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Background: Anaemia has significant impact on health of the fetus as well as that of mother. Increased need of iron during pregnancy especially after 2nd trimester makes iron supplementation mandatory. Ferrous ascorbate is known to exist intact inside the gastrointestinal tract due to the stable chelation of iron with ascorbate. This compound does not dissociate due to any of the food inhibitors. The aim is to study the effec-tiveness of Ferrous Ascorbate and Ferrous sulphate in terms of compliance and cost effectiveness of manage-ment of anaemia in pregnancy. Methodology: Study design: Quasi Experimental study, Study area: District Vidisha, Study participants: Preg-nant women of first trimester registered during the study period in the selected Anganwadis/ Gram Arogya Kendra (GAK), Sample size: 240 antenatal mothers. Results: Baseline mean haemoglobin was 11.31±1.05 gm/dl. The mean increase in Ferrous Sulphate was 0.55 gm/dl, and in Ferrous ascorbate was 1.27 gm/dl. Ferrous Sulphate was less compliant than Ferrous ascorbate, and has higher efficacy and lesser side effects. Only Rs. 10.2 additional cost per antenatal mothers for increase of ≥1gm% in Hb will be borne by government if Ferrous Sulphate is replaced by Ferrous Ascorbate. Conclusions: Study results show statistically significant difference in rise of haemoglobin amongst the ante-natal mothers consuming Ferrous ascorbate over Ferrous Sulphate
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@#Introduction: This study aimed to determine the association between nutrient intake, oral symptoms, and oral health-related quality of life (OHRQoL) among antenatal mothers in the Sri Aman district, Sarawak. Methods: A total of 124 antenatal mothers in the second and third trimesters, through systematic random sampling, participated in this cross-sectional study. A validated selfadministered questionnaire was used to collect their socioeconomic and obstetric profiles, perceived oral health status, and OHRQoL. Three days 24-hour diet recall assessment involving two weekdays and one weekend day was used for nutrient intake assessment. Results: Most mothers (75.0%) had at least one oral symptom: cavitated tooth (51.6%), bleeding gum (32.3%), halitosis (27.4%), gum pain (13.7%), toothache (12.1%), and swollen gum (6.5%). Most mothers also had inadequate intakes of energy, vitamin D, iodine, calcium, zinc, fluoride, and iron. The most affected OHRQoL domain was psychological discomfort, followed by functional limitation and physical pain. Nutrient intake was not significantly different between antenatal mothers with and without oral symptoms. Antenatal mothers with at least one oral symptom, presence of toothache, cavitated tooth, bleeding gum, and halitosis had significantly lower OHRQoL. Conclusion: Most antenatal mothers had inadequate nutrient intake, particularly vitamin D and calcium. Nutrient intake was not significantly associated with oral symptoms. The oral symptoms of dental caries and periodontal disease were prevalent; and the presence of toothache, cavitated tooth, bleeding gum, and halitosis were associated with poor OHRQoL.
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Background: Hemoglobinopathies are the major cause of anemia throughout the world complicating pregnancy outcome. Hence, detection of hemoglobinopathies in antenatal period is of critical importance as it not only predict the possibility of birth of a child with thalassemia but also reduces the complications associated with anemia in pregnancy. Hence, identification of a reliable cost-effective screening method for detection of hemoglobinopathies is of utmost importance. Aims and Objectives: The present study was conducted to evaluate the role of red blood cell (RBC) parameters including hemoglobin (Hb%), RBC count, mean corpuscular volume (MCV), and mean corpuscular hemoglobin (MCH) in detection of thalassemia carriers among healthy antenatal mothers in a tertiary care hospital of Eastern India. Materials and Methods: Venous blood samples were collected from total 1458 antenatal mothers aged 18 years or above with <17 weeks of gestation and were analyzed for complete blood count, serum ferritin level, and high-performance liquid chromatography for identification of abnormal Hb. Patients with iron deficiency anemia as diagnosed by serum ferritin <15 ng/ml were excluded from this study. Results: The prevalence of hemoglobinopathy was found to be 12.55% with ß-thalassemia trait (BTT) being the most common type (7.9%). All the RBC parameters were significantly lower among the BTT group compared to individuals with normal or other hemoglobinopathies (P < 0.05). Conclusion: RBC parameters such as Hb, RBC, MCV, and MCH can be used as cost-effective yet very effective screening method to identify different hemoglobinopathies among antenatal mothers.
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Providing comfort to an antenatal mother is one of the critical components of the nonstress test (NST). An experimental study was conducted on 450 antenatal mothers beyond 34 weeks, who were randomly allocated into three groups – supine, left lateral, and semi?fowler’s position, to explore the association of selected maternal positions on NST results and to find the impact of these positions on the comfort level of antenatal mothers. The fetal parameters were assessed by observing and recording biophysiological measurements from the NST and the maternal comfort of different positions by the Verbal Numerical Rating Scale. The data analyzed reveal a significant association between maternal positions and fetal parameters at P < 0.05 level. Antenatal women who were in semi?fowler’s position exhibited more comfort and fetal NST reactivity as noted by significant variation in the baseline fetal heart rate, beat?to?beat variability, acceleration, deceleration, and fetal movements.
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@#This study examined the impact of universal screening in diagnosing and managing gestational diabetes (GDM) amongst antenatal mother and associated neonatal outcomes. It is a single-centre, retrospective study on routinely collected data of antenatal women in Health Clinic Seremban over one year in 2018. All women diagnosed with GDM, who were not known sufferers of type 1 or type 2 diabetes were included in this study. Participants were stratified according to risk factors for GDM to compare the performance of a selective high-risk screening approach to that of universal screening for detecting GDM. Subjects were categorized as high-risk for GDM based on the guidelines recommended by the Malaysian Clinical Practice guidelines. It was found that through universal screening, 246 antenatal mothers were tested positive for GDM out of the 987 of these mothers without prior diabetes, giving a prevalence of 24.9%. If selective screening using traditional risk factors had been employed, 54 (22%) of the antenatal mothers diagnosed with GDM would have been missed. It was established that risk factors for GDM included advancing age, other ethnicities (patients that are not of Malay, Chinese nor Indian ethnicities), obesity, history of abortion or GDM and family history of diabetes mellitus. Neonatal outcomes of those with GDM as compared to those without were similar. This study highlights that universal screening improved GDM detection rates amongst antenatal mothers. The increased detection helped facilitate an earlier intervention which may have contributed to better antenatal management and outcomes for neonates and their mothers.
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Introduction: Reproductive tract infections (RTIs) are a universal public health problem among young women in developingcountries and occupy the second position in public health problems. RTIs lead to 17% of economic losses in these countries.According to the WHO estimates in 2008, globally, 499 million new cases of RTIs occurred annually among women in thereproductive age group. In India, one among four women in the reproductive age group has any one type of RTIs and the annualincidence of RTI estimated is about 5%. Consequently, the prevalence rate of RTIs in various states of India is 19%–71%. Thereare about 40% of women estimated to have RTIs/sexually transmitted infections (RTI/STI) at any given point of time, but only1% complete the full course of treatment of both partners. The present study was conducted to know about the knowledge,attitude, and practices about the RTI/STIs among the antenatal mothers attending outpatient departments in Goa MedicalCollege as part of needs assessment for formulating educational and preventive strategies.Materials and Methods: This cross-sectional descriptive study was conducted at Goa Medical College, a Tertiary Care Hospital atBambolim-Goa, from December 2018 until February 2019. Institutional Ethics Committee (IEC) approval was taken from the IEC ofthe Goa Medical College. Data were collected by interviewing mothers using a semi-structured questionnaire. Additive scores weredeveloped for awareness, knowledge, and perceptions in specific areas of transmission, prevention, and treatment of RTI/STI. Thescores were characterized as poor, average, and good. Data were entered in EpiData Manager and analyzed using SPSS 22 version.Categorical variables were expressed in percentages and proportions and quantitative variables in mean ± SD. The associationbetween dependent and independent variables was assessed using bivariate analysis. P < 0.05 was taken as statistically significant.Aims and Objectives: The aims of the study were (1) to study the level of awareness regarding RTIs/STIs among antenatalmothers, (2) to study their knowledge regarding symptoms and modes of transmission of RTI/STI, (3) to study awarenessregarding preventive strategies for transmission of RTI/STIs, and (4) to study their attitudes and perceptions toward STIs.Results: The mean age of the study participants was 27.5 years. The majority of antenatal mothers, i.e., 64% were aware of RTI/STIsin our study. There was poor awareness in 46% of study subjects and good awareness in 28% of study subjects. On bivariate analysis,awareness was significantly related to education level (P = 0.000), occupation (P = 0.002), socioeconomic status (P = 0.000), andlocation (P = 0.000). About 59% antenatal mothers knew whitish discharge per vaginum as the most common symptom of STI/RTI.The other symptoms identified were lower abdominal pain by 56%, itching in perineal region by 40%, weakness by 50%, and lossof weight by 22%. The mode of spread of RTI/STIs was identified as a sexual route by 56% and blood transfusion by 35% and 31%and 30% were of the opinion that unhygienic conditions and unsafe deliveries were the modes of spread of RTI/STIs, respectively.About 50% antenatal mothers were aware that safe sexual practices can prevent STI/RTIs, 36% felt that the use of condoms helpsin preventing STI/RTIs, 22% opined that good personal hygiene is the mode of preventing RTI/STIs, and 31% were ignorant aboutits prevention. Thus, 67% subjects had poor knowledge, 24%average knowledge and good knowledge was present in only9% study subjects. On bivariate analysis, knowledge wassignificantly related to age (P = 0.04), education (P = 0.03),occupation (P = 0.002), and location (P = 0.015). Socioeconomicstatus shows significant linear by linear relation trends. About74% study, subjects felt that RTI should be treated to avoidcomplications, while 23% did not want to express themselves.Similarly, 20% subjects refused to talk about STIs. Half of the study participants (48%) had a poor score with respect to perception about STI/RTI. Only 19% had good scores which were significantlyrelated to education (P = 0.012), occupation (P = 0.001), and location (P = 0.000).Conclusion: The study findings show that although there is 64% awareness of STI/RTI, there is a lack of requisite knowledgewith respect to RTIs. The attitude, knowledge, and perception are significantly related to education, occupation, and location.Therefore, the knowledge has to be spread in society through educational programs so as to increase awareness of this problem,thereby curbing the spread of RTI/ STIs and their complications.
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Background: Under 5 mortality is a key indicator of health status of the country. Optimum care in postnatal period with immunization as per recommended schedule and exclusive breastfeeding with appropriate technology are the most essential factors for optimum growth and development of the child and to prevent under five mortality. The study was done to assess the knowledge and attitude of antenatal mothers on vaccination and postnatal care.Methods: Total 150 pregnant women were required to answer a series of questionnaire related to demographic data, awareness and attitude towards postnatal care, breastfeeding and immunization.Results: Total 90% of the women are aware regarding immunization at birth, 87% of them got the information from a person, who is directly related to health system. Statistically 97.3% mother were aware about importance to keep the baby covered. Every 3 out of 4 women knew that breastfeeding to be started within 1 hour of life. Only 40% were aware that prelacteal feed should never be given to newborns and 74% of the women think that jaundice in newborn requires evaluation.Conclusions: There is a need to educate antenatal mothers about various aspects of immunization and postnatal care including breastfeeding.
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Background: Incidence of pregnancy in women with heart disease is increasing due to the increasing number of women with congenital heart disease. Although most cardiac conditions are well tolerated during pregnancy, there are some conditions that have adverse fetal and maternal outcome. Objective of this study is to study the prevalence of heart disease in antenatal mothers and fetal outcome with obstetric management.Methods: This is a prospective observational study carried out in the Department of Obstetrics and Gynaecology at Government Mohan Kumaramangalam Medical College and Hospital during January 2018 to March 2019 for a period of fifteen months. Authors included 149 antenatal mothers with heart disease and analysed the data using percentage analysis through excel software.Results: Incidence of heart disease in pregnancy was observed to be 1.2%. Rheumatic heart disease being 73.8%, congenital being 22.8% and complete heart block was 3.4%. Among rheumatic heart disease mitral stenosis was the most common lesion. Atrial septal defect was the most common congenital heart disease. The mean gestational age of delivery was 37 to 38 weeks. 58% delivered by vaginal route. Most common neonatal complication was prematurity. Pregnancy and neonatal outcome were favorable.Conclusions: Heart disease complicating pregnancy has increased due to late marriage, obesity, hypertension and diabetes. Early referral, regular follow-up and multi-disciplinary approach with tertiary care back-up will bring a favorable maternal and neonatal outcome in patients with heart disease.
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Background: exclusive breast feeding practice is major pillar in preventing infant mortality. This study was undertaken to know the knowledge and attitude of antenatal mothers towards breast feeding.Methods: this is a cross sectional study in our hospital in which 264 antenatal mothers were included after verbal consent. Antenatal mothers were explained about the study, their knowledge and attitude regarding breast feeding is assessed by questionnaire. Study will be analysed by appropriate statistical analysis.Results: In total of 264 antenatal mothers, most of them were between 20-25 years, majority in third trimester. Among them 68.2% knows breast feeding should be initiated within first hour of delivery, 90.2% is for no prelacteal feeds and 95.8% wants to feed colostrum. Only 42.4% wants to continue breastfeeding for two years. About 62.9% of antenatal mothers wants to supplement the child with food after six months.81.8% knows breast feeding is not only helpful to the baby but also it prevents breast cancer in mother later in life. 21.2% wants to feed complimentary feeds as early as 3 months.Conclusions: our study on knowledge of breast feeding among antenatal mothers shown most of them are against prelacteal feeds and wants to feed colostrums, but initiation of breast feeding within first hour of birth and weaning after six months and continuation of breast milk up to two years is lagging. Multiple educational sessions, visual aids, pamphlets, electronic media, counseling during antenatal period and in early post natal period is necessary to inculcate appropriate knowledge on breast feeding.
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Background: Rubella infection in pregnant mothers is of great concern as it acts as a teratogen causing abortions, still births, intra-uterine foetal deaths and multiple birth defects. In India, rubella causes significant bad obstetric pregnancy outcome including congenital deformities due to lack of proper surveillance and immunization coverage with rubella vaccination. Aim: To determine Sero-prevalence of rubella IgM and IgG antibodies in Bad Obstetric History (BOH) pregnant women in Tertiary Rural Medical College in Eastern India. Materials and Methods: Cross sectional study was conducted from 1st January 2017 to 31st March 2017 on sera of 100 antenatal mothers with bad obstetric history aged between 20-40 years of age group with pregnancy of ≥18 wks. Rubella IgM and IgG antibodies were assessed by ELISA. Statistical Analysis: Percentage, proportions and ᵡ2 test were applied. Results: Eleven per cent (11%) sero-prevalence for IgM antibodies and 54% for IgG antibodies was observed with maximum sero-positivity among 20-25 years mothers. Repeated abortions were the commonest pregnancy outcome. Conclusion: All antenatal cases should be routinely screened for rubella, so that early diagnosis will help in proper management and foetal outcome and strong recommendation for universal coverage of MMR in early age group of children.
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Background: Rubella infection in pregnant mothers is of great concern as it acts as a teratogen causing abortions, still births, intra-uterine foetal deaths and multiple birth defects. In India, rubella causes significant bad obstetric pregnancy outcome including congenital deformities due to lack of proper surveillance and immunization coverage with rubella vaccination. Aim: To determine Sero-prevalence of rubella IgM and IgG antibodies in Bad Obstetric History (BOH) pregnant women in Tertiary Rural Medical College in Eastern India. Materials and Methods: Cross sectional study was conducted from 1st January 2017 to 31st March 2017 on sera of 100 antenatal mothers with bad obstetric history aged between 20-40 years of age group with pregnancy of ≥18 wks. Rubella IgM and IgG antibodies were assessed by ELISA. Statistical Analysis: Percentage, proportions and ᵡ2 test were applied. Results: Eleven per cent (11%) sero-prevalence for IgM antibodies and 54% for IgG antibodies was observed with maximum sero-positivity among 20-25 years mothers. Repeated abortions were the commonest pregnancy outcome. Conclusion: All antenatal cases should be routinely screened for rubella, so that early diagnosis will help in proper management and foetal outcome and strong recommendation for universal coverage of MMR in early age group of children.
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Background: IEC (Information, Education, and Communication) strategies may help pregnant women to prevent disease and to improve and maintain health. The present study was carried out with an aim to evaluate the effectiveness of IEC in improving the knowledge and practice regarding prevention/treatment of iron deficiency anaemia among the antenatal women attending Primary Health Centre in Puducherry.Methods: The present study was carried out in Puducherry, as a randomised control trial among antenatal mothers attending antenatal clinics in Primary Health Centre from February 2016 to August 2017. Block randomization technique was used to designate study participants into intervention and non-intervention groups. The minimum required sample size was calculated to be 84 in each group. Then intervention (Information, Education and Communication) was given to these antenatal women by using interpersonal communication methods, PowerPoint presentation and audio visual aids.Results: Correct responses to the questions were compared among the intervention and non intervention group in pre test and post test. It was noted that the proportion of correct responses were significantly higher among intervention group than that of non-intervention groups.Conclusions: Well planned and tailor made IEC material, acceptable by the regional population, by using various modes of interpersonal communication, improves the knowledge and practice of the antenatal mothers. It was also found that the haemoglobin levels of mothers in the intervention group were higher than the antenatal mothers who did not receive any IEC intervention.
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Background: HIV and Hepatitis B are devastating diseases causing serious global public health problems and are rampant in this part of the country. Risk of vertical transmission occurs in a large number of cases in the absence of immunoprophylaxis. About 30% of world’s population has serological evidence of current or past infection with HBV. Detection of carriers is important in control of infections of this magnitude, failure of which may result in serious complications. Aims & Objective: To study of seroprevalence & determinants of HIV and HBsAg among antenatal mothers in tertiary & secondary care hospitals at Bareilly. Material and Methods: The study was conducted at the Department of Pathology & Microbiology, Rohilkhand Medical College and Hospital, Bareilly. All patients attending Antenatal OPD of a Tertiary and secondary care hospitals, over a period of three years were assessed by subjecting them to serological tests for detection of HIV & HBsAg. Data was extensively analyzed and compared. Results: A total of 30,162 patients attended antenatal OPD during the study period, of which 20,699 were tested for HIV and 20,941 were tested for HBsAg. Of these, 12 (0.058%) were positive for HIV and 37 (0.18%) were positive for HBsAg. Conclusion: We studied the dynamics of HIV and Hepatitis B Virus transmission among pregnant women and the factors responsible for its spread to help us take plausible interventions to prevent vertical transmission. The seroprevalence of HIV & HBsAg was low, nonetheless posing a major cause of morbidity and mortality. Prevalence of HIV is found to be low, but it cannot actually be determined due to a very high refusal rate.
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Background & objectives: Developing country like India shows high prevalence of hepatitis C on account of lack of universal precautions while treating patients. This kind of transmission is seen more in cases of Thalesemias on regular blood transfusion, with renal diseases on haemodialysis and co-infection with hepatitis B along with patients admitted in various wards for treatment. Study was conducted with the objective to find out prevalence of HCV infection in patients with hepatitis B, Thalesemias, patients undergoing haemodialysis, patients admitted in hospital for other diseases who are hepatitis B negative, Ante-natal cases and voluntary healthy blood donors. Methods: Blood was collected of 1040 persons from various groups with their consent. All the sera were tested for anti HCV antibody by ELISA and Signal HCV test. Results: Total twelve participants were found positive for HCV infection, majority were belonged to Thalesemic group and rest of the participants belonged to voluntary healthy blood donor group, patients of hepatitis B and patients on haemodialysis. Interpretation & conclusion: those who are at risk of getting Hepatitis C should undergo for HCV testing on regular interval.