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1.
BMC Pregnancy Childbirth ; 23(1): 54, 2023 Jan 23.
Artigo em Inglês | MEDLINE | ID: mdl-36690977

RESUMO

BACKGROUND: The prevalence and impact of fistulas are more common in developing countries with limited access to emergency obstetric care. As a result, women in these settings often experience adverse psychosocial factors. The purpose of this study was to describe the characteristics of Congolese women who developed urogenital fistula following Cesarean sections (CS) to determine the characteristics associated with two etiologies: (1) prolonged obstructed labor; and (2) a complication of CS following obstructed labor. METHODS: We performed a cross-sectional study on abstracted data from all patients with urogenital fistula following CS who received care during a surgical campaign in a remote area of the Democratic Republic of the Congo (DRC). Descriptive analyses characterized patients with fistula related to obstructed labor versus CS. Univariate and multivariate logistic regression models identified factors associated with obstetric fistula after cesarean delivery following obstructed labor. Variables were included in the logistic regression models based upon biological plausibility. RESULTS: Among 125 patients, urogenital fistula etiology was attributed to obstructed labor in 77 (62%) and complications following CS in 48 (38%). Women with a fistula, attributed to obstructed labor, developed the fistula at a younger age (p = .04) and had a lower parity (p = .02). Attempted delivery before arriving at the hospital was associated with an increased risk of obstetric fistula after cesarean delivery following obstructed labor (p < .01). CONCLUSION: CS are commonly performed on women who arrive at the hospital following prolonged obstructed labor and fetal demise, and account for almost 40% of urogenital fistula. Obstetric providers should assess maternal status upon arrival to prevent unnecessary CS and identify women at risk of developing a fistula.


Assuntos
Distocia , Complicações do Trabalho de Parto , Fístula Vesicovaginal , Gravidez , Humanos , Feminino , Cesárea/efeitos adversos , Estudos Transversais , Fístula Vesicovaginal/epidemiologia , Fístula Vesicovaginal/etiologia , Fístula Vesicovaginal/prevenção & controle , Complicações do Trabalho de Parto/epidemiologia , Paridade , Distocia/etiologia
2.
Sci Rep ; 13(1): 1071, 2023 Jan 19.
Artigo em Inglês | MEDLINE | ID: mdl-36658260

RESUMO

Optimal antenatal care visits (ANC4+) and institutional delivery are essentials to save lives of the women and the baby during pregnancy and delivery. Though focused antenatal care visits and institutional delivery is recommended by World Health Organization, Ethiopia has sub-optimal antenatal care and lagged facility delivery. A community-based cross-sectional study was conducted among 811 lactating women in Northwest Ethiopia. Multivariable logistic regression analysis was performed using 95% confidence level and p < 0.05. The prevalence of optimal antenatal care visits and institutional delivery were 39.6% (95%CI: 36.2-43) and 62.6% (95%CI: 59.2-66), respectively. Maternal education (AOR = 2.05; 95%CI: 1.14, 3.69), home visiting by health extension workers (AOR = 1.57; 95%CI: 1.01, 2.29), and early antenatal care booking (AOR = 11.92; 95%CI: 8.22, 17.31) were significant predictors of optimal antenatal care. Exposure to mass media (AOR = 1.65; 95% CI: 1.02, 2.65); intended pregnancy(AOR = 1.68; 95%CI:1.12, 3.63); parity of one (AO = 3.46; 95% CI: 1.73, 6.89); 1-3 antenatal care visits (AOR = 2.17; 95% CI: 1.29, 3.63); and ANC4 + (AOR = 3.57; 95% CI: 2.07, 6.14); history of pregnancy-related complications(AOR = 1.63; 95%CI: 1.04, 2.57), and access to transportation to reach a health facility(AOR = 1.58; 95%CI: 1.00, 2.45) were significant predictors of institutional delivery. Addressing the modifiable factors identified in this study could improve optimal antenatal care visit and institutional delivery.


Assuntos
Lactação , Cuidado Pré-Natal , Feminino , Gravidez , Humanos , Etiópia/epidemiologia , Estudos Transversais , Parto Obstétrico , Paridade , Instalações de Saúde
3.
Artigo em Inglês | MEDLINE | ID: mdl-36673893

RESUMO

This study aimed to determine whether transvaginal sonographic measurement of cervical length before labor induction can predict successful induction. This retrospective study recruited 138 pregnant women who underwent labor induction at 37-41 weeks of gestation. Cervical length was measured using transvaginal ultrasonography before labor induction. Labor was induced according to the hospital protocol. Age, gestational age (GA), parity, body mass index (BMI), Bishop score, hemoglobin level, maternal disease, and epidural anesthesia were also recorded. Labor induction outcomes, including cesarean section for failed induction, time of induction, and the three labor stages, were assessed. From December 2018 to December 2021, 138 women were recruited for our study, including 120 and 18 women with successful and failed labor induction, respectively. Shorter cervical length (≤3.415 cm, OR = 6.22, 95% CI = 1.75-22.15) and multiparity (OR = 17.69, 95% CI = 2.94-106.51) were associated with successful induction. Higher BMI was associated with failed induction (OR = 0.87, 95% CI = 0.75-0.99). Age, GA, Bishop score, and fetal birth weight were not associated with successful labor induction. The ROC curve showed a cervical length cutoff value of 3.415 cm, revealing 76.8% of the area under the curve. In conclusion, a shorter cervical length (≤3.415 cm) was associated with a higher chance of successful labor induction (76.8%). This parameter might be used to predict the chance of successful labor induction. This information could help better inform clinician discussions with pregnant women concerning the chance of successful labor induction and consequent decision-making. Nevertheless, further large-scale clinical trials are warranted.


Assuntos
Cesárea , Ultrassonografia Pré-Natal , Gravidez , Feminino , Humanos , Estudos Retrospectivos , Trabalho de Parto Induzido , Paridade , Curva ROC , Valor Preditivo dos Testes
4.
Artigo em Inglês | MEDLINE | ID: mdl-36674239

RESUMO

In the context of the global increase in the rate of cesarean deliveries, with an associated higher morbidity and mortality, this study aimed to investigate the role of maternal age and parity in the cesarean section rate among women in the Hail Region of Saudi Arabia. This retrospective cohort study used data collected from the labor ward of the Maternity and Child Health Hospital, Hail, over a period of 8 months, forming a cohort of 500 women. Women were categorized into four different parity classes. The results revealed that there was no significant relationship between cesarean deliveries and maternal age (p-value, 0.07). There was no significant difference in the mode of delivery between the study's parity cohort group. A significant increase in cesarean deliveries was noticed among obese women with a BMI between 35-39.9 (52.14%). This increase was even greater among those with a BMI above 40 (63.83%). Fetal distress, malpresentation and abruptio placenta were the most significant indications for CS among all age groups (p-value 0.000, 0.021, and 0.048, respectively). Conclusions: The number of cesarean deliveries has no association with parity or age. However, there was a statistically significant association with BMI, a perineal tear after previous vaginal delivery, and a history of diabetes mellitus and gestational diabetes. The most reported reasons for CS were fetal distress, malpresentation, and abruptio placenta among all age groups.


Assuntos
Cesárea , Diabetes Gestacional , Criança , Gravidez , Feminino , Humanos , Paridade , Arábia Saudita/epidemiologia , Estudos Retrospectivos , Sofrimento Fetal , Apresentação no Trabalho de Parto
5.
J Obstet Gynaecol ; 43(1): 2160929, 2023 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-36645334

RESUMO

Female pelvic organ prolapse (POP) is a common condition, which has a high recurrence rate after reconstructive surgery, and the risk factors for POP recurrence are unclear. The aim of this study was to perform a meta-analysis to determine risk factors for POP recurrence. A thorough search of PubMed, Medline, EMBASE, Cochrane Central Register of Controlled Trials, and China Academic Journal Network Publishing Database was conducted for relevant publications until 29 October 2022, without language restrictions. A total of 29 studies involving 6597 patients were included, and the recurrence rate of POP after surgery was 37.7%. Significant OR and CI were found for levator avulsion (OR: 2.46, 95% CI: 1.80-3.36), preoperative stage ≥ III (OR: 1.87, 95% CI: 1.53-2.27), hiatal area on Valsalva manoeuvre (OR: 1.08, 95% CI: 1.03-1.12) and previous pelvic floor surgery (OR: 1.60, 95% CI: 1.07-2.39). Levator avulsion, preoperative stage ≥ III, hiatal area on Valsalva manoeuvre and previous pelvic floor surgery are significant risk factors for POP recurrence.IMPACT STATEMENTWhat is already known on this subject? It has been reported that genetic factors, parity, obesity, birth-induced injury during delivery, etc. are risk factors for POP development and recurrence after operation.What do the results of this study add? There are few literatures about the risk factors of POP recurrence at present. Our research has increased the information regarding risk factors for POP recurrence.What are the implications of these findings for clinical practice and/or further research? Our study provides an overview of the risk factors affecting POP recurrence and their contribution (OR, CI) to POP recurrence, which provides valuable evidence-based basis for clinical decision-making in POP treatment and prevention of POP recurrence.


Assuntos
Traumatismos do Nascimento , Prolapso de Órgão Pélvico , Gravidez , Humanos , Feminino , Paridade , Prolapso de Órgão Pélvico/epidemiologia , Prolapso de Órgão Pélvico/cirurgia , Prolapso de Órgão Pélvico/etiologia , Fatores de Risco , Obesidade/complicações , Diafragma da Pelve/diagnóstico por imagem , Ultrassonografia/métodos
6.
Health Aff (Millwood) ; 42(1): 83-93, 2023 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-36623216

RESUMO

Many older Americans do not receive needed care for mental health and substance use disorders (MHSUD), and there are substantial racial and ethnic disparities in receipt of this care across the lifespan. Medicare introduced cost-sharing parity for outpatient MHSUD care during the period 2010-14, reducing beneficiaries' out-of-pocket share of MHSUD spending from 50 percent to 20 percent. Among traditional Medicare beneficiaries ages sixty-five and older, we examined changes in MHSUD use and spending during the period 2008-18 for low-income beneficiaries with the cost-sharing reduction versus a control group of beneficiaries with free care throughout the study period among Black, Hispanic, Asian, and American Indian/Alaska Native versus White beneficiaries. Among older Medicare beneficiaries, overall use of MHSUD services increased during this period. For White beneficiaries, MHSUD cost-sharing parity was associated with an increased likelihood of having specialty MHSUD visits and medication use and a reduced likelihood of having unmonitored MHSUD medication use and MHSUD emergency department visits and hospitalizations. However, cost-sharing parity was associated with smaller or no gains in MHSUD services use for racial and ethnic minority beneficiaries compared with White beneficiaries, thus widening racial and ethnic disparities in MHSUD care.


Assuntos
Medicare , Transtornos Relacionados ao Uso de Substâncias , Feminino , Gravidez , Humanos , Idoso , Estados Unidos , Etnicidade , Saúde Mental , Paridade , Grupos Minoritários , Transtornos Relacionados ao Uso de Substâncias/terapia , Disparidades em Assistência à Saúde
7.
J Dairy Sci ; 106(2): 974-989, 2023 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-36526464

RESUMO

The objectives of this experiment were to determine the effects of supplementing 25-hydroxyvitamin D3 (calcidiol, CAL) compared with vitamin D3 (cholecalciferol, CHOL) at 1 or 3 mg/d in late gestation on production outcomes of dairy cows. One hundred thirty-three parous and 44 nulliparous pregnant Holstein cows were enrolled in the experiment. Cows were blocked by parity and previous lactation milk yield (parous) or genetic merit (nulliparous) and assigned randomly to receive 1 or 3 mg/d of CAL or CHOL in a 2 × 2 factorial arrangement of treatments (CAL1, CAL3, CHOL1, and CHOL3). Treatments were provided to individual cows as a top-dress to the prepartum diet from 250 d in gestation until parturition. The prepartum diet had a dietary cation-anion difference of -128 mEq/kg of dry matter. Production and disease were evaluated for the first 42 d in milk, and reproduction was evaluated to 300 d in milk. Incidence of postpartum diseases did not differ among treatments. Feeding CAL compared with CHOL increased yields of colostrum and colostrum fat, protein, and total solids, resulting in an increased amount of net energy for lactation secreted as colostrum (CHOL = 7.0 vs. CAL = 9.0 ± 0.7 Mcal). An interaction between source and amount was observed for milk yield: CAL3 increased milk yield compared with CHOL3 (CHOL3 = 34.1 vs. CAL3 = 38.7 ± 1.4 kg/d) but milk yield did not differ between CAL1 and CHOL1 (CHOL1 = 36.9 vs. CAL1 = 36.4 ± 1.4 kg/d). Concentrations of serum calcidiol on day of calving and average serum Ca from d 2 to 11 postpartum were positively associated with milk yield in the first 42 d in milk. Interactions between source and amount of vitamin D were also observed for pregnancy after first AI: the percentage of cows receiving CHOL1 and CAL3 that became pregnant was smaller than that of cows receiving CHOL3 and CAL1. However, pregnancy per AI and pregnancy by 300 d in milk did not differ among treatments. Overall, CAL3 increased milk yield compared with CHOL3, whereas in cows fed 1 mg/d (CAL1 and CHOL1), the source of vitamin D generally had no effect. The effect of CAL3 may be explained in part by serum CAL concentrations and postpartum serum Ca, which were associated with milk yield.


Assuntos
Calcifediol , Suplementos Nutricionais , Feminino , Gravidez , Bovinos , Animais , Calcifediol/metabolismo , Dieta/veterinária , Vitamina D/farmacologia , Vitamina D/metabolismo , Período Pós-Parto , Lactação , Colecalciferol/metabolismo , Leite/metabolismo , Paridade , Vitaminas/metabolismo
8.
Chemosphere ; 313: 137530, 2023 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-36509187

RESUMO

BACKGROUND: Per- and polyfluoroalkyl substances (PFAS) are persistent organic pollutants. The first exposure to PFAS occurs in utero, after birth it continues via breast milk, food intake, environment, and consumer products that contain these chemicals. Our aim was to identify determinants of PFAS concentrations in sensitive population subgroups- pregnant women and newborns. METHODS: Nine European birth cohorts provided exposure data on PFAS in pregnant women (INMA-Gipuzkoa, Sabadell, Valencia, ELFE and MoBa; total N = 5897) or newborns (3xG study, FLEHS 2, FLEHS 3 and PRENATAL; total N = 940). PFOS, PFOA, PFHxS and PFNA concentrations were measured in maternal or cord blood, depending on the cohort (FLEHS 2 measured only PFOS and PFOA). PFAS concentrations were analysed according to maternal characteristics (age, BMI, parity, previous breastfeeding, smoking, and food consumption during pregnancy) and parental educational level. The association between potential determinants and PFAS concentrations was evaluated using multiple linear regression models. RESULTS: We observed significant variations in PFAS concentrations among cohorts. Higher PFAS concentrations were associated with higher maternal age, primipara birth, and educational level, both for maternal blood and cord blood. Higher PFAS concentrations in maternal blood were associated with higher consumption of fish and seafood, meat, offal and eggs. In cord blood, higher PFHxS concentrations were associated with daily meat consumption and higher PFNA with offal consumption. Daily milk and dairy consumption were associated with lower concentrations of PFAS in both, pregnant women and newborns. CONCLUSION: High detection rates of the four most abundant PFAS demonstrate ubiquitous exposure of sensitive populations, which is of concern. This study identified several determinants of PFAS exposure in pregnant women and newborns, including dietary factors, and these findings can be used for proposing measures to reduce PFAS exposure, particularly from dietary sources.


Assuntos
Ácidos Alcanossulfônicos , Poluentes Ambientais , Fluorcarbonetos , Animais , Gravidez , Feminino , Humanos , Populações Vulneráveis , Paridade , Dieta
9.
J Anim Sci ; 1012023 Jan 03.
Artigo em Inglês | MEDLINE | ID: mdl-36516415

RESUMO

The aim of this study was to quantify some environmental (individual herds, herd productivity, milking system, and season) and animal factors [individual animals, breed, days in milk (DIM) and parity] on the variability of the log-10 transformation of somatic cell count (LSCC) and differential somatic cell count (DSCC) on individual bovine milk. A total of 159,360 test-day records related to milk production and composition were extracted from 12,849 Holstein-Friesian and 9,275 Simmental cows distributed across 223 herds. Herds were classified into high and low productivity, defined according to the average daily milk net energy output (DMEO) yielded by the cows. Data included daily milk yield (DYM; kg/d), milk fat, protein, lactose, SCC, and DSCC, and information on herds (i.e., productivity, milking system). The daily production of total and differential somatic cells in milk was calculated and then log-10 transformed, obtaining DLSCC and DLDSCC, respectively. Data were analyzed using a mixed model including the effects of individual herd, animal, repeated measurements intra animal as random, and herd productivity, milking system, season, breed, DIM, parity, DIM × parity, breed × season, DIM × milking system and parity × milking system as fixed factors. Herds with a high DMEO were characterized by a lower content of LSCC and DSCC, and higher DLSCC and DLDSCC, compared to the low DMEO herds. The association between milking system and somatic cell traits suggested that the use of the automatic milking systems would not allow for a rapid intervention on the cow, as evidenced by the higher content of all somatic cell traits compared to the other milking systems. Season was an important source of variation, as evidenced by high LSCC and DSCC content in milk during summer. Breed of cow had a large influence, with Holstein-Friesian having greater LSCC, DSCC, DLSCC, and DLDSCC compared to Simmental. With regard to DIM, the variability of LSCC was mostly related to that of DSCC, showing an increase from calving to the end of lactation, and suggesting the higher occurrence of chronic mastitis in cows toward the end of lactation. All the somatic cell traits increased across number of parities, possibly because older cows may have increased susceptibility to intramammary infections.


This study investigated factors affecting the variability of somatic cell traits in bovine milk. Animal had greater influence on somatic cell score (SCS) and differential somatic cell count (DSCC) compared to herd factors. Herds producing high average of daily milk energy were characterized by lower SCS and DSCC compared to the low average daily milk energy herds. The SCS and DSCC were higher in Holstein-Friesian than in Simmental, and during summer with respect to the other seasons. Older cows at the end of lactation showed the highest content of somatic cell traits. These results are helpful for the management of somatic cell traits at herd and animal levels.


Assuntos
Lactação , Leite , Gravidez , Feminino , Bovinos/genética , Animais , Leite/metabolismo , Paridade , Contagem de Células/veterinária , Fenótipo , Indústria de Laticínios
10.
J Anim Sci ; 1012023 Jan 03.
Artigo em Inglês | MEDLINE | ID: mdl-36478071

RESUMO

To determine effects of dam parity on perinatal nutrient availability in beef cattle, data and samples were collected from 18 primiparous and 35 multiparous spring-calving Sim-Angus dams and their calves. Time to stand was recorded and neonatal vigor assessed. Jugular blood was collected from a subset of calves at 0 (post-standing and pre-suckling) 6, 12, 24, 48, and 72 h of age, and blood chemistry panels were completed. Expelled placentas were dissected, dried, and weighed. Prepartum maternal circulating glucose, non-esterified fatty acids (NEFA), triglycerides, and urea N were analyzed. All statistical models included the fixed effect of dam parity, and calf sex (when P ≤ 0.25) was included for calf and placental variables. Effects of sampling hour, and parity × hour were included for calf metabolites over time using repeated measures. Multiparous dams had greater body weight prepartum (P < 0.001) but similar (P = 0.25) body condition score. Maternal circulating urea N and triglycerides were greater (P ≤ 0.05) in multiparous dams pre-calving. Calves born to primiparous dams weighed 10% less (P ≤ 0.04) at birth with smaller (P ≤ 0.01) heart and abdominal girths. Cotyledonary, intercotyledonary, and total placental masses were less (P ≤ 0.05) for primiparous dams. Dam parity did not affect (P ≥ 0.58) calf time to stand, vigor score at 10 min, or rectal temperature. Serum glucose was greater (P = 0.03) at 0 h but less (P ≤ 0.04) at all other hours in calves from primiparous dams. Calves from primiparous dams had greater (P ≤ 0.02) serum NEFA at 6, 12, and 24 h although plasma triglycerides were greater (P < 0.001) at 6 h. Calves from primiparous dams had greater (P ≤ 0.04) serum urea N at 12 h and creatinine at 12 and 24 h. Plasma insulin was greater (P ≤ 0.04) in calves from multiparous dams at 12, 48, and 72 h, but parity did not affect (P ≥ 0.18) serum total protein or plasma cortisol. Serum aspartate aminotransferase was greater (P ≤ 0.04) at 6 and 24 h, creatine kinase was greater at 24 h, and gamma-glutamyl transpeptidase was less (P ≤ 0.04) at 6, 12, and 24 h, for calves from primiparous dams. Calves born to primiparous dams had greater (P ≤ 0.02) total bilirubin and direct bilirubin at 12 and 24 h. Data indicate that calves born to first-parity heifers had decreased perinatal nutrient availability, resulting in reduced fetal and placental growth, as well as greater energy reserve mobilization and metabolic indicators of stress as neonates.


Approximately two-thirds of beef calf deaths prior to weaning occur within the first 3 wk after birth. The goal to have heifers produce their first calf by 2 yr of age likely contributes to factors that limit nutrients available for fetuses and calves immediately after birth. However, little is known about differences in heifers (first parity) and cows (later parities) regarding factors affecting calf resilience, such as fetal growth and calf metabolism shortly after birth. Our data show that calves born to first-parity heifers had altered nutrient availability, demonstrated through smaller placentas, lower birth weights, and altered metabolites in early life. Although calves had similar vigor and ability to maintain body temperature, calves born to first-parity heifers had to mobilize more energy and had lower insulin during the first 3 d post-birth. Calves born to first-parity heifers had greater indicators of stress during the first 72 h of life not associated with calving difficulties. Overall, these effects may have increased morbidity and mortality of calves born to first-parity heifers if they were in a less intensively-managed system. Better understanding of challenges faced by calves born to first-parity dams provides opportunities for their improved management.


Assuntos
Ácidos Graxos não Esterificados , Placenta , Gravidez , Bovinos , Animais , Feminino , Paridade , Desenvolvimento Fetal , Triglicerídeos , Glucose
11.
BMC Pregnancy Childbirth ; 22(1): 899, 2022 Dec 03.
Artigo em Inglês | MEDLINE | ID: mdl-36463119

RESUMO

BACKGROUND: Prior studies evaluating the impact of the COVID-19 pandemic on pregnancy physical activity (PA) have largely been limited to internet-based surveys not validated for use in pregnancy. METHODS: This study used data from the Pregnancy PA Questionnaire Validation study conducted from 2019-2021. A prospective cohort of 50 pregnant women completed the Pregnancy PA Questionnaire (PPAQ), validated for use in pregnancy, in early, mid, and late pregnancy and wore an ActiGraph GT3X-BT for seven days. COVID-19 impact was defined using a fixed date of onset (March 13, 2020) and a self-reported date. Multivariable linear mixed effects regression models adjusted for age, early pregnancy BMI, gestational age, and parity. RESULTS: Higher sedentary behavior (14.2 MET-hrs/wk, 95% CI: 2.3, 26.0) and household/caregiving PA (34.4 MET-hrs/wk, 95% CI: 8.5, 60.3 and 25.9 MET-hrs/wk, 95% CI: 0.9, 50.9) and lower locomotion (-8.0 h/wk, 95% CI: -15.7, -0.3) and occupational PA (-34.5 MET-hrs/wk, 95% CI: -61.9, -7.0 and -30.6 MET-hrs/wk, 95% CI: -51.4, -9.8) was observed in middle and late pregnancy, respectively, after COVID-19 vs. before. There was no impact on steps/day or meeting American College of Obstetricians and Gynecologists guidelines. CONCLUSIONS: Proactive approaches for the promotion of pregnancy PA during pandemic-related restrictions are critically needed.


Assuntos
COVID-19 , Comportamento Sedentário , Humanos , Feminino , Gravidez , Estudos Prospectivos , COVID-19/epidemiologia , Pandemias , Exercício Físico , Paridade
12.
Pan Afr Med J ; 42: 317, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-36451989

RESUMO

The aim of our study is to describe the epidemiological profile and indications for caesarean section at the maternity ward of the Provincial General Hospital of Kananga from January 1st 2014 to December 31st 2020. This is a descriptive study of a series of cases from the medical records of cesarean patients and based on non-probabilistic sampling of suitability for cases selection. The sample of our study is composed of 1395 cases. The frequency of caesarean section is 16.10% with an annual average of 199.30 (SD 18.20) cases per year, the average age of patients is 25.39 years (SD 1.23), the primiparity is the most affected with 27.38 %, hemorrhagic placenta previa is the most common indication in 26.86%, maternal complications is present in 46.73% and the maternal mortality rate due to cesarean section is 531 per 100.000 live births. The practice of caesarean section constitutes a real problem and our results can serve as a basis for in-depth studies on indications and maternal complications of caesarean section in order to reduce the risks associated with the practice of caesarean section in our environment.


Assuntos
Hospitais Gerais , Placenta Prévia , Gravidez , Humanos , Feminino , Adulto , Cesárea , Placenta Prévia/epidemiologia , Paridade , Nascido Vivo
13.
PLoS One ; 17(12): e0277877, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-36520849

RESUMO

BACKGROUND: Although studies in Nigeria showed the efficacy of intermittent preventive treatment using sulfadoxine-pyrimethamine (IPT-SP) in preventing malaria in pregnancy among Nigerian women there is still poor implementation of the intervention in Nigeria. METHODS: A mixed method study was conducted in Bwari Area Council, Nigeria in 2018. The quantitative part of the study is presented and discussed in this paper. Pregnant women were interviewed using a validated interviewer-administered questionnaire and observations of current practice were performed. RESULTS: A total of 422 pregnant women were recruited into the study (mean age, 26 years) with the majority being married women (90.3%). Most respondents (68.5%) did not know who could take IPT-SP and 58.5% of respondents did not know when and how many times IPT-SP should be taken during pregnancy. Nearly all participants (99.5%) did not take SP at the facility under direct observation of the health worker. None of the facilities had free SP and all respondents paid for SP through the Drug Revolving Fund. The knowledge of the use of SP was significantly influenced by respondents' parity, ward of residence, antenatal clinic (ANC) attendance history and education. Respondents who had tertiary and secondary education were 8.3 (95% CI: 1.01-68.27) times more likely to use IPT-SP than those without formal education. CONCLUSION: Most women who attend ANC in Bwari Area council did not receive IPT-SP as per the national guidelines. The unavailability of logistics (SP, Water and Cup) on a regular basis, the cost of the SP, poor knowledge of the importance of IPT in malaria prevention, and the non-implementation of the administration of SP under direct observation were factors influencing the use of IPT-SP. Outcomes could be enhanced through the provision of measures to address identified gaps by this study.


Assuntos
Antimaláricos , Malária , Complicações Parasitárias na Gravidez , Feminino , Gravidez , Humanos , Adulto , Cuidado Pré-Natal , Nigéria , Complicações Parasitárias na Gravidez/prevenção & controle , Complicações Parasitárias na Gravidez/tratamento farmacológico , Gestantes , Antimaláricos/uso terapêutico , Sulfadoxina/uso terapêutico , Pirimetamina/uso terapêutico , Malária/epidemiologia , Malária/prevenção & controle , Malária/tratamento farmacológico , Combinação de Medicamentos , Paridade , Atenção Primária à Saúde
14.
BMC Pregnancy Childbirth ; 22(1): 955, 2022 Dec 21.
Artigo em Inglês | MEDLINE | ID: mdl-36544103

RESUMO

BACKGROUND: High blood pressure (HBP) during pregnancy causes maternal and fetal mortality. Studies regarding its prevalence and associated factors in frontline level health care settings are scarce. We thus aimed to evaluate the prevalence of HBP and its associated factors among pregnant women at the first level of the health care system in Burkina Faso. METHODS: This cross-sectional study was conducted in six health facilities between December 2018 and March 2019. HBP was defined as systolic blood pressure ≥ 140 mmHg and/or diastolic blood pressure ≥ 90 mmHg. Multivariable logistic regression analysis was performed to identify factors associated with HBP. RESULTS: A total of 1027 pregnant women were included. The overall prevalence of HBP was 1.4% (14/1027; 95% confidence interval [CI] 0.7-2.3), with 1.6% (7/590; 95% CI 0.8-3.3) in rural and 1.2% (7/437; 95% CI 0.6- 2.5) in semi-urban areas. The prevalence was 0.7% (3/440; 95% CI 0.2-2.1) among women in the first, 1.5% (7/452; 95% CI 0.7-3.2) in the second and 3% (4/135; 95% CI 1.1-7.7) in the third trimester. In the multivariable analysis, pregnancy trimester, maternal age, household income, occupation, parity, and residential area were not associated with HBP during pregnancy. CONCLUSION: The prevalence of HBP among pregnant women at the first level of health system care is significantly lower compared to prevalence's from hospital studies. Public health surveillance, primary prevention activities, early screening, and treatment of HDP should be reinforced in all health facilities to reduce the burden of adverse pregnancy outcomes in Burkina Faso.


Assuntos
Hipertensão , Gestantes , Gravidez , Feminino , Humanos , Estudos Transversais , Burkina Faso/epidemiologia , Prevalência , Hipertensão/epidemiologia , Paridade
15.
Sci Bull (Beijing) ; 67(18): 1865-1873, 2022 09 30.
Artigo em Inglês | MEDLINE | ID: mdl-36546300

RESUMO

Non-hermiticity presents a vast newly opened territory that harbors new physics and applications such as lasing and sensing. However, only non-Hermitian systems with real eigenenergies are stable, and great efforts have been devoted in designing them through enforcing parity-time (PT) symmetry. In this work, we exploit a lesser-known dynamical mechanism for enforcing real-spectra, and develop a comprehensive and versatile approach for designing new classes of parent Hamiltonians with real spectra. Our design approach is based on a new electrostatics analogy for modified non-Hermitian bulk-boundary correspondence, where electrostatic charge corresponds to density of states and electric fields correspond to complex spectral flow. As such, Hamiltonians of any desired spectra and state localization profile can be reverse-engineered, particularly those without any guiding symmetry principles. By recasting the diagonalization of non-Hermitian Hamiltonians as a Poisson boundary value problem, our electrostatics analogy also transcends the gain/loss-induced compounding of floating-point errors in traditional numerical methods, thereby allowing access to far larger system sizes.


Assuntos
Eletricidade , Honorários e Preços , Feminino , Gravidez , Humanos , Eletricidade Estática , Paridade , Física
16.
S D Med ; 75(7): 324-327, 2022 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-36542573

RESUMO

Uterine rupture is a potentially life-threatening complication that is typically seen in pregnant females who have undergone prior uterine surgeries such as cesarean sections. This usually occurs when the uterine myometrium is weakened and thus is more prone to stress during labor. In an unscarred uterus, the incidence of uterine rupture is lower. Risk factors in the unscarred uterus include trauma, obstructed labor, high parity, placental abnormalities, operative deliveries, and imprudent use of uterotonic medications. This case report describes a situation in which uterine rupture occurred in the absence of the common risk factors. With prompt recognition of clinical signs, quick assembly of a team, and emergent interventions, this patient and her infant survived. The goal of this report is to educate clinicians on the occurrence of uterine rupture in an unscarred uterus and how to recognize and manage this complication.


Assuntos
Trabalho de Parto , Ruptura Uterina , Humanos , Gravidez , Feminino , Ruptura Uterina/diagnóstico , Ruptura Uterina/etiologia , Ruptura Uterina/cirurgia , Placenta , Útero , Paridade
17.
Sci Rep ; 12(1): 21358, 2022 Dec 09.
Artigo em Inglês | MEDLINE | ID: mdl-36494399

RESUMO

To investigate the association between maternal age and severe maternal morbidity (SMM) in a Korean population. Data for cases of delivery between 2003 and 2019 were extracted from the Korean National Health Insurance Service-National Delivery Cohort. The main outcome was SMM, which was determined using the Center for Disease Control and Prevention's algorithm. A generalized estimating equation model with a log link was performed for the relationship between SMM and maternal age adjusted for covariates. SMM occurred in 40,959/2,113,615 (1.9%) of delivery cases. Teenagers and women 35 years and older had an increased risk of SMM in both nulliparous and multiparous cases (ages 15-19: risk ratio (RR) 1.32, 95% confidence interval (CI) 1.15-1.46; ages 35-39: RR 1.24, 95% CI 1.21-1.28; ages 40-44: RR 1.57, 95% CI 1.50-1.64; and ages 45 or older: RR 2.07, 95% CI 1.75-2.44). Women aged 40 years and older had the highest rates of SMM. In singleton births as well as in nulliparous and multiparous cases, teenagers and women aged 35 years and older had a particularly high risk of SMM. Identifying and managing risk factors for SMM in these vulnerable age groups may improve maternal health outcomes.


Assuntos
Idade Materna , Gravidez , Adolescente , Feminino , Humanos , Adulto , Pessoa de Meia-Idade , Estudos de Coortes , Fatores de Risco , Paridade , República da Coreia/epidemiologia , Morbidade , Estudos Retrospectivos
18.
Phys Rev Lett ; 129(23): 232501, 2022 Dec 02.
Artigo em Inglês | MEDLINE | ID: mdl-36563216

RESUMO

The recent experimental determination of the parity violating asymmetry A_{PV} in ^{48}Ca and ^{208}Pb at Jefferson Lab is important for our understanding on how neutrons and protons arrange themselves inside the atomic nucleus. To better understand the impact of these measurements, we present a rigorous theoretical investigation of A_{PV} in ^{48}Ca and ^{208}Pb and assess the associated uncertainties. We complement our study by inspecting the static electric dipole polarizability in these nuclei. The analysis is carried out within nuclear energy density functional theory with quantified input. We conclude that the simultaneous accurate description of A_{PV} in ^{48}Ca and ^{208}Pb cannot be achieved by our models that accommodate a pool of global nuclear properties, such as masses and charge radii, throughout the nuclear chart, and describe-within one standard deviation-the experimental dipole polarizabilities α_{D} in these nuclei.


Assuntos
Chumbo , Nêutrons , Gravidez , Feminino , Humanos , Paridade , Eletricidade Estática
19.
Trop Anim Health Prod ; 55(1): 31, 2022 Dec 30.
Artigo em Inglês | MEDLINE | ID: mdl-36585532

RESUMO

The objective of the study was to compare the reproductive performances of gilts and weaned sows grouped at different days after insemination. The study was conducted on a sow farm in the Midwest of Paraná State, Brazil, using animals from the Camborough genetic line (PIC®, Patos de Minas, Brazil, Landrace × Large White crossbred). The groups of comparison have considered the distribution of gilts (n = 407) and sows (parity 1 to 5; n = 843) according to the day of group housing in collective pens in relation to the day of last insemination (AI). Thus, gilts were distributed in four groups of comparison: group housing on days 1, 2, 3, or 4 after the last AI (AI). Sows were distributed in three groups of comparison: group housing on the day after the last AI (0), at day 1 or 2 after the last AI. Farrowing rate (FR), the total number of piglets born (TB), and return to estrus (RE) were recorded. In a subsample (254 gilts and 622 sows), the presence and the score of skin lesions (0, no lesions; 1, low; 2, moderate; or 3, high) were evaluated 24 and 48 h after mixing. Statistical analysis was performed using the SAS® 9.4 software using the GLIMMIX procedure. Comparisons of means were performed using the Tukey-Kramer test and frequencies by logistic regression. Group housing gilts on different days after insemination did not affect FR, TB, and RE (P ≥ 0.79). However, sows mixed 2 days after AI had a reduction in TB compared to those mixed on day 1 (P = 0.05), without differences from sows mixed on the day of the last AI. All the females had low (score 1; 60.5%) or moderate (score 2; 39.5%) skin lesions. For both female categories, the presence of low or moderate lesion scores did not affect ER, FR, and TB (P ≥ 0.25). Fights within 48 h were not severe enough to compromise reproductive performance (P ≥ 0.25). In conclusion, group housing gestating sows 2 days after breeding compromised litter size; however, mixing gilts on days 1 to 4 after breeding did not impair reproductive performance.


Assuntos
Inseminação , Reprodução , Gravidez , Suínos , Feminino , Animais , Paridade , Tamanho da Ninhada de Vivíparos , Sus scrofa
20.
Pan Afr Med J ; 43: 46, 2022.
Artigo em Francês | MEDLINE | ID: mdl-36523291

RESUMO

Introduction: post-term pregnancy is a risky situation for the fetus and the mother. In our context, few data exist on the subject. This aims to determine the associated factors of post-term pregnancy in order to contribute to a reduction in maternal and fetal morbidity and mortality. Methods: we conducted a matched case-control study in the department of gynaecology-obstetrics of the Yalgado Ouédraogo University Hospital. Data were collected between 1st January 2014 and 31st August 2014. Cases were patients who delivered at 41 weeks of amenorrhoea and above and controls were those who delivered between 37 and 41 weeks of amenorrhoea. Results: the study included 153 cases and 153 controls. Risk factors with statistically significant association with post-term pregnancy were high maternal socioeconomic status (adjusted odds ratio (AOR)=3.17; 95% CI [1.13; 9.07]) primiparity (AOR=1.45; 95% CI [1.07; 2.51]), and previous post-term pregnancy (AOR=7.02; 95% CI [2.08; 23.79]). Conclusion: early recognition of risk factors for post-term pregnancy will help health workers identify women with high-risk pregnancies.


Assuntos
Amenorreia , Cuidado Pré-Natal , Gravidez , Feminino , Humanos , Estudos de Casos e Controles , Hospitais Universitários , Paridade , Fatores de Risco
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