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1.
Int Breastfeed J ; 16(1): 22, 2021 02 24.
Artigo em Inglês | MEDLINE | ID: mdl-33627150

RESUMO

BACKGROUND: There are little up-to-date data available on the duration of exclusive breastfeeding in Lithuania. The aim of our study was to examine the factors that could influence exclusive breastfeeding during the first 6 months of life. METHODS: In 2016, a survey was conducted at the Obstetrics and Gynecology Clinic of Vilnius University Hospital, Santaros Klinikos. Women in postnatal wards were opportunistically offered questionnaires and later followed up by telephone interviews at 6 weeks, 3 months, and 6 months postpartum. We used binary logistic regression to determine the factors that impacted exclusive breastfeeding during the first 6 months following childbirth. RESULTS: Of 475 eligible women that were approached, a total of 447 women were recruited, with response rates of 76.1, 71.4 and 67.0% at 6 weeks, 3 months, and 6 months postpartum, respectively. The prevalence of exclusive breastfeeding through the 6 month postpartum period was 39.8%. Exclusive breastfeeding during days 2 to 4 postpartum was positively influenced by factors such as a natural childbirth, the practice of breastfeeding on demand and maternal self-confidence in breastfeeding. Subsequently, exclusive breastfeeding on demand in the immediate postpartum period and exclusive breastfeeding for up to 3 months were associated with successful exclusive breastfeeding up to 6 months. However, the adverse factors that limited the success and duration of exclusive breastfeeding included free samples of human milk substitutes or advertising at primary healthcare centers 6 weeks after childbirth, pacifier use 6 months after childbirth, as well as amniotomy for labor induction. CONCLUSIONS: Our research demonstrated that exclusive breastfeeding is impacted in both directions by a range of factors during particular periods after delivery. One of the novel findings was the adverse influence of amniotomy for labor induction on exclusive breastfeeding rates. Taking into account diverse factors influencing exclusive breastfeeding and the absence of a single way to promote it, there is a crucial need to increase the incidence of exclusive breastfeeding until infants reach the age of 6 months.


Assuntos
Aleitamento Materno , Feminino , Humanos , Lactente , Lituânia , Gravidez , Inquéritos e Questionários , Centros de Atenção Terciária , Fatores de Tempo
2.
Libyan J Med ; 15(1): 1812821, 2020 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-32854606

RESUMO

The aim of this study was to assess if ureaplasmas are associated with pregnancy complications and diseases in newborns. Pregnant women with complaints and threatening signs of preterm delivery were included. A sample, taken from the endocervical canal and from the surface of the cervical portion, was sent to the local microbiology laboratory for DNA detection of seven pathogens: Chlamydia trachomatis, Mycoplasma hominis, Mycoplasma genitalium, Ureaplasma parvum, Ureaplasma urealyticum, Neisseria gonorrhoeae, and Trichomonas vaginalis. The Pearson Chi-Square test was used to determine the difference in unpaired categorical data. A two-sided p value <0.05 was considered to be statistically significant. In all, 50 pregnant women with complaints and threatening signs of preterm delivery were included. Premature rupture of uterine membranes was found in 23 (46%) of the patients and 38 women (76%) had preterm delivery. Ureaplasma infections were associated with a premature rupture of membranes (p < 0.004), the placental inflammation (p < 0.025), a newborn respiratory distress syndrome (p < 0.019). Ureaplasmas could have affected the preterm leakage of fetal amniotic fluid and are associated with the placental inflammation and a newborn respiratory distress syndrome.


Assuntos
Ruptura Prematura de Membranas Fetais/microbiologia , Complicações Infecciosas na Gravidez/microbiologia , Nascimento Prematuro/microbiologia , Infecções por Ureaplasma/complicações , Ureaplasma , Adolescente , Adulto , Colo do Útero/microbiologia , Distribuição de Qui-Quadrado , Estudos Transversais , Feminino , Ruptura Prematura de Membranas Fetais/epidemiologia , Humanos , Recém-Nascido , Lituânia/epidemiologia , Gravidez , Nascimento Prematuro/epidemiologia , Estudos Prospectivos , Síndrome do Desconforto Respiratório do Recém-Nascido/epidemiologia , Síndrome do Desconforto Respiratório do Recém-Nascido/microbiologia , Infecções por Ureaplasma/microbiologia , Adulto Jovem
3.
Medicina (Kaunas) ; 56(5)2020 May 09.
Artigo em Inglês | MEDLINE | ID: mdl-32397497

RESUMO

Objectives: to identify the main reasons of breastfeeding cessation in Lithuania and if there is a link between the length of maternity leave and breastfeeding cessation. Methods: a prospective questionnaire study was conducted in a tertiary hospital from 2016 to 2017. The sample size included 449 women. Results: a total of 41% (n = 123) of respondents weaned off by 6 months after birth, and 57.8% (n = 173) between 6 months and 1 year. During the first few days after delivery, mothers did not breastfeed their infants mainly due to shortage of milk (n = 10; 40%) or separation from their baby due to infant health problems (n = 12; 48%) (p < 0.0001). Mothers who did not breastfeed during the first days after birth more often did not start breastfeeding later at home (p = 0.001). Going back to work was not a significant factor in weaning off. Conclusions: breastfeeding initiation and practice during the first few days after birth has a significant impact on the further commitment for full breastfeeding. Additionally, a perceived lack of support and help from both doctors and midwives influences a woman's decision to choose not to breastfeed.


Assuntos
Aleitamento Materno/efeitos adversos , Suspensão de Tratamento , Adulto , Aleitamento Materno/métodos , Estudos de Coortes , Feminino , Humanos , Recém-Nascido , Entrevistas como Assunto/métodos , Lituânia , Gravidez , Estudos Prospectivos , Inquéritos e Questionários
4.
Medicina (Kaunas) ; 56(2)2020 Jan 21.
Artigo em Inglês | MEDLINE | ID: mdl-31973138

RESUMO

Pregnancy rates are rapidly increasing among women of reproductive age diagnosed with multiple sclerosis (MS). Through pre-conception, pregnancy and post-partum periods, there is a need for disease control management, to decrease chances of MS relapses while avoiding potential risks to the mother and the fetus. However, pregnancy is not always compatible with the available highly effective MS treatments. This narrative review provides the aspects of pregnancy's outcomes and the impact on disease activity, choices of anesthesia and the management of relapses during the pregnancy and breastfeeding period. Available disease modifying treatment is discussed in the article with new data supporting the strategy of continuing natalizumab after conception, as it is related to a decreased risk of MS relapses during the pregnancy and postpartum period.


Assuntos
Esclerose Múltipla/complicações , Esclerose Múltipla/tratamento farmacológico , Adulto , Alemtuzumab/uso terapêutico , Anticorpos Monoclonais Humanizados/uso terapêutico , Crotonatos/uso terapêutico , Fumarato de Dimetilo/uso terapêutico , Feminino , Cloridrato de Fingolimode/uso terapêutico , Acetato de Glatiramer/uso terapêutico , Humanos , Hidroxibutiratos , Interferon beta/uso terapêutico , Esclerose Múltipla/epidemiologia , Natalizumab/uso terapêutico , Nitrilas , Gravidez , Complicações na Gravidez/epidemiologia , Complicações na Gravidez/etiologia , Resultado da Gravidez/epidemiologia , Estudos Prospectivos , Rituximab/uso terapêutico , Toluidinas/uso terapêutico
5.
Medicina (Kaunas) ; 55(2)2019 Feb 17.
Artigo em Inglês | MEDLINE | ID: mdl-30781564

RESUMO

Magnetic resonance imaging (MRI) is used as a clarifying technique after a high-resolution ultrasound examination during pregnancy. Combining ultrasound with MRI, additional diagnostic information is obtained or ultrasound diagnosis is frequently corrected. High spatial resolution provides accurate radiological imaging of internal organs and widens possibilities for detecting perinatal development disorders. The safety of MRI and the use of intravenous contrast agent gadolinium are discussed in this article. There is no currently available evidence that MRI is harmful to the fetus, although not enough research has been carried out to prove enduring safety. MRI should be performed when the benefit outweighs the potential side effects. The narrative review includes several clinical cases of fetal MRI performed in Vilnius University Hospital Santaros Clinics.


Assuntos
Abdome/anormalidades , Abdome/diagnóstico por imagem , Encéfalo/anormalidades , Encéfalo/diagnóstico por imagem , Deficiências do Desenvolvimento/diagnóstico por imagem , Imageamento por Ressonância Magnética/métodos , Ultrassonografia Pré-Natal/métodos , Adulto , Meios de Contraste/efeitos adversos , Feminino , Gadolínio/efeitos adversos , Hospitais Universitários , Humanos , Lituânia , Imageamento por Ressonância Magnética/efeitos adversos , Gravidez , Ultrassonografia Pré-Natal/efeitos adversos
6.
BMC Infect Dis ; 17(1): 394, 2017 06 05.
Artigo em Inglês | MEDLINE | ID: mdl-28583109

RESUMO

BACKGROUND: Bacterial vaginosis (BV) is one of the leading causes of vaginal complaints among women of childbearing age. The role of Gardnerella vaginalis remains controversial due to its presence in healthy and BV-type vaginal microflora. The phenotypic and genotypic heterogeneity of G. vaginalis suggested the existence of strain variants linked with different health conditions. We sought to analyze prevalence and distribution of G. vaginalis subgroups (clades) in BV-positive (n = 29), partial BV (n = 27), and BV-negative (n = 53) vaginal samples from Lithuanian women. METHODS: Vaginal samples were characterized by Amsel criteria and the Nugent method. Bacterial signatures characteristic of BV and concomitant infections were identified by culture and PCR. Using singleplex PCR assays, G. vaginalis subgroups were identified in 109 noncultured vaginal specimens by targeting clade-specific genes. Isolated G. vaginalis clinical strains were subtyped and the presence of the sialidase coding gene was detected by PCR. Data analysis was performed using GraphPad Prism statistical software. RESULTS: G. vaginalis was found in 87% of women without BV. Clade 4 was most frequently detected (79.4%), followed by clade 1 (63.7%), clade 2 (42.2%), and clade 3 (15.7%). Multi-clade G. vaginalis communities showed a positive association with Nugent score (NS) ≥ 4 (OR 3.64; 95% CI 1.48-8.91; p = 0.005). Clade 1 and clade 2 were statistically significantly more common in samples with NS 7-10 (OR 4.69; 95% CI 1.38-15.88; p = 0.01 and OR 6.26; 95% CI 2.20-17.81; p ≤ 0.001, respectively). Clade 3 and clade 4 showed no association with high NS (OR 0.88; 95% CI 0.26-3.04; p = 1.00 and OR 1.31; 95% CI 0.39-4.41; p = 0.767, respectively). The gene coding for sialidase was detected in all isolates of clade 1 and clade 2, but not in clade 4 isolates. CONCLUSIONS: We showed an association between the microbial state of vaginal microflora and specific subgroups of G. vaginalis, the distribution of which may determine the clinical manifestation of BV. The frequent detection of clade 4 in the BV-negative samples might be due its lack of the gene coding for sialidase.


Assuntos
Gardnerella vaginalis/genética , Gardnerella vaginalis/patogenicidade , Infecções por Bactérias Gram-Positivas/microbiologia , Vagina/microbiologia , Vaginose Bacteriana/microbiologia , Adulto , Feminino , Genótipo , Infecções por Bactérias Gram-Positivas/epidemiologia , Humanos , Lituânia/epidemiologia , Pessoa de Meia-Idade , Neuraminidase/genética , Reação em Cadeia da Polimerase/métodos , Vaginose Bacteriana/epidemiologia
7.
J Clin Ultrasound ; 44(5): 267-71, 2016 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-26331948

RESUMO

PURPOSE: To evaluate whether the pain experienced during and after Saline-contrast sonohysterography (SCSH) differs between premenopausal and postmenopausal women. METHODS: Sonohysterography was performed on 133 consecutive women because of suspected endometrial pathology. Of these, 34 women were excluded for the following reasons: they had cervical stenosis; they did not complete or return a questionnaire; or tenaculum or cervical dilatators were used during the procedure. All women were asked to fill out a questionnaire to characterize their pain and mark their pain experience on a 100-mm pain visual analog scale. RESULTS: Data from the 99 patients included were used for statistical analysis. It showed that sonohysterography was well tolerated overall: 41% of the women did not feel any pain. Postmenopausal women experienced pain during SCSH more often than premenopausal women did: 71% (17/24) compared with 32% (24/75) experienced pain; p < 0.002; the median tolerance on the 100-mm visual analog scale was 43. The character of the pain differed between the two groups of women: postmenopausal women more often felt sharp pain (42%; 10/24), whereas premenopausal women more often felt gnawing and/or crampy pain (21%; 16/75) (p < 0.13). CONCLUSIONS: Postmenopausal women were twice as likely to experience pain during SCSH as premenopausal women were. Therefore, postmenopausal women might benefit from analgesia induced prior to the procedure. © 2015 Wiley Periodicals, Inc. J Clin Ultrasound 44:267-271, 2016.


Assuntos
Meios de Contraste/administração & dosagem , Endossonografia/efeitos adversos , Aumento da Imagem/métodos , Dor/epidemiologia , Pós-Menopausa , Cloreto de Sódio/administração & dosagem , Ultrassonografia/efeitos adversos , Adulto , Fatores Etários , Idoso , Feminino , Humanos , Pessoa de Meia-Idade , Medição da Dor/métodos , Estudos Prospectivos , Inquéritos e Questionários , Adulto Jovem
8.
Acta Med Litu ; 23(2): 117-125, 2016.
Artigo em Inglês | MEDLINE | ID: mdl-28356798

RESUMO

BACKGROUND: The Lithuanian Perinatology Program, orders issued by the Ministry of Health, regulating the care and treatment of mothers and their infants, and the well-running perinatal care system helped to improve the diagnostics and treatment of pregnancy pathology. Over the last 20 years, Lithuania has experienced significant improvements in the maternal and perinatal health. MATERIALS AND METHODS: Data was collected from the official statistics database, Medical Data of Births, provided by the Institute of Hygiene Health Information Centre, Vilnius University Faculty of Medicine, and the Vilnius University Centre of Neonatology in 1995-2014. RESULTS: The average maternal age at delivery ranged from 25.8 years in 1995 to 28.8 years in 2014. The comparison of 2001 and 2014 data shows that the incidence of gestational diabetes increased by 6.7 times due to the improved diagnosis. The percentage of hypertensive disorders decreased from 6.1% in 1997 to 3.2% in 2014. Between 1995 and 2014, the prevalence of anemia among pregnant women declined by half. The marked decrease in respiratory, urinary, genital and other diseases was observed among pregnant women. From 1995 to 2014, in Lithuania there were 67 maternal deaths related to pregnancy and childbirth. Hemorrhage and infections during pregnancy, delivery and the postpartum period are considered the most common causes of maternal death.

9.
Arch Dis Child ; 100(10): 948-51, 2015 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-26177656

RESUMO

INTRODUCTION: Functional hypothalamic amenorrhoea (FHA) is a condition characterised by the absence of menses due to suppression of the hypothalamic-pituitary-ovarian axis. OBJECTIVE: The purpose of the study was to estimate uterine and ovarian sizes in adolescents with FHA and to compare these results with findings in peers having regular menstrual cycles. DESIGN: Prospective case-controlled study. SETTINGS: Vilnius University Hospital Santariskiu Klinikos, Lithuania. PATIENTS: Lithuanian adolescents--45 with FHA and 40 comparison group participants. MAIN OUTCOME MEASURES: We assessed ultrasound measurements of internal reproductive organs, levels of luteinising hormone, follicle-stimulating hormone, prolactin, oestradiol and calculated body mass index (BMI). RESULTS: The mean age of the participants was 16.3 ± 1.2 years, the mean age after menarche--3.6 years. In adolescents with FHA the BMI was 17.8 ± 1.8 kg/m(2) and 20.4 ± 1.4 kg/m(2) in the comparison group, p < 0.001. The uterine volume (14.7 ± 6.3 cm(3) vs 31.7 ± 10.6 cm(3), p < 0.001), cervical length (2.3 ± 0.4 cm vs 2.6 ± 0.5 cm, p = 0.03), volume of both ovaries (9.3 ± 3.6 cm(3) vs 13.8 ± 4.3 cm(3), p < 0.001) and levels of LH (2.70 ± 2.59 vs 6.01 ± 2.44, p < 0.001) were significantly lower in girls with FHA. A significantly positive correlation between volume of uterus and levels of LH (r = 0.415; p < 0.001) was found. We identified a positive correlation between uterine volume, uterine corpus length, cervical length, ovarian volume and weight, BMI. CONCLUSIONS: In adolescents with FHA the dimensions of uterus and ovaries were smaller than in girls having regular menstrual cycles. Our study confirmed the influence of oestrogen on uterus size: oestrogen deficiency causes a reduction in uterine size. Uterine size and ovarian size correlate positively with BMI.


Assuntos
Amenorreia/diagnóstico por imagem , Ovário/diagnóstico por imagem , Útero/diagnóstico por imagem , Adolescente , Amenorreia/fisiopatologia , Índice de Massa Corporal , Estudos de Casos e Controles , Estradiol/sangue , Feminino , Hormônio Foliculoestimulante/sangue , Humanos , Lituânia , Hormônio Luteinizante/sangue , Ciclo Menstrual , Ovário/fisiopatologia , Prolactina/sangue , Estudos Prospectivos , Ultrassonografia , Útero/fisiopatologia
10.
Ginekol Pol ; 86(12): 926-31, 2015 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-26995943

RESUMO

OBJECTIVES: The aim of the study was to identify and evaluate a possible correlation between C-reactive protein (CRP) concentration in maternal blood and the risk of developing fetal inflammatory syndrome (FIRS). MATERIAL AND METHODS: The study included 158 infants born at 22-34 weeks of gestation and their mothers. Umbilical cord blood cytokines were evaluated in immunoassay tests and maternal blood was tested for CRP concentration. RESULTS: The period of gestation was significantly shorter in the FIRS group as compared to the control group (29.5 ± 3.1 vs. 32.2 ± 2.4 weeks, p < 0.001). Gestational age was ≤ 30 weeks for 53.8% of the newborns in the FIRS group and 15.8% of the newborns in the control group (p < 0.001). Maternal CRP before, during and after labor was significantly higher in the FIRS group as compared to the control group (p < 0.001). Our study investigated the correlation between CRP in maternal blood and IL-6 concentration during the entire perinatal period (p < 0.001). CONCLUSION: CRP concentration in the FIRS group was significantly higher than in controls before, during, and after labor. Thus, it seems safe to conclude that changing concentration of inflammatory factors in maternal blood are closely related to FIRS. Elevated CRP in maternal blood might signify a progressing intrauterine infection and herald the development of FIRS.


Assuntos
Líquido Amniótico/imunologia , Proteína C-Reativa/análise , Doenças Fetais/sangue , Síndrome de Resposta Inflamatória Sistêmica/sangue , Adulto , Líquido Amniótico/química , Proteína C-Reativa/metabolismo , Ensaio de Imunoadsorção Enzimática , Feminino , Doenças Fetais/diagnóstico , Idade Gestacional , Humanos , Recém-Nascido , Valor Preditivo dos Testes , Gravidez , Resultado da Gravidez , Diagnóstico Pré-Natal , Síndrome de Resposta Inflamatória Sistêmica/diagnóstico , Adulto Jovem
11.
Medicina (Kaunas) ; 43(1): 10-26, 2007.
Artigo em Lituano | MEDLINE | ID: mdl-17297279

RESUMO

OBJECTIVE: To evaluate changes in anthropometric and biochemical parameters in pregnancy and their dynamics during last two decades and to determine the association between anthropometric and biochemical parameters, their influence on fetal and neonatal development. MATERIAL AND METHODS: In 1985-2005, anthropometric (height, body mass, weight gain during pregnancy, pelvic measurements, skinfold thicknesses, passive body mass) and biochemical (cholesterol, triglyceride, protein, and iron levels) parameters, their correlation, changes in pregnancy were examined; also the correlations between these parameters and neonatal body mass indices were evaluated. In 1986-1987, 383 pregnant women were examined, in 1998--130, and in 2003-2005--133. RESULTS: During 20 years, the height of examined women increased on an average of 2.5 cm; they became thinner; body mass index decreased. The body composition became similar to "cylinder" shape due to decreased thickness of adipose tissue in the limbs. The dimensions of bony pelvis--external conjugate and bicristal diameters--decreased. Primiparous women became older (1995--22.5 years of age, 2004--27.6). At the beginning of investigation, the weight gain was on an average of 21.9% of body mass before pregnancy (13.3 kg) and at the end--23.9% (14.2 kg). The values of anthropometric parameters vary in a consistent pattern during pregnancy: the lower body mass and body mass index at the beginning of pregnancy, the higher weight gain at the end of pregnancy. Blood serum levels of cholesterol, triglycerides, and especially iron were decreased during the study. CONCLUSIONS: An inverse correlation between body mass index and lipid metabolism in pregnancy was revealed: the higher body mass index was at the beginning of pregnancy, the lower increase in lipid concentration was during pregnancy. At the beginning of investigation as well as after 20 years, women with low body mass index showed the most significant anthropometric and lipid metabolic changes in pregnancy.


Assuntos
Antropometria , Índice de Massa Corporal , Recém-Nascido , Metabolismo dos Lipídeos , Gravidez , Adulto , Estatura , Colesterol/sangue , Interpretação Estatística de Dados , Feminino , Humanos , Recém-Nascido/fisiologia , Idade Materna , Gravidez/sangue , Gravidez/metabolismo , Dobras Cutâneas , Triglicerídeos/sangue , Aumento de Peso
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