrane sweeping is a mechanical technique by which a clinician inserts one or two fingers into the cervix and detaches the inferior pole of the membranes from the lower uterine segment using a continuous circular sweeping motion. This produces hormones that promote effacement and dilatation, potentially promoting labor. This study aimed to determine the success rate and the outcome of membrane sweeping in postdate pregnant women in Alhasahesa Teaching Hospital.  Methods This prospective descriptive cross-sectional study conducted at Alhashesa Teaching Hospital, Alhashesa, Sudan, between May and October 2022 included all pregnant women at 40 or more weeks of gestation who underwent membrane sweeping to induce labor. We recorded the number of sweeps needed, sweeping-to-delivery interval, mode of delivery, maternal outcome, and fetal outcome (including birth weight, Apgar score at delivery, and the need for neonatal intensive care unit admission [NICU]). Data were collected through patient interviews using a specially designed questionnaire and analyzed using Statistical Package for Social Sciences (SPSS®) software for Windows, Version 26.0 (Armonk, NY: IBM Corp.), Results Membrane sweeping induced labor in 127 postdate women (86.4%). Most of the women in the study (n=138; 93.9%) had no complications, seven (4.8%) had postpartum hemorrhage, one (0.7%) had sepsis, and one (0.7%) was admitted to the intensive care unit. All neonates were alive, and most (n=126; 85.8%) birth weights ranged from 2.5 kg to 3.5 kg. Thirteen (8.8%) neonates weighed less than 2.5 kg, and eight (5.4%) weighed more than 3.5 kg. One hundred thirty-three (90.5%) had Apgar scores <7, eight (5.4%) had Apgar scores under five, and six (4.1%) had Apgar scores of five to six. Seven neonates (4.8%) were admitted to the NICU. Conclusions Membrane sweeping to induce labor has a high success rate, and it can be safe for both the mother and the baby, as it is associated with a low rate of maternal and fetal complications. Additionally, no maternal and/or fetal deaths were reported. A large, controlled study is required to compare its benefits over other methods of induction of labor.

Evaluation of Knowledge About Gestational Diabetes Among Primigravidae Versus Multigravidae in Saudi Arabia: A Quantitative Cross-Sectional Study.

BACKGROUND: Gestational diabetes mellitus (GDM) is a subtype of diabetes that is discovered during pregnancy and may disappear after puerperium. It has an impact on the well-being of expectant mothers and fetuses. Many women have a poor level of knowledge regarding GDM, especially regarding risk factors, diagnosis, and the role of insulin in the management. Also, knowledge, attitudes, and practices regarding GDM are influenced by multiple factors. OBJECTIVES: The objective of this study was to evaluate the level of knowledge among primigravidae versus multigravidas regarding GDM. Additionally, the study sought to identify the factors that are associated with high and low levels of knowledge regarding GDM. METHODOLOGY: This is a prospective, cross-sectional study, conducted in different regions of Saudi Arabia and included 482 women who had a pregnancy history or were currently pregnant. Data were collected using a questionnaire consisting of two parts. A pilot study was carried out to evaluate the validity of the questionnaire. RESULTS: The study data showed that a substantial portion of respondents have had one pregnancy, while there is a relatively even distribution among those with two (n=89, 18.50%), three (n=75, 15.60%), or four or more pregnancies (n=71, 14.70%). Of the participants, 65.6% had good knowledge regarding GDM. It was also found that there were significant differences between primigravidae and multigravidae. CONCLUSION: One-third of the participants in both groups had poor knowledge with significant variation in knowledge between primigravidae and multigravidae. The importance of screening and fasting before testing received widespread recognition, as did the role of diet and exercise in treatment. It is recommended that targeted educational efforts and awareness campaigns be launched to enhance knowledge about GDM among pregnant women in Saudi Arabia.

Women acceptance of episiotomy procedure before and after receiving educational materials: Pretest posttest study.

Objectives: Episiotomy is a frequently performed surgical procedure by obstetricians and midwives during vaginal birth. It is defined as a surgical incision in the perineal area through the second stage of delivery. Therefore, this study aimed to evaluate women's acceptance toward episiotomy before and after providing education. Methods: A Quasi-experiment pretest posttest study was conducted on a total of 234 patients attending antenatal clinics in Maternity and Children hospital and Heraa General hospital in Makkah during June-August 2021. Participants were personally interviewed and provided with evidence-based information about the procedure then re-evaluated by the investigators. The statistical analysis was carried using Two Tailed Tests. Statistical significance was set on a P value of 0.05 or less. Results: Total of 234 participant fulfilling the inclusion criteria were interviewed. Females mean age is 26.2 ± 9.7 years. Exact of 115 (49.1%) women heard about episiotomy. And 79 (33.8%) correctly described it as a surgical incision. Also, 89 (38%) understood that it is not recommended for all, and 109 (46.6%) knew that anesthesia is required. The most reported source of information was internet/ social media (49%; 72), followed by friends/relatives (35.4%; 52). Before education, 112 (47.9%) would accept episiotomy if required which was significantly improved to be among 173 (73.9%) of them after receiving the educational materials. Conclusion: Due to the controversial opinions and practices of episiotomy, ensuring patients awareness and understanding is crucial. Providing correct information from trusted sources will help minimizing the chances of receiving inaccurate information from unreliable sources. Therefore, making wrong decisions, and refusing needed episiotomy. Health practitioners should be encouraged to discuss patients' concerns and correct their misconceptions.