Bridging gaps in antenatal care: Implementation of the WHO ANC model using a web-based mobile application at different levels of the healthcare system.

INTRODUCTION: Antenatal care (ANC) is crucial for ensuring positive maternal and perinatal outcomes. The World Health Organization (WHO) has released comprehensive guidelines on ANC with the aim of providing a "positive pregnancy experience". While mobile health (mHealth) technology shows immense potential in improving healthcare services, evidence of its effectiveness remains limited. OBJECTIVES: This study aimed to develop a mobile application aligned with the WHO antenatal care model and follow a group of antenatal women using that and compare it to the conventional care provided. METHODS: A prospective open-label study was carried out at three health centers, where patients with singleton/twin pregnancies and access to smartphones were recruited after obtaining informed consent. The study group was followed using the mobile application, while the control group received conventional care. A recall-based questionnaire was used to assess the content of care, including comprehensive history, examination, and patient counselling. Patient satisfaction and the feasibility of using the application were also evaluated. RESULTS: A total of 85 patients in the study group and 73 controls were followed until delivery. Baseline demographic details were comparable, while the number of antenatal visits were higher in the intervention group. Patients in the study group had significantly higher mean scores compared to the controls in terms of comprehensive history (8.26 ± 2.26 vs 3.58 ± 2.30; p < 0.001), physical examination (4.26 ± 1.03 vs 3.66 ± 1.09; p = 0.001) and patient counselling (6.09 ± 1.65 vs 4.33 ± 1.69; p < 0.001). Among the recommended investigations, a hemogram (100 % vs 93.2 %; p = 0.02) and ultrasound prior to 24 weeks (89.4 % vs 56.2 %; p < 0.001) were carried out in a larger number of patients in the study group. Patient satisfaction scores, calculated using the PreMAPeQ questionnaire, were higher in the intervention group. CONCLUSION: This study highlights the effectiveness of an m-health application in enhancing the quality of antenatal care and facilitating standardized ANC visits. Further research is necessary to establish mHealth technology as a cost-effective intervention in this area.

Peripheral Gamma Delta T cells secrete inflammatory cytokines in women with idiopathic recurrent pregnancy loss.

BACKGROUND: Gamma delta (γδ) T cells are known to link innate and adaptive immunity. Decidual γδ T cells are known to provide immunotolerance by producing IL-10 and TGF-ß. In recurrent pregnancy loss (RPL) females, the role of peripheral γδ T cells remain unstudied. OBJECTIVE: To investigate the different phenotypes of γδ T cells in the peripheral blood of women with idiopathic RPL and their possible involvement in RPL condition. METHODS: A total of 120 women were recruited for the study. Peripheral blood lymphocytes were isolated and they were stained with appropriate antibodies to determine the phenotype of γδ T cells and major cytokines produced by them in the blood using flow cytometry. RESULTS: We observed a significant decrease in the proportion of CD3+CD4-CD8-γδ T cells (p<0.001) and increase in the percentage of IFN-γ (p<0.05) and IL-17 (p<0.001) producing γδ T cells in RPL pregnant as compared to normal pregnant females. CONCLUSION: Increase in IFN-γ and IL-17-producing CD3+ CD4-CD8- γδ T cells is associated with creating inflammatory cytokine milieu, thereby, may contribute towards pregnancy loss in RPL females.