Preference for male child among married adults in rural and urban field practice areas of Narayana Medical College, Nellore, Andhra Pradesh, India

Background: Reduction of national fertility levels was directly proportional to the preference of male child in many families in India. We conducted this study on 214 married adults, in both sexes to find out whether this strong preference still exists in this decade or not, and if it does what could be the reasons.Methods: A community based cross-sectional study done by face to face interviews using a semi-structured questionnaire containing both qualitative and quantitative variables, among 214 married adults.Results: Upon analysing the results, we identified that higher son preference (61.23%) is seen in many rural families, and is strongly associated with low socio-economic status, literacy rate and caste. The reasons by which these families prefer male child were also broadly categorized and identified. Economic utility (78%) and old age security (61%) was found to be the major reasons most families has quoted in preferring a son.Conclusions: By improving the literacy rate and job opportunities in the community, fertility rate can be reduced, especially in rural areas where the other options are limited.

Reducción embrionaria en embarazo gemelar / Embryo reduction in twin pregnancy

La reducción embrionaria es la interrupción selectiva del desarrollo de uno o varios fetos en el primer trimestre del embarazo. El embarazo gemelar se presenta aproximadamente en uno de cada 100 nacimientos y se considera como una entidad con alto riesgo materno y fetal. Los embarazos múltiples tienen un impacto mayor en los sistemas de salud, debido a la mayor frecuencia de complicaciones. La rotura prematura de membranas causa aproximadamente el 40 por ciento de los partos pretérmino y, como consecuencia, aportan un 10 por ciento de la mortalidad perinatal según la Sociedad Española de Ginecología y Obstetricia. En este caso clínico se observó que una actitud expectante con los pertinentes controles ecográficos (índice del líquido amniótico), analíticos (recuento leucocitario y reacción en cadena de la polimerasa) y clínicos (frecuencia cardiaca y temperatura) pueden llevar a una buena evolución posnatal que justificó al menos en esta ocasión, una actitud conservadora(AU)

Embryonic reduction is the selective interruption of the development of one or several fetuses in the first trimester of pregnancy. Twin pregnancy occurs in approximately one in every 100 births. It is considered an entity with high maternal and fetal risk. Multiple pregnancies have greater impact on health systems due to the higher frequency of complications. Premature rupture of membranes causes approximately 40 percent of preterm births and, consequently, it contributes 10 percent of perinatal mortality according to the Spanish Society of Gynecology and Obstetrics. In this clinical case it was observed that an expectant attitude with the relevant ultrasound (index of amniotic fluid), analytical (leukocyte count and polymerase chain reaction) and clinical (heart rate and temperature) controls can lead to good postnatal evolution, justified at least on this occasion, a conservative attitude(AU)

Gender preference for child among reproductive age group women - A cross-sectional study in Jamnagar district

Background: Today, female feticide and gender preference are a big problem in India. Although there is so much emphasis against it, the problem has become aggravated. In this context, various studies showed that the male child preference leads to skewed sex ratio. The present paper is an attempt to determine the view of the people for giving their preference to the male child. Objectives: The objectives were to study the preference of women for gender of child, as well as reasons for preference for it, and association between socioeconomic factors and demographic factors with gender preference. Materials and Methods: It is a community-based cross–sectional study, in which 500 married women of 15–49 years of reproductive age group, 150 randomly selected women from one urban municipal ward, and 350 randomly selected women from seven villages of rural area were constituted the study population. Widow and separated women were excluded from the study. A pre-tested, semi‑structured questionnaire was administered to each individual to collect information. Microsoft Excel 2007 software and the Chi‑square test were used. Results: Almost half of the women (51.4%) have preference for male child. Women from lower age group (65.25%), currently married (66.42%), Muslim religion (72.22%), lower education (59.01%), and low socioeconomic status (66.67%) and those who are laborer (71.83%) have male child preference. Conclusions: This study concludes that more number of females have preference for male child in women of younger age group. Muslim religion and its customs, thoughts, and rearing practices make difference. Lower socio-economic status and poor education are also major contributory factor. Male child will support in old age and will take social responsibilities are the main basic reasons found to be associated with male child preference.

Rapid initiation of fetal therapy services with a system of learner-centred training under proctorship: the National University Hospital (Singapore) experience

<p><b>INTRODUCTION</b>Management of complicated monochorionic twins and certain intrauterine structural anomalies is a pressing challenge in communities that still lack advanced fetal therapy. We describe our efforts to rapidly initiate selective feticide using radiofrequency ablation (RFA) and selective fetoscopic laser photocoagulation (SFLP) for twin-to-twin transfusion syndrome (TTTS), and present the latter as a potential model for aspiring fetal therapy units.</p><p><b>METHODS</b>Five pregnancies with fetal complications were identified for RFA. Three pregnancies with Stage II TTTS were selected for SFLP. While RFA techniques utilising ultrasonography skills were quickly mastered, SFLP required stepwise technical learning with an overseas-based proctor, who provided real-time hands-off supervision.</p><p><b>RESULTS</b>All co-twins were live-born following selective feticide; one singleton pregnancy was lost. Fetoscopy techniques were learned in a stepwise manner and procedures were performed by a novice team of surgeons under proctorship. Dichorionisation was completed in only one patient. Five of six twins were live-born near term. One pregnancy developed twin anaemia-polycythaemia sequence, while another was complicated by co-twin demise.</p><p><b>DISCUSSION</b>Proctor-supervised directed learning facilitated the rapid provision of basic fetal therapy services by our unit. While traditional apprenticeship is important for building individual expertise, this system is complementary and may benefit other small units committed to providing these services.</p>

A study of gender preference, knowledge and attitude regarding prenatal diagnostic techniques act among pregnant women in an urban slum of Bengaluru.

Background: Preference for a son continues to be a prevalent norm even in modern India which is evident from the recent census report. The most alarming aspect is a further fall in child sex ratio (0-6 years) from 927 in 2001 to 914 in 2011. Sex selective abortion is the major factor responsible for this unfavorable trend. The objective was to assess the knowledge, attitude and practice of pregnant women regarding Prenatal Diagnostic Techniques (PNDT) Act and gender preference. Methods: A cross-sectional study was carried out in100 pregnant women attending the antenatal clinics of Sulthanpalaya Urban health center, Bangalore. A pre-designed and pre-tested questionnaire was used to get information. Data was analyzed by using Statistical Package of Social Sciences (SPSS) 16.0. Results: In this study 53% showed preference for a male child. Only 37% were aware about the decline in sex ratio and 59% knew that PNDT act existed and sex determination was legally wrong. Over all 41% had poor knowledge. Whereas 43% had average and 16% had good knowledge and 74% had the right attitude in this study. Good knowledge about PNDT act had significant influence on the attitude of the people (p< 0.05). Conclusion: The falling ratio of girl child is a matter of grave concern. Effective implementation of the PNDT Act in addition to spreading awareness about this act among people is the need of the hour. Moreover, it is necessary to gear efforts against the cultural, economic and religious roots of this social malady by woman empowerment.

Profiles, Practices and Perceptions towards Gender Preferences among Pregnant Women of Ahmedabad City, Gujarat, India.

Sex selective practices are of serious concern to the rapidly changing societies. The view of the pregnant women residing in urban areas should be considered. The present cross sectional study aims to study the obstetrics profiles, practices and perceptions of suburban pregnant women of communities in the service areas of a medical college. Antenatal women of the community of Saijpur ward attending antenatal clinics of the area formed the study subjects . Two hundreed pregnant women was interviewed using pre-tested Performa taking their consent. Institutional ethical consent was obtained beforehand and the data were analyzed.It was seen that out of the total 200 respondents, most of them (n=184, 92%) were literate. Forty two (21%) already had two daughters at the time of interview. The study showed that 31.5% (n=63) showed preference for male child and only few (n=29, 14.5%) showed preference for a girl child.It was evident that literacy has positive impacts on obstetrics practices of the women. Son preference is also observed among urban subclasses.Pregnant women tend to prefer a male child by and large, especially if the previous child is a daughter. Their views for such choice should be incorporated to bring about desired social change against gender imbalance.

Female feticide in the view of fertile females- A study among suburban pregnant women of Gujarat, India.

Background: Sex selective abortion and Female feticide are growing problems across the world, especially among third world countries like India. Level of awareness and views regarding preventing the same must also be considered among those who are pregnant, before expecting a social change ‘favourable’ to the ‘girl child’. Aims & Objective: To study the attitudes and awareness towards issues of female feticide among suburban pregnant women. Materials and Methods: This cross sectional study was conducted on antenatal women of the community of Saijpur ward attending government antenatal clinics of the area. A sample of 200 pregnant women was interviewed using pre-tested Performa taking their consent. Institutional ethical consent was obtained beforehand and the data were analyzed. Results: Out of all 31.5% and 14.5% preferred to have a male and female child, respectively as their current pregnancy outcome. Less than half (43.5%, n=87) of the respondents were aware about the term ‘Female feticide’ in local language. Most of them (n=183, 91.5%) were aware of the term ‘Pre-natal sex determination’ in their local language. None of the graduate respondents would have liked to go for abortion, had the fetus sex been determined beforehand. Conclusion: Socio-demographic factors play a role in women’s awareness for female feticide. Education forms a critical role for her attitudes towards ‘female feticide’. Television and Health-care providers proved to be better sources for awareness generation than others did.

Nursing of patients with monochorionic twins undergoing selective feticide with bipolar electrocoagulation / 中国实用护理杂志

Objective To summarize the key nursing points in patients with monochorionic twins undergoing selective feticide with bipolar electrocoagulation.Methods Selective feticide with bipolar electrocoagulation were performed in 68 monochorionic twins with one twin anomaly.And the perioperative care was performed on the patients.Results Operations were accomplished successfully in 68 cases.No complications,such as infections,premature rupture of membrane and so on,were found in all cases seven days after operation.Conclusions The nursing key points include preoperative psychological nursing by interpretation of the operations,monitoring fetal heart sounds during operations,and close observation of body temperature,uterine contractions and fetal heart rate in pregnant women after operations.Careful perioperative nursing is helpful for improvement of operative success and to ensure normal development of fetus.

A hospital-based study on knowledge, attitude and practice of pregnant women on gender preference, prenatal sex determination and female feticide.

India has witnessed a decline in sex ratio in the past few decades. A hospital-based cross-sectional study was carried out to find out the attitude toward gender preference and knowledge as well as practice toward prenatal sex determination and female feticide among pregnant women. A majority (66.0%) of the pregnant women did not show any gender preference, followed by male preference (22.2%) and female preference (11.8%). A high proportion, i.e. 84.7% and 89.7%, of the total subjects were aware that prenatal sex determination and female feticide is illegal, respectively.