Exposición a temperaturas extremas y su efecto en la gestación en un departamento de Colombia / Exposure to extreme temperatures and its effect on pregnancy in a department of Colombia

Introducción: Diversas investigaciones han establecido la relación entre temperatura y duración del embarazo, la exposición a temperaturas altas durante el embarazo plantea interrogantes en especial el papel que esta juega frente a los partos prematuros y partos de bajo peso, es indispensable determinar si las temperaturas altas o bajas tienen un comportamiento protector o de riesgo sobre el feto durante la gestación en regiones tropicales. Objetivo: describir la relación entre la exposición a temperaturas altas y bajas durante el embarazo y su efecto en la edad gestacional y peso al momento del parto en los recién nacidos del departamento del Guaviare-Colombia. Metodología: Estudio tipo observacional, analítico, retrospectivo de corte transversal que busco determinar la relación entre exposición a temperaturas altas y bajas durante el embarazo y su efecto en la edad gestacional y peso al momento del parto en los recién nacidos, el universo estuvo conformado por 10.137 nacidos vivos, de los cuales 9.932 cumplieron los criterios de inclusión. Se determinó Odds Ratio para estimar la asociación entre las variables. Resultados: Dentro de la semana de retraso 3 el estar expuesto a temperaturas máximas percentil 90 es un factor protector para la ganancia ponderal de peso OR < 1, la exposición a temperaturas mínimas percentil 10 se asoció como factor protector para el parto prematuro en la semana de retraso 1 y 2 OR < 1.Conclusión: A pesar del beneficio de las altas y bajas temperaturas durante el embarazo en la ganancia ponderal de peso y disminución del parto prematuro, es recomendable prevenir la exposición a temperaturas extremas durante el periodo de gestación[AU]

Introduction: Various investigations have established the relationship between temperature and duration of pregnancy. Exposure to high temperatures during pregnancy raises questions, especially the role it plays in premature births and low-weight births. It is essential to determine whether high temperatures or low have a protective or risky behavior on the fetus during pregnancy in tropical regions.Objective: to describe the relationship between exposure to high and low temperatures during pregnancy and its effect on gestational age and weight at the time of delivery in newborns in the department of Guaviare-Colombia.Methodology:Observational, analytical, retrospective cross-sectional study that sought to determine the relationship between exposure to high and low temperatures during pregnancy and its effect on gestational age and weight at the time of delivery in newborns. The universe was made up of 10,137 births. alive, of which 9,932 met the inclusion criteria. Odds Ratio was determined to estimate the association between the variables.Results:Within the 3rd week of delay, being exposed to maximum temperatures at the 90th percentile is a protective factor for weight gain OR < 1, exposure to minimum temperatures at the 10th percentile was associated as a protective factor for premature birth in the week. of delay 1 and 2 OR < 1. Conclusion: Despite the benefit of high and low temperatures during pregnancy in weight gain and reduction in premature birth, it is advisable to prevent exposure to extreme temperatures during the gestation period[AU]

Introdução: Várias investigações estabeleceram a relação entre temperatura e duração da gravidez. A exposição a altas temperaturas durante a gravidez levanta questões, especialmente o papel que desempenha nos partos prematuros e nos nascimentos de baixo peso. É essencial determinar se as temperaturas altas ou baixas têm um comportamento protetor ou de risco para o feto durante a gravidez em regiões tropicais. Objetivo:descrever a relação entre a exposição a altas e baixas temperaturas durante a gravidez e seu efeito na idade gestacional e no peso no momento do parto em recém-nascidos no departamento de Guaviare-Colômbia. Metodologia: Estudo observacional, analítico, retrospectivo e transversal que buscou determinar a relação entre a exposição a altas e baixas temperaturas durante a gravidez e seu efeito na idade gestacional e no peso no momento do parto em recém-nascidos. O universo foi composto por 10.137 nascimentos. vivos, dos quais 9.932 preencheram os critérios de inclusão. O Odds Ratio foi determinado para estimar a associação entre as variáveis. Resultados:Na 3ª semana de atraso, a exposição a temperaturas máximas no percentil 90 é fator de proteção para ganho de peso OR < 1, a exposição a temperaturas mínimas no percentil 10 foi associada como fator de proteção para parto prematuro na semana. de atraso 1 e 2 OR < 1.Conclusão:Apesar do benefício das altas e baixas temperaturas durante a gravidez no ganho de peso e redução do parto prematuro, é aconselhável evitar a exposição a temperaturas extremas durante o período de gestação[AU]

Assistência pré-natal às usuárias de substâncias psicoativas: dificuldades elencadas pelos profissionais da saúde / Prenatal care for users of psychoactive substances: difficulties listed by health professionals / Atención prenatal a consumidoras de sustancias psicoactivas: dificultades mencionadas por los profesionales de la salud

Objetivo: conhecer as dificuldades elencadas pelos profissionais de saúde na assistência pré-natal às usuárias de substâncias psicoativas. Método: estudo qualitativo, exploratório-descritivo, realizado nas mídias sociais, com profissionais da área da saúde que realizam atendimento pré-natal. A coleta de dados ocorreu de novembro de 2022 a janeiro de 2023 por meio de questionário eletrônico. Os dados foram analisados por meio da análise temática. Protocolo aprovado pelo Comitê de Ética em Pesquisa. Resultados: os profissionais destacam o déficit de conhecimento para abordar este público em específico. A abordagem superficial e condenatória do uso de substâncias pelas políticas públicas corrobora para que os profissionais se sintam preparados em parte para atender essas gestantes. Considerações finais: a capacitação dos profissionais é necessária para superar práticas condenatórias e retrógradas de cuidado que focam unicamente a abstinência; como também, o investimento na capacitação acerca da rede de atenção à saúde, buscando ampliar sua visibilidade e utilização.

Objective: understanding the difficulties listed by health professionals in prenatal care for users of psychoactive substances. Method: this is a qualitative, exploratory-descriptive study carried out on social media with health professionals who provide prenatal care. Data was collected from November 2022 to January 2023 using an electronic questionnaire. The data was analyzed using thematic analysis. Protocol approved by the Research Ethics Committee. Results: the professionals highlight the lack of knowledge to deal with this specific public. The superficial and condemnatory approach to substance use by public policies contributes to making professionals feel partly prepared to deal with these pregnant women. Final considerations: the training of professionals is necessary to overcome condemnatory and retrograde care practices that focus solely on abstinence; and investment in training about the health care network, seeking to increase its visibility and use.

Objetivo: conocer las dificultades mencionadas por los profesionales de la salud en la atención prenatal de las consumidoras de sustancias psicoactivas. Método: estudio cualitativo, exploratorio-descriptivo, realizado en redes sociales, con profesionales de la salud que brindan atención prenatal. La recolección de datos se llevó a cabo de noviembre de 2022 a enero de 2023 a través de un cuestionario electrónico. Los datos se analizaron mediante análisis temático. El protocolo fue aprobado por el Comité de Ética en Investigación. Resultados: los profesionales destacan que les falta el conocimiento para atender a este público específico. El abordaje superficial y condenatorio del consumo de sustancias por parte de las políticas públicas contribuye a que los profesionales se sientan parcialmente preparados para atender a esas gestantes. Consideraciones finales: es necesario capacitar a los profesionales para superar las prácticas asistenciales condenatorias y retrógradas que se centran únicamente en evitar el consumo; e invertir en capacitación sobre la red de atención de salud, para ampliar su visibilidad y uso.

Prevalência de nascimentos prematuros como desfechos de infecções pela COVID-19 na gestação / Prevalence of Preterm Birth as an Outcome of COVID-19 Infections during Pregnancy / Prevalencia de nacimientos prematuros producto de la infección por COVID-19 durante el embarazo

Objetivo: estimar a prevalência de nascimento prematuro em gestantes infectadas pela Covid-19, comparar índices de prematuridade entre infectadas e não infectadas e elucidar fatores associados à prematuridade. Métodos: coorte retrospectiva, com coleta de dados por inquérito online, de abril a dezembro de 2022, com mulheres que estiveram gestantes durante a pandemia, com acesso à internet, idade superior a 18 anos e que preencheram o primeiro inquérito online. Protocolo de pesquisa aprovado pelo Comitê de Ética. Resultados: primeiro inquérito respondido por 304 gestantes/puérperas, e o segundo por 82 (27%), compondo a amostra final. O índice de prematuridade no primeiro inquérito foi de 7,2% (n=14), já no segundo, 8,5% (n=7). A infecção pela Covid-19 não foi associada à prematuridade. A prematuridade associou-se a baixo peso, à necessidade de internação em centros de terapia intensiva neonatal e internações após o nascimento. Conclusão: a infecção pela Covid-19 não influenciou no aumento de nascimentos prematuros.

Objective: to estimate the prevalence of preterm birth in pregnant women infected with Covid-19, compare prematurity rates between infected and non-infected, and elucidate factors associated with prematurity. Methods: a retrospective cohort study was conducted using online survey data collected from April to December 2022, involving women who were pregnant during the pandemic, had internet access, were over 18 years old, and completed the initial online survey. The research protocol was approved by the Ethics Committee. Results: the initial survey was completed by 304 pregnant/postpartum women, and the follow-up survey by 82 (27%), comprising the final sample. The preterm birth rate in the initial survey was 7.2% (n=14), and in the follow-up survey, it was 8.5% (n=7). Covid-19 infection was not associated with prematurity. Prematurity was associated with low birth weight, the need for neonatal intensive care unit admission, and postnatal hospitalizations. Conclusion: Covid-19 infection did not influence an increase in preterm births.

Objetivo: estimar la prevalencia de partos prematuros en gestantes infectadas por Covid-19, comparar las tasas de prematuridad entre gestantes infectadas y no infectadas y determinar los factores asociados a la prematuridad. Métodos: estudio de cohorte retrospectivo, con recolección de datos mediante encuesta online, de abril a diciembre de 2022, con mujeres que estuvieron embarazadas durante la pandemia, con acceso a internet, mayores de 18 años y que completaron la primera encuesta online. El protocolo de investigación fue aprobado por el Comité de Ética. Resultados: la primera encuesta fue respondida por 304 gestantes/puérperas, y la segunda por 82 (27%), que conformaron la muestra final. La tasa de prematuridad en la primera encuesta fue del 7,2% (n=14), en la segunda, del 8,5% (n=7). La infección por Covid-19 no se asoció con la prematuridad. La prematuridad se asoció con bajo peso, necesidad de internación en centros de cuidados intensivos neonatales e internaciones después del nacimiento. Conclusión: La infección por Covid-19 no influyó en el aumento de nacimientos prematuros.

Desfechos obstétricos adversos durante a COVID-19: uma série de casos retrospectiva / Adverse obstetric outcomes during COVID-19: a retrospective case series / Resultados obstétricos adversos durante el COVID-19: serie de casos retrospectiva

Objetivo: analisar as características e os desfechos obstétricos adversos em gestantes/puérperas infectadas pelo SARS-CoV-2 em serviço de referência. Método: série de casos retrospectiva entre gestantes com Covid-19 em um hospital universitário em Minas Gerais, Brasil, atendidas no serviço de 2020 a 2021, coletados em abril de 2022, empregando-se estatística descritiva para análise dos dados através do Statistical Package for the Social Science. Resultados: incluídas 26 gestantes, em sua maioria brancas, que tiveram como principais desfechos obstétricos adversos a internação em UTI (43,5%), parto prematuro (34,6%), dado reestratificado de semanas para dias para investigar o encurtamento da gestação, onde constatou-se média de 38,6 dias potenciais de gravidez perdidos dos 280 dias ideais, e ainda 15,4% evoluíram para óbito materno. Conclusão: o estudo proporcionou evidenciar a necessidade de vigilância e atenção às gestantes com foco nos principais desfechos adversos, podendo-se intervir em tempo oportuno para diminuir adversidades.

Objective: to analyze the characteristics and adverse obstetric outcomes in pregnant/puerperal women infected by SARS-CoV-2 at a reference service. Method: a retrospective case series conducted among pregnant women with Covid-19 in a university hospital from Minas Gerais, Brazil, treated at the service from 2020 to 2021. The cases were collected in April 2022 employing descriptive statistics for data analysis in the Statistical Package for the Social Science. Results: a total of 26 pregnant women were included, mostly white-skinned, whose main adverse obstetric outcomes were admission to the ICU (43.5%), premature birth (34.6%) and data restratified from weeks to days to investigate shortening of pregnancy, where a mean of 38.6 potential days of pregnancy were lost out of the ideal 280 days, and 15.4% resulted in maternal death. Conclusion: the study provided evidence of the need for surveillance and care for pregnant women with a focus on the main adverse outcomes, enabling timely intervention to reduce adversities.

Objetivo: analizar las características y resultados obstétricos adversos en gestantes/puérperas infectadas por SARS-CoV-2 en un servicio de referencia. Método: serie de casos retrospectiva entre gestantes con Covid-19 en un hospital universitario de Minas Gerais, Brasil, atendidas en el servicio de 2020 a 2021. Los datos se recolectaron en abril de 2022, se utilizó estadística descriptiva para analizar los datos mediante el Statistical Package for the Social Science. Resultados: se incluyeron 26 gestantes, la mayoría de raza blanca, cuyos principales resultados obstétricos adversos fueron ingreso a UCI (43,5%), parto prematuro (34,6%), dato reestratificado de semanas a días para investigar el acortamiento de la gestación, que arrojó como resultado un promedio de 38,6. Se comprobó que se perdieron en promedio 38,6 días potenciales de embarazo de los 280 días ideales, y muerte materna (15,4%). Conclusión: la evidencia que proporcionó el estudio indica que es necesario vigilar y atender a las gestantes enfocándose en los principales resultados adversos, lo que permite intervenir de forma oportuna para reducir adversidades.

Representações sociais sobre o planejamento reprodutivo entre mulheres em gravidez não planejada / Social representations of reproductive planning among women with unplanned pregnancies / Representaciones sociales sobre la planificación reproductiva de las mujeres con embarazo no planificado

Objetivo: conhecer as representações sociais sobre o planejamento reprodutivo entre mulheres em gravidez não planejada na Estratégia Saúde da Família. Método: estudo qualitativo, orientado pela Teoria das Representações Sociais, realizado com 15 gestantes, entre abril e maio de 2019. Utilizou-se a entrevista semiestruturada. Os dados foram organizados por meio do Discurso do Sujeito Coletivo, com auxílio do software DSCsoft©. Protocolo de pesquisa aprovado pelo Comitê de Ética em Pesquisa. Resultados: as representações sociais das mulheres em gravidez não planejada evidenciadas pelo Discurso do Sujeito Coletivo foram representadas por oito ideias centrais, a saber: "eu não me preveni, nem ele", "nós nos prevenimos", "eu comprava", "pegava no posto", "construir uma família", "ter esse acesso", "estou por fora" e "eu sei que é disponível". Conclusão: as representações sociais nos discursos das mulheres em gravidez não planejada estavam pautadas no desconhecimento acerca do planejamento reprodutivo, dos anticoncepcionais disponíveis e seu uso correto.

Objective: to understand the social representations of reproductive planning among women with unplanned pregnancies in the Family Health Strategy. Method: qualitative study, guided by the Theory of Social Representations, carried out with 15 pregnant women between April and May 2019. Semi-structured interviews were used. The data was organized using the Discourse of the Collective Subject, with the aid of DSCsoft© software. Research protocol approved by the Research Ethics Committee. Results: the social representations of women with unplanned pregnancies as evidenced by the Collective Subject Discourse were represented by eight central ideas, namely: "I didn't prevent myself, nor did he", "we prevented ourselves", "I would buy it", "I would get it at the health center", "build a family", "have this access", "I am not aware" and "I know it is available". Conclusion: the social representations in the women's speeches about unplanned pregnancies were based on a lack of knowledge about reproductive planning, the contraceptives available and their correct use.

Objetivo: conocer las representaciones sociales sobre la planificación reproductiva de las mujeres con embarazo no planificado en la Estrategia Salud de la Familia. Método: estudio cualitativo, basado en la Teoría de las Representaciones Sociales, realizado con 15 mujeres embarazadas, entre abril y mayo de 2019. Se utilizaron entrevistas semiestructuradas. Los datos fueron organizados mediante el Discurso del Sujeto Colectivo, con ayuda del software DSCsoft©. El protocolo de investigación fue aprobado por el Comité de Ética en Investigación. Resultados: las representaciones sociales de las mujeres con embarazo no planificado reveladas por el Discurso del Sujeto Colectivo fueron representadas por ocho ideas centrales, a saber: "yo no me cuidé y él tampoco", "nos cuidamos", "yo los compraba", "los buscaba en el centro de salud", "construir una familia", "tener acceso", "no participo" y "sé que está disponible". Conclusión: las representaciones sociales en los discursos de las mujeres con embarazo no planificado se basaron en la falta de conocimiento sobre la planificación reproductiva, en los anticonceptivos disponibles y su uso correcto.

Percepção do vínculo parental e variáveis associadas ao apego materno-fetal na gestação de alto risco

Este estudo investigou os efeitos da percepção do vínculo parental, variáveis sociodemográficas e gestacionais na intensidade do apego materno-fetal (AMF) no contexto de gestação de alto risco. Trata-se de um estudo quantitativo e transversal com 119 participantes. Foi aplicado um questionário sociodemográfico, a Escala de Apego Materno-Fetal - Versão Breve e o Parental Bonding Instrument. Os resultados da análise de regressão linear múltipla foram estatisticamente significativos (p < 0,05). O modelo final explicou 28,7 % da variância do AMF e foi composto pelas variáveis de superproteção paterna, cuidado paterno, idade da mulher, idade gestacional e suporte do pai do bebê. Reitera-se que a intensidade do AMF é multideterminada, envolvendo aspectos da história de vida, sociais e situacionais. A percepção da mulher acerca do vínculo paterno durante sua infância e adolescência e o apoio do pai do bebê no período gestacional destacam-se como fatores influentes para a vinculação materno-fetal, indicando a importância do envolvimento paterno ao longo do ciclo vital. São pontuadas implicações para a prática profissional, bem como limitações e recomendações de estudos futuros.

Este estudio investigó los efectos de la percepción del vínculo parental, las variables sociodemográficas y gestacionales en la intensidad del apego materno-fetal (AMF) en el contexto de embarazos de alto riesgo. Se trata de un estudio cuantitativo y transversal con 119 participantes. Se aplicó un cuestionario sociodemográfico, la Escala de Apego Materno-Fetal-Versión Breve y el Instrumento de Vínculo Parental. Los resultados del análisis de regresión lineal múltiple fueron estadísticamente significativos (p < .05). El modelo final explicó el 28.7 % de la varianza del AMF y estuvo compuesto por las variables de sobreprotección paterna, cuidado paterno, edad de la mujer, edad gestacional y apoyo del padre del bebé. Se reitera que la intensidad del AMF es multideterminada, lo que involucra aspectos de la historia de vida, sociales y situacionales. La percepción de la mujer sobre el vínculo paternal durante su infancia y adolescencia, así como el apoyo del padre del bebé durante el período gestacional, destacan como factores influyentes en el apego materno-fetal, lo que indica la importancia de la participación paterna a lo largo del ciclo vital. Se puntualizan implicaciones para la práctica profesional, así como limitaciones y recomendaciones para estudios futuros.

This study investigated the effects of perceived parental bonding, sociodemographic and gestational variables on the intensity of maternal-fetal attachment (MFA) in the context of high-risk pregnancies. This is a quantitative, cross-sectional study involving 119 participants. A sociodemographic questionnaire, the Maternal-Fetal Attachment Scale-Brief Version, and the Parental Bonding Instrument were administered. The results of the multiple linear regression analysis were statistically significant (p < .05). The final model explained 28.7 % of the variance in MFA and included the variables of paternal overprotection, paternal care, maternal age, gestational age, and the support from the baby's father. We emphasize that MFA intensity is multidetermined, involving aspects of life history, social, and situational factors. The woman's perception of paternal bonding during her childhood and adolescence, as well as the support from the baby's father during the gestational period, are highlighted as influential factors for maternal-fetal attachment, indicating the importance of paternal involvement throughout the life cycle. Implications for professional practice, as well as limitations and recommendations for future studies are discussed.

Histerectomía con embrión en útero en paciente con tromboembolismo pulmonar: reporte de un caso / Hysterectomy with embryo in utero in a patient with pulmonary thromboembolism: report of a case

Resumen Antecedentes: la histerectomía en bloque es un procedimiento controvertido y con poca literatura actualizada. Se define como la extirpación del útero grávido con su contenido gestacional in situ, las indicaciones para la realización de esta cirugía son los procesos neoplásicos (como la causa más frecuente( procesos sépticos, enfermedad trofoblástica y hemorragia secundaria a inserción placentaria anómala. Caso clínico: paciente de 45 años con embarazo de 8 semanas y 5 días, según la fecha de última regla, con miomatosis uterina gigante asociada con tromboembolismo pulmonar, quien decide la interrupción voluntaria del embarazo y realizarse la histerectomía en bloque. Conclusiones: la histerectomía en bloque es una cirugía poco realizada en la actualidad, sin embargo, este abordaje quirúrgico es una opción segura y efectiva para la interrupción voluntaria del embarazo, y no se debe descartar entre las alternativas de tratamiento quirúrgico, siempre individualizando cada paciente.

ABSTRACT BACKGROUND: En bloc hysterectomy is defined as the removal of the pregnant uterus with its gestational content in situ. The indications for performing this en bloc surgery are neoplastic processes, as the most frequent cause; septic processes, trophoblastic disease and hemorrhage secondary to abnormal placental insertion, however, it is a controversial procedure, and with little updated literature. CLINICAL CASE: 45-year-old patient with a pregnancy of 8 weeks and 5 days, with giant uterine myomatosis associated with pulmonary thromboembolism who decided to voluntarily terminate the pregnancy, and it was decided to perform en bloc hysterectomy. CONCLUSIONS: En bloc hysterectomy is a surgery rarely performed at present, however, this surgical approach is a safe and effective option for the voluntary termination of pregnancy, and it should not be ruled out among the surgical treatment alternatives, always individualizing each patient.

Food Choices Of Vegetarian And Non-Vegetarian Mothers During Pregnancy - An Investigative Study In Madhya Pradesh

Nutrition is a science which focuses on the overall nourishment of the body and impacts health. A well-balanced diet is very important for pregnancy, which is rich in nutrients and good for normal birth weight and fetal health. Nutritional deficiency during pregnancy is very common and it results in extreme neonatal and pregnancy outcomes. Hence, this study was conducted with an aim to study the food choices of vegetarian and non-vegetarian mothers during pregnancy in Madhya Pradesh. This study explores dietary habits of various pregnant women and suggest vital nutrients for healthy pregnancy and offspring. A self-structured questionnaire was used to conduct an online survey on pregnant mothers to determine their food habits and dietary patterns. The questionnaire included various closed-ended questions based on 5-point Likert scale. The survey responses have been interpreted and analyzed using SPSS software and Excel spreadsheet. It is observed that pregnant women consumed average Indian food in their diet like lentils, rice, beans, salt, oils, roots, etc. during the study period. None of them consumed carbonated beverages or alcohol. Milk was the only source of vitamin B12 which they consumed every day. They also consumed non-vegetarian food items like eggs, meat, fish, chicken, etc. occasionally. Their dietary intake was highly affected by religious and cultural factors, lack of food, and financial constraints

Comparative study of oral iron and intravenous iron sucrose for the treatment of iron-deficiency anemia in pregnancy

Background: The most prevalent nutritional disorder during pregnancy is iron-deficiency anemia (IDA). Management of anemia can be done by either oral, parenteral, or blood transfusion, depending on the severity. Oral iron (OI) replacements can be taken as they are safe, effective, and lower cost. However, one disadvantage is poor tolerability, as they cause gastrointestinal complications. Iron sucrose complex is a relatively new drug used intravenously (IV) for the correction of IDA. Aims and Objectives: This research compared the safety and effectiveness of OI versus iron sucrose in the treatment of IDA during pregnancy. Materials and Methods: A prospective observational study was performed involving 60 patients who attended the antenatal clinic from June 2019 to November 2019 at Bidar Institute of Medical Science between 24 and 36 weeks of gestation and hemoglobin levels between 7 and 10 g/dL. In the IV group, 200 mg of iron sucrose was administered in 100 mL of 0.9% normal saline over 15–20 min on alternate days. In the oral group, 200 mg of ferrous ascorbate per day for 4 weeks was prescribed. All patients were monitored for laboratory responses and adverse effects. An unpaired “t” test was used for statistical analysis. P < 0.05 was considered significance. Results: There was an increase in hemoglobin in both groups, but there was a significant increase in hemoglobin in the IV group. The other laboratory parameters also showed a significant increase in the IV group than in the oral group. The IV group had no major side effects. Conclusion: The IV iron sucrose formulation was more effective than the oral formulation for anemia correction in pregnancy.

Thyroid Dysfunction and Hypertensive Disorders during Pregnancy: A Prospective Observational Study

Background: Hypertensive disorders affect approximately 10% of pregnancies, significantly impacting maternal and fetal health, particularly in low- and middle-income countries. Thyroid dysfunction during pregnancy is an underexplored factor that can exacerbate hypertensive conditions, contributing to poor outcomes. This study investigates the prevalence of thyroid dysfunction in pregnant women with hypertension and its impact on maternal and perinatal outcomes. Methods: A prospective observational study was conducted at NSCB Medical College, including 378 hypertensive pregnant women. Patients were categorized into euthyroid and thyroid dysfunction groups based on thyroid function tests. Data were analyzed using IBM SPSS 20 with p<0.05 considered significant. Results: In this study, 25.93% of hypertensive pregnancies had thyroid dysfunction, with 21.69% subclinical hypothyroidism and 3.17% overt hypothyroidism. Thyroid dysfunction was associated with more severe hypertension (p=0.009) and occurred more frequently in earlier gestational ages. The dysfunction group had significantly higher ICU admissions (64.6%) and maternal deaths (55.6%, p<0.05). Additionally, babies in the dysfunction group had worse perinatal outcomes, with more low birth weight and NICU admissions (57.1%). Conclusion: The study has concluded that thyroid dysfunction, particularly subclinical hypothyroidism, is prevalent among pregnant women with hypertensive disorders and is significantly associated with adverse maternal and perinatal outcomes.

Ectopic Pregnancy Presentation and Management in Tertiary Care Hospital: A Retrospective Study

Background: An ectopic pregnancy is characterized by the implantation of the fertilized ovum occurring outside the confines of the uterine cavity. This form of obstetric emergency is the most severe during the first trimester of pregnancy. Methods: A retrospective analysis was executed at our tertiary medical institution from January 2023 to January 2024. This study collected data on all ectopic patients admitted to the hospital data were collected for this study. Results: Thirty-one cases were recorded, with an incidence of 4.2 per 1000 deliveries. A substantial proportion of cases involved individuals aged between 20 and 30 years, with notable risk factors including a history of cesarean section and sterilization procedures. The predominant symptom was found to be abdominal pain (90.32%), and the classic triad was present in 41.93% of cases. Most study subjects exhibited tenderness in the adnexal and cervical areas, while 19.35% presented with acute shock. The most frequently encountered type of ectopic pregnancy was the right-sided ampullary tubal ectopic, with 67.7% of cases in a ruptured state. Among 64.5% of cases in the study population, salpingectomy was the mainstay treatment. Non-surgical management was successful in 6.4% of cases, and no fatalities or admissions to the intensive care unit were reported. Conclusion: Many of the cases observed in this investigation were found to be in a ruptured state, thereby precluding the possibility of conservative management approaches. With an increase in the rate of caesarean section, a known risk factor, the ectopic pregnancy incidence may unintentionally rise.

Assessment of Maternal Predictors of Intrauterine Growth Retardation-A Case-Control Study

Background: Intrauterine growth restriction (IUGR) is a common disorder in which the birth weight is less than 10th percentile. This ongoing challenging fetal adverse condition leads to postnatal morbidities and fetal mortality. Methods: Forty postnatal women with newborns weighing less than the 10th percentile for gestational age (GA) were recruited as cases in this case-control research, and forty postnatal women whose neonatal weight was within the GA were recruited as controls. A thorough history of medical, obstetric, and maternal Sociodemographic factors was recorded and compared. Results: Most mothers (46.3%) were 21-30 with a mean±SD of 24.83±4.09 years. Most of them (78.8%) belonged to the lower middle class; there was significantly poor weight gain during pregnancy among cases (80%) as compared to among controls (60%). Anemia, hypertensive disorders of pregnancy, previous history of abortion, or IUGR were significantly associated with fetal growth retardation (p<0.05). Conclusion: Low socioeconomic level, low gestational weight gain, anemia, hypertensive disorders of pregnancy, and previous history of abortion are potent risk factors for IUGR. Therefore, proper screening of these risk factors is essential to improve neonatal health.

Investigating Vitamin D-3 Deficiency among Pregnant Women at a Local Tertiary Hospital

Background: Vitamin D deficiency is a pervasive issue globally, particularly among pregnant women, and is linked to various adverse health outcomes. This study investigates the prevalence and characteristics of Vitamin D-3 deficiency among pregnant women in a tertiary care setting in Dhaka, Bangladesh, and explores the association with demographic and clinical factors. Material & Methods: This retrospective observational study was conducted at Uttara Adhunik Medical College and Hospital, Dhaka, over 12 months from January to December 2020. The study included 60 pregnant women suspected of Vitamin D deficiency based on clinical symptoms. Data on age, gravidity, parity, comorbidities, and serum Vitamin D levels were collected and analyzed using descriptive statistics and bivariate correlation analysis. Results: The majority of participants were aged between 26 and 35 years (45.00%), with a high prevalence of Vitamin D deficiency (86.67%). The common comorbidities observed were hypothyroidism (20.00%), preeclampsia (15.00%), and diabetes (13.33%). Bivariate correlation analysis showed no significant associations between Vitamin D levels and demographic factors such as age, parity, and gravidity. Conclusions: Vitamin D deficiency is highly prevalent among pregnant women at the studied hospital in Dhaka, Bangladesh, and is associated with significant comorbidities. These findings underscore the need for targeted public health interventions to address Vitamin D deficiency in this population, including supplementation and dietary education, to improve pregnancy outcomes.

A-study-on-placental-and-umbilical-cord-morphology-in-mothers-with-preeclampsia-and-its-correlation-with-foetal-outcome-at-birth-in-a-tertiary-care-hospital

Introduction: The placenta is a distinctive characteristic of higher mammals which is attached to the uterus and is connected to the foetus through the umbilical cord. The placenta is an organ of vital importance for the continuation of a pregnancy and foetal nutrition. In humans, after the birth of the infant, placenta is often disposed soon after parturition without adequate examination. It has been seen that many disorders of the pregnancy are associated with gross anatomical, physiological, and pathological changes in the placenta. Hypertension is one of the common complications met with in pregnancy and contributes significantly to maternal and perinatal morbidity and mortality. Of the few studies that have explored the subject, it has been seen that morphologically, the placentae of hypertensive disorders of pregnancy are smaller, with lesser weight, diameter, and thickness as compared to placentae of normal women. Even fewer studies have been done which have correlated these altered placental findings with foetal and neonatal outcomes. Objective: Here we did a study on placental and umbilical cord morphology in mothers with pre-eclampsia and its correlation with foetal outcome at birth in a tertiary care hospital. The study populationMaterial And Methods: consisted of women of gestational age >34 weeks with diagnosed pregnancy induced hypertension or pre-eclampsia who were admitted to the labour room of the study institution for delivery. Mothers with hypertensiveConclusion: disorders of pregnancy tend to have a high incidence of abnormal placental and umbilical cord morphology at delivery such as lower placental weight, diameter, thickness, lower umbilical cord weight, diameter, and length.

Evaluation of clinical presentation and maternal outcome of ectopic pregnancy in a tertiary care hospital: An observational cross-sectional study

Background: The implantation and growth of the blastocyst outside of the endometrial lining of the uterine cavity are known as ectopic pregnancy. In our nation, ectopic pregnancy continues to be a major cause of maternal mortality in the first trimester, accounting for about 9% of pregnancy-related deaths. It can have very bad and deadly consequences, including as severe bleeding and maternal death. Therefore, this study is critical to the prevention of problems and enhancement of maternal outcomes by early and correct diagnosis through clinical presentation and investigation. Aim and Objectives: The study aimed to evaluate the clinical presentations and maternal outcomes of ectopic pregnancy cases attending a tertiary care hospital. Materials and Methods: This observational cross-sectional study was conducted in a tertiary care hospital. The 12-months study ran from January 1, 2023, to December 31, 2023, in the dept. of Obstetrics and Gynaecology of Midnapore Medical College and Hospital in West Bengal, India. This study comprised 100 diagnosed cases of ectopic pregnancy. To evaluate the age, socioeconomic status, gravida, gestational period, risk factors, clinical presentation, and maternal outcome of an ectopic pregnancy, data on these patients were recorded and statistical analysis was performed. Results: Of the 100 diagnosed cases of ectopic pregnancy, 72% were aged 21–30, and all were from rural areas. Most patients (61%) had a poor socioeconomic status. The obstetric status varied, with G3 being the most common (33%). A majority (62%) presented between 6 and 8 weeks of amenorrhea. Risk factors included pelvic inflammatory disease (21%), previous surgery (21%), and abortions (16%). Common symptoms were amenorrhea (98%), abdominal pain (85%), and vaginal bleeding (66%). Physical examinations revealed forniceal fullness (72%) and tenderness (65%). Positive pregnancy tests were universal, and 82% had USG findings suggesting ectopic pregnancy. The right fallopian tube was the most common site (63%), with 86% presenting with ruptured ectopic pregnancies. Most (94%) required emergency surgery, predominantly salpingectomy (85%). Blood transfusions were needed in 60% of cases, and 20% required ICU admission. Post-operative complications occurred in 14% of patients, with no mortality reported during the study period. Conclusion: Community education is crucial to urge women to attend health facilities as soon as they develop symptoms, as tubal rupture is a common occurrence in our system. For women who experience ectopic pregnancies, this strategy can greatly lower the risk of complications and improve outcomes. Overall, our study underscores the importance of early recognition, accurate diagnosis, and prompt intervention to optimize maternal outcomes in the management of ectopic pregnancy. By outlining the risk factors as well as the clinical course of ectopic pregnancy in our hospital setting, our findings aim to improve clinical practice and direct future research efforts in this field.

Obstetrical And Neonatal Outcomes Among Elderly Primigravidae At A Tertiary Care Hospital

Background: In the past decade there has been a gradual shift towards delayed childbearing. The outcomes of these pregnancies often are more complicated, in terms of both maternal and neonatal aspects. This study aimed at ?nding signi?cant associations between the age of these mothers and the obstetrical and neonatal outcomes. This prospective longitudinal study conducted over 19 months was based on patientMethods: interview, semi-structured questionnaire and written medical, labor room records from a tertiary care centre with around 5000 deliveries annually. Patients were recruited at ?rst out-patient/in-patient visit, informed consent obtained and followed up in subsequent visits until delivery. The impact of advanced maternal age on maternal medical, obstetrical and neonatal outcomes were assessed using statistical analysis in SPSS software. Results: During the period of 19 months, there were a total of 202 patients over 35 years with the mean (SD) being 37 years (3.2). Cervical cerclage was more common among elderly primigravidae (p value 0.000). Gestational hypertension was signi?cantly associated(p value 0.0027). Among medical disorders, elderly primigravidae had a signi?cantly higher association of age and UTI (p value 0.003) as well as URTI (p value 0.027). There was a signi?cant association of anemia as well (p value 0.032). Antenatal obstetric complications like IUFD (p value 0.007) and Prematurity (p value 0.043) were signi?cant. Induction of labor (p value 0.028) was more likely than spontaneous onset of labor. Neonatal complications that were signi?cant were prematurity (p value 0.045) and congenital/chromosomal abnormalities (p value 0.027). We found thatConclusion: pregnancy complications were more common among elderly primigravida. The neonatal outcomes also were complicated on account of age.

Seroprevalencia de toxoplasmosis en gestantes y recién nacidos: estudio de serologías IgG e IgM en un periodo de 4 años / Seroprevalence of toxoplasmosis in pregnant women and newborns: study of IgG and IgM serologies over a 4-year period

RESUMEN Introducción: la toxoplasmosis es una parasitosis que causa infecciones graves en inmunocomprometidos y recién nacidos. El estado serológico de la madre influye en la posibilidad de transmisión al feto si la infección es contraída durante el embarazo. Es necesario conocer la prevalencia de esta afección en gestantes como primer paso para realizar acciones tendientes a conocer la carga real de la enfermedad y disminuir esta patología. Objetivo: Determinar la seroprevalencia IgG e IgM de toxoplasmosis de gestantes y recién nacidos periodo de enero 2017 a enero 2021. Metodología: se incluyeron las gestantes en su periodo periparto inmediato y recién nacidos hasta la semana de vida extrauterina. Se midió IgG e IgM en sangre periférica por método ECLIA. El tamaño muestral calculado fue de 800 por grupo, para el periodo de estudio. Muestreo no probabilístico de casos consecutivos. Resultados: fueron incluidos 2524 recién nacidos y 2029 gestantes. Las prevalencias de IgG fueron de 97,5 % y 97 % para gestantes y recién nacidos respectivamente, y la IgM: 4,7% y 1,9 % para mujeres y recién nacidos respectivamente. Las tendencias de las seroprevalencias se mantuvieron constantes para IgG para ambos grupos, mientras que la IgM presentó una leve tendencia al aumento. Conclusiones: la seroprevalencia de IgG fue cercana al 100 % en ambas poblaciones, probablemente debido a la transferencia transplacentaria de IgG, sin embargo, se nota un porcentaje pequeño de IgM, probable marcador de infección aguda.

ABSTRACT Introduction: toxoplasmosis is a parasitosis that causes serious infections in immunocompromised patients and newborns. The serological status of the mother influences the possibility of transmission to the fetus if the infection is contracted during pregnancy. It is necessary to know the prevalence of this condition in pregnant women as a first step to carry out actions aimed at knowing the real burden of the disease and reducing this pathology. Objective: determine the IgG and IgM seroprevalence of toxoplasmosis in pregnant women and newborns from January 2017 to January 2021. Methodology: pregnant women in their immediate peripartum period and newborns up to one week of extrauterine life were included. IgG and IgM were measured in peripheral blood by the ECLIA method. The calculated sample size was 800 per group, for the study period. Results: 2524 newborns and 2029 pregnant women were included. The prevalence of IgG was 97.5 % and 97 % for pregnant women and newborns, respectively, and IgM: 4.7 % and 1.9% for women and newborns, respectively. The seroprevalence trends remained constant for IgG for both groups, while IgM showed a slight increasing trend. Conclusions: IgG seroprevalence was close to 100% in both populations, probably due to the transplacental transfer of IgG, however, a small percentage of IgM was noted, a probable marker of acute infection.

Guía para el tratamiento de cólico nefrítico en paciente embarazada / Guidelines for the treatment of nephritic colic in pregnant patients / Diretrizes para o tratamento de cólica nefrítica em mulheres grávidas

Introducción: el cólico nefrítico es una de las causas más frecuentes de consulta en puerta de emergencia. Cuando se presenta en una paciente embarazada, genera un desafío diagnóstico y terapéutico que requiere un abordaje multidisciplinario. Materiales y métodos: se realizó una búsqueda bibliográfica en la base de datos MedLine/PubMed considerando revisiones sistemáticas de literatura, reportes de casos clínicos, estudios observacionales retrospectivos publicados en los últimos 10 años, con el objetivo de obtener sustento informativo para crear un algoritmo diagnóstico y terapéutico que plantee el manejo del cólico nefrítico en la embarazada, dirigido a médicos emergencistas, urólogos y ginecólogos. Resultados: se obtuvieron en total 39 artículos, que fueron analizados, trabajando finalmente en base a 17 textos, que son los citados. Discusión: el diagnóstico se basa en la historia clínica, examen físico, pruebas de laboratorio e imagen. Tratamiento de inicio conservador, que incluye hidratación, analgésicos y antieméticos, reservando la utilización de antibióticos para cuadros infecciosos. De no funcionar éste, se optará por tratamiento intervencionista. Conclusiones: la embarazada con cólico nefrítico se estudia en base a paraclínica humoral y de imagen (ecografía, resonancia nuclear magnética y tomografía axial computada de baja dosis). El tratamiento es principalmente conservador, ante la falla del mismo o ante cuadros infecciosos es quirúrgico.

Introduction: renal colic is one of the most frequent causes of emergency room visits. When it occurs in a pregnant patient, it generates a diagnostic and therapeutic challenge that requires a multidisciplinary approach. Materials and methods: a bibliographic search was carried out in the MedLine/PubMed database considering systematic literature reviews, clinical case reports, retrospective observational studies published in the last 10 years with the aim of obtaining information to create a diagnostic and therapeutic algorithm for the management of nephritic colic in pregnant women, aimed at emergency physicians, urologists and gynecologists. Results: a total of 39 articles were obtained and analyzed, finally working on the basis of 17 texts, which are those cited. Discussion: diagnosis is based on clinical history, physical examination, laboratory and imaging tests. Conservative initial treatment, including hydration, analgesics and antiemetics, reserving the use of antibiotics for infectious conditions. If this does not work, interventional treatment will be chosen. Conclusions: pregnant women with renal colic are studied on the basis of humoral and imaging (ultrasound, magnetic resonance imaging and low dose computed axial tomography). The treatment is mainly conservative; in case of failure or infectious conditions, surgery is performed.

Introdução: a cólica renal é uma das causas mais frequentes de consulta no departamento de emergência. Quando ocorre em uma paciente grávida, gera um desafio diagnóstico e terapêutico que exige uma abordagem multidisciplinar. Materiais e métodos: foi realizada uma pesquisa bibliográfica no banco de dados MedLine/PubMed, considerando revisões sistemáticas da literatura, relatos de casos clínicos, estudos observacionais retrospectivos publicados nos últimos 10 anos, com o objetivo de obter informações para a criação de um algoritmo diagnóstico e terapêutico para o manejo da cólica nefrética em gestantes, destinado a médicos de emergência, urologistas e ginecologistas. Resultados: um total de 39 artigos foi obtido e analisado, sendo que, por fim, trabalhamos com base em 17 textos, que são os citados. Discussão: o diagnóstico é baseado na história clínica, exame físico, exames laboratoriais e de imagem. O tratamento inicial é conservador, incluindo hidratação, analgésicos e antieméticos, reservando o uso de antibióticos para quadros infecciosos. Se isso não funcionar, o tratamento intervencionista será escolhido. Conclusões: as gestantes com cólica renal são estudadas com base em exames humorais e de imagem (ultrassom, ressonância magnética e tomografia axial computadorizada de baixa dose). O tratamento é principalmente conservador, com cirurgia em caso de falha ou condições infecciosas.

Association of birth and periodontal disease in Bolivia, Chile and Colombia / Asociación de parto prematuro y enfermedad periodontal en Bolivia, Chile y Colombia

Introduction. Preterm birth is a major medical, social, and economic problem that causes a large proportion of neonatal mortality and morbidity, has a high impact on the healthcare system, and affects family quality of life. The weight of newborns with mothers with periodontal disease is significantly lower compared to mothers not affected by this oral disease. This adverse outcome is considered a global public health problem based on epidemiological data. Objective. To determine the association between the prevalence of preterm births and periodontal disease in Bolivia, Chile, and Colombia from 2000 to 2020. Materials and methods. This ecological study considered the population of women in Bolivia, Chile, and Colombia, according to the prevalence of preterm births and periodontal disease discriminated by age. The study covered the period between 2000 and 2020. The search strategy within the Institute for Health Metrics and Evaluation investigative tool included prevalence, age groups, causes of preterm births and periodontal disease, context and locations, women, and rates. Statistical analysis included a simple linear regression between preterm births and periodontal disease for each age group within each country. Results. Preterm birth rates were higher in the 15-19 years age group (Bolivia: 697,563; Chile: 844,864; Colombia: 804,126). The periodontal disease prevalence increased with age, as we observed in the 45-49 years group (Bolivia: 22,077,854; Chile: 34,297,901, Colombia: 32,032.830). According to age groups, the linear regression was statistically significant (p < 0.001) in all age groups for the Bolivian population over 30 years for the Colombian, and only in the 15-19 years group for the Chilean women. Conclusion. An association was found between preterm births and periodontal disease in all age groups in Bolivia, only in the group of 15 to 19 years in Chile, and 30 years and up in Colombia over the 20-year period.

Introducción. El parto prematuro es un problema médico, social y económico importante, causa gran mortalidad y morbilidad neonatal, tiene un impacto importante en el sistema de salud y afecta la calidad de vida de las familias. El peso de los recién nacidos de madres con enfermedad periodontal es significativamente menor en comparación con los de madres no afectadas por esta enfermedad bucal. Este resultado adverso se considera un problema de salud pública global según los datos epidemiológicos. Objetivo. Determinar la asociación entre la prevalencia de parto prematuro y la enfermedad periodontal en Bolivia, Chile y Colombia entre el 2000 y el 2020. Materiales y métodos. Este estudio ecológico consideró las poblaciones de mujeres de Bolivia, Chile y Colombia, y la prevalencia de partos prematuros y enfermedad periodontal, discriminadas por grupos de edad. El estudio abarcó el período entre el 2000 y el 2020. La estrategia de búsqueda con la herramienta de investigación del Institute for Health Metrics and Evaluation incluyó prevalencia, grupos de edad, años entre 2000 y 2020, causas de parto prematuro y enfermedad periodontal, contexto y ubicaciones, mujeres y tasas. El análisis estadístico incluyó una regresión lineal simple entre parto prematuro y enfermedad periodontal para cada grupo de edad dentro de cada país. Resultados. Las tasas de partos prematuros fueron mayores en el grupo de 15 a 19 años (Bolivia: 697.563, Chile: 844.864, Colombia: 804.126). La prevalencia de la enfermedad periodontal aumentó con la edad, particularmente en el grupo de 45 a 49 años (Bolivia: 22'077.854, Chile: 34'297.901, Colombia: 32'032,830). Según los grupos de edad, la regresión lineal fue estadísticamente significativa (p < 0,001) para todos los grupos evaluados de la población boliviana, en los grupos mayores de 30 años para las colombianas y solo en el grupo de 15 a 19 años para las mujeres chilenas. Conclusión. Se encontró asociación entre el parto prematuro y la enfermedad periodontal en todos los grupos de edad en Bolivia, solo en el grupo de 15 a 19 años en Chile, y de 30 años y más en Colombia en el período evaluado de 20 años.

Congenital Toxoplasmosis: Current Perspectives On Diagnosis And Therapeutic Approaches

Congenital toxoplasmosis, caused by Toxoplasma gondii, has a global incidence of approximately 190,000 cases annually. Maternal infection prevalence during pregnancy ranges from 1% to 40%, with European seroprevalence varying between 10% and 60%. Early infections often result in severe fetal outcomes, such as hydrocephalus, intracranial calcications, and chorioretinitis. Pathogenesis involves the transmission of tachyzoites, the rapidly dividing form of T. gondii, across the placenta, leading to infection of fetal organs. Clinical manifestations are diverse, including neurological and ocular involvement, as well as systemic symptoms like hepatosplenomegaly and jaundice. Diagnosis involves serological tests, PCR, and imaging studies. Treatment typically includes a combination of pyrimethamine, sulfadiazine, and folinic acid, with glucocorticoids for severe inammation.