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Sample records for antenatal screening lessons

  1. Antenatal screening and the gendering of genetic responsibility

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    Reed Kate

    2007-09-01

    Full Text Available Abstract Background The objective of this study is to explore men's and women's perceptions of antenatal blood screening. The study will assess the impact of these perceptions on decision-making regarding diagnostic testing and selective abortion, and on parental feelings of genetic responsibility. By exploring gender and antenatal screening in this way, the research aims to contribute to our understanding of lay perceptions of genetic screening and increase our knowledge of the decision-making process in screening. Research design This qualitative study will be based on semi-structured interviews with twenty pregnant women and twenty male partners in the post-industrial city of Sheffield, UK. All interviews will be taped, transcribed and analysed thematically using NVIVO, a qualitative software package. Discussion The findings of this study have relevance to existing debates on the social and ethical implications of reproductive genetics. A better understanding of male and female perceptions of the screening process could improve guidance and practice in antenatal screening and genetic counselling. It will also inform and contribute to the development of theory on gender and genetic screening.

  2. Utility of immunochromatographic assay as a rapid point of care test for screening of antenatal syphilis

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    Bineeta Kashyap

    2015-01-01

    Full Text Available Background and Objectives: Syphilis is one of the most common preventable causes of adverse effects during pregnancy. Antenatal screening prevents the delay between diagnosis and treatment there by reducing the risk of congenital syphilis. The objective of this study was to evaluate the utility of an immunochromatographic assay as a point of care test for antenatal screening of syphilis. Materials and Methods: Sera of 200 antenatal mothers were evaluated for serodiagnosis of syphilis by the venereal disease research laboratory (VDRL, Treponema pallidum hemagglutination assay (TPHA and SD BIOLINE Syphilis 3.0 test. The performance of SD BIOLINE Syphilis 3.0 test was compared with VDRL as screening assay and TPHA as a confirmatory test. Results: The antenatal prevalence of syphilis was found to be 2% by both VDRL and TPHA. The sensitivity, specificity, positive predictive value, and the negative predictive value of SD BIOLINE Syphilis 3.0 test were 75%, 100%, 100%, and 99.45%, respectively. Conclusions: Antenatal screening and treatment of maternal syphilis are cost-effective health interventions even under the low prevalence of infection. SD BIOLINE Syphilis 3.0 test, although having less sensitivity than the existing testing strategy, can have a tremendous impact on the disease burden if used prudently for the screening of antenatal mothers in peripheral health settings.

  3. Antenatal screening for HIV, hepatitis B and syphilis in the Netherlands is effective

    NARCIS (Netherlands)

    E.L.M. op de Coul; S. Hahne; Y.W.M. van Weert; P. Oomen; C. Smit; K.P.B. van der Ploeg; D.W. Notermans; K. Boer; M.A.B. van der Sande

    2011-01-01

    Background: A screening programme for pregnant women has been in place since the 1950s in the Netherlands. In 2004 universal HIV screening according to opting out was implemented. Here, we describe the evaluation of the effectiveness of antenatal screening in the Netherlands for 2006-2008 for HIV, h

  4. Antenatal screening for HIV, hepatitis B and syphilis in the Netherlands is effective

    NARCIS (Netherlands)

    Coul, E.L.M. op de; Hahné, S.; Weert, Y.M. van; Oomen, P.; Smit, S.; Ploeg, C.P.B. van der; Notermans, D.W.; Boer, K.; Sande1, M.A.B. van der

    2011-01-01

    A screening programme for pregnant women has been in place since the 1950s in the Netherlands. In 2004 universal HIV screening according to opting out was implemented. Here, we describe the evaluation of the effectiveness of antenatal screening in the Netherlands for 2006-2008 for HIV, hepatitis B v

  5. Using the Cascade Model to Improve Antenatal Screening for the Hemoglobin Disorders

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    Gould, Dinah; Papadopoulos, Irena; Kelly, Daniel

    2012-01-01

    Introduction: The inherited hemoglobin disorders constitute a major public health problem. Facilitators (experienced hemoglobin counselors) were trained to deliver knowledge and skills to "frontline" practitioners to enable them to support parents during antenatal screening via a cascade (train-the-trainer) model. Objectives of evaluation were to…

  6. Using the Cascade Model to Improve Antenatal Screening for the Hemoglobin Disorders

    Science.gov (United States)

    Gould, Dinah; Papadopoulos, Irena; Kelly, Daniel

    2012-01-01

    Introduction: The inherited hemoglobin disorders constitute a major public health problem. Facilitators (experienced hemoglobin counselors) were trained to deliver knowledge and skills to "frontline" practitioners to enable them to support parents during antenatal screening via a cascade (train-the-trainer) model. Objectives of…

  7. Cost-effectiveness of antenatal screening for neonatal alloimmune thrombocytopenia

    DEFF Research Database (Denmark)

    Killie, M K; Kjeldsen-Kragh, J; Husebekk, A

    2007-01-01

    OBJECTIVES: To estimate the costs and health consequences of three different screening strategies for neonatal alloimmune thrombocytopenia (NAIT). DESIGN: Cost-utility analysis on the basis of a decision tree that incorporates the relevant strategies and outcomes. SETTING: Three health regions...... in Norway encompassing a 2.78 million population. POPULATION: Pregnant women (n = 100,448) screened for human platelet antigen (HPA) 1a and anti-HPA 1a antibodies, and their babies. METHOD: Decision tree analysis. In three branches of the decision tree, pregnant women entered a programme while in one...

  8. Report of the first nationally implemented clinical routine screening for fetal RHD in D- pregnant women to ascertain the requirement for antenatal RhD prophylaxis

    DEFF Research Database (Denmark)

    Clausen, Frederik Banch; Christiansen, Mette; Steffensen, Rudi Nora;

    2012-01-01

    BACKGROUND: A combination of antenatal and postnatal RhD prophylaxis is more effective in reducing D immunization in pregnancy than postnatal RhD prophylaxis alone. Based on the result from antenatal screening for the fetal RHD gene, antenatal RhD prophylaxis in Denmark is given only to those D- ...

  9. [HIV screening and counseling in antenatal care: perception of postpartum women].

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    Praça, Neide de Souza; Barrancos, Janaína Teixeira Gardel

    2007-03-01

    This transversal and exploratory study aimed at verifying if pregnant women were receiving antenatal counseling before and after HIV screening. The sample consisted of 161 postpartum HIV-negative women admitted to two maternity hospitals in the city of São Paulo. Interviews were carried out in 2003. Data showed that the number of postpartum women who received pre and post HIV screening counseling during pregnancy was low. The answers of women on the aim of HIV testing were statistically correlated to the average number of prenatal appointments. In conclusion, this study identified the need of a higher involvement of health staff workers in pre- and post-HIV screening counseling of pregnant women during prenatal care.

  10. Advice, authority and autonomy in shared decision-making in antenatal screening: the importance of context.

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    Pilnick, Alison; Zayts, Olga

    2016-03-01

    Shared decision-making (SDM) has been widely advocated across many branches of healthcare, yet there is considerable debate over both its practical application and how it should be examined or assessed. More recent discussions of SDM have highlighted the important of context, both internal and external to the consultation, with a recognition that decisions cannot be understood in isolation. This paper uses conversation analysis (CA) to examine how decision-making is enacted in the context of antenatal screening consultations in Hong Kong. Building on previous CA work (Collins et al. , Toerien et al. 2013), we show that, whilst previously identified formats are used here to present the need for a decision, the overriding basis professionals suggest for actually making a decision in this context is the level of worry or concern a pregnant woman holds about potential foetal abnormality. Professionals take an unknowing 'epistemic stance' (Heritage ) towards this worry, and hence step back from involvement in decision-making. We argue that this is linked to the non-directive ethos that prevails in antenatal screening services, and suggest that more research is needed to understand how the enactment of SDM is affected by wider professional contexts and parameters.

  11. Targeted routine antenatal anti-D prophylaxis in the prevention of RhD immunisation--outcome of a new antenatal screening and prevention program.

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    Eleonor Tiblad

    Full Text Available OBJECTIVE: To estimate the incidence of RhD immunisation after implementation of first trimester non-invasive fetal RHD screening to select only RhD negative women carrying RHD positive fetuses for routine antenatal anti-D prophylaxis (RAADP. MATERIALS AND METHODS: We present a population-based prospective observational cohort study with historic controls including all maternity care centres and delivery hospitals in the Stockholm region, Sweden. All RhD negative pregnant women were screened for fetal RHD genotype in the first trimester of pregnancy. Anti-D immunoglobulin (250-300 µg was administered intramuscularly in gestational week 28-30 to participants with RHD positive fetuses. Main outcome measure was the incidence of RhD immunisation developing during or after pregnancy. RESULTS: During the study period 9380 RhD negative women gave birth in Stockholm. Non-invasive fetal RHD genotyping using cell-free fetal DNA in maternal plasma was performed in 8374 pregnancies of which 5104 (61% were RHD positive and 3270 (39% RHD negative. In 4590 pregnancies with an RHD positive test the women received antenatal anti-D prophylaxis. The incidence of RhD immunisation in the study cohort was 0.26 percent (24/9380 (95% CI 0.15-0.36% compared to 0.46 percent (86/18546 (95% CI 0.37 to 0.56% in the reference cohort. The risk ratio (RR for sensitisation was 0.55 (95% CI 0.35 to 0.87 and the risk reduction was statistically significant (p = 0.009. The absolute risk difference was 0.20 percent, corresponding to a number needed to treat (NNT of 500. CONCLUSIONS: Using first trimester non-invasive antenatal screening for fetal RHD to target routine antenatal anti-D prophylaxis selectively to RhD negative women with RHD positive fetuses significantly reduces the incidence of new RhD immunisation. The risk reduction is comparable to that reported in studies evaluating the outcome of non selective RAADP to all RhD negative women. The cost-effectiveness of this

  12. Microcytic hypochromic anemia: Should high performance liquid chromatography be used routinely for screening anemic and antenatal patients?

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    Joseph Philip

    2013-01-01

    Full Text Available Background: Hemoglobinopathies are the most common inherited red cell disorders worldwide. Identification of these disorders is immensely important epidemiologically and for improved management protocols. Aim and Objectives: Our aim was to determine the prevalence of hemoglobinopathies in patients with microcytic hypochromic anemia and to assess the suitability of using high performance liquid chromatography (HPLC routinely for screening antenatal cases and patients with anemia. Materials and Methods: A total of 4335 cases received from Mar 2007 to Nov 2011 were studied for various hemoglobinopathies and variants on BIO RAD ′VARIANT′ analyzer. Results: Of the 4335 cases studied, 2119 were antenatal cases, 1710 patients with other disorders and 506 family studies. Of these, 688 cases displayed abnormal hemoglobin fractions on HPLC of which 140 were antenatal women. There were 455 cases of β thalassemia trait, 24 β thalassemia major, 20 thalassemia inter-media, 54 sickle cell trait, fivesickle cell disease, 21 double heterozygous β thalassemia-sickle cell trait, nineand 4 Hb D- Punjab heterozygous and homozygous respectively, three Hb D β Thalassemia trait, 20 and 37 Hb E homozygous and heterozygous respectively, three Hb E β Thalassemia trait and four cases of Hb Q India. Twenty nine adults had isolated HbF elevation. Conclusion: Our study found a high prevalence (15.8% of hemoglobinopathies amongst microcytic hypochromic anemia and antenatal cases. An accurate diagnosis helps in preventing unnecessary iron loading. Screening all antenatal cases with anemia helps in timely antenatal counseling, thus preventing the psychological trauma of bearing a transfusion dependent child for life.

  13. The Simplified Edinburgh Postnatal Depression Scale (EPDS for Antenatal Depression: Is It a Valid Measure for Pre-Screening?

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    Sea Kyung Choi, Jung Jin Kim, Yong Gyu Park, Hyun Sun Ko, In Yang Park, Jong Chul Shin

    2012-01-01

    Full Text Available The identification of antenatal depression is critical but poorly conducted. The aim of this study was to construct a simplified depression survey scale and to verify its efficacy as a pre-screening for antenatal depression. A total of 494 pregnant women in the third trimester of gestation who had received antenatal care at Seoul St. Mary's Hospital from July 2009 to June 2010 were included. The Edinburgh Postnatal Depression Scale (EPDS questionnaire was completed by them. The subjects were randomly divided into two groups: 250 of training set and 244 of validation set. We designed a simplified questionnaire comprising two items of EPDS using the training set. We then validated its efficacy with the training set and reaffirmed the results with the validation set. The sum of item 5 (scare or panic and item 8 (sadness or misery explained 75.5% of the total score of the EPDS (AUC = 0.947. Using a score of 3 as a cut-off value of the simplified scale, sensitivity was 92.4% and specificity was 86.3%. The positive and negative predictive values were 56.2% and 98.4%, retrospectively. This study suggests that the simplified EPDS can be an efficient instrument to rule out depression during pregnancy.

  14. Universal HbA1c Measurement in Early Pregnancy to Detect Type 2 Diabetes Reduces Ethnic Disparities in Antenatal Diabetes Screening: A Population-Based Observational Study.

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    R C E Hughes

    Full Text Available In response to the type 2 diabetes epidemic, measuring HbA1c with the first-antenatal blood screen was recently recommended in NZ. This would enable prompt treatment of women with unrecognised type 2 diabetes, who may otherwise go undetected until the gestational diabetes (GDM screen. We compare inter-ethnic antenatal screening practices to examine whether the HbA1c test would be accessed by ethnicities most at risk of diabetes, and we determined the prevalence of unrecognised type 2 diabetes and prediabetes in our pregnant population. This is an observational study of pregnancies in Christchurch NZ during 2008-2010. Utilising electronic databases, we matched maternal characteristics to first-antenatal bloods, HbA1c, and GDM screens (glucose challenge tests and oral glucose tolerance tests. Overall uptake of the first-antenatal bloods versus GDM screening was 83.1% and 53.8% respectively in 11,580 pregnancies. GDM screening was lowest in Māori 39.3%, incidence proportion ratio (IPR 0.77 (0.71, 0.84 compared with Europeans. By including HbA1c with the first-antenatal bloods, the number screened for diabetes increases by 28.5% in Europeans, 40.0% in Māori, 28.1% in Pacific People, and 26.7% in 'Others' (majority of Asian descent. The combined prevalence of unrecognised type 2 diabetes and prediabetes by NZ criteria, HbA1c ≥5.9% (41mmol/mol, was 2.1% in Europeans, Māori 4.7% IPR 2.59 (1.71, 3.93, Pacific People 9.5% IPR 4.76 (3.10, 7.30, and 'Others' 6.2% IPR 2.99 (2.19, 4.07. Applying these prevalence data to 2013 NZ national births data, routine antenatal HbA1c testing could have identified type 2 diabetes in 0.44% and prediabetes in 3.96% of women. Routine HbA1c measurement in early pregnancy is an ideal screening opportunity, particularly benefitting vulnerable groups, reducing ethnic disparities in antenatal diabetes screening. This approach is likely to have world-wide relevance and applicability. Further research is underway to

  15. Is adding HCV screening to the antenatal national screening program in Amsterdam, the Netherlands, cost-effective?

    NARCIS (Netherlands)

    Urbanus, Anouk T.; van Keep, Marjolijn; Matser, Amy A.; Rozenbaum, Mark H.; Weegink, Christine J.; van den Hoek, Anneke; Prins, Maria; Postma, Maarten J.

    2013-01-01

    INTRODUCTION: Hepatitis C virus (HCV) infection can lead to severe liver disease. Pregnant women are already routinely screened for several infectious diseases, but not yet for HCV infection. Here we examine whether adding HCV screening to routine screening is cost-effective. METHODS: To estimate th

  16. [Ultrasound screening of abdominal aortic aneurysm: Lessons from Vesale 2013].

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    Laroche, J P; Becker, F; Baud, J M; Miserey, G; Jaussent, A; Picot, M C; Bura-Rivière, A; Quéré, I

    2015-12-01

    Although aneurysm of the abdominal infra-renal aorta (AAA) meets criteria warranting B mode ultrasound screening, the advantages of mass screening versus selective targeted opportunistic screening remain a subject of debate. In France, the French Society of Vascular Medicine (SFMV) and the Health Authority (HAS) published recommendations for targeted opportunistic screening in 2006 and 2013 respectively. The SFMV held a mainstream communication day on November 21, 2013 in France involving participants from metropolitan France and overseas departments that led to a proposal for free AAA ultrasound screening: the Vesalius operation. Being a consumer operation, the selection criteria were limited to age (men and women between 60 and 75 years); the age limit was lowered to 50 years in case of direct family history of AAA. More than 7000 people (as many women as men) were screened in 83 centers with a 1.70% prevalence of AAA in the age-based target population (3.12% for men, 0.27% for women). The median diameter of detected AAA was 33 mm (range 20 to 74 mm). The prevalence of AAA was 1.7% in this population. Vesalius data are consistent with those of the literature both in terms of prevalence and for cardiovascular risk factors with the important role of smoking. Lessons from Vesalius to take into consideration are: screening is warranted in men 60 years and over, especially smokers, and in female smokers. Screening beyond 75 years should be discussed. Given the importance of screening, the SFMV set up a year of national screening for AAA (Vesalius operation 2014/2015) in order to increase public and physician awareness about AAA detection, therapeutic management, and monitoring. AAA is a serious, common, disease that kills 6000 people each year. The goal of screening is cost-effective reduction in the death toll.

  17. Is adding HCV screening to the antenatal national screening program in Amsterdam, the Netherlands cost-effective?

    NARCIS (Netherlands)

    Urbanus, A.; Van Keep, M.; Matser, A.; Rozenbaum, M.; Weegink, C.; Van Den Hoek, A.; Prins, M.; Postma, M.

    2013-01-01

    Introduction: Hepatitis C virus infection (HCV) can lead to severe liver disease. Recently new improved treatment options have been introduced. Pregnant women are already routinely screened for several infectious diseases, however not yet for HCV infection. Here we examine whether adding HCV screeni

  18. Evaluation of two real-time multiplex PCR screening assays detecting fetal RHD in plasma from RhD negative women to ascertain the requirement for antenatal RhD prophylaxis

    DEFF Research Database (Denmark)

    Clausen, Frederik Banch; Krog, Grethe Risum; Rieneck, Klaus

    2011-01-01

    OBJECTIVE: To evaluate two different multiplex real-time PCR assays detecting fetal RHD for screening of RhD negative women in relation to antenatal RhD prophylaxis. METHODS: We designed a duplex assay for the detection of RHD exon 7 and 10 and a triplex assay for the detection of RHD exon 7, 10...

  19. Screening of pregnant women attending the antenatal care clinic of a tertiary hospital in eastern Saudi Arabia for Chlamydia trachomatis and Neisseria gonorrhoeae infections

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    Alzahrani Alhusain

    2010-01-01

    Full Text Available Inroduction: Of the "top ten" sexually transmitted infections, Chlamydia trachomatis and Neisseria gonorrhoeae are ranked second and fifth, respectively, worldwide. Aim: The aim of this study was to screen the pregnant women for C. trachomatis and N. gonorrhoeae infections and to detect antimicrobial resistance pattern of N. gonorrhoeae. Materials and Methods: This study was a prospective, hospital-based analysis of a random sample of pregnant women visiting the antenatal clinic of a tertiary hospital in eastern Saudi Arabia. Endocervical and high vaginal swabs were collected both from pregnant women and female patients attending gynecology clinic with lower genital tract infection (control group. C. trachomatis antigen was detected using enzyme-linked immunosorbent assay (ELISA. N. gonorrhoeae was detected by culture and identification of isolates, and antimicrobial susceptibility testing was performed. Statistical Package for Social Sciences (SPSS version 13.0 and Chi-square test were used for statistical analysis. Results: C. trachomatis antigen was detected in 10.5% (10/95 and 34.4% (35/102 of pregnant women and control group, respectively (P < 0.001. The isolation rate of N. gonorrhoeae among pregnant women was 0.0% compared to 7.8% (8/102 among the control group (P < 0.01. N. gonorrhoeae were resistant to penicillin (62.5%, tetracycline (50%, ampicillin (25%, amoxycillin-clavulinic acid (25% and ciprofloxacin (37.5%, while they were susceptible to cefepime, ceftriaxone, ceftazidime, spectinomycin, and cefuroxime. Conclusion: Screening of pregnant women for C. trachomatis infection should be included in the antenatal care in this area. The detection rate of both organisms among the control group highlights the importance of preventive strategies. Certain antibiotics previously used in treating gonorrhea are no longer effective.

  20. The cost-effectiveness of 10 antenatal syphilis screening and treatment approaches in Peru, Tanzania, and Zambia

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    Terris-Prestholt, Fern; Vickerman, Peter; Torres-Rueda, Sergio; Santesso, Nancy; Sweeney, Sedona; Mallma, Patricia; Shelley, Katharine D.; Garcia, Patricia J.; Bronzan, Rachel; Gill, Michelle M.; Broutet, Nathalie; Wi, Teodora; Watts, Charlotte; Mabey, David; Peeling, Rosanna W.; Newman, Lori

    2015-01-01

    Objective Rapid plasma reagin (RPR) is frequently used to test women for maternal syphilis. Rapid syphilis immunochromatographic strip tests detecting only Treponema pallidum antibodies (single RSTs) or both treponemal and non-treponemal antibodies (dual RSTs) are now available. This study assessed the cost-effectiveness of algorithms using these tests to screen pregnant women. Methods Observed costs of maternal syphilis screening and treatment using clinic-based RPR and single RSTs in 20 clinics across Peru, Tanzania, and Zambia were used to model the cost-effectiveness of algorithms using combinations of RPR, single, and dual RSTs, and no and mass treatment. Sensitivity analyses determined drivers of key results. Results Although this analysis found screening using RPR to be relatively cheap, most (> 70%) true cases went untreated. Algorithms using single RSTs were the most cost-effective in all observed settings, followed by dual RSTs, which became the most cost-effective if dual RST costs were halved. Single test algorithms dominated most sequential testing algorithms, although sequential algorithms reduced overtreatment. Mass treatment was relatively cheap and effective in the absence of screening supplies, though treated many uninfected women. Conclusion This analysis highlights the advantages of introducing RSTs in three diverse settings. The results should be applicable to other similar settings. PMID:25963907

  1. Lessons Learned From Newborn Screening for Critical Congenital Heart Defects.

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    Oster, Matthew E; Aucott, Susan W; Glidewell, Jill; Hackell, Jesse; Kochilas, Lazaros; Martin, Gerard R; Phillippi, Julia; Pinto, Nelangi M; Saarinen, Annamarie; Sontag, Marci; Kemper, Alex R

    2016-05-01

    Newborn screening for critical congenital heart defects (CCHD) was added to the US Recommended Uniform Screening Panel in 2011. Within 4 years, 46 states and the District of Columbia had adopted it into their newborn screening program, leading to CCHD screening being nearly universal in the United States. This rapid adoption occurred while there were still questions about the effectiveness of the recommended screening protocol and barriers to follow-up for infants with a positive screen. In response, the Centers for Disease Control and Prevention partnered with the American Academy of Pediatrics to convene an expert panel between January and September 2015 representing a broad array of primary care, neonatology, pediatric cardiology, nursing, midwifery, public health, and advocacy communities. The panel's goal was to review current practices in newborn screening for CCHD and to identify opportunities for improvement. In this article, we describe the experience of CCHD screening in the United States with regard to: (1) identifying the target lesions for CCHD screening; (2) optimizing the algorithm for screening; (3) determining state-level challenges to implementation and surveillance of CCHD; (4) educating all stakeholders; (5) performing screening using the proper equipment and in a cost-effective manner; and (6) implementing screening in special settings such as the NICU, out-of-hospital settings, and areas of high altitude.

  2. Efficacy of selective antenatal screening for hepatitis B among pregnant women in Denmark: is selective screening still an acceptable strategy in a low-endemicity country?

    DEFF Research Database (Denmark)

    Jensen, Lise; Heilmann, Carsten; Smith, Else

    2003-01-01

    included in the study. Blood tests were examined for hepatitis B surface antigen (HBsAg), anti-hepatitis B core antigen (HBc) and anti-HCV. Case records were studied to evaluate whether patients at risk for HBV infection had been tested. Among the 4098 women, 18 10.4%, 95% confidence interval (95% CI) 0.......3-0.71 were HBsAg positive. All had a risk factor for HBV infection. Only 13 (72%) were identified as HBsAg positive in the selective screening programme. 115 women (2.8%, 95% CI 2.3-3.4) were anti-HBc positive only. 95 (83%) were at risk for HBV. Only 72 of these (63%) were tested for HBsAg. The screening...

  3. Capture Their Attention: Capturing Lessons Using Screen Capture Software

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    Drumheller, Kristina; Lawler, Gregg

    2011-01-01

    When students miss classes for university activities such as athletic and academic events, they inevitably miss important class material. Students can get notes from their peers or visit professors to find out what they missed, but when students miss new and challenging material these steps are sometimes not enough. Screen capture and recording…

  4. Screening for Iron Overload: Lessons from the HEmochromatosis and IRon Overload Screening (HEIRS Study

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    Paul C Adams

    2009-01-01

    Full Text Available BACKGROUND: The HEmochromatosis and IRon Overload Screening (HEIRS Study provided data on a racially, ethnically and geographically diverse cohort of participants in North America screened from primary care populations.

  5. Genetic screening and democracy: lessons from debating genetic screening criteria in the Netherlands.

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    van El, Carla Geertruida; Pieters, Toine; Cornel, Martina

    2012-04-01

    Recent decades have witnessed increasing possibilities for genetic testing and screening. In clinical genetics, the doctor's office defined a secluded space for discussion of sensitive reproductive options in cases of elevated risk for genetic disorders in individuals or their offspring. When prenatal screening for all pregnant women became conceivable, the potential increase in scale made social and ethical concerns relevant for the whole of society. Whereas genetic testing in clinical genetic practice was widely accepted, prenatal screening at a population level met with unease. Concerns were raised regarding social pressure to screen: the sum of individual choice might result in a 'collective eugenics'. The government's involvement also raised suspicion: actively offering screening evoked associations with eugenic population policies from the first half of the 20th century. By reconstructing elements of policy and public debate on prenatal screening in the Netherlands from the past 30 years, this article discusses how the government has gradually changed its role in balancing the interest of the individual and the collective on genetic reproductive issues. Against a background of increasing knowledge about and demand for prenatal screening among the population, governmental policy changed from focusing on protection by banning screening toward facilitating screening in a careful and ethically sound way by providing adequate information, decision aids and quality assessment instruments. In the meanwhile, invigorating democracy in public debate may entail discussing concepts of 'the good life' in relation to living with or without impairments and dealing with genetic information about oneself or one's offspring.

  6. Adapting Cell-Based Assays to the High Throughput Screening Platform: Problems Encountered and Lessons Learned.

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    Maddox, Clinton B; Rasmussen, Lynn; White, E Lucile

    2008-06-01

    In recent years, cell-based phenotypic assays have emerged as an effective and robust addition to the array of assay technologies available for drug discovery in the high throughput screening arena. Previously, biochemical target-based assays have been the technology of choice. With the emergence of stem cells as a basis for a new screening technology, it is important to keep in mind the lessons that have been learned from the adaptation of existing stable cell lines onto the high throughput screening drug discovery platform, with special consideration being given to assay miniaturization, liquid handling complications and instrument-introduced artifacts. We present an overview of the problems encountered with the implementation of multiple cell-based assays at the High Throughput Screening Center at Southern Research Institute as well as empirically defined effective solutions to these problems. These include examples of artifacts induced by temperature differences throughout the screening campaign, cell plating conditions including the effect of room temperature incubation on assay consistency, DMSO carry-over, and incubator induced artifacts.

  7. Lessons in Medical Record Abstraction from the Prostate, Lung, Colorectal, and Ovarian (PLCO) National Screening Trial.

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    Bazzi, Latifa; Lamerato, Lois E; Varner, Julie; Shambaugh, Vicki L; Cordes, Jill E; Ragard, Lawrence R; Marcus, Pamela M

    2015-01-01

    The most rigorous and accurate approach to evaluating clinical events in cancer screening studies is to use data obtained through medical record abstraction (MRA). Although MRA is complex, the particulars of the procedure-such as the specific training and quality assurance processes, challenges of implementation, and other factors that influence the quality of abstraction--are usually not described in reports of studies that employed the technique. In this paper, we present the details of MRA activities used in the Prostate, Lung, Colorectal, and Ovarian (PLCO) Cancer Screening Trial, which used MRA to determine primary and secondary outcomes and collect data on other clinical events. We describe triggers of the MRA cycle and the specific tasks that were part of the abstraction process. We also discuss training and certification of abstracting staff, and technical methods and communication procedures used for data quality assurance. We include discussion of challenges faced and lessons learned.

  8. Lessons from high-throughput protein crystallization screening: 10 years of practical experience

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    JR, Luft; EH, Snell; GT, DeTitta

    2011-01-01

    Introduction X-ray crystallography provides the majority of our structural biological knowledge at a molecular level and in terms of pharmaceutical design is a valuable tool to accelerate discovery. It is the premier technique in the field, but its usefulness is significantly limited by the need to grow well-diffracting crystals. It is for this reason that high-throughput crystallization has become a key technology that has matured over the past 10 years through the field of structural genomics. Areas covered The authors describe their experiences in high-throughput crystallization screening in the context of structural genomics and the general biomedical community. They focus on the lessons learnt from the operation of a high-throughput crystallization screening laboratory, which to date has screened over 12,500 biological macromolecules. They also describe the approaches taken to maximize the success while minimizing the effort. Through this, the authors hope that the reader will gain an insight into the efficient design of a laboratory and protocols to accomplish high-throughput crystallization on a single-, multiuser-laboratory or industrial scale. Expert Opinion High-throughput crystallization screening is readily available but, despite the power of the crystallographic technique, getting crystals is still not a solved problem. High-throughput approaches can help when used skillfully; however, they still require human input in the detailed analysis and interpretation of results to be more successful. PMID:22646073

  9. Asymptomatic bacteriuria in antenatal women

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    Lavanya S

    2002-01-01

    Full Text Available A total of 500 antenatal women in their first or second trimesters were screened over a period of 2 years for asymptomatic bacteriuria. Out of them, 8.4% (42 were culture positive. A control group of 100 non-pregnant women, both married and unmarried, was also simultaneously screened. The control group yielded an overall culture positivity of 3% (4% in the married non-pregnant women and 2% in the unmarried women. Primigravida had highest percent culture positivity of 66.6%. The incidence was higher in less than 20 years age group i.e. 71.42%. Of the screening tests, Gram stained smear when compared with the standard loop method, showed the highest sensitivity of 95.2%. The specificity of the screening tests was high [Gram stained smear (98.6%, catalase test (97.1% and pus cell count(96.5%]. Escherichia coli was the most common organism isolated in the test and control groups. The organisms were sensitive to cephalexin, nitrofurantoin, amoxycillin and norfloxacin in decreasing order. Incidence of prematurity was 75% and that of low birth weight was 50% in untreated patients.

  10. Serendipity: A Rare Discovery of Haemoglobin D-Iran in An Indian Female During Routine Antenatal Screening for β-Thalassemia.

    Science.gov (United States)

    Chandel, Rittu Surjit; Roy, Abhishek; Abichandani, Leela Gul

    2015-07-01

    Haemoglobin D is a rare form of haemoglobinopathy in homozygous form. However, the heterozygous form of the disease is clinically silent and relatively easier to find in North-West India, Pakistan and Iran. Haemoglobin D is sometimes found to be coexistent with Haemoglobin S and/or Thalassaemia leading to clinically significant conditions like sickle cell anaemia with mild to moderate splenomegaly. In India the more prevalent form is Haemoglobin D-Punjab (also known as Hb D- Los Angeles) which has a prevalence of 2% in Punjab and around 1% in Gujarat. However, the variant, Haemoglobin D- Iran is very rare in India in heterozygous as well as homozygous forms. This report is of a 36-year-old female, who visited for an antenatal check up. On analysing the blood sample using Agarose Gel Electrophoresis in Alkaline media, the migration of abnormal haemoglobin to haemoglobin S/D/G region was observed. Sickle cell solubility test was negative. On capillary electrophoresis, peak in the Haemoglobin D Zone was seen.

  11. [Results and lessons after 10 years of universal neonatal hearing screening in the Champagne-Ardenne region of France].

    Science.gov (United States)

    Chays, André; Labrousse, Marc; Makeieff, Marc

    2014-01-01

    In France, universal newborn hearing screening has been mandatory since April23rd, 2012, but it began in the Champagne-Ardenne region on January 15th 2004. More than 99 % of 160 196 newborns have since been systematically screened in this region. Bilateral hearing impairment was thus identified in 116 infants when they were around 3.5 months old. Earlier diagnosis improves the outcome of deafness, which is only diagnosed around age 20 months without screening. The authors report their experience and the lessons learnt.

  12. HIV testing and treatment in the antenatal care setting.

    LENUS (Irish Health Repository)

    Coulter-Smith, S

    2010-01-01

    Routine linked HIV antenatal screening, with "opt-out", was introduced at the Rotunda in January 1998. This paper reviews the screening and subsequent pregnancy management and outcome in HIV positive women from 1998 to 2006. During this time 225 women (280 pregnancies) were HIV positive and 194 women subsequently delivered at the Rotunda, representing 233 liveborn infants. Overall anti-HIV prevalence was 0.42%, increasing from 0.06% in 1998 to 0.57% in 2006. Of 233 livebirths, 111 (48%) were delivered by spontaneous vaginal delivery (SVD). HIV treatment was started pre-pregnancy in 14 (6%) pregnancies and antenatally in 208 (90%). The vertical transmission rate in mothers receiving >4 weeks of treatment was 0%. We conclude that routine antenatal HIV screening is effective and significantly benefits the health of mother and child.

  13. HIV testing and treatment in the antenatal care setting.

    LENUS (Irish Health Repository)

    Coulter-Smith, S

    2012-02-01

    Routine linked HIV antenatal screening, with "opt-out", was introduced at the Rotunda in January 1998. This paper reviews the screening and subsequent pregnancy management and outcome in HIV positive women from 1998 to 2006. During this time 225 women (280 pregnancies) were HIV positive and 194 women subsequently delivered at the Rotunda, representing 233 liveborn infants. Overall anti-HIV prevalence was 0.42%, increasing from 0.06% in 1998 to 0.57% in 2006. Of 233 livebirths, 111 (48%) were delivered by spontaneous vaginal delivery (SVD). HIV treatment was started pre-pregnancy in 14 (6%) pregnancies and antenatally in 208 (90%). The vertical transmission rate in mothers receiving >4 weeks of treatment was 0%. We conclude that routine antenatal HIV screening is effective and significantly benefits the health of mother and child.

  14. Study of compliance with a new, targeted antenatal D immunization prevention programme in Denmark

    DEFF Research Database (Denmark)

    Damkjaer, M B; Perslev, A; Clausen, F B

    2012-01-01

    A targeted routine antenatal anti-D prophylaxis programme was implemented in Denmark where anti-D immunoglobulin is given based on the result from noninvasive antenatal screening for fetal RHD. Our objective was to evaluate compliance with this new programme right after its initiation. Materials and...

  15. Nutritional Epidemiology of Antenatal Smoking Cessation Among Japanese Women.

    Science.gov (United States)

    Mak, Kwok-Kei; Watanabe, Hiroko; Nomachi, Shinobu; Suganuma, Nobuhiko

    2016-01-01

    This study compared the nutritional status before pregnancy, as well as dietary profiles and biomarkers during first trimester, between never-smokers and antenatal quitters among Japanese women. One hundred fifty pregnant women (79 never-smokers and 71 antenatal quitters) from two obstetrics and gynecology clinics were recruited in Japan. Subjects' prepregnancy nutritional status was indicated by their body mass index (BMI). In the first trimester, their dietary profiles were assessed by the Brief Diet-History Questionnaire (BDHQ) and pregnancy outcomes were screened by biomarker tests. Generalized linear regression was used to examine the differences of energy-adjusted dietary intakes and biomarker results between the two smoking groups, with adjustment of maternal age, BMI, gestation week, and parity. The results showed that antenatal quitters were more likely to have a prepregnancy underweight status than never-smokers. During the first trimester, antenatal quitters had significantly higher intakes of unsaturated fatty acids and antioxidants (vegetable lipids and isoflavone), and lower intakes of total cholesterol than never-smokers. Moreover, antenatal quitters had a significantly higher level of serum homocysteine (6.36 nmol/mL vs 4.88 nmol/mL) than never-smokers. In conclusion, antenatal quitters are more likely to have a poor nutritional status before pregnancy than never-smokers. Quitting smoking before pregnancy and having a good nutritional profile during the trimester may not sufficiently reverse the adverse effects of former smoking behaviors on pregnancy outcomes.

  16. Antenatal screening combined with chromosome analysis to prevent fetus birth with chromosome disease%产前筛查并染色体分析预防染色体病胎儿出生

    Institute of Scientific and Technical Information of China (English)

    王宏; 陈武斌

    2011-01-01

    目的 对产前筛查和染色体分析预防染色体病胎儿出生的工作进行回顾性的总结,为今后减少出生缺陷提供指导.方法 通过对优生咨询、血清筛查检出的高风险孕妇和超声筛查怀疑胎儿有染色体病的孕妇进行胎儿染色体分析,核型严重异常者终止妊娠.结果 ①优生咨询筛查出的高风险孕妇中接受染色体分析者372例,染色体异常检出率为4.57%(17/372),终止妊娠5例;②血清筛查孕妇共32 848例,高风险2 085例,筛查阳性率6.35%;染色体分析740例,染色体异常检出率为4.59%(34/740),终止妊娠18例;③超声筛查异常进行染色体分析177例,异常检出率为19.77%(35/177),终止妊娠32例;④染色体分析共1 289例,异常检出率为6.67%(86/1 289),数目异常50例全部终止妊娠,结构异常36例中有5例终止妊娠,终止妊娠率为4.27%(55/1 289).结论 优生咨询、血清筛查、超声筛查组成的筛查体系结合染色体分析可提高染色体病的检出率,超声筛查的检出率最高;每位孕妇都应接受系统的产前筛查,高危孕妇应接受染色体分析,最大限度地避免染色体病胎儿出生.%Objective To retrospectively analyze the results of antenatal screening and chromosome analysis on the prevalence of fetus birth with chromosome disease so as to provide guidance for reducing birth defects in the future. Methods Fetal chromosomal analysis was done for high-risk pregnant women screened by eugenic consulation and serum screening and for those whose fetus were suspected to have chromosomal abnormalities detected by ultrasonography. Termination of pregnancy ( TOP ) was given to severe abnormal karyotype. Results Among the high-risk pregnant women screened by eugenic consulation, 372 cases received chromosome analysis, and the detection rate of chromosomal abnormality was 4. 57% ( 17/372 ). Five cases accepted TOP. There were 2 085 cases with high risk among 32 848 pregnant women receiving serum

  17. Study of seroprevalance of Toxoplasma gondii, Rubella virus and Cytomegalovirus (ToRC infections in antenatal women presented with bad obstetric history and comparative evaluation of Nanoplex ToRCH screen ELISA kit with VIDAS

    Directory of Open Access Journals (Sweden)

    Susmitha Simgamsetty

    2015-05-01

    Full Text Available Background: Infections caused by Toxoplasma gondii, Rubella virus and Cytomegalovirus are major causes of Bad Obstetric History (BOH. Cause of BOH may be genetic, hormonal, abnormal maternal immune response, and maternal infection. Women affected with any of these diseases during pregnancy are at high risk for miscarriage, stillbirth, or for a child with serious birth defects and/or illness and also a hazard to attending staff nurses. Methods: A total 96 serum samples were collected from antenatal women with BOH attending the out-patient services of department of gynaecology at NRI general hospital, Chinakakani, Guntur district, Andhra Pradesh. Serum samples were obtained and were subjected to screening for Immunoglobulin M (IgM and Immunoglobulin G (IgG antibodies of Toxopalsma gondii, Rubella Virus and CMV infections by VIDAS (bioMerieux, France and Nanoplex ToRCH Screen kit [Lilac Medicare (P Ltd, Maharastra, India]. Results: Majority of cases with BOH were found in females aged 18-23 years (25, 52.08% followed by 24-29 years (18, 37.5%. Congenital anomalies and other complications were found to be more in age group 18-23 years followed by 24-29 years. The disease prevalence as studied with respect to IgM antibodies was found to be 31.25% for Cytomegalovirus Infections, 23.96% for Toxoplasma gondii, 21.88% for Rubella virus infections. The overall agreement in the Sensitivity, Specificity, Positive Predictive Value (PPV and Negative Predictive Value (NPV between VIDAS and Nanoplex ToRCH Screen kit for the detection of specific IgM and IgG antibodies in our study was excellent with sensitivity ranging from 90.91%-96.00% and specificity ranging from 89.47%-95.59% for the detection of IgM and IgG antibodies. The discrepancies were relatively less with 8.3% for CMV IgM, 6.2% for CMV IgG, 5.20% for Rubella IgM, 6.25% for Rubella IgG, 6.25% for Toxo IgM and 5.20% for Toxo IgG. Conclusion: Nanoplex ToRCH Screen Kit is a cheap, cost effective

  18. Antenatal cardiotocography and intrauterine death.

    Science.gov (United States)

    Solum, T; Sjöberg, N O

    1980-01-01

    The purpose of the present study was to elucidate the reliability of antenatal cardiotocography (CTG) in predicting fetal death. During a 4-year period, 1 455 patients eith risk pregnancies have been routinely monitored with antenatal CTG. The total number of tracings amounted to more than 10 000. Five cases of fetal death occurred, in all of which pathological CTG patterns were found. Our experience in the present study indicates that antenatal CTG is a reliable technique for the predicting of fetal death and its use should reduce fetal mortality rates.

  19. Antenatal screening and genetic diagnosis of thalassemia among pregnant women and their husbands in Foshan City%佛山地区孕期夫妇地中海贫血筛查及基因诊断

    Institute of Scientific and Technical Information of China (English)

    罗海玲; 区丽群; 杨光

    2011-01-01

    Aim To investigate the incidence rate,the types of gene mutation,and the constituent ratio of thalassemia among pregnant women and their husbands in Foshan. Methods There 5 102 couples were screened for thalassemia by MCV and MCH. The components of hematoglobin (Hb) of the positive samples were detected by HPLC. If HbA2 was over 3.5% or HbF exceeded 2.0%,the testing of β thalassemia gene would be processed. Simultaneously,all screening-positive samples and the spouse of carriers who were deficiency α-thalassemia of South-East Asia would be detected for αthalassemia. If the couples were the same types of thalaasemia gene carriers by screening,then. antenatal gene diagnosis would be performed for high-risk fetus screening. Results Totally 600 thalassemias cases were detected in 5 102 samples,in which α-thalassemia,β-thalassemia and α,β thalassemia were 391 cases (7.66%),209 cases (4.1%) and 27 cases (0.5%),respectively. The total incidence rate of thalassemia was 12.29%. Among α-thalaasemia ,the rate of deficiency thalassamia of South-East Asia(-SEA/αα) and was 75.19% ,left & right side was 21.22%. The gene frequency of four main types of β-thalassemia was 92.35%,including 42.11% (β41- 42),30.62% (β654), 10.53% (β17) and 9.09% (β-28). The resultls of antenatal diagnosis of 98 fetus whose parents were the same type of thalassemia carriers showed that 23 cases were normal,45 were α-thalassemia (27 with -SEA/αα,3 with thalassemia of leaf & right side,3 with HbH,12 with HbBurt's fetal dropsy),30 cases were β-thalassemia (23 with heterozygote,4 with double heterozygote,3 with homozygote).Conclusion The incidence rate,the types of gene mutation,and the constituent ratio of thalassemia among pregnant couples in Foshan were elucidated.%目的 调查佛山地区孕期夫妇及胎儿地中海贫血(地贫)的发生率、基因突变类型及构成比.方法 对以MCV和MCH进行筛查地贫阳性者,采用高效液相色谱技

  20. Impact of antenatal depression on perinatal outcomes and postpartum depression in Korean women

    Directory of Open Access Journals (Sweden)

    Sae Kyung Choi

    2014-01-01

    Full Text Available Background: Maternal prenatal mental health has been shown to be associated with adverse consequences for the mother and the child. However, studies considering the effect of prenatal depressive symptoms are lacking. The aim of this study was to examine the influence of antenatal depressive symptoms on obstetric outcomes and to determine associations between antenatal and postpartum depressions. Materials and Methods: This was a prospective cohort study. The Edinburgh postnatal depression scale (EPDS questionnaire was completed by pregnant women receiving obstetrical care at Seoul St. Mary′s hospital in the third trimester of gestation. The electronic medical records were reviewed after delivery and perinatal outcomes were evaluated. The association between antenatal and postpartum depression was analyzed using the EPDS questionnaire, which was completed by the same women within 2 months of delivery. Results: Of the 467 participants, 26.34% (n = 123 had antenatal depressive symptoms, with EPDS scores of ≥10. There were no significant perinatal outcomes associated with antenatal depressive symptoms. During the postpartum period, 192 of the women in the initial study cohort were given the EPDS again as a follow-up. Of the 192 participants, 56 (29.17% scored >10. Spearman correlation coefficient between the antenatal and postpartum EPDS scores was 0.604, which was statistically significant (P < 0.001. Conclusion: Antenatal depression does not lead to unfavorable perinatal outcomes. However, screening for antenatal depression may be helpful to identify women at risk of postpartum depression.

  1. A case study of haemoglobinopathy screening in the Netherlands: witnessing the past, lessons for the future.

    NARCIS (Netherlands)

    Jans, S.M.P.J.; El, C.G. van; Houwaart, E.S.; Westerman, M.; Janssens, R.J.P.A.; Lagro-Janssen, A.L.M.; Plass, A.M.C.; Cornel, M.C.

    2012-01-01

    Objectives. In 2007 neonatal screening (NNS) was expanded to include screening for sickle cell disease (SCD) and beta-thalassaemia. Up until that year no formal recommendations for haemoglobinopathy (carrier) screening existed in the Netherlands. Although it has been subject to debate in the past, p

  2. A case study of haemoglobinopathy screening in the Netherlands: witnessing the past, lessons for the future.

    NARCIS (Netherlands)

    Jans, S.M.P.J.; El, C.G. van; Houwaart, E.S.; Westerman, M.J.; Janssens, R.J.; Lagro-Janssen, A.L.M.; Plass, A.M.; Cornel, M.C.

    2012-01-01

    OBJECTIVES: In 2007 neonatal screening (NNS) was expanded to include screening for sickle cell disease (SCD) and beta-thalassaemia. Up until that year no formal recommendations for haemoglobinopathy (carrier) screening existed in the Netherlands. Although it has been subject to debate in the past, p

  3. Prevalence of Antenatal Depression and Associated Risk Factors among Pregnant Women Attending Antenatal Clinics in Abeokuta North Local Government Area, Nigeria.

    Science.gov (United States)

    Thompson, Okechukwu; Ajayi, IkeOluwapo

    2016-01-01

    Objective. The prevalence of antenatal depression (AD) and associated risk factors among pregnant women attending antenatal clinics in Abeokuta North Local Government Area, Nigeria, was determined. Methods. A descriptive cross-sectional survey was conducted, interviewing 314 pregnant women selected by multistage sampling technique from among those attending antenatal clinics. Information was collected using structured questionnaire and a screening tool, Edinburgh Postnatal Depression Scale (EPDS), to assess probable depression. Results. The prevalence of antenatal depression was 24.5%. There were significant associations between antenatal depression and attending public health facility (P = 0.000), young maternal age (P = 0.012), single marital status (P = 0.010), not having formal education (P = 0.022), large family size (P = 0.029), planned pregnancy (P = 0.014), coexisting medical conditions (P = 0.034), history of previous caesarian section (P = 0.032), drinking alcohol during pregnancy (P = 0.004), and gender based abuse (P = 0.001). On health seeking behaviour for antenatal depression among depressed pregnant women, most, 68.9%, consulted their husbands about their symptoms; 57.3% took the decision to get treatment from doctors, and 52% sought prayer in the church. Conclusion. Antenatal depression is prevalent in this study population. Interventions to address its risk factors should be carried out and physicians should suspect depression in pregnant women reporting alcohol use and gender abuse.

  4. Timing of antenatal care and ART initiation in HIV-infected pregnant women before and after introduction of NIMART

    Directory of Open Access Journals (Sweden)

    Coceka Nandipha Mnyani

    2014-05-01

    Full Text Available In this review of routinely collected data from five community health centres in the Johannesburg Health District, we assess timing of antenatal care and antiretroviral therapy (ART initiation in HIV-infected pregnant women before and after the introduction of nurse-initiated management of ART in antenatal clinics. There are important lessons to be learnt as we reflect on the South African prevention of mother-to-child transmission of HIV programme.

  5. An instrument for broadened risk assessment in antenatal health care including non-medical issues

    OpenAIRE

    Amber Amanda Vos; Mieke J van Veen; Erwin Birnie; Semiha Denktas; Eric AP Steegers; Bonsel, Gouke J

    2015-01-01

    Introduction: Growing evidence on the risk contributing role of non-medical factors on pregnancy outcomes urged for a new approach in early antenatal risk selection. The evidence invites to more integration, in particular between the clinical working area and the public health domain. We developed a non-invasive, standardized instrument for comprehensive antenatal risk assessment. The current study presents the application-oriented development of a risk screening instrument for early antenata...

  6. Postnatal Imaging of Antenatal Hydronephrosis

    Directory of Open Access Journals (Sweden)

    David M. Kitchens

    2009-01-01

    Full Text Available Radiologic imaging of the newborn detected prenatally with hydronephrosis should follow a systematic approach. Upper and lower urinary tract imaging should be performed in most cases in order to determine the etiology and gauge the use of future imaging. An overview of renal ultrasound, voiding cystourethrography, renal scintigraphy, and magnetic resonance urography in the setting of antenatal hydronephrosis are discussed.

  7. Review of current international decision-making processes for newborn screening: lessons for Australia

    Directory of Open Access Journals (Sweden)

    Selina Carolyne Metternick-Jones

    2015-09-01

    Full Text Available Newborn bloodspot screening has been operating successfully in Australia for almost 50 years. Recently, the development of new technologies and treatments has led to calls for the addition of new conditions to the screening programs. Internationally it is recognized by governments that national policies for newborn screening should support transparent and evidence-based decision-making, and promote consistency between states within a country. Australia is lagging behind the international community, and currently has no national policies or decision-making processes, agreed by government, to support its newborn screening programs. In contrast, New Zealand (NZ, the United Kingdom (UK and the United States of America (US have robust and transparent processes to assess conditions for screening, which have been developed by, and have pathways to, government. This review provides detail on the current policy environment for newborn screening in Australia, highlighting that there are a number of risks to the programs resulting from the lack of a decision-making process. It also describes the processes used to assess conditions for newborn screening in the US, UK and NZ. These examples highlight the benefits of developing a national decision-making process, including ensuring that screening is evidence based and effective. These examples also provide models that might

  8. Lessons learnt from TB screening in closed immigration centres in Italy

    Science.gov (United States)

    Crepet, Anna; Repetto, Ernestina; Al Rousan, Ahmad; Sané Schepisi, Monica; Girardi, Enrico; Prestileo, Tullio; Codecasa, Luigi; Garelli, Silvia; Corrao, Salvatore; Ippolito, Giuseppe; Decroo, Tom; Maccagno, Barbara

    2016-01-01

    Background Between June 2012 and December 2013 Médecins Sans Frontières launched a pilot project with the aim of testing a strategy for improving timely diagnosis of active pulmonary TB among migrants hosted in four centres of identification and expulsion (CIE) in Italy. Methods This is a descriptive study. For active TB case finding we used an active symptom screening approach among migrants at admission in four CIE's. Here we describe the feasibility and the yield of this programme. Results Overall, 3588 migrants were screened, among whom 87 (2.4%) had a positive questionnaire. Out of 30 migrants referred for further investigations, three were diagnosed as having TB, or 0.1% out of 3588 individuals that underwent screening. Twenty-five (29%, 25/87) migrants with positive questionnaires were not referred for further investigation, following the doctors' decision; however, for 32 (37%, 32/87) migrants the diagnostic work-out was not completed. In multivariate analyses, being over 35 years (OR 1.7; 95% CI 1.1–2.6) and being transgender (OR 4.9; 95% CI 2.1–11.7), was associated with a positive questionnaire. Conclusions TB screening with symptom screening questionnaires of migrants at admission in closed centres is feasible. However, to improve the yield, follow-up of patients with symptoms or signs suggestive for TB needs to be improved. PMID:27208040

  9. CEREBRAL PALSY : ANTENATAL RISK FACTORS

    Directory of Open Access Journals (Sweden)

    Srinivasa Rao

    2015-05-01

    Full Text Available INTRODUCTION: Cerebral palsy (CP is a group of permanent movement disorders that appear in early childhood. Cerebral palsy is caused by abnormal development or damage to the parts of the brain that control movement, balance, and posture. Most often the problems occur during pregnancy; however, they may also occur during childbirth, or shortly after birth. Often the cause is unknown. AIM: To study the different antenatal maternal risk factors associated with cerebral palsy in the study group. MATERIA LS AND METHODS: Retrospective study was done to assess possible associated antenatal risk factors for cerebral palsy. Mothers of 100 cerebral palsy children were selected who are treated in Rani Chandramani Devi Hospital, a Government hospital in Visakhapa tn am, Andhra Pradesh State, India , from 2012 to 2014 and 100 controls, mothers of normal children were studied. Detailed antenatal history was obtained from the mothers of the children in both affected and control group. RESULTS: From the data, we conclude that the association of maternal anaemia with cerebral palsy is 7.3 times higher; association of maternal hypertension with cerebral palsy is 6.6 time higher, association with Pre - eclampsia is 6 times higher; association with Eclampsia is 8.6 times higher ; with antepartum haemorrhage, the association is 8.6 times higher and association of multiple pregnancy with cerebral palsy is 4.8 times higher than with controls. CONCLUSION: From this study of the role of antenatal risk factors, in the occurrence of cer ebral palsy in children it is concluded that the most common risk factor associated with cerebral palsy is the maternal anaemia and the other important risk factors associated being hypertension, pre eclampsia, eclampsia, antepartum haemorrhage and multipl e births.

  10. Integrated screening for tuberculosis and HIV in tuberculosis contact investigations: lessons learned in North Carolina.

    Science.gov (United States)

    Stout, Jason E; Katrak, Shereen; Goswami, Neela D; Norton, Brianna L; Fortenberry, Ellen R; Foust, Evelyn; Leone, Peter A

    2014-01-01

    Combating the syndemics of tuberculosis (TB) and HIV in the United States will require increasing efficiency as the incidence of TB declines. Fortunately, new tools such as the interferon gamma release assays can be combined with existing strategies such as opt-out HIV testing to facilitate simultaneous, integrated testing for both infections. We describe the lessons learned from our experience with integrated testing for TB and HIV in the setting of TB contact investigations in North Carolina. Integrated testing represents a unique opportunity to leverage TB and HIV program resources to enhance case detection and improve linkages to care. However, joint training in field investigations and diagnostics is critical prior to conducting contact investigations. Furthermore, integrated testing must be tightly coupled to treatment and prevention programs to reduce disease transmission and morbidity from untreated disease in communities.

  11. Antenatal care attendance, a surrogate for pregnancy outcome? The case of Kumasi, Ghana.

    Science.gov (United States)

    Asundep, Ntui N; Jolly, Pauline E; Carson, April; Turpin, Cornelius A; Zhang, Kui; Tameru, Berhanu

    2014-07-01

    Antenatal care (ANC) has been shown to influence infant and maternal outcomes. WHO recommends 4 ANC visits for uncomplicated pregnancies. However, pregnant women in Ghana are required to attend 8-13 antenatal visits. We investigated the association of ANC attendance with adverse pregnancy outcomes (defined as low infant birth weight, stillbirth, preterm delivery or small for gestational age). A quantitative cross-sectional study was conducted on 629 women, age 19-48 years who presented for delivery at two selected public hospitals and 16 traditional birth attendants from July to November 2011. Socio-demographic and antenatal information were collected using a structured questionnaire. ANC attendance, medical and obstetric/gynecological history were abstracted from maternal antenatal records. Data were analyzed using Chi square and logistic regression. Twenty-two percent of the women experienced an adverse outcome. Eleven percent of the women attended 5 children) was also associated with adverse birth outcomes. Women screened for syphilis or use of insecticide-treated bed nets had a 40 and 36% (p = 0.0447 and p = 0.0293) reduced likelihood of experiencing an adverse pregnancy outcome respectively. After adjusting for confounders, attending <4 antenatal visits was associated with adverse pregnancy outcome compared with ≥4 ANC visits (Adjusted OR 2.55; 95% CI 1.16-5.63; p = 0.0202). Attending <4 antenatal visits and high parity were associated with adverse pregnancy outcomes for uncomplicated pregnancies.

  12. Prevalence and Risk Factors of Antenatal Depression among Omani Women in a Primary Care Setting; Cross-sectional study

    Directory of Open Access Journals (Sweden)

    Mohammed Al-Azri

    2016-02-01

    Full Text Available Objectives: This study aimed to identify the prevalence of antenatal depression and the risk factors associated with its development among Omani women. No previous studies on antenatal depression have been conducted in Oman. Methods: This descriptive cross-sectional study was carried out between January and November 2014 in Muscat, Oman. Pregnant Omani women ≥32 gestational weeks who were attending one of 12 local primary care health centres in Muscat for routine antenatal care were invited to participate in the study (n = 986. An Arabic version of the validated self-administered Edinburgh Postnatal Depression Scale questionnaire was used to measure antenatal depression. A cut-off score of ≥13 was considered to indicate probable depression. Results: A total of 959 women participated in the study (response rate: 97.3%. Of these, 233 were found to have antenatal depression (24.3%. A bivariate analysis showed that antenatal depression was associated with unplanned pregnancies (P = 0.010, marital conflict (P = 0.001 and a family history of depression (P = 0.019. The adjusted odds ratio (OR after logistic multivariate regression analysis showed that antenatal depression was significantly associated with unplanned pregnancies (OR: 1.37; 95% confidence interval [CI]: 1.02–1.86 and marital conflict (OR: 13.83; 95% CI: 2.99–63.93. Conclusion: The prevalence of antenatal depression among the studied Omani women was high, particularly in comparison to findings from other Arab countries. Thus, antenatal screening for depression should be considered in routine primary antenatal care. Couples should also be encouraged to seek psychological support should marital conflicts develop during pregnancy.

  13. Antenatal hypnosis training and childbirth experience

    DEFF Research Database (Denmark)

    Werner, Anette; Uldbjerg, Niels; Zachariae, Robert

    2013-01-01

    Childbirth is a demanding event in a woman's life. The aim of this study was to explore whether a brief intervention in the form of an antenatal course in self-hypnosis to ease childbirth could improve the childbirth experience.......Childbirth is a demanding event in a woman's life. The aim of this study was to explore whether a brief intervention in the form of an antenatal course in self-hypnosis to ease childbirth could improve the childbirth experience....

  14. Fibrochondrogenesis, an Antenatal and Postnatal Correlation

    Directory of Open Access Journals (Sweden)

    Nischal G Kundaragi

    2012-01-01

    Full Text Available Fibrochondrogenesis is a rare, neonatally lethal osteochondrodysplasia, with autosomal recessive inheritance. It differs from other lethal dwarfisms in that it leads to broad, long-bone metaphyses (dumb-bell shaped and pear-shaped vertebral bodies. We report a case of fibrochondrogenesis with severe pear-shaped platyspondyly, suspected antenatally, and give a comprehensive pictorial review of the antenatal ultrasound and postnatal radiographic findings. Only few cases of fibrochondrogenesis are diagnosed before the termination of pregnancy.

  15. Antenatal hydronephrosis: Negative predictive value of normal postnatal ultrasound - a 5-year study

    Energy Technology Data Exchange (ETDEWEB)

    Moorthy, I.; Joshi, N.; Cook, J.V. E-mail: jcook@epsom-sthelier.nhs.uk; Warren, M

    2003-12-01

    AIM: To determine whether normal postnatal ultrasound, as part of a strict screening protocol for the detection and follow-up of antenatal hydronephrosis, effectively excludes the majority of babies with congenital urinary tract abnormalities that would otherwise present with a urinary tract infection. MATERIALS AND METHODS: We retrospectively reviewed all babies who had postnatal follow-up of antenatally detected hydronephrosis over a 5-year period at our institution, a district general Trust with a specialist paediatric unit. We then studied all babies presenting with urinary tract infection before their first birthday to our institution over the same period. By cross-referencing these two study groups we were able to determine which babies developed a urinary tract infection having been previously discharged after normal postnatal ultrasound. RESULTS: Four hundred and twenty-five babies had postnatal follow-up of antenatal hydronephrosis. Of these, 284 were investigated with ultrasound alone. In the same 5-year period, 230 babies presented with urinary tract infection before their first birthday. Only three of these babies had been previously discharged after normal postnatal ultrasound. The negative predictive value of a normal postnatal ultrasound was therefore 98.9% (281/284) for babies who subsequently presented with a urinary tract infection before their first birthday. CONCLUSION: Careful antenatal and postnatal ultrasound with strict protocols is effective in detecting congenital renal tract abnormalities. Infants discharged after normal postnatal ultrasound are highly unlikely to still have an undetected urinary tract abnormality. We suggest that all babies with antenatal hydronephrosis are started on prophylactic antibiotics at birth, pending further investigation. All babies without features of severe obstruction antenatally should have their postnatal ultrasound delayed for a month. We recommend selective use of micturating cystourethrogram (MCUG

  16. Antenatal Bartter Syndrome: A Review

    Directory of Open Access Journals (Sweden)

    Y. Ramesh Bhat

    2012-01-01

    Full Text Available Antenatal Bartter syndrome (ABS is a rare autosomal recessive renal tubular disorder. The defective chloride transport in the loop of Henle leads to fetal polyuria resulting in severe hydramnios and premature delivery. Early onset, unexplained maternal polyhydramnios often challenges the treating obstetrician. Increasing polyhydramnios without apparent fetal or placental abnormalities should lead to the suspicion of this entity. Biochemical analysis of amniotic fluid is suggested as elevated chloride level is usually diagnostic. Awareness, early recognition, maternal treatment with indomethacin, and amniocentesis allow the pregnancy to continue. Affected neonates are usually born premature, have postnatal polyuria, vomiting, failure to thrive, hypercalciuria, and subsequently nephrocalcinosis. Hypokalemia, metabolic alkalosis, secondary hyperaldosteronism and hyperreninaemia are other characteristic features. Volume depletion due to excessive salt and water loss on long term stimulates renin-angiotensin-aldosterone system resulting in juxtaglomerular hyperplasia. Clinical features and electrolyte abnormalities may also depend on the subtype of the syndrome. Prenatal diagnosis and timely indomethacin administration prevent electrolyte imbalance, restitute normal growth, and improve activity. In this paper, authors present classification, pathophysiology, clinical manifestations, laboratory findings, complications, and prognosis of ABS.

  17. Utilization of antenatal ultrasound scan and implications for caesarean section: a cross-sectional study in rural Eastern China

    Directory of Open Access Journals (Sweden)

    Huang Kun

    2012-04-01

    Full Text Available Abstract Background Antenatal ultrasound scan is a widely accepted component of antenatal care. Studies have looked at the relationship between ultrasound scanning and caesarean section (CS in certain groups of women in China. However, there are limited data on the utilization of antenatal ultrasound scanning in the general population, including its association with CS. The purpose of this study is to describe the utilization of antenatal ultrasound screening in rural Eastern China and to explore the association between antenatal ultrasound scan and uptake of CS. Methods Based on a cluster randomized sample, a total of 2326 women with childbirth participated in the study. A household survey was conducted to collect socio-economic information, obstetric history and utilization of maternal health services. Results Coverage of antenatal care was 96.8% (2251/2326. During antenatal care, 96.1% (2164/2251 women received ultrasound screening and the reported average number was 2.55. 46.8% women received at least 3 ultrasound scans and the maximum number reached 11. The CS rate was found to be 54.8% (1275/2326. After adjusting for socio-demographic and clinical variables, it showed a statistically significant association between antenatal ultrasound scans and uptake of CS by multivariate logistic regression model. High husband education level, high maternal age, having previous adverse pregnant outcome and pregnancy complications during the index pregnancy were also found to be risk factors of choosing a CS. Conclusions A high use of antenatal ultrasound scan in rural Eastern China is found and is influenced by socio-demographic and clinical factors. Evidence-based guidelines for antenatal ultrasound scans need to be developed and disseminated to clinicians including physicians, nurses and sonographers. Guidance about the appropriate use of ultrasound scans should also be shared with women in order to discourage unreasonable expectations and demands. It

  18. Developing a computer touch-screen interactive colorectal screening decision aid for a low-literacy African American population: lessons learned.

    Science.gov (United States)

    Bass, Sarah Bauerle; Gordon, Thomas F; Ruzek, Sheryl Burt; Wolak, Caitlin; Ruggieri, Dominique; Mora, Gabriella; Rovito, Michael J; Britto, Johnson; Parameswaran, Lalitha; Abedin, Zainab; Ward, Stephanie; Paranjape, Anuradha; Lin, Karen; Meyer, Brian; Pitts, Khaliah

    2013-07-01

    African Americans have higher colorectal cancer (CRC) mortality than White Americans and yet have lower rates of CRC screening. Increased screening aids in early detection and higher survival rates. Coupled with low literacy rates, the burden of CRC morbidity and mortality is exacerbated in this population, making it important to develop culturally and literacy appropriate aids to help low-literacy African Americans make informed decisions about CRC screening. This article outlines the development of a low-literacy computer touch-screen colonoscopy decision aid using an innovative marketing method called perceptual mapping and message vector modeling. This method was used to mathematically model key messages for the decision aid, which were then used to modify an existing CRC screening tutorial with different messages. The final tutorial was delivered through computer touch-screen technology to increase access and ease of use for participants. Testing showed users were not only more comfortable with the touch-screen technology but were also significantly more willing to have a colonoscopy compared with a "usual care group." Results confirm the importance of including participants in planning and that the use of these innovative mapping and message design methods can lead to significant CRC screening attitude change.

  19. Number and timing of antenatal HIV testing

    DEFF Research Database (Denmark)

    Nguyen Thi Thuy, Hanh; Gammeltoft, Tine; Rasch, Vibeke

    2011-01-01

    ABSTRACT: BACKGROUND: HIV testing for pregnant women is an important component for the success of prevention of mother-to-child transmission of HIV (PMTCT). A lack of antenatal HIV testing results in loss of benefits for HIV-infected mothers and their children. However, the provision of unnecessary...... repeat tests at a very late stage of pregnancy will reduce the beneficial effects of PMTCT and impose unnecessary costs for the individual woman as well as the health system. This study aims to assess the number and timing of antenatal HIV testing in a low-income setting where PMTCT programmes have been...... scaled up to reach first level health facilities. METHODS: A cross-sectional community-based study was conducted among 1108 recently delivered mothers through face-to-face interviews following a structured questionnaire that focused on socio-economic characteristics, experiences of antenatal care and HIV...

  20. Antenatal imaging of cutis verticis gyrata

    Energy Technology Data Exchange (ETDEWEB)

    Kennedy, Ana [Starship Hospital, Department of Paediatric Cardiology, Auckland (New Zealand); Perry, David [Starship Children' s Hospital, Radiology Department, Auckland (New Zealand); Battin, Malcolm [Auckland City Hospital, Newborn Services, National Women' s Health, Auckland (New Zealand); University of Auckland, Department of Paediatrics, Auckland (New Zealand)

    2008-05-15

    Cutis verticis gyrata (CVG) is a skin condition characterized by thick folds and deep furrows, resembling a cortical gyral pattern. There is a recognized but rare association with Noonan syndrome. We report the antenatal imaging, including three-dimensional surface-rendered sonography and MRI, of a fetus with CVG who was subsequently diagnosed with Noonan syndrome. The case illustrates the antenatal appearances of congenital CVG and the potential yield of antenatal imaging in excluding a major central nervous system anomaly. This is important because without prior knowledge of this condition and its imaging characteristics, it is possible to get a false impression of an underlying skull defect on mid-trimester imaging. (orig.)

  1. Glycemic management after antenatal corticosteroid therapy

    Directory of Open Access Journals (Sweden)

    Sanjay Kalra

    2014-01-01

    Full Text Available Antenatal corticosteroids (ACS are recommended for use in antenatal mothers at risk of preterm delivery before 34 weeks. One common side-effect of these drugs is their propensity to cause hyperglycemia. A PubMed search was made using terms ′steroid,′ ′dexamethasone,′ ′betamethasone′ with diabetes/glucose. Relevant articles were extracted. In addition, important cross-reference articles were reviewed. This review, based upon this literature search, discusses the available evidence on effects on glycemic status as well as management strategies in women with pre-existing diabetes, gestational diabetes mellitus, as well as normoglycemic women after ACS use in pregnancy.

  2. What is the impact of antenatal diagnosis on long-term outlook?

    Energy Technology Data Exchange (ETDEWEB)

    Garel, Laurent [CHU Ste-Justine, Department of Medical Imaging, Montreal (Canada)

    2008-06-15

    Congential malformations result in very significant consequences in paediatrics; more than 20% of infant mortality, more than 30% of paediatric ICU admissions, and one-third of overall admissions in the paediatric age group are linked to congential malformations. Health economics and antenatal diagnosis. Key issues yet to be addressed include: 1. Clarification of the objectives for screening for birth defects: Is it to detect cases or to prevent the birth of affected fetuses? 2. The establishment of the trade-of between resources allocated to screening and those allocated to help families and disabled children. 3. The value of a child born with structural or chromosomal defects compared with miscarriage of a normal fetus following amniocentesis. Apart from the ethical debates related to prenatal screening (variable expertise, rationing of resources, eugenics), the economic evaluations of antenatal diagnosis espouse the hypothesis and value judgment of the health commissioners. Indeed, prenatal screening and antenatal diagnosis carry high political and social stakes that make evidence-based evaluation of their impact more difficult than in any field in medicine. (orig.)

  3. Antenatal care in practice: an exploratory study in antenatal care clinics in the Kilombero Valley, south-eastern Tanzania

    Directory of Open Access Journals (Sweden)

    Kessy Flora

    2011-05-01

    Full Text Available Abstract Background The potential of antenatal care for reducing maternal morbidity and improving newborn survival and health is widely acknowledged. Yet there are worrying gaps in knowledge of the quality of antenatal care provided in Tanzania. In particular, determinants of health workers' performance have not yet been fully understood. This paper uses ethnographic methods to document health workers' antenatal care practices with reference to the national Focused Antenatal Care guidelines and identifies factors influencing health workers' performance. Potential implications for improving antenatal care provision in Tanzania are discussed. Methods Combining different qualitative techniques, we studied health workers' antenatal care practices in four public antenatal care clinics in the Kilombero Valley, south-eastern Tanzania. A total of 36 antenatal care consultations were observed and compared with the Focused Antenatal Care guidelines. Participant observation, informal discussions and in-depth interviews with the staff helped to identify and explain health workers' practices and contextual factors influencing antenatal care provision. Results The delivery of antenatal care services to pregnant women at the selected antenatal care clinics varied widely. Some services that are recommended by the Focused Antenatal Care guidelines were given to all women while other services were not delivered at all. Factors influencing health workers' practices were poor implementation of the Focused Antenatal Care guidelines, lack of trained staff and absenteeism, supply shortages and use of working tools that are not consistent with the Focused Antenatal Care guidelines. Health workers react to difficult working conditions by developing informal practices as coping strategies or "street-level bureaucracy". Conclusions Efforts to improve antenatal care should address shortages of trained staff through expanding training opportunities, including health worker

  4. Health education during antenatal care: the need for more

    Directory of Open Access Journals (Sweden)

    Al-Ateeq MA

    2015-02-01

    Full Text Available Mohammed A Al-Ateeq,1 Amal A Al-Rusaiess21College of Medicine, King Saud Bin Abdul-Aziz University for Health Sciences, 2Department of Family Medicine and Primary Health Care, King Abdul-Aziz Medical City, National Guard Health Affairs, Riyadh, Kingdom of Saudi Arabia Abstract: The aim of health education during ante natal is to provide advice, education, ­reassurance and support, to address and treat the minor problems of pregnancy, and to provide effective screening during the pregnancy. Exploring current practices in this regard revealed the need for more organized educational activities to ensure high quality and clients satisfaction. Keywords: antenatal care, health education, pregnant women, postpartum, misconceptions

  5. Establishing and Sustaining a Prospective Screening Program for Breast Cancer-Related Lymphedema at the Massachusetts General Hospital: Lessons Learned

    Directory of Open Access Journals (Sweden)

    Cheryl Brunelle

    2015-05-01

    Full Text Available There has been an increasing call to prospectively screen patients with breast cancer for the development of breast cancer-related lymphedema (BCRL following their breast cancer treatment. While the components of a prospective screening program have been published, some centers struggle with how to initiate, establish, and sustain a screening program of their own. The intent of this manuscript is to share our experience and struggles in establishing a prospective surveillance program within the infrastructure of our institution. It is our hope that by sharing our history other centers can learn from our mistakes and successes to better design their own prospective screening program to best serve their patient population.

  6. Is routine antenatal venereal disease research laboratory test still justified? Nigerian experience

    Directory of Open Access Journals (Sweden)

    Nwosu BO

    2015-01-01

    Full Text Available Betrand O Nwosu,1 George U Eleje,1 Amaka L Obi-Nwosu,2 Ita F Ahiarakwem,3 Comfort N Akujobi,4 Chukwudi C Egwuatu,4 Chukwudumebi O Onyiuke5 1Department of Obstetrics and Gynecology, Nnamdi Azikiwe University, Nnewi Campus, Nnewi, Anambra State, Nigeria; 2Department of Family Medicine, Nnamdi Azikiwe University Teaching Hospital, Nnewi, Nigeria; 3Department of Medical Microbiology, Imo State University Teaching Hospital, Orlu, Imo State, Nigeria; 4Department of Medical Microbiology, Nnamdi Azikiwe University, Nnewi Campus, Nnewi, Anambra State, Nigeria; 5Department of Medical Microbiology, Nnamdi Azikiwe University Teaching Hospital, Nnewi, Anambra State, NigeriaObjective: To determine the seroreactivity of pregnant women to syphilis in order to justify the need for routine antenatal syphilis screening.Methods: A multicenter retrospective analysis of routine antenatal venereal disease research laboratory (VDRL test results between 1 September 2010 and 31 August 2012 at three specialist care hospitals in south-east Nigeria was done. A reactive VDRL result is subjected for confirmation using Treponema pallidum hemagglutination assay test. Analysis was by Epi Info 2008 version 3.5.1 and Stata/IC version 10.Results: Adequate records were available regarding 2,156 patients and were thus reviewed. The mean age of the women was 27.4 years (±3.34, and mean gestational age was 26.4 weeks (±6.36. Only 15 cases (0.70% were seropositive to VDRL. Confirmatory T. pallidum hemagglutination assay was positive in 4 of the 15 cases, giving an overall prevalence of 0.19% and a false-positive rate of 73.3%. There was no significant difference in the prevalence of syphilis in relation to maternal age and parity (P>0.05.Conclusion: While the prevalence of syphilis is extremely low in the antenatal care population at the three specialist care hospitals in south-east Nigeria, false-positive rate is high and prevalence did not significantly vary with maternal age or

  7. Antenatal prophylaxis of Rh isoimmunization: 28-weeks'-gestation service program.

    Science.gov (United States)

    Bowman, J M; Pollock, J M

    1978-03-18

    Two (0.18%) of 1086 Rh-negative primigravidas or multigravidas treated similarly in all previous pregnancies, who were given a single injection of Rh immune globulin (300 mug) at 28 weeks' gestation and subsequently were delivered of Rh-positive babies, had demonstrable Rh isoimmunization at the time of that injection and must be considered "logistic" failures of antenatal prophylaxis. The remaining 1084 (who were treated again after delivery) had no evidence of Rh isoimmunization at delivery and none of the 512 screened at 6 months after delivery appeared to be immunized. If the 28th-week injection had not been protective, one would have expected 14 of the 1084 to have been demonstrably Rh isoimmunized and evidence of Rh isoimmunization to have persisted in 6 of the 512 observed 6 months after delivery.Six of 719 Rh-negative multigravidas who had not received Rh immune globulin after previous pregnancies or had been treated only after delivery showed evidence of Rh isoimmunization despite a single injection of Rh immune globulin at 28 weeks in a subsequent pregnancy. In three of the six the cause was most likely "sensibilization" due to previous exposure to Rh-positive blood or an untreated Rh-positive pregnancy. in 3 of the remaining 716 (0.42%) there may have been true failure of antenatal Rh prophylaxis administered at the 28th week. One would have expected this figure to be 12 of 716 if antenatal Rh prophylaxis at 28 weeks' gestation were totally unsuccessful.It is concluded that a single intramuscular injection of Rh immune globulin, 300 mug, is 88% effective in preventing Rh isoimmunization during pregnancy in Rh-negative primigravidas and in multigravidas treated antenatally in all previous pregnancies, and is 75% effective in preventing Rh isoimmunization in Rh-negative multigravidas untreated during previous pregnancies. The majority of failures are due to Rh isoimmunization during pregnancy prior to antenatal prophylaxis at 28 weeks.

  8. Rh isoimmunization during pregnancy: antenatal prophylaxis.

    Science.gov (United States)

    Bowman, J M; Chown, B; Lewis, M; Pollock, J M

    1978-03-18

    Of 3533 Rh-negative women who began a pregnancy without detectable Rh antibodies, 62 (1.8%) demonstrated evidence of Rh isoimmunization during pregnancy or within 3 days after delivery. All denied transfusions as well as abortions or previous pregnancies not followed by the administration of Rh immune globulin. Rh isoimmunization during pregnancy or within 3 days after delivery, which will not be prevented by the administration of Rh immune globulin after delivery, is the most important cause of residual Rh isoimmunization. A clinical trial of antenatal administration of Rh immune globulin, initially at 34 weeks's and subsequently at 28 and 34 weeks' gestation, in 1357 Rh-negative pregnant women who were delivered of Rh-positive babies, was effective in preventing the development of Rh isoimmunization during pregnancy or within 3 days after delivery. Antenatal prophylaxis with Rh immune globulin will be necessary if the incidence of Rh isoimmunization is to be reduced to its lowest possible level. Antenatal prophylaxis at 28 weeks' gestation is now an insured service in Manitoba.

  9. Does an Antenatal Care make a difference?

    Directory of Open Access Journals (Sweden)

    Jaspinder Kaur

    2013-04-01

    Full Text Available Antenatal Care utilization and its effects among booked and unbooked women were studied retrospectively in Obstetrics-Gynaecology Department, Punjab Institute of Medical Sciences, Jalandhar (India during April- June, 2012. Demographic variables, obstetric history and event outcomes were explored. Unbooked (58% status was seen with primiparity, low socioeconomic status (p<0.01 and younger age (p<0.001; 20-25 yrs. 37.21% of unbooked mothers had Anemia (p<0.01 while fetuses of 24.14% mothers developed Fetal Distress. Incidence of Oligohydraminos, Pregnancy Induced Hypertension, Intrauterine Growth Retardation, Preterm Premature Rupture Of Membrane and Preterm Labour were higher among unbooked mothers. Unbooked status had higher Preterm (22.42% and Low Birth Weight babies (51.73%. Majority of mothers of moderate age (40.48%; 26-30yrs, high socioeconomic status (26.20% and multiparity (54.77% booked themselves. The lack of required antenatal care might have led to higher obstetric complications among unbooked mothers. Improving socioeconomic status and women literacy rate may increase the number of booked mothers which may provide them the needed antenatal care.

  10. A Qualitative Study about Cervical Cancer Screening among Latinas Living in a Rural Area of California: Lessons for Health Educators

    Science.gov (United States)

    Pinzon-Perez, Helda; Perez, Miguel; Torres, Victor; Krenz, Vickie

    2005-01-01

    Cervical cancer is a major health concern for Latinas, who are also less likely to undergo a Pap smear exam than the general population. This study identifies alterable determinants of Pap smear screening for Latino women living in a rural area of California. It involved the design and pilot testing of a culturally appropriate instrument and the…

  11. A prospective cross-screening study on G-protein-coupled receptors: lessons learned in virtual compound library design.

    NARCIS (Netherlands)

    Sanders, M.P.A.; Roumen, L.; Horst, E. van der; Lane, J.R.; Vischer, H.F.; Offenbeek, J. van; Vries, H. de; Verhoeven, S.; Chow, K.Y.; Verkaar, F.; Beukers, M.W.; McGuire, R.; Leurs, R.; IJzerman, A.P.; Vlieg, J. de; Esch, I.J. de; Zaman, G.J.; Klomp, J.P.G.; Bender, A.; Graaf, C. de

    2012-01-01

    We present the systematic prospective evaluation of a protein-based and a ligand-based virtual screening platform against a set of three G-protein-coupled receptors (GPCRs): the beta-2 adrenoreceptor (ADRB2), the adenosine A(2A) receptor (AA2AR), and the sphingosine 1-phosphate receptor (S1PR1). Nov

  12. Psychoprophylaxis - Antenatal preparation and actual use during labour

    OpenAIRE

    Bergström, Malin

    2010-01-01

    The aim of this thesis was to study the effects of a model of antenatal education, focusing on natural childbirth preparation by including psychoprophylaxis, breathing and relaxation techniques to cope with labour pain, and the actual use of psychoprophylaxis during labour. Satisfaction with antenatal education and experiences of a subgroup of men with antenatal fear of childbirth were also explored. The principal design was a randomised controlled trial where the new mo...

  13. Planning Lessons

    Institute of Scientific and Technical Information of China (English)

    Linda Jensen

    2007-01-01

    @@ Jensen's "Lesson Planning"article serves aS a guide fOr novice teachers who need to create formalized lesson plans.The article covers why,when,and how teachers plan lessons,as well aS basic lesson plan principles and a lesson plan template.

  14. Women's education level, antenatal visits and the quality of skilled antenatal care: a study of three African countries.

    Science.gov (United States)

    Babalola, Stella

    2014-02-01

    Many pregnant women in Africa who access professional antenatal care do not receive all the WHO-recommended components of care. Using Demographic and Health Survey (DHS) data from Kenya, Malawi and Nigeria, this study assesses the relationship of education level with the quality of antenatal care received and highlights how the number of antenatal visits mediates this relationship. The results show that a large proportion of the effect of education level on quality of care is direct, while only a small portion is mediated through the number of antenatal visits. Efforts to improve pregnancy outcomes for under-privileged women should focus on removing structural barriers to access, strengthening the technical and interpersonal skills of providers, and addressing providers' biases and discriminatory practices towards these women. Such efforts should also seek to empower underprivileged women to insist on quality antenatal care by explaining what to expect during an antenatal visit.

  15. An instrument for broadened risk assessment in antenatal health care including non-medical issues

    Directory of Open Access Journals (Sweden)

    Amber Amanda Vos

    2015-03-01

    Full Text Available Introduction: Growing evidence on the risk contributing role of non-medical factors on pregnancy outcomes urged for a new approach in early antenatal risk selection. The evidence invites to more integration, in particular between the clinical working area and the public health domain. We developed a non-invasive, standardized instrument for comprehensive antenatal risk assessment. The current study presents the application-oriented development of a risk screening instrument for early antenatal detection of risk factors and tailored prevention in an integrated care setting.Methods: A review of published instruments complemented with evidence from cohort studies. Selection and standardization of risk factors associated with small for gestational age, preterm birth, congenital anomalies and perinatal mortality. Risk factors were weighted to obtain a cumulative risk score. Responses were then connected to corresponding care pathways. A cumulative risk threshold was defined, which can be adapted to the population and the availability of preventive facilities. A score above the threshold implies multidisciplinary consultation between caregivers.Results: The resulting digital score card consisted of 70 items, subdivided into four non-medical and two medical domains. Weighing of risk factors was based on existing evidence. Pilot-evidence from a cohort of 218 pregnancies in a multi-practice urban setting showed a cut-off of 16 points would imply 20% of all pregnant women to be assessed in a multidisciplinary setting. A total of 28 care pathways were defined.Conclusion: The resulting score card is a universal risk screening instrument which incorporates recent evidence on non-medical risk factors for adverse pregnancy outcomes and enables systematic risk management in an integrated antenatal health care setting.

  16. An instrument for broadened risk assessment in antenatal health care including non-medical issues

    Directory of Open Access Journals (Sweden)

    Amber Amanda Vos

    2015-03-01

    Full Text Available Introduction: Growing evidence on the risk contributing role of non-medical factors on pregnancy outcomes urged for a new approach in early antenatal risk selection. The evidence invites to more integration, in particular between the clinical working area and the public health domain. We developed a non-invasive, standardized instrument for comprehensive antenatal risk assessment. The current study presents the application-oriented development of a risk screening instrument for early antenatal detection of risk factors and tailored prevention in an integrated care setting. Methods: A review of published instruments complemented with evidence from cohort studies. Selection and standardization of risk factors associated with small for gestational age, preterm birth, congenital anomalies and perinatal mortality. Risk factors were weighted to obtain a cumulative risk score. Responses were then connected to corresponding care pathways. A cumulative risk threshold was defined, which can be adapted to the population and the availability of preventive facilities. A score above the threshold implies multidisciplinary consultation between caregivers. Results: The resulting digital score card consisted of 70 items, subdivided into four non-medical and two medical domains. Weighing of risk factors was based on existing evidence. Pilot-evidence from a cohort of 218 pregnancies in a multi-practice urban setting showed a cut-off of 16 points would imply 20% of all pregnant women to be assessed in a multidisciplinary setting. A total of 28 care pathways were defined. Conclusion: The resulting score card is a universal risk screening instrument which incorporates recent evidence on non-medical risk factors for adverse pregnancy outcomes and enables systematic risk management in an integrated antenatal health care setting.

  17. IT-supported skill-mix change and standardisation in integrated eyecare: lessons from two screening projects in The Netherlands

    Directory of Open Access Journals (Sweden)

    Marleen de Mul

    2007-05-01

    Full Text Available Introduction: Information Technology (IT has the potential to significantly support skill-mix change and, thereby, to improve the efficiency and effectiveness of integrated care. Theory and methods: IT and skill-mix change share an important precondition: the standardisation of work processes. Standardisation plays a crucial role in IT-supported skill-mix change. It is not a matter of more or less standardisation than in the ‘old’ situation, but about creating an optimal fit. We used qualitative data from our evaluation of two integrated-care projects in Dutch eyecare to identify domains where this fit is important. Results: While standardisation was needed to delegate screening tasks from physicians to non-physicians, and to assure the quality of the integrated-care process as a whole, tensions arose in three domains: the performance of clinical tasks, the documentation, and the communication between professionals. Unfunctional standardisation led to dissatisfaction and distrust between the professionals involved in screening. Discussion and conclusion: Although the integration seems promising, much work is needed to ensure a synergistic relationship between skill-mix change and IT. Developing IT-supported skill-mix change by means of standardisation is a matter of tailoring standardisation to fit the situation at hand, while dealing with the local constraints of available technology and organisational context.

  18. Use of Antenatal Services in Kampung District, Cambodia

    Directory of Open Access Journals (Sweden)

    Ahmed A. Zafar

    2003-01-01

    Full Text Available This study was conducted to assess factors that influence use of antenatal care services with both quantitative and qualitative designs. Methods used were structured questionnaire interviews and focus group discussions in the Kampung District, Kampot Province in Cambodia with a volunteer sample of 260 postnatal mothers. The outcome measure was factors influencing use of antenatal care services. The results showed that first-time mothers (primigravidas were more likely to use antenatal services than multiparous mothers (OR = 1.87; p = 0.001. Mothers with some school education used antenatal services more than those with no school education (OR = 2.0; p = 0.01. Mothers engaged in professional occupations by virtue of their higher levels of educational attainment were more likely to use antenatal services than those engaged in agriculture (OR = 2.54; p = 0.001. Use of antenatal care services was higher in the districts whose health centers were supported by a foreign nongovernmental organization as compared to other districts with no such support (OR = 2.44; p = 0.001. Although services were generally inadequate, those that existed were underutilized by the mothers. Major factors influencing use of services include distance, lack of transport, and lack of awareness of the benefits of antenatal care by the mothers, thus resulting in a general notion that antenatal care is only important when problems occur during pregnancy. It is concluded that for remote villages, mobile antenatal clinics should be provided to improve access, and greater emphasis should be placed on health educating the mothers about the potential benefits of antenatal care, with special attention to multiparous mothers and those from the lower socio-economic class, among whom use of antenatal services was lowest.

  19. Antenatal care strengthening in Jimma, Ethiopia

    DEFF Research Database (Denmark)

    Villadsen, Sarah Fredsted; Tersbøl, Britt Pinkowski; Negussie, Dereje

    2014-01-01

    was given high priority, and that contributed to a lack of continuity and privacy. To the women, poor user-provider interaction was a serious concern hindering the trust in the health care providers. Further, the care provision was compromised by the inadequate laboratory facilities, unstructured health......Objective. We assessed how health system priorities matched user expectations and what the needs for antenatal care (ANC) strengthening were for improved maternal health in Jimma, Ethiopia. Methods. A questionnaire survey among all recent mothers in the study area was conducted to study the content...

  20. Case report: Antenatal MRI diagnosis of esophageal duplication cyst.

    Science.gov (United States)

    Rangasami, Rajeswaran; Chandrasekharan, Anupama; Archana, Lal; Santhosh, Joseph

    2009-02-01

    Esophageal duplication cysts are classified as a subgroup of foregut duplication cysts. They are very rare and are predominantly detected in children. Antenatal detection is very rare. We report a case of an esophageal duplication cyst that was accurately identified antenatally by USG and MRI.

  1. Antenatal Ultrasound and Risk of Autism Spectrum Disorders

    Science.gov (United States)

    Grether, Judith K.; Li, Sherian Xu; Yoshida, Cathleen K.; Croen, Lisa A.

    2010-01-01

    We evaluated antenatal ultrasound (U/S) exposure as a risk factor for autism spectrum disorders (ASD), comparing affected singleton children and control children born 1995-1999 and enrolled in the Kaiser Permanente health care system. Among children with ASD (n = 362) and controls (n = 393), 13% had no antenatal exposure to U/S examinations;…

  2. Antenatal and postnatal radiologic diagnosis of holocarboxylase synthetase deficiency: a systematic review

    Energy Technology Data Exchange (ETDEWEB)

    Bandaralage, Sahan P.S. [Gold Coast Hospital and Health Service, Southport, Queensland (Australia); Griffith University, School of Medicine, Southport, Queensland (Australia); Farnaghi, Soheil [Caboolture Hospital, Caboolture, Queensland (Australia); Dulhunty, Joel M.; Kothari, Alka [Redcliffe Hospital, Redcliffe, Queensland (Australia); The University of Queensland, School of Medicine, Herston, Queensland (Australia)

    2016-03-15

    Holocarboxylase synthetase deficiency results in impaired activation of enzymes implicated in glucose, fatty acid and amino acid metabolism. Antenatal imaging and postnatal imaging are useful in making the diagnosis. Untreated holocarboxylase synthetase deficiency is fatal, while antenatal and postnatal biotin supplementation is associated with good clinical outcomes. Although biochemical assays are required for definitive diagnosis, certain radiologic features assist in the diagnosis of holocarboxylase synthetase deficiency. To review evidence regarding radiologic diagnostic features of holocarboxylase synthetase deficiency in the antenatal and postnatal period. A systematic review of all published cases of holocarboxylase synthetase deficiency identified by a search of Pubmed, Scopus and Web of Science. A total of 75 patients with holocarboxylase synthetase deficiency were identified from the systematic review, which screened 687 manuscripts. Most patients with imaging (19/22, 86%) had abnormal findings, the most common being subependymal cysts, ventriculomegaly and intraventricular hemorrhage. Although the radiologic features of subependymal cysts, ventriculomegaly, intraventricular hemorrhage and intrauterine growth restriction may be found in the setting of other pathologies, these findings should prompt consideration of holocarboxylase synthetase deficiency in at-risk children. (orig.)

  3. Methodological Considerations in Screening for Cumulative Environmental Health Impacts: Lessons Learned from a Pilot Study in California

    Directory of Open Access Journals (Sweden)

    Lauren Zeise

    2012-08-01

    Full Text Available Polluting facilities and hazardous sites are often concentrated in low-income communities of color already facing additional stressors to their health. The influence of socioeconomic status is not considered in traditional models of risk assessment. We describe a pilot study of a screening method that considers both pollution burden and population characteristics in assessing the potential for cumulative impacts. The goal is to identify communities that warrant further attention and to thereby provide actionable guidance to decision- and policy-makers in achieving environmental justice. The method uses indicators related to five components to develop a relative cumulative impact score for use in comparing communities: exposures, public health effects, environmental effects, sensitive populations and socioeconomic factors. Here, we describe several methodological considerations in combining disparate data sources and report on the results of sensitivity analyses meant to guide future improvements in cumulative impact assessments. We discuss criteria for the selection of appropriate indicators, correlations between them, and consider data quality and the influence of choices regarding model structure. We conclude that the results of this model are largely robust to changes in model structure.

  4. Prevalence and Characteristics of Pregnant Syphilis among Women Attending Antenatal Clinics in Shenzhen (China) in 2003

    Institute of Scientific and Technical Information of China (English)

    Yang Fan(杨帆); Zhou Hua(周华); Hong Fuchang(洪福昌); Luo Bin(罗斌); Cai Yumao(蔡于茂); Wen Lizhang(文立章); Zhang Chunlai(张春来)

    2004-01-01

    Abstract Background: The Nnewly reported cases of congenital syphilis have been increaseding substantially over the past few years. To control the epidemic, a municipal program aimed at preventing mother-to-child transmission of syphilis was introduced in July, 2001,which was designed aimed to screen all pregnant women for syphilis at their first visit to antenatal clinics or at admission to hospitals in Shenzhen.Objectives: The aim of the study is tTo determine the prevalence of syphilis among women attending antenatal clinics and other medical institutions in Shenzhen and identifies its patterns of infection.Methods: Upon giving informed consent, w Women who attended antenatal care centers in Shenzhen from January to December 2003 were included in this study subject to obtaining informed consent. A blood sample was harvested for syphilis screened for syphilising by using rapid plasma reagent test (RPR) and confirmed by TPHA for those who were RPR positive. The women with pregnant syphilispositive serology were systematically interviewed to obtain. During the interview, their demographic detailsinformation, patterns of risk behaviors and other data. Data were collected andwere analyzed retrospectively.Results: Among Of 118,235 pregnant women surveyed,555 pregnant women were confirmed to have syphilis (prevalence of 4.69%), with a incidence of 4.69‰. 123women were excluded from the analysis because of incomplete medical records. Of 432 infected subjects with complete medical records, the average age was 26.8, with a range of 19 to 41. 7.41% (32/432) of them suffered from primary syphilis, 3.24% (14/432) were ofhad secondary syphilis, and 89.35%(386/432) had latent syphilis. Without any conspicuous clinical signs and symptoms. Conclusions: The prevalence of syphilis among the pregnant women in our series was high an most of them were asymptomatic. Screening for syphilis among pregnant women in Shenzhen is of importantce for the prevention of mother

  5. EVALUATION OF HEPATITIS B SURFACE ANTIGEN POSITIVITY IN ANTENATAL WOMEN AND ROLE OF ANTIVIRAL THERAPY

    Directory of Open Access Journals (Sweden)

    Jhansi Rani

    2015-03-01

    Full Text Available BACKGROUND : Hepatitis B infection is a major global health problem . AIM : of the study is to identify the antenatal women who are HBsAg positive and to evaluate their viremic status to prevent vertical transmission from mother to foetus and role of antiviral therapy in pregnancy. STUDY DESIGN : I s two centres prospective cohort study. All the pregnant women who attended the antenatal OPD in Government Victoria hospital/ Andhra Medical C ollege , Visakhapatnam between February 2013 and September 2014 were evaluated. METHODS AND MATERIAL : HBs Ag screening was done using Rapid Stick test to all the pregnant women attending the OPD. 6400 members were screened. 100 subjects were HBsAg positive and confirmed by using ELISA technique. Evaluation for HBeAg and HBV viral load is done in all subjects. If HBV DNA is > 10 5 log copies/ml and Alanine transaminase (ALT is > 2 ULN or HBV DNA is >10 8 log copies/ml will be offered telbivudine therapy. RESULTS: Of the 6400 members screened , 100(1.5% were HBsAg positive. Of them , 10% were HBe Ag positive and 2% had HBV DNA > 10 5 log copies/ml. These patients were treated with drug , telbivudine in their third trimester. The HBV DNA level at the time of delivery is below 10 5 log copies/ml. The babies of these patients were checked for HBsAg and HBV DNA at birth and at 7th month which were negative and also for anti HBS at 7th month. CONCLUSIONS : The present study shows that HBsAg positive antenatal women are not prone for maternal and foetal complications. HBeAg positive individuals with high viremia need to be treated with antiviral drugs during the last trimester of pregnancy in order to prevent vertical transmission.

  6. Uso antenatal do corticosteroide e hemorragia peri-intraventricular Antenatal corticosteroids and intraventricular hemorrhage

    Directory of Open Access Journals (Sweden)

    Luis Eduardo de F. Vinagre

    2010-09-01

    Full Text Available OBJETIVO: Realizar uma revisão bibliográfica sobre o uso antenatal do corticosteroide na prevenção da hemorragia peri-intraventricular. FONTES DE DADOS: Levantamento bibliográfico por meio do Pubmed e SciELO abrangendo os últimos 20 anos. Foram utilizadas as palavras chaves no idioma inglês: "cerebral hemorrhage", "steroids" e "newborn, infant". SÍNTESES DE DADOS: A hemorragia peri-intraventricular é uma importante patologia nos prematuros, sobretudo nos menores de 34 semanas, devido a suas graves sequelas neurológicas. Uma vez ocorrido o sangramento, não há tratamento específico. Desta forma, a prevenção torna-se o maior objetivo das pesquisas. O resultado da meta-análise de estudos randomizados demonstrou que o corticosteroide antenatal reduz a mortalidade e a incidência da doença de membrana hialina e da hemorragia peri-intraventricular. O efeito protetor na redução do risco da hemorragia peri-intraventricular não está completamente esclarecido. Além de acelerar a maturidade pulmonar, o corticosteroide antenatal estimula a maturação da microvasculatura da matriz germinativa, promove o espessamento da membrana basal, acelera a formação proteica nas junções firmes e estabiliza o fluxo sanguíneo cerebral. Também melhora as condições de nascimento dos fetos pré-termo. CONCLUSÕES: O uso antenatal do corticosteroide associado à implementação de melhores práticas de atendimento ao prematuro tem sido responsável pela evidente redução dos índices dessa doença. Apesar de comprovada eficácia e segurança, não é amplamente utilizado. Medidas devem ser tomadas para estimular seu uso como prática rotineira no atendimento de gestantes com risco de parto prematuro.OBJECTIVE: To conduct a literature review on the use of antenatal corticosteroids for the prevention of peri-intraventricular hemorrhage. DATA SOURCE: Bibliography search in Pubmed and SciELO databases covering the past 20 years using the following

  7. Postnatal Treatment in Antenatally Diagnosed Meconium Peritonitis.

    Science.gov (United States)

    Ionescu, S; Andrei, B; Oancea, M; Licsandru, E; Ivanov, M; Marcu, V; Popa-Stanila, R; Mocanu, M

    2015-01-01

    Meconium peritonitis is a rare prenatal disease with an increased rate of morbidity and mortality in the neonatal period. Distinctive features revealed by prenatal and postnatal ultrasoundmay be present: abdominal calcifications, ascites, polyhydramnios, meconium pseudocyst, echogenic mass and dilated bowel or intestinal obstruction. Establishing clear postnatal treatment and prognosis is difficult because of the heterogeneity of the results obtained by ultrasound. The aim of the study is to determine how prenatal diagnosis of meconium peritonitis is associated with perinatal management and further evolution. Clinical results are different depending on the presence of antenatal diagnosis of meconium peritonitis and its form, which can be mild or severe. Surgical treatment and management of meconium peritonitis depend on the clinical presentation of the newborn. Meconium peritonitis diagnosed prenatally differs from that of the newborn, not only concerning the mortality rates but also through reduced morbidity and overall better prognosis.

  8. Antenatal stress: An Irish case study.

    LENUS (Irish Health Repository)

    Carolan-Olah, Mary

    2013-05-16

    BACKGROUND:: stress in pregnancy is common and impacts negatively on women, infants and families. A number of factors contribute to high levels of stress in pregnancy, including financial concerns, marital discord, low support systems and low socio-economic status. OBJECTIVES:: the aim of this study was to evaluate stress anxiety levels and depressive symptoms among low risk women in an area in Ireland that was particularly impacted by the 2008 economic crisis. DESIGN:: a quantitative descriptive cross-sectional design was used. Data were collected using the Edinburgh Postnatal Depression Scale (EPDS), the Perceived Stress Scale and the State Trait Anxiety Inventory (STAI). Data was collected at a single time during the second trimester. SETTING:: this paper reports a case study of one maternity service in Ireland. Participants included low risk pregnant women who were attending the hospital clinic for routine antenatal care. RESULTS:: of 150 questionnaires distributed, 74 completed questionnaires were returned indicating a 49.3% return rate. Findings indicated high levels of stress, anxiety and depressive symptomatology among participants. There were no significant difference in mean EPDS score for different age groups (F4,69=2.48, P=0.052), living arrangements (F4,68=0.90, P=0.5) or usual occupation (F4,69=1.45, P=0.2). A score of ≥12 was taken as indicative of probable antenatal depression and 86.5% of participants responded with a score of 12 or above. PSS scores were also high and more than three quarters of respondents scored ≥15 (75.6%) and more than a third had scores ≥20 (35.1%), out of a total score of 40. There was a significant difference in mean PSS score between the different age groups (F4,69=3.60, P=0.010) but not for living arrangements or usual occupation. A STAI score of ≥39 was taken as indicative of antenatal anxiety, and 74.3% of participants responded with a score of 39 or above. There were no significant differences in mean STAI

  9. Teaching antenatal counseling skills to neonatal providers.

    Science.gov (United States)

    Stokes, Theophil A; Watson, Katie L; Boss, Renee D

    2014-02-01

    Counseling a family confronted with the birth of a periviable neonate is one of the most difficult tasks that a neonatologist must perform. The neonatologist's goal is to facilitate an informed, collaborative decision about whether life-sustaining therapies are in the best interest of this baby. Neonatologists are trained to provide families with a detailed account of the morbidity and mortality data they believe are necessary to facilitate a truly informed decision. Yet these complicated and intensely emotional conversations require advanced communication and counseling skills that our current fellowship-training strategies are not adequately providing. We review educational models for training neonatology fellows to provide antenatal counseling at the threshold of viability. We believe that training aimed at teaching these skills should be incorporated into the neonatal-perinatal medicine fellowship. The optimal approaches for teaching these skills remain uncertain, and there is a need for continued innovation and outcomes-based research.

  10. PHACE syndrome in antenatally diagnosed posterior fossa anomaly

    Directory of Open Access Journals (Sweden)

    Seema Pavaman Sindgikar

    2014-01-01

    Full Text Available PHACE is a neurocutaneous syndrome, an acronym to describe patients with facial segmental hemangiomas and other malformations. We describe a newborn antenatally diagnosed to have posterior fossa anomaly and subsequently as PHACE syndrome.

  11. Risk factors for antenatal depression, postnatal depression and parenting stress

    Directory of Open Access Journals (Sweden)

    Milgrom Jeannette

    2008-04-01

    Full Text Available Abstract Background Given that the prevalence of antenatal and postnatal depression is high, with estimates around 13%, and the consequences serious, efforts have been made to identify risk factors to assist in prevention, identification and treatment. Most risk factors associated with postnatal depression have been well researched, whereas predictors of antenatal depression have been less researched. Risk factors associated with early parenting stress have not been widely researched, despite the strong link with depression. The aim of this study was to further elucidate which of some previously identified risk factors are most predictive of three outcome measures: antenatal depression, postnatal depression and parenting stress and to examine the relationship between them. Methods Primipara and multiparae women were recruited antenatally from two major hoitals as part of the beyondblue National Postnatal Depression Program 1. In this subsidiary study, 367 women completed an additional large battery of validated questionnaires to identify risk factors in the antenatal period at 26–32 weeks gestation. A subsample of these women (N = 161 also completed questionnaires at 10–12 weeks postnatally. Depression level was measured by the Beck Depression Inventory (BDI. Results Regression analyses identified significant risk factors for the three outcome measures. (1. Significant predictors for antenatal depression: low self-esteem, antenatal anxiety, low social support, negative cognitive style, major life events, low income and history of abuse. (2. Significant predictors for postnatal depression: antenatal depression and a history of depression while also controlling for concurrent parenting stress, which was a significant variable. Antenatal depression was identified as a mediator between seven of the risk factors and postnatal depression. (3. Postnatal depression was the only significant predictor for parenting stress and also acted as a mediator

  12. Antenatal diagnosis of a Morgagni hernia in the second trimester.

    Science.gov (United States)

    Jain, Krishan Kumar; Sen, Jyotsna; Rathee, Suresh Kanta; Saini, Jitender

    2008-02-01

    Morgagni hernia is an uncommon type of congenital hernia that is rarely diagnosed antenatally. Herniation of the liver into the fluid-filled pericardial sac resulting in a thoracic mass is a particularly rare form of Morgagni hernia; only 3 cases have been reported in the literature, all with a diagnosis made at 32 weeks' gestation or later. We report a case of Morgagni hernia diagnosed on antenatal sonography at 24 weeks' gestation.

  13. Risk factors for antenatal depression, postnatal depression and parenting stress

    OpenAIRE

    Leigh, Bronwyn; Milgrom, Jeannette

    2008-01-01

    Background Given that the prevalence of antenatal and postnatal depression is high, with estimates around 13%, and the consequences serious, efforts have been made to identify risk factors to assist in prevention, identification and treatment. Most risk factors associated with postnatal depression have been well researched, whereas predictors of antenatal depression have been less researched. Risk factors associated with early parenting stress have not been widely researched, despite the stro...

  14. Risk factors for antenatal depression, postnatal depression and parenting stress

    OpenAIRE

    Milgrom Jeannette; Leigh Bronwyn

    2008-01-01

    Abstract Background Given that the prevalence of antenatal and postnatal depression is high, with estimates around 13%, and the consequences serious, efforts have been made to identify risk factors to assist in prevention, identification and treatment. Most risk factors associated with postnatal depression have been well researched, whereas predictors of antenatal depression have been less researched. Risk factors associated with early parenting stress have not been widely researched, despite...

  15. A review of longitudinal studies on antenatal and postnatal depression.

    Science.gov (United States)

    Underwood, Lisa; Waldie, Karen; D'Souza, Stephanie; Peterson, Elizabeth R; Morton, Susan

    2016-10-01

    Antenatal depression is a known risk factor for postnatal depression; both are common disorders associated with negative impacts on child development. Few studies have followed up women from pregnancy and through the postnatal period to explore how rates of depression change. This review evaluates recent evidence on depression during pregnancy and after childbirth. A search of Embase, PsychINFO, MEDLINE and Cochrane Reviews was carried out to identify longitudinal studies on antenatal and postnatal depression. Studies that measured depression during pregnancy and up to 1 year after childbirth were evaluated against a set of criteria (e.g. less than 50 % attrition). Of the initial 523 studies identified, 16 studies met the final inclusion criteria with a total of 35,419 women. The average rate of antenatal depression across these studies was 17 and 13 % postnatal depression. The longitudinal nature of the studies revealed that on average 39 % of those who experienced antenatal depression went on to have postnatal depression. Similarly, on average, 47 % of those with postnatal depression had also experienced antenatal depression. On average, almost 7 % of women reported significant depressive symptoms in pregnancy that persisted after childbirth. The review provided evidence that rates of depression tend to be higher during pregnancy than in the first year following childbirth. Furthermore, the longitudinal data show that there is much movement between the groups categorised as depressed or not depressed. There is evidence that postnatal depression is often a continuation of existing antenatal depression.

  16. Intestinal Helminth Infections in Pregnant Women Attending Antenatal Clinic at Kitale District Hospital, Kenya

    Directory of Open Access Journals (Sweden)

    A. W. Wekesa

    2014-01-01

    Full Text Available Intestinal helminth infections during pregnancy are associated with adverse outcomes including low birth weight and prenatal mortality. The infections are a major public health problem in developing countries. A hospital based survey was undertaken for six months to determine the infection prevalence, intensity, and risk factors. The study involved expectant women attending antenatal clinic. Stool samples were screened microscopically for helminth ova using Kato Katz technique. Information on risk factors was collected using semistructured questionnaire and analyzed using SPSS. Epidemiological data was analysed using descriptive statistics and multivariate analysis. The overall prevalence of infection was 21 (13.8%. Ascariasis was the most prevalent 10 (6.5%, hookworm infection was 6 (3.9%, and trichuriasis was 2 (1.3%. Pregnant women aged below 29 years (OR = 3.63, CI = 0.87–11.75 and those with primary level of education (OR = 3.21, CI = 0.88–11.75 were at a higher risk of infection compared to those aged ≥ 29 years with secondary level of education. Hand washing was significantly associated with reduced likelihood of infection (OR = 0.18, 95% CI = 0.06–0.57. It was concluded that intestinal helminth infections were prevalent among pregnant women. We recommended that all expectant women visiting antenatal clinics be screened for intestinal helminth infections and positive cases be advised to seek treatment.

  17. Malawi: HIV surveillance in antenatal women.

    Science.gov (United States)

    1997-12-01

    From October to December 1996, a surveillance for HIV among antenatal clinic attenders (ANC) was conducted in 19 hospitals serving as sentinel sites in Malawi. The sites consisted of 3 urban, 8 semiurban, and 8 rural hospitals drawn from all 3 regions of the country. Findings showed that of the 4163 samples, 793 were HIV positive, giving an overall prevalence of 19%, with a range from 27% in the urban areas to 18% in the semiurban areas and 10% in the rural areas. The age distribution of infection showed that seroprevalence was highest in the 25-29 age group. In terms of syphilis infection, the rate was more common in the southern than in the central or northern regions, but it did not vary according to urban, semiurban, or rural sites or according to age. Overall, the results showed that ANC HIV seroprevalence remained relatively stable from 1994 to 1996, increasing from 17.4% in 1994 to 18% in 1995 and 19% in 1996. Moreover, the national estimate for seroprevalence in the entire population was 6.4%, essentially the same as that for 1995 (6.6%), indicating that the level of HIV infection had been fairly stable since 1993. Continued close monitoring is required to assess whether the incidence of new infection is actually declining, particularly among young people, and to identify what interventions have the greatest impact.

  18. Intrauterine Growth Restriction: Antenatal and Postnatal Aspects

    Science.gov (United States)

    Sharma, Deepak; Shastri, Sweta; Sharma, Pradeep

    2016-01-01

    Intrauterine growth restriction (IUGR), a condition that occurs due to various reasons, is an important cause of fetal and neonatal morbidity and mortality. It has been defined as a rate of fetal growth that is less than normal in light of the growth potential of that specific infant. Usually, IUGR and small for gestational age (SGA) are used interchangeably in literature, even though there exist minute differences between them. SGA has been defined as having birth weight less than two standard deviations below the mean or less than the 10th percentile of a population-specific birth weight for specific gestational age. These infants have many acute neonatal problems that include perinatal asphyxia, hypothermia, hypoglycemia, and polycythemia. The likely long-term complications that are prone to develop when IUGR infants grow up includes growth retardation, major and subtle neurodevelopmental handicaps, and developmental origin of health and disease. In this review, we have covered various antenatal and postnatal aspects of IUGR. PMID:27441006

  19. Explaining variation in Down's syndrome screening uptake

    DEFF Research Database (Denmark)

    Crombag, Neeltje M T H; Vellinga, Ynke E; Kluijfhout, Sandra A;

    2014-01-01

    rates across countries can be explained by variation in individual values alone.The aim of this study was to compare Down's syndrome screening policies and programmes in the Netherlands, where uptake is relatively low ( 90% respectively....... RESULTS: There were many similarities in the demographics, healthcare systems, government abortion legislation and Down's syndrome screening policy across the studied countries. However, the additional cost for Down's syndrome screening over and above standard antenatal care in the Netherlands......BACKGROUND: The offer of prenatal Down's syndrome screening is part of routine antenatal care in most of Europe; however screening uptake varies significantly across countries. Although a decision to accept or reject screening is a personal choice, it is unlikely that the widely differing uptake...

  20. Herpes simplex virus type 2: Seroprevalence in antenatal women

    Directory of Open Access Journals (Sweden)

    Rathore Shagufta

    2010-01-01

    Full Text Available Aims: To determine the seroprevalence of herpes simplex type 2 (HSV-2 infection in pregnant females, assess the frequency of unrecognized infection and identify the demographic profile and risk factors associated with the seroprevalence. Materials and Methods: Two hundred randomly selected, asymptomatic pregnant females attending the Obstetrics and Gynecology Outpatient Department for a routine antenatal check-up constituted the study group. Serum specimens were screened for HSV-2 infection by detecting IgG class antibodies against HSV-2-specific glycoprotein G-2 using an enzyme-linked immunosorbent assay kit. Results: A seroprevalence of 7.5% was found in our study. Seropositivity was maximum in the age group ≥30 years (22.20%, followed by 26-30 years (9.7%, 21-25 years (2.20% and ≤20 years (0%. HSV-2 seropositivity was found to be significantly associated with increasing age, parity, number of sexual partners, duration of sexual activity and history of abortions (P < 0.05. No statistically significant correlation was observed between seropositivity and other demographic variables such as place of residence, education, annual family income and occupation (P > 0.05. No statistically significant association of seropositivity with present or past history suggestive of other sexually transmitted infections was found. None of our cases tested positive for human immunodeficiency syndrome (HIV. Conclusion: A relatively low prevalence of HSV-2 seropositivity was found in our study, with a high frequency of unrecognized and asymptomatic infections. Our findings suggest that type-specific serotesting could be an efficient strategy to diagnose clinically asymptomatic HSV-2 infections and, therefore, to reduce the risk of HSV-2 and HIV sexual transmission by prophylactic counseling against unprotected intercourse. It may also be a useful adjunct in detecting cases who present with symptoms not directly suggestive of genital herpes.

  1. PREVENTION OF CANCER OF THE CERVIX UTERI AT AN ANTENATAL CLINIC

    Directory of Open Access Journals (Sweden)

    I. E. Bakhlaev

    2009-01-01

    Full Text Available Cervical cancer (CC morbidity is analyzed on the basis of the data of the Karelian cancer register over the period 1998-2007. During this period, 816 cases of CC were registered and 126 were found at an antenatal clinic (AC. Its early detection rate was ascertained to be 96% during screening at the AC. A comprehensive examination was made in 1742 women with various cervical diseases, of them 37.5% were infected with human papillomavirus (HPV. High-grade dysplasia and carcinoma in situ were diagnosed in 6.6% of the HPV-infected patients. Large-scale screening for HPV infection and pretumor disorders with their further treatment will aid in reduc- ing CC morbidity and mortality rates.

  2. Scaling Down to Scale Up: A Health Economic Analysis of Integrating Point-of-Care Syphilis Testing into Antenatal Care in Zambia during Pilot and National Rollout Implementation

    Science.gov (United States)

    Ncube, Alexander Tshaka; Sweeney, Sedona; Fleischer, Colette; Mumba, Grace Tembo; Gill, Michelle M.; Strasser, Susan; Peeling, Rosanna W.; Terris-Prestholt, Fern

    2015-01-01

    Maternal syphilis results in an estimated 500,000 stillbirths and neonatal deaths annually in Sub-Saharan Africa. Despite the existence of national guidelines for antenatal syphilis screening, syphilis testing is often limited by inadequate laboratory and staff services. Recent availability of inexpensive rapid point-of-care syphilis tests (RST) can improve access to antenatal syphilis screening. A 2010 pilot in Zambia explored the feasibility of integrating RST within prevention of mother-to-child-transmission of HIV services. Following successful demonstration, the Zambian Ministry of Health adopted RSTs into national policy in 2011. Cost data from the pilot and 2012 preliminary national rollout were extracted from project records, antenatal registers, clinic staff interviews, and facility observations, with the aim of assessing the cost and quality implications of scaling up a successful pilot into a national rollout. Start-up, capital, and recurrent cost inputs were collected, including costs of extensive supervision and quality monitoring during the pilot. Costs were analysed from a provider’s perspective, incremental to existing antenatal services. Total and unit costs were calculated and a multivariate sensitivity analysis was performed. Our accompanying qualitative study by Ansbro et al. (2015) elucidated quality assurance and supervisory system challenges experienced during rollout, which helped explain key cost drivers. The average unit cost per woman screened during rollout ($11.16) was more than triple the pilot unit cost ($3.19). While quality assurance costs were much lower during rollout, the increased unit costs can be attributed to several factors, including higher RST prices and lower RST coverage during rollout, which reduced economies of scale. Pilot and rollout cost drivers differed due to implementation decisions related to training, supervision, and quality assurance. This study explored the cost of integrating RST into antenatal care in

  3. Scaling Down to Scale Up: A Health Economic Analysis of Integrating Point-of-Care Syphilis Testing into Antenatal Care in Zambia during Pilot and National Rollout Implementation.

    Directory of Open Access Journals (Sweden)

    Katharine D Shelley

    Full Text Available Maternal syphilis results in an estimated 500,000 stillbirths and neonatal deaths annually in Sub-Saharan Africa. Despite the existence of national guidelines for antenatal syphilis screening, syphilis testing is often limited by inadequate laboratory and staff services. Recent availability of inexpensive rapid point-of-care syphilis tests (RST can improve access to antenatal syphilis screening. A 2010 pilot in Zambia explored the feasibility of integrating RST within prevention of mother-to-child-transmission of HIV services. Following successful demonstration, the Zambian Ministry of Health adopted RSTs into national policy in 2011. Cost data from the pilot and 2012 preliminary national rollout were extracted from project records, antenatal registers, clinic staff interviews, and facility observations, with the aim of assessing the cost and quality implications of scaling up a successful pilot into a national rollout. Start-up, capital, and recurrent cost inputs were collected, including costs of extensive supervision and quality monitoring during the pilot. Costs were analysed from a provider's perspective, incremental to existing antenatal services. Total and unit costs were calculated and a multivariate sensitivity analysis was performed. Our accompanying qualitative study by Ansbro et al. (2015 elucidated quality assurance and supervisory system challenges experienced during rollout, which helped explain key cost drivers. The average unit cost per woman screened during rollout ($11.16 was more than triple the pilot unit cost ($3.19. While quality assurance costs were much lower during rollout, the increased unit costs can be attributed to several factors, including higher RST prices and lower RST coverage during rollout, which reduced economies of scale. Pilot and rollout cost drivers differed due to implementation decisions related to training, supervision, and quality assurance. This study explored the cost of integrating RST into

  4. Scaling Down to Scale Up: A Health Economic Analysis of Integrating Point-of-Care Syphilis Testing into Antenatal Care in Zambia during Pilot and National Rollout Implementation.

    Science.gov (United States)

    Shelley, Katharine D; Ansbro, Éimhín M; Ncube, Alexander Tshaka; Sweeney, Sedona; Fleischer, Colette; Tembo Mumba, Grace; Gill, Michelle M; Strasser, Susan; Peeling, Rosanna W; Terris-Prestholt, Fern

    2015-01-01

    Maternal syphilis results in an estimated 500,000 stillbirths and neonatal deaths annually in Sub-Saharan Africa. Despite the existence of national guidelines for antenatal syphilis screening, syphilis testing is often limited by inadequate laboratory and staff services. Recent availability of inexpensive rapid point-of-care syphilis tests (RST) can improve access to antenatal syphilis screening. A 2010 pilot in Zambia explored the feasibility of integrating RST within prevention of mother-to-child-transmission of HIV services. Following successful demonstration, the Zambian Ministry of Health adopted RSTs into national policy in 2011. Cost data from the pilot and 2012 preliminary national rollout were extracted from project records, antenatal registers, clinic staff interviews, and facility observations, with the aim of assessing the cost and quality implications of scaling up a successful pilot into a national rollout. Start-up, capital, and recurrent cost inputs were collected, including costs of extensive supervision and quality monitoring during the pilot. Costs were analysed from a provider's perspective, incremental to existing antenatal services. Total and unit costs were calculated and a multivariate sensitivity analysis was performed. Our accompanying qualitative study by Ansbro et al. (2015) elucidated quality assurance and supervisory system challenges experienced during rollout, which helped explain key cost drivers. The average unit cost per woman screened during rollout ($11.16) was more than triple the pilot unit cost ($3.19). While quality assurance costs were much lower during rollout, the increased unit costs can be attributed to several factors, including higher RST prices and lower RST coverage during rollout, which reduced economies of scale. Pilot and rollout cost drivers differed due to implementation decisions related to training, supervision, and quality assurance. This study explored the cost of integrating RST into antenatal care in

  5. Antenatal information sources for maternal and infant diet.

    Science.gov (United States)

    Newby, Ruth; Brodribb, Wendy; Ware, Robert S; Davies, Peter S W

    2015-07-01

    This report describes information sources accessed by pregnant women around antenatal and early infant diet. Australian women in their first pregnancy (n = 277) responded to questionnaires online and on paper between June 2010 and March 2011 as part of the Feeding Queensland Babies Study. Antenatal information sources are reported for maternal diet, breastfeeding and formula-feeding. Pregnant women sought and encountered information for their own and their infants' diet from many sources. Health care professionals provided antenatal dietary information for 80% of respondents and infant feeding advice for 69%. Relatives or friends were the respondents' largest reported information source for infant feeding, reported by 78%. Information on artificial baby milk was accessed on television by 77% and on the internet by 52% of respondents. Health care professionals should proactively support clients' informational needs and address encountered nutrition misinformation. Further research is necessary to establish the nature and accuracy of dietary information in the mass media.

  6. Abnormally invasive placenta-prevalence, risk factors and antenatal suspicion

    DEFF Research Database (Denmark)

    Thurn, L; Lindqvist, P G; Jakobsson, M;

    2016-01-01

    of women at high risk will likely strengthen antenatal suspicion. Prior PPH is a novel risk factor associated with an increased prevalence of AIP. TWEETABLE ABSTRACT: An ultrasound assessment in women with placenta praevia or prior CS may double the awareness for AIP.......OBJECTIVE: The objective was to investigate prevalence, estimate risk factors, and antenatal suspicion of abnormally invasive placenta (AIP) associated with laparotomy in women in the Nordic countries. DESIGN: Population-based cohort study. SETTING AND POPULATION: A 3-year Nordic collaboration...... National health registries. MAIN OUTCOME MEASURES: Prevalence, risk factors, antenatal suspicion, birth complications, and risk estimations using aggregated national data. RESULTS: A total of 205 cases of AIP in association with laparotomy were identified, representing 3.4 per 10 000 deliveries. The single...

  7. Midwives' views on of appropriate antenatal counselling for congenital anomaly tests: do they match clients' preferences?

    NARCIS (Netherlands)

    Martin, L.; Hutton, E.K.; Spelten, E.R.; Gitsels-van der Wal, J.T.; Dulmen, S. van

    2014-01-01

    Objective: this study aims to provide insight into: (a) midwives' views on appropriate antenatal counselling for congenital anomaly tests, and (b) whether these views match clients' preferences regarding antenatal counselling. Design: a comparative (midwives versus clients) questionnaire survey. Cog

  8. Midwives' views on appropriate antenatal counselling for congenital anomaly tests: Do they match clients' preferences?

    NARCIS (Netherlands)

    Martin, L.; Hutton, E.K.; Spelten, E.R.; Gitsels-van der Wal, J.T.; Dulmen, S. van

    2014-01-01

    OBJECTIVE: this study aims to provide insight into: (a) midwives' views on appropriate antenatal counselling for congenital anomaly tests, and (b) whether these views match clients' preferences regarding antenatal counselling. DESIGN: a comparative (midwives versus clients) questionnaire survey. Cog

  9. Antenatal treatment in two Dutch families with pyridoxine-dependent seizures.

    NARCIS (Netherlands)

    Bok, L.A.; Been, J.V.; Struys, E.A.; Jakobs, C.; Rijper, E.A.; Willemsen, M.A.A.P.

    2010-01-01

    Incidental reports suggest that antenatal treatment of pyridoxine dependent seizures (PDS) may improve neurodevelopmental outcome of affected patients. Two families with PDS are reported, both with two affected siblings. Antenatal treatment with pyridoxine was instituted during the second pregnancy

  10. Quality of antenatal and childbirth care in northern Ghana.

    Science.gov (United States)

    Duysburgh, E; Williams, A; Williams, J; Loukanova, S; Temmerman, M

    2014-09-01

    The QUALMAT research project aims to improve maternal and newborn health by improving the quality of antenatal and childbirth care provided in primary healthcare facilities. Within the frame of this project, a comprehensive quality assessment took place in selected health centres in northern Ghana. The results of this assessment showed that overall quality of routine antenatal and childbirth care was satisfactory, although some critical gaps were identified. Counselling and health education practices need to be improved; laboratory investigations are often not performed; examination and monitoring of mother and newborn during childbirth are inadequate; partographs are often not used and poorly completed; and equipment to provide assisted vaginal deliveries was absent.

  11. Womens' preference in Down syndrome screening

    NARCIS (Netherlands)

    de Graaf, IM; Tijmstra, T; Bleker, O.P.; van Lith, JMM

    2002-01-01

    Objective To determine the knowledge of pregnant women about prenatal tests. and what tests they would choose if offered. Also, the preference of pregnant women for second-trimester or first-trimester screening was assessed. Patients and methods Pregnant women receiving antenatal care in a decentral

  12. The quality of care in an antenatal clinic in Kenya.

    Science.gov (United States)

    Malone, M I

    1980-02-01

    As part of an operations research project aimed at improving outpatient services in Kenya, the quality of care in Kiambu District Hospital's antenatal clinic was monitored in 1974-76 with particular emphasis on the identification of high risk women. Of the 270 patients studied, 57 (21%) were considered by midwives to be at no risk in terms of their pregnancy and 213 (79%) were considered at risk. 46% of the care observed in this study was considered adequate by the audit method; however, an implicit judgement assessment of the same care rated only 19% as adequate. Since the evaluators were familiar with the working conditions and capabilities of the staff, these low performance statistics suggest that the quality of care being provided in antenatal clinics is a serious problem. Dramatic improvements can be recorded if more attention is given by midwives to obtaining a medical and obstetric history and using an antenatal card. There is a need for clearly defined criteria and instructions for categorizing and managing high and low risk groups of pregnant women. In-service training and clinical meetings are essential to ensure that midwives can interpret abnormal findings and estimate the fundal height of the uterus. Although antenatal cards that guide midwives in the categorization of risk factors are available in Kenya, they are frequently out of stock and replaced with hastily developed, inadequate substitute forms.

  13. Mobile phones improve antenatal care attendance in Zanzibar

    DEFF Research Database (Denmark)

    Lund, Stine; Nielsen, Birgitte B; Hemed, Maryam;

    2014-01-01

    BACKGROUND: Applying mobile phones in healthcare is increasingly prioritized to strengthen healthcare systems. Antenatal care has the potential to reduce maternal morbidity and improve newborns' survival but this benefit may not be realized in sub-Saharan Africa where the attendance and quality o...

  14. Knowledge, attitude and practice study regarding anemia in antenatal women

    Directory of Open Access Journals (Sweden)

    Raksha M

    2016-07-01

    Conclusions: Assessments of knowledge and practice and health education are essential step towards prevention of anaemia in pregnancy. Educating antenatal women about the importance of diet and implementing this into practice will help in the prevention of anemia. [Int J Reprod Contracept Obstet Gynecol 2016; 5(7.000: 2101-2103

  15. Severe antenatally diagnosed renal disorders: background, prognosis and practical approach.

    Science.gov (United States)

    Aulbert, Wiebke; Kemper, Markus J

    2016-04-01

    Nowadays most renal disorders, especially urinary tract malformations and renal cystic disease, are diagnosed antenatally. In cases of severe bilateral disease, intrauterine renal dysfunction may lead to renal oligohydramnios (ROH), resulting in pulmonary hypoplasia which affects perinatal mortality and morbidity as well as the long-term outcome. However, some infants may only have mild pulmonary and renal disease, and advances in postnatal and dialysis treatment have resulted in improved short- and long-term outcome even in those infants with severe ROH. Here, we review the current state of knowledge and clinical experience of patients presenting antenatally with severe bilateral renal disorders and ROH. By addressing underlying mechanisms, intrauterine tools of diagnosis and treatment as well as published outcome data, we hope to improve antenatal counselling and postnatal care. KEY SUMMARY POINTS: 1. Nowadays most renal disorders are diagnosed antenatally, especially urinary tract malformations and renal cystic disease. 2. Severe kidney dysfunction may lead to renal oligohydramnios, which can cause pulmonary hypoplasia and is a risk factor of perinatal mortality and postnatal renal outcome. However, as considerable clinical heterogeneity is present, outcome predictions need to be treated with caution. 3. Advances in postnatal and dialysis treatment have resulted in improved short- and long-term outcomes even in infants with severe renal oligohydramnios. 4. A multidisciplinary approach with specialist input is required when counselling a family with an ROH-affected fetus as the decision-making process is very challenging.

  16. Renal scintigraphy in infants with antenatally diagnosed renal pelvis dilatation

    Directory of Open Access Journals (Sweden)

    Ajdinović Boris

    2008-01-01

    Full Text Available Background/Aim. Ureteropelvic junction obstruction and vesicoureteral reflux are the most frequent entities identified on the basis of antenatal hydronephrosis. The aim of this study was to determine the incidence and pattern of abnormal renal scintigraphy findings in postnatal investigation of children with antenatal hydronephrosis. Methods. Twenty four infants (19 boys and five girls presented with antenatal hydronephrosis and mild to moderate hydronephrosis on ultrasound in newborn period were referred for renal scintigraphy. Ten patients with vesicoureteral reflux documented on micturating cystoureterography underwent 99mTc-DMSA renal scintigraphy and 14 patients were subjected to 99mTc-DTPA scintigraphy. Results. Anteroposterior pelvic diameter on ultrasound ranged from 11 to 24 mm. Renal DMSA scans identified congenital scars in two boys with bilateral reflux of grade V and unilateral reflux of grade III. Relative kidney uptake (RKU less than 40% was found in three, and poor kidney function (RKU less than 10% in two patients. Significant obstruction was shown on DTPA diuretic renal scintigraphy in 6/14 patients. Some slowing in dranaige (T1/2 greater than 10 minutes with no reduction in differential renal function was identified in three patients. Differential renal function less than 10% was obtained in one case. Conclusion. A high percent of abnormal renal scintigraphy findings was obtained. Renal scintigraphy was useful in determination of underlying cause of antenatally detected hydronephrosis.

  17. Antenatal MR diagnosis of urinary hydrometrocolpos due to urogenital sinus

    Energy Technology Data Exchange (ETDEWEB)

    Subramanian, Subramanian; Sharma, Raju; Gamanagatti, Shivanand [All India Institute of Medical Sciences, Department of Radiodiagnosis, New Delhi (India); Agarwala, Sandeep [All India Institute of Medical Sciences, Department of Pediatric Surgery, New Delhi (India); Gupta, Prerna; Kumar, Sunesh [All India Institute of Medical Sciences, Department of Obstetrics and Gynaecology, New Delhi (India)

    2006-10-15

    Hydrometrocolpos is cystic dilatation of the vagina and uterus due to congenital vaginal obstruction. It may be secretory or urinary in character and manifests in the neonatal period with abdominal distension. Urinary hydrometrocolpos occurs in patients with urogenital sinus or cloacal anomaly. A rare case of antenatal MR diagnosis of urinary hydrometrocolpos due to urogenital sinus is presented. (orig.)

  18. CLASSIC DANDY WALKER MALFORMATION: ANTENATAL SONOGRAPHIC FINDINGS AND POSTNATAL STATUS

    Directory of Open Access Journals (Sweden)

    Arvinder

    2014-06-01

    Full Text Available Dandy Walker malformation is a rare congenital abnormality that affects the cerebellum and some of its components; particularly hypoplasia of cerebellar vermis, a cystic dilatation of fourth ventricle and is characterized by an enlarged posterior fossa. Here we present a case of classical DWM with antenatal and postnatal imaging

  19. Enhancing normal labour by adopting antenatal physiotherapy: a prospective study

    Directory of Open Access Journals (Sweden)

    Rooplekha Chauhan

    2016-08-01

    Conclusions: This highlights the very need for physiotherapy to be inculcated into the curriculum during antenatal period with conducive maternal and foetal outcome as it inflates the chances of normal deliveries and abate the rates of cesarean section and subsequent, which is the dire need of the day. [Int J Reprod Contracept Obstet Gynecol 2016; 5(8.000: 2672-2676

  20. Sero-prevalence of Toxoplasma gondii infection among pregnant women attending antenatal clinics in Khartoum and Omdurman Maternity Hospitals, Sudan

    Institute of Scientific and Technical Information of China (English)

    Musa Abdel-Raouff; Mohamed Mobarak Elbasheir

    2014-01-01

    Objective:To determine the sero-prevalence of Toxoplasma gondii (T. gondii) infection among pregnant Sudanese women. Methods:One hundred and sixty three pregnant women attending antenatal care in Omdurman Maternity Hospitals, Khartoum, Sudan during June to August in 2013 were enrolled and screened for immunoglobulin G (IgG) and IgM antitoxoplasma antibodies using enzyme linked immunosorbent assay technique. Results:Among 163 pregnant women, 33 (20.2%) were positive for (IgG) antitoxoplasma antibodies, while 130 (79.8%) were seronegative. None of the examined women had IgM antitoxoplasma antibodies. The highest rate of infection (26.7%) was detected among women aged 21-29 years. No statistically significant relation was observed between T. gondii sero-prevalence and the other variable of risk factors studied. Conclusions: Over 79% Sudanese women screened for antitoxoplasma IgG antibodies were seronegative and they were at risk of seroconversion during pregnancy. Moreover, the study showed that screening of T. gondii infections during antenatal care should be considered in Khartoum state as the main strategy to minimize congenital toxoplasmosis.

  1. Sero-prevalence of Toxoplasma gondii infection among pregnant women attending antenatal clinics in Khartoum and Omdurman Maternity Hospitals, Sudan

    Directory of Open Access Journals (Sweden)

    Musa Abdel-Raouff

    2014-06-01

    Full Text Available Objective: To determine the sero-prevalence of Toxoplasma gondii (T. gondii infection among pregnant Sudanese women. Methods: One hundred and sixty three pregnant women attending antenatal care in Omdurman Maternity Hospitals, Khartoum, Sudan during June to August in 2013 were enrolled and screened for immunoglobulin G (IgG and IgM antitoxoplasma antibodies using enzyme linked immunosorbent assay technique. Results: Among 163 pregnant women, 33 (20.2% were positive for (IgG antitoxoplasma antibodies, while 130 (79.8% were seronegative. None of the examined women had IgM antitoxoplasma antibodies. The highest rate of infection (26.7 % was detected among women aged 21-29 years. No statistically significant relation was observed between T. gondii sero-prevalence and the other variable of risk factors studied. Conclusions: Over 79% Sudanese women screened for antitoxoplasma IgG antibodies were seronegative and they were at risk of seroconversion during pregnancy. Moreover, the study showed that screening of T. gondii infections during antenatal care should be considered in Khartoum state as the main strategy to minimize congenital toxoplasmosis.

  2. Antenatal clinic and Stop Smoking Services staff views on "Opt-Out" referrals for smoking cessation in pregnancy: a framework analysis

    OpenAIRE

    Katarzyna Anna Campbell; Katharine Anna Bowker; Felix Naughton; Melanie Sloan; Sue Cooper; Tim Coleman

    2016-01-01

    Introduction: UK guidance recommends routine exhaled carbon monoxide (CO) screening for pregnant women and "opt-out" referrals to stop smoking services (SSS) of those with CO ≥ 4 ppm. We explored staff views on this referral pathway when implemented in one UK hospital Trust. Methods: Seventeen semi-structured interviews with staff involved in the implementation of the new referral pathway: six antenatal clinic staff (before and after implementation); five SSS staff (after). Data were analyzed...

  3. Dramatic and sustained increase in HIV-testing rates among antenatal attendees in Eastern Uganda after a policy change from voluntary counselling and testing to routine counselling and testing for HIV: a retrospective analysis of hospital records, 2002-2009

    Directory of Open Access Journals (Sweden)

    Onyango Saul

    2010-10-01

    Full Text Available Abstract Background The burden of mother-to-child transmission of HIV in Uganda is high. The aim of this paper is to describe the experience of the first 7 years of the prevention of mother- to- child transmission of HIV (PMTCT programme in Mbale Regional Hospital, Eastern Uganda, with particular reference to the lessons learnt in changing from voluntary counselling and testing (VCT to routine counselling and testing (RCT for HIV testing in antenatal services. Methods The study was a retrospective analysis of the PMTCT records of Mbale Regional Referral Hospital, Uganda, from May 2002 to April 2009. The data on HIV testing of pregnant women and their male partners was extracted from the reports and registers using a standardized data extraction form, and data was analysed using descriptive statistics. Permission to conduct the study was obtained from School of Medicine, Makerere University College of Health Sciences; Uganda National Council of Science and Technology, and Mbale Hospital. Results A total of 54 429 new antenatal (ANC attendees and 469 male-partners accessed antenatal services at Mbale Regional Referral Hospital. There was a sustained, significant increase in HIV testing among new ANC attendees from 22% during the VCT period to 88% during the RCT period (p = 0.002, while among male partners, HIV testing increased from 88% to 100% (p = 0.010 However, the overall number of male partners who tested for HIV remained very low despite the change from VCT to RCT approach in HIV testing. Conclusions Routine offer of antenatal HIV testing dramatically increased HIV testing in pregnant women and their partners in Uganda. Our findings call for further strengthening of the policy for routine HIV testing in antenatal clinics. Our study also showed that male partner HIV testing in antenatal clinics is low and this area needs further work through research and innovative interventions in order to improve male partner involvement.

  4. The urgent need for universally applicable simple screening procedures and diagnostic criteria for gestational diabetes mellitus – lessons from projects funded by the World Diabetes Foundation

    Directory of Open Access Journals (Sweden)

    Maximilian de Courten

    2012-07-01

    Full Text Available Background: To address the risks of adverse pregnancy outcomes and future type 2 diabetes associated with gestational diabetes mellitus (GDM, its early detection and timely treatment is essential. In the absence of an international consensus, multiple different guidelines on screening and diagnosis of GDM have existed for a long time. This may be changing with the publication of the recommendations by the International Association of Diabetes and Pregnancy Study Groups. However, none of these guidelines take into account evidence from or ground realities of resource-poor settings. Objective: This study aimed to investigate whether GDM projects supported by the World Diabetes Foundation in developing countries utilize any of the internationally recommended guidelines for screening and diagnosis of GDM, explore experiences on applicability and usefulness of the guidelines and barriers if any, in implementing the guidelines. These projects have reached out to thousands of pregnant women through capacity building and improvement of access to GDM screening and diagnosis in the developing world and therefore provide a rich field experience on the applicability of the guidelines in resource-poor settings. Design: A mixed methods approach using questionnaires and interviews was utilised to review 11 GDM projects. Two projects were conducted by the same partner; interviews were conducted in person or via phone by the first author with nine project partners and one responded via email. The interviews were analysed using content analysis. Results: The projects use seven different screening procedures and diagnostic criteria and many do not completely adhere to one guideline alone. Various challenges in adhering to the recommendations emerged in the interviews, including problems with screening women during the recommended time period, applicability of some of the listed risk factors used for (pre-screening, difficulties with reaching women for testing in

  5. Seroprevalence of human immunodeficiency virus among antenatal patients and incidence of mother- to- child transmission using single dose nevirapine: a cohort study in Maharashtra

    Directory of Open Access Journals (Sweden)

    Sonal A. Bhuyar

    2015-10-01

    Full Text Available Background: Objective was to study the seroprevalence of human immunodeficiency virus (HIV in antenatal patients and to find out the incidence of mother to child transmission (MTCT using single dose nevirapine (sdNVP to mother- baby pairs in labour. Methods: This prospective study was conducted in the department of Obstetrics and Gynecology, Dr. PDMMC, Amravati, Maharashtra from February 2010 to May 2015. All pregnant women attending the antenatal clinic were subjected to pretest counseling and HIV testing after informed consent. The HIV +ve pregnant patients who opted for delivery at our hospital were included in the study. sdNVP was administered to mother- baby pairs according to NACO guidelines. Babies of these patients were followed up to 18 months of age for HIV testing. Results: 12077 antenatal patients underwent pretest counseling. 11957 antenatal patients were tested for HIV of which 28 were detected positive. Therefore, the seroprevalence in this study was found to be 0.23%. 23 patients delivered at our hospital during the study period and babies of 2 patients tested positive for HIV. Hence the incidence of MTCT was found to be 9.5% in our study. Conclusions: Universal screening of pregnant patients for HIV and judicious use of PPTCT regimens can significantly reduce MTCT of HIV and prevalence of pediatric HIV infection. Single dose nevirapine use over last few years has successfully reduced MTCT, but our aim should be to reduce it further with more effective ART regimens for the seropositive antenatal patients and their babies. [Int J Reprod Contracept Obstet Gynecol 2015; 4(5.000: 1436-1441

  6. Antenatal diagnosis of Patau syndrome with previous anomalous baby

    OpenAIRE

    Keerthi Kocherla; Vasantha Kocherla

    2014-01-01

    Patau syndrome is the least common and most severe of the viable autosomal trisomies with median survival of fewer than 3 days was first identified as a cytogenetic syndrome in 1960. Patau syndrome is caused by an extra copy of chromosome 13. In this case report, we present antenatal imaging findings and gross foetal specimen correlation of foetus with Patau syndrome confirmed by karyotyping in third gravida who had significant previous obstetric history of gastrochisis in monochorionic and...

  7. Obstetrics risk of HIV infection among antenatal women in a rural Nigerian hospital

    Directory of Open Access Journals (Sweden)

    E A Etukumana

    2011-01-01

    Full Text Available Background: Obstetrics risk and practices can lead to the spread of HIV/AIDS. Identification of such obstetrics risk of HIV infection is a useful step in the prevention of transmission of the virus. Objective: We sought to determine obstetrics risk of HIV infection in pregnant women attending antenatal clinic in a rural Northern Nigerian hospital. Methods: We conducted a cross-sectional descriptive study of pregnant women attending antenatal clinic of a rural mission hospital in northern Nigeria between June and October 2005. Data were collected using structured questionnaire. HIV screening and confirmation was carried out on pregnant women after voluntary counseling. Results: 350 pregnant women were enrolled with a mean age (±SD of 26.8± 6.4years. The highest number of HIV infected women was observed in those who had their first coitus between 16 and 20 years. The age at first coitus was not significantly related to the HIV infection (P=0.41. Neither parity (P=0.13 nor past history of abortion (P=0.42 was associated with HIV infection. None of the 41 women who had their last delivery at home had HIV infection compared with 9.8% of the 194 women who delivered in the hospital or clinic (P=0.008. Forty percent of those who had their last delivery in primary health centre had HIV infection while 22.2% of those who delivered under the care of traditional birth had HIV infection. Conclusion: Obstetrics practices may encourage transmission of HIV infection. This calls for re-examination of the obstetrics practices especially in our primary health centers in order to prevent transmission of HIV infection.

  8. Does One Need a 4.5 K Screen in Cryostats of Superconducting Accelerator Devices Operating in Superfluid Helium? Lessons from the LHC

    CERN Document Server

    Lebrun, Ph; Tavian, L

    2014-01-01

    Superfluid helium is increasingly used as a coolant for superconducting devices in particle accelerators: the lower temperature enhances the performance of superconductors in high-field magnets and reduces BCS losses in RF acceleration cavities, while the excellent transport properties of superfluid helium can be put to work in efficient distributed cooling systems. The thermodynamic penalty of operating at lower temperature however requires careful management of the heat loads, achieved inter alia through proper design and construction of the cryostats. A recurrent question appears to be that of the need and practical feasibility of an additional screen cooled by normal helium at around 4.5 K surrounding the cold mass at about 2 K, in such cryostats equipped with a standard 80 K screen. We introduce the issue in terms of first principles applied to the configuration of the cryostats, discuss technical constraints and economical limitations, and illustrate the argumentation with examples taken from large proj...

  9. The urgent need for universally applicable simple screening procedures and diagnostic criteria for gestational diabetes mellitus - lessons from projects funded by the World Diabetes Foundation

    DEFF Research Database (Denmark)

    Nielsen, Karoline Kragelund; de Courten, Maximilian; Kapur, Anil

    2012-01-01

    Background: To address the risks of adverse pregnancy outcomes and future type 2 diabetes associated with gestational diabetes mellitus (GDM), its early detection and timely treatment is essential. In the absence of an international consensus, multiple different guidelines on screening...... and diagnosis of GDM have existed for a long time. This may be changing with the publication of the recommendations by the International Association of Diabetes and Pregnancy Study Groups. However, none of these guidelines take into account evidence from or ground realities of resource-poor settings. Objective......: This study aimed to investigate whether GDM projects supported by the World Diabetes Foundation in developing countries utilize any of the internationally recommended guidelines for screening and diagnosis of GDM, explore experiences on applicability and usefulness of the guidelines and barriers if any...

  10. Can colorectal cancer mass-screening organization be evidence-based? Lessons from failures: The experimental and pilot phases of the Lazio program

    Directory of Open Access Journals (Sweden)

    Valle Sabrina

    2008-09-01

    Full Text Available Abstract Background Screening programmes should be organized to translate theoretical efficacy into effectiveness. An evidence-based organizational model of colorectal cancer screening (CRCS should assure feasibility and high compliance. Methods A multidisciplinary Working Group (WG, reviewed literature and guidelines to define evidence-based recommendations. The WG identified the need for further local studies: physicians' CRCS attitudes, the effect of test type and provider on compliance, and individual reasons for non-compliance. A survey of digestive endoscopy services was conducted. A feasibility study on a target population of 300.000 has begun. Results Based on the results of population trials and on literature review the screening strategy adopted was Faecal Occult Blood Test (FOBT every two years for 50–74 year olds and, for positives, colonoscopy. The immunochemical test was chosen because it has 20% higher compliance than the Guaiac. GPs were chosen as the preferred provider also for higher compliance. Since we observed that distance is the major determinant of non-compliance, we choose GPs because they are the closest providers, both geographically and emotionally, to the public. The feasibility study showed several barriers: GP participation was low, there were administrative problems to involve GPs; opportunistic testing by the GPs; difficulties in access to Gastroenterology centres; difficulties in gathering colonoscopy results; little time given to screening activity by the gastroenterology centre. Conclusion The feasibility study highlighted several limits of the model. Most of the barriers that emerged were consequences of organisational choices not supported by evidence. The principal limit was a lack of accountability by the participating centres.

  11. Analysis of Antenatal Care and its Related Factors among Married Chinese Women

    Institute of Scientific and Technical Information of China (English)

    Guo-qing MI; Xi-kuan CHEN; Er-Sheng Gao

    2004-01-01

    Objective To explore the related factors of antenatal care Methods The data derived from National Demography and Reproductive Health Survey in 1997 conducted by National Population and Family Planning Commission. 11 892 women who had given birth to at least one survival child were involved in this study. SAS software was used in multivariate analysis.Results The average rate of general antenatal care is 57.3% and has increased dramatically in the recent 30 years. The major reason why most subjects didn't have antenatal care was lacking the recognition of the importance of antenatal care. The antenatal care was associated with residence in rural area or urban area, age, educational level, parity of the last birth, local average income, distance between home and township in rural area and so on.Conclusion Women of childbearing age need to improve their health knowledge; the government should increase the availability of antenatal care.

  12. Timing of antenatal care for adolescent and adult pregnant women in south-eastern Tanzania

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    Gross Karin

    2012-03-01

    Full Text Available Abstract Background Early and frequent antenatal care attendance during pregnancy is important to identify and mitigate risk factors in pregnancy and to encourage women to have a skilled attendant at childbirth. However, many pregnant women in sub-Saharan Africa start antenatal care attendance late, particularly adolescent pregnant women. Therefore they do not fully benefit from its preventive and curative services. This study assesses the timing of adult and adolescent pregnant women's first antenatal care visit and identifies factors influencing early and late attendance. Methods The study was conducted in the Ulanga and Kilombero rural Demographic Surveillance area in south-eastern Tanzania in 2008. Qualitative exploratory studies informed the design of a structured questionnaire. A total of 440 women who attended antenatal care participated in exit interviews. Socio-demographic, social, perception- and service related factors were analysed for associations with timing of antenatal care initiation using regression analysis. Results The majority of pregnant women initiated antenatal care attendance with an average of 5 gestational months. Belonging to the Sukuma ethnic group compared to other ethnic groups such as the Pogoro, Mhehe, Mgindo and others, perceived poor quality of care, late recognition of pregnancy and not being supported by the husband or partner were identified as factors associated with a later antenatal care enrolment (p Conclusions Factors including poor quality of care, lack of awareness about the health benefit of antenatal care, late recognition of pregnancy, and social and economic factors may influence timing of antenatal care. Community-based interventions are needed that involve men, and need to be combined with interventions that target improving the quality, content and outreach of antenatal care services to enhance early antenatal care enrolment among pregnant women.

  13. Determinants of folic acid knowledge and use among antenatal women.

    LENUS (Irish Health Repository)

    McDonnell, R

    1999-06-01

    Although recommendations on folic acid use were issued by health authorities in a number of countries in the early 1990s, uptake of peri-conceptional folic acid is still disappointingly low. Regardless of food fortification policies, folic acid promotion will probably be required in most countries to optimize folate levels among women of child-bearing age. The aim of this study was to examine folic acid knowledge and use, and their determinants among antenatal women in the east of Ireland in 1997.

  14. Antenatal testing for cystic fibrosis in Cuba, 1988-2011.

    Science.gov (United States)

    Collazo, Teresa; López, Ixchel; Clark, Yulia; Piloto, Yaixa; González, Laura; Gómez, Manuel; García, Marileivis; Reyes, Lidice; Rodríguez, Fidel

    2014-01-01

    INTRODUCTION Cystic fibrosis is a multisystem autosomal recessive disease with wide variability in clinical severity. It is incurable and characterized by elevated and premature mortality, as well as poor quality of life. Its frequency, lethality and devastating impact on both the physical and psychological wellbeing of patients and their families, make it a serious health problem. Its frequency in Cuba is 1 in 9862 live births, where marked molecular heterogeneity of the CFTR gene makes molecular diagnosis difficult. Six mutations have been identified that together enable molecular characterization of only 55.5% of cystic fibrosis chromosomes. This paper presents national results of antenatal diagnostic testing, using direct and indirect methods, for detection of cystic fibrosis. OBJECTIVE Characterize the Cuban public health system's experience with antenatal molecular testing for cystic fibrosis from 1988 through 2011. METHODS A retrospective descriptive study was conducted with results of antenatal diagnostic testing of amniotic fluid, performed nationwide from 1988 through 2011, for 108 fetuses of couples with some risk of having children affected by cystic fibrosis, who requested testing. Polymerase chain reaction detected mutations p.F508del, p.G542X, p.R1162X, p.R334W, p.R553X and c.3120+1G>A, and markers XV2C and KM19. Data were analyzed using absolute frequencies and percentages, and presented in tables. RESULTS For 93 cases (86.1%), testing for cystic fibrosis was done using direct analysis of mutations p.F508del, p.G542X, p.R1162X, p.R334W, p.R553X and c.3120+1G>A; five cases (4.6%) were tested indirectly using markers XV2C/Taq I and KM19/Pst I; and 10 (9.3%) were tested using a combination of the two methods. A total of 72 diagnoses (66.7% of studies done) were concluded, of which there were 20 healthy fetuses, 16 affected, 27 carrier, and 9 who were either healthy or carriers of an unknown mutation. CONCLUSIONS Direct or indirect molecular study was

  15. Antenatal diagnosis of Patau syndrome with previous anomalous baby

    Directory of Open Access Journals (Sweden)

    Keerthi Kocherla

    2014-06-01

    Full Text Available Patau syndrome is the least common and most severe of the viable autosomal trisomies with median survival of fewer than 3 days was first identified as a cytogenetic syndrome in 1960. Patau syndrome is caused by an extra copy of chromosome 13. In this case report, we present antenatal imaging findings and gross foetal specimen correlation of foetus with Patau syndrome confirmed by karyotyping in third gravida who had significant previous obstetric history of gastrochisis in monochorionic and monoamniotic twins who died at 14 weeks of gestation. [Int J Res Med Sci 2014; 2(3.000: 1172-1175

  16. Diagnostic conundrums in antenatal presentation of a skeletal dysplasia with description of a heterozygous C-propeptide mutation in COL1A1 associated with a severe presentation of osteogenesis imperfecta.

    Science.gov (United States)

    Marshall, Charlotte J; Arundel, Paul; Mushtaq, Talat; Offiah, Amaka C; Pollitt, Rebecca C; Bishop, Nicholas J; Balasubramanian, Meena

    2016-12-01

    Prompt and accurate diagnosis of skeletal dysplasias can play a crucial role in ensuring appropriate counseling and management (both antenatal and postnatal). When a skeletal dysplasia is detected during the antenatal period, especially early in the pregnancy, it can be associated with a poor prognosis. It is important to make a diagnosis in antenatal presentation of skeletal dysplasias to inform diagnosis, predict prognosis, provide accurate recurrence risks, and options for prenatal genetic testing in future pregnancies. Prenatal ultrasound scanning is a useful tool to detect several skeletal dysplasias and sonographic measurements serve as reliable indicators of lethality. The lethality depends on various factors including gestational age at which features are identified, size of the chest and progression of malformations. Although, it is important to type the skeletal presentation as accurately as possible, this is not always possible in an antenatal presentation and it is important to acknowledge this uncertainty. In the case of a live birth, it is always important to reassess the infant. Osteogenesis imperfecta (OI) is a heterogeneous group of disorders characterized by fragile bones. Here, we report an infant with severe OI born following a twin pregnancy in whom the bone disease is caused by a heterozygous pathogenic mutation, c.4160C >T, p.(Ala1387Val) located in the C-propeptide region of COL1A1. An assumption of lethality antenatally complicated his management in early life. We discuss this patient with particular emphasis on the neonatal presentation of a severe skeletal dysplasia and the lessons that may be learned in such situations. © 2016 Wiley Periodicals, Inc.

  17. The results of 15 years of consistent strategy in treating antenatally suspected pelvi-ureteric junction obstruction

    DEFF Research Database (Denmark)

    Thorup, Jørgen Mogens; Jokela, R; Cortes, Dina;

    2003-01-01

    To determine how to select patients for surgery among those with antenatally detected pelvi-ureteric junction (PUJ) obstruction.......To determine how to select patients for surgery among those with antenatally detected pelvi-ureteric junction (PUJ) obstruction....

  18. The results of 15 years of consistent strategy in treating antenatally suspected pelvi-ureteric junction obstruction

    DEFF Research Database (Denmark)

    Thorup, J; Jokela, R; Cortes, D;

    2003-01-01

    OBJECTIVE: To determine how to select patients for surgery among those with antenatally detected pelvi-ureteric junction (PUJ) obstruction. PATIENTS AND METHODS: The study comprised 100 consecutive children with antenatally detected suspected unilateral PUJ obstruction and a normal contralateral...

  19. The comparison of the performance of two screening strategies identifying newly-diagnosed HIV during pregnancy

    NARCIS (Netherlands)

    K. Boer; C. Smit; M. van der Flier; F. de Wolf

    2011-01-01

    In the Netherlands, a non-selective opt-out instead of a selective opt-in antenatal HIV screening strategy was implemented in 2004. In case of infection, screening was followed by prevention of mother-to-child-transmission (PMTCT). We compared the performance of the two strategies in terms of detect

  20. The comparison of the performance of two screening strategies identifying newly-diagnosed HIV during pregnancy

    NARCIS (Netherlands)

    Boer, Kees; Smit, Colette; van der Flier, Michiel; de Wolf, Frank; Borleffs, Jan

    2011-01-01

    BACKGROUND: In the Netherlands, a non-selective opt-out instead of a selective opt-in antenatal HIV screening strategy was implemented in 2004. In case of infection, screening was followed by prevention of mother-to-child-transmission (PMTCT). We compared the performance of the two strategies in ter

  1. Using survival analysis to determine association between maternal pelvis height and antenatal fetal head descent in Ugandan mothers

    Science.gov (United States)

    Munabi, Ian Guyton; Luboga, Samuel Abilemech; Mirembe, Florence

    2015-01-01

    Introduction Fetal head descent is used to demonstrate the maternal pelvis capacity to accommodate the fetal head. This is especially important in low resource settings that have high rates of childbirth related maternal deaths and morbidity. This study looked at maternal height and an additional measure, maternal pelvis height, from automotive engineering. The objective of the study was to determine the associations between maternal: height and pelvis height with the rate of fetal head descent in expectant Ugandan mothers. Methods This was a cross sectional study on 1265 singleton mothers attending antenatal clinics at five hospitals in various parts of Uganda. In addition to the routine antenatal examination, each mother had their pelvis height recorded following informed consent. Survival analysis was done using STATA 12. Results It was found that 27% of mothers had fetal head descent with an incident rate of 0.028 per week after the 25th week of pregnancy. Significant associations were observed between the rate of fetal head descent with: maternal height (Adj Haz ratio 0.93 P < 0.01) and maternal pelvis height (Adj Haz ratio 1.15 P < 0.01). Conclusion The significant associations observed between maternal: height and pelvis height with rate of fetal head descent, demonstrate a need for further study of maternal pelvis height as an additional decision support tool for screening mothers in low resource settings. PMID:26918071

  2. Sero-Prevalence of Hepatitis B Surface Antigen Amongst Pregnant Women Attending an Antenatal Clinic, Volta Region, Ghana

    Science.gov (United States)

    Dassah, Sylvester; Lokpo, Sylvester; Ameke, Louise; Noagbe, Mark; Adatara, Peter; Hagan, Oheneba; Binka, Fred

    2017-01-01

    Hepatitis B virus (HBV) infection remains a global challenge, although there is currently a safe and effective vaccine available. HBV prevalence in Ghana is not well documented, but vary regionally from 4.8% to 12.3% in the general population, 10.8% to 12.7% in blood donors and about 10.6% in pregnant women. This puts Ghana among the high endemic countries in Africa. The study objective was to determine the sero-prevalence of HBs antigen (Ag) and HBeAg among pregnant women in the Ho municipality. Two hundred and eigh participants (pregnant women), attending Ho Municipal antenatal clinic were enrolled into the study. This study recorded a HBsAg sero-prevalence rate of 2.4% among the pregnant women, with primigravida pregnant women recording (0.98%) and multigravida (1.42%). The prevalence of HBsAg among the pregnant women can be classified as Low Intermediate; therefore there is still the need for routine screening of pregnant women during antenatal visits. Amongst HBsAg positives, HBeAg positivity was significantly high (40% of all HBsAg positive women), which suggests high chances of carrier and vertical transmission (mother to child) state. PMID:28299162

  3. Faktor-Faktor yang Mempengaruhi Ibu Hamil dalam Melakukan Pemeriksaan Antenatal Care

    OpenAIRE

    Ritonga, Fatimah Jahra; Sitohang, Nur Asnah

    2016-01-01

    Pemeriksaan Antenatal Care adalah suatu program yang terencana berupa observasi, edukasi dan penanganan medik pada ibu hamil, untuk memperoleh suatu proses kehamilan dan persalinan yang aman dan memuaskan. Faktor-faktor yang mempengaruhi ibu hamil dalam melakukan pemeriksaan antenatal care adalah pengetahuan,pendidikan,umur,ekonomi,sumber informasi, letak geografis dan dukungan keluarga. Nur Asnah Sitohang

  4. Urinary tract infections at first antenatal check-up: a single centre prospective study

    Directory of Open Access Journals (Sweden)

    Saubhagya Kumar Jena

    2016-09-01

    Conclusions: ASB is more common during pregnancy even in first antenatal check-up. We suggest routine urine culture and sensitivity during first antenatal check-up to detect ASB and treat with proper antibiotic to prevent the complications and development of resistance. [Int J Reprod Contracept Obstet Gynecol 2016; 5(9.000: 3103-3106

  5. Early Postnatal Blood Pressure in Preterm Infants : Effects of Chorioamnionitis and Timing of Antenatal Steroids

    NARCIS (Netherlands)

    Been, Jasper V.; Kornelisse, Rene F.; Rours, Ingrid G. I. J. G.; Passos, Valeria Lima; De Krijger, Ronald R.; Zimmermann, Luc J. I.

    2009-01-01

    Previous studies suggest postnatal blood pressure in preterm infants to be decreased by chorioamnionitis and increased by antenatal steroids (AS). We examined the adjusted effects of both antenatal modulators on postnatal blood pressure (BP), with separate effects reported for histologic chorioamnio

  6. Group-based antenatal birth and parent preparation for improving birth outcomes and parenting resources

    DEFF Research Database (Denmark)

    Koushede, Vibeke; Brixval, Carina Sjöberg; Axelsen, Solveig Forberg

    2013-01-01

    To examine the efficacy and cost-effectiveness of group based antenatal education for improving childbirth and parenting resources compared to auditorium based education.......To examine the efficacy and cost-effectiveness of group based antenatal education for improving childbirth and parenting resources compared to auditorium based education....

  7. Antenatal education in small classes may increase childbirth self-efficacy

    DEFF Research Database (Denmark)

    Brixval, Carina S; Axelsen, Solveig F; Thygesen, Lau C

    2016-01-01

    Antenatal education in small classes may increase childbirth self-efficacy. In this randomised trial we assessed the effect of a structured antenatal programme versus auditorium-based lectures on childbirth self-efficacy measured by three single items. We found that women in the intervention group...

  8. The effect of antenatal education in small classes on obstetric and psycho-social outcomes

    DEFF Research Database (Denmark)

    Brixval, Carina Sjöberg; Axelsen, Solveig Forberg; Andersen, Stig Krøger

    2014-01-01

    number of participants, may differ from the effect of other forms of antenatal education. The latest Cochrane review, assessed as up-to-date in 2007, concluded that the effect of antenatal education for childbirth or parenthood or both remains largely unknown. This systematic review and meta...

  9. Effect of daily antenatal iron supplementation on plasmodium infection in Kenyan women. A randomized clinical trial

    NARCIS (Netherlands)

    Mwangi, M.N.; Roth, J.M.; Smit, M.R.; Trijsburg, Laura; Mwangi, A.M.; Demir, A.Y.; Wielders, J.P.M.; Mens, P.F.; Verweij, J.J.; Cox, S.E.; Prentice, A.M.; Brouwer, I.D.; Savelkoul, H.F.J.; Andang'o, P.E.A.; Verhoef, J.C.M.

    2015-01-01

    Importance Anemia affects most pregnant African women and is predominantly due to iron deficiency, but antenatal iron supplementation has uncertain health benefits and can increase the malaria burden. Objective To measure the effect of antenatal iron supplementation on maternal Plasmodium infection

  10. Antenatal renal pelvic dilatation; the long-term outlook

    Energy Technology Data Exchange (ETDEWEB)

    Duncan, K.A. [Royal Aberdeen Children' s Hospital and Aberdeen Maternity Hospital, Foresterhill, Aberdeen (United Kingdom)]. E-mail: k.duncan@nhs.net

    2007-02-15

    Aim: The purpose of this study was twofold: first to provide data for more accurate counselling of parents with regard to prognosis, and second, to ensure that by following a policy of selective micturating cystourethography (MCUG), significant pathology is not missed, in particular vesicoureteric reflux (VUR). (MCUG is only undertaken if the renal pelvic diameter (RPD) is {>=} 10 mm or if there is calyceal or ureteric dilatation.) Material and methods: Data were collected prospectively over a 6-year period. Pre and postnatal imaging findings were collected for all infants in whom a RPD of {>=} 5 mm was identified at any gestational age. The imaging records of all patients were reviewed in 2005 for evidence of pathology detected after re-presentation with symptoms. The age range at review varied from 2-8 years. Results: Complete data were available in 527 infants. The risk of significant pathology was related to the degree of antenatal renal pelvic dilatation varying from 6% for a RPD of 5 mm at 20 weeks gestation to 38% at 10mm. At 28-33 weeks gestation the risk varied from 5% at 5 mm to 15% at 10 mm. Subsequent imaging record review revealed only one patient with grade II VUR in the study population not picked up by our selective MCUG policy. Conclusion: The present study provides prognostic information that can be given to parents both antenatally and postnatally, and reassurance that a selective MCUG policy is appropriate.

  11. Does the time of delivery after antenatal corticosteroids matter?

    Directory of Open Access Journals (Sweden)

    Patrícia Campos

    2016-01-01

    Full Text Available Introduction: Preterm delivery is associated with an increased risk of newborn morbidity and mortality. Respiratory distress syndrome (RDS is the most common comorbidity. It has been proven that this syndrome can be prevented with the administration of antenatal corticosteroids to women at risk of preterm delivery, before 35 weeks of gestational age.Aim: To evaluate the risk factors, severity, co-morbidities, and mortality of RDS in newborns of less than 35 weeks of gestational age, with specific emphasis on the association between the elapsed time since the administration of the last dose of a full cycle of corticosteroids and the frequency and severity of RDS.Methods: This descriptive retrospective study includes all newborns of less than 35 weeks of gestational age, who were born at our center between January 1, 2012 and December 31, 2014 and admitted to Neonatal Intensive Care Unit (NICU. Newborns with major malformations, chromosomopathies, hydrops, congenital TORCH infection or outborns were excluded. RDS was diagnosed according to the criteria of the Update on the European Consensus Guidelines on the Management of Neonatal Respiratory Distress Syndrome in Preterm Infants (2013 and classified with a grade of I to III, in accord with radiographic results.Results: A total of 234 newborns were studied, of which 35.5% had RDS. Antenatal corticosteroids were used for 90.1% of all newborns. When adjusted to the severity of RDS, birth weight, gestational age, and vasopressor support were all predictive factors of newborn mortality. A ROC curve identified a cut-off of at most 10.5 hours between the last dose of a full cycle of corticosteroids and the delivery as higher risk of onset of RDS and another cut-off of at most 6.5 hours as higher risk of onset of moderate to severe RDS (sensitivity of 80.0% and 83.3%, respectively.Conclusion: The last dose of a full antenatal corticosteroids cycle must be given at least 10.5 hours prior to delivery to

  12. Explaining variation in Down's syndrome screening uptake: Comparing the Netherlands with England and Denmark using documentary analysis and expert stakeholder interviews

    NARCIS (Netherlands)

    N.M.T.H. Crombag (Neeltje M.T.H.); Y.E. Vellinga (Ynke E.); S.A. Kluijfhout (Sandra A.); L.D. Bryant (Louise D.); P.A. Ward (Pat A.); R. Iedema-Kuiper (Rita); P.C.J.I. Schielen (Peter); J.M. Bensing (Jozien); G.H. Visser (Gerhard Henk); A. Tabor (Ann); J. Hirst (Janet)

    2014-01-01

    textabstractBackground: The offer of prenatal Down's syndrome screening is part of routine antenatal care in most of Europe; however screening uptake varies significantly across countries. Although a decision to accept or reject screening is a personal choice, it is unlikely that the widely differin

  13. Lesson Learning at JPL

    Science.gov (United States)

    Oberhettinger, David

    2011-01-01

    A lessons learned system is a hallmark of a mature engineering organization A formal lessons learned process can help assure that valuable lessons get written and published, that they are well-written, and that the essential information is "infused" into institutional practice. Requires high-level institutional commitment, and everyone's participation in gathering, disseminating, and using the lessons

  14. National health insurance, social influence and antenatal care use in Ghana.

    Science.gov (United States)

    Owoo, Nkechi S; Lambon-Quayefio, Monica P

    2013-08-06

    The study explores the importance of social influence and the availability of health insurance on maternal care utilization in Ghana through the use of antenatal care services. A number of studies have found that access to health insurance plays a critical role in women's decision to utilize antenatal care services. However, little is known about the role that social forces play in this decision. This study uses village-level data from the 2008 Ghana Demographic and Health Survey to investigate the effects of health insurance and social influences on the intensity of antenatal care utilization by Ghanaian women. Using GIS information at the village level, we employ a spatial lag regression model in this study. Results indicate that, controlling for a host of socioeconomic and geographical factors, women who have health insurance appear to use more antenatal services than women who do not. In addition, the intensity of antenatal visits appears to be spatially correlated among the survey villages, implying that there may be some social influences that affect a woman's decision to utilize antenatal care. A reason for this may be that women who benefit from antenatal care through positive pregnancy outcomes may pass this information along to their peers who also increase their use of these services in response. Traditional/Cultural leaders as "gate-keepers" may be useful in the dissemination of maternal health care information. Public health officials may also explore the possibility of disseminating information relating to maternal care services via the mass media.

  15. Approaches to the management of antenatally diagnosed congenital tumours

    Energy Technology Data Exchange (ETDEWEB)

    Mahony, Rhona; McParland, Peter [National Maternity Hospital, Department of Fetal and Maternal Medicine, Dublin (Ireland)

    2009-11-15

    Congenital fetal tumours are rare, but current imaging modalities including US and MRI facilitate antenatal diagnosis and investigation, allowing a presumptive diagnosis and management strategy. Although the prevalence of fetal tumours is difficult to ascertain, an incidence of 7.2 per 100,000 live births has previously been reported, with the incidence of neonatal malignancy estimated at 36.5 per million births. Teratomas and neuroblastomas are the most common solid tumours described. Tumours may be very large or associated with severe hydrops leading to significant dystocia with the potential for difficult vaginal or caesarean delivery. Once the diagnosis of a fetal tumour is made, optimal management incorporates a multidisciplinary approach including obstetrician, neonatologist, paediatric surgeon and paediatric oncologist so that counselling is appropriate and a clear management plan is in place for parents. (orig.)

  16. Autosomal Recessive Polycystic Kidney Disease: Antenatal Diagnosis and Histopathological Correlation

    Directory of Open Access Journals (Sweden)

    Dayananda Kumar Rajanna

    2013-01-01

    Full Text Available Autosomal recessive polycystic kidney disease (ARPKD is one of the most common inheritable disease manifesting in infancy and childhood with a frequency of 1:6,000 to 1:55,000 births. The patient in her second trimester presented with a history of amenorrhea. Ultrasound examination revealed bilateral, enlarged, hyperechogenic kidneys, placentomegaly, and severe oligohydramnios. The pregnancy was terminated. An autopsy was performed on the fetus. Both the kidneys were found to be enlarged and the cut surface showed numerous cysts. The liver sections showed changes due to fibrosis. The final diagnosis of autosomal recessive polycystic kidney disease was made based on these findings. In this article, we correlate the ante-natal ultrasound and histopathological findings in autosomal recessive polycystic kidney disease.

  17. Assessment of prescription profile of pregnant women visiting antenatal clinics.

    Directory of Open Access Journals (Sweden)

    Eze UI

    2007-09-01

    Full Text Available Managing medical complications in pregnancy is a challenge to clinicians. Objectives: This study profiled some disease and prescription patterns for pregnant women attending antenatal clinics (ANCs in Nigeria. A risk classification of the medicines was also determined. Methods: Medical case files of 1,200 pregnant women attending antenatal clinics of 3 health facilities in Benin City, Nigeria were investigated. Disease pattern was determined from their diagnoses. The prescription pattern was assessed using WHO indicators, and the United States Food and Drug Administration classification of medicines according to risk to the foetus. Results: A total of 1,897 prescriptions of the 1,200 pregnant women attendees during the period under review were evaluated. Results indicated that malaria 554 (38% was the most prevalent disease, followed by upper respiratory tract infections (URTIs, 13% and gastrointestinal disturbances (GIT, 12%. The average number of drugs prescribed per encounter was found to be 3.0, and 2,434 (43% of medicines were prescribed by generic name. Minerals/ Vitamins 2,396 (42% were the most frequently prescribed medicines, and antibiotics occurred in 502 (8.8% of the total medicines. Of all medicines prescribed, 984 (17% were included in the foetal risk category C and 286 (5% in category D. Conclusion: The study concluded that malaria fever occurred most frequently followed by URTIs and GIT disturbances among the pregnant women. Minerals, vitamins and to a less extent anti-malarials topped the list of the prescribed medicines. The average number of medicines per encounter was much higher than WHO standards. The occurrence of contraindicated medicines was low.

  18. Antenatal glucocorticoid treatment affects hippocampal development in mice.

    Directory of Open Access Journals (Sweden)

    Cornelle W Noorlander

    Full Text Available Synthetic glucocorticoids are administered to pregnant women at risk for preterm delivery, to enhance fetal lung maturation. The benefit of this treatment is well established, however caution is necessary because of possible unwanted side effects on development of different organ systems, including the brain. Actions of glucocorticoids are mediated by corticosteroid receptors, which are highly expressed in the hippocampus, a brain structure involved in cognitive functions. Therefore, we analyzed the effects of a single antenatal dexamethasone treatment on the development of the mouse hippocampus. A clinically relevant dose of dexamethasone (0.4 mg/kg was administered to pregnant mice at embryonic day 15.5 and the hippocampus was analyzed from embryonic day 16 until adulthood. We investigated the effects of dexamethasone treatment on anatomical changes, apoptosis and proliferation in the hippocampus, hippocampal volume and on total body weight. Our results show that dexamethasone treatment reduced body weight and hippocampal volume transiently during development, but these effects were no longer detected at adulthood. Dexamethasone treatment increased the number of apoptotic cells in the hippocampus until birth, but postnatally no effects of dexamethasone treatment on apoptosis were found. During the phase with increased apoptosis, dexamethasone treatment reduced the number of proliferating cells in the subgranular zone of the dentate gyrus. The number of proliferative cells was increased at postnatal day 5 and 10, but was decreased again at the adult stage. This latter long-term and negative effect of antenatal dexamethasone treatment on the number of proliferative cells in the hippocampus may have important implications for hippocampal network function.

  19. Antenatal glucocorticoid treatment affects hippocampal development in mice.

    Science.gov (United States)

    Noorlander, Cornelle W; Tijsseling, Deodata; Hessel, Ellen V S; de Vries, Willem B; Derks, Jan B; Visser, Gerard H A; de Graan, Pierre N E

    2014-01-01

    Synthetic glucocorticoids are administered to pregnant women at risk for preterm delivery, to enhance fetal lung maturation. The benefit of this treatment is well established, however caution is necessary because of possible unwanted side effects on development of different organ systems, including the brain. Actions of glucocorticoids are mediated by corticosteroid receptors, which are highly expressed in the hippocampus, a brain structure involved in cognitive functions. Therefore, we analyzed the effects of a single antenatal dexamethasone treatment on the development of the mouse hippocampus. A clinically relevant dose of dexamethasone (0.4 mg/kg) was administered to pregnant mice at embryonic day 15.5 and the hippocampus was analyzed from embryonic day 16 until adulthood. We investigated the effects of dexamethasone treatment on anatomical changes, apoptosis and proliferation in the hippocampus, hippocampal volume and on total body weight. Our results show that dexamethasone treatment reduced body weight and hippocampal volume transiently during development, but these effects were no longer detected at adulthood. Dexamethasone treatment increased the number of apoptotic cells in the hippocampus until birth, but postnatally no effects of dexamethasone treatment on apoptosis were found. During the phase with increased apoptosis, dexamethasone treatment reduced the number of proliferating cells in the subgranular zone of the dentate gyrus. The number of proliferative cells was increased at postnatal day 5 and 10, but was decreased again at the adult stage. This latter long-term and negative effect of antenatal dexamethasone treatment on the number of proliferative cells in the hippocampus may have important implications for hippocampal network function.

  20. A CASE REPORT-ANTENATAL DIAGNOSIS OF FETAL INTRACRANIAL HAEMORHAGE

    Directory of Open Access Journals (Sweden)

    Kalyani

    2015-10-01

    Full Text Available 26 years old para 1 with 26 weeks of pregnancy presented with intermittent fever. Her obstetric history included one spontaneous first trimester miscarriage and one previous Caesarean Section for meconium stained amniotic fluid. Her antenatal course was uneventful so far. On investigation she tested IgM dengue positive. Her WBC count, platelet count and coagulation profiles were within normal limits. Obstetric sonography was done which was suggestive of a single live intrauterine gestation corresponding with growth appropriate for gestational age with moderate polyhydramnios (AFI 25cms with hyperechoic cerebral cisterns suggestive of intracranial haemorrhage. Fetal MRI was done which revealed generalized atrophy of the brain parenchyma with subdural haematoma over posterior cerebral convexities extending along tentorial leaflets. Patient went into preterm labour at 27 weeks and delivered male baby of 980gms which was an intrapartum fetal demise. Fetal intracranial hemorrhage occurs in 5 in 10,000 pregnancies. Hemorrhage may occur either within the cerebral ventricles (Intraventricular haemorrhage, IVH, subdural space or infratentorial fossa. IVH are common variety and are characteristic of immature brain. IVH are subdivided according to their severity into four grades: the first three grades are limited to the ventricles, while the fourth grade includes parenchymal involvement occurring in the most severe cases. Fetal stroke is caused by antenatal hemorrhagic, ischemic or thrombotic injury. Although there is no identifiable risk factor in 50% of cases of fetal stroke, the most common maternal conditions associated with it are alloimmune thrombocytopenia and trauma. Outcome is usually poor, for those fetuses affected with high grade IVH or subdural hemorrhages. USG helps in accurate diagnosis of fetal ICH and prenatal MRI also contributes to the accuracy of diagnosis.

  1. [Antenatal closure of ductus arteriosus following maternal intoxication by niflumic acid].

    Science.gov (United States)

    Bouissou, A; Glorieux, I; Dulac, Y; Marcoux, M O; Casper, C

    2006-01-01

    Antenatal closure of the ductus arteriosus is an uncommon event that has been considered as a risk factor for development of congestive heart failure and persistent pulmonary hypertension of the newborn. We report here on a case of antenatal ductus arteriosus closure due to niflumic acid maternal intoxication at 32 weeks of gestation. Fetal extraction was performed few days later because of echographic signs of congestive heart failure. The child survived after 3 days of severe persistent pulmonary hypertension. This case emphasizes the potential risk of niflumic acid during pregnancy and the need of antenatal echographic monitoring for optimal management.

  2. Integrating couple relationship education in antenatal education - a study of perceived relevance among expectant Danish parents.

    Science.gov (United States)

    Axelsen, Solveig Forberg; Brixval, Carina Sjöberg; Due, Pernille; Koushede, Vibeke

    2014-12-01

    Little is known about which elements antenatal education should encompass to meet the needs of parents today. Psycho-social aspects relating to couple- and parenthood have generally not been covered in Danish antenatal education, although studies suggest that parents need this information. The aim of this study was to examine perceived relevance of couple relationship topics integrated in an antenatal programme among intervention participants in the NEWBORN trial. Our study shows that 84% of the participants found it relevant to learn about communication skills and changes in the relationship during and after pregnancy.

  3. Integrating couple relationship education in antenatal education - A study of perceived relevance among expectant Danish parents

    DEFF Research Database (Denmark)

    Axelsen, Solveig Forberg; Brixval, Carina Sjöberg; Due, Pernille;

    2014-01-01

    Little is known about which elements antenatal education should encompass to meet the needs of parents today. Psycho-social aspects relating to couple- and parenthood have generally not been covered in Danish antenatal education, although studies suggest that parents need this information. The aim...... of this study was to examine perceived relevance of couple relationship topics integrated in an antenatal programme among intervention participants in the NEWBORN trial. Our study shows that 84% of the participants found it relevant to learn about communication skills and changes in the relationship during...

  4. SCREENING FOR DIABETES IN PREGNANCY

    Directory of Open Access Journals (Sweden)

    Vidya Manoj

    2015-09-01

    Full Text Available AIM: All pregnant women are screened for gestational diabetes mellitus during pregnancy with timely intervention to reduce perinatal morbidity and obstetrics complication. OBJECTIVES: To determine the proportion of diabetes in ANC mother attending ANC OPD at Bh arati Hospital, to evaluate the high risk factor causing abnormal GTT and to evaluate outcome of pregnant mother with GDM. METHODS/STUDY DESIGN: The prospective study was conducted in 100 pregnant women attending antenatal checkup who had no previous histo ry of diabetes. ANC mothers were given 75gm glucose irrespective of last meal. A venous sample was collected at 2hr for estimating plasma glucose. Gestational Diabetes Mellitus was diagnosed if 2hrs . plasma glucose levels came >140mg/dl. RESULT AND CONCLUS ION : The screening of pregnant woman for diabetes on their first visit to antenatal clinic can be an effective method in detection of diabetes during pregnancy. Though the higher incidence is found in the risk group women in comparison to non - risk group, u niversal screening can be recommended instead of selective screening. Early screening does help in early detection of diabetes. Chances of gestational diabetes are increasing with increase in age & gravidity. Increasing maternal carbohydrate intolerance in pregnant women is associated with a graded increase in adverse maternal and fetal outcome. Women diagnosed to have GDM are at increased risk of future diabetes predominantly type 2 DM as are their children. Thus GDM offers an important opportunity for the development, testing and implementation of clinical strategies for diabetes prevention and reducing perinatal morbidity and obstetrics complications.

  5. Whose Knowledge Counts? : A Study of Providers and Users of Antenatal Care in Rural Zimbabwe

    OpenAIRE

    2005-01-01

    This thesis presents perspectives and experiences of different stakeholders and their ways of reasoning around pregnancy and pregnancy care. Data were generated from individual interviews with 25 health care providers, 18 women and 6 traditional birth attendants (TBAs) as well as 11 focus groups discussions with women, men and TBAs. The challenges experienced by health care providers in their provision of antenatal care, while attempting to change antenatal care through routines proven to ha...

  6. Enhancing focused antenatal care in Ghana: An exploration into perceptions of practicing midwives

    OpenAIRE

    A. Baffour-Awuah; P.P. Mwini-Nyaledzigbor; Richter, S.

    2015-01-01

    Objective: The specific objectives of this study were to explore the perceptions of midwives on focused antenatal care at a large urban hospital in Tema, Ghana. Methodology: An interpretive descriptive design was used to explore, interpret and describe the perceptions of midwives in the provision of focused antenatal services to pregnant women. Purposive sampling techniques were used to recruit participants (midwives). Data were collected by conducting individual semi-structured interviews...

  7. Socio Demographic Factors Determining the Adequacy of Antenatal Care among Pregnant Women Visiting Ekiti State Primary Health Centers

    Directory of Open Access Journals (Sweden)

    Ikeoluwapo O. Ajayi

    2013-08-01

    Full Text Available A cross sectional study was conducted in Primary Health Centers among pregnant women to elucidate adequacy of antenatal care across different socio demographic variables. Four hundred respondents were proportionately selected from 18 primary health centers using simple random sampling. Exit interviews were conducted using the adapted antenatal care exit interview form of the Safe Motherhood Needs Assessment package. Data was analyzed using descriptive statistics and Chi square test. Adequacy of antenatal care in this study was measured by the single adequacy indicators which are duration of pregnancy at entry into antenatal care and number of antenatal visits; which are particularly suitable for developing countries. Age of respondents, means of transportation to the PHCs, occupation, location and level of education of the respondents were found to be determinants of whether the pregnant women attended their first antenatal visit in the first trimester, similarly, age of the respondents was a predictor of whether the women made up to four antenatal visits by their third trimester. Occupation and level of education were determinants of whether or not the pregnant women made their first antenatal visits at the first trimester. More respondents who were not working and those who were unskilled workers made their first antenatal visit at the first trimester compared to those who were skilled workers; work place policies and the fact that antenatal booking are made on weekdays and at work hours may hinder or be discouraging to the working class mothers.

  8. Effects of Antenatal Maternal Depression and Anxiety on Children's Early Cognitive Development: A Prospective Cohort Study.

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    Gladys Ibanez

    Full Text Available Studies have shown that depression or anxiety occur in 10-20% of pregnant women. These disorders are often undertreated and may affect mothers and children's health. This study investigates the relation between antenatal maternal depression, anxiety and children's early cognitive development among 1380 two-year-old children and 1227 three-year-old children.In the French EDEN Mother-Child Cohort Study, language ability was assessed with the Communicative Development Inventory at 2 years of age and overall development with the Ages and Stages Questionnaire at 3 years of age. Multiple regressions and structural equation modeling were used to examine links between depression, anxiety during pregnancy and child cognitive development.We found strong significant associations between maternal antenatal anxiety and poorer children's cognitive development at 2 and 3 years. Antenatal maternal depression was not associated with child development, except when antenatal maternal anxiety was also present. Both postnatal maternal depression and parental stimulation appeared to play mediating roles in the relation between antenatal maternal anxiety and children's cognitive development. At 3 years, parental stimulation mediated 13.2% of the effect of antenatal maternal anxiety while postnatal maternal depression mediated 26.5%.The partial nature of these effects suggests that other mediators may play a role. Implications for theory and research on child development are discussed.

  9. Multiple Antenatal Dexamethasone Treatment Alters Brain Vessel Differentiation in Newborn Mouse Pups.

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    Winfried Neuhaus

    Full Text Available Antenatal steroid treatment decreases morbidity and mortality in premature infants through the maturation of lung tissue, which enables sufficient breathing performance. However, clinical and animal studies have shown that repeated doses of glucocorticoids such as dexamethasone and betamethasone lead to long-term adverse effects on brain development. Therefore, we established a mouse model for antenatal dexamethasone treatment to investigate the effects of dexamethasone on brain vessel differentiation towards the blood-brain barrier (BBB phenotype, focusing on molecular marker analysis. The major findings were that in total brains on postnatal day (PN 4 triple antenatal dexamethasone treatment significantly downregulated the tight junction protein claudin-5, the endothelial marker Pecam-1/CD31, the glucocorticoid receptor, the NR1 subunit of the N-methyl-D-aspartate receptor, and Abc transporters (Abcb1a, Abcg2 Abcc4. Less pronounced effects were found after single antenatal dexamethasone treatment and in PN10 samples. Comparisons of total brain samples with isolated brain endothelial cells together with the stainings for Pecam-1/CD31 and claudin-5 led to the assumption that the morphology of brain vessels is affected by antenatal dexamethasone treatment at PN4. On the mRNA level markers for angiogenesis, the sonic hedgehog and the Wnt pathway were downregulated in PN4 samples, suggesting fundamental changes in brain vascularization and/or differentiation. In conclusion, we provided a first comprehensive molecular basis for the adverse effects of multiple antenatal dexamethasone treatment on brain vessel differentiation.

  10. Do assisted-reproduction twin pregnancies require additional antenatal care?

    Science.gov (United States)

    Jauniaux, E; Ben-Ami, I; Maymon, R

    2013-02-01

    obviously at higher risk of perinatal complications than singletons due to a natural increase in the incidence of fetal anomalies, antenatal disorders and obstetric and neonatal complications associated with the development of two fetuses instead of one. Overall, our review indicates that some antenatal complications are more frequent in assisted-conception twin pregnancies than in spontaneous twin pregnancies but their prevalence is low and thus their impact on the morbidity and mortality of an individual assisted-conception twin pregnancy is limited. Assisted reproduction treatment has become available to older women with pre-existing maternal medical conditions such as chronic hypertension and diabetes. The increased obstetrical risks in this population must be considered prior to attempts at assisted conception, and the transfer of more than one embryo should be avoided in women with a pre-existing maternal medical condition.

  11. A Model of Tuberculosis Screening for Pregnant Women in Resource-Limited Settings Using Xpert MTB/RIF

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    Eleanor R. Turnbull

    2012-01-01

    Full Text Available Timely diagnosis and treatment of maternal tuberculosis (TB is important to reduce morbidity and mortality for both the mother and child, particularly in women who are coinfected with HIV. The World Health Organization (WHO recommends the integration of TB/HIV screening into antenatal services but available diagnostic tools are slow and insensitive, resulting in delays in treatment initiation. Recently the WHO endorsed Xpert MTB/RIF, a highly sensitive, real-time PCR assay for Mycobacterium tuberculosis that simultaneously detects rifampicin resistance directly from sputum and provides results within 100 minutes. We propose a model for same-day TB screening and diagnosis of all pregnant women at antenatal care using Xpert MTB/RIF. Pilot studies are urgently required to evaluate strategies for the integration of TB screening into antenatal clinics using new diagnostic technologies.

  12. Late entry to antenatal care in New South Wales, Australia

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    Rubin George

    2006-08-01

    Full Text Available Abstract Aims This study aimed to assess the prevalence of women who entered antenatal care (ANC late and to identify factors related to the late entry to ANC in New South Wales (NSW in 2004. Methods The NSW Midwives Data Collection contained data of 85,034 women who gave birth in 2004. Data were downloaded using SAS and transferred to STATA 8.0. Entering ANC after 12 weeks of gestation was classified as late. The Andersen Health Seeking Behaviour Model was used for selection and analyses of related factors. Regression and hierarchical analyses were used to identify significant factors and their relative contributions to the variation of pregnancy duration at entry to ANC. Results 41% of women commenced ANC after 12 weeks of gestation. Inequality existed between groups of women with predisposing characteristics and enabling resources contributed more to the variation in pregnancy duration at entry to ANC than needs. The groups of women with highest risk were teenagers, migrants from developing countries, women living in Western Sydney, Aboriginal and Torres Strait Islanders, women with three or more previous pregnancies and heavy smokers. The high risk groups with largest number of women were migrants from developing countries and women living in Western Sydney. Conclusion A large number of women in NSW entered ANC late in their pregnancies. Efforts to increase early entry to ANC should be targeted on identified high risk groups of women.

  13. Hubungan Frekuensi Kunjungan Antenatal Care (ANC dengan Kejadian Prematur

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    Evi Esti Utami

    2016-03-01

    Full Text Available The cause of infant mortality is mostly due to perinatal matters. Almost 2-27% of all perinatal death is caused by prematurity with low birth weight (BBLR. Reducing mortality rate on perinatal can be achieved by observing all pregnant women and fi nding as well as addressing infl uenced factors of neonatal safety. This research aims to identify correlation between frequencies of Antenatal Care (ANC with incidence of prematurity. This is an observational study with case-control design using retrospective approach. Total population was 1335 and of 156 was choosen as research respondents deviding into 78 as case respondents and 78 as control groups. The result of statistic analysis showed that p value=0,837 (p>0,05 means frequencies of ANC did not have correlation with prematurity. Conclusion, (1 during the period of 1 January 2011 and 29 February 2012, it found 207 (8,13% premature baby delivered, (2 at about 80,8% mother who delivered premature baby had normal ANC 4 times or more with the pattern 1-1-2 in every semester, (3 statistically ANC was not having correlation with premature baby.

  14. Awareness Regarding Anemia, Gestational Diabetes and Pregnancy Induced Hypertension among Antenatal Women Attending Outpatient Department in a Rural Hospital

    OpenAIRE

    George M; George N; Ramesh N

    2016-01-01

    "Introduction: Antenatal mothers should not only be aware of normal antenatal care but also be aware about common morbidities like anemia, gestational diabetes mellitus (GDM), pregnancy induced hypertension (PIH), etc., which can have adverse pregnancy outcomes. This study was conducted to assess the awareness regarding anemia, GDM and PIH among antenatal women attending outpatient clinic in a rural hospital. Methods: This was a cross sectional study done during the period of October-Novem...

  15. Male perspectives on incorporating men into antenatal HIV counseling and testing.

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    David A Katz

    Full Text Available BACKGROUND: Male partner involvement in antenatal voluntary HIV counseling and testing (VCT has been shown to increase uptake of interventions to reduce the risk of HIV transmission in resource-limited settings. We aimed to identify methods for increasing male involvement in antenatal VCT and determine male correlates of accepting couple counseling in these settings. METHODOLOGY/PRINCIPAL FINDINGS: We invited women presenting to a Nairobi antenatal clinic to return with their male partners for individual or couples VCT. Male attitudes towards VCT and correlates of accompanying female partners to antenatal clinic and receiving couple counseling were determined. Of 1,993 women who invited their partner, 313 (16% returned with their partners to ANC. Men attending antenatal clinic were married (>99%, employed (98%, and unlikely to report prior HIV testing (14%. Wanting an HIV test (87% or health information (11% were the most commonly cited reasons for attending. Most (95% men who came to antenatal clinic accepted HIV testing and 39% elected to receive counseling as a couple. Men who received counseling with partners were younger, had fewer children, and were less knowledgeable about prevention of mother-to-child HIV transmission (PMTCT than those who received counseling individually (p<0.05. Only 27% of men stated they would prefer HIV testing at a site other than the ANC. There was agreement between male and female reports for sociodemographic characteristics; however, men were more likely to report HIV preventive behaviors and health communication within the partnership than their partners (p<0.05. CONCLUSIONS/SIGNIFICANCE: Offering VCT services to men at antenatal clinic with options for couple and individual counseling is an important opportunity and acceptable strategy for increasing male involvement in PMTCT and promoting male HIV testing.

  16. Risk factors for incident HIV infection among antenatal mothers in rural Eastern Cape, South Africa

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    Charles Bitamazire Businge

    2016-01-01

    Full Text Available Background: The prevalence of HIV among antenatal clients in South Africa has remained at a very high rate of about 29% despite substantial decline in several sub-Saharan countries. There is a paucity of data on risk factors for incident HIV infection among antenatal mothers and women within the reproductive age bracket in local settings in the Eastern Cape, South Africa. Objective: To establish the risk factors for incident HIV infection among antenatal clients aged 18–49 years attending public antenatal clinics in rural Eastern Cape, South Africa. Design: This was an unmatched case–control study carried out in public health antenatal clinics of King Sabata District Municipality between January and March 2014. The cases comprised 100 clients with recent HIV infection; the controls were 200 HIV-negative antenatal clients. Socio-demographic, sexual, and behavioral data were collected using interviewer-administered questionnaires adapted from the standard DHS5 women's questionnaire. Multivariate logistic regression models were used to identify the independent risk factors for HIV infection. A p<0.05 was considered statistically significant. Results: The independent risk factors for incident HIV infection were economic dependence on the partner, having older male partners especially among women aged ≤20 years, and sex under the influence of alcohol. Conclusions: Therefore, effective prevention of HIV among antenatal mothers in KSDM must target the improvement of the economic status of women, thereby reducing economic dependence on their sexual partners; address the prevalent phenomenon of cross-generation sex among women aged <20 years; and regulate the brewing, marketing, and consumption of alcohol.

  17. Antenatal exposure to betamethasone: psychological functioning and health related quality of life 31 years after inclusion in randomised controlled trial

    OpenAIRE

    Dalziel, Stuart R; Lim, Vanessa K; Lambert, Anthony; McCarthy, Dianne; Parag, Varsha; Rodgers, Anthony; Harding, Jane E.

    2005-01-01

    Objectives To determine if antenatal exposure to betamethasone for the prevention of neonatal respiratory distress syndrome alters psychological functioning and health related quality of life in adulthood.

  18. Neuromodulation and antenatal depression: a review

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    Kim DR

    2015-04-01

    Full Text Available Deborah R Kim,1 Jessica L Snell,1 Grace C Ewing,1 John O’Reardon2 1Department of Psychiatry, Penn Center for Women’s Behavioral Health, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, 2Department of Psychiatry, Rowan University, Rowan School of Medicine, Cherry Hill, NJ, USA Background: Depression during pregnancy affects 5%–8% of women. While the percentage of women in the US taking serotonin reuptake inhibitors during pregnancy has risen over the last decade, pregnant women continue to report that they prefer non-pharmacologic interventions. Objective: We review the literature regarding neuromodulation techniques for major depressive disorder during pregnancy. The rationale for their use in this population, new developments, and future directions are discussed. Methods: A literature search was conducted in PubMed Plus, Ovid Medline, and Embase to collect all articles on neuromodulation for the treatment of depression during pregnancy. Key search words included electroconvulsive therapy, transcranial magnetic stimulation, deep brain stimulation, transcranial direct current stimulation, neuromodulation, depression, and pregnancy. Given the sparse literature, all articles from 1960 to 2014 that addressed the use of neuromodulation in pregnancy were included. Conclusion: The data support the use of electroconvulsive therapy in all trimesters of pregnancy for major depressive disorder. New data are emerging for the use of transcranial magnetic stimulation in pregnancy, which is likely safe, but more data are needed before it can be recommended as a primary treatment modality during pregnancy. Other neuromodulation techniques have not been well studied in this population. Keywords: electroconvulsive therapy, transcranial magnetic stimulation, pregnancy, depression, antenatal depression, perinatal

  19. Contraception awareness and practice among antenatal attendees in Uyo, Nigeria

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    Augustine Vincent Umoh

    2011-12-01

    Full Text Available INTRODUCTION: Contraception is major component of reproductive health. The study aims to document the awareness of contraception and its use in Uyo, South-south Nigeria and provide useful information for future intervention strategies. METHODS: A cross-sectional study using pretested questionnaires among antenatal attendees in a tertiary and a secondary health facility in Uyo. RESULTS: A total of 550 women took part in the study. Majority of respondents (92.4% were aware of contraception while 52.6% had ever used any form of contraception. The condom (60.3% and the pill (49.9% were the most common forms of contraception that the women had heard of, mostly from the doctor (36.9%, radio (33.8% and nurse (28.5%. The condom (46.7%, withdrawal method (14.1% and the pills (13.3% were the most commonly used forms of contraception. Majority of the women (70.5% planned to use contraception in the future and this intention was significantly related to the woman's educational status (p<0.05 but not to religion or occupation. Fear of side effects, uncertainty about its need, partner objection and previous side effects were the common reasons given for unwillingness to use contraception in the future. CONCLUSION: Our study has shown that while there is good contraceptive awareness in Uyo, Nigeria, this is not matched by commensurate contraceptive prevalence but prospects for improvement exist. There�s need to tackle known obstacles to contraceptive uptake. Also targeted campaigns and every available opportunity should be used to provide reproductive counseling to women especially on contraception.

  20. Under-attending free antenatal care is associated with adverse pregnancy outcomes

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    Heinonen Seppo

    2007-09-01

    Full Text Available Abstract Background Most pertinent studies of inadequate antenatal care concentrate on the risk profile of women booking late or not booking at all to antenatal care. The objective of this study was to assess the outcome of pregnancies when free and easily accessible antenatal care has been either totally lacking or low in number of visits. Methods This is a hospital register based cohort study of pregnancies treated in Kuopio University Hospital, Finland, in 1989 – 2001. Pregnancy outcomes of women having low numbers (1–5 of antenatal care visits (n = 207 and no antenatal care visits (n = 270 were compared with women having 6–18 antenatal visits (n = 23137. Main outcome measures were: Low birth weight, fetal death, neonatal death. Adverse pregnancy outcomes were controlled for confounding factors (adjusted odds ratios, OR: s in multiple logistic regression models. Results Of the analyzed pregnant population, 1.0% had no antenatal care visits and 0.77% had 1–5 visits. Under- or non-attendance associated with social and health behavioral risk factors: unmarried status, lower educational level, young maternal age, smoking and alcohol use. Chorio-amnionitis or placental abruptions were more common complications of pregnancies of women avoiding antenatal care, and pregnancy outcome was impaired. After logistic regression analyses, controlling for confounding, there were significantly more low birth weight infants in under- and non-attenders (OR:s with 95% CI:s: 9.18 (6.65–12.68 and 5.46 (3.90–7.65, respectively more fetal deaths (OR:s 12.05 (5.95–24.40 and 5.19 (2.04–13.22, respectively and more neonatal deaths (OR:s 10.03 (3.85–26.13 and 8.66 (3.59–20.86, respectively. Conclusion Even when birth takes place in hospital, non- or under-attendance at antenatal care carries a substantially elevated risk of severe adverse pregnancy outcome. Underlying adverse health behavior and possible abuse indicate close surveillance of the

  1. Antenatal depressive symptoms associated with specific life events and sources of social support among Italian women.

    Science.gov (United States)

    Agostini, Francesca; Neri, Erica; Salvatori, Paola; Dellabartola, Sara; Bozicevic, Laura; Monti, Fiorella

    2015-05-01

    This study aimed to identify different kinds of stressful life events and social support associated with antenatal depressive symptoms in a sample of pregnant Italian women. We conducted the study at a primary health-care centre in an urban area (northeast Italy). Mainly recruited at antenatal classes, 404 eligible pregnant women completed a socio-demographic questionnaire that included questions about the present pregnancy, the Edinburgh Depression Scale (EDS) to estimate the prevalence of depressive symptoms, the Multidimensional Scale of Perceived Social Support and List of Threatening Experiences Questionnaire to investigate the quality and nature of social support and recent negative life events. Of the 404 women, 60 (14.9 %) scored 13 or higher on the EDS. This group reported significantly lower social support from various sources-family, friends, and significant others; only in primiparous women were depressive symptoms significantly related to lower support from friends. Women with EDS scores equal or higher than 13 also reported a higher occurrence of recent stressful life events-specifically, death or a serious problem with a close friend or relative, unemployment, financial problems, and moving or housing difficulties. Regression analyses showed that women with high levels of social support or with a positive experience of pregnancy were less likely to experience antenatal depressive symptoms. Our results underscore the associations among antenatal depression, specific life stressors, and low social support from various sources. Clinical attention to these psychosocial correlates is recommended toward detecting vulnerability to antenatal depressive symptoms.

  2. Thrown off balance: the effect of antenatal inflammation on the developing lung and immune system.

    Science.gov (United States)

    Kunzmann, Steffen; Collins, Jennifer J P; Kuypers, Elke; Kramer, Boris W

    2013-06-01

    In recent years, translational research with various animal models has been helpful to answer basic questions about the effect of antenatal inflammation on maturation and development of the fetal lung and immune system. The fetal lung and immune systems are very plastic and their development can be conditioned and influenced by both endogenous and/or exogenous factors. Antenatal inflammation can induce pulmonary inflammation, leading to lung injury and remodeling in the fetal lung. Exposure to antenatal inflammation can induce interleukin-1α production, which enhances surfactant protein and lipid synthesis thereby promoting lung maturation. Interleukin-1α is therefore a candidate for the link between lung inflammation and lung maturation, preventing respiratory distress syndrome in preterm infants. Antenatal inflammation can, however, cause structural changes in the fetal lung and affect the expression of growth factors, such as transforming growth factor-beta, connective tissue growth factor, fibroblast growth factor-10, or bone morphogenetic protein-4, which are essential for branching morphogenesis. These alterations cause alveolar and microvascular simplification resembling the histology of bronchopulmonary dysplasia. Antenatal inflammation may also affect neonatal outcome by modulating the responsiveness of the immune system. Lipopolysaccharide-tolerance (endotoxin hyporesponsiveness/immunoparalysis), induced by exposure to inflammation in utero, may prevent fetal lung damage, but increases susceptibility to postnatal infections. Moreover, prenatal exposure to inflammation appears to be a predisposition for the development of adverse neonatal outcomes, like bronchopulmonary dysplasia, if the preterm infant is exposed to a second postnatal hit, such as mechanical ventilation oxygen exposure, infections, or steroids.

  3. Antenatal treatment in two Dutch families with pyridoxine-dependent seizures.

    Science.gov (United States)

    Bok, Levinus A; Been, Jasper V; Struys, Eduard A; Jakobs, Cornelis; Rijper, Elisabeth A M; Willemsen, Michèl A

    2010-03-01

    Incidental reports suggest that antenatal treatment of pyridoxine dependent seizures (PDS) may improve neurodevelopmental outcome of affected patients. Two families with PDS are reported, both with two affected siblings. Antenatal treatment with pyridoxine was instituted during the second pregnancy in each family (50 and 60 mg daily from 3 and 10 weeks of gestation, respectively). Perinatal characteristics and neurodevelopmental outcome at 4 (Family A) and 12 (Family B) years of age were compared between the untreated and treated child within each family. Meconium-stained amniotic fluid was present in both first pregnancies and abnormal foetal movements were noticed in one. In the treated infants, pregnancy and birth were uncomplicated. In family A, postnatal pyridoxine supplementation prevented neonatal seizures. Both children in family A were hypotonic and started walking after 2 years of age; both had white matter changes on MRI, and the first child was treated for squint. IQ was 73 and 98 in the antenatally untreated and treated child, respectively. The second child in family B developed seizures on the seventh day, because pyridoxine maintenance therapy had not been instituted after birth. Seizures responded rapidly to pyridoxine supplementation. MRI showed large ventricles and a mega cisterna magna. IQ was 80 and 106 in the antenatally untreated and treated child respectively. Both children had normal motor development. These results suggest that antenatal pyridoxine supplementation may be effective in preventing intrauterine seizures, decreasing the risk of complicated birth and improving neurodevelopmental outcome in PDS.

  4. Pelaksanaan Antenatal Care Berhubungan dengan Anemia pada Kehamilan Trimester III di Puskesmas Sedayu I Yogyakarta

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    Fatimah Fatimah

    2015-11-01

    Full Text Available Anemia is one of the problems in Indonesia that important to examine, especially for pregnant women. This research used quantitative with explanatory design. Population were 44 pregnant women in 3 trimester selected by the total sampling technique. The independent variable were implementation of the antenatal care by midwives and dependent variable is anemia in 3 trimester of pregnancy at Puskesmas Sedayu I Yogyakarta. Data was collected using questionnaire. The analysis used was chi-square. The results of study showed that there was 33 (75% of antenatal care in good category, with no anemia were 32 (72.7% respondents, and there was a significant relationship between antenatal care and anemia in the third trimester of pregnancy with p-value=0.004. In conclusion, there was a significant relationship between antenatal care and anemia in the third trimester of pregnancy. Suggestions were needed to maintain and improve the care of midwives in antenatal care to improve the health of pregnant women, especially anemia in pregnancy.

  5. Teenage pregnancy antenatal and perinatal morbidity: results from a tertiary centre in Greece.

    Science.gov (United States)

    Pergialiotis, V; Vlachos, D-E G; Gkioka, E; Tsotra, K; Papantoniou, N; Vlachos, G D

    2015-01-01

    We present the experience of a tertiary referral hospital in Greece, evaluating obstetric and perinatal outcomes among teenage and average maternal age (AMA) women. We retrospectively assessed all singleton pregnancies during a twelve-month period (January-December 2012). A total of 1,704 cases were reviewed and divided into two groups: one of AMA mothers (20-34 years old) (1,460 women) and the other of teenage mothers (12-19 years old) (244 women). We observed significantly higher incidence rates of preterm births (p teenage mothers. Antenatal surveillance was decreased among teenage mothers (p Teenage pregnancy is accompanied by significant antenatal and perinatal complications that need specific obstetrical attention. Obstetricians should be aware of these complications in order to ameliorate the antenatal outcome of childbearing teenagers.

  6. HUBUNGAN PENGETAHUAN, SIKAP IBU HAMIL TERHADAP KUNJUNGAN PELAYANAN ANTENATAL DI KECAMATAN KALIMANAH KABUPATEN PURBALINGGA

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    Ichda Masrianto

    2012-09-01

    Full Text Available Low coverage of antenatal care are caused by efficiency knowledge of antenatal care (ANC, and correspounds with attitude of pregnant women to ward ANC. The research were examined correlation between knowledge and attitude of pregnant women to ward ANC and ANC visits. Subject were 76 women who have the first baby (born on Agust 1999, in Kalimanah Purbalingga district. The result indicated no significant correlation were found between pregnant women age and ANC visits, there is no significant correlation between women children number and ANC visits, but some significant correlation were found between education, knowledge, attitude and ANC visits, knowledge and attitude with ANC visits.  Key Words : Attitude to Health, Antenatal Care.

  7. Antenatal pelvic floor exercises: a survey of both patients' and health professionals' beliefs and practice.

    Science.gov (United States)

    Guerrero, K; Owen, L; Hirst, G; Emery, S

    2007-10-01

    The aim was to discover how often women perform pelvic floor exercises (PFE) in the antenatal period and how they wished to be taught. We compared this with the opinions of the health professionals looking after them. A total of 54 women attending the antenatal day assessment unit completed questionnaires. A total of 21 obstetricians, 29 midwives and 25 GPs returned similar questionnaires. Most women think they should be performing PFE daily but only 15% do so. Some 57% of the women wanted to be taught in the antenatal period. Over 50% of the women/midwives believed that PFE should be taught in an individual basis. Obstetricians/GPs favoured classes. A total of 76% of the women want midwives to teach them PFE and 57% of midwives agree. Most health professionals felt that they had not received adequate training on PFE. The midwife is felt to be the best placed person to teach PFE. Health professionals give PFE low priority.

  8. The influence of antenatal exposure to phthalates on subsequent female reproductive development in adolescence

    DEFF Research Database (Denmark)

    Hart, Roger; Doherty, Dorota A; Frederiksen, Hanne

    2014-01-01

    We hypothesised that antenatal exposure to ubiquitous phthalates may lead to an earlier menarche and a lower prevalence of polycystic ovarian syndrome (PCOS) and polycystic ovarian morphology (PCO) in adolescence. The Western Australian Pregnancy Cohort (Raine) Study recruited 3000 women at 18...... weeks of gestation in 1989-91, 1377 had antenatal serum stored without thawing at -80°C. An unselected subset was evaluated in the early follicular phase for PCO and PCOS by ultrasound and serum evaluation in adolescence. Serum was analysed for Anti-Mullerian Hormone (AMH), inhibin B, sex.......m) was protective against PCOS in adolescence (p=0.001, p=0.005, respectively). There were negative associations of MEP with PCO (p=0.022), and MEP with serum AMH (p=0.031). Consequently our data suggests that antenatal exposure to environmental phthalates may be associated with oestrogenic and/or anti...

  9. Experiences of expressing and storing colostrum antenatally: A qualitative study of mothers in regional Western Australia.

    Science.gov (United States)

    Brisbane, Joanna M; Giglia, Roslyn C

    2015-06-01

    This qualitative study explored the experiences and breastfeeding outcomes of a group of mothers who expressed colostrum in the antenatal period. In-depth interviews were conducted over the telephone with 12 women who had attended a unique antenatal lactation clinic appointment at 37 weeks' gestation. Seven main response themes were identified. Most women reflected positively upon their attendance and reported that the experience of expressing colostrum allowed them to become familiar with their breasts and gave them a sense of security by having a supply of colostrum stored for possible use after birth. The main negative emotions reported were a sense of embarrassment at expressing the colostrum, particularly in front of another person, the difficulties with expressing colostrum and in one instance, the physical pain associated with the process. Antenatal expression of colostrum may improve maternal breastfeeding confidence. Further research using long-term records will determine whether this practice improves breastfeeding outcomes.

  10. Do antenatal education classes decrease use of epidural analgesia during labour? – a Danish RCT

    DEFF Research Database (Denmark)

    Brixval, Carina Sjöberg; Thygesen, Lau Caspar; Axelsen, Solveig Forberg;

    , and reduce fear during birth which in turn may decrease use of pain relief. Few randomised trials have examined the effect of attending antenatal education in small groups on use of epidural analgesia and among these conclusions are conflicting. The objective of this study was therefore to examine the effect......Background: Epidural analgesia is widely used as pain relief during labour but has negative side effects, such as prolonged labour and increased risk of obstetric interventions. Antenatal education in small groups may increase trust in own ability to cope at home in the early stages of labour...... on whether to implement the NEWBORN program in a clinical setting also depend upon the trial effect on psycho-social outcomes which will be analysed in near future. Main messages (max 200 anslag): 1. No effect of antenatal education in small groups on use of epidural analgesia as pain relief during labour...

  11. Strategies for coping with labour: does antenatal education translate into practice?

    Science.gov (United States)

    Spiby, H; Henderson, B; Slade, P; Escott, D; Fraser, R B

    1999-02-01

    There is little evidence to associate attendance at antenatal classes with a reduction in psychological distress or increased satisfaction with the experience of labour. There may be several reasons for this, including failure to implement coping strategies. A within-subjects research design explored the use in labour of coping strategies taught in antenatal classes and the role of practice. Women's views about using these strategies and their expectations of their midwives and birth companions were also identified. Following Ethics Committee approval and providing informed consent, 121 nulliparous women completed a questionnaire at their final antenatal class. This included questions on confidence and the amount of effort required to use coping strategies, the involvement hoped for from birth companions and midwives in using coping strategies in labour and satisfaction with the amount of practice of coping strategies. Within 72 hours of delivery, women were interviewed to obtain a narrative of the events of labour and their use of the coping strategies (sighing-out-slowly breathing, Laura Mitchell relaxation and postural change). A questionnaire obtained information on the involvement of the midwife and birth companion. Women used the three coping strategies to different extents. Midwives were not involved to the extent that women had hoped for antenatally. Birth companions achieved a level of involvement closer to women's hopes than that achieved by midwives. A significant proportion of women expressed dissatisfaction with the amount of practice of coping strategies during antenatal classes. The findings of this study of a group of well-prepared women raise questions about the correct components of antenatal classes and how midwives and birth companions can be involved optimally in this aspect of a woman's labour. Further research is required to determine how women can best be helped to cope with the experience of labour.

  12. Discourse Acts in Antenatal Clinic Literacy Classroom in South-Western Nigeria

    Directory of Open Access Journals (Sweden)

    Taiwo, Rotimi

    2007-01-01

    Full Text Available This study examines the organization of discourse in antenatal classrooms in south-western Nigeria. Antenatal literacy classrooms are classes organized in hospitals and health centres for pregnant women to intimate them with the necessary health information needed in pregnancy. The data for this study were randomly selected from series of data recorded during some antenatal classes in some selected hospitals in Ile-Ife and its environs, all in south-western Nigeria. The data consist of tape recordings of the classroom sessions and observational notes. The study reveals that three categories of discourse act were most prominent in the data - informative, elicitation and directive. This shows that the antenatal educators were more active in the classes than the students. They maximized the use of their power in discourse, which gives them the [+ HIGHER] role. They therefore had the privilege to talk while the mothers listened. This places the pregnant women at the disadvantage of being passive learners, who cannot see the knowledge being passed across beyond the context of the class. Despite that they have access to information, they are not adequately empowered to influence the society with what they are being exposed to. Their perception of their role in the discourse was that of listeners. The findings have significant implications for health literacy programmes in Nigeria. It clearly shows that health literacy programmes, as we have observed in antenatal classrooms exist only as an aspect of functional health literacy - the aspect that recognizes that pregnant women need to know about their health by listening to experts. This makes the practice, as it is essentially transactional. The study concludes that for antenatal classrooms to achieve their goal of health security of pregnant women and their foetus, they have to be more interactive. There must be a departure from the lecture method used now to a method that actually involves the mothers.

  13. Antenatal Clinic and Stop Smoking Services Staff Views on "Opt-Out" Referrals for Smoking Cessation in Pregnancy: A Framework Analysis.

    Science.gov (United States)

    Campbell, Katarzyna Anna; Bowker, Katharine Anna; Naughton, Felix; Sloan, Melanie; Cooper, Sue; Coleman, Tim

    2016-10-12

    Introduction: UK guidance recommends routine exhaled carbon monoxide (CO) screening for pregnant women and "opt-out" referrals to stop smoking services (SSS) of those with CO ≥ 4 ppm. We explored staff views on this referral pathway when implemented in one UK hospital Trust. Methods: Seventeen semi-structured interviews with staff involved in the implementation of the new referral pathway: six antenatal clinic staff (before and after implementation); five SSS staff (after). Data were analyzed using framework analysis. Results: Two themes were identified: (1) views on implementation of the pathway and (2) impact of the pathway on the women. Generally, staff felt that following training, referrals were less arduous to implement and better received than expected. The majority believed this pathway helped engage women motivated to quit and offered a unique chance to impart smoking cessation knowledge to hard-to-reach women, who might not otherwise contact SSS. An unexpected issue arose during implementation-dealing with non-smokers with high CO readings. Conclusions: According to staff, the "opt-out" referral pathway is an acceptable addition to routine antenatal care. It can help engage hard-to-reach women and educate them about the dangers of smoking in pregnancy. Incorporating advice on dealing with non-smokers with high CO into routine staff training could help future implementations.

  14. Antenatal Clinic and Stop Smoking Services Staff Views on “Opt-Out” Referrals for Smoking Cessation in Pregnancy: A Framework Analysis

    Directory of Open Access Journals (Sweden)

    Katarzyna Anna Campbell

    2016-10-01

    Full Text Available Introduction: UK guidance recommends routine exhaled carbon monoxide (CO screening for pregnant women and “opt-out” referrals to stop smoking services (SSS of those with CO ≥ 4 ppm. We explored staff views on this referral pathway when implemented in one UK hospital Trust. Methods: Seventeen semi-structured interviews with staff involved in the implementation of the new referral pathway: six antenatal clinic staff (before and after implementation; five SSS staff (after. Data were analyzed using framework analysis. Results: Two themes were identified: (1 views on implementation of the pathway and (2 impact of the pathway on the women. Generally, staff felt that following training, referrals were less arduous to implement and better received than expected. The majority believed this pathway helped engage women motivated to quit and offered a unique chance to impart smoking cessation knowledge to hard-to-reach women, who might not otherwise contact SSS. An unexpected issue arose during implementation—dealing with non-smokers with high CO readings. Conclusions: According to staff, the “opt-out” referral pathway is an acceptable addition to routine antenatal care. It can help engage hard-to-reach women and educate them about the dangers of smoking in pregnancy. Incorporating advice on dealing with non-smokers with high CO into routine staff training could help future implementations.

  15. Prevalence of anemia in women with asymptomatic malaria parasitemia at first antenatal care visit at the University of Calabar Teaching Hospital, Calabar, Nigeria

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    TU Agan

    2010-07-01

    severity of parasitemia (χ2 = 36.52, P < 0.001.Conclusion: Anemia at first antenatal booking was significantly associated with malaria parasitemia. Routine screening for anemia and malaria parasites at booking, prompt parasite clearance, use of intermittent preventive treatment (IPT during pregnancy and correction of anemia can reduce the prevalence of malaria related anemia and obstetric complications associated with it.Keywords: anemia, malaria, pregnancy, first antenatal booking

  16. Utilization Patterns of Antenatal Services Among Pregnant Women: A Longitudinal Study in Rural Area of North Karnataka.

    Directory of Open Access Journals (Sweden)

    C.S.Metgud

    2009-05-01

    Full Text Available Objectives: 1.To study the profile of antenatal care received 2. To know the factors influencing the utilization Study Design: Longitudinal study.Setting: Shindolli village of Belgaum District Participants: All women (n =130 in this village who were pregnant at the start of the study and who became pregnant during the study. Statistical Analysis: Proportions and Chi-square Test Results: Most of the pregnant women (92.31% were registered for antenatal care, but only 30.00% of them were registered in the 1st trimester of pregnancy. As regards to TT immunization, 70.77% of the pregnant women had received 2 doses or 1 booster dose. Iron and Folic Acid supplementation was taken by 59.68% of the pregnant women. Nearly 39.52 % of pregnant women were provided with full antenatal care. The main antenatal care provider for pregnant women was doctor (64.52%. The provision of full antenatal care package was found to be significantly higher among the pregnant women belonging to social classes I and II and in those who have studied above SSLC. Conclusion: The study shows early and wide spread use of antenatal care, but it also reveals that the antenatal visits occur late in the pregnancy. The literacy of women has significant bearing on utilization of antenatal care by the pregnant women.

  17. The Process of Adapting an Australian Antenatal Group-Based Parenting Program to Japanese and Vietnamese Public Service Settings

    Science.gov (United States)

    Goto, Aya; Suzuki, Yuriko; Tsutomi, Hiroshi; Nguyen, Vinh Quang; Nguyen, Tu Van Thi; Yamazaki, Sachiko; Okazaki, Keiko; Nguyen, Tuyet Hong Thi; Hoang, Hoa Quoc; Yasumura, Seiji

    2012-01-01

    Antenatal maternal mental health status not only predicts postpartum mental status, but also influences family health. In Asia, however, little scientific research has been conducted on antenatal parenting intervention to date, nor has there been much emphasis on fathers in considerations of parenting support. Building upon our past research…

  18. Rural Indonesia women’s traditional beliefs about antenatal care

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    Agus Yenita

    2012-10-01

    Full Text Available Abstract Background The Indonesia Maternal Mortality Rate (MMR of 420/100.00 live births remains among the highest in East Asia while coverage of births assisted by skilled providers is still low. Traditional beliefs have been a key factor associated with the choice between midwives or traditional birth attendants (TBA and the low number of antenatal care visits in rural West Sumatra. Methods We conducted three focus groups with 16 women from rural West Java to describe their perception regarding issues related to traditional beliefs. Focus group discussions provided data for the content analysis. Results The majority of the 16 women interviewed was from Village Dago, West Java and had only an elementary school education. Their ages ranged from 19 to 40 years. Most were multiparous housewives with an income of IDR 918.750 per month, which was lower than the monthly income in West Java (IDR. 1.172.060. Emerging from the focus group discussion were four main themes regarding their pregnancy and traditional beliefs: 1 pregnancy was a normal cycle in women’s life (pregnancy is a natural phenomena, not a sickness; no recognition of danger signs during pregnancy and death of baby or mother during pregnancy was brought about by God’s will; 2 women followed the traditional beliefs (positive motivation to follow the traditional beliefs and fear of not following the traditional beliefs; 3 relying on TBA called paraji rather than midwife (parajis are kind, tolerant and patient and have more experience than midwives; more accessibility than midwives and encouragement of natural birth and 4 midwives are more secure than paraji; (they use a medical standard of care. Conclusions Women’s beliefs grounded in religion and tradition permeated the village culture making it difficult to counter their long held health practices with practices based on recent advances in health care. Use of TBA in this village was still dominant and women believed that following

  19. [Antenatal emergency call. Indications. Role of the SAMU (Medical Emergency Care Services)].

    Science.gov (United States)

    Lallemand, E; Drouet, N; Faudemay, C; Lacroute, J M; Menthonnex, P

    1989-01-01

    The increased incidence of antenatal distress calls to the SAMU (emergency medical squad) by pediatric obstetricians in maternity departments (6 times in 5 years) poses the problem of recognizing their indications. Based on case reports of 128 newborns who profited from antenatal assistance, the authors attempt to define the indications. The elimination of student physicians in training for anesthesiology-intensive care, additional participants during SAMU transportation of patients, makes it even more necessary to define these indications accurately so that a single language of communication and procedure may be instituted for all who are involved in this effort.

  20. Changing prevalence and the risk factors for antenatal obstetric hospitalizations in Denmark 2003-2012

    DEFF Research Database (Denmark)

    Bendix, Jane; Hegaard, Hanne Kristine; Langhoff-Roos, Jens;

    2016-01-01

    PURPOSE: Population-based studies evaluating the use and extent of antenatal obstetric hospitalizations (AOH) are sparse. The objective of the present study was to describe the prevalence, time trend, and risk factors for AOH in Denmark. MATERIALS AND METHODS: A retrospective national register......-based cohort study was conducted that included all pregnancies with delivery after 22 gestational weeks in Denmark from 2003 to 2012. The outcomes were AOH and the diagnoses leading to these hospitalizations. AOH was defined as an antenatal hospitalization for at least 1 day with at least one obstetric...

  1. Wealth and antenatal care use: Implications for maternal health care utilisation in Ghana

    OpenAIRE

    Arthur, Eric

    2012-01-01

    The study investigates the effect of wealth on maternal health care utilization in Ghana via its effect on Antenatal care use. Antenatal care serves as the initial point of contact of expectant mothers to maternal health care providers before delivery. The study is pivoted on the introduction of the free maternal health care policy in April 2005 in Ghana with the aim of reducing the financial barrier to the use of maternal health care services, to help reduce the high rate of maternal deaths....

  2. NASA Engineering Network Lessons Learned

    Data.gov (United States)

    National Aeronautics and Space Administration — The NASA Lessons Learned system provides access to official, reviewed lessons learned from NASA programs and projects. These lessons have been made available to the...

  3. 产前诊断21三体综合征的临床分析%Clinical analysis on trisomy 21 syndrome by amniocentesis antenatal diagnosis

    Institute of Scientific and Technical Information of China (English)

    徐聚春; 胡斌; 董艳玲; 胡华梅; 龙洋; 许欢欢; 胡华; 姚宏

    2012-01-01

    Objective: To understand the effect of menstrual age, screening of Down syndrome, family history of genetics diseases and B - mode ultrasonography Abnorm on the cases of trisomy 21 syndrome confirmed. Methods: We had collected 3960 cases of antenatal diagnosis by amniocentesis from 2005 to 2011 in our hospital and 43 cases of them had been confirmed as trisomy 21 syndrome. Then all the cases of trisomy 21 syndrome were aggregately investigated though menstrual age, screening of Down syndrome, family history of genetics diseases and B - mode ultrasonography Abnorm. Results: Eighteen pregnant women of 43 cases were more than 34 years, which was 41. 9%. Fifteen cases, 34. 9% , were positive in screening of Down syndrome. Six cases, 13. 9% , had family history of genetics diseases. Four cases, 9. 3% , were found with abnormal signals by type - B - mode ultrasonography Abnorm. Conclusion : It could reduce the birth rate of trisomy 21 syndrome that the pregnant women with clinical indications followed antenatal diagnosis. Amniocentesis should be introduced to more pregnant women and families to improve the social consciousness on antenatal diagnosis.%目的 通过对产前诊断中21三体综合征进行临床分析,了解孕龄、唐氏征筛查、家族遗传史及B超异常对21三体综合征发生的影响.方法 收集我院2005年至今羊水穿刺产前诊断标本共3960例,其中21三体综合征43例,通过对43例孕妇从发病年龄、家族遗传史、唐氏征筛查及B超异常来综合分析21三体综合征的发生情况.结果 43例21三体综合征中:年龄≥34岁18例,占41.9%;唐筛阳性15例,占34.9%;遗传病史6例,占13.9%;B超异常4例,占9.3%.结论 加强对有产前诊断指征孕妇进行必要的产前诊断,可减少21三体综合征患儿的出生;加强宣传,提高孕妇、家庭及社会的对羊水产前诊断的认识.

  4. Male partner attendance of skilled antenatal care in peri-urban Gulu district, Northern Uganda

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    Tweheyo Raymond

    2010-09-01

    Full Text Available Abstract Background Male partner attendance of skilled Antenatal Care (ANC is beneficial to improving maternal outcomes. This study investigated the level, perceived benefits and factors associated with male partner attendance of skilled ANC in a peri-urban community recovering from two decades of civil conflict. Methods This cross-sectional survey used multi-stage sampling in 12 villages of Omoro county to select 331 married male respondents aged 18 years or more, whose female spouses had childbirth within 24 months prior to the survey. A structured questionnaire elicited responses about male partner attendance of ANC during pregnancy at a public health facility as the main outcome variable. Analysis used Generalized Linear Model (GLM in Stata version 10.0 to obtain Prevalence Risk Ratios (PRR for association between the binary outcome and independent factors. All factors significant at p Results Overall, 65.4% (95%CI; 60.3, 70.5 male partners attended at least one skilled ANC visit. Mean age was 31.9 years [SD 8.2]. Perceived benefits of attending ANC were: HIV screening (74.5%, monitoring foetal growth (34% and identifying complications during pregnancy (18.9%. Factors independently associated with higher ANC attendance were: knowledge of 3 or more ANC services (adj.PRR 2.77; 95%CI 2.24, 3.42, obtaining health information from facility health workers (adj.PRR 1.14; 95%CI 1.01, 1.29 and if spouse had skilled attendance at last childbirth (adj.PRR 1.31; 95%CI 1.04-1.64. However, factors for low attendance were: male partners intending their spouse to carry another pregnancy (adj.PRR 0.83; 95%CI 0.71, 0.97 and living more than 5 Km from a health facility (adj.PRR 0.83, 95%CI 0.70, 0.98. Conclusions Men who were knowledgeable of ANC services, obtained health information from a health worker and whose spouses utilised skilled delivery at last pregnancy were more likely to accompany their spouses at ANC, unlike those who wanted to have more

  5. Assessing the Extent of Adherence to the Recommended Antenatal Care Content in Malaysia: Room for Improvement.

    Directory of Open Access Journals (Sweden)

    Ping Ling Yeoh

    Full Text Available Recent papers on monitoring of health services affirmed that while antenatal care (ANC is an effective measure, quality is still a problem. Quality in maternal services "…involves providing a minimum level of care to all pregnant women…" Yet adherence to a minimum level of recommended ANC content appears to be unmet. Comprehensive review of ANC content rendered in environments with rapid changes in demographic, socio-economic, lifestyle and morbidity was sparse. Malaysia is such a country that has undergone these transitions with tremendous progress in health. However, recent progress in pregnancy outcomes is stagnating. This study aims to analyse adherence to recommended ANC; specifically, to examine the extent of adherence to recommended ANC content and to determine the factors influencing ANC content score.A retrospective cohort study of 522 randomly selected women who used ANC was conducted. Data were extracted from individual records. The study examined adherence to essential ANC guidelines using weighted scoring for physical examination, health screening, case management, and health education. GLM Univariate analysis procedure was used to determine the factors associated with ANC content score. Binary logistic regression was used to assess ANC content level and pregnancy outcomes, controlled for ANC utilisation.Around half of the women had <80% of recommended ANC content documented. Health education had the lowest mean score, at around 35%. The low-risk pregnancies had a higher ANC content score than the high-risk pregnancies (78% vs. 75%; P = 0.002. The smallest clinics had a higher ANC content score than the bigger clinics (78% vs. 74-76%; P<0.001. ANC content score among the women with "adequate" ANC utilisation, as defined by the modified Adequacy of Prenatal Care Utilisation Index, was lower than the women with "adequate-plus" ANC utilisation (75% vs. 78%, P<0.001. Assessment of symphysis-fundal height, foetal presentation and

  6. A survey of midwives' views on providing aspects of antenatal care in Estonia

    DEFF Research Database (Denmark)

    Lazarus, Jeffrey V; Rull, Kristiina; Wyn Huws, Dyfed

    2007-01-01

    OBJECTIVE: to survey the views of midwives in Estonia about who they considered should have responsibility for carrying out certain aspects of antenatal care (ANC) in Estonia. DESIGN, SETTING AND STUDY POPULATION: in collaboration with key stakeholder organisations, the authors developed eight...

  7. Effects of Antenatal Glucocorticoid Therapy on Hippocampal Histology of Preterm Infants

    NARCIS (Netherlands)

    Tijsseling, Deodata; Wijnberger, Lia D. E.; Derks, Jan B.; van Velthoven, Cindy T. J.; de Vries, Willem B.; van Bel, Frank; Nikkels, Peter G. J.; Visser, Gerard H. A.

    2012-01-01

    Objective: To investigate if antenatal glucocorticoid treatment has an effect on hippocampal histology of the human preterm newborn. Patients and Methods: Included were consecutive neonates with a gestational age between 24 and 32 weeks, who were born between 1991 to 2009, who had died within 4 days

  8. Socio-economic and Demographic Determinants of Antenatal Care Services Utilization in Central Nepal

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    Srijana Pandey, PhD

    2014-09-01

    Full Text Available Background/Objective: The importance of maternal health services in lessening maternal mortality and morbidity as well as neonatal deaths has received substantial recognition in the past decade. The lack of antenatal care has been identified as a risk factor for maternal mortality and other adverse pregnancy outcomes. The purpose of this study was to determine the factors affecting attendance of antenatal care services in Nepal. Methods: This is a cross-sectional descriptive study carried out in Central Nepal. Using semi-structured questionnaire, interviews were conducted with married women aged between 15-49 years, who had delivered their babies within one year. Systematic random sampling method was used to select the sample. Results were obtained by frequency distribution and cross-tabulation of the variables. Results: More than half of the women were not aware of the consequences of lack of antenatal care. Age, education, income, type of family were strongly associated with the attendance at antenatal care service. Conclusions and Public Health Implications: In Nepal and in other developing countries, maternal mortality and morbidity continue to pose challenges to the health care delivery system. Variety of factors including socio-demographic, socio-economic, cultural and service availability as well as accessibility influences the use of maternal health services.

  9. Hypnosis Antenatal Training for Childbirth (HATCh: a randomised controlled trial [NCT00282204

    Directory of Open Access Journals (Sweden)

    Baghurst Peter

    2006-03-01

    Full Text Available Abstract Background Although medical interventions play an important role in preserving lives and maternal comfort they have become increasingly routine in normal childbirth. This may increase the risk of associated complications and a less satisfactory birth experience. Antenatal hypnosis is associated with a reduced need for pharmacological interventions during childbirth. This trial seeks to determine the efficacy or otherwise of antenatal group hypnosis preparation for childbirth in late pregnancy. Methods/design A single centre, randomised controlled trial using a 3 arm parallel group design in the largest tertiary maternity unit in South Australia. Group 1 participants receive antenatal hypnosis training in preparation for childbirth administered by a qualified hypnotherapist with the use of an audio compact disc on hypnosis for re-enforcement; Group 2 consists of antenatal hypnosis training in preparation for childbirth using an audio compact disc on hypnosis administered by a nurse with no training in hypnotherapy; Group 3 participants continue with their usual preparation for childbirth with no additional intervention. Women > 34 and Discussion If effective, hypnosis would be a simple, inexpensive way to improve the childbirth experience, reduce complications associated with pharmacological interventions, yield cost savings in maternity care, and this trial will provide evidence to guide clinical practice.

  10. Stigma and Attitudes towards Antenatal Depression and Antidepressant Use during Pregnancy in Healthcare Students

    Science.gov (United States)

    Gawley, Laura; Einarson, Adrienne; Bowen, Angela

    2011-01-01

    Depression in pregnancy or antenatal depression (AD) occurs in approximately one in five women, with potentially deleterious effects to the mother and fetus. People are encouraged to get treatment for depression; however, pregnant women can experience stigma when they reach out for help with depression. Research indicates that healthcare…

  11. Sociodemographic factors associated with anaemia in pregnancy at booking for antenatal care.

    Science.gov (United States)

    Adanikin, A I; Awoleke, J O

    2016-01-01

    Late patronage of antenatal care by women in low-resource areas makes timely intervention at correcting anaemia difficult. This study aimed to identify modifiable sociodemographic factors that predict anaemia before commencing antenatal care and make appropriate recommendation. A survey of sociodemographic features and haemoglobin concentrations of 232 women booking for antenatal care was conducted. Anaemia was diagnosed in 119 (51.3%), of which 87 (37.5%) had mild anaemia and 32 (13.8%) were moderately anaemic. There was no severe anaemia. Anaemia was highest among respondents who were 35 years of age, Muslims, of Igbo ethnicity (64.3%), single (55.0%), student/unemployed (58.8%), nulliparous (57.3%) and those who registered at 21 weeks' gestation (54.2%). Only occupation of the woman showed association with anaemia before antenatal care (p 0.007). A personal source of income may reduce anaemia in pregnancy; and it is advisable to have a social welfare package for unemployed pregnant women.

  12. Antenatal corticosteroid therapy : short-term effects on fetal behaviour and haemodynamics

    NARCIS (Netherlands)

    Mulder, E. J. H.; de Heus, R.; Visser, G. H. A.

    2009-01-01

    Antenatal corticosteroid therapy to enhance fetal lung maturity in threatened preterm delivery has a number of non-pulmonary side-effects, both beneficial and undesirable. This review focuses on the short-term (transient) effects of betamethasone and dexamethasone on aspects of fetal circulation and

  13. Seroprevalence of HIV in women attending antenatal clinic at KIMS hospital, Narketpally

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    Venna Guru Prasad

    2012-12-01

    Full Text Available Background: To assess seroprevalence of HIV among antenatal women and the extent of utilization of therapeutic interventions to minimize the risk of mother to child transmission. Methods: Pregnant women attending antenatal clinic of a medical college in a rural area of Nalgonda district of Andhra Pradesh, India from August 2006 to July 2009 were tested for HIV by Rapid Test which included pre and post test counseling. Antiretroviral prophylaxis with nevirapine was given to seropositive mother-baby pairs during delivery. Results: Of the 5809 new antenatal booking visits 4848 attended pretest counseling and 4698 accepted HIV testing. Fifty three women were found to be seropositive. Sero-prevalence rate of HIV infection was 1.12%. Ten had opted for pregnancy termination. Out of forty three deliveries four were intrauterine deaths. All the newborns received nevirapine prophylaxis. Conclusions: The seroprevalence of HIV infection among antenatal women is 1.12% which was high as the institute is located in Andhra Pradesh which is a known high prevalence state. Thirty one babies tested after 18 months of age were negative. Nine babies died before they reached 18 months of age. [Int J Reprod Contracept Obstet Gynecol 2012; 1(1.000: 17-21

  14. Risk factors for RhD immunisation despite antenatal and postnatal anti-D prophylaxis

    NARCIS (Netherlands)

    J.M. Koelewijn; M. de Haas; T.G.M. Vrijkotte; C.E. van der Schoot; G.J. Bonsel

    2009-01-01

    Objective To identify risk factors for Rhesus D (RhD) immunisation in pregnancy, despite adequate antenatal and postnatal anti-D prophylaxis in the previous pregnancy. To generate evidence for improved primary prevention by extra administration of anti-D Ig in the presence of a risk factor. Design C

  15. An instrument for broadened risk assessment in antenatal health care including non-medical issues.

    NARCIS (Netherlands)

    A.A. Vos (Amber); M.J. van Veen (Mieke); E. Birnie (Erwin); S. Denktaş (Semiha); E.A.P. Steegers (Eric); G.J. Bonsel (Gouke)

    2015-01-01

    markdownabstractGrowing evidence on the risk contributing role of non-medical factors on pregnancy outcomes urged for a new approach in early antenatal risk selection. The evidence invites to more integration, in particular between the clinical working area and the public health domain. We developed

  16. Feasibility and reliability of a newly developed antenatal risk score card in routine care

    NARCIS (Netherlands)

    Veen, M.J.; Birnie, E.; Poeran, J.; Torij, H.W.; Steegers, E.A.P.; Bonsel, G.J.

    2015-01-01

    OBJECTIVE: to study in routine care the feasibility and inter-rater reliability of the Rotterdam Reproductive Risk Reduction risk score card (R4U), a new semi-quantitative score card for use during the antenatal booking visit. The R4U covers clinical and non-clinical psychosocial factors and ident

  17. Assessing the extent of adherence to the recommended antenatal care content in Malaysia: Room for improvement

    NARCIS (Netherlands)

    Yeoh, P.L.; Hornetz, K.; Shauki, N.I.A.; Dahlui, M.; Wouwe, J.P. van

    2015-01-01

    Background Recent papers on monitoring of health services affirmed that while antenatal care (ANC) is an effective measure, quality is still a problem. Quality in maternal services "⋯involves providing a minimum level of care to all pregnant women⋯" Yet adherence to a minimum level of recommended AN

  18. Associations of life events during pregnancy with longitudinal change in symptoms of antenatal anxiety and depression

    NARCIS (Netherlands)

    Meijer, Judith L; Bockting, Claudi L H; Stolk, Ronald P; Kotov, Roman; Ormel, Johan; Burger, Huibert

    2014-01-01

    OBJECTIVE: to investigate the association of life events during pregnancy with change in antenatal anxiety and depression symptoms. We distinguished pregnancy related and non-pregnancy related events and assessed specificity of these associations for depressive or anxious symptoms. In addition, we i

  19. The effects of antenatal depression and antidepressant treatment on placental gene expression

    NARCIS (Netherlands)

    Olivier, Jocelien D A; Åkerud, Helena; Skalkidou, Alkistis; Kaihola, Helena; Sundström-Poromaa, Inger

    2015-01-01

    The effects of antenatal depression and antidepressant treatment during pregnancy on both mother and child are vigorously studied, but the underlying biology for these effects is largely unknown. The placenta plays a crucial role in the growth and development of the fetus. We performed a gene expres

  20. Preventing female virilisation in congenital adrenal hyperplasia: The controversial role of antenatal dexamethasone.

    Science.gov (United States)

    Heland, Sarah; Hewitt, Jacqueline K; McGillivray, George; Walker, Susan P

    2016-06-01

    Congenital adrenal hyperplasia (CAH) refers to a group of recessively inherited disorders of cortisol production, which in the classical form results in virilisation of female fetuses. Since the 1980s, antenatal treatment with dexamethasone has been recommended in high-risk pregnancies to minimise the risk of virilising the female genitalia of affected fetuses. To be effective, this treatment requires implementation in early pregnancy, prior to the commencement of autonomous fetal adrenal androgen synthesis. Using this approach, seven of eight high-risk pregnancies are treated unnecessarily, prior to establishing the fetal gender or the confirmed diagnosis of a genetically affected pregnancy. In the face of ongoing concerns regarding potential adverse maternal-fetal effects of antenatal dexamethasone exposure, a review of this practice has been advocated by expert advisory groups. In this review, we summarise current controversies, potential improvements and future directions in the management of pregnancies at risk of CAH. In high-risk families, recent genomic advances include early prenatal diagnosis utilising noninvasive genetic techniques to minimise unnecessary dexamethasone exposure to unaffected fetuses. In affected pregnancies when families elect for antenatal treatment, optimal antenatal dosing regimens need to be defined and a standardised treatment and follow-up protocol are recommended. Establishment of a national registry with standardised follow-up will allow future families to be better informed of the risks and benefits of both treated and untreated fetal CAH.

  1. Prevalence of sexually transmitted infections among women attending antenatal clinics in Tanga, north eastern Tanzania

    DEFF Research Database (Denmark)

    Chiduo, M; Theilgaard, Z P; Bakari, V

    2012-01-01

    This study aimed to determine the prevalence of sexually transmitted infections (STIs) among HIV-infected and uninfected pregnant women in Tanga, Tanzania. Retrospective data on syphilis and HIV status during 2008-2010 were collected from antenatal clinic (ANC) records. Prospective data were...

  2. Antenatal diagnosis of mirror-image dextrocardia in association with situs inversus and Turner's mosaicism.

    Science.gov (United States)

    Ortiga, D J; Chiba, Y; Kanai, H; Hosono, T

    2001-10-01

    We describe the antenatal diagnosis of a fetus with mirror-image dextrocardia, complete situs inversus and Turner's mosaicism (45,XO/46,XY) that was artificially terminated at 19 weeks. Autopsy confirmed our initial findings. This case represents an unusual combination of anomalies rarely encountered in clinical practice.

  3. Maternal and feto-placental prostanoid responses to a single course of antenatal betamethasone.

    Science.gov (United States)

    Cho, Steve; Beharry, Kay D A; Valencia, Arwin M; Guajardo, Leonel; Nageotte, Michael P; Modanlou, Houchang D

    2005-12-01

    We tested the hypothesis that antenatal betamethasone alters prostanoid levels in the maternal and feto-placental compartments. Forty-three singleton pregnancies were studied. Group I were women treated with a single course of antenatal betamethasone and who delivered 38 weeks. Maternal and mixed cord blood; and placental samples were collected at delivery and analyzed for PGE2, PGF(2alpha), 6-ketoPGF(1alpha), and TxB2 levels. Antenatal betamethasone decreased maternal PGE2 levels with concomitant increases in the feto-placental compartment. Umbilical cord TxB2 levels in the treated group were significantly lower than the non-treated pre-term and term groups resulting in a higher 6-ketoPGF(1alpha):TxB2 ratio. Considering the regulatory role of PGE2 and PGI2 in fetal lung development and neonatal transition homeostasis, these results suggest a mechanism, at least in part, for the beneficial effects of antenatal steroids on fetal lung maturation and neonatal cardio-pulmonary homeostasis at birth.

  4. Factors associated with antenatal depression in pregnant Korean females: the effect of bipolarity on depressive symptoms

    OpenAIRE

    Park, Chul Min; Seo, Hye-Jin; Jung, Young-Eun; Kim, Moon-Doo; Hong,Seong-Chul; Bahk, Won-Myong; Yoon, Bo-Hyun; Hur, Min Hee; Song, Jae Min

    2014-01-01

    Background This cross-sectional study sought to identify factors associated with antenatal depression in pregnant Korean females, including sociodemographic parameters, social support, social conflict, and bipolarity. Methods Eighty-four pregnant women were recruited to complete questionnaires on sociodemographic factors, obstetric history, depressive symptoms, and bipolarity. Depressive symptoms were assessed using the Korean version of the Edinburgh Postnatal Depression Scale. Bipolarity wa...

  5. Mini Lessons from FDA.

    Science.gov (United States)

    Food and Drug Administration (DHEW), Washington, DC.

    Eight self-contained lessons present information about topics of current interest in the Food and Drug Administration. Multidisciplinary in nature, the lessons can be integrated into ongoing activities in elementary or secondary level reading, math, language arts, social studies, science, art, health, consumer education, and home economics. The…

  6. Ben Franklin. [Lesson Plan].

    Science.gov (United States)

    Discovery Communications, Inc., Bethesda, MD.

    Based on Benjamin Franklin's "Poor Richard's Almanac," this lesson plan presents activities designed to help students understand that Ben Franklin is known, among other things, for his wit and wisdom; that Franklin published an almanac for 25 years; and he scattered aphorisms throughout the almanac. The main activity in the lesson is for students…

  7. "Frankenstein." [Lesson Plan].

    Science.gov (United States)

    Simon, Melanie

    Based on Mary Shelley's novel "Frankenstein," this lesson plan presents activities designed to help students understand that active readers interpret a novel (its characters, plot, setting, and theme) in different ways; and the great literature can be and has been adapted in many ways over time. The main activity of the lesson involves students…

  8. Soybean Production Lesson Plan.

    Science.gov (United States)

    Carlson, Keith R.

    These lesson plans for teaching soybean production in a secondary or postsecondary vocational agriculture class are organized in nine units and cover the following topics: raising soybeans, optimum tillage, fertilizer and lime, seed selection, pest management, planting, troubleshooting, double cropping, and harvesting. Each lesson plan contains…

  9. Great Expectations. [Lesson Plan].

    Science.gov (United States)

    Devine, Kelley

    Based on Charles Dickens' novel "Great Expectations," this lesson plan presents activities designed to help students understand the differences between totalitarianism and democracy; and a that a writer of a story considers theme, plot, characters, setting, and point of view. The main activity of the lesson involves students working in groups to…

  10. Gulliver's Travels. [Lesson Plan].

    Science.gov (United States)

    Rooks, Kirsten; McLean, Mary

    Based on Jonathan Swift's novel "Gulliver's Travels," this lesson plan presents activities designed to help students understand that Swift comments on undesirable outcomes of advances in science; and other authors have also warned against abuse of science. The main activity of the lesson involves students developing a poster illustrating views of…

  11. "Walden". [Lesson Plan].

    Science.gov (United States)

    Surber, Gretchen C.

    Based on Henry David Thoreau's book "Walden," this lesson plan presents activities designed to help students understand that acquisitiveness and simplicity can be opposing life philosophies; and that both philosophies have had notable adherents. The main activity of the lesson involves students researching historical characters (including Thoreau)…

  12. Fish Facts. Lesson Plan.

    Science.gov (United States)

    Chan, Mike

    This lesson plan is designed for a 50-minute class to teach extension home economists and homemakers about buying, storing, and using fish. The lesson plan contains references, a list of equipment needed, objectives, and the presentation. The presentation consists of an outline of instruction coordinated with methods of instruction and aids and…

  13. Antenatal and postnatal corticosteroid and resuscitation induced lung injury in preterm sheep

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    Kallapur Suhas G

    2009-12-01

    Full Text Available Abstract Background Initiation of ventilation using high tidal volumes in preterm lambs causes lung injury and inflammation. Antenatal corticosteroids mature the lungs of preterm infants and postnatal corticosteroids are used to treat bronchopulmonary dysplasia. Objective To test if antenatal or postnatal corticosteroids would decrease resuscitation induced lung injury. Methods 129 d gestational age lambs (n = 5-8/gp; term = 150 d were operatively delivered and ventilated after exposure to either 1 no medication, 2 antenatal maternal IM Betamethasone 0.5 mg/kg 24 h prior to delivery, 3 0.5 mg/kg Dexamethasone IV at delivery or 4 Cortisol 2 mg/kg IV at delivery. Lambs then were ventilated with no PEEP and escalating tidal volumes (VT to 15 mL/kg for 15 min and then given surfactant. The lambs were ventilated with VT 8 mL/kg and PEEP 5 cmH20 for 2 h 45 min. Results High VT ventilation caused a deterioration of lung physiology, lung inflammation and injury. Antenatal betamethasone improved ventilation, decreased inflammatory cytokine mRNA expression and alveolar protein leak, but did not prevent neutrophil influx. Postnatal dexamethasone decreased pro-inflammatory cytokine expression, but had no beneficial effect on ventilation, and postnatal cortisol had no effect. Ventilation increased liver serum amyloid mRNA expression, which was unaffected by corticosteroids. Conclusions Antenatal betamethasone decreased lung injury without decreasing lung inflammatory cells or systemic acute phase responses. Postnatal dexamethasone or cortisol, at the doses tested, did not have important effects on lung function or injury, suggesting that corticosteroids given at birth will not decrease resuscitation mediated injury.

  14. Ontogeny of hippocampal corticosteroid receptors: effects of antenatal glucocorticoids in human and mouse.

    Science.gov (United States)

    Noorlander, C W; De Graan, P N E; Middeldorp, J; Van Beers, J J B C; Visser, G H A

    2006-12-20

    Women at risk for preterm delivery are treated with synthetic glucocorticoids (GCs) to enhance fetal lung maturation. GCs can bind to two intracellular receptors, the glucocorticoid receptor (GR) and the mineralocorticoid receptor (MR), which function as transcription factors. Both are highly expressed in the hippocampus. Several studies have focused on adverse side effects of antenatal GC treatment. However, relatively little is known about the ontogeny of GR and MR, especially in human. Therefore, we studied the ontogeny of both receptors in the human and mouse hippocampus and investigated the effects of antenatal dexamethasone (dex) treatment, a synthetic glucocorticoid, on MR and GR mRNA levels during hippocampal development. The results demonstrate that MR mRNA was first expressed in mouse hippocampus at embryonic day (E)15.5, at the timepoint when dex was administered. In contrast, GR mRNA expression was first observed after birth at postnatal day (P)5. However, in the human hippocampus both receptors are expressed at 24 weeks of gestation, when antenatal GCs are administered in clinical practice. Quantitative in situ hybridization demonstrated that MR mRNA levels were reduced only shortly after dex treatment at E16, but were unaffected from E18 onwards. These findings indicate that a single antenatal dex administration at E15.5 transiently affects MR mRNA levels in the mouse hippocampus. No effect of antenatal dex treatment was found on the human hippocampus at the third trimester of pregnancy. These data on the prenatal ontogeny of both corticosteroid receptors in the human hippocampus is important for understanding the significance of fetal glucocorticoid or stress exposure and its potential effects on health and disease.

  15. Increasing institutional deliveries among antenatal clients: effect of birth preparedness counselling.

    Science.gov (United States)

    Soubeiga, Dieudonné; Sia, Drissa; Gauvin, Lise

    2014-12-01

    The World Health Organization recommends birth and emergency preparedness (BEP) as essential components of the Focused Antenatal Care model. The purpose of providing BEP messages to women during their antenatal visits is to increase the use of skilled attendance at childbirth. However, the effectiveness of this component has not yet been clearly established in routine contexts. This retrospective cohort study examined the association between exposing women to BEP messages during antenatal visits and the use of the skilled attendance at childbirth in two rural districts of Burkina Faso (Koupela and Dori). The study included 456 antenatal care users in 30 rural health centres in these two districts. Data were collected using modified questionnaires from the Johns Hopkins Program for International Education in Gynecology and Obstetrics and from demographic and health surveys. Logistic regression was performed with a model of generalized estimating equation to adjust for clustered effects. In the Koupela district, where the rate of institutional deliveries (80%) was relatively high, the use of BEP messages was not associated with an increase in institutional deliveries. In contrast, in the district of Dori, where the rate of institutional deliveries (47%) was lower, messages regarding danger signs [Adjusted Odds Ratio (AOR) = 1.93; 95% Confidence Interval (CI): 1.07, 3.49] and cost of care (AOR = 2.13; 95% CI: 1.09, 4.22) were associated with an increased probability of institutional births. Based on these results, it appears that birth and emergency preparedness messages provided during antenatal visits may increase the use of skilled attendance (increase the rate of institutional births) in areas where institutional births are low. Therefore, it is important to adapt the content of the messages to meet the particular needs of the users in each locality. Furthermore, BEP counselling should be implemented in health facilities.

  16. The effects of antenatal depression and antidepressant treatment on placental gene expression

    Directory of Open Access Journals (Sweden)

    Jocelien DA Olivier

    2015-01-01

    Full Text Available The effects of antenatal depression and antidepressant treatment during pregnancy on both mother and child are vigorously studied, but the underlying biology for these effects is largely unknown. The placenta plays a crucial role in the growth and development of the fetus. We performed a gene expression study on the fetal side of the placenta to investigate gene expression patterns in mothers with antenatal depression and in mothers using antidepressant treatment during pregnancy.Placental samples from mothers with normal pregnancies, from mothers with antenatal depression, and from mothers using antidepressants were collected. We performed a pilot microarray study to investigate alterations in the gene expression and selected several genes from the microarray for biological validation with qPCR in a larger sample.In mothers with antenatal depression 108 genes were differentially expressed, whereas 109 genes were differentially expressed in those using antidepressants. Validation of the microarray revealed more robust gene expression differences in the seven genes picked for confirmation in antidepressant-treated women than in depressed women. Among the genes that were validated ROCK2 and C12orf39 were differentially expressed in both depressed and antidepressant-treated women, whereas ROCK1, GCC2, KTN1, and DNM1L were only differentially expressed in the antidepressant-treated women. In conclusion, antenatal depression and antidepressant exposure during pregnancy are associated with altered gene expression in the placenta. Findings on those genes picked for validation were more robust among antidepressant-treated women than in depressed women, possibly due to the fact that depression is a multifactorial condition with varying degrees of endocrine disruption. It remains to be established whether the alterations found in the gene expression of the placenta are found in the fetus as well.

  17. Client Factors Affect Provider Adherence to Clinical Guidelines during First Antenatal Care.

    Directory of Open Access Journals (Sweden)

    Mary Amoakoh-Coleman

    Full Text Available The first antenatal clinic (ANC visit helps to distinguish pregnant women who require standard care, from those with specific problems and so require special attention. There are protocols to guide care providers to provide optimal care to women during ANC. Our objectives were to determine the level of provider adherence to first antenatal visit guidelines in the Safe Motherhood Protocol (SMP, and assess patient factors that determine complete provider adherence.This cross-sectional study is part of a cohort study that recruited women who delivered in eleven health facilities and who had utilized antenatal care services during their pregnancy in the Greater Accra region of Ghana. A record review of the first antenatal visit of participants was carried out to assess the level of adherence to the SMP, using a thirteen-point checklist. Information on their socio-demographic characteristics and previous pregnancy history was collected using a questionnaire. Percentages of adherence levels and baseline characteristics were estimated and cluster-adjusted odds ratios (OR calculated to identify determinants.A total of 948 women who had delivered in eleven public facilities were recruited with a mean age (SD of 28.2 (5.4 years. Overall, complete adherence to guidelines pertained to only 48.1% of pregnant women. Providers were significantly more likely to completely adhere to guidelines when caring for multiparous women [OR = 5.43 (1.69-17.44, p<0.01] but less likely to do so when attending to women with history of previous pregnancy complications [OR = 0.50 (0.33-0.75, p<0.01].Complete provider adherence to first antenatal visit guidelines is low across different facility types in the Greater Accra region of Ghana and is determined by parity and history of previous pregnancy complication. Providers should be trained and supported to adhere to the guidelines during provision of care to all pregnant women.

  18. Antenatal diagnosis, prevalence and outcome of congenital anomalies of the kidney and urinary tract in Saudi Arabia

    Directory of Open Access Journals (Sweden)

    Nabeel S Bondagji

    2014-01-01

    Full Text Available Objective: To study the prevalence, pattern of distribution, and the outcome of different types of kidney and urinary tract anomalies (CAKUT diagnosed during the antenatal period. The second objective is to test the accuracy of antenatal diagnosis of CAKUT. Materials and Methods: In a cross-sectional hospital-based study, all cases diagnosed antenatally with urinary tract anomalies at King Abdulaziz University Hospital (KAUH, Jeddah, Kingdom of Saudi Arabia, were studied. The prevalence, pattern of distribution, and immediate postnatal outcomes, in addition to the accuracy of antenatal diagnosis, of those cases are reported. Results: One hundred and forty-one cases of urinary tract anomalies were antenatally diagnosed; postnatal diagnosis was confirmed in 128 cases (90.1%. The prevalence of CAKUT in our population is 3.26 per 1000 births. The most common abnormalities detected were hydronephrosis, polycystic kidney disease, multicystic dysplastic kidney, and renal agenesis, in descending order of frequency. The perinatal mortality rate among fetuses with CAKUT is 310 per 1000, the majority of these cases (90% occurred in cases with renal parenchyma involvement. Conclusions: The prevalence of different types of CAKUT is higher than that reported in developed countries. Urinary tract anomalies can be accurately diagnosed and classified in the antenatal period using ultrasonography imaging. Antenatal diagnosis is a helpful tool in planning immediate postnatal care and deciding the place for delivery. This might prevent or slow renal function deterioration and help in early identification of patients who need early surgical intervention.

  19. The Global Epidemiology of Syphilis in the Past Century - A Systematic Review Based on Antenatal Syphilis Prevalence.

    Directory of Open Access Journals (Sweden)

    Chris Richard Kenyon

    2016-05-01

    Full Text Available How can we explain the uneven decline of syphilis around the world following the introduction of penicillin? In this paper we use antenatal syphilis prevalence (ASP to investigate how syphilis prevalence varied worldwide in the past century, and what risk factors correlate with this variance.1 A systematic review using PubMed and Google Scholar was conducted to identify countries with published data relating to ASP estimates from before 1952 until the present. Eleven countries were identified (Canada, Denmark, Finland, India, Japan, Norway, Singapore, South Africa, United States of America (USA, United Kingdom (UK and Zimbabwe. The ASP epidemic curve for each population was depicted graphically. In South Africa and the USA, results are reported separately for the black and white populations. 2 National antenatal syphilis prevalence estimates for 1990 to 1999 and 2008 were taken from an Institute for Health Metrics and Evaluation database on the prevalence of syphilis in low risk populations compiled for the Global Burden of Diseases study and from a recent review paper respectively. National ASPs were depicted graphically and regional median ASPs were calculated for both time periods. 3 Linear regression was used to test for an association between ASP in 1990-1999 and 2008 and four risk factors (efficacy of syphilis screening/treatment, health expenditure, GDP per capita and circumcision prevalence. WHO world regions were included as potential explanatory variables.In most populations, ASP dropped to under 1% before 1960. In Zimbabwe and black South Africans, ASP was high in the pre-penicillin period, dropped in the post-penicillin period, but then plateaued at around 6% until the end of the 20th century when ASP dropped to just above 1%. In black Americans, ASP declined in the post penicillin period, but plateaued at 3-5% thereafter. ASP was statistically significantly higher in sub-Saharan Africa in 1990-1999 and 2008 than in the other world

  20. How Does a Lesson Plan?

    Science.gov (United States)

    New York City Board of Education, Brooklyn, NY. Div. of Curriculum and Instruction.

    This manual for secondary school teachers offers sample lesson plans that may be used to guide and stimulate experimentation and development of creative instructional units. Lesson plan components are defined, and various types of lessons and their significant characteristics are identified. These characteristic types of lessons are illustrated,…

  1. First trimester ultrasound screening of chromosomal abnormalities

    Directory of Open Access Journals (Sweden)

    Trninić-Pjević Aleksandra

    2007-01-01

    Full Text Available Introduction: A retrocervical subcutaneous collection of fluid at 11-14 weeks of gestation, can be visualized by ultrasound as nuchal translucency (NT. Objective. To examine the distribution of fetal nuchal translucency in low risk population, to determine the detection rate of chromosomal abnormalities in the population of interest based on maternal age and NT measurement. Method. Screening for chromosomal defects, advocated by The Fetal Medicine Foundation (FMF, was performed in 1,341 pregnancies in the period January 2000 - April 2004. Initial risk for chromosomal defects (based on maternal and gestational age and corrected risk, after the NT measurement, were calculated. Complete data were collected from 1,048 patients. Results. Out of 1,048 pregnancies followed, 8 cases of Down’s syndrome were observed, 7 were detected antenatally and 6 out of 7 were detected due to screening that combines maternal age and NT measurement. According to our results, sensitivity of the screening for aneuploidies based on maternal age alone was 12.5% and false positive rate 13.1%, showing that screening based on NT measurement is of great importance. Screening by a combination of maternal age and NT, and selecting a screening-positive group for invasive testing enabled detection of 75% of fetuses with trisomy 21. Conclusion. In screening for chromosomal abnormalities, an approach which combines maternal age and NT is effective and increases the detection rate compared to the use of any single test. .

  2. Male partner antenatal attendance and HIV testing in eastern Uganda: a randomized facility-based intervention trial

    Directory of Open Access Journals (Sweden)

    Byamugisha Robert

    2011-09-01

    Full Text Available Abstract Background The objective of the study was to evaluate the effect of a written invitation letter to the spouses of new antenatal clinic attendees on attendance by couples and on male partner acceptance of HIV testing at subsequent antenatal clinic visits. Methods The trial was conducted with 1060 new attendees from October 2009 to February 2010 in an antenatal clinic at Mbale Regional Referral Hospital, Mbale District, eastern Uganda. The intervention comprised an invitation letter delivered to the spouses of new antenatal attendees, while the control group received an information letter, a leaflet, concerning antenatal care. The primary outcome measure was the proportion of pregnant women who attended antenatal care with their male partners during a follow-up period of four weeks. Eligible pregnant women were randomly assigned to the intervention or non-intervention groups using a randomization sequence, which was computer generated utilizing a random sequence generator (RANDOM ORG that employed a simple randomization procedure. Respondents, health workers and research assistants were masked to group assignments. Results The trial was completed with 530 women enrolled in each group. Participants were analyzed as originally assigned (intention to treat. For the primary outcome, the percentage of trial participants who attended the antenatal clinic with their partners were 16.2% (86/530 and 14.2% (75/530 in the intervention and non-intervention groups, respectively (OR = 1.2; 95% CI: 0.8, 1.6. For the secondary outcome, most of the 161 male partners attended the antenatal clinic; 82 of 86 (95% in the intervention group and 68 of 75 (91% in the non-intervention group were tested for HIV (OR = 2.1; 95% CI: 0.6 to 7.5. Conclusions The effect of the intervention and the control on couple antenatal attendance was similar. In addition, the trial demonstrated that a simple intervention, such as a letter to the spouse, could increase couple

  3. The effect of antenatal administration of solcoseryl on hepatic glycogen synthesis in rat fetuses with intrauterine growth retardation.

    Science.gov (United States)

    Takahashi, H; Cheng, K M; Araki, T

    1993-06-01

    The effect of antenatal solcoseryl administration on hepatic glycogen synthesis and storage was studied in normal developing and intrauterine growth-retarded (IUGR) rat fetuses using biochemical analyses. The maximal effect of solcoseryl occurred 2 hours after administration. The glycogen content of the liver showed a significant increase in normal and IUGR fetuses with antenatal solcoseryl administration compared to their non-solcoseryl counterparts (p solcoseryl administration. Active synthase also increased in normal fetuses with antenatal solcoseryl administration (p solcoseryl administration stimulates hepatic glycogen synthesis and storage in IUGR rat fetuses, and thus might favorably influence the development of neonatal hypoglycemia.

  4. Antenatal corticosteroids trial in preterm births to increase neonatal survival in developing countries: study protocol

    Directory of Open Access Journals (Sweden)

    Althabe Fernando

    2012-09-01

    Full Text Available Abstract Background Preterm birth is a major cause of neonatal mortality, responsible for 28% of neonatal deaths overall. The administration of antenatal corticosteroids to women at high risk of preterm birth is a powerful perinatal intervention to reduce neonatal mortality in resource rich environments. The effect of antenatal steroids to reduce mortality and morbidity among preterm infants in hospital settings in developed countries with high utilization is well established, yet they are not routinely used in developing countries. The impact of increasing antenatal steroid use in hospital or community settings with low utilization rates and high infant mortality among premature infants due to lack of specialized services has not been well researched. There is currently no clear evidence about the safety of antenatal corticosteroid use for community-level births. Methods We hypothesize that a multi country, two-arm, parallel cluster randomized controlled trial to evaluate whether a multifaceted intervention to increase the use of antenatal corticosteroids, including components to improve the identification of pregnancies at high risk of preterm birth and providing and facilitating the appropriate use of steroids, will reduce neonatal mortality at 28 days of life in preterm newborns, compared with the standard delivery of care in selected populations of six countries. 102 clusters in Argentina, Guatemala, Kenya, India, Pakistan, and Zambia will be randomized, and around 60,000 women and newborns will be enrolled. Kits containing vials of dexamethasone, syringes, gloves, and instructions for administration will be distributed. Improving the identification of women at high risk of preterm birth will be done by (1 diffusing recommendations for antenatal corticosteroids use to health providers, (2 training health providers on identification of women at high risk of preterm birth, (3 providing reminders to health providers on the use of the kits, and

  5. Antenatal evaluation of fetal interrupted aortic arch type B

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    Ali Babacan

    2015-06-01

    Full Text Available Interruption of the aortic arch (IAA is a rare, severe form of congenital heart defect characterized by complete anatomical discontinuity between two adjacent segments of the aortic arch. The data on the features and outcomes of fetal IAA are limited. Three anatomical types have been described according to the site of interruption. The current recommendations for screening on the obstetric fetal anomaly scan include identification of a 4-chamber view, all 4 valves, and the outflow tracts, all of which can appear to be normal to the ultrasonographer in fetuses with conotruncal anomalies. Although the identification of IAA on a prenatal echocardiogram can be challenging, a number of anatomic features can facilitate the diagnosis. We aim to present the features and outcome of a case of IAA type B referred to our centre in the light of literatures.

  6. Hepatitis C: is there a case for universal screening in pregnancy?

    LENUS (Irish Health Repository)

    Martyn, F

    2012-02-01

    Hepatitis C (HCV) is not routinely screened for antenatally in all maternity hospitals. Most hospitals adopt a policy of targeted screening. The policy in the Coombe Women and Infants University Hospital in Dublin changed from targeted screening in 2006 to universal screening in 2007. We audited the two consecutive years. The prevalence of HCV in our antenatal population was 1.4% for 2006 (67\\/4666) when targeted screening applied and in 2007--0.71% (66\\/9222) when universal screening came into affect. One woman in 2007 would not have been detected by targeted screening--1.49% (1\\/67). Fifty five percent (37\\/67) of women were HCV-RNA positive in 2006 and 57.5% (38\\/66) were positive in 2007. We conclude that there were similar detection rates for HCV in 2006 and 2007 and that universal screening is not required if inclusive criteria for selective screening are employed but is of use in research context.

  7. Hepatitis C: is there a case for universal screening in pregnancy?

    LENUS (Irish Health Repository)

    Martyn, F

    2011-05-01

    Hepatitis C (HCV) is not routinely screened for antenatally in all maternity hospitals. Most hospitals adopt a policy of targeted screening. The policy in the Coombe Women and Infants University Hospital in Dublin changed from targeted screening in 2006 to universal screening in 2007. We audited the two consecutive years. The prevalence of HCV in our antenatal population was 1.4% for 2006 (67\\/4666) when targeted screening applied and in 2007--0.71% (66\\/9222) when universal screening came into affect. One woman in 2007 would not have been detected by targeted screening--1.49% (1\\/67). Fifty five percent (37\\/67) of women were HCV-RNA positive in 2006 and 57.5% (38\\/66) were positive in 2007. We conclude that there were similar detection rates for HCV in 2006 and 2007 and that universal screening is not required if inclusive criteria for selective screening are employed but is of use in research context.

  8. Health insurance determines antenatal, delivery and postnatal care utilisation: evidence from the Ghana Demographic and Health Surveillance data

    OpenAIRE

    Browne, Joyce L.; Kayode, Gbenga A; Arhinful, Daniel; Fidder, Samuel A J; Grobbee, Diederick E; Klipstein-Grobusch, Kerstin

    2016-01-01

    OBJECTIVE: This study aims to evaluate the effect of maternal health insurance status on the utilisation of antenatal, skilled delivery and postnatal care. DESIGN: A population-based cross-sectional study. SETTING AND PARTICIPANTS: We utilised the 2008 Demographic and Health Survey data of Ghana, which included 2987 women who provided information on maternal health insurance status. PRIMARY OUTCOMES: Utilisation of antenatal, skilled delivery and postnatal care. STATISTICAL ANALYSES: Multivar...

  9. Lessons of Educational Technology

    Directory of Open Access Journals (Sweden)

    Manuela Repetto

    2006-01-01

    Full Text Available Reception of the book "Lessons of Educational Technology." The book contains materials work in certain aspects relevant to the formation of a teacher who is able to meet the challenges of society 'knowledge.

  10. Fetal echopsy (ultrasonographic autopsy of an acardius myelancephalus and its correlation with antenatal ultrasonographic findings

    Directory of Open Access Journals (Sweden)

    Balakumar Karippaliyil

    2015-01-01

    Full Text Available Aberrant transplacental arteriovenous shunts between the placental and cord vessels of monozygotic monoamniotic twins or triplets result in the formation of an acardius. The prenatal diagnosis of this condition has been reported occasionally in the literature. A subtype categorized as acardius myelancephalus was diagnosed at 32 weeks of gestation by ultrasonography (USG. The pregnancy was aborted because of poor prognostic predictors and the acardius was subjected to ultrasonographic autopsy (fetal echopsy. The antenatal USG features were correlated with echopsy findings for confirmation of the antenatal findings and for a better visual perception of the prenatal diagnostic features. The echopsy revealed more precise details. Fetal echopsy avoids the medicolegal problems concerned with parental consent for classical invasive fetal autopsy.

  11. FACTORS LEAD TO DEPRESION DURING ANTENATAL CARE EVERY TRIMESTER OF PREGNANT MOTHER

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    Eddy Surya Kurniawan

    2013-03-01

    Full Text Available The most important factor in reducing maternal and infant mortality rates began during pregnancy. In 2000, one in twenty children die before reaching the age of five years and a mother died of childbirth out of every 325 live births. The death rate in research mainly indicated comparable levels of depression due to stress in pregnant women. The occurrence of symptoms of depression during the perinatal period can be easily recognized. Depression during pregnancy is a common mood disorder such as depression that occurs in the laity in general, where the incidence of depression will occur chemical changes in the brain. Each trimester of pregnancy are at risk of psychological disorders respectively. Antenatal care plays a very important for the safety of the mother and fetus, minimizing the risks of pregnancy, and reduce the number of neonatal deaths. Nursing antenatal care should have run in accordance with minimum standards for pregnant women to obtain a safe childbirth and satisfying.

  12. Antenatal care strengthening for improved health behaviours in Jimma, Ethiopia, 2009-2011

    DEFF Research Database (Denmark)

    Villadsen, Sarah Fredsted; Negussie, Dereje; GebreMariam, Abebe

    2016-01-01

    given birth within the previous 12 months. The effect of the intervention was assessed by comparing the change in health behaviours (number of antenatal visits, health facility delivery, breast feeding, preventive infant health check, and infant immunisation) from before to after the intervention period...... at intervention sites, relative to control sites, using logistic mixed effect regression. RESULTS: on the basis of 1357 women included before and 2262 after the intervention, there were positive effects of the intervention on breast feeding practices (OR 3.0, 95% CI: 1.4; 3.6) and preventive infant health check...... (OR 2.4, 95% CI: 1.5; 3.5). There was no effect on infant immunisation coverage and negative effect on number of antenatal visits. The effect on various outcomes was modified by maternal education, and results indicate increased health facility delivery (OR 2.4, 95% CI: 0.8; 6.9) and breast feeding...

  13. QUALITY ASSESSEMENT OF ANTE-NATAL CARE USING THE METHOD OF LOT QUALITY ASSURANCE SAMPLING

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    Sh. Salarilak

    1999-08-01

    Full Text Available To determine the coverage rate, timeliness and quality of ante-natal care in rural areas under the coverage of Health Houses in West Azerbaijan province, 30 Health Houses (HH were randomly selected out of 731 HH in the province. In each HH, using the method of Lot Quality Assurance Sampling (LQAS 28 women having recently born babies was selected. Data were collected using check-list for facilities, and questionnaires and forms to be completed from the files by interview. The study showed that the method of LQAS is quite effective for evaluation of this service at HH level. The weighted total coverage of ante-natal care was 46.2%. Quality of care was acceptable for 53.9% of mothers. The weighted average of time lines of care was 49.8%. Availability of facilities in delivery of this service was 100%, showing there was no short coming in this respect.

  14. Impact on infants' cognitive development of antenatal exposure to iron deficiency disorder and common mental disorders.

    Directory of Open Access Journals (Sweden)

    Thach Duc Tran

    Full Text Available OBJECTIVES: The aim of this study was to examine the effects of antenatal exposure to iron deficiency anemia (IDA and common mental disorders (CMD on cognitive development of 6 months old infants in a developing country. METHODS: A prospective population-based study in a rural province in Vietnam, which enrolled pregnant women at 12-20 weeks gestation and followed them up with their infants until six months postpartum. Criteria for IDA were Hb 30 years and primiparity had an indirect adverse effect on infants' Bayley cognitive scores. CONCLUSIONS: These findings suggest that antenatal IDA and CMD both have adverse effects on child cognitive development, which if unrecognized and unaddressed are likely to be lasting. It is crucial that both these risks are considered by policy makers, clinicians, and researchers seeking to improve child cognitive function in developing countries.

  15. The effect of antenatal education in small classes on obstetric and psycho-social outcomes

    DEFF Research Database (Denmark)

    Brixval, Carina Sjöberg; Axelsen, Solveig Forberg; Lauemøller, Stine Glenstrup

    2015-01-01

    , with participation of a small number of participants, may differ from the effect of other forms of antenatal education due to, for example, group dynamic. The objective of this systematic review is to assess the effects of antenatal education in small groups on obstetric as well as psycho-social outcomes. METHODS......: Bibliographic databases (Medline, EMBASE, CENTRAL, CINAHL, Web of Science, and PsycINFO) were searched. We included randomized and quasi-randomized trials irrespective of language, publication year, publication type, and publication status. Only trials carried out in the Western world were considered...... in this review. Studies were assessed for bias using the Cochrane risk of bias tool. Results are presented as structured summaries of the included trials and as forest plots. RESULTS: We identified 5,708 records. Of these, 17 studies met inclusion criteria. Studies varied greatly in content of the experimental...

  16. Antenatal management of the expectant mother and extreme preterm infant at the limits of viability.

    LENUS (Irish Health Repository)

    Khan, R

    2012-01-31

    We explored the opinions of healthcare providers on the antenatal management and outcome of preterm delivery at less than 28 weeks gestation. An anonymous postal questionnaire was sent to health care providers. The response rate was 55% (74% Obstetrician, 70% neonatologist). Twenty four weeks is the limit at which most would advocate intervention. At 23 weeks 67% of neonatologists advocate antenatal steroids. 50% of all health care providers advocate cardiotocographic monitoring at 24 weeks gestation. Written information on survival and long-term outcome is provided by 8% of the respondents. Neonatologists (50%) were more likely than obstetrician (40%) to advocate caesarean section at 25 weeks. We conclude that 24 weeks is the limit at which most would advocate intervention. Significant variation exists both between and within each health care group at less than 25 weeks. Establishment and provision of national outcome data may aid decision making at the limits of viability.

  17. Late Antenatal Care Booking And Its Predictors Among Pregnant Women In South Western Nigeria

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    Adekanle DA

    2008-04-01

    Full Text Available Introduction: Antenatal care is concerned mainly with prevention, early diagnosis and treatment of general medical and pregnancy associated disorders. For it to be meaningful, early booking is recommended, however, late booking is still a major problem.Objective: To determine the prevalence of late booking in our environment and factors related to it.Methodology: A descriptive cross-sectional study using structured interviewer assisted questionnaires.Results: Mean gestational age at booking was 20.3±6.2 weeks. Prevalence of late entry to antenatal care was 82.6%. Maternal education and age remained significant factors influencing late booking.Conclusion: Late booking is still a major problem in this part of the world. Public enlightenment, health education coupled with women empowerment would be helpful in reducing the problem

  18. Factors related to the use of antenatal care services in Ethiopia: Application of the zero-inflated negative binomial model.

    Science.gov (United States)

    Assefa, Enyew; Tadesse, Mekonnen

    2016-08-11

    The major causes for poor health in developing countries are inadequate access and under-use of modern health care services. The objective of this study was to identify and examine factors related to the use of antenatal care services using the 2011 Ethiopia Demographic and Health Survey data. The number of antenatal care visits during the last pregnancy by mothers aged 15 to 49 years (n = 7,737) was analyzed. More than 55% of the mothers did not use antenatal care (ANC) services, while more than 22% of the women used antenatal care services less than four times. More than half of the women (52%) who had access to health services had at least four antenatal care visits. The zero-inflated negative binomial model was found to be more appropriate for analyzing the data. Place of residence, age of mothers, woman's educational level, employment status, mass media exposure, religion, and access to health services were significantly associated with the use of antenatal care services. Accordingly, there should be progress toward a health-education program that enables more women to utilize ANC services, with the program targeting women in rural areas, uneducated women, and mothers with higher birth orders through appropriate media.

  19. The Prevalence and Risk Factors of Paternal Depression from the Antenatal to the Postpartum Period and the Relationships between Antenatal and Postpartum Depression among Fathers in Hong Kong

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    Y. W. Koh

    2014-01-01

    Full Text Available Introduction. Despite the fact that maternal perinatal mental health problems have been extensively studied and addressed to be a significant health problem, the literature on paternal perinatal mental health problems is relatively scarce. The present study aims at determining the prevalence of paternal perinatal depression and identifying the risk factors and the relationship between antenatal and postpartum depression. Methodology. 622 expectant fathers were recruited from regional maternal clinics. The expectant fathers were assessed using standardized and validated psychological instruments on 3 time points including early pregnancy, late pregnancy, and six weeks postpartum. Results. Results showed that a significant proportion of expectant fathers manifested depressive symptoms during the perinatal period. Paternal antenatal depression could significantly predict higher level of paternal postpartum depression. Psychosocial risk factors were consistently associated with paternal depression in different time points. Conclusions. The present study points to the need for greater research and clinical attention to paternal depression given that it is a highly prevalent problem and could be detrimental to their spouse and children development. The present findings contribute to theoretical basis of the prevalence and risk factors of paternal perinatal depression and have implications of the design of effective identification, prevention, and interventions of these clinical problems.

  20. Antenatal Care Services Utilization in Yobe State, Nigeria: Examining Predictors and Barriers

    OpenAIRE

    2015-01-01

    Objective: In Nigeria, wide disparities exist between the different parts of the country, with the states in the North East zone having poor health resources. The objective of this study is to assess whether women’s biological, sociocultural, and economic characteristics are associated with utilization of ante natal care services as measured by number of antenatal care (ANC) visits in Yobe State. Methods: This is a secondary data analysis of the 2008 Nigeria Demographic and Health Survey ...

  1. Antenatal taurine supplementation increases taurine content in intrauterine growth restricted fetal rat brain tissue.

    Science.gov (United States)

    Li, Fang; Teng, Hui-Yun; Liu, Jing; Wang, Hua-Wei; Zeng, Li; Zhao, Li-Fang

    2014-09-01

    This study aimed to determine the influence of antenatal taurine supplementation on taurine content in the brains of fetal rats with intrauterine growth restriction (IUGR). Experiments were performed at the Central Laboratory of Bayi Children's Hospital Affiliated to Beijing Military General Hospital in China from January to June 2013. Fifteen pregnant rats were randomly divided into three groups: normal controls, an IUGR group and an IUGR + antenatal taurine supplement group (Taurine group) (n = 5). The IUGR model was induced using a low-protein diet throughout gestation. Rats in the taurine group were fed a diet supplemented with 300 mg/kg/day taurine for 12 days after conception until natural delivery. Two fetal rats were randomly selected in every litter, and taurine levels in the brains of rats were detected using high-performance liquid chromatography-mass spectrometry. Results showed that (1) the mean body weight of the fetal rats in the normal control, IUGR and IUGR + antenatal taurine supplement groups was 6.619 ± 0.4132, 4.509 ± 0.454, and 5.176 ± 0.436 g (F = 429.818, P taurine levels in the brains of the fetal rats in the normal control, IUGR and taurine groups were (2.399 ± 0.134) × 10(5), (1.881 ± 0.166) × 10(5) and (2.170 ± 0.191) × 10(5) μg/g (F = 24.828, P taurine levels in IUGR fetal rat brains were lower than in the control animals, and that antenatal taurine supplementation could significantly increase taurine levels in the brains of fetal rats with IUGR.

  2. Factors associated with antenatal mental disorder in West Africa: A cross-sectional survey

    OpenAIRE

    Ola Bola; Crabb Jim; Tayo Adetokunbo; Gleadow Ware Selena H; Dhar Arup; Krishnadas Rajeev

    2011-01-01

    Abstract Background Maternal mental illness is likely to have a profound impact in less developed parts of the world. A mother experiencing mental illness in a low income setting is at risk of providing sub-optimal care for her offspring which can have grave consequences in an environment where poverty, overcrowding, poor sanitation, malnutrition, tropical diseases and a lack of appropriate medical services may be pronounced. Given the profound consequences of antenatal and postnatal mental i...

  3. Effects of Antenatal Maternal Depression and Anxiety on Children's Early Cognitive Development: A Prospective Cohort Study

    OpenAIRE

    Gladys Ibanez; Bernard, Jonathan Y.; Claire Rondet; Hugo Peyre; Anne Forhan; Monique Kaminski; Marie-Josèphe Saurel-Cubizolles

    2015-01-01

    International audience; IntroductionStudies have shown that depression or anxiety occur in 10–20% of pregnant women. These disorders are often undertreated and may affect mothers and children’s health. This study investigates the relation between antenatal maternal depression, anxiety and children’s early cognitive development among 1380 two-year-old children and 1227 three-year-old children.MethodsIn the French EDEN Mother-Child Cohort Study, language ability was assessed with the Communicat...

  4. Extracranial vascular malformation: value of antenatal and postnatal MRI in management

    Energy Technology Data Exchange (ETDEWEB)

    Roche, C.J.; Pilling, D.W. [Dept. of Radiology, Royal Liverpool Children' s Hospital NHS Trust (United Kingdom); Walkinshaw, S.A. [Dept. of Fetal Medicine, Liverpool Women' s Hospital (United Kingdom); May, P.L. [Dept. of Neurosurgery, Royal Liverpool Children' s Hospital NHS Trust (United Kingdom)

    2001-10-01

    We report a case where fetal MRI using a low-field-strength magnet (0.5 T) accurately confirmed a large extracranial vascular malformation, which was suspected on antenatal US. Fetal MRI enabled better counselling of the parents and allowed suitable plans to be made regarding method of delivery and early management of the neonate. To our knowledge this is the first case of an extracranial vascular malformation imaged using fetal MRI. (orig.)

  5. Pelayanan antenatal care dalam pengelolaan anemia berhubungan dengan kepatuhan ibu hamil minum tablet besi

    OpenAIRE

    Subarda, Subarda; Hakimi, Mohammad; Helmyati, Siti

    2017-01-01

    Background: The prevalence of pregnant women with anemia is still one of nutrition problems in Indonesia. The main cause of this case is low iron supplementation compliance as the effect of lack of antenatal care (ANC) services and lack promotion of anemia prevention and iron tablet benefit.Objective: The study was aimed to know the relationship between ANC services in anemia management with iron supplementation compliance of pregnant women.Method: The study was observational with cross secti...

  6. Urinary tract infections at first antenatal check-up: a single centre prospective study

    OpenAIRE

    2016-01-01

    Background: Pregnant women with asymptomatic bacteriuria (ASB) are more likely to develop acute pyelonephritis, postpartum UTI, hypertensive disease, anemia, prematurity, low birth weight babies and prenatal death if untreated. Methods: Total 780 pregnant women attending for first antenatal check-up in a medical college were enrolled for the study. Those with any symptoms of UTI, like burning micturition, frequency, urgency, dysuria or fever were excluded from the study. All were subjected...

  7. Effect of aerobic exercise during pregnancy on antenatal depression

    Directory of Open Access Journals (Sweden)

    El-Rafie MM

    2016-02-01

    Full Text Available Mervat M El-Rafie,1 Ghada M Khafagy,2 Marwa G Gamal31Department of Public Health, 2Department of Family Medicine, Faculty of Medicine, Cairo University, Giza, Egypt; 3Family Health Unit, Ministry of Health, Cairo, EgyptBackground: Antenatal depression is not uncommon and is associated with a greater risk of negative pregnancy outcomes.Aim: Exploring the effect of exercise in preventing and treating antenatal depression.Methods: This was a prospective interventional controlled study carried out in 100 pregnant women treated at the Ain-Shams Family Medicine Center and Maadi Outpatient Clinic, Cairo, Egypt. The participants were divided into two groups (n=50 in the exercise group and n=50 in the control group. The exercise group regularly attended supervised sessions for 12 weeks. The activities in each session included walking, aerobic exercise, stretching, and relaxation. The control group completed their usual antenatal care. The Center for Epidemiological Studies Depression Scale (CES-D was used to assess depression symptoms at the first interview and immediately after the 12-week intervention.Results: Compared to the control group, the exercise group showed significantly improved depressive symptoms as measured with the CES-D after the 12-week intervention on the CES-D (P=0.001. Within groups, the exercise group demonstrated a significant improvement of depressive symptoms from baseline to intervention completion, while the control group demonstrated no significant changes over time.Conclusion: Exercise during pregnancy was positively associated with reduced depressive symptoms.Keywords: antenatal depression, pregnant women, exercise

  8. Racial/Ethnic Disparities in Antenatal Depression in the United States: A Systematic Review.

    Science.gov (United States)

    Mukherjee, Soumyadeep; Trepka, Mary Jo; Pierre-Victor, Dudith; Bahelah, Raed; Avent, Tenesha

    2016-09-01

    Objectives More than 10 % of pregnant women in the United States (U.S.) suffer from depression, which has far-reaching consequences on maternal and fetal well-being. There is conflicting evidence regarding the prevalence of antenatal depression among different race and ethnic groups. This systematic review aimed to summarize the existing literature concerning racial/ethnic disparities in the prevalence and correlates of antenatal depression in the U.S. Methods PubMed, CINAHL and PsycINFO databases were searched online for research studies published in English in peer-reviewed journals until March 2015, using a pre-designed search strategy. Eligibility was determined using pre-specified criteria; and quality was assessed. Results Forty-one (41) articles met the criteria; 13 were cross-sectional, and 21 were longitudinal studies. Overall, the prevalence of antenatal depression was 10-30 %; it was higher among non-Hispanic blacks (NHBs) and Hispanics, compared to non-Hispanic whites (NHWs). Few studies looked at the correlates of depression by race/ethnicity. Among employed women, higher depression scores were observed among NHBs, compared to NHWs; while there was no racial difference among unemployed women. Racial difference and race-employment interaction disappeared once discrimination was accounted for. In another study, higher parity, higher stress, and lower self-esteem were significant correlates of depression among NHBs, while less satisfaction with social support, and higher stress predicted higher depression scores among NHWs and Hispanics respectively. Conclusions The findings of our review suggest that not only is antenatal depression a major public health issue that needs to be addressed, but different racial/ethnic groups seem to differ in their vulnerability and risk factors.

  9. Factors associated with antenatal depression in pregnant Korean females: the effect of bipolarity on depressive symptoms

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    Park CM

    2014-06-01

    Full Text Available Chul Min Park,1 Hye-Jin Seo,2 Young-Eun Jung,3 Moon-Doo Kim,3 Seong-Chul Hong,4 Won-Myong Bahk,5 Bo-Hyun Yoon,6 Min Hee Hur,7 Jae Min Song31Department of Obstetrics and Gynecology, School of Medicine, Jeju National University, Jeju, 2Department of Psychiatry, Yeonkang Hospital, Jeju, 3Department of Psychiatry, 4Department of Preventive Medicine, School of Medicine, Jeju National University, Jeju, 5Department of Psychiatry, Yeouido St Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, 6Department of Psychiatry, Naju National Hospital, Naju, 7School of Medicine, Jeju National University, Jeju, KoreaBackground: This cross-sectional study sought to identify factors associated with antenatal depression in pregnant Korean females, including sociodemographic parameters, social support, social conflict, and bipolarity.Methods: Eighty-four pregnant women were recruited to complete questionnaires on sociodemographic factors, obstetric history, depressive symptoms, and bipolarity. Depressive symptoms were assessed using the Korean version of the Edinburgh Postnatal Depression Scale. Bipolarity was assessed using the Korean version of the Mood Disorder Questionnaire.Results: Nineteen participants (22.6% had positive Mood Disorder Questionnaire scores, suggesting the presence of bipolarity, and were significantly more likely to score high on the Edinburgh Postnatal Depression Scale. Antenatal depression was associated with bad marital communication and marital dissatisfaction.Conclusion: These results suggest that spousal interactions play a significant role in antenatal depression, and pregnant women with bipolarity may be more depressed than those without bipolarity.Keywords: antenatal depression, bipolarity, pregnancy, Korea

  10. A study of anemia in women with asymptomatic malaria parasitaemia at their first antenatal care visit at the General Hospital, Ikot Ekpene, Akwa Ibom State, Nigeria

    Institute of Scientific and Technical Information of China (English)

    Ekanem EI; Agan TU; Efiok EE; Ekott MI; Okodi E

    2010-01-01

    Objective:To assess the prevalence of anemia and asymptomatia malaria parasitemia and the effect of prior antimalarials therapy on the parasite density in pregnant women at their first antenatal visit at the secondary level health care facility in Nigeria. Methods:This cross sectional observational study was carried out in the antenatal clinic of General Hospital, Ikot Ekpene, Akwa Ibom State, Nigeria for 3 months period (1st June to 31st August, 2009). Five hundred and fourteen women attending their first antenatal registration visits in the hospital were recruited in the study. Socio-demographic information was obtained using pre-tested questionnaires. The malaria parasite was obtained by examining thick and thin blood films prepared on 2 glass slides while the hematocrit was obtained through 2 capillary tubes read by a Hawksleys microhematocrit reader. Results:A total of 514 pregnant women participated in the study with a mean maternal age of 21.4 years and a mean gestational age at booking of 18.3 weeks. The primigravid women booked at significantly lower gestational age than multigravidae (16.2 weeks vs 21.6 weeks). Most of the women (59.3%) were anemic, out of which 60.4%were primigravida. More than half of the women had moderate to high parasite density and only 6.8%had no malaria parasitemia. All patients with severe anemia were parasitemic. Out of the 479 (93.2%) women with parasitemia, a third had taken antimalarial drugs. A majority (60.3%) of those without prior antimalarial drugs had moderate to high density parasitemia. Conclusions:This study shows high prevalence of anemia in women with asymptomatic malarial parasitemia, particularly the primigravida. The severity of anemia is directly related to the density of malaria parasitemia. Those with effective antimalarial therapy appear to have low density parasitemia and therefore mild anemia. Routine screening for anemia and malaria parasites at booking, prompt parasite clearance and correction of anemia

  11. Association of antenatal depression with adverse consequences for the mother and newborn in rural Ghana: findings from the DON population-based cohort study.

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    Benedict Weobong

    Full Text Available BACKGROUND: Whilst there is compelling evidence of an almost 2-fold increased risk of still births, and suggestive evidence of increased mortality among offspring of mothers with psychotic disorders, only three studies have addressed the role of antenatal depression (AND on survival of the baby. We examined these associations in a large cohort of pregnant women in Ghana. METHODS: A Cohort study nested within 4-weekly surveillance of all women of reproductive age to identify pregnancies and collect data on births and deaths in the Kintampo Health Research Centre study area of Ghana. Women were screened for AND using the Patient Health Questionnaire (PHQ-9 to ascertain DSM-IV major or minor depression. Outcomes were adverse birth outcomes, maternal/infant morbidity, and uptake of key newborn care practices, examined using logistic regression; effect sizes reported as relative risks with 95% confidence intervals. RESULTS: 20679 (89.6% pregnant women completed the PHQ-9. The prevalence of AND was 9.9% (n = 2032 (95% confidence interval 9.4%-10.2%. AND was associated with: prolonged labour (RR 1.25, 95% CI 1.02-1.53; peripartum complications (RR 1.11, 95% CI 1.07-1.15; postpartum complications (RR 1.27, 96% CI 1.21-1.34; non-vaginal delivery (RR 1.19, 95% CI 1.02-1.40; newborn illness (RR 1.52, 95% CI 1.16-1.99; and bed net use during pregnancy (RR 0.93, 95% CI 0.89-0.98, but not neonatal deaths, still births, low birth weight, immediate breast feeding initiation, or exclusive breastfeeding. AND was marginally associated with preterm births (RR 1.32, 95% CI 0.98-1.76. CONCLUSION: This paper has contributed important evidence on the role of antenatal depression as a potential contributor to maternal and infant morbidity. Non-pharmacological treatments anchored on primary care delivery structures are recommended as an immediate step. We further recommend that trials are designed to assess if treating antenatal depression in conjunction with

  12. Antenatal and postnatal psychopathology among women with current and past eating disorders: longitudinal patterns.

    Science.gov (United States)

    Easter, Abigail; Solmi, Francessca; Bye, Amanda; Taborelli, Emma; Corfield, Freya; Schmidt, Ulrike; Treasure, Janet; Micali, Nadia

    2015-01-01

    This study aims to investigate longitudinal patterns of psychopathology during the antenatal and postnatal periods among women with current (C-ED) and past (P-ED) eating disorders. Women were recruited to a prospective longitudinal study: C-ED (n = 31), P-ED (n = 29) and healthy control (HC; n = 57). Anxiety, depression and ED symptoms were measured at four time points: first/second trimester, third trimester, 8 weeks and 6 months postpartum. Linear mixed effects models were used to test for group differences. Women with C-ED and P-ED, in all diagnostic categories, had significantly higher levels of psychopathology at all time points. ED symptoms decreased in the C-ED group, compared with an overall increase in the other two groups but subsequently increased after pregnancy. Overall, depression and state and trait anxiety scores decreased in the C-ED group compared with the HC group throughout the antenatal and postnatal periods. High levels of psychopathology are common throughout the antenatal and postnatal periods among women with current and past ED, and despite some overall reductions, symptoms remain clinically significant. © 2014 The Authors. European Eating Disorders Review published by John Wiley & Sons, Ltd.

  13. Effects of antenatal glucocorticoid therapy on hippocampal histology of preterm infants.

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    Deodata Tijsseling

    Full Text Available OBJECTIVE: To investigate if antenatal glucocorticoid treatment has an effect on hippocampal histology of the human preterm newborn. PATIENTS AND METHODS: Included were consecutive neonates with a gestational age between 24 and 32 weeks, who were born between 1991 to 2009, who had died within 4 days after delivery and underwent brain autopsy. Excluded were neonates with congenital malformations and neonates treated postnatally with glucocorticoids. The brains were routinely fixed, samples of the hippocampus were stained with haematoxylin and eosin and sections were examined for presence or absence of large and small neurons in regions of the hippocampus. Additional staining with GFAP, neurofilament and vimentin was performed to evaluate gliosis and myelination. The proliferation marker Ki67 was used to evaluate neuronal proliferation. Staining with acid fuchsin-thionin was performed to evaluate ischemic damage. RESULTS: The hippocampi of ten neonates who had been treated with antenatal glucocorticoids showed a lower density of large neurons (p = 0.01 and neurons irrespective of size (p = 0.02 as compared to eleven neonates who had not been treated with glucocorticoids. No difference was found in density of small neurons, in myelination, gliosis, proliferation or ischemic damage. CONCLUSION: We found a significantly lower density of neurons in the hippocampus of neonates after antenatal glucocorticoid treatment. Although the pathophysiological and clinical interpretations of these findings are not clear, they are consistent with those from experiments in mice and rhesus monkeys.

  14. Prevalence of asymptomatic bacteriuria in antenatal women attending a tertiary care hospital

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    Ananthi Kasinathan

    2014-04-01

    Methods: A total of 174 antenatal women of and #8804;28 weeks of gestation who had no clinical features of urinary tract infection were recruited for this study over a period of 6 months. Midstream urine sample was collected and sent for routine examination and culture-sensitivity testing. Results: Significant bacteriuria was detected in 22 (12.6% antenatal women. Of them 13 (59.1% belonged to the age group 26-30 years. Nearly half of the culture positive cases, that is 10 (45.5% were educated upto primary school and they belonged to socioeconomic status class 4. Majorities (68% were in the second trimester of pregnancy and the commonest organism isolated was E. coli. Conclusions: Undetected and untreated asymptomatic bacteriuria leads to chronic drug resistant infection, hypertension, anemia, etc. in the mother and prematurity, intrauterine growth restriction etc. in the fetus. Hence it is important to do urine culture for all women during antenatal check-up. [Int J Reprod Contracept Obstet Gynecol 2014; 3(2.000: 437-441

  15. Disrupted secretory activation of the mammary gland after antenatal glucocorticoid treatment in sheep.

    Science.gov (United States)

    Henderson, Jennifer J; Hartmann, Peter E; Moss, Timothy J M; Doherty, Dorota A; Newnham, John P

    2008-11-01

    Antenatal glucocorticoids are administered to women at risk of preterm delivery to prevent neonatal respiratory morbidity. The effects of exogenous glucocorticoids on the development of lactation are unknown. This study investigated the effects of a single dose of antenatal glucocorticoids on secretory activation in sheep before and after parturition. Pregnant ewes (N=36) were randomised to receive either medroxyprogesterone acetate (MPA) at 118 days of pregnancy and betamethasone at 125 days (BETA group), MPA at 118 days and saline at 125 days (MPA group) or saline at 118 and 125 days (SALINE group). The concentration of lactose, progesterone, cortisol and prolactin in maternal plasma was measured during pregnancy. After term parturition, the concentration of lactose in milk and maternal plasma was measured daily for 5 days. Lambs were weighed at birth and at 5 days of age; milk volume was measured on day 5. The concentration of lactose in maternal plasma increased significantly after betamethasone administration, corresponding to a fall in plasma progesterone. No changes in lactose were observed in MPA or SALINE ewes. Transient decreases in cortisol and increases in prolactin were observed in the BETA group, but not in either the MPA or SALINE group. After parturition, BETA ewes experienced reduced milk yield and lamb weight gain, and delayed increases in milk lactose levels compared with MPA and saline controls. This study demonstrated that, in sheep, antenatal glucocorticoid administration disrupted secretory activation, causing precocious mammary secretion before parturition and compromising postpartum milk production and lamb growth.

  16. Between life and death: exploring the sociocultural context of antenatal mental distress in rural Ethiopia.

    Science.gov (United States)

    Hanlon, Charlotte; Whitley, Rob; Wondimagegn, Dawit; Alem, Atalay; Prince, Martin

    2010-10-01

    The high prevalence of antenatal common mental disorders in sub-Saharan Africa compared to high-income countries is poorly understood. This qualitative study explored the sociocultural context of antenatal mental distress in a rural Ethiopian community. Five focus group discussions and 25 in-depth interviews were conducted with purposively sampled community stakeholders. Inductive analysis was used to develop final themes. Worry about forthcoming delivery and fears for the woman's survival were prominent concerns of all participants, but only rarely perceived to be pathological in intensity. Sociocultural practices such as continuing physical labour, dietary restriction, prayer and rituals to protect against supernatural attack were geared towards safe delivery and managing vulnerability. Despite strong cultural norms to celebrate pregnancy, participants emphasised that many pregnancies were unwanted and an additional burden on top of pre-existing economic and marital difficulties. Short birth interval and pregnancy out of wedlock were both seen as shameful and potent sources of mental distress. The notion that pregnancy in traditional societies is uniformly a time of joy and happiness is misplaced. Although antenatal mental distress may be self-limiting for many women, in those with enduring life difficulties, including poverty and abusive relationships, poor maternal mental health may persist.

  17. ANTENATAL DETERMINANTS OF PARENTAL ATTACHMENT AND PARENTING ALLIANCE: HOW DO MOTHERS AND FATHERS DIFFER?

    Science.gov (United States)

    Luz, Rita; George, Astrid; Vieux, Rachel; Spitz, Elisabeth

    2017-03-01

    Parental (parent-to-infant) attachment and parenting alliance are defined as two important components of psychoaffective adjustment to the parental role. This study aimed to build a predictive model of parental attachment and parenting alliance for mothers and fathers using partial least squares-structural equation modeling. Specifically, we were interested in assessing how adult romantic attachment, marital quality, and psychological distress influenced parental attachment (parent-to-infant) and parenting alliance. Forty heterosexual couples completed questionnaires during the third trimester of pregnancy and 2 months after childbirth. Results showed that adult romantic attachment, marital quality, and psychological distress were important antenatal determinants of parental attachment and parenting alliance, although they behaved differently for mothers and fathers. Hence, different predictive models were therefore proposed for mothers and fathers. Mothers' attachment to the child was influenced by internal factors as adult attachment dimensions; for fathers, it also depended on mothers' antenatal attachment to the child and on marital quality. Concerning parenting alliance, both mothers and fathers depended on own and partner's variables. Antenatal variables are important for what occurs during the transition to parenthood in terms of parenting adjustment and act differently for mothers and fathers. It thus is important to assess the psychological functioning of both mothers and fathers.

  18. Depression Screening

    Science.gov (United States)

    ... Centers Diseases + Condition Centers Mental Health Medical Library Depression Screening (PHQ-9) - Instructions The following questions are ... this tool, there is also text-only version . Depression Screening - Manual Instructions The following questions are a ...

  19. Sero-Prevalence of Hepatitis B amongst Pregnant Women Attending the Antenatal Clinic of a Tertiary Care Hospital, Jamnagar (Gujarat.

    Directory of Open Access Journals (Sweden)

    Vipul Mansukhbhai Khakhkhar

    2012-06-01

    Full Text Available Abstract: Background: Majority of the transmission of Hepatitis-B in India and other developing countries occurs by vertical transmission from an infected carrier mother to the neonate, intrapartum or antenatally. Up to 90% of babies born to carrier mothers may also become carriers and they are at a very high risk of developing chronic liver disease at a younger age. Aims & Objectives: Present study was done to know the determination of sero-markers of hepatitis B surface antigen (HBsAg amongst pregnant women. Further, to find prevalence of HBeAg and Anti HBe-IgM Ab amongst HBsAg positive pregnant women. Methods: A retrospective study was done based on review of records of pregnant women. Blood samples were collected from 2050 pregnant women with age ranging from 16-40 years during the January 2001 to December 2003. Screening of HBs Ag was done by RPHA method and positive HBsAg tests were confirmed by ELISA. The positive samples were then further tested for HBeAg and Anti-HBe-IgM Ab. Results: Amongst, 2050 pregnant women, 63 (3.07% were positive by RPHA and ELISA. Significant statistical association was found between HBsAg positive carriers 63, with HBeAg positive 11 (17.46% and Anti-HBe IgM Ab positive 18 (28.57% samples (χ2=128.14, P<0.001. Statistically significant association was not found for age group (χ2=8.05, P>0.05, history of disease (χ2=6.56, P>0.05 and trimester of pregnancy (χ2=1.66, P>0.05 with HBsAg positivity in pregnant women. Though, highest HBsAg positivity was found with age group of 21-25 year (4.20%, history of Jaundice (13.95% and third trimester of pregnancy (3.56%. Conclusion: Screening of pregnant women for HBsAg is presently practiced in order to identify those neonates at risk of transmission. However, HBsAg positive mothers should further be screened for HBV markers particularly, the test for HBeAg and Anti-HBe-IgM-Ab which suggests high chances of carrier state. [National J of Med Res 2012; 2(3.000: 362-365

  20. Cancer Screening

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    Krishna Prasad

    2004-10-01

    Full Text Available Cancer screening is a means to detect cancer early with the goal of decreasing morbidity and mortality. At present, there is a reasonable consensus regarding screening for breast, cervical and colorectal cances and the role of screening is under trial in case of cancers of the lung,  ovaries and prostate. On the other hand, good screening tests are not available for some of the commonest cancers in India like the oral, pharyngeal, esophageal and stomach cancers.

  1. Bacteriological study of urinary tract infection in antenatal care patients

    Directory of Open Access Journals (Sweden)

    Srivastava Ritu, Singh Brij N, Begum Rehana, Yadav Ramesh

    2014-04-01

    Full Text Available Aims & Objective: To isolate and diagnose the Uropathogens and its antibiotic sensitivity pattern in anti-natal care patient suffering from Urinary tract Infections. Material and Methods: 150 samples were collected by consent pregnant women between the age group of 18 to 40 years. A midstream clean catch is adequate, provided by all pregnant women’s through given careful instructions. For enumeration of bacteria we perform standard loop techniques method. The number of colonies counted or estimated, and this number used to calculate the number of viable bacteria per ml of urine. The bacterial strains were identified by colonies character stick, gram staining, morphological and biochemical character. The bacterial strains identification was done up to genus and species level. The antibiotics sensitivity test of bacterial strains was done as per CLSI guidelines by Kirby-Baure Disc Diffusion Methods. Results: The significant bactiurea was found in 50 patients among 150 patients used. The most commonly isolated bacteria was Escherichia coli 23(40% Klebsiellaaerogens 11 (22% Staphylococcus aureus 10 (20% Pseudomonas aerugenosa 4(8%.The incidence of bacteriuria among in their first pregnancy was 22.2%.The higher incidence of UTI in 2nd and 3rd trimester was found to have 31.4% & 40%. These studies were showing high level of resistance to first line antibiotics such as Cotrimaxozole. Conclusion: To minimizing the complication of the pregnant women should be educated about the physiology of pregnancy clinical presentation includes asymptomatic bacteria, acute cystitis & pyelonephritis. Pregnant women should be screened for asymptomatic bacteriuria by urine culture and treated with appropriate antibiotics. After the post treatment pregnant women should be examine again to confirm post treatment urine sterility.

  2. Antenatal treatment with corticosteroids for preterm neonates: impact on the incidence of respiratory distress syndrome and intra-hospital mortality

    Directory of Open Access Journals (Sweden)

    Joice Fabíola Meneguel

    Full Text Available CONTEXT: Although the benefits of antenatal corticosteroids have been widely demonstrated in other countries, there are few studies among Brazilian newborn infants. OBJECTIVE: To evaluate the effectiveness of antenatal corticosteroids on the incidence of respiratory distress syndrome and intra-hospital mortality among neonates with a gestational age of less than 34 weeks. TYPE OF STUDY: Cross-sectional. SETTING: A tertiary-care hospital. PARTICIPANTS: Neonates exposed to any dose of antenatal corticosteroids for fetal maturation up to 7 days before delivery, and newborns paired by sex, birth weight, gestational age and time of birth that were not exposed to antenatal corticosteroids. The sample obtained consisted of 205 exposed newborns, 205 non-exposed and 39 newborns exposed to antenatal corticosteroids for whom it was not possible to find an unexposed pair. PROCEDURES: Analysis of maternal and newborn records. MAIN MEASUREMENTS: The primary clinical outcomes for the two groups were compared: the incidence of respiratory distress syndrome and intra-hospital mortality; as well as secondary outcomes related to neonatal morbidity. RESULTS: Antenatal corticosteroids reduced the occurrence of respiratory distress syndrome (OR: 0.33; 95% CI: 0.21-0.51 and the protective effect persisted when adjusted for weight, gestational age and the presence of asphyxia (adjusted OR: 0.27; 95% CI: 0.17-0.43. The protective effect could also be detected through the reduction in the need for and number of doses of exogenous surfactant utilized and the number of days of mechanical ventilation needed for the newborns exposed to antenatal corticosteroids. Their use also reduced the occurrence of intra-hospital deaths (OR: 0.51: 95% CI: 0.38-0.82. However, when adjusted for weight, gestational age, presence of prenatal asphyxia, respiratory distress syndrome, necrotizing enterocolitis and use of mechanical ventilation, the antenatal corticosteroids did not maintain the

  3. Ashkenazi Jewish population screening for Tay-Sachs disease: the international and Australian experience.

    Science.gov (United States)

    Lew, Raelia M; Burnett, Leslie; Proos, Anné L; Barlow-Stewart, Kristine; Delatycki, Martin B; Bankier, Agnes; Aizenberg, Harry; Field, Michael J; Berman, Yemima; Fleischer, Ronald; Fietz, Michael

    2015-03-01

    Internationally, Tay-Sachs disease (TSD) preconception screening of Ashkenazi Jewish (AJ) individuals and couples has led to effective primary prevention of TSD. In Australia, adolescent preconception genetic screening programs operate mainly in Jewish community high schools. These existing programs offer an effective means of primary prevention of TSD, are cost effective and safe. However, in the broader Australian community TSD screening is not systematically performed and cases still occur in unscreened AJ individuals. In order to improve the effectiveness of Australian screening, there is a need for definitive guidelines for healthcare professionals to facilitate extension of the proven benefits of preconception TSD screening to all AJ individuals at risk. We performed a systematic review of the relevant literature relating to AJ pre-conception and antenatal screening for TSD. The evidence was assessed using an established National Health and Medical Research Council evidence grading system. Evaluations of efficacy of TSD screening programs design and execution, cost-benefit and cost-utility health economic evaluation, and population outcomes were undertaken. The results have been used to propose a model for universal AJ TSD preconception and antenatal screening for the primary care setting.

  4. Alloantibodies to human platelet glycoprotein antigens (HPA) and HLA class 1 in a cross section of Nigerian antenatal women.

    Science.gov (United States)

    Jeremiah, Zaccheaus Awortu; Atiegoba, Anne Ifeanyi; Mgbere, Osaro

    2011-01-01

    The prevalence of antibodies to human platelet antigens (HPA) and human leukocyte antigens (HLA) class 1 antigens among Nigerian pregnant women has not been reported in our country. This study was therefore aimed at screening the obstetric population for evidence of alloimmunization due to human platelet and HLA class 1 antigens. One hundred and forty four (144) pregnant women attending the obstetric clinic of Military Hospital, Port Harcourt, participated in the study. Their sera were tested for antibodies to HPA and HLA class 1 antigens using GTI PakPlus solid phase ELISA Kit. The total prevalence rate of antibody production was 60.5% (87 out of 144). Among the positive samples, 60 had platelet glycoprotein specific antibodies (41.7%) and 27 had HLA class 1 antibodies (18.8%). In 39.6% of the pregnant women, both platelet specific antibodies and HLA class 1 antibodies appeared. The prevalence of platelet specific glycoprotein antibodies were obtained as follows: GP 11b/111a 12 (8.3%), GP 1a/11a 35 (20.8%), GP Ib/IX 18 (12.5%) and GP IV 9 (6.3%). The prevalence of each platelet antibody subgroup was obtained as follows: anti-HPA-1a,-3a,-4a (4.2%), anti-HPA-1b,-3b,-4a (4.2%), anti-HPA-30 5a and anti-GP Ib/IX (12.5% each), anti-HPA-5b (8.3%) and anti-GP IV (6.3%). A high prevalence rate of human platelet arid cytotoxic antibodies has been observed in our obstetric population. There is need to establish platelet serology laboratory for the proper antenatal and postnatal management of pregnant mothers in this region.

  5. Breathing Life into Engineering: A Lesson Study Life Science Lesson

    Science.gov (United States)

    Lawrence, Maria; Yang, Li-Ling; Briggs, May; Hession, Alicia; Koussa, Anita; Wagoner, Lisa

    2016-01-01

    A fifth grade life science lesson was implemented through a lesson study approach in two fifth grade classrooms. The research lesson was designed by a team of four elementary school teachers with the goal of emphasizing engineering practices consistent with the "Next Generation Science Standards" (NGSS) (Achieve Inc. 2013). The fifth…

  6. Creating A Guided- discovery Lesson

    Institute of Scientific and Technical Information of China (English)

    田枫

    2005-01-01

    In a guided - discovery lesson, students sequentially uncover layers of mathematical information one step at a time and learn new mathematics. We have identified eight critical steps necessary in developing a successful guided- discovery lesson.

  7. Influence of pregnancy perceptions on patterns of seeking antenatal care among women in reproductive age of Masaka District, Uganda.

    Science.gov (United States)

    Atekyereza, Peter R; Mubiru, Kenneth

    2014-10-01

    Maternal mortality remains a challenge in Sub-Saharan Africa including Uganda. Antenatal Care (ANC) is one of the recommended measures to improve maternal and child health. However, the influence of pregnancy definition and perception on patterns of seeking regular and timely antenatal care among women in the reproductive age group (15-49 years) is not known. The objectives of this study were to: (i) understand the women's social definitions and perceptions on their pregnancy; (ii) understand the socio-cultural beliefs related to pregnancy among women of the reproductive age group; and, (iii) examine the influence of social definitions, perceptions and beliefs about pregnancy on women's antenatal care seeking behaviour patterns to inform the decentralised health care delivery system in Uganda. A total of 45 women, mothers and expectant women who were purposively selected from Kimanya sub county of Masaka district in Uganda participated in the study. Ten key informant interviews and four Focus Group Discussions (FGDs) were also conducted. Key findings indicate that the women's socio-definitions and perceptions of pregnancy influence their seeking behaviour on antenatal health care. To the women with a positive orientation towards antenatal care, pregnancy provides joy, happiness, pride, promotes their social status and safe-guards their marriage. Pregnancy is rewarding with care, love, support and gifts. Women who shun antenatal care perceive pregnancy to be a source of misery, sadness, pain and suffering. It is an uncomfortable and regrettable experience. Women also hold socio-cultural beliefs on pregnancy, which are culturally constructed and rooted in taboos, rituals and practices of their communities. It is therefore important to sensitise women and those who attend to them when they are pregnant to understand these perceptions and definitions to motivate them to seek antenatal and postnatal care for better maternal and child health.

  8. Colon cancer screening

    Science.gov (United States)

    Screening for colon cancer; Colonoscopy - screening; Sigmoidoscopy - screening; Virtual colonoscopy - screening; Fecal immunochemical test; Stool DNA test; sDNA test; Colorectal cancer - screening; Rectal ...

  9. A Lesson-Planning Model

    Science.gov (United States)

    Linder, Sandra M.

    2010-01-01

    Many models of planning and lesson construction in the United States advocate an objective-driven approach whereby teachers create performance-based goals that their students should accomplish by the end of the lesson. Teachers then evaluate lessons by determining if students have accomplished these objectives. Often, this model of planning…

  10. Lesson Planning the Kodaly Way.

    Science.gov (United States)

    Boshkoff, Ruth

    1991-01-01

    Discusses the contribution of Zoltan Kodaly to music lesson planning. Emphasizes preparation, presentation, and practice as the three important strategies in teaching concepts and skills to be included in a lesson plan. Includes a sample lesson plan covering a semester and advice on choosing song material. (DK)

  11. Estimation of the incidence of bacterial vaginosis and other vaginal infections and its consequences on maternal/fetal outcome in pregnant women attending an antenatal clinic in a tertiary care hospital in North India

    Directory of Open Access Journals (Sweden)

    Lata Indu

    2010-01-01

    Full Text Available Aims: This study was undertaken to estimate the incidence of bacterial vaginosis (BV and other vaginal infections during pregnancy and its association with urinary tract infections (UTI and its consequences on pregnancy outcome, maternal and fetal morbidity and mortality. Settings and Design: Prospective cohort study. Materials and Methods: The present prospective cohort study was conducted on 200 women attending the antenatal clinic (ANC of a tertiary hospital. All pertinent obstetric and neonatal data covering antenatal events during the course of pregnancy, delivery, puerperium and condition of each newborn at the time of birth were collected. BV was detected by both Gram stain and gold standard clinical criteria (Amsel′s composite criteria. Statistical analysis used: Data were analyzed using SPSS version 9. Fischer′s exact test, chi square tests and Student′s′ test has been used for analysis. The probability of 5% was considered as significant for continuous variables such as age, period of gestation and birth weight. Odds ratio (OR and confidence interval (CI with 95% probability were determined. Results: The incidence of bacterial vaginosis was 41 in 200 patients. Adverse outcomes such as preterm labor, PROM and fetal complications were found more in pregnant women who had bacterial vaginosis (N=41, bacterial vaginosis with UTI (N=14 as compared to those without bacterial vaginosis (N=118. Conclusions: The incidence of poor pregnancy outcome was higher in bacterial vaginosis with UTI. Prevention of BV and UTI is cost effective to minimize the pregnancy-related complications and preterm labor to decrease in perinatal and maternal mortality and morbidity. We recommend all antenatal patients should be screened for the presence of bacterial vaginosis, other infections and UTI.

  12. Responsible implementation of expanded carrier screening

    Science.gov (United States)

    Henneman, Lidewij; Borry, Pascal; Chokoshvili, Davit; Cornel, Martina C; van El, Carla G; Forzano, Francesca; Hall, Alison; Howard, Heidi C; Janssens, Sandra; Kayserili, Hülya; Lakeman, Phillis; Lucassen, Anneke; Metcalfe, Sylvia A; Vidmar, Lovro; de Wert, Guido; Dondorp, Wybo J; Peterlin, Borut

    2016-01-01

    This document of the European Society of Human Genetics contains recommendations regarding responsible implementation of expanded carrier screening. Carrier screening is defined here as the detection of carrier status of recessive diseases in couples or persons who do not have an a priori increased risk of being a carrier based on their or their partners' personal or family history. Expanded carrier screening offers carrier screening for multiple autosomal and X-linked recessive disorders, facilitated by new genetic testing technologies, and allows testing of individuals regardless of ancestry or geographic origin. Carrier screening aims to identify couples who have an increased risk of having an affected child in order to facilitate informed reproductive decision making. In previous decades, carrier screening was typically performed for one or few relatively common recessive disorders associated with significant morbidity, reduced life-expectancy and often because of a considerable higher carrier frequency in a specific population for certain diseases. New genetic testing technologies enable the expansion of screening to multiple conditions, genes or sequence variants. Expanded carrier screening panels that have been introduced to date have been advertised and offered to health care professionals and the public on a commercial basis. This document discusses the challenges that expanded carrier screening might pose in the context of the lessons learnt from decades of population-based carrier screening and in the context of existing screening criteria. It aims to contribute to the public and professional discussion and to arrive at better clinical and laboratory practice guidelines. PMID:26980105

  13. Responsible implementation of expanded carrier screening.

    Science.gov (United States)

    Henneman, Lidewij; Borry, Pascal; Chokoshvili, Davit; Cornel, Martina C; van El, Carla G; Forzano, Francesca; Hall, Alison; Howard, Heidi C; Janssens, Sandra; Kayserili, Hülya; Lakeman, Phillis; Lucassen, Anneke; Metcalfe, Sylvia A; Vidmar, Lovro; de Wert, Guido; Dondorp, Wybo J; Peterlin, Borut

    2016-06-01

    This document of the European Society of Human Genetics contains recommendations regarding responsible implementation of expanded carrier screening. Carrier screening is defined here as the detection of carrier status of recessive diseases in couples or persons who do not have an a priori increased risk of being a carrier based on their or their partners' personal or family history. Expanded carrier screening offers carrier screening for multiple autosomal and X-linked recessive disorders, facilitated by new genetic testing technologies, and allows testing of individuals regardless of ancestry or geographic origin. Carrier screening aims to identify couples who have an increased risk of having an affected child in order to facilitate informed reproductive decision making. In previous decades, carrier screening was typically performed for one or few relatively common recessive disorders associated with significant morbidity, reduced life-expectancy and often because of a considerable higher carrier frequency in a specific population for certain diseases. New genetic testing technologies enable the expansion of screening to multiple conditions, genes or sequence variants. Expanded carrier screening panels that have been introduced to date have been advertised and offered to health care professionals and the public on a commercial basis. This document discusses the challenges that expanded carrier screening might pose in the context of the lessons learnt from decades of population-based carrier screening and in the context of existing screening criteria. It aims to contribute to the public and professional discussion and to arrive at better clinical and laboratory practice guidelines.

  14. The history of a lesson

    DEFF Research Database (Denmark)

    Rasmussen, Mikkel Vedby

    2003-01-01

    and emphasises the need to study the history of lessons rather than the lessons of history. This approach shows that Munich is the end point of a constitutive history that begins in the failure of the Versailles treaty to create a durable European order following the First World War. The Munich lesson is thus...... one element of the lesson of Versailles, which is a praxeology that defines how the West is to make peace, and against whom peace must be defended. The lesson of Versailles has been, at least in part, constitutive of the outbreak of the Cold War, and it continues to define the Western conception...

  15. Psychosocial Characteristics and Obstetric Health of Women Attending a Specialist Substance Use Antenatal Clinic in a Large Metropolitan Hospital

    Directory of Open Access Journals (Sweden)

    Lucy Burns

    2011-01-01

    Full Text Available Objective. This paper reports the findings comparing the obstetrical health, antenatal care, and psychosocial characteristics of pregnant women with a known history of substance dependence (n=41 and a comparison group of pregnant women attending a general antenatal clinic (n=47. Method. Face-to-face interviews were used to assess obstetrical health, antenatal care, physical and mental functioning, substance use, and exposure to violence. Results. The substance-dependent group had more difficulty accessing antenatal care and reported more obstetrical health complications during pregnancy. Women in the substance-dependent group were more likely to report not wanting to become pregnant and were less likely to report using birth control at the time of conception. Conclusions. The profile of pregnant women (in specialised antenatal care for substance dependence is one of severe disadvantage and poor health. The challenge is to develop and resource innovative and effective multisectoral systems to educate women and provide effective care for both women and infants.

  16. Practices of rural Egyptian birth attendants during the antenatal, intrapartum and early neonatal periods.

    Science.gov (United States)

    Darmstadt, Gary L; Hussein, Mohamed Hassan; Winch, Peter J; Haws, Rachel A; Gipson, Reginald; Santosham, Mathuram

    2008-03-01

    Neonatal deaths account for almost two-thirds of infant mortality worldwide; most deaths are preventable. Two-thirds of neonatal deaths occur during the first week of life, usually at home. While previous Egyptian studies have identified provider practices contributing to maternal mortality, none has focused on neonatal care. A survey of reported practices of birth attendants was administered. Chi-square tests were used for measuring the statistical significance of inter-regional differences. In total, 217 recently-delivered mothers in rural areas of three governorates were interviewed about antenatal, intrapartum and postnatal care they received. This study identified antenatal advice of birth attendants to mothers about neonatal care and routine intrapartum and postpartum practices. While mothers usually received antenatal care from physicians, traditional birth attendants (dayas) conducted most deliveries. Advice was rare, except for breastfeeding. Routine practices included hand-washing by attendants, sterile cord-cutting, prompt wrapping of newborns, and postnatal home visits. Suboptimal practices included lack of disinfection of delivery instruments, unhygienic cord care, lack of weighing of newborns, and lack of administration of eye prophylaxis or vitamin K. One-third of complicated deliveries occurred at home, commonly attended by relatives, and the umbilical cord was frequently pulled to hasten delivery of the placenta. In facilities, mothers reported frequent use of forceps, and asphyxiated neonates were often hung upside-down during resuscitation. Consequently, high rates of birth injuries were reported. Priority areas for behaviour change and future research to improve neonatal health outcomes were identified, specific to type of provider (physician, nurse, or daya) and regional variations in practices.

  17. Inequalities in advice provided by public health workers to women during antenatal sessions in rural India.

    Directory of Open Access Journals (Sweden)

    Abhishek Singh

    Full Text Available OBJECTIVES: Studies have widely documented the socioeconomic inequalities in maternal and child health related outcomes in developing countries including India. However, there is limited research on the inequalities in advice provided by public health workers on maternal and child health during antenatal visits. This paper investigates the inequalities in advice provided by public health workers to women during antenatal visits in rural India. METHODS AND FINDINGS: The District Level Household Survey (2007-08 was used to compute rich-poor ratios and concentration indices. Binary logistic regressions were used to investigate inequalities in advice provided by public health workers. The dependent variables comprised the advice provided on seven essential components of maternal and child health care. A significant proportion of pregnant women who attended at least four ANC sessions were not advised on these components during their antenatal sessions. Only 51%-72% of the pregnant women were advised on at least one of the components. Moreover, socioeconomic inequalities in providing advice were significant and the provision of advice concentrated disproportionately among the rich. Inequalities were highest in the case of advice on family planning methods. Advice on breastfeeding was least unequal. Public health workers working in lower level health facilities were significantly less likely than their counterparts in the higher level health facilities to provide specific advice. CONCLUSION: A significant proportion of women were not advised on recommended components of maternal and child health in rural India. Moreover, there were enormous socioeconomic inequalities. The findings of this study raise questions about the capacity of the public health care system in providing equitable services in India. The Government of India must focus on training and capacity building of the public health workers in communication skills so that they can deliver

  18. Quality of antenatal care in rural Tanzania: counselling on pregnancy danger signs

    Directory of Open Access Journals (Sweden)

    Lindmark Gunilla

    2010-07-01

    Full Text Available Abstract Background The high rate of antenatal care attendance in sub-Saharan Africa, should facilitate provision of information on signs of potential pregnancy complications. The aim of this study was to assess quality of antenatal care with respect to providers' counselling of pregnancy danger signs in Rufiji district, Tanzania. Methods A cross-sectional study was conducted in 18 primary health facilities. Thirty two providers were observed providing antenatal care to 438 pregnant women. Information on counselling on pregnancy danger signs was collected by an observer. Exit interviews were conducted to 435 women. Results One hundred and eighty five (42% clients were not informed of any pregnancy danger signs. The most common pregnancy danger sign informed on was vaginal bleeding 50% followed by severe headache/blurred vision 45%. Nurse auxiliaries were three times more likely to inform a client of a danger sign than registered/enrolled nurses (OR = 3.7; 95% CI: 2.1-6.5 and Maternal Child Health Aides (OR = 2.3: 95% CI: 1.3-4.3 and public health nurses (OR = 2.5; CI: 1.4-4.2 were two times more likely to provide information on danger signs than registered/enrolled nurses. The clients recalled less than half of the pregnancy danger signs they had been informed during the interaction. Conclusion Two out of five clients were not counselled on pregnancy danger signs. The higher trained cadre, registered/enrolled nurses were not informing majority of clients pregnancy danger signs compared to the lower cadres. Supportive supervision should be made to enhance counselling of pregnancy danger signs. Nurse auxiliaries should be encouraged and given chance for further training and upgrading to improve their performance and increase human resource for health.

  19. Antenatal corticosteroids impact the inflammatory rather than the antiangiogenic profile of women with preeclampsia.

    Science.gov (United States)

    Nayeri, Unzila A; Buhimschi, Irina A; Laky, Christine A; Cross, Sarah N; Duzyj, Christina M; Ramma, Wenda; Sibai, Baha M; Funai, Edmund F; Ahmed, Asif; Buhimschi, Catalin S

    2014-06-01

    Circulating antiangiogenic factors and proinflammatory cytokines are implicated in the pathogenesis of preeclampsia. This study was performed to test the hypothesis that steroids modify the balance of inflammatory and proangiogenic and antiangiogenic factors that potentially contribute to the patient's evolving clinical state. Seventy singleton women, admitted for antenatal corticosteroid treatment, were enrolled prospectively. The study group consisted of 45 hypertensive women: chronic hypertension (n=6), severe preeclampsia (n=32), and superimposed preeclampsia (n=7). Normotensive women with shortened cervix (preeclampsia cases were obtained before steroids and then serially up until delivery. A clinical severity score was designed to clinically monitor disease progression. Serum levels of angiogenic factors (soluble fms-like tyrosine kinase-1 [sFlt-1], placental growth factor [PlGF], soluble endoglin [sEng]), endothelin-1 (ET-1), and proinflammatory markers (IL-6, C-reactive protein [CRP]) were assessed before and after steroids. Soluble IL-2 receptor (sIL-2R) and total immunoglobulins (IgG) were measured as markers of T- and B-cell activation, respectively. Steroid treatment coincided with a transient improvement in clinical manifestations of preeclampsia. A significant decrease in IL-6 and CRP was observed although levels of sIL-2R and IgG remained unchanged. Antenatal corticosteroids did not influence the levels of angiogenic factors but ET-1 levels registered a short-lived increase poststeroids. Although a reduction in specific inflammatory mediators in response to antenatal steroids may account for the transient improvement in clinical signs of preeclampsia, inflammation is unlikely to be the major contributor to severe preeclampsia or useful for therapeutic targeting.

  20. Women's experiences and views about costs of seeking malaria chemoprevention and other antenatal services

    DEFF Research Database (Denmark)

    Mubyazi, Godfrey M.; Bloch, Paul; Magnussen, Pascal

    2010-01-01

    ABSTRACT: BACKGROUND: The Tanzanian government recommends women who attend antenatal care (ANC) clinics to accept receiving intermittent preventive treatment against malaria during pregnancy (IPTp) and vouchers for insecticide-treated nets (ITNs) at subsidized prices. Little emphasis has been paid...... and indirect costs, travel distances and waiting time. Strengthening of user-fee exemption practices and bringing services closer to the users, for example by promoting community-directed control of selected public health services, including IPTp, are urgently needed measures for increasing equity in health...

  1. Patients’ perspectives on antenatal group consultations: Identifying communicative strengths and weaknesses

    DEFF Research Database (Denmark)

    Jensen, Matilde Nisbeth; Fage-Butler, Antoinette Mary

    -patient communication unfolds in a group consultation with a midwife in order to identify its communicative strengths and weaknesses. Methods: Using a sequential multi-methods design, we performed eight individual interviews with pregnant women from a Danish antenatal clinic about their experiences of two group...... effect, and the power of experiential knowledge became clear when second-time pregnant women shared their experiences with women who were pregnant with their first baby, prompting new sets of questions and answers. Interviewees highlighted the fact that group composition affected their experiences...

  2. Noninvasive Antenatal Determination of Fetal Blood Group Using Next-Generation Sequencing

    DEFF Research Database (Denmark)

    Rieneck, Klaus; Clausen, Frederik Banch; Dziegiel, Morten Hanefeld

    2015-01-01

    Hemolytic disease of the fetus and newborn (HDFN) is a condition characterized by a decreased lifespan of fetal red blood cells caused by maternally produced allospecific antibodies transferred to the fetus during pregnancy. The antibodies bind to the corresponding blood group antigens on fetal red....... This determination carries no risk to the fetus. It is important to determine if the fetus is at risk of hemolysis to enable timely intervention. Many tests for blood groups are based solely on the presence or absence of a single nucleotide polymorphism (SNP). Antenatal determination of fetal blood group by NGS...

  3. [Effects of alcoholic intoxication in the antenatal period on the development of male germ cells].

    Science.gov (United States)

    Khil'kevich, L V; Kirilo, L F

    1992-09-01

    During 1-20 days of pregnancy rats were given 20% alcohol orally in a dose 0.4 mg/kg bw. This led to a significant increase in the nuclear volume of germ cells in male 19-day embryos. A karyological analysis of 2-month offspring germ cell generations at stage VII of seminiferous epithelium cycle revealed a reliable decrease in the number of spermatids on step 7 of development after introduction of antenatal alcohol. The increased proportion of spermatocytes with meiotic chromosomes pathological behaviour due to alcohol was determined by the proposed quantitative analysis of meiotic divisions.

  4. Ellis Van Creveld Syndrome with Synpolydactyly, an Antenatal Diagnosis with Postnatal Correlation

    Directory of Open Access Journals (Sweden)

    Nischal G Kundaragi

    2011-01-01

    Full Text Available Ellis Van Creveld syndrome (EVC, also known as chondroectodermal dysplasia, presents at birth with short limbs accompanied by postaxial polydactyly, nail dysplasia, and dental anomalies. Other manifestations of EVC include atrial septum defects and other congenital heart diseases. We report a case of the EVC syndrome with postaxial polydactyly (Synpolydactyly with seven fingers on the right side and hexadactyly on the left side and a partial atrioventricular canal defect diagnosed antenatally. This variation of EVS has not been reported in English literature till date.

  5. Ellis van creveld syndrome with synpolydactyly, an antenatal diagnosis with postnatal correlation.

    Science.gov (United States)

    Kundaragi, Nischal G; Taori, Kishor; Kumawat, Ritesh; Rathod, Jawahar; Sawant, Atul E

    2011-01-01

    Ellis Van Creveld syndrome (EVC), also known as chondroectodermal dysplasia, presents at birth with short limbs accompanied by postaxial polydactyly, nail dysplasia, and dental anomalies. Other manifestations of EVC include atrial septum defects and other congenital heart diseases. We report a case of the EVC syndrome with postaxial polydactyly (Synpolydactyly with seven fingers on the right side and hexadactyly on the left side) and a partial atrioventricular canal defect diagnosed antenatally. This variation of EVS has not been reported in English literature till date.

  6. Dracula. [Lesson Plan].

    Science.gov (United States)

    Discovery Communications, Inc., Bethesda, MD.

    Based on Bram Stoker's novel "Dracula," this lesson plan presents activities designed to help students understand that some fictional literary characters become so famous that they enter popular culture in other forms (movies, games, toys); and that working on a product such as a game often demands collaborative effort. The main activity of the…

  7. From a writing lesson

    Directory of Open Access Journals (Sweden)

    Bruno Mafra Ney Reinhardt

    Full Text Available Beginning with Jacques Derrida's interpolation of the celebrated chapter A Writing Lesson by Claude Lévi-Strauss's, and James Clifford critique of the ethnographic text, the authors of this essay reflect on the written dimension of the ethnographic métier.

  8. Brothers Grimm. [Lesson Plan].

    Science.gov (United States)

    Discovery Communications, Inc., Bethesda, MD.

    Based on Grimm's fairy tales, this lesson plan presents activities designed to help students understand that fairy tales connect them to earlier generations, help them think about present situations, that magic figures prominently in fairy tales, and that fairy tales can inspire readers to create original works of art. The main activity in the…

  9. A Lesson from Mangroves.

    Science.gov (United States)

    Davis, Stephen

    1987-01-01

    Discusses the importance of interpretive programs in the Northern Territory of Australia. Describes the typical interpretive approach of local school science curricula, which serve 20,000 Aboriginal children. Addresses the curriculum framework, learning strategies, and process skill development, illustrating them through a lesson on mangroves. (TW)

  10. A Makeup Lesson.

    Science.gov (United States)

    Eagles, Cheryl

    1991-01-01

    Presents a hands-on lesson that can integrate the use of makeup with studies of the history of Halloween; the history and practices of the theater; Native American or African tribes and their use of paint, makeup, and masks; and the history, skills, and makeup of clowns. (MDH)

  11. Cooperative Science Lesson Plans.

    Science.gov (United States)

    Cooperative Learning, 1991

    1991-01-01

    Offers several elementary level cooperative science lesson plans. The article includes a recipe for cooperative class learning, instructions for making a compost pile, directions for finding evidence of energy, experiments in math and science using oranges to test density, and discussions of buoyancy using eggs. (SM)

  12. Screening CO

    NARCIS (Netherlands)

    Ramírez, A.; Hagedoorn, S.; Kramers, L.; Wildenborg, T.; Hendriks, C.

    2010-01-01

    This paper describes the development and application of a methodology to screen and rank Dutch reservoirs suitable for long-term large scale CO2 storage. The screening focuses on off- and on-shore individual aquifers, gas and oil fields. In total 176 storage reservoirs have been taken int

  13. Antenatal and neonatal visits increase complete immunization status among children aged 12-23 months in rural area of Indonesia

    Directory of Open Access Journals (Sweden)

    Suparmi Suparmi

    2015-01-01

    Full Text Available AbstrakLatar Belakang: Anak yang memiliki status imunisasi dasarlengkap di daerah pedesaan di Indonesia lebih rendah dibandingkan di perkotaan. Penelitian ini menilai hubungan kunjungan antenatal dan neonatal terhadap status imunisasi lengkap pada anak usia 12-23 bulan di daerah pedesaan Indonesia.Metode: Penilaian menggunakan data Riset Kesehatan Dasar 2013 (Riskesdas. Sub-sampel terdiri dari anak usia 12-23 bulan di daerah pedesaan. Dari 8747 anak umur 12-23 bulan di wilayah perdesaan, 5452 memiliki data yang lengkap untuk dilakukan analisis. Status imunisasi dasar lengkap berdasarkan catatan pada kartu imunisasi dan wawancara. Analisis menggunakan regresi Cox dengan waktu yang konstan.Hasil: Dari 5452 responden, 52,8% (2880/5452 mempunyai imunisasi dasar lengkap. Faktor-faktor dominan yang berhubungan dengan status dasar imunisasi lengkap adalah kunjungan antenatal dan neonatal, indeks kekayaan, pendidikan ibu, dan pekerjaan ibu. Dibandingkan dengan yang tidak melakukan kunjungan antenatal, mereka yang melakukan kunjungan antenatal 38% lebih besar kemungkinan mendapatkan imunisasi dasar lengkap [risiko relatif suaian (RRa = 1,38; 95% interval kepercayaan (CI = 1,27-1,50; P = 0,000]. Menurut kunjungan neonatal, mereka yang melakukan kunjungan neonatal 37% lebih besar untuk mendapatkan imunisasi dasar yang lengkap dibandingkan dengan yang tidak melakukan kunjungan neonatal (RRa = 1,37; 95% CI = 1,29-1,46; P = 0,000.Kesimpulan: Anak-anak di pedesaan Indonesia yang melakukan kunjungan antenatal dan neonatal lebih mempunyai kemungkinan mendapatkan imunisasi dasar lengkap.  (Health Science Indones 2014;2:73-7Kata kunci: imunisasi dasar lengkap, kunjungan antenatal dan neonatal, pedesaanAbstractBackground: The children who had complete basic immunization status in rural areas in Indonesia was lower than in urban areas. This study assessed the association of antenatal and neonatal visits with complete immunization status among children aged 12

  14. Application of Ultrasonography Measuring the Thickness of the Fetal Nuchal Translucency in Antenatal Examination%超声测量胎儿颈项透明层厚度在产前筛查中的应用

    Institute of Scientific and Technical Information of China (English)

    梁庄

    2012-01-01

    Ultrasonography oi the fetus is accurate and safe in diagnosis with non-invasive, no teratogenir efferts,and no additive effert. It's ruiTently the preferred diagnostic imaging method oi screening the ietal malformations and obstetrie prenatal diagnosis. Antenatal examination is the necessary method oi diagnosing ietal malformation currently, and at the 11-13+6weeks oi gestation ultrasound screening for the measurement oi ietal nuchal translucency is the most significant examination in first trimester oi pregnancy, which is especially now considered the most sensitive target ior screening the ietal chromosomal all normalities. Here is to make a review on the application oi ultrsonography measuring the thickness oi the ietal nuchal translucency in antenatal examination.%超声检查对胎儿无创伤、无致畸作用、无叠加效应,诊断准确且安全性高,是目前产科产前诊断与筛查胎儿畸形首选的影像诊断方法.产前筛查是目前诊断胎儿畸形的必要手段,孕11 ~13+6周超声测量胎儿颈项透明层(NT)厚度是孕早期诊断胎儿畸形最有意义的一项检查,特别是筛查染色体异常的较敏感的指标.现将超声测量胎儿NT厚度在产前筛查中的应用予以综述.

  15. Coverage and quality of antenatal care provided at primary health care facilities in the 'Punjab' province of 'Pakistan'.

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    Muhammad Ashraf Majrooh

    Full Text Available BACKGROUND: Antenatal care is a very important component of maternal health services. It provides the opportunity to learn about risks associated with pregnancy and guides to plan the place of deliveries thereby preventing maternal and infant morbidity and mortality. In 'Pakistan' antenatal services to rural population are being provided through a network of primary health care facilities designated as 'Basic Health Units and Rural Health Centers. Pakistan is a developing country, consisting of four provinces and federally administered areas. Each province is administratively subdivided in to 'Divisions' and 'Districts'. By population 'Punjab' is the largest province of Pakistan having 36 districts. This study was conducted to assess the coverage and quality antenatal care in the primary health care facilities in 'Punjab' province of 'Pakistan'. METHODS: Quantitative and Qualitative methods were used to collect data. Using multistage sampling technique nine out of thirty six districts were selected and 19 primary health care facilities of public sector (seventeen Basic Health Units and two Rural Health Centers were randomly selected from each district. Focus group discussions and in-depth interviews were conducted with clients, providers and health managers. RESULTS: The overall enrollment for antenatal checkup was 55.9% and drop out was 32.9% in subsequent visits. The quality of services regarding assessment, treatment and counseling was extremely poor. The reasons for low coverage and quality were the distant location of facilities, deficiency of facility resources, indifferent attitude and non availability of the staff. Moreover, lack of client awareness about importance of antenatal care and self empowerment for decision making to seek care were also responsible for low coverage. CONCLUSION: The coverage and quality of the antenatal care services in 'Punjab' are extremely compromised. Only half of the expected pregnancies are enrolled and

  16. Asymptomatic bacteriuria among antenatal women attending a tertiary care hospital in Kanchipuram: evaluation of screening tests and antibiotic susceptibility pattern

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    Abirami Lakshmy Jayachandran

    2016-02-01

    Results: Out of the 120 samples 14 (11.66% were positive for asymptomatic bacteriuria. The Gram staining showed specificity and negative predictive value of 95.2% and 98.1% respectively. Pus cell count showed a specificity and negative predictive value of 96.29% and 98.11% respectively. Escherichia coli were the predominant species isolated 5 (35.7%. Among the gram negative bacteria, amikacin and nitrofurantoin showed a susceptibility of 90% and 80% each. All the staphylococcus aureus isolates showed 100% sensitivity for nitrofurantoin. Two Klebsiella spp and one Escherichia coli isolate were identified as ESBL producers. Among the S. aureus isolates 3 were identified as Methicillin resistant (MRSA. Conclusions: Urine culture should be performed for all pregnant women irrespective of the symptoms and should be treated promptly to prevent the complications arising out of ASB. [Int J Res Med Sci 2016; 4(2.000: 540-544

  17. Antenatal taurine supplementation for improving brain ultrastructure in fetal rats with intrauterine growth restriction.

    Science.gov (United States)

    Liu, J; Liu, L; Chen, H

    2011-05-05

    Changes in brain ultrastructure of fetal rats with intrauterine growth restriction (IUGR) were explored and the effects of antenatal taurine supplementation on their brain ultrastructure were determined. Fifteen pregnant rats were randomly divided into three groups: control group, IUGR model group and IUGR group given antenatal taurine supplements. Taurine was added to the diet of the taurine group at a dose of 300 mg/kg/d from 12 days after conception until natural delivery. Transmission electron microscopy was used to observe ultrastructural changes in the brains of the newborn rats. At the same time, brain cellular apoptosis was detected using TUNEL, and the changes in protein expression of neuron specific enolase and glial fibrillary acidic protein were analyzed using immunohistochemistry. The results showed that: 1) The average body weight and cerebral weight were significantly lower in the IUGR group than in the control group (ptaurine was supplemented (ptaurine supplementation. 3) The results of TUNEL showed that the counts of apoptotic brain cells in IUGR groups were significantly increased from those in control groups and that taurine could significantly decrease brain cell apoptosis (ptaurine-supplementation could significantly increase the counts of neuron specific enolase and glial fibrillary acidic protein immunoreactive cells in fetal rats with IUGR (ptaurine can significantly improve the IUGR fetal brain development.

  18. Unilateral pulmonary agenesis: a report of four cases, two diagnosed antenatally and literature review.

    Science.gov (United States)

    Kayemba-Kay's, S; Couvrat-Carcauzon, V; Goua, V; Podevin, G; Marteau, M; Sapin, E; Levard, G

    2014-03-01

    Pulmonary agenesis is a rare congenital malformation of lung development defined as complete absence of lung tissues, bronchi, and pulmonary vessels; it may be uni- or bilateral. The right-sided form carries the poorest prognosis due to severity of co-existent anomalies. Its diagnostic circumstances are variables: first reported cases were diagnosed at autopsy, but early postnatal as well as fortuitous discovery have been reported. In recent years, progress in obstetrical imaging has made antenatal diagnosis possible so that fetal ultrasound and MRI allow early diagnosis and refinement by permitting the elimination of differential diagnoses (diaphragmatic hernia, cystic adenomatoid malformation of the lung, giant lobar emphysema, and situs inversus). This anomaly is compatible with normal life provided co-existent malformations are thoroughly investigated and managed in a multidisciplinary setting. We report four cases of lung agenesis two of which were diagnosed antenatally at 23rd and 30th weeks of gestation respectively. Our aim is to describe the circumstances having led to diagnosis and report both follow-up and outcome of our patients.

  19. A STUDY OF KNOWLEDGE, ATTITUDE & PRACTICE OF FAMILY PLANNING METHODS AMONG ANTENATAL WOMEN OF ANDHRA PRADESH

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    Shailaja

    2015-01-01

    Full Text Available OBJECTIVE: To assess the knowledge and attitude regarding family planning and the practice of contraceptives among Antenatal women attending OPD and to determine the prevalence of unintended pregnancy among them. METHOD: A cross sectional descriptive study was done in the Obstetrics and Gynecology Department of Andhra Medical College Visakhapatnam which is a tertiary center for three districts Visakhapatnam , Vijayanagaram , and Srika kulam. 499 antenatal women attending the OPD were included in the study. Their knowledge , attitude and practice on contraceptives were evaluated with the help of a predesigned questionnaire. RESULTS: Overall awareness of permanent methods of family plannin g 96.3% and that of temporary methods is only 62.9% (314. 69.9% of women became aware of contraceptive method , by obtaining information from relatives and friends and 23.2% from media (television. 42.1% are of the opinion that these contraceptive methods are available in the medical shops and only 13% know that they are available in the government hospitals. 99.8% are aware of female sterilization , and 92.8% are aware of vasectomy. But awareness of temporary methods is very poor. CONCLUSION: The study hig hlights that knowledge and awareness doesn’t always lead to the use of contraceptives. There is still a need to educate and motivate the couples and improve family planning services to achieve more effective and appropriate use of contraceptives and to arr est the trend towards increase in population

  20. The perception of midwives regarding psychosocial risk assessment during antenatal care

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    Johanna M. Mathibe-Neke

    2014-05-01

    Full Text Available Background: The physiological and psychological changes caused by pregnancy may increase a woman’s vulnerability to depression, which may in turn have adverse effects on both maternal and foetal wellbeing. Inadequate psychosocial risk assessment of women by midwives may lead to lack of psychosocial support during pregnancy and childbirth. Pregnant women who lack psychosocial support may experience stress, anxiety and depression that could possibly affect foetal wellbeing. Objective:The objective of this study was toexplore and describe the perception of psychosocial risk assessment and psychosocial care by midwives providing antenatal care to pregnant women. Method: An interpretive and descriptive qualitative approach was adopted. Three focus group interviews were conducted with midwives working in three Maternal Obstetric Units in Gauteng Province, using a semi-structured interview guide. The constant comparison data analysis approach was used. Results:Findings revealed that midwives are aware of and have encountered a high prevalence of psychosocial problems in pregnant women. Furthermore, they acknowledged the importance of psychosocial care for pregnant women although they stated that they were not equipped adequately to offer psychosocial assessment and psychosocial care. Conclusion:The findings provided a basis for incorporation of psychosocial care into routine antenatal care.

  1. Jacques Ranciere's Lesson on the Lesson

    Science.gov (United States)

    Chambers, Samuel A.

    2013-01-01

    This article examines the significance of Jacques Ranciere's work on pedagogy, and argues that to make sense of Ranciere's "lesson on the lesson" one must do more but also less than merely explicate Ranciere's texts. It steadfastly refuses to draw out the lessons of Ranciere's writings in the manner of a series of…

  2. Quadruple screen test

    Science.gov (United States)

    Quad screen; Multiple marker screening; AFP plus; Triple screen test; AFP maternal; MSAFP; 4-marker screen; Down syndrome - quadruple; Trisomy 21 - quadruple; Turner syndrome - quadruple; Spina bifida - ...

  3. Hypertension screening

    Science.gov (United States)

    Foulke, J. M.

    1975-01-01

    An attempt was made to measure the response to an announcement of hypertension screening at the Goddard Space Center, to compare the results to those of previous statistics. Education and patient awareness of the problem were stressed.

  4. Airport Screening

    Science.gov (United States)

    ... cannot become radioactive from this procedure. However, some photographic film may need to be hand-screened because ... level. An American National Standards Institute/Health Physics Society industry standard states that the maxi- mum allowable ...

  5. Toxicology screen

    Science.gov (United States)

    Toxicology screening is most often done using a blood or urine sample. However, it may be done soon after the person swallowed the medication, using stomach contents taken through gastric lavage (stomach pumping) or after vomiting.

  6. The psychological and psychiatric effects of terrorism: lessons from London.

    Science.gov (United States)

    Rubin, G James; Wessely, Simon

    2013-09-01

    The 7 July 2005 bombings in London caused heightened levels of distress among some in the general community. This distress was most notable in Muslims and members of ethnic minority groups. These effects were transient for most. An estimated 30% of those who were more affected by the attacks, including victims and witnesses, developed psychiatric disorders as a result. An outreach program was set up to screen those who were exposed to potentially traumatic events and to offer them evidence-based treatment. This article discusses what lessons might be learned from studies of the general community and the screen-and-treat approach.

  7. Lesson plans in surgical training.

    Science.gov (United States)

    Lester, S E; Robson, A K R

    2007-06-01

    Lesson plans in surgery enable trainers and trainees to agree on goals that balance training needs with service commitments. Lesson plans are individualised to the trainee and encourage ownership of learning. They are based on SMART criteria and therefore have a sound educational footing. Most of the work in creating a lesson plan falls to the trainee. The total time for creation of each plan is approximately 20 min. Our use of lesson plans for surgical training has been met with favourable response from both trainer and trainees.

  8. Somalia Operations: Lessons Learned

    Science.gov (United States)

    1995-01-01

    are the only other • .o" ’" "- THE OPERATIONAL COwnTEX FI(GUM1, EI Smoall Gulf of Aden DJIEBO U.S. and SomaMa Flelol Sin 12 SOMALIA OPERATIONS: LESSONS...demeanor that sawess q-d let diplomacy and reasuing wMii achiev- more than arogance. anger, disdain. coon. or sarcasm . PmmmeI mut be able to cope pq

  9. RUSSIAN LESSONS FOR 1999

    CERN Multimedia

    1999-01-01

    This autumn, Russian courses will be continued at CERN for beginners and advanced.The first lesson for advanced students will take place on 6th September at 12.00 noon as scheduled.A general briefing for beginners is planned for Thursday30th September at 17.00 in 54-1-002.For further details, please contact the teacher, Mrs Macha Mikhailova by e-mail at: Vladimir.Mikhailov@cern.ch

  10. Incidence and distribution of pathogens in early-onset neonatal sepsis in the era of antenatal antibiotics.

    Science.gov (United States)

    Kuhn, Pierre; Dheu, Céline; Bolender, Chantal; Chognot, Didier; Keller, Laurence; Demil, Houria; Donato, Lionel; Langer, Bruno; Messer, Jean; Astruc, Dominique

    2010-09-01

    In 2001 France issued a new set of guidelines for the use of antenatal antibiotics (AA). These guidelines recommended intrapartum antimicrobial prophylaxis (IAP) to prevent group B streptococcal (GBS) disease and AA to prolong pregnancy in the event of preterm premature rupture of membranes (AA for PPROM). This study aims to determine the effects of AA, recommended by national guidelines, on the incidence and distribution of pathogens in early-onset neonatal sepsis (EONS). We performed a population-based, prospective, observational study of level II and III perinatal centres throughout the region of Alsace, a northeastern area of France, between March 2004 and February 2005. The study population included all neonates with confirmed or probable EONS, who were treated with antibiotics for at least 5 days. We analysed exposure to AA, as well as clinical and microbiological data obtained from medical records. A total of 20 131 neonates were born during the study period, and 217 were included in the study. Of these, 24 subjects had confirmed sepsis, 140 had probable sepsis and 53 had possible EONS. The overall incidence of confirmed EONS was 1.19 per 1000 births. The infecting bacteria was GBS in 15 of 24 (62.5%) confirmed EONS cases (incidence: 0.75 per 1000 births) and in 81 of 140 (58%) probable sepsis cases. Escherichia coli was identified in 6 of 24 (25%) cases of confirmed EONS (incidence: 0.3 per 1000 births) and in 30 of 140 (21%) cases of clinical sepsis. Among E. coli infections (n= 36), amoxicillin resistance (n= 18) was statistically linked with AA use (P = 0.045). This link was significant in cases of PPROM (P = 0.015), but not when IAP was administered to prevent GBS disease (P = 0.264). IAP was not performed in 18 of 60 (30%) cases and 32 of 93 (34%) cases, despite positive screening or the presence of risk factors for EONS, respectively. Group B streptococcus remains the predominant pathogen in the era of AA. Aminopenicillin-resistant E. coli infections

  11. Antenatal care and uptake of HIV testing among pregnant women in sub-Saharan Africa: a cross-sectional study

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    Jayleen K L Gunn

    2016-01-01

    Full Text Available Introduction: Current guidelines recommend inclusion of HIV testing in routine screening tests for all pregnant women. For this reason, antenatal care (ANC represents a vital component of efforts to prevent mother-to-child transmission (PMTCT of HIV. To elucidate the relationship between ANC services and HIV testing among pregnant women in sub-Saharan Africa, we undertook an analysis of data from four countries. Methods: Four countries (Congo, Mozambique, Nigeria and Uganda were purposively selected to represent unique geographical regions of sub-Saharan Africa. Using Demographic and Health Survey datasets, weighted crude and adjusted logistic regression models were used to explore factors that influenced HIV testing as part of ANC services. The study was approved by the Institutional Review Board of the University of Arizona. Results: Pooled results showed that 60.7% of women received HIV testing as part of ANC. Ugandan women had the highest rate of HIV testing as part of ANC (81.5% compared with women in Mozambique (69.4%, Nigeria (54.4% and Congo (45.4%. Difficulty reaching a health facility was a barrier in Congo and Mozambique but not Nigeria or Uganda. HIV testing rates were lower in rural areas, among the poorest women, the least educated and those with limited knowledge of HIV. In every country, crude regression analyses showed higher odds of being tested for HIV if women received their ANC services from a skilled attendant compared with an unskilled attendant. After adjusting for confounders, women in the total sample had 1.78 (99% CI: 1.45–2.18 times the odds of having an HIV test as part of their ANC if they went to a skilled attendant compared with an unskilled attendant. Conclusions: There is a need for integration of HIV testing into routine ANC service to increase opportunities for PMTCT programmes to reach HIV-positive pregnant women. Attention should be paid to the expansion of outreach services for women in rural settings

  12. The utilization of antenatal care among rural-to-urban migrant women in Shanghai:a hospital-based cross-sectional study

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    Zhao Qi

    2012-11-01

    Full Text Available Abstract Background Improving utilization of antenatal care is a critical strategy for achieving China’s Millennium Development Goal of decreasing the maternal mortality ratio (MMR. While overall utilization has increased recently in China, an urban vs. rural disparity in access remains. Here we aim to assess utilization of antenatal care in rural-to-urban migrant women and identify its risk and protective factors. Methods Migrant women who had been living in Shanghai for more than six months, delivered in one of the two study hospitals between August 2009 and February 2010, and provided written consent were interviewed using a structured questionnaire. Results Of 767 women, 90.1% (691 made at least one antenatal care visit, while 49.7% (381 had adequately utilized antenatal care (i.e., made five or more antenatal care visits. Only 19.7% of women visited an antenatal care center during the first trimester (12 weeks. Women between the ages of 25 and 30 and women older than 30 were more likely than younger women to have adequately utilized antenatal care (AOR=2.2 and 1.9, 95%CI=1.4-3.5 and 1.1-3.2, respectively. Women whose husbands held Shanghai residency status (AOR=4.9, 95%CI=2.2-10.9 or who had more than 10 years of education (AOR=1.8, 95%CI=1.2-2.9, previously experienced a miscarriage or abortion (AOR=2.2, 95%CI=1.3-3.8, had higher household income (AOR=1.6, 95%CI=1.0-2.5 were more likely to have adequately utilized antenatal care. Women from high-income households were also more likely to receive antenatal care during the first 12 weeks (AOR=3.5, 95%CI=1.7-5.5. Conclusions Many migrant women in Shanghai did not receive adequate antenatal care and initiated antenatal care later than the optimal first 12 weeks of pregnancy. Poor antenatal care utilization was associated with low socioeconomic status, education, and certain demographic factors. Tailored health education for both migrant women and their husbands should be strengthened to

  13. Seroprevalence and Predictors of Hepatitis B Virus Infection among Pregnant Women Attending Routine Antenatal Care in Arba Minch Hospital, South Ethiopia

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    Tsegaye Yohanes

    2016-01-01

    Full Text Available Hepatitis B virus (HBV is a serious cause of liver disease affecting millions of people throughout the world. When HBV is acquired during pregnancy, prenatal transmission can occur to the fetus. Therefore, this study is aimed at estimating seroprevalence and associated factors of HBV infection among pregnant women attending Antenatal Clinic (ANC of Arba Minch Hospital, Southern Ethiopia. A facility based cross-sectional study was conducted on 232 pregnant women visiting ANC from February to April, 2015. Data regarding sociodemographic and associated factors were gathered using questionnaire. Serum samples were tested for hepatitis B surface antigen (HBsAg by Enzyme Linked Immunosorbent Assay. Data was analyzed using SPSS version 20. The overall seroprevalence of HBV infection was 4.3% (95% CI: 2.2–6.9%. Multivariate analysis showed that history of abortion (AOR = 7.775; 95% CI: 1.538–39.301 and having multiple sexual partners (AOR = 7.189; 95% CI: 1.039–49.755 were independent predictors of HBsAg seropositivity. In conclusion, the prevalence of HBV infection is intermediate. Therefore, screening HBV infection should be routine part of ANC; health information on having single sexual partner for women of childbearing age and on following aseptic techniques during abortion should be provided to health facilities working on abortion.

  14. Ethnic differences in antenatal care use in a large multi-ethnic urban population in the Netherlands

    NARCIS (Netherlands)

    Chote, Anushka A.; de Groot, Christianne J. M.; Bruijnzeels, Marc A.; Redekop, Ken; Jaddoe, Vincent W. V.; Hofman, Albert; Steegers, Eric A. P.; Mackenbach, Johan P.; Foets, Marleen

    2011-01-01

    Objective: to determine differences in antenatal care use between the native population and different ethnic minority groups in the Netherlands. Design: the Generation R Study is a multi-ethnic population-based prospective cohort study. Setting: seven midwife practices participating in the Generatio

  15. Antenatal counselling for congenital anomaly tests: an exploratory video-observational study about client-midwife communication

    NARCIS (Netherlands)

    Martin, L.; Hutton, E.K.; Gitsels-van der Wal, J.T.; Spelten, E.R.; Kuiper, F.; Pereboom, M.T.; Dulmen, S. van

    2015-01-01

    OBJECTIVE: antenatal counselling for congenital anomaly tests is conceptualised as having both Health Education (HE) and Decision-Making Support (DMS) functions. Building and maintaining a client-midwife relation (CMR) is seen as a necessary condition for enabling these two counselling functions. Ho

  16. Antenatal counselling for congenital anomaly tests: an exploratory video-observational study about client-midwife communication.

    NARCIS (Netherlands)

    Martin, L.; Hutton, E.K.; Gitsels-van der Wal, J.T.; Spelten, E.R.; Kuiper, F.; Pereboom, M.T.R.; Dulmen, S. van

    2015-01-01

    Objective: antenatal counselling for congenital anomaly tests is conceptualised as having both Health Education (HE) and Decision-Making Support (DMS) functions. Building and maintaining a client–midwife relation (CMR) is seen as a necessary condition for enabling these two counselling functions. Ho

  17. Public health facility resource availability and provider adherence to first antenatal guidelines in a low resource setting in Accra, Ghana

    NARCIS (Netherlands)

    Amoakoh-Coleman, Mary; Agyepong, Irene Akua; Kayode, Gbenga A; Grobbee, Diederick E; Klipstein-Grobusch, Kerstin; Ansah, Evelyn K

    2016-01-01

    BACKGROUND: Lack of resources has been identified as a reason for non-adherence to clinical guidelines. Our aim was to describe public health facility resource availability in relation to provider adherence to first antenatal visit guidelines. METHODS: A cross-sectional analysis of the baseline data

  18. Feasibility of Providing Culturally Relevant, Brief Interpersonal Psychotherapy for Antenatal Depression in an Obstetrics Clinic: A Pilot Study

    Science.gov (United States)

    Grote, Nancy K.; Bledsoe, Sarah E.; Swartz, Holly A.; Frank, Ellen

    2004-01-01

    Objective: To minimize barriers to care, ameliorate antenatal depression, and prevent postpartum depression, we conducted a pilot study to assess the feasibility of providing brief interpersonal psychotherapy (IPT-B) to depressed, pregnant patients on low incomes in an obstetrics and gynecological (OB/GYN) clinic. Method: Twelve pregnant,…

  19. Ten years' trend of HIV seroprevalence among Indian pregnant women attending antenatal clinic at tertiary hospital in Dhule, Maharashtra, India

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    Vaishali Milind Patil

    2016-05-01

    Conclusions: Declining HIV seroprevalence rate is noted among pregnant women attending the antenatal clinics from 2004 to 2013. The effective implementation of prevention of parent to child transmission of HIV/AIDS (PPTCT programmed is helping in control of the spread of HIV. [Int J Reprod Contracept Obstet Gynecol 2016; 5(5.000: 1514-1519

  20. Study of prognostic significance of antenatal ultrasonography and renin angiotensin system activation in predicting disease severity in posterior urethral valves

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    Divya Bhadoo

    2015-01-01

    Full Text Available Aims: Study on prognostic significance of antenatal ultrasonography and renin angiotensin system activation in predicting disease severity in posterior urethral valves. Materials and Methods: Antenatally diagnosed hydronephrosis patients were included. Postnatally, they were divided into two groups, posterior urethral valve (PUV and non-PUV. The studied parameters were: Gestational age at detection, surgical intervention, ultrasound findings, cord blood and follow up plasma renin activity (PRA values, vesico-ureteric reflux (VUR, renal scars, and glomerular filtration rate (GFR. Results: A total of 25 patients were included, 10 PUV and 15 non-PUV. All infants with PUV underwent primary valve incision. GFR was less than 60 ml/min/1.73 m 2 body surface area in 4 patients at last follow-up. Keyhole sign, oligoamnios, absent bladder cycling, and cortical cysts were not consistent findings on antenatal ultrasound in PUV. Cord blood PRA was significantly higher (P < 0.0001 in PUV compared to non-PUV patients. Gestational age at detection of hydronephrosis, cortical cysts, bladder wall thickness, and amniotic fluid index were not significantly correlated with GFR while PRA could differentiate between poor and better prognosis cases with PUV. Conclusions: Ultrasound was neither uniformly useful in diagnosing PUV antenatally, nor differentiating it from cases with non-PUV hydronephrosis. In congenital hydronephrosis, cord blood PRA was significantly higher in cases with PUV compared to non-PUV cases and fell significantly after valve ablation. Cord blood PRA could distinguish between poor and better prognosis cases with PUV.

  1. Health insurance determines antenatal, delivery and postnatal care utilisation : evidence from the Ghana Demographic and Health Surveillance data

    NARCIS (Netherlands)

    Browne, Joyce L; Kayode, Gbenga A; Arhinful, Daniel; Fidder, Samuel A J; Grobbee, Diederick E; Klipstein-Grobusch, Kerstin

    2016-01-01

    OBJECTIVE: This study aims to evaluate the effect of maternal health insurance status on the utilisation of antenatal, skilled delivery and postnatal care. DESIGN: A population-based cross-sectional study. SETTING AND PARTICIPANTS: We utilised the 2008 Demographic and Health Survey data of Ghana, wh

  2. Provider adherence to first antenatal care guidelines and risk of pregnancy complications in public sector facilities : a Ghanaian cohort study

    NARCIS (Netherlands)

    Amoakoh-Coleman, Mary; Klipstein-Grobusch, Kerstin; Agyepong, Irene Akua; Kayode, Gbenga A; Grobbee, Diederick E; Ansah, Evelyn K

    2016-01-01

    BACKGROUND: Guideline utilization aims at improvement in quality of care and better health outcomes. The objective of the current study was to determine the effect of provider complete adherence to the first antenatal care guidelines on the risk of maternal and neonatal complications in a low resour

  3. Maternal demand for cesarean section: perception and willingness to request by Nigerian antenatal clients

    Directory of Open Access Journals (Sweden)

    Okonkwo NS

    2012-03-01

    Full Text Available Ngozi S Okonkwo1, Oladosu A Ojengbede2, Imran O Morhason-Bello1, Babatunde O Adedokun31Department of Obstetrics and Gynecology, University College Hospital; 2Center for Population and Reproductive Health, College of Medicine, University of Ibadan, Ibadan; 3Department of Epidemiology, Medical Statistics, and Environmental Health, College of Medicine, Ibadan, Oyo State, NigeriaBackground: Contrary to the widely reported aversion to cesarean section in the West African subregion, maternal demand for cesarean section (MDCS seems to be on the increase, and there is little evidence to explain this trend. The purpose of this study was to determine the perception and attitudes of Nigerian antenatal clients towards MDCS, their willingness to request MDCS, and the relationship between willingness to request MDCS and sociodemographic characteristics.Methods: A cross-sectional survey was undertaken among 843 antenatal clients at Agbongbon/Orayan primary health care centers (PHCs, Adeoyo Maternity Hospital (SHC, and UCH Ibadan (THC, representing the three different levels of health care in Nigeria, ie, primary, secondary, and tertiary.Results: The proportion of women aware of MDCS was 39.6%. Predictors of awareness were education and type of health facility. Women from THC and those with tertiary education and above were more likely to be aware of MDCS than others (P = 0.001. Doctors were major sources of information on MDCS (30.8% as well as friends (24.3%. Common reasons reported for MDCS were fear of labor pains (68.9%, and fear of poor labor outcome (60.1%, and fear of fecal (20.2% and urinary incontinence (16.8%. More women from the THC than other facilities believed that requests for MDCS should be granted (P < 0.001. However, willingness to request MDCS was low (6.6%. More than 50% of those willing to request MDCS would likely be criticized, mainly by their husbands. On multiple logistic regression, respondents at the THC were significantly more

  4. Changing prevalence and the risk factors for antenatal obstetric hospitalizations in Denmark 2003-2012

    Directory of Open Access Journals (Sweden)

    Bendix J

    2016-06-01

    Full Text Available Jane Bendix,1 Hanne Kristine Hegaard,2 Jens Langhoff-Roos,3 Thomas Bergholt3 1Department of Gynaecology and Obstetrics, Nordsjaellands Hospital Hillerod, University of Copenhagen, Hillerod, Denmark; 2The Research Unit of Women’s and Children’s Health, The Juliane Marie Centre for Women, Children and Reproduction, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark; 3Department of Obstetrics, The Juliane Marie Centre, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark Purpose: Population-based studies evaluating the use and extent of antenatal obstetric hospitalizations (AOH are sparse. The objective of the present study was to describe the prevalence, time trend, and risk factors for AOH in Denmark. Materials and methods: A retrospective national register-based cohort study was conducted that included all pregnancies with delivery after 22 gestational weeks in Denmark from 2003 to 2012. The outcomes were AOH and the diagnoses leading to these hospitalizations. AOH was defined as an antenatal hospitalization for at least 1 day with at least one obstetric International Classification of Diseases-10 diagnosis and admission date more than 3 days before delivery. Results: The study included 617,906 pregnancies; 48,366 (7.8% pregnancies were associated with 64,072 AOH before delivery. The percentage of pregnancies with AOH decreased from 8.6% to 7.1%. The median length of stay decreased from 3 to 2 days, and admission for at least 7 days was almost halved. Threatened preterm delivery was the most frequent diagnostic category for AOH. A decline was seen in all diagnostic categories except maternal diseases. Significant risk factors for AOH were multiple pregnancies, low or high maternal age and body mass index, nulliparity, lower educational levels, unemployment or being outside the workforce, single partner status, and smoking. The relative risk of very preterm delivery before gestational age of 34 weeks was higher in

  5. HCC screening; HCC-Screening

    Energy Technology Data Exchange (ETDEWEB)

    Albrecht, T. [Charite-Unversitaetsmedizin,Freie Universitaet und Humboldt-Universitaet zu Berlin, Klinik und Hochschulambulanz fuer Radiologie und Nuklearmedizin,Campus Benjamin Franklin, Berlin (Germany)

    2008-01-15

    Hepatocellular carcinoma (HCC) is one of the most frequently diagnosed tumour diseases throughout the world. In the vast majority of cases those affected are high-risk patients with chronic viral hepatitis and/or liver cirrhosis, which means there is a clearly identifiable target group for HCC screening. With resection, transplantation, and interventional procedures for local ablation, following early diagnosis curative treatment options are available with which 5-year survival rates of over 60% can be reached. Such early diagnosis is a reality only in a minority of patients, however, and in the majority of cases the disease is already in an advanced stage at diagnosis. One of the objects of HCC screening is diagnosis in an early stage when curative treatment is still possible. Precisely this is achieved by screening, so that the proportion of patients treated with curative intent is decisively higher. There is not yet any clear evidence as to whether this leads to a lowering of the mortality of HCC. As lower mortality is the decisive indicator of success for a screening programme the benefit of HCC screening has so far been neither documented nor refuted. Nonetheless, in large regions of the world it is the practice for high-risk patients to undergo HCC screening in the form of twice-yearly ultrasound examination and determination of AFP. (orig.) [German] Das hepatozellulaere Karzinom (HCC) ist eine der weltweit haeufigsten Tumorerkrankungen. Es tritt in der grossen Mehrzahl der Faelle bei Hochrisikopatienten mit chronischer Virushepatitis bzw. Leberzirrhose auf, woraus sich eine klar identifizierbare Zielgruppe fuer das HCC-Screening ergibt. Mit der Resektion, der Transplantation und interventionellen lokal ablativen Verfahren stehen bei rechtzeitiger Diagnosestellung kurative Therapieoptionen zur Verfuegung, die 5-Jahres-Ueberlebensraten von >60% erreichen. Diese rechtzeitige Diagnosestellung erfolgt jedoch nur bei einer Minderzahl der Patienten, waehrend die

  6. Newborn Screening for Krabbe’s Disease

    Science.gov (United States)

    Orsini, Joseph J.; Saavedra-Matiz, Carlos A.; Gelb, Michael H.; Caggana, Michele

    2017-01-01

    Live newborn screening for Krabbe’s disease (KD) was initiated in New York on August 7, 2006, and started in Missouri in August, 2012. As of August 7, 2015, nearly 2.5 million infants had been screened, and 443 (0.018%) infants had been referred for followup clinical evaluation; only five infants had been determined to have KD. As of August, 2015, the combined incidence of infantile KD in New York and Missouri is ~1 per 500,000; however, patients who develop later-onset forms of KD may still emerge. This Review provides an overview of the processes used to develop the screening and followup algorithms. It also includes updated results from screening and discussion of observations, lessons learned, and suggested areas for improvement that will reduce referral rates and the number of infants defined as at risk for later-onset forms of KD. Although current treatment options for infants with early-infantile Krabbe’s disease are not curative, over time treatment options should improve; in the meantime, it is essential to evaluate the lessons learned and to ensure that screening is completed in the best possible manner until these improvements can be realized. PMID:27638592

  7. Antenatal Dexamethasone Exposure in Preterm Infants Is Associated with Allergic Diseases and the Mental Development Index in Children

    Directory of Open Access Journals (Sweden)

    Wan-Ning Tseng

    2016-12-01

    Full Text Available Background: Antenatal steroid administration may benefit fetal lung maturity in preterm infants. Although some studies have shown that this treatment may increase asthma in childhood, the correlation between antenatal dexamethasone exposure and allergic diseases remains unclear. The purpose of this study is to investigate the association between antenatal dexamethasone and T cell expression in childhood allergic diseases. Methods: We recruited a cohort of preterm infants born at Kaohsiung Chang Gung Memorial Hospital between 2007 and 2010 with a gestational age of less than 35 weeks and body weight at birth of less than 1500 g. The status of antenatal exposure to steroids and allergic diseases were surveyed using a modified ISAAC questionnaire for subjects aged 2–5 years old. We analyzed Th1/Th2/Th17 expression of mRNA, cytokines (using the Magpix® my-system, and mental development index (MDI. Results: Among the 40 patients that were followed, the data showed that the antenatal dexamethasone exposure group (N = 24 had a significantly higher incidence of allergic diseases (75.0% vs. 18.8%, p < 0.0001 when compared to the non-dexamethasone exposure group (N = 16, especially with regard to asthma (41.7% vs. 0.0%, p = 0.003 and allergic rhinitis (58.3% vs. 18.8%, p = 0.013, but not atopic dermatitis. No statistical difference was observed in the mRNA expression levels of total white blood cell count between the dexamethasone exposure and non-exposure groups (p > 0.05. However, the asthma group had higher IL-5 levels (p = 0.009, and the MDI was shown to be significantly higher in the dexamethasone exposure group (90.38 ± 3.31 vs. 79.94 ± 3.58, p = 0.043 while no significant difference was found between the PDI of the two groups. Conclusions: Exposure to antenatal dexamethasone in preterm infants will increase their susceptibility to allergic diseases, particularly asthma and allergic rhinitis. Preterm infants’ exposure to antenatal

  8. Pandemic of Pregnant Obese Women: Is It Time to Re-Evaluate Antenatal Weight Loss?

    Directory of Open Access Journals (Sweden)

    Anne M. Davis

    2015-08-01

    Full Text Available The Obesity pandemic will afflict future generations without successful prevention, intervention and management. Attention to reducing obesity before, during and after pregnancy is essential for mothers and their offspring. Preconception weight loss is difficult given that many pregnancies are unplanned. Interventions aimed at limiting gestational weight gain have produced minimal maternal and infant outcomes. Therefore, increased research to develop evidence-based clinical practice is needed to adequately care for obese pregnant women especially during antenatal care. This review evaluates the current evidence of obesity interventions during pregnancy various including weight loss for safety and efficacy. Recommendations are provided with the end goal being a healthy pregnancy, optimal condition for breastfeeding and prevent the progression of obesity in future generations.

  9. Antenatal care strengthening for improved quality of care in Jimma, Ethiopia

    DEFF Research Database (Denmark)

    Villadsen, Sarah Fredsted; Negussie, Dereje; GebreMariam, Abebe

    2015-01-01

    increased priority of ANC among health care providers. The organizational structure of the facilities and lack of continuity in care provision turned out to be a major challenge for implementation. There was a positive effect of the intervention on health education on danger signs during pregnancy (OR: 3...... of intervention on various outcomes was significantly modified by maternal education. CONCLUSION: The quality of care can be improved in some important aspects with limited resources. Moreover, the study provides strategic perspectives on how to facilitate improved quality of ANC.......BACKGROUND: Interventions for curing most diseases and save lives of pregnant and delivering women exist, yet the power of health systems to deliver them to those in most need is not sufficient. The aims of this study were to design a participatory antenatal care (ANC) strengthening intervention...

  10. Antenatal Counseling Regarding Resuscitation and Intensive Care Before 25 Weeks of Gestation.

    Science.gov (United States)

    Cummings, James

    2015-09-01

    The anticipated birth of an extremely low gestational age (,25 weeks) infant presents many difficult questions, and variations in practice continue to exist.Decisions regarding care of periviable infants should ideally be well informed,ethically sound, consistent within medical teams, and consonant with the parents' wishes. Each health care institution should consider having policies and procedures for antenatal counseling in these situations. Family counseling may be aided by the use of visual materials, which should take into consideration the intellectual, cultural, and other characteristics of the family members. Although general recommendations can guide practice, each situation is unique; thus, decision-making should be individualized. In most cases, the approach should be shared decision-making with the family, guided by considering both the likelihood of death or morbidity and the parents' desires for their unborn child. If a decision is made not to resuscitate,providing comfort care, encouraging family bonding, and palliative care support are appropriate.

  11. Body Mass Index (BMI) in women booking for antenatal care: comparison between selfreported and digital measurements.

    LENUS (Irish Health Repository)

    Fattah, Chro

    2012-02-01

    OBJECTIVE: We set out to compare measurement of Body Mass Index (BMI) with selfreporting in women early in pregnancy. STUDY DESIGN: We studied 100 women booking for antenatal care in the first trimester with a normal ongoing pregnancy. Selfreported maternal weight and height were recorded and the Body Mass Index was calculated. Afterwards maternal weight and height were digitally measured and actual BMI was calculated. RESULTS: If selfreporting is used for BMI classification, we found that 22% of women were classified incorrectly when BMI was measured. 12% of the women who were classified as having a normal selfreported BMI were overweight and 5% classified as overweight were obese. Similar findings have been reported outside pregnancy. CONCLUSIONS: These findings have implications for clinical practice, and for research studies exploring the relationship between maternal adiposity and pregnancy complications.

  12. Next-Generation Sequencing for Antenatal Prediction of KEL1 Blood Group Status

    DEFF Research Database (Denmark)

    Rieneck, Klaus; Clausen, Frederik Banch; Dziegiel, Morten Hanefeld

    2015-01-01

    The KEL1 antigen can give rise to immunization of KEL2 mothers. Maternal antibodies can be transferred to the fetus and destroy fetal red blood cells and their stem cell precursors and give rise to serious fetal disease. It is important to be able to predict the fetal KEL status in order...... to intervene in those pregnancies where the fetus is at risk, and to ascertain when the fetus is not at risk. Technically it can be demanding to predict KEL1 status from a maternal blood sample. The KEL1 allele is based on a single SNP present in about 1-10 % of cell-free maternal DNA after gestation week 10....... Here we describe our protocol for antenatal prediction of fetal KEL1 status by NGS analysis of maternal DNA on a MiSeq instrument....

  13. Dopamine receptor polymorphism modulates the relation between antenatal maternal anxiety and fetal movement.

    Science.gov (United States)

    Kaitz, Marsha; Mankuta, David; Rokem, Ann Marie; Faraone, Stephen

    2016-12-01

    We determined whether the combination of fetal genotype (dopamine D4 receptor; DRD4) and mothers' anxiety during pregnancy is associated with fetal behavior. Two hundred and six pregnant women underwent an ultrasound exam. Fetal movement measures (Movement Frequency, Total Activity, Movement Duration, and Longest Quiet Time) were derived from off-line coding. A moderating role of the DRD4-III polymorphism was found: Results indicate that higher levels of antenatal maternal anxiety symptoms were associated with more frequent fetal movements among fetuses carrying a 7R allele, but not among fetuses carrying shorter alleles. Total Activity did not show full moderation by DRD4, though the measure was correlated with maternal anxiety among fetuses in the Anxious Group with a 7R allele; not among fetuses without both factors. The findings provide the first evidence of a GXE interaction in association with fetal behavior. Results also demonstrate that some individuals are inherently more susceptible to uterine environmental influences than are others.

  14. Are pregnant women receiving support for smoking dependence when attending routine antenatal appointments?

    LENUS (Irish Health Repository)

    Cully, G

    2010-09-01

    Early and consistent intervention with pregnant smokers can reduce the incidence of adverse pregnancy outcomes associated with smoking during pregnancy. A survey of 470 pregnant women was conducted to establish the care they received in relation to smoking whilst attending routine public antenatal appointments. The overall prevalence of smoking was 23.5%. Age, level of education and nationality were associated with smoking status with younger, less educated Irish women being most likely to smoke. Women attending for their first visit were much more likely to be asked about their smoking status 71 (85.5) versus 68 (17.8) and advised to quit if they were smokers 11 (73.3) versus 11 (15.7). None of the women were offered specific assistance to help them stop smoking or had a follow-up appointment arranged specifically to do with smoking. 167 women (35.6) were exposed to passive smoking in their own homes.

  15. Maternal bereavement in the antenatal period and oral cleft in the offspring

    DEFF Research Database (Denmark)

    Ingstrup, Katja Glejsted; Liang, H.; Olsen, J.;

    2013-01-01

    in the offspring, especially when the bereavement was due to a sudden death or death of a child. WHAT IS KNOWN ALREADY: The aetiology of oral cleft is unknown but includes both genetic and environmental causes. STUDY DESIGN, SIZE AND DURATION: We performed a population-based cohort study based on several national...... to a sudden death, the risk of oral cleft in the offspring was higher (OR: 1.76, 95% CI: 1.06; 2.94). Losing a relative in the time period before pregnancy and during the first trimester showed a tendency to an increased risk. The risk increase was 77% when the mother was bereaved due to sudden death......STUDY QUESTION: Is maternal bereavement (emotional stress) due to loss of a close relative in the antenatal period associated with the risk of oral cleft in the offspring? SUMMARY ANSWER: Our study suggests prenatal maternal bereavement is associated with an increased risk of oral cleft...

  16. Men's role in women's antenatal health status: evidence from rural Rajshahi, Bangladesh.

    Science.gov (United States)

    Rahman, Mosiur; Islam, Mohammad Touhidul; Mostofa, Md Golam; Reza, Md Shahin

    2015-03-01

    This study aimed to extend notions of men's role in women's antenatal care (ANC) status in rural Rajshahi, Bangladesh. The analyses were based on response of 480 men aged 15 to 54 years, living with at least 1 child younger than 3 years. Only 27% men accompanied their wives for ANC. Men's perception of actual roles for ANC services was low: 63% approved of women undergoing checkups; 33% discussed their wives' pregnancy with health professionals. Only 18% scored highly on the overall index of knowledge. From multivariate analysis, it was found that the number of men accompanying their wives for ANC was higher among those respondents who were married for the first time in the age-group 25 to 34 years and aged 35 years or more, had their last child at age-group 20 to 24 years or 25 to 34 years, had completed primary or secondary and higher education, and had mass media facilities.

  17. Geometrical Analogies in Mathematics Lessons

    Science.gov (United States)

    Eid, Wolfram

    2007-01-01

    A typical form of thinking to approach problem solutions humanly is thinking in analogous structures. Therefore school, especially mathematical lessons should help to form and to develop corresponding heuristic abilities of the pupils. In the contribution, a summary of possibilities of mathematics lessons regarding this shall particularly be…

  18. Can You Haiku? [Lesson Plan].

    Science.gov (United States)

    National Endowment for the Humanities (NFAH), Washington, DC.

    In this lesson plan, students learn the rules and conventions of haiku, study examples by Japanese masters, and create haiku of their own. Its 4 lessons seek to help students be able to: (1) describe the traditional rules and conventions of haiku; (2) interpret examples of haiku; (3) characterize the image-evoking power of haiku; (4) develop a…

  19. Masterwork Art Lesson: Kandinsky Watercolors.

    Science.gov (United States)

    LiPira, Michael

    2003-01-01

    Presents an art lesson used with sixth-grade students which also can be used with other grade levels. Explains that the artwork of Wassily Kandinsky served as inspiration for this lesson. Explains that the students learned about abstract art and used watercolors to create their own paintings in the style of Kandinsky. (CMK)

  20. Heart of Darkness. [Lesson Plan].

    Science.gov (United States)

    Discovery Communications, Inc., Bethesda, MD.

    Based on Joseph Conrad's novel "Heart of Darkness," this lesson plan presents activities designed to help students understand that critics have debated some of Conrad's choices in the novel; and that the novel reflects the world as Conrad saw it. The main activity of the lesson involves students rewriting the ending of the novel so that Marlow…

  1. Keiko, Killer Whale. [Lesson Plan].

    Science.gov (United States)

    Discovery Communications, Inc., Bethesda, MD.

    This lesson plan presents activities designed to help students understand that Keiko, the killer whale, lived for a long time in an aquarium and had to be taught to live independently; and that computer users can get updates on how Keiko is doing. The main activity of the lesson involves middle school students working in small groups to produce a…

  2. Psychosocial factors of antenatal anxiety and depression in Pakistan: is social support a mediator?

    Directory of Open Access Journals (Sweden)

    Ahmed Waqas

    Full Text Available Pregnancy is generally viewed as a time of fulfillment and joy; however, for many women it can be a stressful event. In South Asia it is associated with cultural stigmas revolving around gender discrimination, abnormal births and genetic abnormalities.This cross-sectional study was done at four teaching hospitals in Lahore from February, 2014 to June, 2014. A total of 500 pregnant women seen at hospital obstetrics and gynecology departments were interviewed with a questionnaire consisting of three sections: demographics, the Hospital Anxiety and Depression Scale (HADS and the Social Provisions Scale (SPS. Pearson's chi-squared test, bivariate correlations and multiple linear regression were used to analyze associations between the independent variables and scores on the HADS and SPS.Mean age among the 500 respondents was 27.41 years (5.65. Anxiety levels in participants were categorized as normal (145 women, 29%, borderline (110, 22% or anxious (245, 49%. Depression levels were categorized as normal (218 women, 43.6%, borderline (123, 24.6% or depressed (159, 31.8%. Inferential analysis revealed that higher HADS scores were significantly associated with lower scores on the SPS, rural background, history of harassment, abortion, cesarean delivery and unplanned pregnancies (P < .05. Social support (SPS score mediated the relationship between the total number of children, gender of previous children and HADS score. Women with more daughters were significantly more likely to score higher on the HADS and lower on the SPS, whereas higher numbers of sons were associated with the opposite trends in the scores (P < .05.Because of the predominantly patriarchal sociocultural context in Pakistan, the predictors of antenatal anxiety and depression may differ from those in developed countries. We therefore suggest that interventions designed and implemented to reduce antenatal anxiety and depression should take into account these unique factors.

  3. HIV-infected women delivering without antenatal care in a large Bangkok hospital, 1997.

    Science.gov (United States)

    Bennetts, A; Inneam, B; Krajangthong, R; Bhengsri, S; Jetsawang, B; Siriwasin, W; Simond, R J; Shaffer, N

    2000-03-01

    The aim was to estimate the proportion of HIV-infected women giving birth at a large Bangkok hospital who had not received antenatal care (ANC) and to identify predictors of not receiving ANC. At Rajavithi Hospital, Bangkok, women with ANC are routinely tested for HIV at their first antenatal visit; women without ANC are routinely tested at delivery. Hospital staff interview all HIV-infected women and record sociodemographic and HIV risk factor information in a delivery room log book. We abstracted and analyzed data recorded in this log book for all HIV-infected women who gave birth at Rajavithi Hospital in 1997. Of 303 HIV-infected women who gave birth, 75% had received ANC at Rajavithi Hospital, 10% had received ANC at other locations, and 15% had not received ANC. On multivariate analysis, HIV-infected women who had received ANC were more likely to work or have partners who worked in construction (25% vs 11%; adjusted odds ratio [AOR]; 2.6; p = 0.03) or have a history of injection drug use (4% vs 0.4%; AOR = 20.8; p = 0.02) than those who had not received ANC, but were less likely to report their current partner as a risk factor for acquiring HIV infection (22% vs. 40%; AOR = 0.4; p = 0.05). Because a substantial number of HIV-infected women give birth in this large Bangkok hospital without receiving ANC, interventions are needed to increase the number of HIV-infected women who receive ANC and to prevent perinatal HIV transmission from HIV-infected pregnant women who have not received ANC.

  4. Comparison of micromorphometric testis tissue structures in antenatal fetuses and patients with congenital cryptorchidism

    Directory of Open Access Journals (Sweden)

    K. V. Bunkov

    2015-01-01

    Full Text Available Investigation of paired organs, testicles in particular, in the antenatal period as compared to congenital cryptorchidism in the context of interrelationship can objectively approach the consideration of the whole set of physiological and pathological processes in them, by taking into account histophysiological identity. The paper gives the results of micromorphometric examinations of the units of a communication system (cellular populations and the areas of parenchymatous and stromal structures (intertubular connective tissue, convoluted seminiferous tubules, and spermatogenic epithelium in two groups: 1 34 antenatal (ANT fetuses at 20–41 weeks' gestation and 2 46 children with congenital unilateral cryptorchidism (CR, in whom testis tissue biopsy specimens were examined at the age of 1 to 14 years. Determination of the similarity of micromorphometric structures (the number of cellular population in the intertubular connective tissue, convoluted seminiferous tubules, and the areas of intertubular connective tissue, spermatogenic epithelium, and capillary lumens was analyzed to discover an identity in the testes tissues of the ANT fetuses versus the children with congenital unilateral CR, by considering the position and site of testicles. The findings indicate that there are synchronous changes of individual similar structures between the right and left testicle during its natural descent into the scrotum in the ANT fetuses and in the patients with congenital CR, which is suggestive of the symmetry and relationship between the contralateral sex glands in different ontogenetic groups. This may testify that there are similar processes occurring between the testis tissues in the children with congenital CR and in the ANT fetuses. The findings may become a ground for further consideration of congenital CR in the context of not only the micromorphometry, but also functional activity of tests tissue structures when comparatively analyzing these

  5. Comparing HIV prevalence estimates from prevention of mother-to-child HIV transmission programme and the antenatal HIV surveillance in Addis Ababa

    Directory of Open Access Journals (Sweden)

    Mirkuzie Alemnesh H

    2012-12-01

    Full Text Available Abstract Background In the absence of reliable data, antenatal HIV surveillance has been used to monitor the HIV epidemic since the late 1980s. Currently, routine data from Prevention of Mother-to-child HIV transmission (PMTCT programmes are increasingly available. Evaluating whether the PMTCT programme reports provide comparable HIV prevalence estimates with the antenatal surveillance reports is important. In this study, we compared HIV prevalence estimates from routine PMTCT programme and antenatal surveillance in Addis Ababa with the aim to come up with evidence based recommendation. Methods Summary data were collected from PMTCT programmes and antenatal surveillance reports within the catchment of Addis Ababa. The PMTCT programme data were obtained from routine monthly reports from 2004 to 2009 and from published antenatal HIV surveillance reports from 2003 to 2009. Data were analysed using descriptive statistics. Results In Addis Ababa, PMTCT sites had increased from six in 2004 to 54 in 2009. The site expansion was accompanied by an increased number of women testing. There were marked increases in the rate of HIV testing following the introduction of routine opt-out HIV testing approach. Paralleling these increases, the HIV prevalence showed a steady decline from 10.0% in 2004 to 4.5% in 2009. There were five antenatal surveillance sites from 2003 to 2007 in Addis Ababa and they increased to seven by 2009. Four rounds of surveillance data from five sites showed a declining trend in HIV prevalence over the years. The overall antenatal surveillance data also showed that the HIV prevalence among antenatal attendees had declined from 12.4% in 2003 to 5.5% in 2009. The HIV prevalence estimates from PMTCT programme were 6.2% and 4.5% and from antenatal surveillance 6.1 and 5.5% in 2008 and 2009 respectively. Conclusions There were consistent HIV prevalence estimates from PMTCT programme and from antenatal surveillance reports. Both data sources

  6. Physical examinations and laboratory tests in antenatal care visits in Denmark. Do reported practice and current official guidelines concord with results of literature reviews? A nationwide study of the public scheme of shared antenatal care in general practice, centres of midwifery and hospital

    DEFF Research Database (Denmark)

    Kristensen, F B; Andersen, K V; Andersen, A M

    1995-01-01

    To analyse physical examinations and laboratory tests reported in antenatal care visits in relation to official guidelines and reviews of appropriateness.......To analyse physical examinations and laboratory tests reported in antenatal care visits in relation to official guidelines and reviews of appropriateness....

  7. Freqüência de testagem rápida para o HIV durante a admissão para o parto em puérperas no Instituto Materno Infantil Prof. Fernando Figueira, IMIP HIV testing prevalence during antenatal care in women admitted for delivery at the Instituto Materno Infantil Professor Fernando Figueira, IMIP

    Directory of Open Access Journals (Sweden)

    Maria Celina Rocha Morimura

    2006-05-01

    ,001, the number of professionals providing antenatal care and education level (p=0,006 were significantly associated to anti-HIV testing during antenatal care, but not with results delivery. Counseling and test access during antenatal care and hospital admission for delivery were significantly associated to anti-HIV testing during antenatal care as well. CONCLUSIONS: anti-HIV testing prevalence during antenatal care and/or screening was satisfactory in quantitative terms, however, results delivery during antenatal care, admission for delivery, and post-test counseling fell short of recommendations.

  8. Classroom Management and Lesson Planning(4)

    Institute of Scientific and Technical Information of China (English)

    2006-01-01

    @@ Lesson Planning Task 1 As teachers,we all need to plan our lessons before we teach.Make a list of things that you think need to be included in a lesson plan.Then compare and discuss your list with another teacher.Also think about reasons why we need to plan our lessons.

  9. Classroom Management and Lesson Planning(4)

    Institute of Scientific and Technical Information of China (English)

    2006-01-01

    Lesson PlanningTask 1As teachers,we all need to plan our lessons before we teach.Make a list of things that you think need tobe included in a lesson plan.Then compare and discuss your list with another teacher.Also think about reasonswhy we need to plan our lessons.

  10. Geographic Alliance of Iowa. Lesson Plans.

    Science.gov (United States)

    Weller, Kay E.; Howe-Ford, Nancy

    This collection of five lesson plans in geography can be adapted for use with K-12 students. Each lesson plan explains the lesson and provides basic instructions. The lesson plans are titled: "Teaching Geography Using Literature in K-University Classrooms" (Kay Weller); "Geography and a Mystery Novel" (Kay Weller);…

  11. Financial Lessons Learned

    Institute of Scientific and Technical Information of China (English)

    2010-01-01

    @@ As the Wall Street chaos of 2008 swept the globe,China-with little exposure to subprime mortgages-was one of the only calm ports in the growing financial storm.Ifone lesson can be learned from the crisis,it is this: maintain a constant state of financial vigilance against risks even in boom times.China now faces the task of ensuring its financial health as it further opens to the world amid a global financial landscape reshaped by deep recessions.Economists and finance professors discussed these challenges at the Asia-Pacific Economic and Financial Forum recently held in Beijing.Edited excerpts follow:

  12. Financial Lessons Learned

    Institute of Scientific and Technical Information of China (English)

    2010-01-01

    As the Wall Street chaos of 2008 swept the globe,China-with little exposure to subprime mortgages-was one of the only calm ports in the growing financial storm.If one lesson can be learned from the crisis,it is this: maintain a constant state of financial vigilance against risks even in boom times.China now faces the task of ensuring its financial health as it further opens to the world amid a global financial landscape reshaped by deep recessions.Economists and finance professors discussed these challenges at the Asia-Pacific Economic and Financial Forum recently held in Beijing.Edited excerpts follow

  13. French Lessons A Memoir

    CERN Document Server

    Kaplan, Alice

    2009-01-01

    Brilliantly uniting the personal and the critical, French Lessons is a powerful autobiographical experiment. It tells the story of an American woman escaping into the French language and of a scholar and teacher coming to grips with her history of learning. Kaplan begins with a distinctly American quest for an imaginary France of the intelligence. But soon her infatuation with all things French comes up against the dark, unimagined recesses of French political and cultural life.The daughter of a Jewish lawyer who prosecuted Nazi war criminals at Nuremburg, Kaplan grew up in the 1960s in the Mi

  14. Lessons from Mayan Astronomy

    CERN Document Server

    Loeb, Abraham

    2016-01-01

    The Mayan culture collected exquisite astronomical data for over a millennium. However, it failed to come up with the breakthrough ideas of modern astronomy because the data was analyzed within a mythological culture of astrology that rested upon false but mathematically sophisticated theories about the Universe. Have we learned the necessary lessons to prevent our current scientific culture from resembling Mayan Astronomy? Clearly, data collection by itself is not a guarantee for good science as commonly assumed by funding agencies. A vibrant scientific culture should cultivate multiple approaches to analyzing existing data and to collecting new data.

  15. Shuttle Lesson Learned - Toxicology

    Science.gov (United States)

    James, John T.

    2010-01-01

    This is a script for a video about toxicology and the space shuttle. The first segment is deals with dust in the space vehicle. The next segment will be about archival samples. Then we'll look at real time on-board analyzers that give us a lot of capability in terms of monitoring for combustion products and the ability to monitor volatile organics on the station. Finally we will look at other issues that are about setting limits and dealing with ground based lessons that pertain to toxicology.

  16. Vacuum performance and lessons for 2012

    CERN Document Server

    Baglin, V; Jimenez, J M; Lanza, G

    2012-01-01

    During the LHC run 2011, a tremendous progress has been made towards the machine operation with design parameters. In the same time, the run confirmed the sensitivity of the beam vacuum system to the machine parameters. As expected, a successful scrubbing period allowed mitigating the effects of the electron cloud giving room to an entire filling of the ring with 50 ns beams. In parallel issues such as the impact of the beam screen regulation, pressures spikes and local outgassing were observed during the year. On-line mitigations and immediate compensatory measures implemented during the winter technical stop are reviewed together with their efficiencies. The expected limitations while waiting for LS1 consolidation or when running with 25 ns beams are addressed. Lessons for 2012 are discussed.

  17. Analisis Cakupan Antenatal Care K4 Program Kesehatan Ibu dan Anak di Wilayah Kerja Dinas Kesehatan Kabupaten Padang Pariaman

    Directory of Open Access Journals (Sweden)

    Elmispendriya Gusna

    2016-01-01

    Full Text Available AbstrakPencapaian target K4 (kunjungan ibu hamil ke tenaga kesehatan yang dilakukan paling sedikit 4 kali selama hamil akan terlaksana jika adanya motivasi bidan di desa ditambah pembinaan dari bidan koordinator yang secara rutin dilakukan dalam bentuk supervisi. Tujuan penelitian ini adalah menganalisis cakupan antenatal care K4 program kesehatan ibu dan anak di wilayah kerja dinas kesehatan kabupaten Padang Pariaman. Penelitian ini menggunakan metode penelitian gabungan antara kuantitatif dan kualitatif. Subjek penelitian untuk penelitian kuantitatif  adalah 49 orang bidan desa, sedangkan informan untuk kualitatif adalah kepala bidang kesehatan keluarga dan Kasie kesehatan ibu dan anak dinas kesehatan kabupaten Padang Pariaman, kepala puskesmas, petugas pemegang program KIA dan bidan pengelola KIA di puskesmas Sungai Limau. Hasil penelitian ini mendapatkan lebih dari separoh (53,1% bidan desa memiliki motivasi rendah, sedangkan lebih dari separoh (67,3% bidan koordinator sudah melakukan supervisi  ke bidan desa dan pada umumnya (91,8% responden memiliki cakupan K4 yang rendah. Tidak terdapat hubungan antara motivasi bidan desa dan supervisi bidan koordinator dengan cakupan antenatal care K4 (p < 0.05. Cakupan antenatal care K4 di Kabupaten Padang Pariaman belum berhasil karena kurangnya peran aktif bidan desa di tengah masyarakat, monitoring dan evaluasi dari dinas kesehatan dan pimpinan puskesmas serta supervisi bidan koordinator belum optimal, serta sumber daya manusia yang belum memaksimalkan perannya dalam melaksanakan tugas ditambah masih kurangnya  kelengkapan sarana dan prasarana. Perlu optimalisasi peran dan fungsi bidan di desa dan optimalisasi kemitraan dengan berbagai pihak dalam komunitas.Kata kunci: cakupan antenatal care K4, motivasi, supervisi AbstractThe achievement of K4 (four time antenatal care target will be success with support from motivation of village midwives and routine supervision of coordinator midwives. The

  18. Efficacy of selective antenatal screening for hepatitis B among pregnant women in Denmark: is selective screening still an acceptable strategy in a low-endemicity country?

    DEFF Research Database (Denmark)

    2003-01-01

    included in the study. Blood tests were examined for hepatitis B surface antigen (HBsAg), anti-hepatitis B core antigen (HBc) and anti-HCV. Case records were studied to evaluate whether patients at risk for HBV infection had been tested. Among the 4098 women, 18 10.4%, 95% confidence interval (95% CI) 0...

  19. Number and timing of antenatal HIV testing: Evidence from a community-based study in Northern Vietnam

    Directory of Open Access Journals (Sweden)

    Rasch Vibeke

    2011-03-01

    Full Text Available Abstract Background HIV testing for pregnant women is an important component for the success of prevention of mother-to-child transmission of HIV (PMTCT. A lack of antenatal HIV testing results in loss of benefits for HIV-infected mothers and their children. However, the provision of unnecessary repeat tests at a very late stage of pregnancy will reduce the beneficial effects of PMTCT and impose unnecessary costs for the individual woman as well as the health system. This study aims to assess the number and timing of antenatal HIV testing in a low-income setting where PMTCT programmes have been scaled up to reach first level health facilities. Methods A cross-sectional community-based study was conducted among 1108 recently delivered mothers through face-to-face interviews following a structured questionnaire that focused on socio-economic characteristics, experiences of antenatal care and HIV testing. Results The prevalence of women who lacked HIV testing among the study group was 10% while more than half of the women tested had had more than two tests during pregnancy. The following factors were associated with the lack of antenatal HIV test: having two children (aOR 2.1, 95% CI 1.3-3.4, living in a remote rural area (aOR 7.8, 95% CI 3.4-17.8, late antenatal care attendance (aOR 3.6, 95% CI 1.3-10.1 and not being informed about PMTCT at their first antenatal care visits (aOR 7.4, 95% CI 2.6-21.1. Among women who had multiple tests, 80% had the second test after 36 weeks of gestation. Women who had first ANC and first HIV testing at health facilities at primary level were more likely to be tested multiple times (OR 2.9 95% CI 1.9-4.3 and OR = 4.7 95% CI 3.5-6.4, respectively. Conclusions Not having an HIV test during pregnancy was associated with poor socio-economic characteristics among the women and with not receiving information about PMTCT at the first ANC visit. Multiple testing during pregnancy prevailed; the second tests were often

  20. St. Louis FUSRAP Lessons Learned

    Energy Technology Data Exchange (ETDEWEB)

    Eberlin, J.; Williams, D.; Mueller, D.

    2003-02-26

    The purpose of this paper is to present lessons learned from fours years' experience conducting Remedial Investigation and Remedial Action activities at the St. Louis Downtown Site (SLDS) under the Formerly Utilized Sites Remedial Action Program (FUSRAP). Many FUSRAP sites are experiencing challenges conducting Remedial Actions within forecasted volume and budget estimates. The St. Louis FUSRAP lessons learned provide insight to options for cost effective remediation at FUSRAP sites. The lessons learned are focused on project planning (budget and schedule), investigation, design, and construction.

  1. Why do women not use antenatal services in low- and middle-income countries? A meta-synthesis of qualitative studies.

    Directory of Open Access Journals (Sweden)

    Kenneth Finlayson

    Full Text Available BACKGROUND: Almost 50% of women in low- and middle-income countries (LMICs don't receive adequate antenatal care. Women's views can offer important insights into this problem. Qualitative studies exploring inadequate use of antenatal services have been undertaken in a range of countries, but the findings are not easily transferable. We aimed to inform the development of future antenatal care programmes through a synthesis of findings in all relevant qualitative studies. METHODS AND FINDINGS: Using a predetermined search strategy, we identified robust qualitative studies reporting on the views and experiences of women in LMICs who received inadequate antenatal care. We used meta-ethnographic techniques to generate themes and a line-of-argument synthesis. We derived policy-relevant hypotheses from the findings. We included 21 papers representing the views of more than 1,230 women from 15 countries. Three key themes were identified: "pregnancy as socially risky and physiologically healthy", "resource use and survival in conditions of extreme poverty", and "not getting it right the first time". The line-of-argument synthesis describes a dissonance between programme design and cultural contexts that may restrict access and discourage return visits. We hypothesize that centralised, risk-focused antenatal care programmes may be at odds with the resources, beliefs, and experiences of pregnant women who underuse antenatal services. CONCLUSIONS: Our findings suggest that there may be a misalignment between current antenatal care provision and the social and cultural context of some women in LMICs. Antenatal care provision that is theoretically and contextually at odds with local contextual beliefs and experiences is likely to be underused, especially when attendance generates increased personal risks of lost family resources or physical danger during travel, when the promised care is not delivered because of resource constraints, and when women experience

  2. How much time do health services spend on antenatal care? Implications for the introduction of the focused antenatal care model in Tanzania

    Directory of Open Access Journals (Sweden)

    Mpembeni Rose

    2006-06-01

    Full Text Available Abstract Background Antenatal care (ANC is a widely used strategy to improve the health of pregnant women and to encourage skilled care during childbirth. In 2002, the Ministry of Health of the United Republic of Tanzania developed a national adaptation plan based on the new model of the World Health Organisation (WHO. In this study we assess the time health workers currently spent on providing ANC services and compare it to the requirements anticipated for the new ANC model in order to identify the implications of Focused ANC on health care providers' workload. Methods Health workers in four dispensaries in Mtwara Urban District, Southern Tanzania, were observed while providing routine ANC. The time used for the overall activity as well as for the different, specific components of 71 ANC service provisions was measured in detail; 28 of these were first visits and 43 revisits. Standard time requirements for the provision of focused ANC were assessed through simulated consultations based on the new guidelines. Results The average time health workers currently spend for providing ANC service to a first visit client was found to be 15 minutes; the provision of ANC according to the focused ANC model was assessed to be 46 minutes. For a revisiting client the difference between current practise and the anticipated standard of the new model was 27 minutes (9 vs. 36 min.. The major discrepancy between the two procedures was related to counselling. On average a first visit client was counselled for 1:30 minutes, while counselling in revisiting clients did hardly take place at all. The simulation of focused ANC revealed that proper counselling would take about 15 minutes per visit. Conclusion While the introduction of focused ANC has the potential to improve the health of pregnant women and to raise the number of births attended by skilled staff in Tanzania, it may need additional investment in human resources. The generally anticipated saving effect of

  3. Development and pretesting of an information, education and communication (IEC focused antenatal care handbook in Pakistan

    Directory of Open Access Journals (Sweden)

    Avan Bilal

    2011-03-01

    Full Text Available Abstract Background Improvement of maternal morbidity and mortality indicators remains a major challenge for developing countries. Antenatal care is one of the key strategies in maintaining safe motherhood. The objective of this study was to develop and pretest a culturally relevant Antenatal Care Handbook (ANC handbook utilizing the principles of information, education, and communication (IEC. We developed the ANC handbook after an extensive review of existing literature, available instruments (for keeping track of pregnancy and informing pregnant women, and seeking expert opinion. To pretest the ANC handbook, a cross-sectional approach was adopted, and information was collected from 300 expectant women, 150 women each from the community and from the health facility arm. Trained field workers conducted the pretesting from May 2004 to June 2004. Feedback on messages for pregnant mothers contained in the handbook was also assessed. At the same time, the ANC handbook was reviewed by 25 health care providers (including community health workers, physicians, nurses, and other health staff working at various kinds of health care facilities. Data were analyzed using both quantitative and qualitative methods. Findings Twenty-three percent of the interviewed women were primigravida, 50% were multigravida and 27% were grandmultipara. The mean age of the women in the community sample was 25.8 SD: 4.9 years and in the hospital sample it was 25.7 SD: 5.2 years. No significant differences were observed between women interviewed at community or health facilities related to their understanding of ANC messages, and the majority of messages were well understood. Similarly, health care providers found all of the instruments useful and workable in the health system. Finally, feedback from pregnant women and health care staff regarding different components of the handbook were incorporated and later verified by them. Conclusions Findings of pretesting reveal that a

  4. Antenatal psychological intervention maternal influence%护理干预对产妇的影响

    Institute of Scientific and Technical Information of China (English)

    杨艳

    2013-01-01

    Objective to explore the nursing intervention on antenatal anxiety status and the function of the choice of the delivery method. Methods 120 cases were I branch of expectant mothers were randomly divided into observation group and control group and control group in for regular prenatal care,the observation group in conventional care given based on psychological intervention,compare two sets of mothers were admitted to the hospital with before childbirth anxiety conditions,and choose the changes to the way the results delivery. Results the observation group mothers before childbirth anxiety states significantly reduce maternal,and lower than those of the control group(P<0.01);Before childbirth the observation group choose natural birth the proportion of way significantly increased,two groups of comparisons also has the obvious difference (P<0.01).Conclusion maternal antenatal psychological intervention,can reduce maternal anxiety,and can improve the natural childbirth.%  目的探讨护理干预对产妇焦虑状况及分娩方式的选择影响。方法将我科收治的120例待产妇随机分为对照组及观察组,对照组进行常规孕妇产前护理,观察组在常规护理基础上给予心理干预,比较2组产妇入院时与分娩前焦虑状况及分娩方式选择情况。结果观察组产妇干预后焦虑状态较入院前明显减轻,且焦虑评分低于对照组产妇(P<0.01);观察组选择自然分娩方式的比例显著提高,2组比较有明显差异(P<0.01)。结论对产妇进行产前心理干预,可以减轻产妇焦虑状况,并可提高自然分娩率。

  5. Plasma viraemia in HIV-positive pregnant women entering antenatal care in South Africa

    Directory of Open Access Journals (Sweden)

    Landon Myer

    2015-07-01

    Full Text Available Introduction: Plasma HIV viral load (VL is the principle determinant of mother-to-child HIV transmission (MTCT, yet there are few data on VL in populations of pregnant women in sub-Saharan Africa. We examined the distribution and determinants of VL in HIV-positive women seeking antenatal care (ANC in Cape Town, South Africa. Methods: Consecutive HIV-positive pregnant women making their first antenatal clinic visit were recruited into a cross-sectional study of viraemia in pregnancy, including a brief questionnaire and specimens for VL testing and CD4 cell enumeration. Results & discussion: Overall 5551 pregnant women sought ANC during the study period, of whom 1839 (33% were HIV positive and 1521 (85% were included. Approximately two-thirds of HIV-positive women in the sample (n=947 were not on antiretrovirals at the time of the first ANC visit, and the remainder (38%, n=574 had initiated antiretroviral therapy (ART prior to conception. For women not on ART, the median VL was 3.98 log10 copies/mL; in this group, the sensitivity of CD4 cell counts ≤350 cells/µL in detecting VL>10,000 copies/mL was 64% and this increased to 78% with a CD4 threshold of ≤500 cells/µL. Among women on ART, 78% had VL1000 copies/mL at the time of their ANC visit. Conclusions: VL >10,000 copies/mL was commonly observed in women not on ART with CD4 cell counts >350 cells/µL, suggesting that CD4 cell counts may not be adequately sensitive in identifying women at greatest risk of MTCT. A large proportion of women entering ANC initiated ART before conception, and in this group more than 10% had VL>1000 copies/mL despite ART use. VL monitoring during pregnancy may help to identify pregnancies that require additional clinical attention to minimize MTCT risk and improve maternal and child health outcomes.

  6. A study to assess knowledge and attitude of antenatal women about maternal nutrition attending a tertiary care centre

    OpenAIRE

    Renu Gupta; Shaily Agarwal; Neetu Singh; Rimjhim Jain; Arti Katiyar; Almas siddiqui

    2016-01-01

    Background: Nutrition is the fundamental pillar of human life. All human beings need a balanced amount of nutrients for proper functioning of body system. Inadequate nutrition during pregnancy has a negative impact on the pregnant mother as well as short and long term consequences on the newborn. This study aims to assess knowledge and attitude of antenatal women about maternal nutrition in pregnancy and highlights the need of interventions aimed at promoting awareness about healthy diet duri...

  7. STUDY OF PREMATURE BABIES IN RELATION TO ITS OUTCOME AND ANTENATAL RISK FACTORS AT GENERAL HOSPITAL SANGLI

    OpenAIRE

    Satish D; Suresh K; Renuka S

    2014-01-01

    : OBJECTIVE: To know the neonatal outcome and antenatal risk factors among premature babies. MATERIAL & METHODS: STUDY DESIGN: A retrospective study. SETTING: Neonatal Intensive Care Unit (NICU) of General Hospital Sangli under Government Medical College, Miraj. SAMPLE SIZE: 134 Premature babies admitted during the year 2013 in NICU. DATA COLLECTION: From the case sheet of the study subjects, with the help of pre structured proforma. STUDY PERIOD: January 2013 to December ...

  8. Pregnant women and midwives are not in tune with each other about dietary counseling : studies in Swedish antenatal care

    OpenAIRE

    Wennberg, Anna Lena

    2015-01-01

    Background During pregnancy, a healthy diet is beneficial for the expecting mother and her fetus. Midwives in antenatal care have an ideal position for promoting a healthy diet and thereby help women to not only lower the risks of pregnancy complications and adverse birth outcomes, but improve maternal health. The overall aim of this thesis was to describe diet and dietary changes during pregnancy from the women’s and the midwives’ perspectives with a focus on dietary counseling. The thesis c...

  9. Survey of Women's Opinions on Female Genital Mutilation (FGM) in Southeast Nigeria: Study of Patients Attending Antenatal Clinic

    OpenAIRE

    Ezenyeaku, CC; Okeke, TC; Chigbu, CO; Ikeako, LC

    2011-01-01

    Background: Female genital mutilation is known to exist especially in many third world countries including Nigeria with many women being victims of this harmful practice and its complications. The practice is rife in Southeast Nigeria and efforts have been made to discourage it. Objective: To determine women's views on aspects of female genital mutilation and the prevalence among the study population. Method: Women attending the antenatal clinics of two university teaching hospitals in Southe...

  10. The association between maltreatment in childhood and pre-pregnancy obesity in women attending an antenatal clinic in Australia.

    Directory of Open Access Journals (Sweden)

    Katharine Hollingsworth

    Full Text Available INTRODUCTION: Obesity in pregnancy is associated with increased risk of complications and adverse outcomes in mother and child. Childhood adverse experiences are known to have numerous negative physical and emotional sequelae. We aimed to examine if exposure to abuse and/or neglect in childhood increased the likelihood of pre-pregnancy obesity. METHODS: Demographic and clinical data including weight, height, mental health as measured by the General Health Questionnaire and exposure to childhood trauma as measured by the childhood trauma questionnaire was collected from 239 women attending antenatal care at an Australian tertiary hospital. RESULTS: More than one quarter of women were obese prior to pregnancy and approximately 20% of women self reported experiencing moderate to severe physical, sexual or emotional abuse. Almost 60% of women scored in the clinical range on the GHQ. Pre-pregnancy obesity in women attending antenatal care was associated with a self-reported history of emotional or physical abuse with those exposed to moderate or severe emotional or physical abuse having increased odds of being obese prior to pregnancy (O.R. and 95% CI: 2.40; 1.19-4.84 and 2.38; 1.18-4.79 respectively. There was no significant association between other forms of childhood maltreatment, demographic or current mental health status and pre-pregnancy obesity. CONCLUSIONS: The high rates of obesity, mental health problems and self reported childhood maltreatment in the Australian antenatal population are serious public health concerns due to the extra health risks conferred on mother and offspring. Exposure to physical or emotional abuse during childhood increases the likelihood of obesity in women attending antenatal care. Further research is required to determine reasons for this association.

  11. Environments For Healthy Living (EFHL Griffith birth cohort study: characteristics of sample and profile of antenatal exposures

    Directory of Open Access Journals (Sweden)

    Cameron Cate M

    2012-12-01

    Full Text Available Abstract Background The Environments for Healthy Living (EFHL study is a repeated sample, longitudinal birth cohort in South East Queensland, Australia. We describe the sample characteristics and profile of maternal, household, and antenatal exposures. Variation and data stability over recruitment years were examined. Methods Four months each year from 2006, pregnant women were recruited to EFHL at routine antenatal visits on or after 24 weeks gestation, from three public maternity hospitals. Participating mothers completed a baseline questionnaire on individual, familial, social and community exposure factors. Perinatal data were extracted from hospital birth records. Descriptive statistics and measures of association were calculated comparing the EFHL birth sample with regional and national reference populations. Data stability of antenatal exposure factors was assessed across five recruitment years (2006–2010 inclusive using the Gamma statistic for ordinal data and chi-squared for nominal data. Results Across five recruitment years 2,879 pregnant women were recruited which resulted in 2904 live births with 29 sets of twins. EFHL has a lower representation of early gestational babies, fewer still births and a lower percentage of low birth weight babies, when compared to regional data. The majority of women (65% took a multivitamin supplement during pregnancy, 47% consumed alcohol, and 26% reported having smoked cigarettes. There were no differences in rates of a range of antenatal exposures across five years of recruitment, with the exception of increasing maternal pre-pregnancy weight (p=0.0349, decreasing rates of high maternal distress (p=0.0191 and decreasing alcohol consumption (p Conclusions The study sample is broadly representative of births in the region and almost all factors showed data stability over time. This study, with repeated sampling of birth cohorts over multiple years, has the potential to make important contributions to

  12. A novel variant in the SLC12A1 gene in two families with antenatal Bartter syndrome

    DEFF Research Database (Denmark)

    Breinbjerg, Anders; Rittig, Charlotte Siggaard; Gregersen, Niels;

    2016-01-01

    , followed by bi-directional direct deoxyribonucleic acid sequencing. RESULTS: Each affected child in the two families were homozygous for a novel inherited variant in the SLC12A1gene, c.1614T>A. The variant predicts a change from a tyrosine codon to a stop codon (p.Tyr538Ter). The two cases presented....... The phenotypes of the patients were similar to other patients with antenatal Bartter syndrome. This article is protected by copyright. All rights reserved....

  13. Household cost of antenatal care and delivery services in a rural community of Kaduna state, northwestern Nigeria

    Directory of Open Access Journals (Sweden)

    Mohd Nasiq Sambo

    2013-01-01

    Full Text Available Background: Maternal mortality remains a leading cause of death among women of reproductive age. While Nigeria has only two percent of the global population, it contributes 10% to the global maternal mortality burden. Antenatal care (ANC reduces the incidence of maternal mortality. However, financial capability affects access to antenatal care. Thus, the rural poor are at a higher risk of maternal mortality. Materials and Methods: A cross-sectional descriptive study involving 135 women (pregnant women and those who are 6 weeks postpartum. Structured interviewer-administered questionnaires were used for data collection. Data analysis was carried out using statistical package for social sciences software (version 17. Results: The average amount spent on booking and initial laboratory investigations were N77 (half a dollar and N316 ($2, respectively. Per ANC visit, average amount spent on drugs and transportation were N229 ($1.5 and N139 ($0.9 respectively. For delivery, the average amount spent was N1500 ($9.6. On an average, ANC plus delivery cost about N3,365.00 ($22. There was a statistically significant association between husband′s income and ANC attendance (X 2 = 2.451, df = 2, P = 0.048. Conclusion: Cost of Antenatal care and delivery services were not catastrophic but were a barrier to accessing antenatal care and facility-based delivery services in the study area. ANC attendance was associated with the income of household heads. Pro-poor policies and actions are needed to address this problem, as it will go a long way in reducing maternal mortality in this part of the country.

  14. Teacher Training: The Demonstration Lesson

    Science.gov (United States)

    Moore, Alan C.

    1977-01-01

    A teacher training technique is discussed involving a demonstration class given by a local teacher and observed by prospective teachers. After the class a discussion is held analyzing lesson content and teaching techniques. (CHK)

  15. Associations Between the KIAA0319 Dyslexia Susceptibility Gene Variants, Antenatal Maternal Stress, and Reading Ability in a Longitudinal Birth Cohort.

    Science.gov (United States)

    D'Souza, Stephanie; Backhouse-Smith, Amelia; Thompson, John M D; Slykerman, Rebecca; Marlow, Gareth; Wall, Clare; Murphy, Rinki; Ferguson, Lynnette R; Mitchell, Edwin A; Waldie, Karen E

    2016-11-01

    Maternal stress during pregnancy has been associated with detrimental cognitive developmental outcomes in offspring. This study investigated whether antenatal maternal perceived stress and variants of the rs12193738 and rs2179515 polymorphisms on the KIAA0319 gene interact to affect reading ability and full-scale IQ (FSIQ) in members of the longitudinal Auckland Birthweight Collaborative study. Antenatal maternal stress was measured at birth, and reading ability was assessed at ages 7 and 16. Reading data were available for 500 participants at age 7 and 479 participants at age 16. FSIQ was measured at ages 7 and 11. At age 11, DNA samples were collected. Analyses of covariance revealed that individuals with the TT genotype of the rs12193738 polymorphism exposed to high maternal stress during pregnancy possessed significantly poorer reading ability (as measured by Woodcock-Johnson Word Identification standard scores) during adolescence compared with TT carriers exposed to low maternal stress. TT carriers of the rs12193738 SNP also obtained lower IQ scores at age 7 than C allele carriers. These findings suggest that the KIAA0319 gene is associated with both reading ability and general cognition, but in different ways. The effect on IQ appears to occur earlier in development and is transient, whereas the effect of reading ability occurs later and is moderated by antenatal maternal stress. Copyright © 2016 John Wiley & Sons, Ltd.

  16. Maternal health care amid political unrest: the effect of armed conflict on antenatal care utilization in Nepal.

    Science.gov (United States)

    Price, James I; Bohara, Alok K

    2013-05-01

    Armed conflicts, which primarily occur in low- and middle-income countries, have profound consequences for the health of affected populations, among them a decrease in the utilization of maternal health care services. The quantitative relationship between armed conflict and maternal health care utilization has received limited attention in the public health literature. We evaluate this relationship for a particular type of health care service, antenatal care, in Nepal. Using count regression techniques, household survey data and sub-national conflict data, we find a negative correlation between the number of antenatal care visits and incidents of conflict-related violence within a respondent's village development committee. Specifically, we find that under high-intensity conflict conditions women receive between 0.3 and 1.5 fewer antenatal care check-ups. These findings imply that maternal health care utilization is partially determined by characteristics of the social environment (e.g. political instability) and suggest health care providers need to revise maternal health strategies in conflict-affected areas. Strategies may include decentralization of services, maintaining neutrality among factions, strengthening community-based health services and developing mobile clinics.

  17. Womens' opinions on antenatal care in developing countries: results of a study in Cuba, Thailand, Saudi Arabia and Argentina

    Directory of Open Access Journals (Sweden)

    Farnot Ubaldo

    2003-05-01

    Full Text Available Abstract Background The results of a qualitative study carried out in four developing countries (Cuba, Thailand, Saudi Arabia and Argentina are presented. The study was conducted in the context of a randomised controlled trial to test the benefits of a new antenatal care protocol that reduced the number of visits to the doctor, rationalised the application of technology, and improved the provision of information to women in relation to the traditional protocol applied in each country. Methods Through focus groups discussions we were able to assess the concepts and expectations underlying women's evaluation of concepts and experiences of the care received in antenatal care clinics. 164 women participated in 24 focus groups discussion in all countries. Results Three areas are particularly addressed in this paper: a concepts about pregnancy and health care, b experience with health services and health providers, and c opinions about the modified Antenatal Care (ANC programme. In all three topics similarities were identified as well as particular opinions related to country specific social and cultural values. In general women have a positive view of the new ANC protocol, particularly regarding the information they receive. However, controversial issues emerged such as the reduction in the number of visits, particularly in Cuba where women are used to have 18 ANC visits in one pregnancy period. Conclusion Recommendations to improve ANC services performance are being proposed. Any country interested in the application of a new ANC protocol should regard the opinion and acceptability of women towards changes.

  18. Antenatal risk factors for postnatal depression: a prospective study of chinese women at maternal and child health centres

    Directory of Open Access Journals (Sweden)

    Siu Bonnie WM

    2012-03-01

    Full Text Available Abstract Background Risk factors for postnatal depression (PND are under-explored in the Chinese populations. There is increasing recognition of the importance of identifying predictive factors during the antenatal period for PND. The present study aimed to identify the risk factors for postnatal depression in a community cohort of Chinese women with special focus on the antenatal risk factors. Methods Eight hundred and five Chinese women were interviewed during their third trimester of pregnancy and at around 2 months postnatally. Putative risk factors for PND were collected and the diagnosis of PND was confirmed by the Structured Clinical Interview for DSM-IV Axis I Disorders. The 2-month postnatal depression status was used as the dependent variable for univariate and multivariate analyses against putative risk factors. Results Marital dissatisfaction (Relative Risk = 8.27, dissatisfied relationship with mother-in-law (Relative Risk = 3.93, antenatal depressive symptomatology (Relative Risk = 3.90, and anxiety-prone personality (Relative Risk = 2.14 predicted PND in Chinese women independently. Conclusions Chinese women tend to keep their own feelings and emotions and it is important to monitor Chinese pregnant women with these predictive risk factors so that PND can be identified early.

  19. Supporting pregnant Aboriginal and Torres Strait Islander women to quit smoking: views of antenatal care providers and pregnant indigenous women.

    Science.gov (United States)

    Passey, Megan E; Sanson-Fisher, Rob W; Stirling, Janelle M

    2014-12-01

    To assess support for 12 potential smoking cessation strategies among pregnant Australian Indigenous women and their antenatal care providers. Cross-sectional surveys of staff and women in antenatal services providing care for Indigenous women in the Northern Territory and New South Wales, Australia. Respondents were asked to indicate the extent to which each of a list of possible strategies would be helpful in supporting pregnant Indigenous women to quit smoking. Current smokers (n = 121) were less positive about the potential effectiveness of most of the 12 strategies than the providers (n = 127). For example, family support was considered helpful by 64 % of smokers and 91 % of providers; between 56 and 62 % of smokers considered advice and support from midwives, doctors or Aboriginal Health Workers likely to be helpful, compared to 85-90 % of providers. Rewards for quitting were considered helpful by 63 % of smokers and 56 % of providers, with smokers rating them more highly and providers rating them lower, than most other strategies. Quitline was least popular for both. This study is the first to explore views of pregnant Australian Indigenous women and their antenatal care providers on strategies to support smoking cessation. It has identified strategies which are acceptable to both providers and Indigenous women, and therefore have potential for implementation in routine care. Further research to explore their feasibility in real world settings, uptake by pregnant women and actual impact on smoking outcomes is urgently needed given the high prevalence of smoking among pregnant Indigenous women.

  20. Lessons Learned from FUSRAP

    Energy Technology Data Exchange (ETDEWEB)

    Castillo, Darina [U.S. Department of Energy, Office of Legacy Management; Carpenter, Cliff [U.S. Department of Energy, Office of Legacy Management; Miller, Michele [Navarro Research and Engineering

    2016-03-06

    The US DOE Office of Legacy Management (LM) is the long-term steward for 90 sites remediated under numerous regulatory regimes including the Formerly Utilized Sites Remedial Action Program (FUSRAP) sites. In addition, LM holds considerable historical information, gathered in the 1970s, to determine site eligibility for remediation under FUSRAP. To date, 29 FUSRAP sites are in LM’s inventory of sites for long-term surveillance and maintenance (LTS&M), and 25 are with the US Army Corps of Engineers (USACE) for remediation or in the process of being transitioned to LM. It is forecasted that 13 FUSRAP sites will transfer from the USACE to LM over the next 10 years; however, the timing of the transfers is strongly dependent upon federal funding of the ongoing remedial actions. Historically, FUSRAP sites were generally cleaned up for “unrestricted” industrial use or remediated to the “cleanup standards” at that time, and their use remained unchanged. Today, these sites as well as the adjacent properties are now changing or envisioned to have changes in land use, typically from industrial to commercial or residential uses. The implication of land-use change affects DOE’s LTS&M responsibility for the sites under LM stewardship as well as the planning for the additional sites scheduled to transition in time. Coinciding with land-use changes at or near FUSRAP sites is an increased community awareness of these sites. As property development increases near FUSRAP sites, the general public and interested stakeholders regularly inquire about the sufficiency of cleanups that impact their neighborhoods and communities. LM has used this experience to address a series of lessons learned to improve our program management in light of the changing conditions of our sites. We describe these lessons learned as (1) improved stakeholder relations, (2) enhanced LTS&M requirements for the sites, and (3) greater involvement in the transition process.

  1. Lesson "Balance in Nature

    Science.gov (United States)

    Chapanova, V.

    2012-04-01

    Lesson "Balance in Nature" This simulation game-lesson (Balance in Nature) gives an opportunity for the students to show creativity, work independently, and to create models and ideas. It creates future-oriented thought connected to their experience, allowing them to propose solutions for global problems and personal responsibility for their activities. The class is divided in two teams. Each team chooses questions. 1. Question: Pollution in the environment. 2. Question: Care for nature and climate. The teams work on the chosen tasks. They make drafts, notes and formulate their solutions on small pieces of paper, explaining the impact on nature and society. They express their points of view using many different opinions. This generates alternative thoughts and results in creative solutions. With the new knowledge and positive behaviour defined, everybody realizes that they can do something positive towards nature and climate problems and the importance of individuals for solving global problems is evident. Our main goal is to recover the ecological balance, and everybody explains his or her own well-grounded opinions. In this work process the students obtain knowledge, skills and more responsible behaviour. This process, based on his or her own experience, dialogue and teamwork, helps the participant's self-development. Making the model "human↔ nature" expresses how human activities impact the natural Earth and how these impacts in turn affect society. Taking personal responsibility, we can reduce global warming and help the Earth. By helping nature we help ourselves. Teacher: Veselina Boycheva-Chapanova " Saint Patriarch Evtimii" Scholl Str. "Ivan Vazov"-19 Plovdiv Bulgaria

  2. Breast cancer screening

    Science.gov (United States)

    Mammogram - breast cancer screening; Breast exam - breast cancer screening; MRI - breast cancer screening ... performed to screen women to detect early breast cancer when it is more likely to be cured. ...

  3. Moderate antenatal anxiety symptoms and birth outcomes of boys and girls.

    Science.gov (United States)

    Kaitz, Marsha; Mankuta, David; Rokem, Ann Marie; Faraone, Stephen V

    2014-12-01

    Women's antenatal anxiety, especially if paired with significant life stressors or comorbid physical or mental health disorders, can predict adverse birth outcomes, defined in terms of birth weight, gestational age at birth and obstetric complications. Here, we tested for an impact of moderate anxiety symptoms on these outcomes because many women experience these kinds of symptoms during pregnancy, and even subtle differences in birth outcomes can have significant effects on children's development. We also tested for moderation of anxiety effects by infant gender. The sample comprised 219 women with anxiety symptoms ranging from none to moderate levels on the Beck Anxiety Inventory. Multivariate models estimated main effects of Group (no/minimal versus moderate symptoms) and interactions between Group and infant Gender. Results indicate that moderate anxiety predicted more obstetric complications, particularly among mothers of daughters. Results also demonstrate a Group × Gender interaction on BW, indicating that sons of anxious mothers weighed more than sons of controls; whereas, daughters of anxious mothers weighed less than daughters of controls. These findings show that moderate anxiety symptoms may affect some birth outcomes, and differently for males and females.

  4. Antenatal Care Strengthening in Jimma, Ethiopia: A Mixed-Method Needs Assessment

    Directory of Open Access Journals (Sweden)

    Sarah Fredsted Villadsen

    2014-01-01

    Full Text Available Objective. We assessed how health system priorities matched user expectations and what the needs for antenatal care (ANC strengthening were for improved maternal health in Jimma, Ethiopia. Methods. A questionnaire survey among all recent mothers in the study area was conducted to study the content of ANC and to identify the predictors of low ANC satisfaction. Further, a qualitative approach was applied to understand perceptions, practices, and policies of ANC. Results. There were no national guidelines for ANC in Ethiopia. Within the health system, the teaching of health professional students was given high priority, and that contributed to a lack of continuity and privacy. To the women, poor user-provider interaction was a serious concern hindering the trust in the health care providers. Further, the care provision was compromised by the inadequate laboratory facilities, unstructured health education, and lack of training of health professionals. Conclusions. Health system trials are needed to study the feasibility of ANC strengthening in the study area. Nationally and internationally, the leadership needs to be strengthened with supportive supervision geared towards building trust and mutual respect to protect maternal and infant health.

  5. Antenatal Corticosteroids: A Risk Factor for the Development of Chronic Disease

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    Elizabeth Asztalos

    2012-01-01

    Full Text Available Preterm birth remains a major health issue worldwide. Since the 1990s, women at risk for preterm birth received a single course of exogenous antenatal corticosteroids (ACSs to facilitate fetal lung maturity. More recently, repeated or multiple courses of ACS have been supported to provide continued fetal maturity support for women with continued risk of preterm birth. However, exogenous ACS reduces birth weight which, in turn, is associated with adverse adult outcomes such as coronary heart disease, stroke, hypertension, and type 2 diabetes. The long-term effects of ACS exposure on HPA axis activity and neurological function are well documented in animal studies, and it appears that ACS, regardless of dose exposure, is capable of affecting fetal HPA axis development causing permanent changes in the HPA axis that persists through life and is manifested by chronic illness and behavioral changes. The challenge in human studies is to demonstrate whether an intervention such as ACS administration in pregnancy contributes to developmental programming and how this is manifested in later life.

  6. Deep venous thrombosis in the antenatal period in a large cohort of pregnancies from western India

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    Salvi Vinita

    2007-07-01

    Full Text Available Abstract Background Deep venous thrombosis (DVT is an important complication in the peripartal and postpartal period. Methods We followed up prospectively the prevalence of DVT in 34720 prenatal mothers between June 2002 and July 2006 attending the antenatal clinics of two major hospitals in Mumbai, India. Thirty two women (0.1% presented for the first time with symptomatic DVT i.e. 17 in the first trimester, 6 in the second and 9 in the third trimester of pregnancy. Nine had history of fetal loss while in the remaining twenty three there was no history of fetal loss. Results The evaluation of both acquired and heritable thrombophilia showed a conglomeration of thrombophilia in this group when compared to 100 normal pregnant women who have given birth to at least one healthy baby with no history of fetal death, DVT or other obstetrical complications. The relative risks for all the antiphospholipid antibodies (APA studied i.e lupus anticoagulant (LA, IgG/IgM antibodies for cardiolipin (ACA, β2 glycoprotein 1 (β2 GP 1 and annexin V were significantly higher in women with pregnancy associated DVT (RR 7.4 95% CI 4.3–11.3 P Conclusion We conclude that the prevalence of DVT in India is more or less similar to other reports published and both acquired and heritable thrombophilia show strong association with DVT associated with pregnancy.

  7. Astroglial Plasticity Is Implicated in Hippocampal Remodelling in Adult Rats Exposed to Antenatal Dexamethasone.

    Science.gov (United States)

    Shende, Vishvesh H; McArthur, Simon; Gillies, Glenda E; Opacka-Juffry, Jolanta

    2015-01-01

    The long-term effects of antenatal dexamethasone treatment on brain remodelling in 3-month-old male Sprague Dawley rats whose mothers had been treated with dexamethasone were investigated in the present study. Dorsal hippocampus, basolateral amygdala and nucleus accumbens volume, cell numbers, and GFAP-immunoreactive astroglial cell morphology were analysed using stereology. Total brain volume as assessed by micro-CT was not affected by the treatment. The relative volume of the dorsal hippocampus (% of total brain volume) showed a moderate, by 8%, but significant reduction in dexamethasone-treated versus control animals. Dexamethasone had no effect on the total and GFAP-positive cell numbers in the hippocampal subregions, basolateral amygdala, and nucleus accumbens. Morphological analysis indicated that numbers of astroglial primary processes were not affected in any of the hippocampal subregions analysed but significant reductions in the total primary process length were observed in CA1 by 32%, CA3 by 50%, and DG by 25%. Mean primary process length values were also significantly decreased in CA1 by 25%, CA3 by 45%, and DG by 25%. No significant astroglial morphological changes were found in basolateral amygdala and nucleus accumbens. We propose that the dexamethasone-dependent impoverishment of hippocampal astroglial morphology is the case of maladaptive glial plasticity induced prenatally.

  8. Astroglial Plasticity Is Implicated in Hippocampal Remodelling in Adult Rats Exposed to Antenatal Dexamethasone

    Directory of Open Access Journals (Sweden)

    Vishvesh H. Shende

    2015-01-01

    Full Text Available The long-term effects of antenatal dexamethasone treatment on brain remodelling in 3-month-old male Sprague Dawley rats whose mothers had been treated with dexamethasone were investigated in the present study. Dorsal hippocampus, basolateral amygdala and nucleus accumbens volume, cell numbers, and GFAP-immunoreactive astroglial cell morphology were analysed using stereology. Total brain volume as assessed by micro-CT was not affected by the treatment. The relative volume of the dorsal hippocampus (% of total brain volume showed a moderate, by 8%, but significant reduction in dexamethasone-treated versus control animals. Dexamethasone had no effect on the total and GFAP-positive cell numbers in the hippocampal subregions, basolateral amygdala, and nucleus accumbens. Morphological analysis indicated that numbers of astroglial primary processes were not affected in any of the hippocampal subregions analysed but significant reductions in the total primary process length were observed in CA1 by 32%, CA3 by 50%, and DG by 25%. Mean primary process length values were also significantly decreased in CA1 by 25%, CA3 by 45%, and DG by 25%. No significant astroglial morphological changes were found in basolateral amygdala and nucleus accumbens. We propose that the dexamethasone-dependent impoverishment of hippocampal astroglial morphology is the case of maladaptive glial plasticity induced prenatally.

  9. Effect of antenatal zinc supplementation on impetigo in infants in Bangladesh.

    Science.gov (United States)

    Darmstadt, Gary L; Osendarp, Saskia J M; Ahmed, Saifuddin; Feldman, Candace; Van Raaij, Joop M A; Baqui, Abdullah H; Hautvast, J G A J; Fuchs, George J

    2012-04-01

    We sought to determine the effects of maternal zinc supplementation on skin infections among infants in poor urban areas of Dhaka, Bangladesh. A double-blind, placebo-controlled, randomized trial was conducted among 199 and 221 Bangladeshi infants whose mothers were administered 30 mg daily of zinc or placebo, respectively. The mothers received zinc supplementation from 12-16 weeks' gestation until delivery, and the infants were followed up until 6 months of age. Among the infants of mothers who received zinc supplementation during the antenatal period, 10.6% had at least 1 episode of impetigo compared with 19.6% of the infants of mothers in the placebo group (P = 0.01). Infants in the treatment group had a 54% reduction in incidence rate of episodes of impetigo when compared with infants in the placebo group (P = 0.01). The effect of zinc supplementation was more pronounced among male infants (64% reduction) and intrauterine growth restricted and low birth weight infants (73% reduction) and among infants of mothers with increased parity (60% reduction) or decreased socioeconomic status (71% reduction).

  10. Long-term cognitive sequelae of antenatal maternal anxiety: involvement of the orbitofrontal cortex.

    Science.gov (United States)

    Mennes, Maarten; Stiers, Peter; Lagae, Lieven; Van den Bergh, Bea

    2006-01-01

    Anxiety and stress experienced by the mother during pregnancy are reported to have a negative association with the cognitive development of the child. An integration of recent evidence from cognitive reaction time tasks pointed to a deficit in endogenous response inhibition, a function ascribed to prefrontal cortex. To further delineate the cognitive sequelae associated with antenatal maternal anxiety, we reviewed recent neuro-imaging literature to create a cortical map of regions commonly and selectively activated by well-known cognitive tasks. The pragmatic value of this cortical map was tested in a follow-up sample of 49 17-year old adolescents. Adolescents of mothers with high levels of anxiety during week 12-22 of their pregnancy performed significantly lower in tasks which required integration and control of different task parameters. Working memory, inhibition of a prepotent response, and visual orienting of attention were not impaired. Based on the established cortical map, these results were related to subtle developmental aberrations in a part of, or in cortical and sub-cortical regions linked to, the orbitofrontal cortex.

  11. A retrospective cohort study exploring the relationship between antenatal reflexology and intranatal outcomes.

    Science.gov (United States)

    McNeill, Jennifer A; Alderdice, Fiona A; McMurray, Frances

    2006-05-01

    The integration of reflexology into midwifery care has become more common in recent years as a result of a developing interest in alternative and complementary therapies and also due to the integration of new skills into midwifery practice. The objective of this study was to investigate the association of antenatal reflexology with different outcomes in the intranatal period. The key variables of interest were onset of labour, duration of labour, analgesia used and mode of delivery. The findings showed there was no significant difference in the onset of labour or duration of labour between the two groups. The group who had four or more reflexology treatments had a reduced length of labour but this was not statistically significant. There was a significant difference in the use of Entonox between the two groups with the reflexology group having a lower uptake. Fewer women in the reflexology group had a normal labour with a higher percentage of women having a forceps delivery. In conclusion the only statistically significant difference between groups was less use of Entonox in the reflexology group. Further research requires standardized treatment and outcome measurement using prospective randomized designs with large samples.

  12. A comparison between antenatal care quality in public and private sector in rural Hebei, China

    Science.gov (United States)

    Chen, Li; Dai, Yaohua; Zhang, Yanfeng; Wu, Qiong; Rudan, Diana; Saftić, Vanja; van Velthoven, Michelle H.M.M.T.; Su, Jianqiang; Tan, Zangwen; Scherpbier, Robert W.

    2013-01-01

    Aim To evaluate the quality of antenatal care (ANC) in Hebei Province and compare it between the public and private sector and within the public sector. Methods We conducted a Maternal, Newborn and Child Health Household Survey in 2010 using a two-stage sampling procedure and included 1079 mothers. The quality of ANC was assessed on the basis of the number of ANC visits, the time of the first ANC visit, 16 different ANC procedures, owning a maternal health care booklet, and the type of service provider. Results Almost all women (98%) received ANC services at least once, 80% at least four times, and 54% at least five times. About half of the women (46%) visited ANC facility within their first trimester. Neither public nor private sector provided all 16 standardized services, but significantly more women in public sector received ANC procedures. Most women received ANC in county or higher-level hospitals (75%) and very few in township hospitals (8%). Significantly fewer women were weighed and tested for HIV/AIDS in township than in county or higher-level hospitals. Conclusion The quality of ANC in Hebei was poorer than required by China’s national and World Health Organization norms. Although the public sector performed better than the private sector, the utilization and quality of care of ANC services in this sector varied and women generally visited county or higher-level health facilities. PMID:23630142

  13. Sexually transmitted diseases among randomly selected attenders at an antenatal clinic in The Gambia.

    Science.gov (United States)

    Mabey, D C; Lloyd-Evans, N E; Conteh, S; Forsey, T

    1984-10-01

    One hundred randomly selected women attending a free government antenatal clinic in the town of Bakau, The Gambia, were examined. Vaginal swabs were taken for microscopical examination for Trichomonas vaginalis and for culture on Sabouraud's medium. Cervical swabs were taken for culture of Neisseria gonorrhoeae and Chlamydia trachomatis and, in 50 cases, Herpesvirus hominis; in addition, urethral swabs were taken for culture of N gonorrhoeae. Serum samples were tested for antibodies to Treponema pallidum by the Venereal Diseases Research Laboratory (VDRL) test and T pallidum haemagglutination assay (TPHA), and to C trachomatis and H hominis by microimmunofluorescence. The prevalence of infection with Candida albicans was found to be 35%, T vaginalis 32%, C trachomatis 6.9%, N gonorrhoeae 6.7%, T pallidum 1%, and H hominis 0%. IgG antibodies at a titre of at least 1/16 to C trachomatis serotypes D-K were found in 29.4%, and to serotypes A-C in a further 10.6%. IgG antibodies at a titre of at least 1/16 to H hominis type I were found in 94%, and to type II in 53%, although a proportion of the latter probably represent cross reacting antibodies to type I.

  14. COMPARATIVE STUDY OF IRON SUPPLEMENTS IN SOUTH INDIAN ANTENATAL WOMEN WITH IRON DEFICIENCY ANEMIA

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    Geetha

    2014-09-01

    Full Text Available BACKGROUND: Iron deficiency anemia is the most common nutritional disorder in the world. It is a major public health problem particularly among pregnant women with adverse effects on the mother and the new born. Iron supplementation is universally recommended to correct or prevent iron deficiency. AIMS & OBJECTIVE: The present study was conducted to compare the efficacy and tolerability of three oral iron preparations in anemic pregnant women of more than 14 weeks of gestation. MATERIALS AND METHODS: Randomized Control trial, done at Tagore Medical College and Hospital, Chennai. 60 antenatal women were selected; they were divided into three groups, 20 in each group. They were treated with Carbonyl iron, ferrous sulphate and ferrous fumarate. Hemoglobin estimation was done at 0 day, 30th and 60th day. Adverse effects were monitored. RESULTS: Data analysis showed an increase in haemoglobin levels in all three groups after the 30th day (p<0.05. Carbonyl iron showed highly significant increase (p<0.05 in the haemoglobin level as compared to the other two drugs at the end of the 60th day. CONCLUSION: Carbonyl iron is superior in efficacy when compared to ferrous sulphate and ferrous fumarate and is better tolerated. So carbonyl iron is safe in pregnancy and can be given as a supplement to treat iron deficiency anemia during pregnancy.

  15. KAJIAN PEMBERIAN ANTENATAL KORTIKOSTEROID UNTUK IBU HAMIL YANG BERISIKO MELAHIRKAN BAYI PREMATUR

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    Yuyun Yuniar

    2016-03-01

    Full Text Available Latar Belakang: Kelahiran prematur merupakan salah satu penyebab utama kematian bayi terkait dengan komplikasi yang terjadi khususnya sindrom gagal nafas. Pemberian antenatal corticosteroid (ACS merupakan intervensi yang efektif untuk mencegah gangguan pernafasan pada bayi prematur. Cakupan pemberian ACS diperkirakan hanya 10 persen dari yang membutuhkan. Tujuan: Kajian ini dilakukan untuk mengumpulkan data mengenai kebijakan, manfaat dan kerugian ACS, serta rekomendasi berbagai organisasi profesi terkait pemberian ACS. Metode: Data dikumpulkan melalui penelusuran data kebijakan, penelusuran literatur secara online untuk dibuat telaah secara sistematik serta pertemuan dengan narasumber dari organisasi profesi terkait. Hasil: Kebijakan yang sudah ada belum menjadi landasan hukum pemberian ACS dan belum ada prosedur teknis pelaksanaannya. ACS terbukti bermanfaat untuk membantu pematangan paru-paru pada janin sehingga mengurangi risiko komplikasi pada bayi prematur dan tidak memberikan komplikasi yang serius pada ibu. Pemberian ACS harus dilakukan sebagai satu paket komprehensif oleh tenaga kesehatan yang meliputi proses deteksi dini, pemberian tokolitik, pemberian ACS dan diikuti dengan rujukan ke fasilitas yang memadai. Pemahaman dan kompetensi tenaga kesehatan baik di rumah sakit maupun puskesmas perlu ditingkatkan dan didukung dengan peraturan yang memadai. Kesimpulan: Peningkatan cakupan pemberian ACS memerlukan dukungan kebijakan pemerintah serta peran organisasi profesi dan tenaga kesehatan.

  16. Thyroid disorders in antenatal women in a rural hospital in central India

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    Kalyani S. Mahajan

    2016-01-01

    Conclusions: The occurrence of thyroid disorders was high in our study with associated adverse maternal and fetal outcomes. Routine screening for thyroid dysfunction is recommended to prevent adverse fetal and maternal outcomes. Serum TSH is a sufficient and cost-effective screening tool. [Int J Reprod Contracept Obstet Gynecol 2016; 5(1.000: 62-67

  17. Antenatal and obstetric care in Afghanistan – a qualitative study among health care receivers and health care providers

    Science.gov (United States)

    2013-01-01

    Background Despite attempts from the government to improve ante- and perinatal care, Afghanistan has once again been labeled “the worst country in which to be a mom” in Save the Children’s World’s Mothers’ Report. This study investigated how pregnant women and health care providers experience the existing antenatal and obstetric health care situation in Afghanistan. Methods Data were obtained through one-to-one semi-structured interviews of 27 individuals, including 12 women who were pregnant or had recently given birth, seven doctors, five midwives, and three traditional birth attendants. The interviews were carried out in Kabul and the village of Ramak in Ghazni Province. Interviews were taped, transcribed, and analyzed according to the principles of Giorgi’s phenomenological analysis. Results Antenatal care was reported to be underused, even when available. Several obstacles were identified, including a lack of knowledge regarding the importance of antenatal care among the women and their families, financial difficulties, and transportation problems. The women also reported significant dissatisfaction with the attitudes and behavior of health personnel, which included instances of verbal and physical abuse. According to the health professionals, poor working conditions, low salaries, and high stress levels contributed to this matter. Personal contacts inside the hospital were considered necessary for receiving high quality care, and bribery was customary. Despite these serious concerns, the women expressed gratitude for having even limited access to health care, especially treatment provided by a female doctor. Health professionals were proud of their work and enjoyed the opportunity to help their community. Conclusion This study identified several obstacles which must be addressed to improve reproductive health in Afghanistan. There was limited understanding of the importance of antenatal care and a lack of family support. Financial and

  18. A STUDY OF ROUTINE ANTENATAL CARE AND ITS RELATIONSHIP WITH BIRTH WEIGHT IN DIMORIA BLOCK, KAMRUP DISTRICT, ASSAM

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    Mousumi

    2015-03-01

    Full Text Available BACKGROUND: Globally , more than 20 million infants are born with low birth weight . The large number of factors that could theoretically influence birth weight indicates that each of them may have rather small individual impact . [1] In Assam study indicates the prevalence of low birth weight of 25 . 5 % , 13% , and 8 . 7% . [ 2 , 3 , 4] Again the NFHS 3 data shows that the percentage of at least three ANC in last pregnancy was only 36 . 3% . With this rationale , the present study was undertaken from August 2010to July 2011 in Dimoria block with the objective to know the distribution of birth weight in the study area and Relationship of Birth weight with r outine antenatal care . METHODS: A total of 257 mothers and their new born were included in the study from 13 randomly selected village of Dimoria block . For calculation the sample size , correction factor for finite population was used . All the relevant inf ormation were collected in pre designed and pre tested schedule and the salient findings are summarized below . RESULT : Mean birth weight was more in mothers receiving ANC than those who did not . Out of 233 mothers (90 . 66% who had received antenatal care , majority (43 . 35% had 2 antenatal visits . A definite trend of increase mean birth weight was observed with increasing number of antenatal visit of mothers . A trend of decreasing mean birth weight was observed with increasing weeks of gestation at first a ntenatal checkup which was highly significant . Percentage of low birth weight baby was highest among the mothers who did not receive any doses of TT . Low birth weight babies were highest among the mothers who had not taken any IFA tablet during their pregn ancy . CONCLUSION: The study reveals that highest number of mothers was availing antenatal care during their pregnancy and it was noted that the mean birth weight was more in mothers receiving ANC than those who did not . To bring down the percentage of low birth weight in

  19. Predictors of ante-natal care, delivery and infant feeding practices among rural women in Madhya Pradesh, India

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    Indrapal Ishwarji Meshram

    2014-10-01

    Full Text Available Background: Maternal and infant mortality rates and prevalence of under nutrition are high in the State Madhya Pradesh. Regular ante-natal check-ups (ANC, delivery by trained health personnel, delivery practices and optimal infant feeding practices are important to reduce maternal and infant mortality. Objectives: The aim was to assess antenatal care, delivery and infant feeding practices of mothers of <1-year-old children in Madhya Pradesh. Materials and Methods: This was community-based cross-sectional study carried out in the rural areas of Madhya Pradesh by adopting systematic random sampling procedure. Data were collected from 5324 mothers having <1-year-old children. Information on household (HH socioeconomic and demographic particulars was collected from the mothers. Bivariate and multivariate analysis was performed to study the association between dependent and independent variables. Results and Interpretations: About 36% mothers had undergone at least three ante-natal check-ups and 73% delivered either at government or private hospitals. Only 26% mothers initiated breastfeeding within 1-h of birth and 92% fed colostrum. Step-wise regression analysis showed that ante-natal care for <3 times was significantly (P < 0.01 higher among women with high parity (≥5, illiterate women, and among lower socioeconomic group,s while home delivery was higher among women with high parity (≥5 (odds ratio [OR]: 2.3, among Scheduled Caste and Tribe women (OR: 1.5, illiteracy of head of HH (OR: 2, and among lower socioeconomic groups (OR: 1.3. Discarding colostrum was higher among illiterate women (OR: 1.6, belonging to lower socioeconomic groups (OR: 1.4 and delivery conducted by untrained person (OR: 3.9, while initiation of breastfeeding after 1-h of childbirth was higher among ≥30 years women (OR: 1.9, illiterate women (OR: 1.4, and delivery by untrained person (OR: 2.9. Conclusions: It was observed that antenatal care, delivery and infant and

  20. Antenatal corticosteroids for maturity of term or near term fetuses: systematic review and meta-analysis of randomized controlled trials

    Science.gov (United States)

    Saccone, Gabriele

    2016-01-01

    Objective To evaluate the effectiveness of antenatal corticosteroids given at ≥34 weeks’ gestation. Design Systematic review with meta-analysis. Data sources Electronic databases were searched from their inception to February 2016. Eligibility criteria for study selection Randomized clinical trials comparing antenatal corticosteroids with placebo or no treatment in women with a singleton pregnancy at ≥34 weeks’ gestation. Trials on antenatal steroids in women expected to deliver late preterm (340-366 weeks) and trials given before planned cesarean delivery at term (≥37 weeks) were included. Data synthesis The primary outcome was the incidence of severe respiratory distress syndrome (RDS). The summary measures were reported as relative risks or mean differences with 95% confidence intervals. Results Six trials, including 5698 singleton pregnancies, were analyzed. Three included 3200 women at 340-366 weeks’ gestation and at risk of imminent premature delivery at the time of hospital admission. The three other trials included 2498 women undergoing planned cesarean delivery at ≥37 weeks. Overall, infants of mothers who received antenatal corticosteroids at ≥34 weeks had a significantly lower risk of RDS (relative risk 0.74, 95% confidence interval 0.61 to 0.91), mild RDS (0.67, 0.46 to 0.96), moderate RDS (0.39, 0.18 to 0.89), transient tachypnea of the newborn (0.56, 0.37 to 0.86), severe RDS (0.55, 0.33 to 0.91), use of surfactant, and mechanical ventilation, and a significantly lower time receiving oxygen (mean difference −2.06 hours, 95% confidence interval −2.17 to −1.95), lower maximum inspired oxygen concentration (−0.66%, −0.69% to −0.63%), shorter stay on a neonatal intensive care unit (−7.64 days, −7.65 to −7.64), and higher APGAR scores compared with controls. Infants of mothers who received antenatal betamethasone at 340-366 weeks’ gestation had a significantly lower incidence of transient tachypnea of the newborn

  1. Using Lesson Study and Four-Column Lesson Planning with Preservice Teachers

    Science.gov (United States)

    Matthews, Michael E.; Hlas, Christopher S.; Finken, Teresa M.

    2009-01-01

    This article presents four-column lesson planning, an adaptation of lesson study, for preservice secondary school teachers. Four-column plans, an integral part of Japanese lesson study, have been less emphasized in the United States. This article presents study results indicating how these teachers were affected by this lesson study adaptation:…

  2. Designing and Adapting Tasks in Lesson Planning: A Critical Process of Lesson Study

    Science.gov (United States)

    Fujii, Toshiakira

    2016-01-01

    There is no doubt that a lesson plan is a necessary product of Lesson Study. However, the collaborative work among teachers that goes into creating that lesson plan is largely under-appreciated by non-Japanese adopters of Lesson Study, possibly because the effort involved is invisible to outsiders, with our attention going to its most visible…

  3. Factors associated with underutilization of antenatal care services in Indonesia: results of Indonesia Demographic and Health Survey 2002/2003 and 2007

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    Titaley Christiana R

    2010-08-01

    Full Text Available Abstract Background Antenatal care aims to prevent maternal and perinatal mortality and morbidity. In Indonesia, at least four antenatal visits are recommended during pregnancy. However, this service has been underutilized. This study aimed to examine factors associated with underutilization of antenatal care services in Indonesia. Methods We used data from Indonesia Demographic and Health Survey (IDHS 2002/2003 and 2007. Information of 26,591 singleton live-born infants of the mothers' most recent birth within five years preceding each survey was examined. Twenty-three potential risk factors were identified and categorized into four main groups, external environment, predisposing, enabling, and need factors. Logistic regression models were used to examine the association between all potential risk factors and underutilization of antenatal services. The Population Attributable Risk (PAR was calculated for selected significant factors associated with the outcome. Results Factors strongly associated with underutilization of antenatal care services were infants from rural areas and from outer Java-Bali region, infants from low household wealth index and with low maternal education level, and high birth rank infants with short birth interval of less than two years. Other associated factors identified included mothers reporting distance to health facilities as a major problem, mothers less exposed to mass media, and mothers reporting no obstetric complications during pregnancy. The PAR showed that 55% of the total risks for underutilization of antenatal care services were attributable to the combined low household wealth index and low maternal education level. Conclusions Strategies to increase the accessibility and availability of health care services are important particularly for communities in rural areas. Financial support that enables mothers from poor households to use health services will be beneficial. Health promotion programs targeting

  4. Debye screening

    Science.gov (United States)

    Brydges, David C.; Federbush, Paul

    1980-10-01

    The existence and exponential clustering of correlation functions for a classical coulomb system at low density or high temperature are proven using methods from constructive quantum field theory, the sine gordon transformation and the Glimm, Jaffe, Spencer expansion about mean field theory. This is a vindication of a belief of long standing among physicists, known as Debye screening. That is, because of special properties of the coulomb potential, the configurations of significant probability are those in which the long range parts of r -1 are mostly cancelled, leaving an effective exponentially decaying potential acting between charge clouds. This paper generalizes a previous paper of one of the authors in which these results were obtained for a special lattice system. The present treatment covers the continuous mechanics situation, with essentially arbitrary short range forces and charge species. Charge symmetry is not assumed.

  5. The triple test as a screening technique for Down syndrome: reliability and relevance

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    Tim Reynolds

    2010-05-01

    Full Text Available Tim ReynoldsClinical Chemistry Department, Queen’s Hospital, Burton-on-Trent, Staffordshire, UKAbstract: The triple test is a second trimester screening test used to identify those pregnant women who should be offered a diagnostic test to identify whether their fetus has an aneuploidy. It was first described in 1988, but has largely been superseded by newer tests either conducted earlier in the first trimester (ie, the combined test, using ultrasound measurement of nuchal translucency,pregnancy-associated plasma protein A, and human chorionic gonadotrophin [hCG] or in the second trimester (ie, the quadruple test, using α-fetoprotein, hCG, uE3, and inhibin. These newer tests have been introduced because they offer greater detection and lower screen positive results thereby enhancing diagnosis rates, while decreasing the risk of iatrogenic harm caused by the invasive testing required when collecting suitable sample tissue. Noninvasive alternatives to the triple test have been identified, but these have not been adopted despite 13 years of development. It is likely, therefore, that the triple test (or variants thereof will continue to be used in routine antenatal care for the foreseeable future.Keywords: pregnancy, screening test, antenatal, Down syndrome

  6. Lesson planning in English language teaching

    OpenAIRE

    FAFÍLKOVÁ, Gabriela

    2009-01-01

    ABSTRACT The diploma thesis ``Lesson planning in English language teaching`` explores the aspects of lesson planning in English language teaching of three teachers with various length of the pedagogical teaching practice. The aim of this diploma thesis is to find out how detailed lesson planning the teachers prepare, what they focus on, if the methodology is more important than language and if they use their lesson planning in other parallel classes. The thesis is divided into a theoretical a...

  7. Lessons from the Sun

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    Robitaille P.-M.

    2011-07-01

    Full Text Available In this brief note, the implications of a condensed Sun will be examined. A celestial body composed of liquid metallic hydrogen brings great promise to astronomy, relative to understanding thermal emission and solar structure. At the same time, as an incom- pressible liquid, a condensed Sun calls into question virtually everything which is cur- rently believed with respect to the evolution and nature of the stars. Should the Sun be condensed, then neutron stars and white dwarfs will fail to reach the enormous densities they are currently believed to possess. Much of cosmology also falls into question, as the incompressibility of matter curtails any thought that a primordial atom once existed. Aging stars can no longer collapse and black holes will know no formative mechanism. A condensed Sun also hints that great strides must still be made in understanding the nature of liquids. The Sun has revealed that liquids possess a much greater potential for lattice order than previously believed. In addition, lessons may be gained with regards to the synthesis of liquid metallic hydrogen and the use of condensed matter as the basis for initiating fusion on Earth.

  8. Femtosecond photography lessons

    Science.gov (United States)

    Fanchenko, S. D.

    1999-06-01

    Antic scientists, sailors, warriors, physician, etc. were perceiving the space by means of their eye vision system. Nowadays the same people use eyeglasses, telescopes, microscopes, image converters. All these devices fit the necessary magnification, intensification gain and image spectrum to the eyes. The human brain is processing the image data offered to him in a format pertaining to eyes. Hence, the cognition of images can be regarded as a direct measurement. As to the time scale converters, they turned out to be harder done as compared with the spatial scale converters. Hence, the development of the high-speed photography (HSP) continues for more than a hundred and fifty years. The recent pico- femtosecond HSP branch sprang up in 1949 at the Kurchatov Institute -- its cradle. All about the HSP had been advertised. Instead of reprinting what is already well known, it makes sense to emphasize some instructive lessons drawn from past experience. Also it is tempting to look a bit into the high-speed photography future.

  9. Lessons from Rotor 37

    Institute of Scientific and Technical Information of China (English)

    J.D.Denton

    1997-01-01

    NASA rotor 37 was used as a blind test case for turbomachinery CFD by the Turbomachinery Committee of the IGTI.The rotor is a transonic compressor with a tip speed of 454 m/s(1500ft/s)and a relatively high pressure ratio of 2.1.It was tested in isolation with a circumferentially uniform inlet flow so that the flow through it should be steady apart from and effects of passage to passage geometry variation and mechanical vibration.As such it represents the simplest possible type of test for three-dimensional turbomachinery flow solvers.Howerver,the rotor still presents a real challenge to 3D viscous flow solvers because the shock wave-boudary layer interaction is strong and the effects of viscosity are dominant in determining the flow deviation and hence the pressure ration.Eleven blind solutions were submittewd and in addition a non-blind solution was used to prepare for the exercies.This paper reviews the flow in the test case and the comparisons of the CFD solutions with the test data.Lessons for both the Flow physics in transonic fans and for the application of CFD to such machines are pointed out.

  10. More than Tolerance for Engineering Lessons

    Science.gov (United States)

    Burrows, Andrea; Herfat, Safa; Truesdell, Pam; Miller, Richard

    2013-01-01

    Described herein is a science, mathematics, engineering, and technology (STEM) secondary lesson created by graduate engineering student Safa Herfat, with modifications by her co-authors. The lessons learned from this case study are explored through an explanation of tolerance, a description of the lesson, the results obtained, and participant…

  11. Lessons from 30 Years of Flight Software

    Science.gov (United States)

    McComas, David C.

    2015-01-01

    This presentation takes a brief historical look at flight software over the past 30 years, extracts lessons learned and shows how many of the lessons learned are embodied in the Flight Software product line called the core Flight System (cFS). It also captures the lessons learned from developing and applying the cFS.

  12. Environmental Restoration Disposal Facility Lessons Learned

    Energy Technology Data Exchange (ETDEWEB)

    Caulfield, R.

    2012-07-12

    The purpose of lessons learned is to identify insight gained during a project – successes or failures – that can be applied on future projects. Lessons learned can contribute to the overall success of a project by building on approaches that have worked well and avoiding previous mistakes. Below are examples of lessons learned during ERDF’s ARRA-funded expansion project.

  13. Effectiveness of Lesson Planning: Factor Analysis

    Science.gov (United States)

    Panasuk, Regina M.; Todd, Jeffrey

    2005-01-01

    The paper presents the conceptual framework that guided the development of the Lesson Plan Evaluation Rubric (LPER) instrument derived from the Four Stages of Lesson Planning (FSLP) strategy and the empirical results that provide the insight into the elements of lesson planning. Teachers from urban low-performing middle schools in one of the New…

  14. Lesson Plays: Planning Teaching versus Teaching Planning

    Science.gov (United States)

    Zazkis, Rina; Liljedahl, Peter; Sinclair, Nathalie

    2009-01-01

    We introduce Lesson Play as an imaginary interaction between teacher and students presented in a form of a dialogue or play. We suggest that lesson plays are a valuable professional development tool in preparing for teaching that can be juxtaposed with, or used as a replacement for, traditional lesson planning. The article begins with an…

  15. Improving Teaching through Lesson Study Debriefing

    Science.gov (United States)

    Groth, Randall E.

    2011-01-01

    The lesson study model of professional development that originated in Japan is becoming increasingly popular in the United States. At its core, lesson study is a means of bringing teachers together to carry out the process of planning a lesson, implementing and observing it, and then examining it during a debriefing session. The debriefing…

  16. Lesson Plan Design for Facilitating Differentiated Instruction

    Science.gov (United States)

    Baker, Pamela Hudson; Fleming, Louise Conn

    2005-01-01

    This study examines the role of lesson plan design in helping teacher candidates to meet diverse learning needs. The authors studied student teachers who had been taught to use a differential lesson plan to see if they were differentiating in their planning, assessment, and instruction. They concluded that, indeed, lesson plan design does…

  17. Antenatal Corticosteroids Alter Insulin Signaling Pathways in Fetal Baboon Skeletal Muscle

    Science.gov (United States)

    BLANCO, Cynthia L.; MOREIRA, Alvaro G.; McGILL, Lisa L.; ANZUETO, Diana G.; NATHANIELSZ, Peter; MUSI, Nicolas

    2015-01-01

    Objective We hypothesize that prenatal exposure to glucocorticoids (GCs) will negatively alter the insulin signal transduction pathway and has differing effects on the fetus according to gestational age at exposure. Methods Twenty-three fetal baboons were delivered from twenty-three healthy, non-diabetic mothers. Twelve preterm (0.67 gestational age) and eleven near term (0.95 gestational age) baboons were euthanized immediately after delivery. Half of the pregnant baboons at each gestation received two doses of intramuscular betamethasone 24-hours apart (170 μg.kg−1) before delivery, while the other half received no intervention. Vastus lateralis muscle was obtained from postnatal animals to measure protein content and gene expression of insulin receptor (IR)-β, IR-β Tyr 1361 phosphorylation (pIR-β), IR substate-1 (IRS-1), IRS-1 tyrosine phosphorylation (pIRS-1), p85 subunit of PI3-kinase (p85), Akt (Protein Kinase B), phospho-Akt Ser473 (pAkt), Akt-1, Akt-2, and glucose transporters (GLUT1 and GLUT4). Results Skeletal muscle from preterm baboons exposed to glucocorticoids had markedly reduced protein content of Akt and Akt-1 (respectively, 73% and 72% from 0.67 gestational age Control, P<0.001); IR-β and pIR-β were decreased (respectively, 94% and 85%, P<0.01) in the muscle of premature GC exposed fetuses, but not in term fetuses. GLUT1 and GLUT4 tended to increase with GC exposure in preterm animals (P=0.09), while GLUT4 increased 6.0 fold in term animals after GC exposure (P<0.05). Conclusion Exposure to a single course of antenatal GCs during fetal life alters the insulin-signaling pathway in fetal muscle in a manner dependent on the stage of gestation. PMID:24756099

  18. Abnormal antenatal sonogram: an indicator of disease severity in children with posterior urethral valves

    Energy Technology Data Exchange (ETDEWEB)

    Harvie, S. [Peterborough Health Centre, Dept. of Radiology, Peterborough, Ontario (Canada); McLeod, L. [IWK Health Centre, Dept. of Obstetrics and Gynaecology, Halifax, Nova Scotia (Canada); Acott, P. [IWK Health Centre, Dept. of Nephrology, Halifax, Nova Scotia (Canada); Walsh, E. [Dr. Charles A. Janeway Children' s Health Centre, Dept. of Radiology, St. John' s, Newfoundland (Canada); Abdolell, M. [QE II Health Sciences Centre, Dept. of Radiology, Halifax, Nova Scotia (Canada); Macken, M.B., E-mail: mmacken@dal.ca [IWK Health Centre, Dept. of Diagnostic Imaging, Halifax, Nova Scotia (Canada)

    2009-10-15

    To review the association of an abnormal prenatal sonogram with most recent serum creatinine in patients with proven posterior urethral valves (PUV). Since 1992, all live-born patients between 1992-2004 with clinically proven PUV, with postnatally proven PUV, from 2 pediatric tertiary care centers, were reviewed for age at diagnosis, most recent serum creatinine, presence of chronic renal failure (CRF) (serum creatinine >2 standard deviations above normal for age), or end stage renal disease (dialysis or transplant). Available antenatal reports from the 2 centres and surrounding community hospitals were reviewed for gestational age (GA) at the time of ultrasound, volume of amniotic fluid, and urinary-tract abnormality. Thirty-four patients with proven PUV and prenatal sonograms were identified (1992-2004). Eighteen patients had abnormalities on their prenatal sonogram, with poor outcome in 5 (mean follow-up, 8 years [1-13 y]). No specific features were identified on prenatal sonogram. Sixteen patients had normal prenatal sonograms, with poor outcomes in 2 (mean follow-up, 8 years [3-13 y]). There is an increased risk of an abnormal serum creatinine among those patients with an abnormal prenatal study, odds ratio (OR) 2.6 (95% confidence interval, 0.35-32). PUV represents a spectrum of disease severity. A normal prenatal ultrasound does not preclude PUV. The majority of patients with a normal prenatal examination have good outcomes. The OR suggests that there may be increased risk for poor outcome in those with an abnormal prenatal examination. A multicenter study is necessary to obtain a larger sample size and more precise ORs. (author)

  19. Contraceptive Awareness and Practice Among Antenatal Attendees in a Tertiary Hospital in South-South Nigeria

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    Aniekan Monday Abasiattai

    2011-02-01

    Full Text Available Background: Use of effective contraceptive methods has been shown to improve health, sexual life and partner relations and also significantly reduce maternal and infant mortality by protecting against unplanned pregnancy, high fertility and high parity. The aim of this study is to determine the degree of awareness and practice of contraception by women in Uyo, Nigeria. Materials and Methods: Semi-structured questionnaires were administered to three hundred and seventy women in the antenatal clinic of the University of Uyo Teaching Hospital. Results: Majority of the respondents were 21-30 years old (64.1%, 53.8% were multiparous and 66.5% had tertiary level education. Three hundred and twenty women (87.6% had heard about contraception (OR=49.6, P< 0.001, while only 49.5% of the respondents had practiced contraception previously (OR=0.96, P=0.76 of which the male condom (40.0% and the safe period/calendar method (31.1% were the most commonly practiced methods. Majority of the respondents (66.8% preferred to have 3 to 4 children and 78.4% of the respondents would want to used a method of contraception to either space their family or limit child bearing (OR=13.14, P< 0.001. Fear of side effects (20.0% and previous bad experience (8.8% were the most common reasons given by those respondents who would not want to practice contraception. Conclusion: This study reveals a high level of awareness of contraception but a significant unmet need among the respondents. There is need to intensify public enlightenment campaigns in our environment emphasizing the benefits and safety of modern contraceptive methods. Community leaders and heads of social groups and women organisations should be co-opted in the dissemination of accurate information on contraception. [TAF Prev Med Bull 2011; 10(1.000: 29-34

  20. Understanding why women adopt and sustain home water treatment: insights from the Malawi antenatal care program.

    Science.gov (United States)

    Wood, Siri; Foster, Jennifer; Kols, Adrienne

    2012-08-01

    In many settings in Africa, social marketing has proven more successful in generating brand recognition for chlorine water treatment products than in promoting their use. To promote household use of one such product in Malawi, WaterGuard, the Ministry of Health (MOH) and Population Services International (PSI) distributed free hygiene kits that included WaterGuard to pregnant women attending antenatal clinics in 2007. Follow-up surveys documented a sustained increase in WaterGuard use three years after the initial intervention. In 2010, PATH (www.path.org) conducted qualitative research on the factors motivating women to adopt, sustain, or discontinue use. To provide context, interviews were also conducted with their friends, relatives, and husbands. Interviews revealed that sustained use of WaterGuard does not necessarily imply consistent use. Most respondents reported switching back and forth between WaterGuard and stock chlorine distributed for free by the government, and many treated water seasonally rather than year-round. Qualitative findings suggest that two program strategies strongly influenced women's decisions to adopt, purchase, and continue using WaterGuard. First, positive, ongoing contacts with health care workers, especially during home visits, raised awareness of the need to treat water, encouraged trial use, and supported continuing use. Second, an extended free trial of the product overcame initial cost barriers and allowed women and their families to experience the health benefits of WaterGuard, appreciate its value and relevance to their lives, and get used to its taste. Social support-from like-minded relatives, friends, neighbors, health care workers, husbands, and children-was also a critical factor that promoted consistent, ongoing use of WaterGuard. The findings confirm the importance of interpersonal communication in prompting adoption of household water treatment and suggest that consumers assess the perceived value of a product, not

  1. Antenatal Care Services Utilization in Yobe State, Nigeria: Examining Predictors and Barriers

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    Abubakar Sadiq Umar, MBBS, MPH, MHPM, FWACP

    2015-10-01

    Full Text Available Objective: In Nigeria, wide disparities exist between the different parts of the country, with the states in the North East zone having poor health resources. The objective of this study is to assess whether women’s biological, sociocultural, and economic characteristics are associated with utilization of ante natal care services as measured by number of antenatal care (ANC visits in Yobe State. Methods: This is a secondary data analysis of the 2008 Nigeria Demographic and Health Survey with records from 33,385 women between 15-49 years who had given birth between January 2003 and December 2008 in Yobe State. Bivariate Pearson’s Chi square test and two stages of Multivariate regression analysis were conducted. Results: Women with at least primary level education (adjusted OR (AOR = 2.40; CI 1.24 – 4.67, belonging to professional employment category (AOR = 12.07; CI 0.19 – 75.74 and those who had access to skilled health workers (AOR = 5.13; CI 2.50 – 10.52 are more likely to make the required number of ANC visits compared to those who are illiterates, unemployed and had no access to skilled health workers. Conclusion and Global Health Implications: This study demonstrated that educational level, family wealth income, and availability of skilled health worker were consistently associated with the number of ANC visits even after controlling for covariates. These three covariates are in tandem with the Millenium Development Goals (MDG 1 – eradication of extreme poverty and hunger; MDG 2 – universal basic education; MDG 3 – gender equality; and MDG 4 – maternal mortality. There is the need for inter-sectoral holistic intervention approach.

  2. Factors affecting antenatal care attendance: results from qualitative studies in Ghana, Kenya and Malawi.

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    Christopher Pell

    Full Text Available BACKGROUND: Antenatal care (ANC is a key strategy to improve maternal and infant health. However, survey data from sub-Saharan Africa indicate that women often only initiate ANC after the first trimester and do not achieve the recommended number of ANC visits. Drawing on qualitative data, this article comparatively explores the factors that influence ANC attendance across four sub-Saharan African sites in three countries (Ghana, Kenya and Malawi with varying levels of ANC attendance. METHODS: Data were collected as part of a programme of qualitative research investigating the social and cultural context of malaria in pregnancy. A range of methods was employed interviews, focus groups with diverse respondents and observations in local communities and health facilities. RESULTS: Across the sites, women attended ANC at least once. However, their descriptions of ANC were often vague. General ideas about pregnancy care - checking the foetus' position or monitoring its progress - motivated women to attend ANC; as did, especially in Kenya, obtaining the ANC card to avoid reprimands from health workers. Women's timing of ANC initiation was influenced by reproductive concerns and pregnancy uncertainties, particularly during the first trimester, and how ANC services responded to this uncertainty; age, parity and the associated implications for pregnancy disclosure; interactions with healthcare workers, particularly messages about timing of ANC; and the cost of ANC, including charges levied for ANC procedures - in spite of policies of free ANC - combined with ideas about the compulsory nature of follow-up appointments. CONCLUSION: In these socially and culturally diverse sites, the findings suggest that 'supply' side factors have an important influence on ANC attendance: the design of ANC and particularly how ANC deals with the needs and concerns of women during the first trimester has implications for timing of initiation.

  3. Evaluation of the 'healthy start to pregnancy' early antenatal health promotion workshop: a randomized controlled trial

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    Wilkinson Shelley A

    2012-11-01

    Full Text Available Abstract Background Pregnancy is an ideal time to encourage healthy lifestyles as most women access health services and are more receptive to health messages; however few effective interventions exist. The aim of this research was to deliver a low-intensity, dietitian-led behavior change workshop at a Maternity Hospital to influence behaviors with demonstrated health outcomes. Methods Workshop effectiveness was evaluated using an RCT; ‘usual care’ women (n = 182 received a nutrition resource at their first antenatal visit and 'intervention' women also attended a one-hour ‘Healthy Start to Pregnancy’ workshop (n = 178. Dietary intake, physical activity levels, gestational weight gain knowledge, smoking cessation, and intention to breastfeed were assessed at service-entry and 12 weeks later. Intention-to-treat (ITT and per-protocol (PP analyses examined change over time between groups. Results Approximately half (48.3% the intervention women attended the workshop and overall response rate at time 2 was 67.2%. Significantly more women in the intervention met pregnancy fruit guidelines at time 2 (+4.3%, p = 0.011 and had a clinically-relevant increase in physical activity (+27 minutes/week compared with women who only received the resource (ITT. Women who attended the workshop increased their consumption of serves of fruit (+0.4 serves/day, p = 0.004, vegetables (+0.4 serves/day, p = 0.006, met fruit guidelines (+11.9%, p , had a higher diet quality score (p = 0.027 and clinically-relevant increases in physical activity (+21.3 minutes/week compared with those who only received the resource (PP. Conclusions The Healthy Start to Pregnancy workshop attendance facilitates improvements in important health behaviors. Service changes and accessibility issues are required to assist women's workshop attendance to allow more women to benefit from the workshop’s effects. Trial registration Australian New Zealand Clinical Trials Registry ACTRN

  4. Rural/urban and socioeconomic differentials in quality of antenatal care in Ghana.

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    Patience A Afulani

    Full Text Available Approximately 800 women die of pregnancy-related complications every day. Over half of these deaths occur in sub-Saharan Africa (SSA. Most maternal deaths can be prevented with high quality maternal health services. It is well established that use of maternal health services vary by place of residence and socioeconomic status (SES, but few studies have examined the determinants of quality of maternal health services in SSA. The purpose of this study is to examine the determinants of antenatal care (ANC quality in Ghana-focusing on the role of place of residence and SES (education and wealth. The analysis also examines the interactions of these variables and the mediating role of ANC timing, frequency, facility type, and provider type.The data are from the Ghana Maternal Health Survey (N = 4,868. Analytic techniques include multilevel linear regression with mediation and moderation analysis.Urban residence and higher SES are positively associated with higher ANC quality, but the urban effect is completely explained by sociodemographic factors. Specifically, about half of the urban effect is explained by education and wealth alone, with other variables accounting for the remainder. The effects of education are conditional on wealth and are strongest for poor women. Starting ANC visits early and attending the recommended four visits as well as receiving ANC from a higher level facility and from a skilled provider are associated with higher quality ANC. These factors partially explain the SES differentials.Ghanaian women experience significant disparities in quality of ANC, with poor illiterate women receiving the worst care. Targeted efforts to increase quality of ANC may significantly reduce maternal health disparities in Ghana and SSA. A particularly crucial step is to improve ANC quality in the lower level health facilities, where the most vulnerable women are more likely to seek ANC.

  5. The effectiveness of antenatal care programmes to reduce infant mortality and preterm birth in socially disadvantaged and vulnerable women in high-income countries: a systematic review

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    Brocklehurst Peter

    2011-02-01

    Full Text Available Abstract Background Infant mortality has shown a steady decline in recent years but a marked socioeconomic gradient persists. Antenatal care is generally thought to be an effective method of improving pregnancy outcomes, but the effectiveness of specific antenatal care programmes as a means of reducing infant mortality in socioeconomically disadvantaged and vulnerable groups of women has not been rigorously evaluated. Methods We conducted a systematic review, focusing on evidence from high income countries, to evaluate the effectiveness of alternative models of organising or delivering antenatal care to disadvantaged and vulnerable groups of women vs. standard antenatal care. We searched Medline, Embase, Cinahl, PsychINFO, HMIC, CENTRAL, DARE, MIDIRS and a number of online resources to identify relevant randomised and observational studies. We assessed effects on infant mortality and its major medical causes (preterm birth, congenital anomalies and sudden infant death syndrome (SIDS Results We identified 36 distinct eligible studies covering a wide range of interventions, including group antenatal care, clinic-based augmented care, teenage clinics, prenatal substance abuse programmes, home visiting programmes, maternal care coordination and nutritional programmes. Fifteen studies had adequate internal validity: of these, only one was considered to demonstrate a beneficial effect on an outcome of interest. Six interventions were considered 'promising'. Conclusions There was insufficient evidence of adequate quality to recommend routine implementation of any of the programmes as a means of reducing infant mortality in disadvantaged/vulnerable women. Several interventions merit further more rigorous evaluation.

  6. Knowledge attitude and practices for antenatal care and delivery of the mothers of tea garden in Jalpaiguri and Darjeeling districts, West Bengal

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    Prabir Kumar Manna, Debasis De and Debidas Ghosh

    2011-01-01

    Full Text Available The present study aimed to access the influence of socioeconomic factors on antenatal care and delivery practices of the mother of North Bengal. A community based study was carried out among 1772 families of the 7 blocks of the two districts. Various socio economic factors were considered for the antenatal care and delivery practices. We also tried to find out the relationship between antenatal check up with perinatal mortality. The study shows that the muslim mothers, Scheduled tribe mothers, non -educated and mothers with higher age group are less interested about ANC. Family income 2000/- month showing 62.42% ANC coverage. We found that only 7.11% mother used Govt. hospital and 2.65% used private clinic. The mother with medical problems and obstetric problems has high ANC coverage. So, socioeconomic factors significantly influence the antenatal coverage and delivery practices. Hence initiative may be taken at Government and non government levels to raise knowledge, attitude and practices for the improvement of antenatal care and delivery practices of the mother at these zones.

  7. Antenatal care practice and the chance of having nurse/midwife birth attendant: a study in Central Mountain of Papua

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    Marinda Asiah Nuril Haya

    2015-01-01

    Full Text Available AbstrakLatar belakang: Papua merupakan salah satu propinsi di Indonesia dengan angka kematian ibu tertinggi di Indonesia. Penolong persalinan terlatih dan asuhan antenatal (ANC merupakan salah satu faktor yang penting untuk menurunkan angka kematian ibu. Tujuan studi ini untuk mengidentifikasi pengaruh ANC dan beberapa faktor yang lain terhadap kemungkinan persalinan yang ditolong oleh perawat/bidan di Papua.Metode: Studi potong lintang dengan sampling purposif dilakukan terhadap perempuan yang mempunyai anak balita yang datang ke Posyandu pada 15-30 Januari 2014 di 24 desa wilayah pegunungan tengah Jayawijaya, Papua. Karakteristik demografi, praktek ANC dan persalinan didapatkan melalui wawancara. Subjek diklasifikasikan ke dalam 2 kelompok, yang bersalin didampingi perawat/bidan dan yang menolong sendiri atau ditolong keluarga. Analisis dilakukan dengan regresi Cox dengan waktu konstan. Hasil: Dari 469 subjek, 391 subjek yang dianalisis terdiri dari 280 subjek yang melahirkan ditolong sendiri/keluarga dan 111 subjek yang ditolong perawat/bidan. Subjek yang yang melahirkan di hutan atau kandang hina hanya 3 orang. Dibandingkan dengan yang tidak pernah ANC, subjek yang melakukan ANC di Posyandu 5,6 kali kemungkinan melahirkan ditolong perawat/bidan [risiko relatif suaian (RRa = 5,60; interval kepercayaan 95% (CI = 2,99-10,47]. Selain itu, subjek yang mendapatkan pemeriksaan ANC oleh bidan dan kunjungan ANC 4 kali memiliki kemungkinan lebih tinggi untuk melahirkan ditolong perawat/bidan, masing-masing 4,9 kali (RRa = 4,89; 95% CI = 2,70-8,86 dan 6,9 kali (RRa = 6.90; 95% CI = 3,59-13,27.Kesimpulan: Asuhan antenatal adalah cara untuk meningkatkan angka persalinan yang ditolong oleh tenaga tenaga perawat/bidan di Papua. (Health Science Indones 2014;2:60-6Kata kunci: asuhan antenatal, persalinan oleh perawat/bidan, PapuaAbstractBackground: Papua has one of the highest maternal mortality rates in Indonesia. Nurse/midwife birth attendants and regular

  8. ANTENATAL THYROID DYSFUNCTION IN RAYALASEEMA REGION: A PRELIMINARY CROSS SECTIONAL STUDY BASED ON CIRCULATING SERUM THYROTROPIN LEVELS

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    Pandit Vinodh Bandela

    2013-12-01

    Full Text Available The foetal brain development can be influenced by thyroid gland functioning. Sub normal function of thyroid gland in first trimester of pregnancy leads to miscarriages, stillborn and anomalies of central nervous system in foetus. The environmental factors that will effect thyroid gland functioning are deficit soil iodine, high fluoridation of water and low dietary iodine intake. Rayalaseema is endemic for iodine and most of the communities are suffering from high fluoride levels of water. Therefore study was designed to estimate prevalence of thyroid dysfunction in pregnant women of Rayalaseema region. Materials and Methods: 139 first trimester pregnant women randomly selected from Obstetrics and Gynaecology department of Santhiram medical college and General Hospital, Nandyal during the period from April 2013 to June 2013 in respect of inclusion and exclusion criteria. And fasting blood samples of the participants were analyzed for T3, T4 and TSH. Based on the TSH levels subjects were categorised in to euthyroid, hypothyroid, subclinical hypothyroid and hyper thyroid. Results: The prevalence of antenatal thyroid dysfunction is 18.70% [10.0% - subclinical hypothyroid, 2.87% - overt hypothyroid, 5.75% - hyperthyroid and 81.29% - euthyroid]. 37.5%- tribal, 10.81% - rural and 21.21% urban antenatal are suffering from thyroid dysfunction. Median maternal age was 25 years and gestational age was 8.5 weeks. Prevalence of pregnancy related risk factors include 26.92% - personnel thyroid history, 11.53% - hypertension, 15.38% - elevated fasting blood glucose, 30.76 % - family thyroid history. Conclusion: Subclinical hypothyroidism was highly prevalent among Rayalaseema region antenatal women at first trimester of pr

  9. The influence of antenatal exposure to phthalates on subsequent female reproductive development in adolescence: a pilot study.

    Science.gov (United States)

    Hart, Roger; Doherty, Dorota A; Frederiksen, Hanne; Keelan, Jeffrey A; Hickey, Martha; Sloboda, Deborah; Pennell, Craig E; Newnham, John P; Skakkebaek, Niels E; Main, Katharina M

    2014-01-01

    We hypothesised that antenatal exposure to ubiquitous phthalates may lead to an earlier menarche and a lower prevalence of polycystic ovarian syndrome (PCOS) and polycystic ovarian morphology (PCO) in adolescence. The Western Australian Pregnancy Cohort (Raine) Study recruited 3000 women at 18 weeks of gestation in 1989-1991, 1377 had antenatal serum stored without thawing at -80 °C. An unselected subset was evaluated in the early follicular phase for PCO and PCOS by ultrasound and serum evaluation in adolescence. Serum was analysed for anti-Müllerian hormone (AMH), inhibin B, sex hormone binding globulin (SHBG), testosterone, androstenedione and DHEAS. Four hundred microlitres of the frozen maternal serum underwent isotope-diluted liquid chromatography-tandem mass spectrometry, with preceding enzymatic deconjugation followed by solid-phase extraction to determine phthalate exposure. Two hundred and forty four girls attended assessment and most common phthalate metabolites were detectable in the majority of the 123 samples available. Several phthalates were negatively associated with maternal SHBG, and associations with maternal androgens were less consistent. The sum of the metabolites of di-(2-ethylhexyl) phthalate was associated with a non-significant tendency towards an earlier age at menarche (P=0.069). Uterine volume was positively associated with mono-(carboxy-iso-octyl) phthalate (P=0.018). Exposure to monoethyl phthalate (MEP) and the sum of all phthalate metabolites (Σall phth.m) were protective against PCOS in adolescence (P=0.001 and P=0.005 respectively). There were negative associations of MEP with PCO (P=0.022) and of MEP with serum AMH (P=0.031). Consequently, our data suggest that antenatal exposure to environmental phthalates may be associated with oestrogenic and/or anti-androgenic reproductive effects in adolescent girls.

  10. Gestational age at booking for antenatal care in a tertiary health facility in north-central, Nigeria

    Directory of Open Access Journals (Sweden)

    Dennis Isaac Ifenne

    2012-01-01

    Full Text Available Background: Early initiation of antenatal care is widely believed to improve maternal and fetal outcome. This study was designed to ascertain the gestational age at booking using World Health Organization recommendations for developing countries. Materials and Methods: This cross-sectional study was carried out using interviewer-administered questionnaire to 345 willing participants at a booking clinic in a tertiary health facility in North-Central, Nigeria. Results: A total of 345 women were interviewed. The average age of the clients was 27.1±5.1 years. Almost (45.8% had at least secondary level of education. One-third of the women were not working women. The average gestational age at booking was 19.1±7.8. Late booking (≥17 weeks was significantly influenced by the client′s level of education ( P=0.017. Reasons for booking late were given as follows: Not being sick (26.1%, Lack of knowledge of booking time (22.8%, having booked elsewhere (14.1%, financial constraints (9.2%, fear of too many follow-up visits (4.9%, spouse′s un co-operative attitude (3.9%, lack of transport to the health care facility (2.2%, and other minor reasons (16.8%. Conclusion: Most women booked for antenatal care (ANC late. Efforts toward maternal education, public health enlightenment campaigns, poverty reduction, and use of focused antenatal care model should be sustained as measures to encourage early initiation of ANC.

  11. Cost-effectiveness analysis for triple markers serum screening for Down′s syndrome in Thai setting

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    Viroj Wiwanitkit

    2014-01-01

    Full Text Available Background: Down′s syndrome is an important congenital chromosomal disorder that can be seen around the world. The antenatal screening for this disorder is an important processing in present obstetrics. Objective: Due to the concept of first do no harm, the use of noninvasive test is recommended. The triple marker screening test has been introduced for a few years and acceptable for its effi cacy. Result: However, an important concern is on its cost-effectiveness. Here, the author analyze and present the cost-effectiveness of the triple markers serum screening for Down′s syndrome in Thai setting. Conclusion: According to this work, the cost per effectiveness of triple markers serum screening is slightly lower than standard amniocentesis test.

  12. Determinants of Antenatal Care Attendance among Pregnant Women Living in Endemic Malaria Settings: Experience from the Democratic Republic of Congo

    Science.gov (United States)

    Manianga, Célestin; Kapanga, Serge; Mona, Esther; Pululu, Philippe

    2016-01-01

    Background. Antenatal care (ANC) attendance helps pregnant women to benefit from preventive and curative services. Methods. Determinants for ANC attendance were identified through a cross-sectional survey in the Democratic Republic of Congo. Sociocultural bottlenecks were assessed via focus groups discussion of married men and women. Results. In this survey, 28 of the 500 interviewed pregnant women (5.6%) did not attend ANC services and 82.4% booked over the first trimester. The first visit is positively influenced by the reproductive age (OR: 0.52, 95% CI(0.28–0.95), p attendance is delayed among poor women with little education and living alone.

  13. Antenatal Iron Supplementation Regimens for Pregnant Women in Rural Vietnam and Subsequent Haemoglobin Concentration and Anaemia among Their Infants.

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    Thach Duc Tran

    Full Text Available Little evidence about the effects of antenatal iron supplementation on infant anaemia is available. The aim was to compare effects on six-month-old infants' Haemoglobin (Hb concentration and anaemia of daily iron-folic acid (IFA, twice-weekly IFA with or without other micronutrients (MMN and usual antenatal care in rural Vietnam.Secondary data analysis from: a prospective population-based observational study (OS which examined effects of antenatal psychosocial factors, anaemia and iron deficiency on infant development and health; and a three-arm cluster randomised trial (CRT of different antenatal iron supplementation regimens. In the OS 497 women (<20 weeks gestation from 50 randomly-selected communes participated, and in the CRT 1,258 pregnant women (<16 weeks gestation in 104 communes were allocated randomly to trial arms. The main outcome was six-month-old infant Hb concentration. Baseline data included women's socio-demographic characteristics, reproductive health, Hb and serum ferritin. Mean differences in infant Hb and odds ratios of infant anaemia between CRT arms and OS were calculated by multivariable regression models, controlling for baseline differences and clustering, using robust standard errors. Infant anaemia prevalence was 68.6% in the OS, 47.2% daily IFA, 53.5% weekly IFA, and 50.3% MMN conditions. After adjustment, mean infant haemoglobin levels in daily IFA (mean difference = 0.95 g/dL; 95%CI 0.7-11.18; weekly IFA (0.91; 95%CI 0.69-1.12 and MMN (1.04; 95%CI 0.8-1.27 were higher than in the OS. After adjustment there were lower odds ratios of anaemia among infants in the daily IFA (OR = 0.31; 95% CI 0.22-0.43, weekly IFA (0.38; 95%CI 0.26-0.54 and MMN (0.33; 95%CI 0.23-0.48 groups than in the OS.Infant anaemia is a public health problem in Vietnam and other resource-constrained countries. All supplementation regimens could have clinically significant benefits for Hb and reduce anaemia risk among six-month-old infants

  14. Applying the theory of planned behaviour to explain HIV testing in antenatal settings in Addis Ababa - a cohort study

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    Mirkuzie Alemnesh H

    2011-08-01

    Full Text Available Abstract Background To facilitate access to the prevention of mother-to-child HIV transmission (PMTCT services, HIV counselling and testing are offered routinely in antenatal care settings. Focusing a cohort of pregnant women attending public and private antenatal care facilities, this study applied an extended version of the Theory of Planned Behaviour (TPB to explain intended- and actual HIV testing. Methods A sequential exploratory mixed methods study was conducted in Addis Ababa in 2009. The study involved first time antenatal attendees from public- and private health care facilities. Three Focus Group Discussions were conducted to inform the TPB questionnaire. A total of 3033 women completed the baseline TPB interviews, including attitudes, subjective norms, perceived behavioural control and intention with respect to HIV testing, whereas 2928 completed actual HIV testing at follow up. Data were analysed using descriptive statistics, Chi-square tests, Fisher's Exact tests, Internal consistency reliability, Pearson's correlation, Linear regression, Logistic regression and using Epidemiological indices. P-values Results The TPB explained 9.2% and 16.4% of the variance in intention among public- and private health facility attendees. Intention and perceived barriers explained 2.4% and external variables explained 7% of the total variance in HIV testing. Positive and negative predictive values of intention were 96% and 6% respectively. Across both groups, subjective norm explained a substantial amount of variance in intention, followed by attitudes. Women intended to test for HIV if they perceived social support and anticipated positive consequences following test performance. Type of counselling did not modify the link between intended and actual HIV testing. Conclusion The TPB explained substantial amount of variance in intention to test but was less sufficient in explaining actual HIV testing. This low explanatory power of TPB was mainly due

  15. Antenatal endotoxin disrupts lung vitamin D receptor and 25-hydroxyvitamin D 1α-hydroxylase expression in the developing rat.

    Science.gov (United States)

    Mandell, Erica; Seedorf, Gregory J; Ryan, Sharon; Gien, Jason; Cramer, Scott D; Abman, Steven H

    2015-11-01

    Vitamin D [vit D; 1,25-(OH)2D] treatment improves survival and lung alveolar and vascular growth in an experimental model of bronchopulmonary dysplasia (BPD) after antenatal exposure to endotoxin (ETX). However, little is known about lung-specific 1,25-(OH)2D3 regulation during development, especially regarding maturational changes in lung-specific expression of the vitamin D receptor (VDR), 1α-hydroxylase (1α-OHase), and CYP24A1 during late gestation and the effects of antenatal ETX exposure on 1,25-(OH)2D3 metabolism in the lung. We hypothesized that vit D regulatory proteins undergo maturation regulation in the late fetal and early neonatal lung and that prenatal exposure to ETX impairs lung growth partly through abnormal endogenous vit D metabolism. Normal fetal rat lungs were harvested between embryonic day 15 and postnatal day 14. Lung homogenates were assayed for VDR, 1α-OHase, and CYP24A1 protein contents by Western blot analysis. Fetal rats were injected on embryonic day 20 with intra-amniotic ETX, ETX + 1,25-(OH)2D3, or saline and delivered 2 days later. Pulmonary artery endothelial cells (PAECs) from fetal sheep were assessed for VDR, 1α-OHase, and CYP24A1 expression after treatment with 25-(OH)D3, 1,25-(OH)2D3, ETX, ETX + 25-(OH)D3, or ETX + 1,25-(OH)2D3. We found that lung VDR, 1α-OHase, and CYP2741 protein expression dramatically increase immediately before birth (P < 0.01 vs. early fetal values). Antenatal ETX increases CYP24A1 expression (P < 0.05) and decreases VDR and 1α-OHase expression at birth (P < 0.001), but these changes are prevented with concurrent vit D treatment (P < 0.001). ETX-induced reduction of fetal PAEC growth and tube formation and lung 1α-OHase expression are prevented by vit D treatment (P < 0.001). We conclude that lung VDR, 1α-OHase, and CYP24A1 protein content markedly increase before birth and that antenatal ETX disrupts lung vit D metabolism through downregulation of VDR and increased vit D catabolic enzyme

  16. Lung Cancer Screening

    Science.gov (United States)

    ... Treatment Lung Cancer Prevention Lung Cancer Screening Research Lung Cancer Screening (PDQ®)–Patient Version What is screening? Go ... These are called diagnostic tests . General Information About Lung Cancer Key Points Lung cancer is a disease in ...

  17. Skin Cancer Screening

    Science.gov (United States)

    ... Genetics of Skin Cancer Skin Cancer Screening Research Skin Cancer Screening (PDQ®)–Patient Version What is screening? ... These are called diagnostic tests . General Information About Skin Cancer Key Points Skin cancer is a disease ...

  18. Mental Health Screening Center

    Science.gov (United States)

    ... Releases & Announcements Public Service Announcements Partnering with DBSA Mental Health Screening Center These online screening tools are not ... you have any concerns, see your doctor or mental health professional. Depression This screening form was developed from ...

  19. Testicular Cancer Screening

    Science.gov (United States)

    ... Health Professional Testicular Cancer Treatment Testicular Cancer Screening Testicular Cancer Screening (PDQ®)–Patient Version What is screening? Go ... These are called diagnostic tests . General Information About Testicular Cancer Key Points Testicular cancer is a disease in ...

  20. Antenatal testing for human immunodeficiency virus. Results from the Royal College of Obstetricians and Gynaecologists' National Study of HIV Infection in Pregnancy.

    Science.gov (United States)

    Davison, C F; Ades, A E; Hudson, C N; Peckham, C S

    1989-12-16

    Current policies on antenatal testing for human immunodeficiency virus (HIV) in the main obstetric units of the United Kingdom and the Republic of Ireland were surveyed by postal questionnaire; 294 of 299 units responded. HIV testing was available at 192 (65%) of the 294 units that responded. 414 HIV-positive pregnancies in 386 women were reported from 74 (25%) units. Most were from Scotland, the four Thames Regions, and Ireland. In 46% of the HIV-positive women the infection was identified by antenatal testing; the remainder had been tested previously and knew that they were infected. The findings support the view that selective antenatal testing should be established in areas where no testing is offered at present and possibly that testing should be offered to all pregnant women in high-prevalence areas.

  1. The cost-effectiveness of neonatal screening for Cystic Fibrosis: an analysis of alternative scenarios using a decision model

    Directory of Open Access Journals (Sweden)

    Tu Karen

    2005-08-01

    Full Text Available Abstract Background The use of neonatal screening for cystic fibrosis is widely debated in the United Kingdom and elsewhere, but the evidence available to inform policy is limited. This paper explores the cost-effectiveness of adding screening for cystic fibrosis to an existing routine neonatal screening programme for congenital hypothyroidism and phenylketonuria, under alternative scenarios and assumptions. Methods The study is based on a decision model comparing screening to no screening in terms of a number of outcome measures, including diagnosis of cystic fibrosis, life-time treatment costs, life years and QALYs gained. The setting is a hypothetical UK health region without an existing neonatal screening programme for cystic fibrosis. Results Under initial assumptions, neonatal screening (using an immunoreactive trypsin/DNA two stage screening protocol costs £5,387 per infant diagnosed, or £1.83 per infant screened (1998 costs. Neonatal screening for cystic fibrosis produces an incremental cost-effectiveness of £6,864 per QALY gained, in our base case scenario (an assumed benefit of a 6 month delay in the emergence of symptoms. A difference of 11 months or more in the emergence of symptoms (and mean survival means neonatal screening is both less costly and produces better outcomes than no screening. Conclusion Neonatal screening is expensive as a method of diagnosis. Neonatal screening may be a cost-effective intervention if the hypothesised delays in the onset of symptoms are confirmed. Implementing both antenatal and neonatal screening would undermine potential economic benefits, since a reduction in the birth incidence of cystic fibrosis would reduce the cost-effectiveness of neonatal screening.

  2. Effects of natural childbirth preparation versus standard antenatal education on epidural rates, experience of childbirth and parental stress in mothers and fathers: a randomised controlled multicentre trial

    Science.gov (United States)

    Bergström, M; Kieler, H; Waldenström, U

    2009-01-01

    Objective To examine the effects of antenatal education focussing on natural childbirth preparation with psychoprophylactic training versus standard antenatal education on the use of epidural analgesia, experience of childbirth and parental stress in first-time mothers and fathers. Design Randomised controlled multicentre trial. Setting Fifteen antenatal clinics in Sweden between January 2006 and May 2007. Sample A total of 1087 nulliparous women and 1064 of their partners. Methods Natural group: Antenatal education focussing on natural childbirth preparation with training in breathing and relaxation techniques (psychoprophylaxis). Standard care group: Standard antenatal education focussing on both childbirth and parenthood, without psychoprophylactic training. Both groups: Four 2-hour sessions in groups of 12 participants during third trimester of pregnancy and one follow-up after delivery. Main outcome measures Epidural analgesia during labour, experience of childbirth as measured by the Wijma Delivery Experience Questionnaire (B), and parental stress measured by the Swedish Parenthood Stress Questionnaire. Results The epidural rate was 52% in both groups. There were no statistically significant differences in the experience of childbirth or parental stress between the randomised groups, either in women or men. Seventy percent of the women in the Natural group reported having used psychoprophylaxis during labour. A minority in the Standard care group (37%) had also used this method, but subgroup analysis where these women were excluded did not change the principal findings. Conclusion Natural childbirth preparation including training in breathing and relaxation did not decrease the use of epidural analgesia during labour, nor did it improve the birth experience or affect parental stress in early parenthood in nulliparous women and men, compared with a standard form of antenatal education. PMID:19538406

  3. Assessment of the risk status of pregnant women presenting for antenatal care in a rural health facility in Ebonyi State, South Eastern Nigeria

    Directory of Open Access Journals (Sweden)

    Patrick Gold Oyibo

    2011-01-01

    Full Text Available Background: Nigeria has one of the worst maternal and child health indices globally. Aims: The objective of this study was to assess the risk status of pregnant women presenting for antenatal care in a rural health facility in Ebonyi State, South East Nigeria. Subjects and Method: This was a cross-sectional descriptive study of pregnant women selected by systematic random sampling. The study instrument was a pre-tested semi-structured interviewer-administered questionnaire. Result: The age range of the women in the study was 16-43 years. The mean age was 25.3 ± 1.3 years. According to the scoring system used, about one-fourth of the women (26% had a high risk pregnancy while about a tenth (9.1% had very high risk pregnancy. The vast majority of the women with at-risk pregnancies registered for antenatal care late: 58.9 % registered for antenatal care in the second trimester and 37.0 % registered for antenatal care in the third trimester of pregnancy. Of the women with an at-risk pregnancy, 79.5% had their last delivery at home and 67.1 % of them preferred to deliver at home in their current pregnancies. Conclusion: This study revealed that a substantial proportion of rural women with at-risk pregnancies go through their pregnancy period without significant modern antenatal care. The local government health department should intensify efforts through health enlightenment campaigns to educate rural pregnant women of the benefits of utilizing modern antenatal care services.

  4. Uso antenatal de corticosteróide e evolução clínica de recém-nascidos pré-termo Antenatal corticosteroid use and clinical evolution of preterm newborn infants

    Directory of Open Access Journals (Sweden)

    2004-08-01

    Full Text Available OBJETIVO: Descrever a freqüência de utilização de corticosteróide antenatal e a evolução clínica dos recém-nascidos pré-termo. MÉTODOS: Estudo observacional prospectivo tipo coorte de todos os neonatos com idade gestacional entre 23 e 34 semanas nascidos na Rede Brasileira de Pesquisas Neonatais entre agosto e dezembro de 2001. Os prontuários médicos foram revistos, as mães entrevistadas e os pré-termos acompanhados. A análise dos dados foi realizada com o teste do qui-quadrado, t de Student, Mann-Whitney, ANOVA e regressão logística múltipla, com nível de significância de 5%. RESULTADOS: Avaliaram-se 463 gestantes e seus 514 recém-nascidos. As gestantes tratadas tiveram mais gestações prévias, consultas de pré-natal, hipertensão arterial e maior uso de tocolíticos. Suas crianças apresentaram melhores escores de Apgar no 1º e 5º minutos, menor necessidade de intervenção na sala de parto e menor SNAPPE II. Nasceram com maior peso e idade gestacional, receberam menos surfatante exógeno, ventilação mecânica e oxigenoterapia. Após regressão logística, o uso pré-natal de corticosteróides manteve de forma independente o efeito protetor para as condições de nascimento e para a diminuição do tempo de ventilação mecânica e esteve associado com aumento na ocorrência de sepse neonatal. CONCLUSÃO: O uso do corticosteróide antenatal foi associado a melhor atendimento pré-natal. As crianças nasceram em melhores condições e tiveram melhor evolução, porém com maior risco de infecção.OBJECTIVES: To describe the use of antenatal corticosteroid and clinical evolution of preterm babies. METHODS: An observational prospective cohort study was carried out. All 463 pregnant women and their 514 newborn babies with gestational age ranging from 23 to 34 weeks, born at the Brazilian Neonatal Research Network units, were evaluated from August 1 to December 31, 2001. The data were obtained through maternal

  5. Plant ID. Agricultural Lesson Plans.

    Science.gov (United States)

    Southern Illinois Univ., Carbondale. Dept. of Agricultural Education and Mechanization.

    This lesson plan is intended for use in conducting classes on plant identification. Presented first are a series of questions and answers designed to convey general information about the scientific classification of plants. The following topics are among those discussed: main types of plants; categories of vascular plants; gymnosperms and…

  6. In Old Pompeii. [Lesson Plan].

    Science.gov (United States)

    2001

    In this Web-based interdisciplinary lesson (involving social studies, geography, history, and language arts) students take a virtual field trip to the ruins of Pompeii to learn about everyday life in Roman times, then create a travelogue to attract visitors to the site and write an account of their field trip modeled on a description of Pompeii…

  7. Multimedia Principle in Teaching Lessons

    Science.gov (United States)

    Kari Jabbour, Khayrazad

    2012-01-01

    Multimedia learning principle occurs when we create mental representations from combining text and relevant graphics into lessons. This article discusses the learning advantages that result from adding multimedia learning principle into instructions; and how to select graphics that support learning. There is a balance that instructional designers…

  8. Charismatic Leaders: A Lesson Plan.

    Science.gov (United States)

    Johns, Robert W.

    1983-01-01

    Focusing upon Franklin D. Roosevelt and Adolf Hitler, these lessons for high school students in U.S. or world history courses deal with what charismatic leadership is, what circumstances and personality factors generate charismatic movements, and the role, results, and dangers of charismatic leadership. (RM)

  9. "Pride and Prejudice". [Lesson Plan].

    Science.gov (United States)

    Soderquist, Alisa

    Based on Jane Austen's novel "Pride and Prejudice," this lesson plan presents activities designed to help students understand that classics are those pieces of literature that continue to be popular long after they were written; classics tend to have universal themes; and Austen's writing has been updated and dramatized and, most likely, will…

  10. Lessons Learned from Exemplary Schools

    Science.gov (United States)

    Schrum, Lynne; Levin, Barbara B.

    2013-01-01

    This article presents lessons learned about successful professional development for promoting technology integration from eight exemplary schools. Through a qualitative investigation into school leaders' and teachers' intentional goals of improving student engagement and achievement, formal, informal, and individual opportunities are described…

  11. Analysing student teachers’ lesson plans

    DEFF Research Database (Denmark)

    Carlsen, Louise Meier

    2015-01-01

    I investigate 17 mathematics student teachers’ productions, in view of examining the synergy and interaction between their mathematical and didactical knowledge. The concrete data material consists in lesson plans elaborated for the final exam of a unit on “numbers, arithmetic and algebra...

  12. Student-Negotiated Lesson Style

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    Sampson, Richard J.

    2010-01-01

    This paper presents an overview of action research conducted in an EFL university context, in which data was collected about students' past English learning experiences and hopes for college speaking classes. This data was then used to guide the lesson style for the semester. The study used three cycles of action research over one 15-week…

  13. A Lesson in Number Pattern

    Science.gov (United States)

    Fletcher, Rodney

    2008-01-01

    This article presents a guided investigation into the spacial relationships between the centres of the squares in a Fibonacci tiling. It is essentially a lesson in number pattern, but includes work with surds, coordinate geometry, and some elementary use of complex numbers. The investigation could be presented to students in a number of ways…

  14. Children of War. [Lesson Plan].

    Science.gov (United States)

    Discovery Communications, Inc., Bethesda, MD.

    This lesson plan presents activities in which students read, analyze, and discuss excerpts from children's war diaries; and create a storyboard for a public service announcement on children's rights in wartime. It includes objectives, materials, procedures, extension activities, excerpts of children's war diaries, suggested readings, and web…

  15. Dr. King's Dream. [Lesson Plan].

    Science.gov (United States)

    National Endowment for the Humanities (NFAH), Washington, DC.

    This lesson plan teaches students about the life and work of Martin Luther King, Jr. Students listen to a brief biography, view photographs of the March on Washington, hear a portion of King's "I Have a Dream" speech, and discuss what King's words mean to them. Finally, they will create picture books about their own dreams of freedom for…

  16. The Great Gatsby. [Lesson Plan].

    Science.gov (United States)

    Zelasko, Ken

    Based on F. Scott Fitzgerald's novel "The Great Gatsby," this lesson plan presents activities designed to help students understand that adapting part of a novel into a dramatic reading makes students more intimate with the author's intentions and craft; and that a part of a novel may lend itself to various oral interpretations. The main activity…

  17. Salem Witch Trials. [Lesson Plan].

    Science.gov (United States)

    Maupin, Lara

    Based on Arthur Miller' play "The Crucible," this lesson plan presents activities designed to help students understand that in 17th-century New England, people were persecuted for allegedly practicing witchcraft; students of this period have looked into the allegations and offer alternatives to witchcraft to explain the people's behavior; and…

  18. Writing Lessons with Gavin Curtis.

    Science.gov (United States)

    Fu, Danling; Lamme, Linda

    2002-01-01

    Discusses a literature-inspired model of teaching writing and two scenarios of reading and writing connections in the classroom. Presents several reading and writing lessons drawn from the children's book "The Bat Boy and His Violin" by Gavin Curtis. Discusses Curtis' craft and demonstrates how to use this book to teach writing. Includes brief…

  19. For Sale: Your Lesson Plans

    Science.gov (United States)

    Greene, Kim

    2016-01-01

    The last several years has seen an increasingly popular trend of teachers buying and selling their lesson plans and other self-created classroom materials in online marketplaces. The leader in this space is a website called Teachers Pay Teachers, which boasts 3.8 million active users. In this article, the author examines why these sites became…

  20. Moby-Dick. [Lesson Plan].

    Science.gov (United States)

    Soderquist, Alisa

    Based on Herman Melville's novel "Moby-Dick," this lesson plan presents activities designed to help students understand that the novel is grounded in facts that Melville acquired in his own experiences at sea; New England was the center of a prospering whaling industry in the 19th century; and journal keeping was not uncommon among 19th-century…

  1. Avaliação da vitalidade fetal anteparto Antenatal fetal surveillance

    Directory of Open Access Journals (Sweden)

    Roseli Mieko Yamamoto Nomura

    2009-10-01

    Full Text Available O contexto atual da atividade médica exige do obstetra e ginecologista ampla compreensão dos avanços científicos e tecnológicos de sua área. O objetivo primordial da avaliação fetal antenatal é identificar fetos de risco para eventos adversos ou para o óbito e, assim, atuar preventivamente para evitar o insucesso. O perfil biofísico fetal atinge sua máxima eficiência quando aplicado dentro do contexto clínico de cada caso. Em gestações de alto risco, a doplervelocimetria da artéria umbilical mostrou-se útil para melhorar os resultados perinatais. Na restrição de crescimento fetal por insuficiência placentária grave, antes da 34ª semana de gestação, a doplervelocimetria do ducto venoso tem sido importante instrumento na condução dos casos. Nenhum teste isoladamente é considerado o melhor na avaliação da vitalidade fetal anteparto, entretanto, a análise conjunta de todos os métodos irá propiciar melhor compreensão da resposta fetal à hipóxia.The present context of medical practice demands from the obstetrician and gynecologist broad understanding of the scientific and technological advances of the area. The main purpose of prenatal evaluation is to identify fetuses at risk for adverse events or death, for preventive action to avoid mishappenings. The determination of fetal biophysical profile reaches its maximum efficiency when applied within the clinical context of each case. In high risk gestations, the Doppler velocimetry of the umbilical artery has shown to be useful to improve perinatal outcome. In the fetal growth deficit, due to severe placentary insufficiency, Doppler velocimetry of the venous duct has been showing to be an important tool in handling of the cases before the 34th week of gestation. Although no test itself is considered the best to evaluate the fetus's prenatal vitality, the joint analysis of all methods may lead to a better understanding of the fetal response to hypoxia.

  2. Factors associated with antenatal mental disorder in West Africa: A cross-sectional survey

    Directory of Open Access Journals (Sweden)

    Ola Bola

    2011-11-01

    Full Text Available Abstract Background Maternal mental illness is likely to have a profound impact in less developed parts of the world. A mother experiencing mental illness in a low income setting is at risk of providing sub-optimal care for her offspring which can have grave consequences in an environment where poverty, overcrowding, poor sanitation, malnutrition, tropical diseases and a lack of appropriate medical services may be pronounced. Given the profound consequences of antenatal and postnatal mental illness on maternal mental health, foetal wellbeing and childhood growth and development the factors associated with mental illness in a Sub-Saharan setting merit clarification and investigation. Methods A prospective survey design was conducted in Lagos. Self reporting questionnaire 20 items - SRQ20 - assessed the presence of mental illness. The WHO Multi-country Study on Women's Health and Domestic Violence Questions assessed women's exposure to violence. Numerous variables potentially associated with mental illness including maternal socio-economic factors, maternal characteristics, obstetric variables and the characteristics of previous children were recorded. Direct logistic regression was performed to assess the impact of a number of variables on the likelihood of presence of mental disorder in the population. Results 189 women were surveyed. 7% met the criteria for experiencing a common mental disorder according to their score on the SRQ-20. Of variables examined only the number of female children and the presence of inter personal violence predicted being a case of mental illness (OR = 3.400; 95%CI = 1.374 - 8.414 and OR = 5.676; 95%CI = 1.251 - 25.757 respectively. Conclusions Rates of mental disorder found in our study were lower than those previously observed internationally and in Africa, perhaps reflecting stigma about disclosing symptoms. The predictive nature of violence on mental disorder is in keeping with international evidence. Our study

  3. Exaggerated sympathetic mediated responses to behavioral or pharmacological challenges following antenatal betamethasone exposure.

    Science.gov (United States)

    Shaltout, Hossam A; Chappell, Mark C; Rose, James C; Diz, Debra I

    2011-06-01

    Glucocorticoid administration to women at risk for preterm delivery is standard practice to enhance neonatal survival. However, antenatal betamethasone exposure (β-exposure) increases mean arterial pressure (MAP) in adult sheep (1.8 yr old) and results in impaired baroreflex sensitivity (BRS) for control of heart rate (HR). In the current studies we tested the hypothesis that enhanced sympathetic nervous system and hypothalamo-pituitary-adrenal (HPA) axis-mediated responses are evident at an early age in β-exposed sheep. Pregnant ewes were administered betamethasone (0.17 mg/kg twice over 24 h) or vehicle (Veh-control) on the 80th day of gestation, and offspring were delivered at full term. Female β-exposed and control offspring instrumented at age 42 ± 3 days for conscious continuous recording of MAP and HR had similar resting values at baseline. However, BRS was ~45% lower in β-exposed offspring. β-Exposed lambs allowed to suckle for 10 min had a greater elevation in MAP than Veh-control lambs (19 ± 1 vs 12 ± 2 mmHg; n = 4-5, P < 0.05). MAP was reduced by 20% from baseline via sodium nitroprusside infusion (SNP) over 10 min, which triggered a rebound increase in MAP only in β-exposed lambs. HR increased with the reduction in MAP during SNP infusion in Veh-control lambs, whereas there was no change in HR with the reduction in MAP in β-exposed lambs. Combined vasopressin-CRF injection caused greater increases in MAP in the β-exposed lambs. Cortisol and ACTH responses were higher in response to SNP hypotension in the β-exposed lambs. The data reveal enhanced sympathetic and HPA axis responses associated with impaired BRS preceding differences in resting MAP in preweanling female lambs exposed in utero to glucocorticoids. The consequences of these alterations at an early age include eventual development of higher blood pressure in this ovine model of fetal programming.

  4. Refugee and migrant women's views of antenatal ultrasound on the Thai Burmese border: a mixed methods study.

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    Marcus J Rijken

    Full Text Available BACKGROUND: Antenatal ultrasound suits developing countries by virtue of its versatility, relatively low cost and safety, but little is known about women's or local provider's perspectives of this upcoming technology in such settings. This study was undertaken to better understand how routine obstetric ultrasound is experienced in a displaced Burmese population and identify barriers to its acceptance by local patients and providers. METHODOLOGY/PRINCIPAL FINDINGS: Qualitative (30 observations, 19 interviews, seven focus group discussions and quantitative methods (questionnaire survey with 644 pregnant women were used to provide a comprehensive understanding along four major themes: safety, emotions, information and communication, and unintended consequences of antenatal ultrasound in refugee and migrant clinics on the Thai Burmese border. One of the main concerns expressed by women was the danger of childbirth which they mainly attributed to fetal malposition. Both providers and patients recognized ultrasound as a technology improving the safety of pregnancy and delivery. A minority of patients experienced transitory shyness or anxiety before the ultrasound, but reported that these feelings could be ameliorated with improved patient information and staff communication. Unintended consequences of overuse and gender selective abortions in this population were not common. CONCLUSIONS/SIGNIFICANCE: The results of this study are being used to improve local practice and allow development of explanatory materials for this population with low literacy. We strongly encourage facilities introducing new technology in resource poor settings to assess acceptability through similar inquiry.

  5. Using mHealth to Improve Usage of Antenatal Care, Postnatal Care, and Immunization: A Systematic Review of the Literature.

    Science.gov (United States)

    Watterson, Jessica L; Walsh, Julia; Madeka, Isheeta

    2015-01-01

    Mobile health (mHealth) technologies have been implemented in many low- and middle-income countries to address challenges in maternal and child health. Many of these technologies attempt to influence patients', caretakers', or health workers' behavior. The purpose of this study was to conduct a systematic review of the literature to determine what evidence exists for the effectiveness of mHealth tools to increase the coverage and use of antenatal care (ANC), postnatal care (PNC), and childhood immunizations through behavior change in low- and middle-income countries. The full text of 53 articles was reviewed and 10 articles were identified that met all inclusion criteria. The majority of studies used text or voice message reminders to influence patient behavior change (80%, n = 8) and most were conducted in African countries (80%, n = 8). All studies showed at least some evidence of effectiveness at changing behavior to improve antenatal care attendance, postnatal care attendance, or childhood immunization rates. However, many of the studies were observational and further rigorous evaluation of mHealth programs is needed in a broader variety of settings.

  6. Antenatal magnesium individual participant data international collaboration: assessing the benefits for babies using the best level of evidence (AMICABLE

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    2012-03-01

    Full Text Available Abstract Background The primary aim of this study is to assess, using individual participant data (IPD meta-analysis, the effects of administration of antenatal magnesium sulphate given to women at risk of preterm birth on important clinical outcomes for their child such as death and neurosensory disability. The secondary aim is to determine whether treatment effects differ depending on important pre-specified participant and treatment characteristics, such as reasons at risk of preterm birth, gestational age, or type, dose and mode of administration of magnesium sulphate. Methods Design The Antenatal Magnesium Individual Participant Data (IPD International Collaboration: assessing the benefits for babies using the best level of evidence (AMICABLE Group will perform an IPD meta-analysis to answer these important clinical questions. Setting/Timeline The AMICABLE Group was formed in 2009 with data collection commencing late 2010. Inclusion Criteria Five trials involving a total 6,145 babies are eligible for inclusion in the IPD meta-analysis. Primary study outcomes For the infants/children: Death or cerebral palsy. For the women: Any severe maternal outcome potentially related to treatment (death, respiratory arrest or cardiac arrest. Discussion Results are expected to be publicly available in 2012.

  7. Low serum Vitamin C status among pregnant women attending antenatal care at general hospital Dawakin Kudu, Northwest Nigeria

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    Emmanuel Ajuluchukwu Ugwa

    2016-01-01

    Full Text Available Background: Vitamin C levels are low in pregnancy. The purpose of this study was to determine serum Vitamins C levels among pregnant women attending antenatal care at a General Hospital in Dawakin Kudu, Kano, and this can help further research to determine the place of Vitamin C supplementation in pregnancy. Methods: This was a prospective study of 400 pregnant women who presented for antenatal care in General Hospital Dawakin Kudu, Kano, Nigeria. Research structured questionnaire was administered to 400 respondents. Determination of serum Vitamin C was done using appropriate biochemical methods. Results: Vitamin C deficiency was found in 79.5% of the participants. The values for Vitamin C were 0.20 ± 0.18 mg/dl during the first trimester, 0.50 ± 0.99 mg/dl in the second trimester, and 0.35 ± 0.36 mg/dl in the third trimester and P = 0.001. Conclusions: There is a significant reduction in the serum Vitamins C concentration throughout the period of pregnancy with the highest levels in the second trimester. Therefore, Vitamin C supplementation is suggested during pregnancy, especially for those whose fruit and vegetable consumption is inadequate.

  8. Using mHealth to Improve Usage of Antenatal Care, Postnatal Care, and Immunization: A Systematic Review of the Literature

    Directory of Open Access Journals (Sweden)

    Jessica L. Watterson

    2015-01-01

    Full Text Available Mobile health (mHealth technologies have been implemented in many low- and middle-income countries to address challenges in maternal and child health. Many of these technologies attempt to influence patients’, caretakers’, or health workers’ behavior. The purpose of this study was to conduct a systematic review of the literature to determine what evidence exists for the effectiveness of mHealth tools to increase the coverage and use of antenatal care (ANC, postnatal care (PNC, and childhood immunizations through behavior change in low- and middle-income countries. The full text of 53 articles was reviewed and 10 articles were identified that met all inclusion criteria. The majority of studies used text or voice message reminders to influence patient behavior change (80%, n=8 and most were conducted in African countries (80%, n=8. All studies showed at least some evidence of effectiveness at changing behavior to improve antenatal care attendance, postnatal care attendance, or childhood immunization rates. However, many of the studies were observational and further rigorous evaluation of mHealth programs is needed in a broader variety of settings.

  9. Comparing couples' and individual voluntary counseling and testing for HIV at antenatal clinics in Tanzania: a randomized trial.

    Science.gov (United States)

    Becker, Stan; Mlay, Rose; Schwandt, Hilary M; Lyamuya, Eligius

    2010-06-01

    Voluntary counseling and testing (VCT) for couples (CVCT) is an important HIV-prevention effort in sub-Saharan Africa where a substantial proportion of HIV transmission occurs within stable partnerships. This study aimed to determine the acceptance and effectiveness of CVCT as compared to individual VCT (IVCT). 1,521 women attending three antenatal clinics in Dar es Salaam were randomized to receive IVCT during that visit or CVCT with their husbands at a subsequent visit. The proportion of women receiving test results in the CVCT arm was significantly lower than in the IVCT arm (39 vs. 71%). HIV prevalence overall was 10%. In a subgroup analysis of HIV-positive women, those who received CVCT were more likely to use preventive measures against transmission (90 vs. 60%) and to receive nevirapine for themselves (55 vs. 24%) and their infants (55 vs. 22%) as compared to women randomized to IVCT. Uptake of CVCT is low in the antenatal clinic setting. Community mobilization and couple-friendly clinics are needed to promote CVCT.

  10. Cellular uptake: lessons from supramolecular organic chemistry.

    Science.gov (United States)

    Gasparini, Giulio; Bang, Eun-Kyoung; Montenegro, Javier; Matile, Stefan

    2015-07-04

    The objective of this Feature Article is to reflect on the importance of established and emerging principles of supramolecular organic chemistry to address one of the most persistent problems in life sciences. The main topic is dynamic covalent chemistry on cell surfaces, particularly disulfide exchange for thiol-mediated uptake. Examples of boronate and hydrazone exchange are added for contrast, comparison and completion. Of equal importance are the discussions of proximity effects in polyions and counterion hopping, and more recent highlights on ring tension and ion pair-π interactions. These lessons from supramolecular organic chemistry apply to cell-penetrating peptides, particularly the origin of "arginine magic" and the "pyrenebutyrate trick," and the currently emerging complementary "disulfide magic" with cell-penetrating poly(disulfide)s. They further extend to the voltage gating of neuronal potassium channels, gene transfection, and the delivery of siRNA. The collected examples illustrate that the input from conceptually innovative chemistry is essential to address the true challenges in biology beyond incremental progress and random screening.

  11. Prevalence of gestational diabetes mellitus in antenatal women and its associated risk factors

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    Leila J. Gracelyn

    2016-02-01

    Conclusions: Prevalence of GDM is progressively increasing and it was significantly associated with multiple risk factors. Universal screening should be done for all pregnant women for better maternal and fetal outcome. [Int J Reprod Contracept Obstet Gynecol 2016; 5(2.000: 285-291

  12. Cost-effectiveness estimates for antenatal HIV testing in the Netherlands

    NARCIS (Netherlands)

    Rozenbaum, M.H.; Verweel, G.; Folkerts, D.K.F.; Dronkers, F.; van den Hoek, J.A.R.; Hartwig, N.G.; de Groot, R.; Postma, M.J.

    2008-01-01

    This paper provides an estimation of the lifetime health-care cost of HIV-infected children and an update of the cost-effectiveness of universal HIV-screening of pregnant women in Amsterdam (The Netherlands). During 2003-2005, we collected data concerning the prevalence of newly diagnosed HIV-infect

  13. Cost-effectiveness estimates for antenatal HIV testing in the Netherlands.

    NARCIS (Netherlands)

    Rozenbaum, M.H.; Verweel, G.; Folkerts, D.K.; Dronkers, F.; Hoek, JA van den; Hartwig, N.G.; Groot, R. de; Postma, M.J.

    2008-01-01

    This paper provides an estimation of the lifetime health-care cost of HIV-infected children and an update of the cost-effectiveness of universal HIV-screening of pregnant women in Amsterdam (The Netherlands). During 2003-2005, we collected data concerning the prevalence of newly diagnosed HIV-infect

  14. WELL WOMAN CLINIC - SCREENING PROGRAM FOR CERVICAL C ARCINOMAS

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    Vani Padmaja

    2014-02-01

    Full Text Available Cervical cancer is a common cancer occurring in women in the reproductive age group. It is also a cancer that can be easily prevented by taking Cervical Smears, staining them by the Papanicalou’s stain, diagnosing and treating them at an early stage . It is a very cost effective, sensitive, specific and easy method of early detection of cervical canc er and thereby helps in preventing the mortality and morbidity caused by invasive carcinomas. This screening program was conducted in the outpatient department of Gandhi hospital. All th e women between the age of 21 and 65years were included. The antenatal women were excluded. A total of 2864 women were screened and 2562 Pap smears were done. 228 High grade intraepithelial lesions [HSIL ] and 365 Low Grade intraepithelial lesions [LSIL] were diagnosed. Cervical biopsy was done. Curative treatment was offered to all those who had intraepithelial lesions on biopsy. Hence such screening programs are of great help in detecting early cancer and preventing invasive cancers. Thus reducing mortality and morbidity associated with invasive cancers

  15. Prenatal screening and genetics

    NARCIS (Netherlands)

    Alderson, P.; Aro, A.R.; Dragonas, T.; Ettorre, E.; Hemminki, E.; Jalinoja, P.; Santalahti, P.; Tijmstra, T.

    2001-01-01

    Although the term 'genetic screening' has been used for decades, this paper discusses how, in its most precise meaning, genetic screening has not yet been widely introduced. 'Prenatal screening' is often confused with 'genetic screening'. As we show, these terms have different meanings, and we exami

  16. Stomach (Gastric) Cancer Screening

    Science.gov (United States)

    ... Gastric Cancer Treatment Stomach Cancer Prevention Stomach Cancer Screening Research Stomach (Gastric) Cancer Screening (PDQ®)–Patient Version What is ... from the . There is no standard or routine screening test for stomach cancer. Several types of screening tests have been ...

  17. Prenatal screening and genetics

    DEFF Research Database (Denmark)

    Alderson, P; Aro, A R; Dragonas, T

    2001-01-01

    Although the term 'genetic screening' has been used for decades, this paper discusses how, in its most precise meaning, genetic screening has not yet been widely introduced. 'Prenatal screening' is often confused with 'genetic screening'. As we show, these terms have different meanings, and we ex...

  18. Screening for abdominalt aortaaneurisme

    DEFF Research Database (Denmark)

    Lindholt, J S; Juul, Svend; Henneberg, E W;

    1997-01-01

    rupture. Ultrasonographic screening for AAA takes 10 minutes per scan, and the sensitivity and specificity are high. Ultrasonographic screening for AAA is a reliable, safe and inexpensive method for screening, and screening for AAA is discussed worldwide. One point four percent of deaths among men from 65...... on uncertain assumptions concerning prevalence, incidence and risk of rupture. Therefore a randomized trial screening of 65-73 year old males is taking place in the County of Viborg in Denmark. Udgivelsesdato: 1997-Mar-24...

  19. Screening for abdominalt aortaaneurisme

    DEFF Research Database (Denmark)

    Lindholt, Jes Sanddal; Juul, Søren; Henneberg, E W;

    1997-01-01

    rupture. Ultrasonographic screening for AAA takes 10 minutes per scan, and the sensitivity and specificity are high. Ultrasonographic screening for AAA is a reliable, safe and inexpensive method for screening, and screening for AAA is discussed worldwide. One point four percent of deaths among men from 65...... on uncertain assumptions concerning prevalence, incidence and risk of rupture. Therefore a randomized trial screening of 65-73 year old males is taking place in the County of Viborg in Denmark....

  20. Control de gestación en inmigrantes Antenatal care in immigrants

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    J. de la Torre

    2006-01-01

    is diverse. The immigrant population is characterised by its being young and healthy, and with a capacity to adapt to changes, but its social, economic and labour conditions are frequently insecure and favour vulnerability to disease. In spite of the number of immigrants of the male sex being globally higher than that of women, the percentage of immigrants of the female sex is growing. This increase of the female immigrant population has resulted in the appearance of specific health care needs, especially with respect to sexual and reproductive health. To which we must add a substantial increase in pathologies prevalent in the countries of origin, such as anaemia, tuberculosis, malnutrition, haemoglobinopathies, consanguinity, hypocalcaemia, hepatitis B and/or C, sexually transmitted infections, infectious diseases transmitted by arthropods, such as Chagas disease and other parasitoses, as well as genital mutilations. The aim of this article is to analyse the factors that make it difficult to control gestation in the immigrant population, as well as to establish guidelines for acting in antenatal care consultations. Insistence is placed on health education and prevention during pregnancy, and consideration is given to the appearance of rare diseases related to some of these groups.