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  1. Evolution of maternal effect senescence.

    Science.gov (United States)

    Moorad, Jacob A; Nussey, Daniel H

    2016-01-12

    Increased maternal age at reproduction is often associated with decreased offspring performance in numerous species of plants and animals (including humans). Current evolutionary theory considers such maternal effect senescence as part of a unified process of reproductive senescence, which is under identical age-specific selective pressures to fertility. We offer a novel theoretical perspective by combining William Hamilton's evolutionary model for aging with a quantitative genetic model of indirect genetic effects. We demonstrate that fertility and maternal effect senescence are likely to experience different patterns of age-specific selection and thus can evolve to take divergent forms. Applied to neonatal survival, we find that selection for maternal effects is the product of age-specific fertility and Hamilton's age-specific force of selection for fertility. Population genetic models show that senescence for these maternal effects can evolve in the absence of reproductive or actuarial senescence; this implies that maternal effect aging is a fundamentally distinct demographic manifestation of the evolution of aging. However, brief periods of increasingly beneficial maternal effects can evolve when fertility increases with age faster than cumulative survival declines. This is most likely to occur early in life. Our integration of theory provides a general framework with which to model, measure, and compare the evolutionary determinants of the social manifestations of aging. Extension of our maternal effects model to other ecological and social contexts could provide important insights into the drivers of the astonishing diversity of lifespans and aging patterns observed among species.

  2. The evolution of multivariate maternal effects.

    Science.gov (United States)

    Kuijper, Bram; Johnstone, Rufus A; Townley, Stuart

    2014-04-01

    There is a growing interest in predicting the social and ecological contexts that favor the evolution of maternal effects. Most predictions focus, however, on maternal effects that affect only a single character, whereas the evolution of maternal effects is poorly understood in the presence of suites of interacting traits. To overcome this, we simulate the evolution of multivariate maternal effects (captured by the matrix M) in a fluctuating environment. We find that the rate of environmental fluctuations has a substantial effect on the properties of M: in slowly changing environments, offspring are selected to have a multivariate phenotype roughly similar to the maternal phenotype, so that M is characterized by positive dominant eigenvalues; by contrast, rapidly changing environments favor Ms with dominant eigenvalues that are negative, as offspring favor a phenotype which substantially differs from the maternal phenotype. Moreover, when fluctuating selection on one maternal character is temporally delayed relative to selection on other traits, we find a striking pattern of cross-trait maternal effects in which maternal characters influence not only the same character in offspring, but also other offspring characters. Additionally, when selection on one character contains more stochastic noise relative to selection on other traits, large cross-trait maternal effects evolve from those maternal traits that experience the smallest amounts of noise. The presence of these cross-trait maternal effects shows that individual maternal effects cannot be studied in isolation, and that their study in a multivariate context may provide important insights about the nature of past selection. Our results call for more studies that measure multivariate maternal effects in wild populations.

  3. The evolution of multivariate maternal effects.

    Directory of Open Access Journals (Sweden)

    Bram Kuijper

    2014-04-01

    Full Text Available There is a growing interest in predicting the social and ecological contexts that favor the evolution of maternal effects. Most predictions focus, however, on maternal effects that affect only a single character, whereas the evolution of maternal effects is poorly understood in the presence of suites of interacting traits. To overcome this, we simulate the evolution of multivariate maternal effects (captured by the matrix M in a fluctuating environment. We find that the rate of environmental fluctuations has a substantial effect on the properties of M: in slowly changing environments, offspring are selected to have a multivariate phenotype roughly similar to the maternal phenotype, so that M is characterized by positive dominant eigenvalues; by contrast, rapidly changing environments favor Ms with dominant eigenvalues that are negative, as offspring favor a phenotype which substantially differs from the maternal phenotype. Moreover, when fluctuating selection on one maternal character is temporally delayed relative to selection on other traits, we find a striking pattern of cross-trait maternal effects in which maternal characters influence not only the same character in offspring, but also other offspring characters. Additionally, when selection on one character contains more stochastic noise relative to selection on other traits, large cross-trait maternal effects evolve from those maternal traits that experience the smallest amounts of noise. The presence of these cross-trait maternal effects shows that individual maternal effects cannot be studied in isolation, and that their study in a multivariate context may provide important insights about the nature of past selection. Our results call for more studies that measure multivariate maternal effects in wild populations.

  4. Maternal effects in molecular evolution

    CERN Document Server

    Wilke, C O

    2002-01-01

    We introduce a model of molecular evolution in which the fitness of an individual depends both on its own and on the parent's genotype. The model can be solved by means of a nonlinear mapping onto the standard quasispecies model. The dependency on the parental genotypes cancels from the mean fitness, but not from the individual sequence concentrations. For finite populations, the position of the error threshold is very sensitive to the influence from parent genotypes. In addition to biological applications, our model is important for understanding the dynamics of self-replicating computer programs.

  5. Evolution of Clinical Enzymology

    OpenAIRE

    Büttner, J

    1981-01-01

    The evolution of clinical enzymology is discussed in relation to the history of general enzymology and clinical chemistry. The discussion is limited to the period from 1835 (definition of catalysis by Berzelius) to 1935 (description of the optical test by Warburg). In conclusion, a general account is given of the introduction of the concept of quantitative enzyme activity determination into clinical medicine.

  6. A Comparison of Medical Birth Register Outcomes between Maternity Health Clinics and Integrated Maternity and Child Health Clinics in Southwest Finland

    OpenAIRE

    Tuominen, Miia; Kaljonen, Anne; Ahonen, Pia; Mäkinen, Juha; Rautava, Päivi

    2016-01-01

    Introduction: Primary maternity care services are globally provided according to various organisational models. Two models are common in Finland: a maternity health clinic and an integrated maternity and child health clinic. The aim of this study was to clarify whether there is a relation between the organisational model of the maternity health clinics and the utilisation of maternity care services, and certain maternal and perinatal health outcomes.Methods: A comparative, register-based cros...

  7. HIV and pregnancy: Maternal and neonatal evolution

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    Diego Cecchini

    2011-10-01

    Full Text Available Data regarding epidemiological aspects, antiretroviral drug safety, and outcomes of HIV-infected pregnant women and their newborns are limited in Argentina. We underwent a retrospective analysis of registries of HIV-infected pregnant women assisted at Helios Salud, Buenos Aires, Argentina (1997-2006. Variables associated with preterm delivery and neonatal complications were analyzed by univariate and logistic regression analyses. A total of 204 mother-child binomium were included. Maternal age (median: 29 years; 32.5% without prior diagnosis of HIV-infection. Baseline median CD4 T-cell count: 417 cell/μl; 98% received antiretroviral drugs during pregnancy [2 nucleoside analogs plus either nevirapine (55% or a protease inhibitor (32%]. Overall incidence of toxicity was 12.5%: rash (8%, anemia (3.5% and hepatotoxicity (1%. Rash was associated with exposure to nevirapine. Eighty one percent and 50% reached HIV-viral loads <1000 and <50 copies/ml at the end of pregnancy, respectively. Twenty six percent had obstetric complications and 16% had preterm delivery. Of the newborns, 1.6% had congenital defects and 9% had neonatal complications. Overall neonatal mortality was 1% and perinatal transmission was 0.7%. Protease inhibitor use and obstetric complications were associated to preterm delivery while obstetric complications were associated with neonatal complications. In our population, hepatotoxicity was low despite frequent use of nevirapine. Protease inhibitor use was associated to preterm delivery. A favorable virological response and a low rate of perinatal transmission was observed, what supports the consensus that antiretroviral therapy benefits during pregnancy outweigh risks of maternal and neonatal adverse events.

  8. A Comparison of Medical Birth Register Outcomes between Maternity Health Clinics and Integrated Maternity and Child Health Clinics in Southwest Finland

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    Miia Tuominen

    2016-07-01

    Full Text Available Introduction: Primary maternity care services are globally provided according to various organisational models. Two models are common in Finland: a maternity health clinic and an integrated maternity and child health clinic. The aim of this study was to clarify whether there is a relation between the organisational model of the maternity health clinics and the utilisation of maternity care services, and certain maternal and perinatal health outcomes. Methods: A comparative, register-based cross-sectional design was used. The data of women (N = 2741 who had given birth in the Turku University Hospital area between 1 January 2009 and 31 December 2009 were collected from the Finnish Medical Birth Register. Comparisons were made between the women who were clients of the maternity health clinics and integrated maternity and child health clinics. Results: There were no clinically significant differences between the clients of maternity health clinics and integrated maternity and child health clinics regarding the utilisation of maternity care services or the explored health outcomes. Conclusions: The organisational model of the maternity health clinic does not impact the utilisation of maternity care services or maternal and perinatal health outcomes. Primary maternity care could be provided effectively when integrated with child health services.

  9. Fears in Clinic-Referred Children: Relations with Child Anxiety Sensitivity, Maternal Overcontrol, and Maternal Phobic Anxiety

    Science.gov (United States)

    Ollendick, Thomas H.; Horsch, Laura M.

    2007-01-01

    Relations among maternal phobic anxiety, maternal overcontrol, child anxiety sensitivity, and child level of fear were explored in 156 children referred to an outpatient clinic for psychological evaluation. In addition, these relations were examined separately in analyses of age, gender, and diagnostic status. Overall, age, gender, and child…

  10. Adaptation to Temporally Fluctuating Environments by the Evolution of Maternal Effects.

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    Snigdhadip Dey

    2016-02-01

    Full Text Available All organisms live in temporally fluctuating environments. Theory predicts that the evolution of deterministic maternal effects (i.e., anticipatory maternal effects or transgenerational phenotypic plasticity underlies adaptation to environments that fluctuate in a predictably alternating fashion over maternal-offspring generations. In contrast, randomizing maternal effects (i.e., diversifying and conservative bet-hedging, are expected to evolve in response to unpredictably fluctuating environments. Although maternal effects are common, evidence for their adaptive significance is equivocal since they can easily evolve as a correlated response to maternal selection and may or may not increase the future fitness of offspring. Using the hermaphroditic nematode Caenorhabditis elegans, we here show that the experimental evolution of maternal glycogen provisioning underlies adaptation to a fluctuating normoxia-anoxia hatching environment by increasing embryo survival under anoxia. In strictly alternating environments, we found that hermaphrodites evolved the ability to increase embryo glycogen provisioning when they experienced normoxia and to decrease embryo glycogen provisioning when they experienced anoxia. At odds with existing theory, however, populations facing irregularly fluctuating normoxia-anoxia hatching environments failed to evolve randomizing maternal effects. Instead, adaptation in these populations may have occurred through the evolution of fitness effects that percolate over multiple generations, as they maintained considerably high expected growth rates during experimental evolution despite evolving reduced fecundity and reduced embryo survival under one or two generations of anoxia. We develop theoretical models that explain why adaptation to a wide range of patterns of environmental fluctuations hinges on the existence of deterministic maternal effects, and that such deterministic maternal effects are more likely to contribute to

  11. Adaptation to Temporally Fluctuating Environments by the Evolution of Maternal Effects.

    Science.gov (United States)

    Dey, Snigdhadip; Proulx, Stephen R; Teotónio, Henrique

    2016-02-01

    All organisms live in temporally fluctuating environments. Theory predicts that the evolution of deterministic maternal effects (i.e., anticipatory maternal effects or transgenerational phenotypic plasticity) underlies adaptation to environments that fluctuate in a predictably alternating fashion over maternal-offspring generations. In contrast, randomizing maternal effects (i.e., diversifying and conservative bet-hedging), are expected to evolve in response to unpredictably fluctuating environments. Although maternal effects are common, evidence for their adaptive significance is equivocal since they can easily evolve as a correlated response to maternal selection and may or may not increase the future fitness of offspring. Using the hermaphroditic nematode Caenorhabditis elegans, we here show that the experimental evolution of maternal glycogen provisioning underlies adaptation to a fluctuating normoxia-anoxia hatching environment by increasing embryo survival under anoxia. In strictly alternating environments, we found that hermaphrodites evolved the ability to increase embryo glycogen provisioning when they experienced normoxia and to decrease embryo glycogen provisioning when they experienced anoxia. At odds with existing theory, however, populations facing irregularly fluctuating normoxia-anoxia hatching environments failed to evolve randomizing maternal effects. Instead, adaptation in these populations may have occurred through the evolution of fitness effects that percolate over multiple generations, as they maintained considerably high expected growth rates during experimental evolution despite evolving reduced fecundity and reduced embryo survival under one or two generations of anoxia. We develop theoretical models that explain why adaptation to a wide range of patterns of environmental fluctuations hinges on the existence of deterministic maternal effects, and that such deterministic maternal effects are more likely to contribute to adaptation than

  12. Adaptation to Temporally Fluctuating Environments by the Evolution of Maternal Effects.

    Science.gov (United States)

    Dey, Snigdhadip; Proulx, Stephen R; Teotónio, Henrique

    2016-02-01

    All organisms live in temporally fluctuating environments. Theory predicts that the evolution of deterministic maternal effects (i.e., anticipatory maternal effects or transgenerational phenotypic plasticity) underlies adaptation to environments that fluctuate in a predictably alternating fashion over maternal-offspring generations. In contrast, randomizing maternal effects (i.e., diversifying and conservative bet-hedging), are expected to evolve in response to unpredictably fluctuating environments. Although maternal effects are common, evidence for their adaptive significance is equivocal since they can easily evolve as a correlated response to maternal selection and may or may not increase the future fitness of offspring. Using the hermaphroditic nematode Caenorhabditis elegans, we here show that the experimental evolution of maternal glycogen provisioning underlies adaptation to a fluctuating normoxia-anoxia hatching environment by increasing embryo survival under anoxia. In strictly alternating environments, we found that hermaphrodites evolved the ability to increase embryo glycogen provisioning when they experienced normoxia and to decrease embryo glycogen provisioning when they experienced anoxia. At odds with existing theory, however, populations facing irregularly fluctuating normoxia-anoxia hatching environments failed to evolve randomizing maternal effects. Instead, adaptation in these populations may have occurred through the evolution of fitness effects that percolate over multiple generations, as they maintained considerably high expected growth rates during experimental evolution despite evolving reduced fecundity and reduced embryo survival under one or two generations of anoxia. We develop theoretical models that explain why adaptation to a wide range of patterns of environmental fluctuations hinges on the existence of deterministic maternal effects, and that such deterministic maternal effects are more likely to contribute to adaptation than

  13. Patients' perceptions of safety and quality of maternity clinical handover

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    Chin Georgiana SM

    2011-08-01

    Full Text Available Abstract Background Maternity clinical handover serves to address the gaps in knowledge existing when transitions between individuals or groups of clinicians occur throughout the antenatal, intra-partum and postnatal period. There are limited published studies on maternity handover and a paucity of information about patients' perceptions of the same. This paper reports postnatal patients' perceptions of how maternity handover contributes to the quality and safety of maternity care. Methods This paper reports on a mixed-methods study consisting of qualitative interviews and quantitative medical record analysis. Thirty English-speaking postnatal patients who gave birth at an Australian tertiary maternity hospital participated in a semi-structured interview prior to discharge from hospital. Interview data were coded thematically using the constant comparative method and managed via NVivo software; this data set was supplemented by medical record data analysed using STATA. Results Almost half of the women were aware of a handover process. Clinician awareness of patient information was seen as evidence that handover had taken place and was seen as representing positive aspects of teamwork, care and communication by participants, all important factors in the perception of quality health care. Collaborative cross-checking, including the use of cognitive artefacts such as hand held antenatal records and patient-authored birth plans, and the involvement of patients and their support people in handover were behaviours described by participants to be protective mechanisms that enhanced quality and safety of care. These human factors also facilitated team situational awareness (TSA, shared decision making and patient motivation in labour. Conclusions This study illustrates that many patients are aware of handover processes. For some patients, evidence of handover, through clinician awareness of information, represented positive aspects of teamwork, care and

  14. Maternal-Zygotic Epistasis and the Evolution of Genetic Diseases

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    Nicholas K. Priest

    2010-01-01

    Full Text Available Many birth defects and genetic diseases are expressed in individuals that do not carry the disease causing alleles. Genetic diseases observed in offspring can be caused by gene expression in mothers and by interactions between gene expression in mothers and offspring. It is not clear whether the underlying pattern of gene expression (maternal versus offspring affects the incidence of genetic disease. Here we develop a 2-locus population genetic model with epistatic interactions between a maternal gene and a zygotic gene to address this question. We show that maternal effect genes that affect disease susceptibility in offspring persist longer and at higher frequencies in a population than offspring genes with the same effects. We find that specific forms of maternal-zygotic epistasis can maintain disease causing alleles at high frequencies over a range of plausible values. Our findings suggest that the strength and form of epistasis and the underlying pattern of gene expression may greatly influence the prevalence of human genetic diseases.

  15. Evolution of quality in maternal health in India: Lessons and priorities

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    Aradhana Srivastava

    2014-01-01

    Full Text Available Background: Quality of care is central to current efforts under National Rural Health Mission (NRHM in India to sustain gains in utilization of institutional maternal and newborn care. For effective planning around institutionalizing quality improvement systems, it is important to critically evaluate India's maternal health policy and services in historical perspective. Objectives: The narrative review was conducted (i to trace the evolution of concern with quality in maternal health in the context of health system development in India from independence (1947 to the present; and (ii identify quality-related issues and areas for further action to improve maternal and infant survival outcomes. Materials and Methods: Peer reviewed scientific publications were identified through systematic searches of scientific databases, grey literature and policy documents. Altogether 174 documents were reviewed. Prospectively designed forms extracted data on (i health system and quality development; (ii service performance; (iii health and safe delivery outcomes. Results: In the first four decades after independence, concerns with infrastructure expansion and vertical disease eradication programmes neglected quality of maternal healthcare in India. With growing concern for quality, strategies addressing this were incorporated in NRHM launched in 2005, including public health standards and quality assurance system in reproductive and child health services. Conclusion: Focus on quality in maternal health in India has increased in recent years, especially under NRHM, and this has helped accelerate progress in maternal and neonatal outcomes. Further action areas include the need to increase funding, match rising demand with quality services and enhance functioning of quality assurance system.

  16. A maternal-offspring coadaptation theory for the evolution of genomic imprinting.

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    Jason B Wolf

    2006-11-01

    Full Text Available Imprinted genes are expressed either from the maternally or paternally inherited copy only, and they play a key role in regulating complex biological processes, including offspring development and mother-offspring interactions. There are several competing theories attempting to explain the evolutionary origin of this monoallelic pattern of gene expression, but a prevailing view has emerged that holds that genomic imprinting is a consequence of conflict between maternal and paternal gene copies over maternal investment. However, many imprinting patterns and the apparent overabundance of maternally expressed genes remain unexplained and may be incompatible with current theory. Here we demonstrate that sole expression of maternal gene copies is favored by natural selection because it increases the adaptive integration of offspring and maternal genomes, leading to higher offspring fitness. This novel coadaptation theory for the evolution of genomic imprinting is consistent with results of recent studies on epigenetic effects, and it provides a testable hypothesis for the origin of previously unexplained major imprinting patterns across different taxa. In conjunction with existing hypotheses, our results suggest that imprinting may have evolved due to different selective pressures at different loci.

  17. 75 FR 51083 - Office of Clinical and Preventive Services Maternal and Child Health Program: Project Choices...

    Science.gov (United States)

    2010-08-18

    ... HUMAN SERVICES Indian Health Service Office of Clinical and Preventive Services Maternal and Child...) Morbidity and Mortality Weekly Report (MMWR) dated May 2009 cites studies showing that 0.2 to 1.5 cases of... programmatic involvement will be provided under this CA. The IHS Maternal and Child Health (MCH) Coordinator...

  18. Clinical evolution of the Invisalign appliance.

    Science.gov (United States)

    Vlaskalic, Vicki; Boyd, Robert L

    2002-10-01

    The Invisalign System of tooth movement has been available to orthodontists since 1999 and has now become available to the entire dental profession. This paper explores the role of this system within the dental armamentarium and describes the clinical evolution of the appliance, based on a feasibility study initiated at the University of the Pacific in 1997.

  19. Maternal factors and the evolution of developmental mode: evolution of oogenesis in Heliocidaris erythrogramma.

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    Byrne, M; Villinski, J T; Cisternas, P; Siegel, R K; Popodi, E; Raff, R A

    1999-05-01

    Evolutionary change in developmental mode in sea urchins is closely tied to an increase in maternal provisioning. We examined the oogenic modifications involved in production of a large egg by comparison of oogenesis in congeneric sea urchins with markedly different sized oocytes and divergent modes of development. Heliocidaris tuberculata has small eggs (95 microm diameter) and the ancestral mode of development through feeding larvae, whereas H. erythrogramma has large eggs (430 microm diameter) and highly modified non-feeding lecithotrophic larvae. Production of a large egg in H. erythrogramma involved both conserved and divergent mechanisms. The pattern and level of vitellogenin gene expression is similar in the two species. Vitellogenin processing is also similar with the gonads of both species incorporating yolk protein from coelomic and hemal stores into nutritive cells with subsequent transfer of this protein into yolk granules in the developing vitellogenic oocyte. Immunocytology of the eggs of both Heliocidaris species indicates they incorporate similar levels of yolk protein. However, H. erythrogramma has evolved a highly divergent second phase of oogenesis characterised by massive deposition of non-vitellogenic material including additional maternal protein and lipid. Maternal provisioning in H. erythrogramma exhibits recapitulation of the ancestral vitellogenic program followed by a novel oogenic phase with hypertrophy of the lipogenic program being a major contributor to the increase in egg size.

  20. Maternal antibodies: clinical significance, mechanism of interference with immune responses, and possible vaccination strategies

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    Stefan eNiewiesk

    2014-09-01

    Full Text Available Neonates have an immature immune system which cannot adequately protect against infectious diseases. Early in life, immune protection is accomplished by maternal antibodies transferred from mother to offspring. However, decaying maternal antibodies inhibit vaccination as is examplified by the inhibition of seroconversion after measles vaccination. This phenomenon has been described in both human and veterinary medicine and is independent of the type of vaccine being used. This review will discuss the use of animal models for vaccine research. I will review clinical solutions for inhibition of vaccination by maternal antibodies, and the testing and development of potentially effective vaccines. These are based on new mechanistic insight about the inhibitory mechanism of maternal antibodies. Maternal antibodies inhibit the generation of antibodies whereas the T cell response is usually unaffected. B cell inhibition is mediated through a cross-link between B-cell receptor (BCR with the Fcg receptor IIB (FcgRIIB by a vaccine-antibody complex. In animal experiments, this inhibition can be partially overcome by injection of a vaccine-specific monoclonal IgM antibody. IgM stimulates the B-cell directly through cross-linking the BCR via complement protein C3d and antigen to the complement receptor 2 (CR2 signaling complex. In addition, it was shown that interferon alpha binds to the CD21 chain of CR2 as well as the interferon receptor and that this dual receptor usage drives B cell responses in the presence of maternal antibodies. In lieu of immunizing the infant the concept of maternal immunization as a strategy to protect neonates has been proposed. This approach would still not solve the question of how to immunize in the presence of maternal antibodies but would defer the time of infection to an age where infection might not have such a detrimental outcome as in neonates. I will review successful examples and potential challenges of implementing

  1. Perceived Maternal Role Competence among the Mothers Attending Immunization Clinics of Dharan, Nepal

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    Shah Shrooti

    2016-04-01

    Full Text Available Background: Being a mother is considered by many women as their most important role in life. Women’s perceptions of their abilities to manage the demands of parenting and the parenting skills they posses are reflected by perceived maternal role competence. The present study was carried out to assess the perceived maternal role competence and its associated factors among mothers. Methods: A descriptive cross-sectional research study was carried out on 290 mothers of infant in four immunization clinics of Dharan, Nepal. Data were collected using a standardized predesigned, pretested questionnaire (Parent sense of competence scale, Rosenberg’s self esteem scale, Maternity social support scale. The data were analyzed using descriptive and inferential statistics and multiple regression analysis at 0.05 level of significance. Results: The mean score of the perceived maternal role competence obtained by mothers was 64.34±7.90 and those of knowledge/skill and valuing/comfort subscale were 31±6.01 and 33±3.75, respectively. There was a significant association between perceived maternal role competence and factors as the age of the mother (P<0.001, educational status (P=0.015, occupation (P=0.001 and readiness for pregnancy (P=0.022. The study findings revealed a positive correlation between perceived maternal role competence and age at marriage (r=0.132, P=0.024, per capita income (r=0.118, P=0.045, self esteem (r=0.379, P<0.001, social support (r=0.272, P<0.001, and number of support persons (r=0.119, P=0.043. The results of the step wise multiple regression analysis revealed that the major predictor of perceived maternal role competence was self esteem. Conclusion: The factors associated with perceived maternal role competence were age, education, occupation, per capita income, self esteem, social support, and the number of support persons.

  2. RANDOMIZED CONTROLLED TRIALS OF MATERNAL-FETAL SURGERY : A CHALLENGE TO CLINICAL EQUIPOISE

    NARCIS (Netherlands)

    Rodrigues, H. C. M. L.; van den Berg, P. P.

    2014-01-01

    This article focuses on maternal-fetal surgery (MFS) and on the concept of clinical equipoise that is a widely accepted requirement for conducting randomized controlled trials (RCT). There are at least three reasons why equipoise is unsuitable for MFS. First, the concept is based on a misconception

  3. Maternal Drug Abuse History, Maltreatment, and Functioning in a Clinical Sample of Urban Children

    Science.gov (United States)

    Onigu-Otite, Edore C.; Belcher, Harolyn M. E.

    2012-01-01

    Objective: This study examined the association between maternal drug abuse history, maltreatment exposure, and functioning, in a clinical sample of young children seeking therapy for maltreatment. Methods: Data were collected on 91 children, mean age 5.3 years (SD 1.0). The Preschool and Early Childhood Functional Assessment Scales (PECFAS) was…

  4. Maternal Control and Adolescent Depression: Ethnic Differences among Clinically Referred Girls.

    Science.gov (United States)

    Finkelstein, Jo-Ann S.; Donenberg, Geri R.; Martinovich, Zoran

    2001-01-01

    Examined the relationship between perceived maternal control and depression for 11 urban adolescent girls seeking psychological services at an outpatient clinic. No relation between control and depression was found for Caucasian and Latina girls, but high control was linked to less depression among African American girls. Findings highlight the…

  5. A prospective clinical study of feto-maternal outcome in pregnancies with abnormal liquor volume

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    Rutwa J. Chavda

    2014-02-01

    Conclusions: A good clinical examination can pick up most subjects of abnormal liquor volume. Abnormal liquor volumes are associated with increased maternal morbidity and adverse perinatal outcome. [Int J Reprod Contracept Obstet Gynecol 2014; 3(1.000: 181-184

  6. Maternal Lipid Provisioning Mirrors Evolution of Reproductive Strategies in Direct-Developing Whelks.

    Science.gov (United States)

    Carrasco, Sergio A; Phillips, Nicole E; Sewell, Mary A

    2016-06-01

    The energetic input that offspring receive from their mothers is a well-studied maternal effect that can influence the evolution of life histories. Using the offspring of three sympatric whelks: Cominella virgata (one embryo per capsule); Cominella maculosa (multiple embryos per capsule); and Haustrum scobina (multiple embryos per capsule and nurse-embryo consumption), we examined how contrasting reproductive strategies mediate inter- and intraspecific differences in hatchling provisioning. Total lipid content (as measured in μg hatchling(-1) ± SE) was unrelated to size among the 3 species; the hatchlings of H. scobina were the smallest but had the highest lipid content (33.8 ± 8.1 μg hatchling(-1)). In offspring of C. maculosa, lipid content was 6.6 ± 0.4 μg hatchling(-1), and in offspring of C. virgata, it was 21.7 ± 3.2 μg hatchling(-1) The multi-encapsulated hatchlings of C. maculosa and H. scobina were the only species that contained the energetic lipids, wax ester (WE) and methyl ester (ME). However, the overall composition of energetic lipid between hatchlings of the two Cominella species reflected strong affinities of taxonomy, suggesting a phylogenetic evolution of the non-adelphophagic development strategy. Inter- and intracapsular variability in sibling provisioning was highest in H. scobina, a finding that implies less control of allocation to individual hatchlings in this adelphophagic developer. We suggest that interspecific variability of lipids offers a useful approach to understanding the evolution of maternal provisioning in direct-developing species. PMID:27365414

  7. Maternal vitamin D levels during pregnancy and neonatal health: evidence to date and clinical implications.

    Science.gov (United States)

    Karras, Spyridon N; Fakhoury, Hana; Muscogiuri, Giovanna; Grant, William B; van den Ouweland, Johannes M; Colao, Anna Maria; Kotsa, Kalliopi

    2016-08-01

    Low maternal vitamin D levels during pregnancy have been associated with a plethora of adverse neonatal outcomes, including small for gestational age and preterm births, detrimental effect on offspring bone and teeth development, and risk of infectious diseases. Although most observational studies indicate a significant linear relationship between maternal 25-hydroxyvitamin D and the above outcomes, some randomized controlled trials to date are inconclusive, mostly due to differences in study design and supplementation regimen. The currently available results indicate that vitamin D supplementation during pregnancy reduces the risk of preterm birth, low birth weight, dental caries of infancy, and neonatal infectious diseases such as respiratory infections and sepsis. This narrative review aims to summarize available trial results regarding the effect of low maternal vitamin D levels during pregnancy, in conjunction with neonatal outcomes on the field, with a discourse on the appropriate clinical approach of this important issue. PMID:27493691

  8. Maternal characteristics and clinical diagnoses influence obstetrical outcomes in Indonesia.

    Science.gov (United States)

    Adisasmita, Asri; Smith, Carl V; El-Mohandes, Ayman A E; Deviany, Poppy Elvira; Ryon, Judith J; Kiely, Michele; Rogers-Bloch, Quail; Gipson, Reginald F

    2015-07-01

    This Indonesian study evaluates associations between near-miss status/death with maternal demographic, health care characteristics, and obstetrical complications, comparing results using retrospective and prospective data. The main outcome measures were obstetric conditions and socio-economic factors to predict near-miss/death. We abstracted all obstetric admissions (1,358 retrospective and 1,240 prospective) from two district hospitals in East Java, Indonesia between 4/1/2009 and 5/15/2010. Prospective data added socio-economic status, access to care and referral patterns. Reduced logistic models were constructed, and multivariate analyses used to assess association of risk variables to outcome. Using multivariate analysis, variables associated with risk of near-miss/death include postpartum hemorrhage (retrospective AOR 5.41, 95 % CI 2.64-11.08; prospective AOR 10.45, 95 % CI 5.59-19.52) and severe preeclampsia/eclampsia (retrospective AOR 1.94, 95 % CI 1.05-3.57; prospective AOR 3.26, 95 % CI 1.79-5.94). Associations with near-miss/death were seen for antepartum hemorrhage in retrospective data (AOR 9.34, 95 % CI 4.34-20.13), and prospectively for poverty (AOR 2.17, 95 % CI 1.33-3.54) and delivering outside the hospital (AOR 2.04, 95 % CI 1.08-3.82). Postpartum hemorrhage and severe preeclampsia/eclampsia are leading causes of near-miss/death in Indonesia. Poverty and delivery outside the hospital are significant risk factors. Prompt recognition of complications, timely referrals, standardized care protocols, prompt hospital triage, and structured provider education may reduce obstetric mortality and morbidity. Retrospective data were reliable, but prospective data provided valuable information about barriers to care and referral patterns. PMID:25656716

  9. Maternal near miss in the intensive care unit: clinical and epidemiological aspects

    OpenAIRE

    Oliveira, Leonam Costa; da Costa, Aurélio Antônio Ribeiro

    2015-01-01

    Objective To analyze the epidemiological clinical profile of women with maternal near miss according to the new World Health Organization criteria. Methods A descriptive crosssectional study was conducted, in which the records of patients admitted to the obstetric intensive care unit of a tertiary hospital in Recife (Brazil) over a period of four years were analyzed. Women who presented at least one near miss criterion were included. The variables studied were age, race/color, civil status, e...

  10. A prospective clinical study of feto-maternal outcome in pregnancies with abnormal liquor volume

    OpenAIRE

    Rutwa J. Chavda; Hardev B. Saini

    2014-01-01

    Background: Evaluating feto-maternal outcome in pregnancies with abnormal liquor volume. Methods: 200 pregnant subjects between 20 and 42 weeks of gestation, who were clinically suspected to have an abnormal amniotic fluid volume (oligohydramnios or polyhydramnios) were subjected to ultrasonographic (USG) assessment of amniotic fluid index. The subjects were closely monitored during pregnancy, labour and puerperium. Results: Ultrasonically, abnormal liquor volume was confirmed in 90-93...

  11. Associations between maternal helminth and malaria infections in pregnancy, and clinical malaria in the offspring

    DEFF Research Database (Denmark)

    Ndibazza, Juliet; Webb, Emily L; Lule, Swaib;

    2013-01-01

    %), Schistosoma mansoni (18%), and Plasmodium falciparum (11%). At age 5 years, 69% of the children were still under follow-up. The incidence of malaria was 34 episodes per 100 child-years, and the mean prevalence of asymptomatic malaria at annual visits was 5.4%. Maternal hookworm and M. perstans infections were...... associated with an increased rate of childhood clinical malaria (adjusted hazard ratio [aHR], 1.24 [95% confidence interval (CI), 1.10-1.41] and 1.20 [95% CI, 1.05-1.38], respectively). S. mansoni infection had no consistent association with childhood malaria.Conclusion. This is the first report...

  12. Disposable Soma Theory and the Evolution of Maternal Effects on Ageing.

    Science.gov (United States)

    van den Heuvel, Joost; English, Sinead; Uller, Tobias

    2016-01-01

    Maternal effects are ubiquitous in nature and affect a wide range of offspring phenotypes. Recent research suggests that maternal effects also contribute to ageing, but the theoretical basis for these observations is poorly understood. Here we develop a simple model to derive expectations for (i) if maternal effects on ageing evolve; (ii) the strength of maternal effects on ageing relative to direct environmental effects; and (iii) the predicted relationships between environmental quality, maternal age and offspring lifespan. Our model is based on the disposable soma theory of ageing, and the key assumption is thus that mothers trade off their own somatic maintenance against investment in offspring. This trade-off affects the biological age of offspring at birth in terms of accumulated damage, as indicated by biomarkers such as oxidative stress or telomere length. We find that the optimal allocation between investment in maternal somatic investment and investment in offspring results in old mothers and mothers with low resource availability producing offspring with reduced life span. Furthermore, the effects are interactive, such that the strongest maternal age effects on offspring lifespan are found under low resource availability. These findings are broadly consistent with results from laboratory studies investigating the onset and rate of ageing and field studies examining maternal effects on ageing in the wild. PMID:26752635

  13. Disposable Soma Theory and the Evolution of Maternal Effects on Ageing.

    Directory of Open Access Journals (Sweden)

    Joost van den Heuvel

    Full Text Available Maternal effects are ubiquitous in nature and affect a wide range of offspring phenotypes. Recent research suggests that maternal effects also contribute to ageing, but the theoretical basis for these observations is poorly understood. Here we develop a simple model to derive expectations for (i if maternal effects on ageing evolve; (ii the strength of maternal effects on ageing relative to direct environmental effects; and (iii the predicted relationships between environmental quality, maternal age and offspring lifespan. Our model is based on the disposable soma theory of ageing, and the key assumption is thus that mothers trade off their own somatic maintenance against investment in offspring. This trade-off affects the biological age of offspring at birth in terms of accumulated damage, as indicated by biomarkers such as oxidative stress or telomere length. We find that the optimal allocation between investment in maternal somatic investment and investment in offspring results in old mothers and mothers with low resource availability producing offspring with reduced life span. Furthermore, the effects are interactive, such that the strongest maternal age effects on offspring lifespan are found under low resource availability. These findings are broadly consistent with results from laboratory studies investigating the onset and rate of ageing and field studies examining maternal effects on ageing in the wild.

  14. Male partners’ views of involvement in maternal healthcare services at Makhado Municipality clinics, Limpopo Province, South Africa

    Directory of Open Access Journals (Sweden)

    Kenneth Nesane

    2016-03-01

    Full Text Available Background: Male partners have a strong influence on pregnant partners’ health and their access to care. Their involvement is critical in the delivery and uptake of maternal healthcare services and improving maternal and child health outcomes.Aim: The study sought to determine male partners’ views on their involvement in maternal healthcare services.Setting: The Makhado Municipality’s Kutama, Madombidzha and Vleifontein clinics.Methods: A qualitative study design, which is exploratory, descriptive and contextual in nature, was used. The population comprised 15 men whose partners had been pregnant within the last 2 years. A non-probability, purposive sampling procedure was used. Data were collected via in-depth individual interviews using a voice recorder and an interview schedule guide. Tesch’s open coding method was used to analyse data.Results: The findings revealed one major theme, namely that maternal health issues are viewed as a woman’sdomain; and three sub-themes: culture and participation in childbirth, male partners’ employment status, and male partners’ unwillingness to participate in maternal health issues.Conclusions: The involvement of male partners in maternal healthcare services, and further research in promoting this activity, should be proposed to policymakers.Keywords: Views, partners, involvement, maternal health care services, antenatal care, labour and postnatal care.

  15. The quality of clinical maternal and neonatal healthcare - a strategy for identifying 'routine care signal functions'.

    Directory of Open Access Journals (Sweden)

    Stephan Brenner

    Full Text Available A variety of clinical process indicators exists to measure the quality of care provided by maternal and neonatal health (MNH programs. To allow comparison across MNH programs in low- and middle-income countries (LMICs, a core set of essential process indicators is needed. Although such a core set is available for emergency obstetric care (EmOC, the 'EmOC signal functions', a similar approach is currently missing for MNH routine care evaluation. We describe a strategy for identifying core process indicators for routine care and illustrate their usefulness in a field example.We first developed an indicator selection strategy by combining epidemiological and programmatic aspects relevant to MNH in LMICs. We then identified routine care process indicators meeting our selection criteria by reviewing existing quality of care assessment protocols. We grouped these indicators into three categories based on their main function in addressing risk factors of maternal or neonatal complications. We then tested this indicator set in a study assessing MNH quality of clinical care in 33 health facilities in Malawi.Our strategy identified 51 routine care processes: 23 related to initial patient risk assessment, 17 to risk monitoring, 11 to risk prevention. During the clinical performance assessment a total of 82 cases were observed. Birth attendants' adherence to clinical standards was lowest in relation to risk monitoring processes. In relation to major complications, routine care processes addressing fetal and newborn distress were performed relatively consistently, but there were major gaps in the performance of routine care processes addressing bleeding, infection, and pre-eclampsia risks.The identified set of process indicators could identify major gaps in the quality of obstetric and neonatal care provided during the intra- and immediate postpartum period. We hope our suggested indicators for essential routine care processes will contribute to streamlining

  16. Male partners’ views of involvement in maternal healthcare services at Makhado Municipality clinics, Limpopo Province, South Africa

    Science.gov (United States)

    Nesane, Kenneth; Shilubane, Hilda

    2016-01-01

    Background Male partners have a strong influence on pregnant partners’ health and their access to care. Their involvement is critical in the delivery and uptake of maternal healthcare services and improving maternal and child health outcomes. Aim The study sought to determine male partners’ views on their involvement in maternal healthcare services. Setting The Makhado Municipality’s Kutama, Madombidzha and Vleifontein clinics. Methods A qualitative study design, which is exploratory, descriptive and contextual in nature, was used. The population comprised 15 men whose partners had been pregnant within the last 2 years. A non-probability, purposive sampling procedure was used. Data were collected via in-depth individual interviews using a voice recorder and an interview schedule guide. Tesch’s open coding method was used to analyse data. Results The findings revealed one major theme, namely that maternal health issues are viewed as a woman’sdomain; and three sub-themes: culture and participation in childbirth, male partners’ employment status, and male partners’ unwillingness to participate in maternal health issues. Conclusions The involvement of male partners in maternal healthcare services, and further research in promoting this activity, should be proposedto policymakers. PMID:27380843

  17. Randomized controlled trials of maternal-fetal surgery: a challenge to clinical equipoise.

    Science.gov (United States)

    Rodrigues, H C M L; van den Berg, P P

    2014-10-01

    This article focuses on maternal-fetal surgery (MFS) and on the concept of clinical equipoise that is a widely accepted requirement for conducting randomized controlled trials (RCT). There are at least three reasons why equipoise is unsuitable for MFS. First, the concept is based on a misconception about the nature of clinical research and the status of research subjects. Second, given that it is not clear who the research subject/s in MFS is/are, if clinical equipoise is to be used as a criterion to test the ethical appropriateness of RCT, its meaning should be unambiguous. Third, because of the multidisciplinary character of MFS, it is not clear who should be in equipoise. As a result, we lack an adequate criterion for the ethical review of MFS protocols. In our account, which is based on Chervenak and McCullough's seminal work in the field of obstetric ethics, equipoise is abandoned. and RCT involving MFS can be ethically initiated when a multidisciplinary ethics review board (ERB), having an evidence-based assessment of the risks involved, is convinced that the value of answering the research hypothesis, for the sake of the health interests of future pregnant women carrying fetuses with certain congenital birth defects, justifies the actual risks research participants might suffer within a set limit of low/manageable.

  18. Mother Knows Best: Epigenetic Inheritance, Maternal Effects, and the Evolution of Human Intelligence

    Science.gov (United States)

    Bjorklund, David F.

    2006-01-01

    Contemporary evolution biology has recognized the role of development in evolution. Evolutionarily oriented psychologists have similarly recognized the role that behavioral plasticity, particularly early in development, may have had on the evolution of species, harking back to the ideas of Baldwin (the Baldwin effect). Epigenetic theories of…

  19. Clinical study of placenta previa and its effect on maternal health and fetal outcome

    Directory of Open Access Journals (Sweden)

    Sarojini

    2016-10-01

    Conclusions: Advancing maternal age, multiparity, prior cesarean section, and prior abortions are independent risk factors for placenta previa. Placenta praevia remains a risk factor for adverse maternal and perinatal outcome. The detection of placenta previa should encourage a careful evaluation with timely delivery to reduce the associated maternal and perinatal complications. [Int J Reprod Contracept Obstet Gynecol 2016; 5(10.000: 3496-3499

  20. MRI Contrast Agents: Evolution of Clinical Practice and Dose Optimization.

    Science.gov (United States)

    Khan, Rihan

    2016-08-01

    Accurate detection of lesions throughout the body is of paramount importance in contrast-enhanced magnetic resonance imaging (MRI). Optimal contrast agent performance is therefore of great importance and given the number of MRI contrast agent options today, this topic is of much ongoing study. The goal of this review article is to bring the read up to date on pertinent articles that relate to the evolution of radiological clinical practice and dose optimization pertaining to gadolinium contrast agents. PMID:27367313

  1. Clinical correlation of maternal and fetal placental growth hormone in Type 1 diabetic pregnancy

    LENUS (Irish Health Repository)

    Higgins, M

    2011-02-01

    Institute of Obstetricians & Gynaecologists, RCPI Four Provinces Meeting, Junior Obstetrics & Gynaecology Society Annual Scientific Meeting, Royal Academy of Medicine in Ireland Dublin Maternity Hospitals Reports Meeting, Nov 2011

  2. Persistent influence of maternal obesity on offspring health: Mechanisms from animal models and clinical studies

    Science.gov (United States)

    The consequences of excessive maternal weight and adiposity at conception for the offspring are now well recognized. Maternal obesity increases the risk of overweight and obesity even in children born with appropriate-for-gestational age (AGA) birth weights. Studies in animal models have employed bo...

  3. The early evolution of Jean Piaget's clinical method.

    Science.gov (United States)

    Mayer, Susan Jean

    2005-11-01

    This article analyzes the early evolution of Jean Piaget's renowned "clinical method" in order to investigate the method's strikingly original and generative character. Throughout his 1st decade in the field, Piaget frequently discussed and justified the many different approaches to data collection he used. Analysis of his methodological progression during this period reveals that Piaget's determination to access the genuine convictions of children eventually led him to combine 3 distinct traditions in which he had been trained-naturalistic observation, psychometrics, and the psychiatric clinical examination. It was in this amalgam, first evident in his 4th text, that Piaget discovered the clinical dynamic that would drive the classic experiments for which he is most well known. PMID:17152748

  4. Maternal evaluations of young children’s developmental status: A comparison of clinic- and non-clinic-groups

    Directory of Open Access Journals (Sweden)

    Pia Deimann

    2011-06-01

    Full Text Available The question whether parents’ reports on their children’s development provide reliable information is a subject of controversial debate. While parental rating scales and parental interviews are widely used in clinical practice, empirical findings have shown that parents cannot assess their children well. Previous research has illustrated that most parents tend to overestimate the developmental status and cognitive performance of their children. If the child displays behavior problems, the accuracy of mothers’ appraisals decreases substantially. The aim of this study was (1 to examine whether mothers who are concerned about their children’s development still overestimate the developmental status and (2 whether maternal beliefs about developmental norms influence the accuracy of evaluation. The sample consisted of 14 mother-child-dyads who were clients of two outpatient clinics in Vienna and had concerns about the child’s development, 16 mother-child-dyads without concerns who sought advice because of their children’s potential high abilities, and 30 mother-child-dyads without concerns and no clinic referral. While the children were tested using the Wiener Entwicklungstest (Viennese Developmental Test, WET, Kastner-Koller & Deimann, 2002, a developmental test for children 3 to 6 years old, mothers were asked to estimate which items of the WET (1 their own child and (2 a normal peer would be able to solve. Mothers with concerns had limited knowledge of what a child of a certain age can achieve and they expected too much. Though they realized that their own developmentally delayed child did not fulfill these high expectations, they were not able to appraise his/her performance accurately. Mothers whose children were normally developed or even above average were able to evaluate their own children much more precisely. Moreover, these mothers estimated developmental norms more accurately. Both mothers of gifted children and of

  5. Antiretroviral Therapy Initiation Before, During, or After Pregnancy in HIV-1-Infected Women: Maternal Virologic, Immunologic, and Clinical Response

    OpenAIRE

    Melekhin, Vlada V.; Shepherd, Bryan E.; Stinnette, Samuel E.; Peter F Rebeiro; Gema Barkanic; Raffanti, Stephen P.; Sterling, Timothy R

    2009-01-01

    BACKGROUND: Pregnancy has been associated with a decreased risk of HIV disease progression in the highly active antiretroviral therapy (HAART) era. The effect of timing of HAART initiation relative to pregnancy on maternal virologic, immunologic and clinical outcomes has not been assessed. METHODS: We conducted a retrospective cohort study from 1997-2005 among 112 pregnant HIV-infected women who started HAART before (N = 12), during (N = 70) or after pregnancy (N = 30). RESULTS: Women initiat...

  6. Maternal mortality in different Pakistani sites: ratios, clinical causes and determinants.

    Science.gov (United States)

    Fikree, F F; Midhet, F; Sadruddin, S; Berendes, H W

    1997-08-01

    To determine the magnitude of and factors associated with maternal mortality in Pakistan, population-based surveys were conducted in selected clusters in Karachi, Balochistan, and North West Frontier Provinces during 1989-92. Questionnaires were administered to 38,563 households and verbal autopsy questionnaires were conducted when a maternal death was reported. The overall maternal mortality ratio was 433 per 100,000 live births, with a range from 281 in Karachi to 673 in Balochistan. The leading causes of death were hemorrhage (52.9%), puerperal sepsis (16.3%), and eclampsia (14.4%). Overall, the majority of maternal deaths occurred among women 20-35 years of age with 2-7 children. According to logistic regression analysis, the primary risk factors for maternal mortality were poor housing construction material (odds ratio (OR), 2.1; 95% confidence interval (CI), 1.3-3.2), distance of 40 miles or more from the nearest hospital (OR, 1.3; 95% CI, 0.9-1.8), grandmultigravidae (OR, 1.6; 95% CI, 1.1-2.4), and prior fetal losses (OR, 5.3; 95% CI, 3.8-7.4). These findings indicate a need to focus on special groups of pregnant women, especially those with a poor obstetric history and disadvantaged socioeconomic status, to decrease the high rate of maternal mortality in Pakistan.

  7. The effects of vitamin D supplementation on maternal and neonatal outcome: A randomized clinical trial

    Directory of Open Access Journals (Sweden)

    Mahdieh Mojibian

    2015-11-01

    Full Text Available Background: Vitamin D supplementation during pregnancy has been supposed to defend against adverse gestational outcomes. Objective: This randomized clinical trial study was conducted to assess the effects of 50,000 IU of vitamin D every two weeks supplementation on the incidence of gestational diabetes (GDM, gestational hypertension, preeclampsia and preterm labor, vitamin D status at term and neonatal outcomes contrasted with pregnant women that received 400 IU vitamin D daily. Materials and Methods: 500 women with gestational age 12-16 weeks and serum 25 hydroxy vitamin D (25 (OH D less than 30 ng/ml randomly categorized in two groups. Group A received 400 IU vitamin D daily and group B 50,000 IU vitamin D every 2 weeks orally until delivery. Maternal and Neonatal outcomes were assessed in two groups. Results: The incidence of GDM in group B was significantly lower than group A (6.7% versus 13.4% and odds ratio (95% Confidence interval was 0.46 (0.24-0.87 (P=0.01. The mean ± SD level of 25 (OH D at the time of delivery in mothers in group B was significantly higher than A (37.9 ± 19.8 versus 27.2 ± 18.8 ng/ml, respectively (P=0.001. There were no differences in the incidence of preeclampsia, gestational hypertension, preterm labor, and low birth weight between two groups. The mean level of 25 (OH D in cord blood of group B was significantly higher than group A (37.9 ± 18 versus 29.7 ± 19ng/ml, respectively. Anthropometric measures between neonates were not significantly different. Conclusion: Our study showed 50,000 IU vitamin D every 2 weeks decreased the incidence of GDM.

  8. Lamellar Diffuse Keratitis. Its management and clinical evolution.

    Directory of Open Access Journals (Sweden)

    Jenny García Milián

    2009-12-01

    Full Text Available The new advances in Refractive Surgery have led to an increment in the indications of the LASIK, but also of their complications. Among the postoperative complications, Diffuse Lamellar Keratitis (DLK can occur with a frequency of approximately between 1.8% and 12% of the cases. The objective of this work is to describe the behavior of DLK in patients intervened by the LASIK technique and its clinical evolution. A retrospective cross-sectional descriptive study was made of 5 cases of DLK observed in 253 patients (eyes operated by Lasik in the Ophthalmological Center of Sancti Spíritus between April 3 2008 and April 9 2009. The studied variables were: associated risk factors, beginning of clinical assessment in days, reached stage, type of treatment, duration and time of follow-up and visual results. In the 5 studied cases an average beginning of clinical assessment was observed at 3 days with blurred vision and slight ocular troubles, all were treated with steroidal antinflamatory drugs topically administered obtaining a mean AVC/SC preQX =0, 98 AV mean last control =0, 94, and a average duration of treatment of 15 days, with stages I and II being the ones that prevailed in the sample. It has been shown that DLQ is a complication that can be innocuous for visual results after the application of LASIK, if it is treated appropriately and in an early way.

  9. Maternal-fetal unit interactions and eutherian neocortical development and evolution

    Science.gov (United States)

    Montiel, Juan F.; Kaune, Heidy; Maliqueo, Manuel

    2013-01-01

    The conserved brain design that primates inherited from early mammals differs from the variable adult brain size and species-specific brain dominances observed across mammals. This variability relies on the emergence of specialized cerebral cortical regions and sub-compartments, triggering an increase in brain size, areal interconnectivity and histological complexity that ultimately lies on the activation of developmental programs. Structural placental features are not well correlated with brain enlargement; however, several endocrine pathways could be tuned with the activation of neuronal progenitors in the proliferative neocortical compartments. In this article, we reviewed some mechanisms of eutherians maternal–fetal unit interactions associated with brain development and evolution. We propose a hypothesis of brain evolution where proliferative compartments in primates become activated by “non-classical” endocrine placental signals participating in different steps of corticogenesis. Changes in the inner placental structure, along with placenta endocrine stimuli over the cortical proliferative activity would allow mammalian brain enlargement with a concomitant shorter gestation span, as an evolutionary strategy to escape from parent-offspring conflict. PMID:23882189

  10. Maternal Side-Effects of Continuous vs. Intermittent Method of EntonoxDuring Labor: A Randomized Clinical Trial.

    Science.gov (United States)

    Agah, Jila; Baghani, Roya; Tabaraei, Yaser; Rad, Abolfazl

    2016-01-01

    Labor pain is one of the most tiresome types of pain. So human has been seeking to allay this pain until now. Administration of a suitable agent such as Entonox during labor is very beneficial for childbirth outcomes. Entonox can be administered in two ways: intermittently and continuously. The aim of this study is to demonstrate whether continuous method is as safe as intermittent method? This randomized clinical trial was performed in Mobini Hospital, Sabzevar, Iran. One hundred admitted women for vaginal delivery were included in this study. Fitted patients were randomly divided into two equal groups. After thorough training, the patients used Entonox during active phase of labor. Fifty parturients used it intermittently and 50 others used it continuously. Then, maternal adverse effects, satisfaction and labor progression were registered and compared in two groups. Statistical Analysis was performed by spss17 software, t-test and chi square test. The maternal side effects of Entonox had no significant difference in two groups (p>0.05). Mothers' satisfaction rate in continuous group was more than the intermittent group significantly (p<0.001). Meantime of active phase of labor had no significant difference between two groups (p=0.2). It seems that by more investigations, there will be conditions for mothers to choose the desired method of Entonox usage, intermittently or continuously. This approach leads to reduction of difficult labor and cesarean section and consequently helps improvement of maternal health level, both physically and psychologically. PMID:27642337

  11. Black holes in multiple sclerosis: definition, evolution, and clinical correlations.

    Science.gov (United States)

    Sahraian, M A; Radue, E-W; Haller, S; Kappos, L

    2010-07-01

    Magnetic resonance imaging (MRI) is a sensitive paraclinical test for diagnosis and assessment of disease progression in multiple sclerosis (MS) and is often used to evaluate therapeutic efficacy. The formation of new T2-hyperintense MRI lesions is commonly used to measure disease activity, but lacks specificity because edema, inflammation, gliosis, and axonal loss all contribute to T2 lesion formation. As the role of neurodegeneration in the pathophysiology of MS has become more prominent, the formation and evolution of chronic or persistent Tl-hypointense lesions (black holes) have been used as markers of axonal loss and neuronal destruction to measure disease activity. Despite the use of various detection methods, including advanced imaging techniques such as magnetization transfer imaging and magnetic resonance spectroscopy, correlation of persistent black holes with clinical outcomes in patients with MS remains uncertain. Furthermore, although axonal loss and neuronal tissue destruction are known to contribute to irreversible disability in patients with MS, there are limited data on the effect of therapy on longitudinal change in Tl-hypointense lesion volume. Measurement of black holes in clinical studies may elucidate the underlying pathophysiology of MS and may be an additional method of evaluating therapeutic efficacy. PMID:20003089

  12. Use of a computerised maternity information system to improve clinical effectiveness: thromboprophylaxis at caesarean section

    OpenAIRE

    Taylor, G.; Mckenzie, C.; Mires, G.

    2000-01-01

    An audit of the introduction of a protocol for thromboprophylaxis at caesarean section revealed over treatment of low risk women and the under treatment of high risk women. A routine computer generated risk assessment profile was introduced as part of a maternity information system. Reaudit showed a significant improvement in adherence to the thromboprophylaxis protocol in all risk groups.


Keywords: thromboprophylaxis; caesarean section; computerised assessment

  13. Allergic proctocolitis refractory to maternal hypoallergenic diet in exclusively breast-fed infants: a clinical observation

    Directory of Open Access Journals (Sweden)

    Frediani Simone

    2011-07-01

    Full Text Available Abstract Background Allergic proctocolitis (APC in exclusively breast-fed infants is caused by food proteins, deriving from maternal diet, transferred through lactation. In most cases a maternal cow milk-free diet leads to a prompt resolution of rectal bleeding, while in some patients a multiple food allergy can occur. The aim of this study was to assess whether the atopy patch test (APT could be helpful to identify this subgroup of patients requiring to discontinue breast-feeding due to polisensitization. Additionally, we assessed the efficacy of an amino acid-based formula (AAF when multiple food allergy is suspected. amino acid-based formula Methods We have prospectively enrolled 14 exclusively breast-fed infants with APC refractory to maternal allergen avoidance. The diagnosis was confirmed by endoscopy with biopsies. Skin prick tests and serum specific IgE for common foods, together with APTs for common foods plus breast milk, were performed. After a 1 month therapy of an AAF all patients underwent a follow-up rectosigmoidoscopy. Results Prick tests and serum specific IgE were negative. APTs were positive in 100% infants, with a multiple positivity in 50%. Sensitization was found for breast milk in 100%, cow's milk (50%, soy (28%, egg (21%, rice (14%, wheat (7%. Follow-up rectosigmoidoscopy confirmed the remission of APC in all infants. Conclusions These data suggest that APT might become a useful tool to identify subgroups of infants with multiple gastrointestinal food allergy involving a delayed immunogenic mechanism, with the aim to avoid unnecessary maternal dietary restrictions before discontinuing breast-feeding.

  14. CLINICAL STUDY TO EVALUATE THE MATERNAL AND PERINATAL OUTCOME OF PREGNANCIES WITH POLYHYDRAMNIOS

    OpenAIRE

    Sudha; Juhi; Mahendra

    2013-01-01

    ABSTRACT: BACKGROUND : Due to active involvement of fetal system in regulation of amn iotic fluid volume, AFI has been identified as indicator of intrauterine fetal status. USG has revolutionized the process of assessment of amniotic fluid thus becoming an integral part of fetal surveillance . Polyhydramnios is an obstetrical condition assoc iated with significant perinatal and maternal morbidity and mortality. In a low resource health facility as Ind...

  15. Spatial distribution and evolution of cerebral microbleeds: impact on the clinical therapy

    International Nuclear Information System (INIS)

    Cerebral microbleeds reflect the pathological changes of cerebral small vessel diseases. It has characterized spatial distribution and evolution. The occurrence of microbleeds impacts on clinical treatment. Susceptibility weighted imaging can improve the detection of cerebral microbleeds which could help for the diagnosis and differential diagnosis. We reviewed the pathology, characteristics of spatial and evolution of cerebral microbleeds and its impact on clinical therapy. (authors)

  16. Viral competition and maternal immunity influence the clinical disease caused by very virulent infectious bursal disease virus.

    Science.gov (United States)

    Jackwood, Daral J

    2011-09-01

    The very virulent form of infectious bursal disease virus (vvIBDV) causes an immunosuppressive disease that is further characterized by the rapid onset of morbidity and high mortality in susceptible chickens. In 2009, vvIBDV was first reported in California, U. S. A., and since that time only a few cases of acute infectious bursal disease attributed to vvIBDV have been recognized in California. In other countries where vvIBDV has become established, it rapidly spreads to most poultry-producing regions. Two factors that may be involved in limiting the spread or reducing the severity of the clinical disease caused by vvIBDV in the U. S. A. are maternal immunity and competition with endemic variant strains of the virus. In this study, the ability of vvIBDV to infect and cause disease in maternally immune layer chickens was examined at weekly intervals over a 5-wk period during which their neutralizing maternal antibodies waned. Birds inoculated with vvIBDV at 2, 3, and 4 wk of age seemed healthy throughout the duration of the experiment, but macroscopic and microscopic lesions were observed in their bursa tissues. A real-time reverse transcriptase-polymerase chain reaction (RT-PCR) assay also confirmed the presence of vvIBDV RNA in their bursa tissues, indicating this virus was infecting the birds even at 2 wk of age when neutralizing maternal antibodies to infectious bursal disease virus were still relatively high (> 2000 geometric mean antibody titer). No mortality was observed in any birds when inoculated at 2, 3, or 4 wk of age; however, inoculation at 5 and 6 wk of age resulted in 10% and 20% mortality, respectively. Three experiments on the competition between vvIBDV and the two variant viruses T1 and FF6 were conducted. In all three experiments, specific-pathogen-free (SPF) birds that were inoculated with only the vvIBDV became acutely moribund, and except for Experiment 1 (62% mortality) all succumbed to the infection within 4 days of being exposed. When the

  17. 临近死亡孕产妇295例临床分析%Clinical analysis of 295 cases of maternal near miss

    Institute of Scientific and Technical Information of China (English)

    伍军平; 黄伟雯; 张金陶; 钟景如; 李丽芬

    2015-01-01

    Objective To analyze the clinical features of maternal near miss cases and summarize the treatment experiences, in order to provide a scientific basis for reducing maternal mortality. Methods The datum and clinical characteristics of maternal near miss cases occurred in maternity hospitals in Huadu District from 2013 to 2014 were retrospective analyzed. Results The number of live birth and maternal near miss case were 49 278 and 295 respectively in the two years, and the mobidity of maternal near miss was 5. 99 ‰. Direct obstetric causes and indirect causes were 83. 39 % and 16. 61 % respectively. The top four causes of maternal near miss were obstetric hemorrhage, ectopic pregnancy, severe preeclampsia/eclampsia, and pregnancy with medical disease. Conclusion The causes of maternal near miss close to maternal death, and to ensure the success rate of treatment for maternal near miss is the main measure to reduce maternal mortality.%目的:分析临近死亡孕产妇临床特征,总结救治经验,为降低孕产妇死亡率提供科学依据。方法回顾性分析2013~2014年度广州市花都区助产机构监测的孕产妇临近死亡病例资料及临床特征。结果两年间全区活产数为49278例,孕产妇临近死亡病例295例,发生率为5.99‰。临近死亡病因中直接和间接产科因素分别占83.39%和16.61%。居于前4位分别为产科出血、异位妊娠、重度子痫前期/子痫、妊娠合并内科疾病。结论孕产妇临近死亡与孕产妇死亡病例有相同的病因,保证危重症孕产妇救治成功率是降低孕产妇死亡率的主要措施。

  18. 临近死亡孕产妇295例临床分析%Clinical analysis of 295 cases of maternal near miss

    Institute of Scientific and Technical Information of China (English)

    伍军平; 黄伟雯; 张金陶; 钟景如; 李丽芬

    2015-01-01

    目的:分析临近死亡孕产妇临床特征,总结救治经验,为降低孕产妇死亡率提供科学依据。方法回顾性分析2013~2014年度广州市花都区助产机构监测的孕产妇临近死亡病例资料及临床特征。结果两年间全区活产数为49278例,孕产妇临近死亡病例295例,发生率为5.99‰。临近死亡病因中直接和间接产科因素分别占83.39%和16.61%。居于前4位分别为产科出血、异位妊娠、重度子痫前期/子痫、妊娠合并内科疾病。结论孕产妇临近死亡与孕产妇死亡病例有相同的病因,保证危重症孕产妇救治成功率是降低孕产妇死亡率的主要措施。%Objective To analyze the clinical features of maternal near miss cases and summarize the treatment experiences, in order to provide a scientific basis for reducing maternal mortality. Methods The datum and clinical characteristics of maternal near miss cases occurred in maternity hospitals in Huadu District from 2013 to 2014 were retrospective analyzed. Results The number of live birth and maternal near miss case were 49 278 and 295 respectively in the two years, and the mobidity of maternal near miss was 5. 99 ‰. Direct obstetric causes and indirect causes were 83. 39 % and 16. 61 % respectively. The top four causes of maternal near miss were obstetric hemorrhage, ectopic pregnancy, severe preeclampsia/eclampsia, and pregnancy with medical disease. Conclusion The causes of maternal near miss close to maternal death, and to ensure the success rate of treatment for maternal near miss is the main measure to reduce maternal mortality.

  19. Some of the experimental and clinical aspects of the effectsof the maternal diabetes on developing hippocampus

    Institute of Scientific and Technical Information of China (English)

    Javad Hami; Fatemeh Shojae; Saeed Vafaee-Nezhad; Nasim Lotfi; Hamed Kheradmand; Hossein Haghir

    2015-01-01

    Diabetes mellitus during pregnancy is associated with an increased risk of multiple congenital anomalies in progeny. There are sufficient evidence suggesting that the children of diabetic women exhibit intellectual and behavioral abnormalities accompanied by modification of hippocampus structure and function. Although, theexact mechanism by which maternal diabetes affectsthe developing hippocampus remains to be defined.Multiple biological alterations, including hyperglycemia,hyperinsulinemia, oxidative stress, hypoxia, and irondeficiency occur in pregnancies with diabetes and affectthe development of central nervous system (CNS) ofthe fetus. The conclusion from several studies is thatdisturbance in glucose and insulin homeostasis inmothers and infants are major teratogenic factor in thedevelopment of CNS. Insulin and Insulin-like growthfactor-1 (IGF-1) are two key regulators of CNS functionand development. Insulin and IGF-1 receptors (IR andIGF1R, respectively) are distributed in a highly specificpattern with the high density in some brain regionssuch as hippocampus. Recent researches have clearlyestablished that maternal diabetes disrupts the regulationof both IR and IGF1R in the hippocampus of ratnewborn. Dissecting out the mechanisms responsible formaternal diabetes-related changes in the developmentof hippocampus is helping to prevent from impairedcognitive and memory functions in offspring.

  20. Clinical and tomography evolution of frontal osteomyelitis: Case report

    Directory of Open Access Journals (Sweden)

    Raquel Crisóstomo Lima Verde1, , , , ,

    2012-01-01

    Full Text Available Introduction: The frontal osteomyelitis is a complication of rhinosinusitis which can evolve to acute or chronicle. There is inflammatory reaction by the increasing of intraosseous pressure, ischemia and local necrosis, leading to bone abscess formation. There is no drainage, it will occur detachment of the periosteum, soft tissue invasion and worsening of ischemia with subsequent bone sequestration. Method: Case report of an inpatient in an emergency service of another institution by the complication of rhinosinusitis who was referred to the Otorhinolaryngology Service of University Hospital Professor Edgard Santos of Federal University of Bahia. Case Report: Male patient, 16 years-old, presented himself to the ER of another institution with cephalea, vomits and fever which evolved to periorbital edema and frontal to the left, moving to palpebral fluctuation and frontal. Subjected to frontal and palpebral abscess drainage, with broad-spectrum antibiotic therapy with no improvement. He was referred to our service keeping edema and fluctuation in region frontal and light edema in left periorbital region. The nasal endoscopy showed edema in meatus to the left and the computerized tomography showed fronto-ethmoid sinusitis to the left and signs of frontal osteomyelitis with bone sequestration and epidural empyema. Subjected to sinasal endoscopy surgery, external Access or removal of the frontal one affected and epidural empyema drainage. Evolved to the remission of the disease. Final Considerations: Failure in the diagnosis and rhinosinusitis complication treatment can lead to sequalae and fatal complications. The diagnosis of the frontal osteomyelitis is confirmed by the clinical suspicion and confirmed by radiological examination. The surgery is indicated when the evolution is insidious, there is bone sequestration and intracranial complications.

  1. CLINICAL STUDY TO EVALUATE THE MATERNAL AND PERINATAL OUTCOME OF PREGNANCIES WITH POLYHYDRAMNIOS

    Directory of Open Access Journals (Sweden)

    Sudha

    2013-10-01

    Full Text Available ABSTRACT: BACKGROUND : Due to active involvement of fetal system in regulation of amn iotic fluid volume, AFI has been identified as indicator of intrauterine fetal status. USG has revolutionized the process of assessment of amniotic fluid thus becoming an integral part of fetal surveillance . Polyhydramnios is an obstetrical condition assoc iated with significant perinatal and maternal morbidity and mortality. In a low resource health facility as India with poor coverage of antenatal care and malnutrition it still becomes more important to screen pregnancies for such high risk factors. AIMS: 1. To study incidence of polyhydramnios. 2. To identify major etiological factors of polyhydramnios. 3. To study perinatal outcome. SETTINGS AND DESIGN: A hospital based cross section study for duration from 1 st May 2009 to 31 st October 2010. MATERIAL & ME THOD: All the cases identified as polyhydramnios according to AFI in four pocket were included in the study. The cases identified as having polyhydramnios but not delivered at the facility were excluded. OBSERVATION: Incidence of polyhydramnios is 0.72% of the total antenatal cases, multiparous ie, 52% more than primiparous cases. Majority were unbooked (77.3% 63% were from rural set up. 76% belonged to low socio economic status. Majority 66% of the cases had their 1 st antenatal visit at term. Increased in cidence of operative delivery was seen in the study. Associated maternal factors found with polyhydramnios were gestation hypertension (8.4%, preeclampsia (2.9%, eclampsia (2.9%, anaemia (11%, twins (8.4%, malpresentation (5%, RH negative factor (3.7 %, and diabetes (1.9%. Fetal complication include prematurity 21.6%, IUFT 20.7%, congenital malformation 21.6%, cord prolapse 3.7%, birth asphyxia 1.9%. Most common congenital anomaly was anencephaly i.e., 11%. CONCLUSION : The study gives us the underst anding of the impact of polyhydramnios on the maternal and fetal outcome. Our study demonstrate s

  2. Effect of maternally derived antibodies on the clinical signs and immune response in pigs after primary and secondary infection with an influenza H1N1 virus

    NARCIS (Netherlands)

    Loeffen, W.L.A.; Heinen, P.P.; Bianchi, A.T.J.; Hunneman, W.A.; Verheijden, J.H.M.

    2003-01-01

    The aim of this study was to determine the role of maternally derived antibodies (MDA) against an influenza H1N1 virus in the clinical protection of piglets and especially their effect on the development of the active immunity after an infection with a homologous influenza H1N1 virus. Twenty piglets

  3. A clinical study of association of maternal height and estimated foetal weight on mode of delivery

    Directory of Open Access Journals (Sweden)

    Anup Ramrao Patil

    2015-08-01

    Methods: 240 full term primigravida women without any obstetric and medical complications who were admitted in Acharya Vinoba Bhave Rural Hospital Wardha for delivery were randomly selected for study. After delivery 138 women who underwent caesarean delivery formed the study group and 102 women who underwent vaginal delivery formed control group. These two groups were compared for their maternal heights and antenatal estimated foetal weight (by Johnson's formula. Results: In present study (1 Mean height of women in study group was 147 cm while that in control group was 155 cm. (2 Out of 49 short statured women (height and #8804; 145 cm 47 (95.91% had emergency caesarean section and 2(4.08% women were delivered vaginally. (3 Estimated foetal weight in study group was 2956 grams while that in control group was 2845 grams. Conclusions: We conclude that short statured women with larger baby size has higher incidence of emergency caesarean delivery. [Int J Reprod Contracept Obstet Gynecol 2015; 4(4.000: 1020-1024

  4. Postnatal infant crying and maternal tiredness : examining their evolution and interaction in the first 12 weeks postpartum

    OpenAIRE

    Kurth, Elisabeth

    2010-01-01

    A new mother lazing in childbed is a blessing for her family” is an old Swiss proverb. Maternal rest and recuperation after birth was a common concern in the past and was frequently supported by the extended family. However, mothers today barely enjoy restful days after birth; instead they enter directly into the challenge of combining baby- and selfcare. They often struggle to soothe a crying baby, while coping with their own exhaustion, which can adversely affect family healt...

  5. The frequency of gestational diyabetes mellitus in a maternity hospital antepartum clinic

    Directory of Open Access Journals (Sweden)

    Abdulkadir Turgut

    2011-09-01

    Full Text Available Objectives: The aim of this study was to determine gestational diabetes mellitus (GDM frequency and age related frequency with GDM screening tests in patients whom referred to our hospital’s antepartum clinic for routine follow-up.Materials and methods: Totally, 2617 pregnant women who did not have any risk factors for GDM and attended to our antepartum clinic for routine follow-up between August 2009 and March 2011 enrolled in this study. A 50-g glucose challenge test (GCT applied at 24-28 weeks’ gestation. The patients who had a value of blood glucose ≥ 140 mg/dl undergone 100-g oral glucose tolerance test (OGTT. Patients who had a value of ≥200 mg/dl blood glucose in GCT or one value of ≥200 mg/dl in OGTT or had two values exceeded normal ranges in OGTT were accepted as GDM. Age related GDM frequency was also determined.Results: Of the 2617 pregnant women 110 patients diagnosed as GDM (4.2%. For the age related frequency, there was a tendency towards GDM after the age of 33. The age 44 was the most risky with a 33% ratio of GDM occurrence rate.Conclusion: In this study the GDM frequency in our hospital’s routine follow-up clinic was found as compatible with the 1% to 6% frequency reported in the literature. The higher frequency of GDM was found in advanced age pregnancies.

  6. Clinical, Aetiologic, And Evolution-Related Aspects Of Pleurisy In Children

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    Corina Frecus

    2015-11-01

    Full Text Available Objectives: Establishing the frequency of pleurisy from the total number of admissions in the Paediatrics Department, as well as the frequency of pleurisy from the total number of respiratory ailments that required hospitalization; evaluating age group distribution and determining the influence of environmental factors; describing clinical manifestations, laboratory, radiologic, and bacteriological investigations in patients with pleurisy; quantifying clinical manifestations and investigations so as to establish an appropriate therapeutic approach; identifying clinical aspects that indicate a favourable/unfavourable evolution; analyzing the evolution of cases after treatment as revealed by radiologic imaging.

  7. Maternal Serum Resistin Is Reduced in First Trimester Preeclampsia Pregnancies and Is a Marker of Clinical Severity

    DEFF Research Database (Denmark)

    Christiansen, Michael; Hedley, Paula L; Placing, Sophie;

    2015-01-01

    OBJECTIVE: To examine whether resistin levels in first trimester maternal serum are associated with insulin resistance or preeclampsia (PE). METHODS: A case-control study of maternal serum resistin concentration conducted using 285 normal pregnancies and 123 PE pregnancies matched for gestational...

  8. Clinical utility of calf front hoof circumference and maternal intrapelvic area in predicting dystocia in 103 late gestation Holstein-Friesian heifers and cows.

    Science.gov (United States)

    Hiew, Mark W H; Megahed, Ameer A; Townsend, Jonathan R; Singleton, Wayne L; Constable, Peter D

    2016-02-01

    The objective of this study was to determine the clinical utility of measuring calf front hoof circumference, maternal intrapelvic area, and selected morphometric values in predicting dystocia in dairy cattle. An observational study using a convenience sample of 103 late-gestation Holstein-Friesian heifers and cows was performed. Intrapelvic height and width of the dam were measured using a pelvimeter, and the intrapelvic area was calculated. Calf front hoof circumference and birth weight were also measured. Data were analyzed using Spearman's correlation coefficient (rs), Mann-Whitney U test, and binary or ordered logistic regression; P 0.068 cm/cm(2)). Determining the ratio of calf front hoof circumference to maternal intrapelvic area has clinical utility in predicting the calving difficulty score in Holstein-Friesian cattle. PMID:26474687

  9. Maternal clinical diagnoses and hospital variation in the risk of cesarean delivery: analyses of a National US Hospital Discharge Database.

    Directory of Open Access Journals (Sweden)

    Katy B Kozhimannil

    2014-10-01

    Full Text Available BACKGROUND: Cesarean delivery is the most common inpatient surgery in the United States, where 1.3 million cesarean sections occur annually, and rates vary widely by hospital. Identifying sources of variation in cesarean use is crucial to improving the consistency and quality of obstetric care. We used hospital discharge records to examine the extent to which variability in the likelihood of cesarean section across US hospitals was attributable to individual women's clinical diagnoses. METHODS AND FINDINGS: Using data from the 2009 and 2010 Nationwide Inpatient Sample from the Healthcare Cost and Utilization Project--a 20% sample of US hospitals--we analyzed data for 1,475,457 births in 1,373 hospitals. We fitted multilevel logistic regression models (patients nested in hospitals. The outcome was cesarean (versus vaginal delivery. Covariates included diagnosis of diabetes in pregnancy, hypertension in pregnancy, hemorrhage during pregnancy or placental complications, fetal distress, and fetal disproportion or obstructed labor; maternal age, race/ethnicity, and insurance status; and hospital size and location/teaching status. The cesarean section prevalence was 22.0% (95% confidence interval 22.0% to 22.1% among women with no prior cesareans. In unadjusted models, the between-hospital variation in the individual risk of primary cesarean section was 0.14 (95% credible interval 0.12 to 0.15. The difference in the probability of having a cesarean delivery between hospitals was 25 percentage points. Hospital variability did not decrease after adjusting for patient diagnoses, socio-demographics, and hospital characteristics (0.16 [95% credible interval 0.14 to 0.18]. A limitation is that these data, while nationally representative, did not contain information on parity or gestational age. CONCLUSIONS: Variability across hospitals in the individual risk of cesarean section is not decreased by accounting for differences in maternal diagnoses. These

  10. Evolution in clinical knowledge management strategy at Intermountain Healthcare.

    Science.gov (United States)

    Hulse, Nathan C; Galland, Joel; Borsato, Emerson P

    2012-01-01

    In this manuscript, we present an overview of the clinical knowledge management strategy at Intermountain Healthcare in support of our electronic medical record systems. Intermountain first initiated efforts in developing a centralized enterprise knowledge repository in 2001. Applications developed, areas of emphasis served, and key areas of focus are presented. We also detail historical and current areas of emphasis, in response to business needs.

  11. Evolution of the clinical trial landscape in Asia Pacific

    Directory of Open Access Journals (Sweden)

    Yathindranath S

    2014-07-01

    Full Text Available Shourav Yathindranath,1 Amar Kureishi,2 Simranjit Singh,3 Spencer Yeow,3 Grace Geng,4 Karen Wai,1 Audrey Ho,1 Elvira Zenaida Lansang,1 Ken J Lee5 1Feasibility and Site Identification Asia, 2Drug Development Asia, 3Strategic Planning Asia, Quintiles East Asia Private Limited, Singapore; 4People’s Republic of China Site Services, Quintiles, Beijing, People’s Republic of China; 5Asia Site Services, Quintiles East Asia Private Limited, Singapore Introduction: Asia Pacific has and continues to be one of the fastest-growing pharmaceutical markets in the world. This growth has a carry-over effect of driving pharmaceutical research and development investment in the region. Coupled with this, there have been multiple initiatives conducted by governments and other research focused organizations and societies in the region to help support this growth in research. In this report, we discuss the latest developments in pharmaceutical research and development in Asia Pacific and how these various initiatives have made an impact. Methods: An extensive search of the major clinical trial registries, along with the literature and Internet review of the recent developments in clinical trials, was performed comparing two time periods – 2009–2010 and 2011–2012. Results: In overall numbers, the clinical trial industry in Asia Pacific has remained stable when comparing the two time periods, with stable volumes of clinical trial numbers and site numbers. However, on closer inspection, a dynamic change in geography, nature, and therapeutic areas of the trials being conducted is observed. Japan, South Korea, People’s Republic of China, and Taiwan continue to be major clinical trial destinations. Developing countries, such as Indonesia, Vietnam, and Philippines, have seen rising standards of living and medical care; this is starting to impact their contribution to trials. Also, there are an increasing number of local trials in Asia Pacific with a bigger role

  12. Early evolution of the thermometer and application to clinical medicine.

    Science.gov (United States)

    Wright, William F

    2016-02-01

    By the time of Hippocrates and Galen the notion of fevers and temperature were known. Through ensuing centuries, ancient Greek, Roman, and medieval savants and physicians made additional contributions to the understanding of fever, temperature, and thermometry. By the end of that era, there was a working definition of what constitutes a rationale temperature scale, the distinction between fever as a symptom and fever as a disease, an elaborate classification scheme for temperature, hypotheses as to the causes of fever, and methods for measuring fevers. Based on the definition of fever at that time, the 16th century scientist Galileo promulgated production of thermometric instruments hundreds of years before they were routinely used in the clinical setting. In this work we examine the history of fever and clinical thermometry in the ancient world through the end of the eighteenth century with descriptions of instruments for its measure and human relationship to fever. PMID:26857973

  13. [Asperger syndrome: evolution of the concept and current clinical data].

    Science.gov (United States)

    Aussilloux, C; Baghdadli, A

    2008-05-01

    Although Asperger syndrome is described by international classifications as a category of pervasive developmental disorder (PDD), its validity as a specific entity distinct from autistic disorders remains controversial. The syndrome, first described by Hans Asperger, could not be distinguished from high functioning autism (onset, symptoms, outcome...). However, international classifications propose a distinction between the two syndromes based on a delayed onset, the absence of speech delay, the presence of motor disorders and a better outcome in Asperger syndrome. This categorical differentiation is not confirmed by current studies and in the absence of biological markers, no clinical, neuropsychological or epidemiological criteria makes it possible to distinguish high functioning autism from Asperger syndrome. From a clinical perspective, it is nevertheless of interest to isolate Asperger syndrome from other autistic disorders to propose specific assessment and therapy.

  14. Evolution in clinical knowledge management strategy at Intermountain Healthcare.

    Science.gov (United States)

    Hulse, Nathan C; Galland, Joel; Borsato, Emerson P

    2012-01-01

    In this manuscript, we present an overview of the clinical knowledge management strategy at Intermountain Healthcare in support of our electronic medical record systems. Intermountain first initiated efforts in developing a centralized enterprise knowledge repository in 2001. Applications developed, areas of emphasis served, and key areas of focus are presented. We also detail historical and current areas of emphasis, in response to business needs. PMID:23304309

  15. Clinical Decision Support Tools: The Evolution of a Revolution.

    Science.gov (United States)

    Mould, D R; D'Haens, G; Upton, R N

    2016-04-01

    Dashboard systems for clinical decision support integrate data from multiple sources. These systems, the newest in a long line of dose calculators and other decision support tools, utilize Bayesian approaches to fully individualize dosing using information gathered through therapeutic drug monitoring. In the treatment of inflammatory bowel disease patients with infliximab, dashboards may reduce therapeutic failures and treatment costs. The history and future development of modern Bayesian dashboard systems is described. PMID:26785109

  16. Capturing Provenance, Evolution and Modification of Clinical Protocols via a Heterogeneous, Semantic Social Network.

    Science.gov (United States)

    Portokallidis, Nick; Drosatos, George; Kaldoudi, Eleni

    2016-01-01

    Healthcare delivery is largely based on medical best practices as in clinical protocols. Research so far has addressed the computerized execution of clinical protocols by developing a number of related representation languages, execution engines and integrated platforms to support real time execution. However, much less effort has been put into organizing clinical protocols for use and reuse. In this paper we propose a heterogeneous semantic social network to describe and organize clinical protocols based on their provenance, evolution and modifications. The proposed approach allows semantic tagging and enrichment of clinical protocols so that they can be used and re-used across platforms and also be linked directly to other relevant scientific information, e.g. published works in PubMed or personal health records, and other clinical information systems. PMID:27332270

  17. Evaluation of the response to treatment and clinical evolution in patients with burning mouth syndrome

    OpenAIRE

    M.E. Rodríguez de Rivera Campillo; López López, José

    2013-01-01

    Objective: the aim of this study is to investigate the clinical evolution, the spontaneous remission of the symptomatology and the response to different treatments in a group of burning mouth syndrome patients. Study Design: the sample was formed by a group of patients that were visited in the Unit of Oral Medicine of the Dentistry Clinic of the University of Barcelona, from the year 2000 to 2011. After revising the clinical records of all the patients that had been under control for a period...

  18. The major clinical determinants of maternal death among obstetric near-miss patients: a tertiary centre experience

    International Nuclear Information System (INIS)

    Objective: To evaluate the characteristics of obstetric near-miss patients to clarify the major risk factors of maternal mortality. Methods: From among the patients referred to the Department of Obstetrics and Gynaecology, Inonu University of Medical Sciences, Turkey, between August 1, 2010 and March 1, 2012, electronic records of obstetric near-miss cases were retrospectively analysed. The obstetric and demographic characteristics of cases that were successfully treated (Group 1) as well as cases with maternal death (Group 2) were analysed and compared. SPSS 11.5 was used for statistical analysis. Results: Of the total 2687 cases handled during the study period, 95 (3.53%) were of the near-miss nature. The most frequently encountered underlying aetiology was severe preeclampsia (n=55; 57.89%) and haemolysis, elevated liver enzymes, low platelet count syndrome (n=20; 21.1%). These were followed by cases of postpartum bleeding (n=18; 18.9%). Maternal mortality occurred in 10 (10.5%) patients, representing Group 2. The amount of haemorrhage and blood transfused were significantly higher in the group. Maternal mortality cases had also significantly longer duration of intensive care unit admission. Conclusion: Early diagnosis and immediate management of the complications noted by the study can be the most important measures to prevent the occurrence of mortality. (author)

  19. Detection and clinical evolution of scrapie in sheep by 3rd eyelid biopsy.

    Science.gov (United States)

    Vargas, Francisco; Luján, Lluís; Bolea, Rosa; Monleón, Eva; Martín-Burriel, Inmaculada; Fernández, Antonio; De Blas, Ignacio; Badiola, Juan José

    2006-01-01

    The goal of this article was to characterize the clinical evolution of scrapie in naturally affected sheep. Eighteen sheep with scrapie diagnosed by examination of 3rd eyelid biopsy and 12 control ewes were studied throughout the duration of their disease. Diagnosis was confirmed postmortem by histopathologic, immunohistochemical, and Western blot analysis of nervous tissue. Complete clinical examinations were performed every 2 weeks for each animal, of which 3 clinical examinations per animal are reported. Those clinical signs that showed a significant frequency within the corresponding clinical examination were considered representative of each stage of the disease (ie, early, middle, and late). The representative clinical signs for the early stage were hypoesthesia in the limbs, alteration of mental status, and a body condition score gait abnormalities, and teeth grinding. On the basis of these results, we propose the calculation of an objective clinical index that allows the differentiation among clinical stages and that could be useful for further studies. The usefulness of 3rd eyelid lymphoid tissue biopsies for sequential clinical studies in naturally scrapie-affected sheep is demonstrated. PMID:16496940

  20. Survival and evolution of a large multidrug resistance plasmid in new clinical bacterial hosts

    DEFF Research Database (Denmark)

    Porse, Andreas; Schønning, Kristian; Munck, Christian;

    2016-01-01

    and population sequencing to show that the long-term persistence and molecular integrity of the plasmid is highly influenced by multiple factors within a 25 kb plasmid region constituting a host-dependent burden. In the E. coli hosts investigated here, improved plasmid stability readily evolves via IS......Large conjugative plasmids are important drivers of bacterial evolution and contribute significantly to the dissemination of antibiotic resistance. Although plasmid borne multidrug resistance is recognized as one of the main challenges in modern medicine, the adaptive forces shaping the evolution...... of these plasmids within pathogenic hosts are poorly understood. Here we study plasmid-host adaptations following transfer of a 73 kb conjugative multidrug resistance plasmid to naïve clinical isolates of Klebsiella pneumoniae and Escherichia coli We use experimental evolution, mathematical modelling...

  1. Does the organizational model of the maternity health clinic have an influence on women’s and their partners’ experiences? A service evaluation survey in Southwest Finland

    Directory of Open Access Journals (Sweden)

    Tuominen Miia

    2012-09-01

    Full Text Available Abstract Background In high-income countries, great disparities exist in the organizational characteristics of maternity health services. In Finland, primary maternity care is provided at communal maternity health clinics (MHC. At these MHCs there are public health nurses and general practitioners providing care. The structure of services in MHCs varies largely. MHCs are maintained independently or merged with other primary health care sectors. A widely used organizational model of services is a combined maternity and child health clinic (MHC & CHC where the same public health nurse takes care of the family from pregnancy until the child is at school age. The aim of this study was to determine how organizational model, MHC independent or combined MHC & CHC, influence on women’s and their partners’ service experiences. Methods A comparative, cross-sectional service evaluation survey was used. Women (N = 995 and their partners (N = 789 were recruited from the MHCs in the area of Turku University Hospital. Four months postpartum, the participants were asked to evaluate the content and amount of the MHC services via a postal questionnaire. Comparisons were made between the clients of the separate MHCs and the MHCs combined to the child health clinics. Results Women who had used the combined MHC & CHCs generally evaluated services more positively than women who had used the separate MHCs. MHC’s model was related to several aspects of the service which were evaluated “good” (the content of the service or “much” (the amount of the service. Significant differences accumulated favoring the combined MHC & CHCs’ model. Twelve aspects of the service were ranked more often as “good” or “much” by the parents who had used the combined MHC & CHC, only group activities regarding delivery were evaluated better by women who had used the separate MHCs. Conclusions Based on the women’s and partners’ experiences an organizational

  2. Association of ADHD symptoms severity with higher paternal and lower maternal age of a clinical sample of children.

    Directory of Open Access Journals (Sweden)

    Ahmad Ghanizadeh

    2014-01-01

    Full Text Available This study examines the association of father's and mother's age with the severity of inattention and hyperactivity/impulsivity. Participants are 470 children with attention deficit hyperactivity disorder (ADHD diagnosed according to DSM-IV diagnostic criteria. Moreover, parents reported the severity of ADHD symptoms through completing ADHD checklist. Mother's and father's age was associated with the score of hyperactivity/impulsivity. Lower father's age and advanced maternal age are associated with higher severity of hyperactivity/impulsivity in children and adolescents with ADHD. None of mothers' and fathers' age is associated with ADHD inattentiveness severity in children. Maternal and paternal education levels are not associated with ADHD severity. Older mothers and younger fathers have ADHD children with higher hyperactivity/impulsivity severity. It should be investigated whether the father's and mother's age are risk factors for ADHD.

  3. HIV and pregnancy: Maternal and neonatal evolution HIV y embarazo: Evolución materna y neonatal

    Directory of Open Access Journals (Sweden)

    Diego Cecchini

    2011-10-01

    Full Text Available Data regarding epidemiological aspects, antiretroviral drug safety, and outcomes of HIV-infected pregnant women and their newborns are limited in Argentina. We underwent a retrospective analysis of registries of HIV-infected pregnant women assisted at Helios Salud, Buenos Aires, Argentina (1997-2006. Variables associated with preterm delivery and neonatal complications were analyzed by univariate and logistic regression analyses. A total of 204 mother-child binomium were included. Maternal age (median: 29 years; 32.5% without prior diagnosis of HIV-infection. Baseline median CD4 T-cell count: 417 cell/μl; 98% received antiretroviral drugs during pregnancy [2 nucleoside analogs plus either nevirapine (55% or a protease inhibitor (32%]. Overall incidence of toxicity was 12.5%: rash (8%, anemia (3.5% and hepatotoxicity (1%. Rash was associated with exposure to nevirapine. Eighty one percent and 50% reached HIV-viral loads La información sobre aspectos epidemiológicos, seguridad de drogas antirretrovirales y evolución de mujeres embarazadas HIV positivas y sus hijos es limitada en la Argentina. Realizamos un análisis retrospectivo de registros de embarazadas HIV positivas asistidas en Helios Salud, Buenos Aires, Argentina (1997-2006. Las variables asociadas con parto prematuro y complicaciones neonatales se estudiaron mediante análisis univariado y regresión logística. Estudiamos 204 binomios madre-hijo. Edad materna (mediana: 29 años, 32.5% sin diagnóstico previo de HIV. Recuento de linfocitos T CD4+ (mediana: 417 células/μl. El 98% recibió tratamiento antirretroviral durante el embarazo [dos análogos de nucleósidos más nevirapina (55% o un inhibidor de proteasa (32%]. La incidencia global de toxicidad fue 12.5%: erupción cutánea (8%, anemia (3.5% y hepatotoxicidad (1%. La exposición a nevirapina se asoció con rash. El 81% y 50% alcanzaron cargas virales <1000 y <50 copias/ml preparto, respectivamente. Cesárea programada: 68

  4. Assessment of the quality of the management of childbirth by vaginal delivery in 5 reference maternity clinics in Dakar, Senegal

    Directory of Open Access Journals (Sweden)

    Omar Gassama

    2016-10-01

    Conclusions: In our study, the most followed A-category recommendations from the WHO are: encouraged mobility, the use of single-use equipment, AMTSL and skin-on-skin contact. However, some B, C and D-category practices are still widely used in our maternity hospitals. The health authorities should make sure that the WHO recommendations are followed. [Int J Reprod Contracept Obstet Gynecol 2016; 5(10.000: 3378-3383

  5. Clinical complications in pregnant women with sickle cell disease: prospective study of factors predicting maternal death or near miss

    OpenAIRE

    Patrícia Santos Resende Cardoso; Regina Amélia Lopes Pessoa Aguiar; Marcos Borato Viana

    2014-01-01

    OBJECTIVE: To evaluate complications in pregnant women with sickle cell disease, especially those leading to maternal death or near miss (severe obstetric complications). METHODS: A prospective cohort of 104 pregnant women registered in the Blood Center of Belo Horizonte (Hemominas Foundation) was followed up at high-risk prenatal units. They belonged to Group I (51 hemoglobin SS and three hemoglobin S/ß0-thalassemia) or Group II (49 hemoglobin SC and one hemoglobin S/ß+-thalassemia). Bo...

  6. CLECOS_P: clinical evolution control system on Parkinsonian patients undergoing neural transplantation.

    Science.gov (United States)

    Morales, F; Molina, H; Cruz, N; Valladares, P; Muñoz, J; Ortega, I; Torres, O; Leon, M

    1995-01-01

    The CLECOS_P system was conceived for registering and automating the processing of clinical evaluations performed on patients with Parkinson's disease who undergo functional neurosurgery and/or neural transplant. CLECOS_P represents the first time a computerized system is able to offer--with high precision and considerable time-savings--an integral analysis of the evolutive behavior of the universe in integrated variables at the core assessment program for intracerebral transplantations (CAPIT). CAPIT is used internationally for the evaluation and follow-up of patients with this pathology who have undergone neural transplant. We used the so-called MEDSAC methodology for the preparation of this system. The methodology that was used for the design of an intelligent system aimed at medical decision-making was based on the quantitative analysis of the clinical evolution. At the present moment, there are 20 patients controlled by this system: 11 bilaterally transplanted, 9 unilaterally (registered in ranks of 3 months before operation up to 1, 2, 3, 6, 9, 12, 18, and 24 months after operation). The application of CLECOS_P to these patients permitted the evaluation of 400 clinical variables, where a better evolutive characterization of the patients was obtained, thus getting most favorable results with personalized therapeutic methods aimed at raising their quality of life. CLECOS_P is used in a multi-user environment on a local area network running Novell Netware version 3.11. PMID:8591284

  7. Early descriptions of acromegaly and gigantism and their historical evolution as clinical entities.

    Science.gov (United States)

    Mammis, Antonios; Eloy, Jean Anderson; Liu, James K

    2010-10-01

    Giants have been a subject of fascination throughout history. Whereas descriptions of giants have existed in the lay literature for millennia, the first attempt at a medical description was published by Johannes Wier in 1567. However, it was Pierre Marie, in 1886, who established the term "acromegaly" for the first time and established a distinct clinical diagnosis with clear clinical descriptions in 2 patients with the characteristic presentation. Multiple autopsy findings revealed a consistent correlation between acromegaly and pituitary enlargement. In 1909, Harvey Cushing postulated a “hormone of growth" as the underlying pathophysiological trigger involved in pituitary hypersecretion in patients with acromegaly. This theory was supported by his observations of clinical remission in patients with acromegaly in whom he had performed hypophysectomy. In this paper, the authors present some of the early accounts of acromegaly and gigantism, and describe its historical evolution as a medical and surgical entity.

  8. Early descriptions of acromegaly and gigantism and their historical evolution as clinical entities.

    Science.gov (United States)

    Mammis, Antonios; Eloy, Jean Anderson; Liu, James K

    2010-10-01

    Giants have been a subject of fascination throughout history. Whereas descriptions of giants have existed in the lay literature for millennia, the first attempt at a medical description was published by Johannes Wier in 1567. However, it was Pierre Marie, in 1886, who established the term "acromegaly" for the first time and established a distinct clinical diagnosis with clear clinical descriptions in 2 patients with the characteristic presentation. Multiple autopsy findings revealed a consistent correlation between acromegaly and pituitary enlargement. In 1909, Harvey Cushing postulated a “hormone of growth" as the underlying pathophysiological trigger involved in pituitary hypersecretion in patients with acromegaly. This theory was supported by his observations of clinical remission in patients with acromegaly in whom he had performed hypophysectomy. In this paper, the authors present some of the early accounts of acromegaly and gigantism, and describe its historical evolution as a medical and surgical entity. PMID:20887119

  9. Clinical complications in pregnant women with sickle cell disease: prospective study of factors predicting maternal death or near miss

    Directory of Open Access Journals (Sweden)

    Patrícia Santos Resende Cardoso

    2014-07-01

    Full Text Available OBJECTIVE: To evaluate complications in pregnant women with sickle cell disease, especially those leading to maternal death or near miss (severe obstetric complications. METHODS: A prospective cohort of 104 pregnant women registered in the Blood Center of Belo Horizonte (Hemominas Foundation was followed up at high-risk prenatal units. They belonged to Group I (51 hemoglobin SS and three hemoglobin S/ß0-thalassemia or Group II (49 hemoglobin SC and one hemoglobin S/ß+-thalassemia. Both groups had similar median ages. Predictive factors for 'near miss' or maternal death with p-value = 0.25 in the univariate analysis were included in a multivariate logistic model (significance set for p-value = 0.05. RESULTS: Group I had more frequent episodes of vaso-occlusive crises, more transfusions in the antepartum and postpartum, and higher percentage of preterm deliveries than Group II. Infections and painful crises during the postpartum period were similar in both the groups. The mortality rate was 4.8%: three deaths in Group I and two in Group II. One-third of the women in both the groups experienced near miss. The most frequent event was pneumonia/acute chest syndrome. Alpha-thalassemia co-inheritance and ß-gene haplotypes were not associated with near miss or maternal death. In multivariate analysis predictors of near miss or death were parity above one and baseline red blood cell macrocytosis. In Group I, baseline hypoxemia (saturation < 94% was also predictive of near miss or death. CONCLUSION: One-third of pregnant women had near miss and 4.8% died. Both hemoglobin SS and SC pregnant women shared the same risk of death or of severe complications, especially pulmonary events.

  10. CLINICAL AND SOCIO - ECONOMIC PROFILE OF BLACK WOMEN PRONE MATERNAL DEATH: ASSISTANCE TO WOMEN IN A UNIT OF PUBLIC DF

    Directory of Open Access Journals (Sweden)

    Judith Aparecida Trevisan

    2013-05-01

    Full Text Available Sample survey conducted in the Public Health Unit of the Federal District, with only blackwomen pregnant. Aims to verify the compliance of specific group and degree of receptivityand awareness on health pregnancy. The study area lies in women's health and training ofhealth professionals in nursing.The analyzed result goes against the interests of publicmanagement in health through compliance with international agreements established in theMillennium Development Goals to reduce maternal and infant death and the eradication ofracism-4th 5th and 9th MDG / UN. He attempts to verify the paucity of nursing actions inthe face of known pre-existing impairment of hypertension, abortions, sickle cell anemia, pre-eclampsia in women of black ethnic group, living in communities of less infrastructure andless education. Registers the range, in the Federal District, the public health policies aimed atfulfilling agreements for equality and reducing child mortality and achieving the targets for2015 of reducing the maternal and infant mortality, according tothe United Nations, which isthe 5th goal millennium.Keywords: Women's Health, the black population, the UnitedNations

  11. Decreases in perceived maternal criticism predict improvement in subthreshold psychotic symptoms in a randomized trial of family-focused therapy for individuals at clinical high risk for psychosis.

    Science.gov (United States)

    O'Brien, Mary P; Miklowitz, David J; Cannon, Tyrone D

    2015-12-01

    Perceived criticism (PC) is a measure of how much criticism from 1 family member "gets through" to another. PC ratings have been found to predict the course of psychotic disorders, but questions remain regarding whether psychosocial treatment can effectively decrease PC, and whether reductions in PC predict symptom improvement. In a sample of individuals at high risk for psychosis, we examined a) whether Family Focused Therapy for Clinical High-Risk (FFT-CHR), an 18-session intervention that consists of psychoeducation and training in communication and problem solving, brought about greater reductions in perceived maternal criticism, compared to a 3-session family psychoeducational intervention; and b) whether reductions in PC from baseline to 6-month reassessment predicted decreases in subthreshold positive symptoms of psychosis at 12-month follow-up. This study was conducted within a randomized controlled trial across 8 sites. The perceived criticism scale was completed by 90 families prior to treatment and by 41 families at 6-month reassessment. Evaluators, blind to treatment condition, rated subthreshold symptoms of psychosis at baseline, 6- and 12-month assessments. Perceived maternal criticism decreased from pre- to posttreatment for both treatment groups, and this change in criticism predicted decreases in subthreshold positive symptoms at 12-month follow-up. This study offers evidence that participation in structured family treatment is associated with improvement in perceptions of the family environment. Further, a brief measure of perceived criticism may be useful in predicting the future course of attenuated symptoms of psychosis for CHR youth.

  12. Survival and evolution of a large multidrug resistance plasmid in new clinical bacterial hosts

    DEFF Research Database (Denmark)

    Porse, Andreas; Schønning, Kristian; Munck, Christian;

    2016-01-01

    Large conjugative plasmids are important drivers of bacterial evolution and contribute significantly to the dissemination of antibiotic resistance. Although plasmid borne multidrug resistance is recognized as one of the main challenges in modern medicine, the adaptive forces shaping the evolution...... sequencing to show that the long-term persistence and molecular integrity of the plasmid is highly influenced by multiple factors within a 25 kb plasmid region constituting a host-dependent burden. In the E. coli hosts investigated here, improved plasmid stability readily evolves via IS26 mediated deletions...... consistently followed by all evolved E. coli lineages exposes a trade-off between horizontal and vertical transmission that may ultimately limit the dissemination potential of clinical multidrug resistance plasmids in these hosts....

  13. [Clinical aspects of the evolution of dental caries and periodontal disease in patients treated with corticosteroids].

    Science.gov (United States)

    Lăcătuşu, St; Ghiorghe, Angela

    2004-01-01

    Patients treated with adrenal glucocorticoids may run a higher risk of dental caries, both as a result of their medical condition and of the physical and physiological effects of their pharmacotherapy. Our clinical study reports about patients treated with glucocorticoids who were also having an odonto-periodontal condition. They were examined and we found rampant caries and periodontal diseases. The slow evolution of asymptomatic periodontal disease encouraged destruction of teeth in root caries. The rampant caries were correlated with immunodeficiency and treatment of these caries must take into account the general treatment.

  14. Evolution of clinical research: A history before and beyond james lind

    Directory of Open Access Journals (Sweden)

    Arun Bhatt

    2010-01-01

    Full Text Available The evolution of clinical research traverses a long and fascinating journey. From the first recorded trial of legumes in biblical times to the first randomized controlled of trial of streptomycin in 1946, the history of clinical trial covers a wide variety of challenges - scientific, ethical and regulatory. The famous 1747 scurvy trial conducted by James Lind contained most elements of a controlled trial. The UK Medical Research Council′s (MRC trial of patulin for common cold in 1943 was the first double blind controlled trial. This paved the way for the first randomized control trial of streptomycin in pulmonary tuberculosis carried out in 1946 by MRC of the UK. This landmark trial was a model of meticulousness in design and implementation, with systematic enrolment criteria and data collection compared with the ad hoc nature of other contemporary research. Over the years, as the discipline of controlled trials grew in sophistication and influence, the streptomycin trial continues to be referred to as ground breaking. The ethical advances in human protection include several milestones - Nuremberg Code, Declaration of Helsinki, Belmont Report, and 1996, International Conference on Harmonization Good Clinical Practice guidance. In parallel to ethical guidelines, clinical trials started to become embodied in regulation as government authorities began recognizing a need for controlling medical therapies in the early 20th century. As the scientific advances continue to occur, there will be new ethical and regulatory challenges requiring dynamic updates in ethical and legal framework of clinical trials.

  15. "So Either You Have a Foetal Monitor or You Have Your Waters Broken, Basically Is It?": Articulating Maternity Care Policy at a Midwives' Ante-Natal Clinic

    Science.gov (United States)

    O'Malley, Mary-Pat

    2010-01-01

    Maternity care in Ireland has been described as a "testament to the strength and influence of the medical profession" (Mc Kee 1986: 192). A review of maternity and gynaecology services in the Dublin area in 2004 revealed that "no participant...thought that the maternity services were women centred at the time" (Women's Health Council, 2007,…

  16. Clinical, epidemiological and evolution of severe nosocomial pneumonia in intensive care unit

    Directory of Open Access Journals (Sweden)

    Abel Arroyo- Sanchez

    2016-03-01

    Full Text Available Objective: To describe the clinical and epidemiological characteristics, evolution and to identify mortality factors associated in patients with SNP. Material and Methods: Descriptive study of a serie of cases of the Intensive Care Unit (ICU of a General Hospital. Medical records of patients which received medical attention and who meet the selection criteria were reviewed Results: Forty-one clinical records were evaluated. The average age was 69 old, predominantly male (68,3%. SNP was the reason of admission in 60.9% and 95.1% required mechanical ventilation. Hospital stay prior to diagnosis was 10 days, 65% of patients had some risk factor for multi resistence organisms, CPIS of entry was 9.3, cultures were positive in 39% of the cases and of these, 48.8% received proper antibiotic according to culture results. The days of stay in ICU were 20.6 days and 20 of the 41 medical records were for death patients. The clinical and epidemiological characteristics were similar between death and alive patients. An analysis of factors that could be associated with mortality SNP was made and it was found that for an age ≥ 70 years, the presence of any risk factor for multidrug resistence organism and control CPIS ≥ 6 were associated with higher mortality; while acquisition of the ICU was associated to lower mortality. Conclusions: The clinical, epidemiological characteristics and evolution of patients with SNP in our ICU were similar to those describe in the literature. Three factors associated with mortality in the ICU were identified.

  17. The impact of maternal plasma volume expansion and antihypertensive treatment with intravenous dihydralazine on fetal and maternal hemodynamics during pre-eclampsia: a clinical, echo-Doppler and viscometric study.

    NARCIS (Netherlands)

    Boito, S.M.; Struijk, P.C.; Pop, G.A.M.; Visser, W. de; Steegers, E.A.P.; Wladimiroff, J.W.

    2004-01-01

    OBJECTIVES: To establish the effects of plasma volume expansion (PVE) followed by intravenous dihydralazine (DH) administration on maternal whole blood viscosity (WBV) and hematocrit, uteroplacental and fetoplacental downstream impedance and umbilical venous (UV) volume flow in pre-eclampsia. METHOD

  18. 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.

  19. Evolution of clinical features in possible DLB depending on FP-CIT SPECT result

    Science.gov (United States)

    Moreno, Emilio; Thomas, Alan; Inglis, Fraser; Tabet, Naji; Stevens, Tim; Whitfield, Tim; Aarsland, Dag; Rainer, Michael; Padovani, Alessandro

    2016-01-01

    Objective: To test the hypothesis that core and suggestive features in possible dementia with Lewy bodies (DLB) would vary in their ability to predict an abnormal dopamine transporter scan and therefore a follow-up diagnosis of probable DLB. A further objective was to assess the evolution of core and suggestive features in patients with possible DLB over time depending on the 123I-FP-CIT SPECT scan result. Methods: A total of 187 patients with possible DLB (dementia plus one core or one suggestive feature) were randomized to have dopamine transporter imaging or to follow-up without scan. DLB features were compared at baseline and at 6-month follow-up according to imaging results and follow-up diagnosis. Results: For the whole cohort, the baseline frequency of parkinsonism was 30%, fluctuations 29%, visual hallucinations 24%, and REM sleep behavior disorder 17%. Clinician-rated presence of parkinsonism at baseline was significantly (p = 0.001) more frequent and Unified Parkinson’s Disease Rating Scale (UPDRS) score at baseline was significantly higher (p = 0.02) in patients with abnormal imaging. There was a significant increase in UPDRS score in the abnormal scan group over time (p < 0.01). There was relatively little evolution of the rest of the DLB features regardless of the imaging result. Conclusions: In patients with possible DLB, apart from UPDRS score, there was no difference in the evolution of DLB clinical features over 6 months between cases with normal and abnormal imaging. Only parkinsonism and dopamine transporter imaging helped to differentiate DLB from non-DLB dementia. PMID:27511183

  20. 'The one with the purse makes policy': Power, problem definition, framing and maternal health policies and programmes evolution in national level institutionalised policy making processes in Ghana.

    Science.gov (United States)

    Koduah, Augustina; Agyepong, Irene Akua; van Dijk, Han

    2016-10-01

    This paper seeks to advance our understanding of health policy agenda setting and formulation processes in a lower middle income country, Ghana, by exploring how and why maternal health policies and programmes appeared and evolved on the health sector programme of work agenda between 2002 and 2012. We theorized that the appearance of a policy or programme on the agenda and its fate within the programme of work is predominately influenced by how national level decision makers use their sources of power to define maternal health problems and frame their policy narratives. National level decision makers used their power sources as negotiation tools to frame maternal health issues and design maternal health policies and programmes within the framework of the national health sector programme of work. The power sources identified included legal and structural authority; access to authority by way of political influence; control over and access to resources (mainly financial); access to evidence in the form of health sector performance reviews and demographic health surveys; and knowledge of national plans such as Ghana Poverty Reduction Strategy. Understanding of power sources and their use as negotiation tools in policy development should not be ignored in the pursuit of transformative change and sustained improvement in health systems in low- and middle income countries (LMIC).

  1. 'The one with the purse makes policy': Power, problem definition, framing and maternal health policies and programmes evolution in national level institutionalised policy making processes in Ghana.

    Science.gov (United States)

    Koduah, Augustina; Agyepong, Irene Akua; van Dijk, Han

    2016-10-01

    This paper seeks to advance our understanding of health policy agenda setting and formulation processes in a lower middle income country, Ghana, by exploring how and why maternal health policies and programmes appeared and evolved on the health sector programme of work agenda between 2002 and 2012. We theorized that the appearance of a policy or programme on the agenda and its fate within the programme of work is predominately influenced by how national level decision makers use their sources of power to define maternal health problems and frame their policy narratives. National level decision makers used their power sources as negotiation tools to frame maternal health issues and design maternal health policies and programmes within the framework of the national health sector programme of work. The power sources identified included legal and structural authority; access to authority by way of political influence; control over and access to resources (mainly financial); access to evidence in the form of health sector performance reviews and demographic health surveys; and knowledge of national plans such as Ghana Poverty Reduction Strategy. Understanding of power sources and their use as negotiation tools in policy development should not be ignored in the pursuit of transformative change and sustained improvement in health systems in low- and middle income countries (LMIC). PMID:27614028

  2. The Evolution of the AASM Clinical Practice Guidelines: Another Step Forward

    Science.gov (United States)

    Morgenthaler, Timothy I.; Deriy, Ludmila; Heald, Jonathan L.; Thomas, Sherene M.

    2016-01-01

    One of the goals of the American Academy of Sleep Medicine (AASM) is to provide clear, evidence-based recommendations in our clinical practice guidelines. Periodically, the AASM will assess and update the process by which these guidelines are developed so that it is in line with the standards currently being used for guideline development. The AASM is now taking the next step forward by fully adopting GRADE (Grading of Recommendation Assessment, Development and Evaluation) as the methodology used for evaluating evidence and forming clinical practice guidelines recommendations. Starting this year, AASM recommendations will be based on the following four interdependent domains: 1. quality of evidence; 2. balance of desirable and undesirable consequences; 3. patients' values and preferences; and 4. resource use (when known). AASM strengths of recommendations will be dichotomized into two categories: “Strong” and “Weak,” either for or against a patient-care strategy. In an effort to provide clarity and transparency, all AASM recommendations will be actionable statements that include the specific patient population for which the patient-care strategy is recommended, and clearly define the comparator against which the patient-care strategy was evaluated. In some recommendations, the comparator will be an alternative patient-care strategy (e.g., a “gold standard” or previously available alternative), while in other recommendations the comparator will be a placebo or no treatment; this is determined by the availability of evidence, and analyses decisions made by the AASM task force. Implementation of the complete GRADE criteria by the AASM allows us the best path forward towards continuing to provide high quality clinical practice guidelines. Citation: Morgenthaler TI, Deriy L, Heald JL, Thomas SM. The evolution of the AASM clinical practice guidelines: another step forward. J Clin Sleep Med 2016;12(1):129–135. PMID:26518707

  3. CLINICAL AND STATISTICAL STUDY OF PREGNANCY EVOLUTION ON MALFORMED UTERUS.PROGNOSTIC AND BIRTH MODALITIES

    Directory of Open Access Journals (Sweden)

    Maria Chifan

    2011-05-01

    Full Text Available Our study aims to communicate the author’s experience concerning the pregnancy evolution at 316 women with various uterus malformations. At the beginning of this study, none of them was pregnant. The proportions of the various types of malformations encountered at the 316 cases were: septate uterus – 83%, arcuate uterus – 3%, bicornuate uterus – 3%, pseudounicorn – 3%, pseudodidelphys – 2%, “H” shaped – 1%, Rokitansky-Kuster-Hauser – 4%, uterine hypoplasia – 1%. The diagnosis was established clinically and para-clinically (non-pregnant women. The paraclinical methods that were used were: ecography at all the patients, hysterosalpyngography at 80% of the cases, hysteroscopy at 60% of the cases, RMN at 10% of the cases, celioscopy at 10% of the cases, the exam of the sexual chromatin and caryotype at 5% of the cases, hormonal dosage at 5% of the cases. The conventional as well as endoscopical surgery was performed with a successful rate of 67 – 82% pf the cases. The author concludes that uterine malformations precociously found benefit the best of surgical treatment, the difficult cases having the most reserved prognostic. The cause of reduced fertility in patients with endometriosis but patent fallopian tubes is not clear. In the mild stages of the disease a full course of hormonal suppression therapy should be the first therapeutic modality. In the advanced stages, a microsurgical approach, together with hormonal suppressive drugs, should be offered to the patients.

  4. Evolution of neurodegeneration-imaging biomarkers from clinically normal to dementia in the Alzheimer disease spectrum.

    Science.gov (United States)

    Knopman, David S; Jack, Clifford R; Lundt, Emily S; Weigand, Stephen D; Vemuri, Prashanthi; Lowe, Val J; Kantarci, Kejal; Gunter, Jeffrey L; Senjem, Matthew L; Mielke, Michelle M; Machulda, Mary M; Roberts, Rosebud O; Boeve, Bradley F; Jones, David T; Petersen, Ronald C

    2016-10-01

    The availability of antemortem biomarkers for Alzheimer's disease (AD) enables monitoring the evolution of neurodegenerative processes in real time. Pittsburgh compound B (PIB) positron emission tomography (PET) was used to select participants in the Mayo Clinic Study of Aging and the Mayo Alzheimer's Disease Research Center with elevated β-amyloid, designated as "A+," and hippocampal volume and (18)fluorodeoxyglucose (FDG) positron emission tomography were used to characterize participants as having evidence of neurodegeneration ("N+") at the baseline evaluation. There were 145 clinically normal (CN) A+ individuals, 62 persons with mild cognitive impairment (MCI) who were A+ and 20 with A+ AD dementia. Over a period of 1-6 years, MCI A+N+ individuals showed declines in medial temporal, lateral temporal, lateral parietal, and to a lesser extent, medial parietal regions for both FDG standardized uptake value ratio and gray matter volume that exceeded declines seen in the CN A+N+ group. The AD dementia group showed declines in the same regions on FDG standardized uptake value ratio and gray matter volume with rates that exceeded that in MCI A+N+. Expansion of regional involvement and faster rate of neurodegeneration characterizes progression in the AD pathway. PMID:27460147

  5. IMPACT Observatory: tracking the evolution of clinical trial data sharing and research integrity

    Science.gov (United States)

    Krleža-Jerić, Karmela; Gabelica, Mirko; Banzi, Rita; Martinić, Marina Krnić; Pulido, Bibiana; Mahmić-Kaknjo, Mersiha; Reveiz, Ludovic; Šimić, Josip; Utrobičić, Ana; Hrgović, Irena

    2016-01-01

    Introduction The opening of research data is emerging thanks to the increasing possibilities of digital technology. The opening of clinical trial (CT) data is a part of this process, expected to have positive scientific, ethical, health, and economic impacts thus contributing to research integrity. The January 2016 proposal by the International Council of Medical Journal Editors triggered ample discussion about CT data sharing and reconfirmed the need for an ongoing assessment of its dynamics. The IMProving Access to Clinical Trials data (IMPACT) Observatory aims to play such a role, and assess the data sharing culture, policies, and practices of key players, the impact of their interventions on CTs, and contribute to a transformation of research. The objective of this paper is to present the IMPACT Observatory as well as share some of its preliminary findings. Materials and methods Methods include a scoping study of research, surveys, interviews, and an environmental scan of research data repositories. Results Our preliminary findings indicate that although opening of CT data has not yet been achieved, its evolution is encouraging. Initiatives by key players contribute to increasing of CT data sharing, and many barriers are shrinking or disappearing. Conclusions The major barrier is the lack of data sharing standards, from preparing data for public sharing to its curatorship, findability and access. However, experiences accumulated by sharing CT data according to “upon request” or “open” mechanisms could inform the development of such standards. The Vivli, CORBEL-ECRIN and Open Trials projects are currently working in this direction.

  6. Maternal care

    OpenAIRE

    2001-01-01

    In June 2000 a distinguished group of obstetricians, midwives, general practitioners, and medical statisticians came together to discuss maternal care. Chaired by Professor James Drife from Leeds, discussion ranged over many topics, including: the changing role of the obstetrician, general practitioners, and the increasing status and responsibility of midwives. Other subjects include the induction of labour, obstetric analgesia and anaesthesia, and debates about the place and kind of delivery...

  7. Maternal phenylketonuria

    Directory of Open Access Journals (Sweden)

    Kristina Štuikienė

    2013-04-01

    Full Text Available Phenylketonuria is a hereditary metabolic disorder inherited in an autosomal recessive pattern. Elevated phenylalanine levels in a pregnant woman with phenylketonuria result in phenylalanine embryopathy. Failure to follow special diets during gestation results in neonatal dysplasia. More favorable outcomes are observed when phenylalanine levels remain within normal ranges prior to conception, or at least when they reach normal levels by the 4th-10th weeks of gestation. We report the case of a newborn with maternal phenylketonuria.

  8. Positive predictive value of non-invasive prenatal screening for fetal chromosome disorders using cell-free DNA in maternal serum: independent clinical experience of a tertiary referral center

    OpenAIRE

    Neufeld-Kaiser, Whitney A.; Cheng, Edith Y.; Liu, Yajuan J

    2015-01-01

    Background Non-invasive prenatal screening (NIPS) for fetal chromosome abnormalities using cell-free deoxyribonucleic acid (cfDNA) in maternal serum has significantly influenced prenatal diagnosis of fetal aneuploidies since becoming clinically available in the fall of 2011. High sensitivity and specificity have been reported in multiple publications, nearly all of which have been sponsored by the commercial performing laboratories. Once results are returned, positive and negative predictive ...

  9. Effects of low birth weight, maternal smoking in pregnancy and social class on the phenotypic manifestation of Attention Deficit Hyperactivity Disorder and associated antisocial behaviour: investigation in a clinical sample

    Directory of Open Access Journals (Sweden)

    van den Bree Marianne BM

    2007-06-01

    Full Text Available Abstract Background Attention Deficit Hyperactivity Disorder (ADHD is a genetically influenced condition although indicators of environmental risk including maternal smoking during pregnancy, low birth weight and low social class have also been found to be associated with the disorder. ADHD is a phenotypically heterogeneous disorder in terms of the predominant symptom types (inattention, hyperactive-impulsivity, their severity and comorbidity, notably Conduct Disorder. It is possible that these different clinical manifestations of the disorder may arise because of the differing effects of the environmental indicators of environmental risk. We set out to test this hypothesis. Methods In a sample of 356 children diagnosed with ADHD, we sought to investigate possible effects of three indicators of environmental risk – maternal smoking during pregnancy, birth weight and social class – on comorbid Conduct Disorder, conduct disorder symptoms and inattentive and hyperactive-impulsive symptom severity. Results Multiple regression analysis revealed that, after controlling for significant covariates, greater hyperactive-impulsive symptom severity was significantly associated with maternal smoking during pregnancy (r2 = 0.02, Beta = 0.11, t = 1.96, p = 0.05 and social class (r2 = 0.02, Beta = 0.12, t = 2.19, p = 0.03 whilst none of the environmental risk indicators significantly predicted number of inattentive symptoms. Conduct Disorder symptoms were positively predicted by maternal smoking in pregnancy (r2 = 0.04, Beta = 0.18, t = 3.34, p = 0.001 whilst both maternal smoking during pregnancy and social class significantly predicted a diagnosis of Conduct Disorder (OR = 3.14, 95% CI: 1.54, 6.41, Wald = 9.95, p = 0.002 and (OR = 1.95 95% CI: 1.18, 3.23 Wald = 6.78, p = 0.009 respectively. Conclusion These findings suggest that indicators of environmental risk, in this instance maternal smoking in pregnancy and environmental adversity indexed by lower

  10. Effects of low birth weight, maternal smoking in pregnancy and social class on the phenotypic manifestation of Attention Deficit Hyperactivity Disorder and associated antisocial behaviour: investigation in a clinical sample

    Science.gov (United States)

    Langley, Kate; Holmans, Peter A; van den Bree, Marianne BM; Thapar, Anita

    2007-01-01

    Background Attention Deficit Hyperactivity Disorder (ADHD) is a genetically influenced condition although indicators of environmental risk including maternal smoking during pregnancy, low birth weight and low social class have also been found to be associated with the disorder. ADHD is a phenotypically heterogeneous disorder in terms of the predominant symptom types (inattention, hyperactive-impulsivity), their severity and comorbidity, notably Conduct Disorder. It is possible that these different clinical manifestations of the disorder may arise because of the differing effects of the environmental indicators of environmental risk. We set out to test this hypothesis. Methods In a sample of 356 children diagnosed with ADHD, we sought to investigate possible effects of three indicators of environmental risk – maternal smoking during pregnancy, birth weight and social class – on comorbid Conduct Disorder, conduct disorder symptoms and inattentive and hyperactive-impulsive symptom severity. Results Multiple regression analysis revealed that, after controlling for significant covariates, greater hyperactive-impulsive symptom severity was significantly associated with maternal smoking during pregnancy (r2 = 0.02, Beta = 0.11, t = 1.96, p = 0.05) and social class (r2 = 0.02, Beta = 0.12, t = 2.19, p = 0.03) whilst none of the environmental risk indicators significantly predicted number of inattentive symptoms. Conduct Disorder symptoms were positively predicted by maternal smoking in pregnancy (r2 = 0.04, Beta = 0.18, t = 3.34, p = 0.001) whilst both maternal smoking during pregnancy and social class significantly predicted a diagnosis of Conduct Disorder (OR = 3.14, 95% CI: 1.54, 6.41, Wald = 9.95, p = 0.002) and (OR = 1.95 95% CI: 1.18, 3.23 Wald = 6.78, p = 0.009) respectively. Conclusion These findings suggest that indicators of environmental risk, in this instance maternal smoking in pregnancy and environmental adversity indexed by lower social class

  11. Evolution of the clinical and epidemiological knowledge about Chagas disease 90 years after its discovery

    Directory of Open Access Journals (Sweden)

    Prata Aluízio

    1999-01-01

    Full Text Available Three different periods may be considered in the evolution of knowledge about the clinical and epidemiological aspects of Chagas disease since its discovery: (a early period concerning the studies carried out by Carlos Chagas in Lassance with the collaboration of other investigators of the Manguinhos School. At that time the disease was described and the parasite, transmitters and reservoirs were studied. The coexistence of endemic goiter in the same region generated some confusion about the clinical forms of the disease; (b second period involving uncertainty and the description of isolated cases, which lasted until the 1940 decade. Many acute cases were described during this period and the disease was recognized in many Latin American countries. Particularly important were the studies of the Argentine Mission of Regional Pathology Studies, which culminated with the description of the Romaña sign in the 1930 decade, facilitating the diagnosis of the early phase of the disease. However, the chronic phase, which was the most important, continued to be difficult to recognize; (c period of consolidation of knowledge and recognition of the importance of Chagas disease. Studies conducted by Laranja, Dias and Nóbrega in Bambuí updated the description of Chagas heart disease made by Carlos Chagas and Eurico Villela. From then on, the disease was more easily recognized, especially with the emphasis on the use of a serologic diagnosis; (d period of enlargement of knowledges on the disease. The studies on denervation conducted in Ribeirão Preto by Fritz Köberle starting in the 1950 decade led to a better understanding of the relations between Chagas disease and megaesophagus and other visceral megas detected in endemic areas.

  12. Finnish families' need for special support as evaluated by public health nurses working in maternity and child welfare clinics.

    Science.gov (United States)

    Häggman-Laitila, Arja; Euramaa, Katri-Ina

    2003-01-01

    The purpose of this study was to describe public health nurses' views of the everyday problems of families and their needs for special support. Seventy-four nurses filled in a tripartite questionnaire. The needs varied by region and were seen in 4% to 23% of all families expecting a baby or with a child younger than 3 age in the nurses' clientele. Approximately one-third of the families were considered to have a pressing need for support. More than half of families (54%) had difficulties coping with parenthood and family structure, almost one-third (30%) with raising their children and with childcare, and nearly one-third (27%) with their social network. In 20% of the families, the parents experienced problems relating to their relationship as a couple; 20% of the families had problems connected to the children's development, growth, and health; and in 19% of the families, the parents had health problems. Special needs were also caused by the parents' use of alcohol (15%) and by disputes over the children's custody and visiting rights (7%). The information provided by the study can be used in developing clinical services and the family work supporting them. PMID:12823793

  13. Clinical and epidemiological evolution of modern therapy and measles in children

    Directory of Open Access Journals (Sweden)

    V. N. Timchenko

    2015-01-01

    Full Text Available Clinical and epidemiological research on the evolution of measles in children in Leningrad – St. Petersburg from 1927–2014 with an analysis of the effectiveness of treatment of this infection. Divided into three periods of fighting «child plague». First period – to use in the practice of specific therapies and antibacterial drugs, characterized by high morbidity, severe weight, high rates of mortality. In the second period the use of donor serum syvotrotki convalescents and sulfa drugs significantly lowered the mortality rate due to the effective treatment of pneumococcal pneumonia. The use of penicillin and broad-spectrum antibiotics led to a further reduction in the severity of measles, a sharp decline in mortality – to tenths and hundredths of a percent. The third period is due to the mass of active immunization against measles, characterized by a significant decline in incidence rates up to her absence in some years. Combined therapy of children with measles in modern conditions with the inclusion etiotropic drugs (Viferon causes rapid regression of the symptoms of measles, warns layering respiratory viral infection contributes to the smooth course of the disease. 

  14. Pulmonary tuberculosis among women with cough attending clinics for family planning and maternal and child health in Dar Es Salaam, Tanzania

    Directory of Open Access Journals (Sweden)

    Wandwalo Eliud R

    2009-08-01

    Full Text Available Abstract Background Tuberculosis (TB case detection in women has remained low in developing world. This study was conducted to determine the proportion of smear positive TB among women with cough regardless of the duration attending family Planning (FP and Maternal and child health (MCH clinics in Dar es Salaam. Methods We conducted a cross sectional study in all three municipal hospitals of Dar es Salaam, between October 2007 and June 2008. All women with cough attending FP and MCH clinics were screened for TB by smear microscopy. Pearson chi-square was used to compare group difference for categorical variables. Risk factors for smear positive were estimated by logistics regression with 95% confidence intervals (CI given for odds ratios indicating statistically significant relationship if the CI did not include one. Results We enrolled a total of 749 TB suspects. Five hundred and twenty nine patients (70.6% were from MCH clinics. Mean (SD age was 27.6 (5.2 years. A total of 616 (82.2% patients were coughing for less than two weeks as compared to 133 (17.8%, who coughed for two or more weeks. Among 616 TB suspects, 14 (2.3% were smear positive TB patients, and of the 133 who had coughed for two or more weeks, 13 (9.8% were smear positive TB patients. Risk factors associated with smear positive results were having attended more than one visit to any facility prior to diagnosis (OR = 6.8; 95%CI 2.57–18.0 and having HIV/AIDS (OR = 4.4; 95%CI 1.65–11.96. Long duration of cough was not a risk factor for being smear positive (OR = 1.6; 95%CI 0.59–4.49. Conclusion The proportion of smear positive TB patients among women with cough attending MCH and FP was 3.8%. Visits to any health facility prior to Diagnosis and HIV infection were risk for having a smear positive TB.

  15. Putting the "M" back in the Maternal and Child Health Bureau: reducing maternal mortality and morbidity.

    Science.gov (United States)

    Lu, Michael C; Highsmith, Keisher; de la Cruz, David; Atrash, Hani K

    2015-07-01

    Maternal mortality and severe morbidity are on the rise in the United States. A significant proportion of these events are preventable. The Maternal Health Initiative (MHI), coordinated by the Maternal and Child Health Bureau at the Health Resources and Services Administration, is intensifying efforts to reduce maternal mortality and severe morbidity in the U.S. Through a public-private partnership, MHI is taking a comprehensive approach to improving maternal health focusing on five priority areas: improving women's health before, during and beyond pregnancy; improving the quality and safety of maternity care; improving systems of maternity care including both clinical and public health systems; improving public awareness and education; and improving surveillance and research.

  16. Survey of knowledge and perception on the access to evidence-based practice and clinical practice change among maternal and infant health practitioners in South East Asia

    Directory of Open Access Journals (Sweden)

    Crowther Caroline A

    2008-08-01

    Full Text Available Abstract Background Evidence-based practice (EBP can provide appropriate care for women and their babies; however implementation of EBP requires health professionals to have access to knowledge, the ability to interpret health care information and then strategies to apply care. The aim of this survey was to assess current knowledge of evidence-based practice, information seeking practices, perceptions and potential enablers and barriers to clinical practice change among maternal and infant health practitioners in South East Asia. Methods Questionnaires about IT access for health information and evidence-based practice were administered during August to December 2005 to health care professionals working at the nine hospitals participating in the South East Asia Optimising Reproductive and Child Health in Developing countries (SEA-ORCHID project in Indonesia, Malaysia, Thailand and The Philippines. Results The survey was completed by 660 staff from six health professional groups. Overall, easy IT access for health care information was available to 46% of participants. However, over a fifth reported no IT access was available and over half of nurses and midwives never used IT health information. Evidence-based practice had been heard of by 58% but the majority did not understand the concept. The most frequent sites accessed were Google and PubMed. The Cochrane Library had been heard of by 47% of whom 51% had access although the majority did not use it or used it less than monthly. Only 27% had heard of the WHO Reproductive Health Library and 35% had been involved in a clinical practice change and were able to identify enablers and barriers to change. Only a third of participants had been actively involved in practice change with wide variation between the countries. Willingness to participate in professional development workshops on evidence-based practice was high. Conclusion This survey has identified the need to improve IT access to health care

  17. Causality Assessment in Premarketing Drug Clinical Trials: Regulatory Evolution in the USA and Ongoing Concerns.

    Science.gov (United States)

    Goldman, Stephen A

    2016-10-01

    Since 1993, how to assess the causality of serious adverse events in premarketing drug clinical trials has undergone sustained regulatory evolution in the USA. In that year, an investigational drug study for chronic hepatitis B virus infection was emergently stopped after a patient suddenly exhibited hepatic failure and lactic acidosis, which later developed, along with pancreatitis and peripheral neuropathy, in several others after drug discontinuation. Five patients eventually died, including three despite emergency liver transplantation. The drug's multisystem toxicity was not predicted by preclinical animal studies, with grave injury to human mitochondria subsequently implicated. A concerned US Food and Drug Administration (FDA) created a task force whose findings would have a lasting impact on the agency's thinking. In 1994, the FDA proposed to amend its investigational new drug reporting requirements largely based on task force recommendations for ways to enhance the likelihood that sponsors and investigators would consider investigational agents as a possible cause of serious adverse events mimicking the underlying disease or concomitant drug toxicity. Then, in its 1997 final rule for expedited safety reporting requirements for drugs and biologics, the FDA advised sponsors that such reporting of serious, unexpected clinical trial cases would be expected when "there is a reasonable suspected causal relationship between the investigational product and the adverse event (i.e., the causal relationship cannot be ruled out)." This last clause was codified into the suspected adverse drug reaction definition in the FDA's 2003 safety reporting requirements for drugs and biologics proposed rule. The negatively received suspected adverse drug reaction and proposed causality standard were not adopted in the FDA's 2010 finalized investigational new drug safety reporting regulations, the agency stating that "'reasonable possibility' means there is evidence to suggest a

  18. [The root of the deep and fast ongoing evolution of both structure and methodology of clinical research].

    Science.gov (United States)

    Tavazzi, Luigi

    2016-03-01

    The growing scientific knowledge and technology development are leading to radical changes in biological and medical research. The prevalent lines of development deal with a pragmatic evolution of controlled clinical trials, a massive diffusion of observational research, which is progressively incorporated in clinical practice, new models and designs of clinical research, the systematic use of information technology to build up vast networks of medical centers producing huge amounts of shared data to be managed through the big data methodology, personalized as well as precision medicine, a reshaped physician-patient relationship based on a co-working principle. All this is leading to profound changes in public health governance, a renewal of clinical epidemiology and prevention, a modified structure of several specific sectors of medical care, hopefully guided by scientific evidences. A few aspects of such an evolving picture are discussed in this article.

  19. Clinical diagnosis and treatment of postpartum hemorrhage in maternal near-miss%产后大出血危重产妇的临床诊治

    Institute of Scientific and Technical Information of China (English)

    周文婷; 周哲颖; 黄俊峰; 段涛

    2016-01-01

    目的:探讨产后出血超过2000 m L危重产妇的高危因素、治疗措施和预后。方法:回顾2012年1月至2015年1月,同济大学附属上海市第一妇婴保健院产后出血超过2000 m L的危重产妇50例的临床资料特点,分析出血原因、出血量及不同止血方式的临床效果。结果:本组危重产妇中,高龄产妇(36%),试管婴儿(16%),双胎(18%),肿瘤(10%),均高于普通人群。产后出血原因依次为:胎盘因素(58%)、子宫收缩乏力(30%)、凝血功能障碍(8.0%)和软产道损伤(4.0%)。其中,单用缝合压迫止血3例(6.0%),平均出血(3363.3±1448.5)mL ;单用Bakri球囊填塞止血6例(12%),平均出血(3212.7±1422.4)m L。联合子宫动脉结扎+缝合压迫止血23例(46%),平均出血(2995.2±1049.7)m L ;联合子宫动脉结扎+缝合压迫+Bakri球囊填塞止血11例(22%),平均出血(3270.8±1182.5)mL。全子宫切除止血7例(14%),平均出血(4137.1±2409.0)m L。除了单用缝合组外,全子宫切除组与其他各组产后平均出血量比较,差异有统计学意义( P<0.05);其余各组间产后平均出血量比较,差异无统计学意义。单一止血方式与全子宫切除出血量分布比较,差异有统计学意义(P< 0.05)。结论:产后出血量超过2000 m L的危重产妇,产前高危因素比例高;根据产后出血的不同原因,合理地采用单一或联合止血措施,均确实有效;胎盘原因仍是产后大出血的主要因素,应积极实施联合止血方案,降低全子宫切除率。%Objective:To evaluate the risk factors ,treatment measures and prognosis of maternal near-miss with postpartum hemorrhage (PPH) more than 2 ,000 ml .Methods:The clinical data of 50 cases of critically ill pregnant women with postpartum hemorrhage more than 2

  20. The Recent Evolution of a Maternally-Inherited Endosymbiont of Ticks Led to the Emergence of the Q Fever Pathogen, Coxiella burnetii.

    Directory of Open Access Journals (Sweden)

    Olivier Duron

    2015-05-01

    Full Text Available Q fever is a highly infectious disease with a worldwide distribution. Its causative agent, the intracellular bacterium Coxiella burnetii, infects a variety of vertebrate species, including humans. Its evolutionary origin remains almost entirely unknown and uncertainty persists regarding the identity and lifestyle of its ancestors. A few tick species were recently found to harbor maternally-inherited Coxiella-like organisms engaged in symbiotic interactions, but their relationships to the Q fever pathogen remain unclear. Here, we extensively sampled ticks, identifying new and atypical Coxiella strains from 40 of 58 examined species, and used this data to infer the evolutionary processes leading to the emergence of C. burnetii. Phylogenetic analyses of multi-locus typing and whole-genome sequencing data revealed that Coxiella-like organisms represent an ancient and monophyletic group allied to ticks. Remarkably, all known C. burnetii strains originate within this group and are the descendants of a Coxiella-like progenitor hosted by ticks. Using both colony-reared and field-collected gravid females, we further establish the presence of highly efficient maternal transmission of these Coxiella-like organisms in four examined tick species, a pattern coherent with an endosymbiotic lifestyle. Our laboratory culture assays also showed that these Coxiella-like organisms were not amenable to culture in the vertebrate cell environment, suggesting different metabolic requirements compared to C. burnetii. Altogether, this corpus of data demonstrates that C. burnetii recently evolved from an inherited symbiont of ticks which succeeded in infecting vertebrate cells, likely by the acquisition of novel virulence factors.

  1. Maternal and perinatal mortality.

    Science.gov (United States)

    Krishna Menon, M K

    1972-01-01

    A brief analysis of data from the records of the Government Hospital for Women and Children in Madras for a 36-year period (1929-1964) is presented. India with a population of over 550 million has only 1 doctor for each 6000 population. For the 80% of the population which is rural, the doctor ratio is only 88/1 million. There is also a shortage of paramedical personnel. During the earlier years of this study period, abortions, puerperal infections; hemorrhage, and toxemia accounted for nearly 75% of all meternal deaths, while in later years deaths from these causes were 40%. Among associated factors in maternal mortality, anemia was the most frequent, it still accounts for 20% and is a contributory factor in another 20%. The mortality from postpartum hemorrhage was 9.3% but has now decreased to 2.8%. Eclampsia is a preventable disease and a marked reduction in maternal and perinatal mortality from this cause has been achieved. Maternal deaths from puerperal infections have dropped from 25% of all maternal deaths to 7%. Uterine rupture has been reduced from 75% to 9.3% due to modern facilities. Operative deliveries still have an incidence of 2.1% and a mortality rate of 1.4% of all deliveries. These rates would be further reduced by more efficient antenatal and intranatal care. Reported perinatal mortality of infants has been reduced from 182/1000 births to an average of 78/1000 in all areas, but is 60.6/1000 in the city of Madras. Socioeconomic standards play an important role in perinatal mortality, 70% of such deaths occurring in the lowest economic groups. Improvement has been noted in the past 25 years but in rural areas little progress has been made. Prematurity and low birth weights are still larger factors in India than in other countries, with acute infectious diseases, anemia, and general malnutrition among mothers the frequent causes. Problems requiring further efforts to reduce maternal and infant mortality are correct vital statistics, improved

  2. 瘢痕子宫合并前置胎盘临床分析%Clinical analysis of scar uterus combined with placenta previa on maternal pregnancy outcome

    Institute of Scientific and Technical Information of China (English)

    程春花; 李根霞; 崔世红; 许雅娟

    2013-01-01

    目的 探讨瘢痕子宫合并前置胎盘对母婴妊娠结局的影响.方法 回顾性分析郑州大学第三附属医院2011年11月至2012年11月住院分娩148例前置胎盘患者的临床资料,其中瘢痕子宫合并前置胎盘者74例为观察组,单纯前置胎盘组74例为对照组.比较两组间产后出血量、子宫切除率、胎盘植入及早产等发生率.结果 瘢痕子宫合并前置胎盘组与对照组相比,产后出血发生率高、产后出血量多(P<0.01).瘢痕子宫合并前置胎盘组子宫切除率、胎盘植入率明显升高(P<0.01),新生儿的早产率也明显升高(P<0.05).结论 瘢痕子宫合并前置胎盘对母儿影响大,术前应提高警惕,做好充分术前准备,必要时及时切除子宫.%Objective To explore the influence of scar uterus combined with placenta previa on maternal pregnancy outcom.Methods Retrospective analysis of our hospital from 2011 November to 2012 November hospitalized childbirth the clinical data of 148 patients with placenta previa,the merger of scar uterus placenta previa 74 cases as the observation group,pure placenta previa group 74 cases as control group.Comparison of postpartum blood loss between the two groups,uterus resection rate,and the incidence of preterm birth placenta increta.Results Merger of scar uterus placenta previa group compared with control group,the high incidence of postpartum hemorrhage,postpartum blood loss (P < 0.01).Scar uterus uterus resection rate,rate of placenta implantation combined placenta previa group increased significantly (P < 0.01),neonatal preterm birth rates also increased significantly (P < 0.05).Conclusion Scar uterus combined with placenta previa big influence on mothers and infants preoperative should be vigilant,makes adequate preoperative preparation,timely removal of the uterus when necessary.

  3. 产科门诊母乳喂养健康课堂对促进纯母乳喂养效果观察%Breastfeeding Maternity Clinic Health Class to Promote Exclusive Breastfeeding Effect Observation

    Institute of Scientific and Technical Information of China (English)

    陈娟; 范二林

    2015-01-01

    Objective Investigate the maternity clinic breastfeeding health class to promote the ef ect of exclusive breastfeeding.Methods Direct questions, investigation in May 2014~June of exclusive breastfeeding mothers in our production.Results In obstetrics outpatient health education training through breastfeeding, ten days at the hospital, postpartum maternal postpartum 42 days exclusive breastfeeding rate was significantly higher than that of without training of maternal, both comparisons are significant ( <0.05).Conclusion Outpatient service of breastfeeding education classroom has positive significance to promote exclusive breastfeeding.%目的调查产科门诊母乳喂养健康课堂对促进纯母乳喂养的效果。方法直接询问方式,调查2014年5月~6月在我院生产的产妇纯母乳喂养情况。结果在产科门诊经历过母乳喂养健康教育培训的产妇在出院时、产后10d、产后42d时纯母乳喂养率显著高于未经过培训的产妇,两者对比有显著意义(<0.05)。结论门诊开展的母乳喂养教育课堂对促进纯母乳喂养有积极的意义。

  4. EVOLUTION OF PATIENTS WITH AIDS AFTER cART: CLINICAL AND LABORATORY EVOLUTION OF PATIENTS WITH AIDS AFTER 48 WEEKS OF ANTIRETROVIRAL TREATMENT

    Directory of Open Access Journals (Sweden)

    Ana Esther Carvalho Gomes Fukumoto

    2013-07-01

    Full Text Available SUMMARY Combination Antiretroviral Therapy (cART aims to inhibit viral replication, delay immunodeficiency progression and improve survival in AIDS patients. The objective of this study was to compare two different schemes of cART, based on plasma viral load (VL and CD4+ T lymphocyte count, during 48 weeks of treatment. For this purpose, 472 medical charts of a Specialized Outpatient Service were reviewed from 1998 to 2005. Out of these, 58 AIDS patients who had received a triple drug scheme as the initial treatment were included in the study and two groups were formed: Group 1 (G1: 47 individuals treated with two nucleoside reverse-transcriptase inhibitors (NRTI and one non-nucleoside reverse-transcriptase inhibitor; Group 2 (G2: 11 patients treated with two NRTI and one protease inhibitor. In G1 and G2, 53.2% and 81.8% respectively were patients with an AIDS-defining disease. The T CD4+ lymphocyte count increased progressively up until the 24th week of treatment in all patients, while VL became undetectable in 68.1% of G1 and in 63.6% of G2. The study concluded that the evolutions of laboratory tests were similar in the two treatment groups and that both presented a favorable clinical evolution.

  5. THE MATERNAL-FETAL MEDICINE: AN UPDATE

    Directory of Open Access Journals (Sweden)

    Vincenzo Berghella

    2013-12-01

    Full Text Available The development of Maternal-Fetal Medicine is contributing to an improvement of maternal well-being and of neonatal health, introducing a number of new and useful technologies. Advances in genomics in the field of prenatal screening and diagnosis allowed the discovery of fragments of cell-free fetal DNA in the maternal circulation and the use of chromosomal microarrays, which can test for microdeletions and microduplications in addition to aneuploidies. Color Doppler applications during pregnancy are expanding exponentially and Doppler flow velocity waveforms indices have provided important information from maternal, placental and fetal circulation with clinical implications. Ultrasound monitoring of fetal growth represents a fundamental tool to evaluate fetal wellbeing and several methods have been developed to improve fetal weight estimation accuracy. The combination of new biophysical and biochemical markers is enriching Maternal-Fetal Medicine and more research will allow to improve pregnancy outcome.

  6. Emerging role of bioinformatics tools and software in evolution of clinical research.

    Science.gov (United States)

    Gill, Supreet Kaur; Christopher, Ajay Francis; Gupta, Vikas; Bansal, Parveen

    2016-01-01

    Clinical research is making toiling efforts for promotion and wellbeing of the health status of the people. There is a rapid increase in number and severity of diseases like cancer, hepatitis, HIV etc, resulting in high morbidity and mortality. Clinical research involves drug discovery and development whereas clinical trials are performed to establish safety and efficacy of drugs. Drug discovery is a long process starting with the target identification, validation and lead optimization. This is followed by the preclinical trials, intensive clinical trials and eventually post marketing vigilance for drug safety. Softwares and the bioinformatics tools play a great role not only in the drug discovery but also in drug development. It involves the use of informatics in the development of new knowledge pertaining to health and disease, data management during clinical trials and to use clinical data for secondary research. In addition, new technology likes molecular docking, molecular dynamics simulation, proteomics and quantitative structure activity relationship in clinical research results in faster and easier drug discovery process. During the preclinical trials, the software is used for randomization to remove bias and to plan study design. In clinical trials software like electronic data capture, Remote data capture and electronic case report form (eCRF) is used to store the data. eClinical, Oracle clinical are software used for clinical data management and for statistical analysis of the data. After the drug is marketed the safety of a drug could be monitored by drug safety software like Oracle Argus or ARISg. Therefore, softwares are used from the very early stages of drug designing, to drug development, clinical trials and during pharmacovigilance. This review describes different aspects related to application of computers and bioinformatics in drug designing, discovery and development, formulation designing and clinical research. PMID:27453827

  7. Emerging role of bioinformatics tools and software in evolution of clinical research

    Science.gov (United States)

    Gill, Supreet Kaur; Christopher, Ajay Francis; Gupta, Vikas; Bansal, Parveen

    2016-01-01

    Clinical research is making toiling efforts for promotion and wellbeing of the health status of the people. There is a rapid increase in number and severity of diseases like cancer, hepatitis, HIV etc, resulting in high morbidity and mortality. Clinical research involves drug discovery and development whereas clinical trials are performed to establish safety and efficacy of drugs. Drug discovery is a long process starting with the target identification, validation and lead optimization. This is followed by the preclinical trials, intensive clinical trials and eventually post marketing vigilance for drug safety. Softwares and the bioinformatics tools play a great role not only in the drug discovery but also in drug development. It involves the use of informatics in the development of new knowledge pertaining to health and disease, data management during clinical trials and to use clinical data for secondary research. In addition, new technology likes molecular docking, molecular dynamics simulation, proteomics and quantitative structure activity relationship in clinical research results in faster and easier drug discovery process. During the preclinical trials, the software is used for randomization to remove bias and to plan study design. In clinical trials software like electronic data capture, Remote data capture and electronic case report form (eCRF) is used to store the data. eClinical, Oracle clinical are software used for clinical data management and for statistical analysis of the data. After the drug is marketed the safety of a drug could be monitored by drug safety software like Oracle Argus or ARISg. Therefore, softwares are used from the very early stages of drug designing, to drug development, clinical trials and during pharmacovigilance. This review describes different aspects related to application of computers and bioinformatics in drug designing, discovery and development, formulation designing and clinical research.

  8. Emerging role of bioinformatics tools and software in evolution of clinical research

    Directory of Open Access Journals (Sweden)

    Supreet Kaur Gill

    2016-01-01

    Full Text Available Clinical research is making toiling efforts for promotion and wellbeing of the health status of the people. There is a rapid increase in number and severity of diseases like cancer, hepatitis, HIV etc, resulting in high morbidity and mortality. Clinical research involves drug discovery and development whereas clinical trials are performed to establish safety and efficacy of drugs. Drug discovery is a long process starting with the target identification, validation and lead optimization. This is followed by the preclinical trials, intensive clinical trials and eventually post marketing vigilance for drug safety. Softwares and the bioinformatics tools play a great role not only in the drug discovery but also in drug development. It involves the use of informatics in the development of new knowledge pertaining to health and disease, data management during clinical trials and to use clinical data for secondary research. In addition, new technology likes molecular docking, molecular dynamics simulation, proteomics and quantitative structure activity relationship in clinical research results in faster and easier drug discovery process. During the preclinical trials, the software is used for randomization to remove bias and to plan study design. In clinical trials software like electronic data capture, Remote data capture and electronic case report form (eCRF is used to store the data. eClinical, Oracle clinical are software used for clinical data management and for statistical analysis of the data. After the drug is marketed the safety of a drug could be monitored by drug safety software like Oracle Argus or ARISg. Therefore, softwares are used from the very early stages of drug designing, to drug development, clinical trials and during pharmacovigilance. This review describes different aspects related to application of computers and bioinformatics in drug designing, discovery and development, formulation designing and clinical research.

  9. Clinical and haemodynamic evolution of lesions treated by means of atherectomy with SilverHawk in the femoropopliteal sector

    Energy Technology Data Exchange (ETDEWEB)

    Ibanez, Maria Antonia, E-mail: marianim5@yahoo.es [Department of Angiology and Vascular Surgery, Valladolid University Hospital, Valladolid, C/Ramon y Cajal no 3, 47005 Valladolid (Spain); Cenizo, Noelia, E-mail: noecen@yahoo.es [Department of Angiology and Vascular Surgery, Valladolid University Hospital, Valladolid, C/Ramon y Cajal no 3, 47005 Valladolid (Spain); Rio, Lourdes, E-mail: mlriosol@yahoo.es [Department of Angiology and Vascular Surgery, Valladolid University Hospital, Valladolid, C/Ramon y Cajal no 3, 47005 Valladolid (Spain); Sanchez, Ana, E-mail: assantiago@yahoo.es [Department of Angiology and Vascular Surgery, Valladolid University Hospital, Valladolid, C/Ramon y Cajal no 3, 47005 Valladolid (Spain); San Norberto, Enrique, E-mail: esannorberto@hotmail.com [Department of Angiology and Vascular Surgery, Valladolid University Hospital, Valladolid, C/Ramon y Cajal no 3, 47005 Valladolid (Spain); Brizuela, Jose-Antonio, E-mail: brizsanz@yahoo.es [Department of Angiology and Vascular Surgery, Valladolid University Hospital, Valladolid, C/Ramon y Cajal no 3, 47005 Valladolid (Spain); Gutierrez, Vicente, E-mail: vgutierrezalonso@gmail.com [Department of Angiology and Vascular Surgery, Valladolid University Hospital, Valladolid, C/Ramon y Cajal no 3, 47005 Valladolid (Spain); Vaquero, Carlos, E-mail: cvaquero@med.uva.es [Department of Angiology and Vascular Surgery, Valladolid University Hospital, Valladolid, C/Ramon y Cajal no 3, 47005 Valladolid (Spain)

    2011-11-15

    The objective of the work is to study the clinical and haemodynamic evolution, over 1 year, in patients with femoropopliteal arterial pathology treated by means of atherectomy with the SilverHawk device. Materials and methods: Nineteen (19) patients were treated between December 2008 and May 2009, collecting data on sex, age, comorbidity and clinical degree, with prospective monitoring over 12 months of clinical symptoms, physical examination and ecodoppler, obtaining results on diameter and peak systolic velocity at different arterial levels. Results: Of the 19 patients, 14 were men and 5 women, with a mean age of 70 years, hypertensive (73%), diabetic (63%) and smokers (63%). Six (6) presented disabling claudication and 13 critical ischemia with advanced distal trophic lesions in 5. A good arteriographic result was obtained in 12 cases, a stent was placed on the superficial femoral artery in 5 due to suboptimal outcome. Contrast extravasation was observed in 2, with femoropopliteal bypass performed and one exclusion with endoprosthesis for repair. In the ecodoppler after 1, 3, 6 and 12 months, a progressive reduction in lumen diameter and peak intraarterial systolic velocity was observed, particularly on the distal superficial femoral artery. After one year, 7 patients (36.8%) were symptom-free, 5 (26.3%) presented mild or moderate intermittent claudication and 1 patient (5.3%) presented localised distal trophic lesion. Four (4) major amputations were performed, in 2 the knee was preserved, there were 3 thromboses due to the procedure, a secondary endovascular procedure was performed in one case and a femoropopliteal bypass in another, and there were 2 non procedure-related deaths. Discussion: atherectomy with SilverHawk achieves an improvement in clinical degree, with a good rate of extremity salvage in patients with critical ischemia. In the first year, the ecodoppler shows evolution of the arteriopathy, without this necessarily meaning a clinical worsening.

  10. Evolution, current structure, and role of a primary care clinical pharmacy service in an integrated managed care organization.

    Science.gov (United States)

    Heilmann, Rachel M F; Campbell, Stephanie M; Kroner, Beverly A; Proksel, Jenel R; Billups, Sarah J; Witt, Daniel M; Helling, Dennis K

    2013-01-01

    The impact of the declining number of primary care physicians is exacerbated by a growing elderly population in need of chronic disease management. Primary care clinical pharmacy specialists, with their unique knowledge and skill set, are well suited to address this gap. At Kaiser Permanente of Colorado (KPCO), primary care clinical pharmacy specialists have a long history of integration with medical practices and are located in close proximity to physicians, nurses, and other members of the health care team. Since 1992, Primary Care Clinical Pharmacy Services (PCCPS) has expanded from 4 to 30 full-time equivalents (FTEs) to provide services in all KPCO medical office buildings. With this growth in size, PCCPS has evolved to play a vital role in working with primary care medical teams to ensure that drug therapy is effective, safe, and affordable. In addition, PCCPS specialists provide ambulatory teaching sites for pharmacy students and pharmacy residents. There is approximately 1 specialist FTE for every 13,000 adult KPCO members and every 9 clinical FTEs of internal medicine and family medicine physicians. All clinical pharmacy specialists in the pharmacy department are required to have a PharmD degree, to complete postgraduate year 2 residencies, and, as a condition of employment, to become board certified in an applicable specialty. The evolution, current structure, and role of PCCPS at KPCO, including factors facilitating successful integration within the medical team, are highlighted. Patient and nonpatient care responsibilities are described.

  11. Phase I pilot clinical trial of antenatal maternally administered melatonin to decrease the level of oxidative stress in human pregnancies affected by pre-eclampsia (PAMPR): study protocol

    OpenAIRE

    Hobson, Sebastian R; Lim, Rebecca; Gardiner, Elizabeth E; Alers, Nicole O; Wallace, Euan M

    2013-01-01

    Introduction Pre-eclampsia is a common pregnancy condition affecting between 3% and 7% of women. Unfortunately, the exact pathophysiology of the disease is unknown and as such there are no effective treatments that exist notwithstanding prompt delivery of the fetus and culprit placenta. As many cases of pre-eclampsia occur in preterm pregnancies, it remains a significant cause of maternal and perinatal morbidity and mortality. Recently, in vitro and animal studies have highlighted the potenti...

  12. 妊娠早期甲状腺毒症的临床研究%The clinical research of maternal thyrotoxicosis in the first trimester

    Institute of Scientific and Technical Information of China (English)

    徐樱溪; 李玉姝; 李晨嫣; 刘通; 王颜蕾; 王玉; 刘珊珊; 邹红锦; 单忠艳

    2014-01-01

    目的 研究妊娠早期甲状腺毒症发病率及妊娠期一过性甲状腺毒症(GTT)与Graves病在甲状腺功能变化情况、妊娠早期临床表现等方面的区别.方法 研究对象来自于2011年至2013年参与《妊娠早期妇女碘铁营养缺乏、亚临床甲状腺激素缺乏:筛查与干预》项目的妊娠12周前妇女(8 105名),均在妊娠早期(1 ~12周)进行问卷调查、体格检查并检测血清促甲状腺激素(TSH)、游离甲状腺素(FT4)、甲状腺过氧化物酶抗体(TPOAb)、尿碘及甲状腺超声,甲状腺毒症患者加测血清游离三碘甲状腺原氨酸(FT3)、促甲状腺激素受体抗体(TRAb).对71例GTT患者、32例Graves病患者和与之年龄匹配的219名甲状腺功能正常妊娠妇女(对照组)分别在妊娠中期(13 ~27周)、妊娠晚期(≥28周)进行随访.结果 (1)8 105名妊娠妇女中甲状腺毒症患者共109名,甲状腺毒症发病率为1.34%,GTT和Graves病发病率分别为0.90%和0.44%.(2)Graves病患者出现严重甲状腺功能亢进体征的频率显著高于GTT患者(P<0.05).GTT和Graves病妊娠早期妇女的甲状腺体积、体重指数与对照组妊娠妇女存在显著差异(P<0.05).(3)妊娠各期Graves病患者的TSH、FT4、TRAb、TPOAb与GTT患者存在显著差异(P<0.05).妊娠早期Graves病患者FT3显著高于GTT患者(P<0.05).Graves病患者在妊娠早、中、晚期TSH、FT4与对照组相比存在显著差异(P<0.01).GTT患者妊娠早期、中期TSH、FT4与对照组妇女相比存在显著差异(P<0.01),而妊娠晚期FT4与对照组差异无统计学意义.结论 妊娠早期甲状腺毒症以GTT为主,GTT患者甲状腺功能及临床表现与Graves病患者存在显著差异.妊娠中、晚期,GTT患者甲状腺功能均恢复正常,而Graves病患者仍多存在FT4升高,TSH降低.%Objective To study the incidence of maternal thyrotoxicosis in the first trimester and compare thyroid function,clinical manifestations in the

  13. Maternal anxiety, maternal sensitivity, and attachment

    NARCIS (Netherlands)

    Stevenson-Hinde, J.; Chicot, R.; Schouldice, A.; Hinde, C.A.

    2013-01-01

    Previous research has related maternal anxiety to insecurity of attachment. Here we ask whether different aspects of maternal sensitivity mediate this link. From a community sample of intact families with 1-3 children, mothers with 4.5-year-olds were selected for low, medium, or high anxiety levels

  14. Maternal anxiety, maternal sensitivity, and attachment.

    Science.gov (United States)

    Stevenson-Hinde, Joan; Chicot, Rebecca; Shouldice, Anne; Hinde, Camilla A

    2013-01-01

    Previous research has related maternal anxiety to insecurity of attachment. Here we ask whether different aspects of maternal sensitivity mediate this link. From a community sample of intact families with 1-3 children, mothers with 4.5-year-olds were selected for low, medium, or high anxiety levels (N = 98). Following Mary Ainsworth's lead, our maternal sensitivity measures were primarily based on ratings of direct observations. Six sets of measures were obtained: positive maternal style at home (a mean of four different ratings); providing a sensitive framework, limit setting, allowing autonomy, criticizing/cutting in (each a mean over two laboratory joint tasks); and tension-making (a mean of three different ratings in a fear-inducing task). Regression analyses showed firstly that maternal anxiety rather than behavioral inhibition or sex of child was the significant predictor of each maternal sensitivity measure; and secondly that these measures rather than maternal anxiety or sex were the significant predictors of security of attachment. Finally, ANOVA's indicated which sets of maternal ratings were associated with each pattern of attachment (Avoidant, Secure, Ambivalent, or Controlling).

  15. Maternal anxiety, maternal sensitivity, and attachment

    NARCIS (Netherlands)

    Stevenson-Hinde, Joan; Chicot, Rebecca; Shouldice, Anne; Hinde, Camilla A.

    2016-01-01

    Previous research has related maternal anxiety to insecurity of attachment. Here we ask whether different aspects of maternal sensitivity mediate this link. From a community sample of intact families with 1-3 children, mothers with 4.5-year-olds were selected for low, medium, or high anxiety leve

  16. Maternal obesity and prenatal programming.

    Science.gov (United States)

    Elshenawy, Summer; Simmons, Rebecca

    2016-11-01

    Obesity is a significant and increasing public health concern in the United States and worldwide. Clinical and epidemiological evidence clearly shows that genetic and environmental factors contribute to the increased susceptibility of humans to obesity and its associated comorbidities; the interplay of these factors is explained by the concept of epigenetics. The impact of maternal obesity goes beyond the newborn period; fetal programming during the critical window of pregnancy, can have long term detrimental effects on the offspring as well as future generations. Emerging evidence is uncovering a link between the clinical and molecular findings in the offspring with epigenetic changes in the setting of maternal obesity. Research targeted towards reducing the transgenerational propagation and developmental programming of obesity is vital in reducing the increasing rates of disease.

  17. Propeller Perforator Flaps in Distal Lower Leg:Evolution and Clinical Applications

    OpenAIRE

    Georgescu, Alexandru V.

    2012-01-01

    Simple or complex defects in the lower leg, and especially in its distal third, continue to be a challenging task for reconstructive surgeons. A variety of flaps were used in the attempt to achieve excellence in form and function. After a long evolution of the reconstructive methods, including random pattern flaps, axial pattern flaps, musculocutaneous flaps and fasciocutaneous flaps, the reappraisal of the works of Manchot and Salmon by Taylor and Palmer opened the era of perforator flaps. T...

  18. The measurement of maternal adiposity.

    LENUS (Irish Health Repository)

    Fattah, C

    2012-02-01

    The issue of maternal obesity has become a major public health problem. Internationally, the diagnosis of obesity is based on body mass index (BMI) that is, weight in kg\\/height in m2. While epidemiological associations have been shown between different BMI categories and adverse clinical outcomes, there is also a growing realisation that BMI has significant limitations. In this review, we assess current methods to measure body fat and, in particular, their application in pregnant women.

  19. Identification and evolution of drug efflux pump in clinical Enterobacter aerogenes strains isolated in 1995 and 2003.

    Directory of Open Access Journals (Sweden)

    Jacqueline Chevalier

    Full Text Available BACKGROUND: The high mortality impact of infectious diseases will increase due to accelerated evolution of antibiotic resistance in important human pathogens. Development of antibiotic resistance is a evolutionary process inducing the erosion of the effectiveness of our arsenal of antibiotics. Resistance is not necessarily limited to a single class of antibacterial agents but may affect many unrelated compounds; this is termed 'multidrug resistance' (MDR. The major mechanism of MDR is the active expulsion of drugs by bacterial pumps; the treatment of gram negative bacterial infections is compromised due to resistance mechanisms including the expression of efflux pumps that actively expel various usual antibiotics (beta-lactams, quinolones, .... METHODOLOGY/PRINCIPAL FINDINGS: Enterobacter aerogenes has emerged among Enterobacteriaceae associated hospital infections during the last twenty years due to its faculty of adaptation to antibiotic stresses. Clinical isolates of E. aerogenes belonging to two strain collections isolated in 1995 and 2003 respectively, were screened to assess the involvement of efflux pumps in antibiotic resistance. Drug susceptibility assays were performed on all bacterial isolates and an efflux pump inhibitor (PAbetaN previously characterized allowed to decipher the role of efflux in the resistance. Accumulation of labelled chloramphenicol was monitored in the presence of an energy poison to determine the involvement of active efflux on the antibiotic intracellular concentrations. The presence of the PAbetaN-susceptible efflux system was also identified in resistant E. aerogenes strains. CONCLUSIONS/SIGNIFICANCE: For the first time a noticeable increase in clinical isolates containing an efflux mechanism susceptible to pump inhibitor is report within an 8 year period. After the emergence of extended spectrum beta-lactamases in E. aerogenes and the recent characterisation of porin mutations in clinical isolates, this study

  20. Propeller Perforator Flaps in Distal Lower Leg:Evolution and Clinical Applications

    Directory of Open Access Journals (Sweden)

    Alexandru V. Georgescu

    2012-03-01

    Full Text Available Simple or complex defects in the lower leg, and especially in its distal third, continue to bea challenging task for reconstructive surgeons. A variety of flaps were used in the attemptto achieve excellence in form and function. After a long evolution of the reconstructivemethods, including random pattern flaps, axial pattern flaps, musculocutaneous flaps andfasciocutaneous flaps, the reappraisal of the works of Manchot and Salmon by Taylor andPalmer opened the era of perforator flaps. This era began in 1989, when Koshima and Soeda,and separately Kroll and Rosenfield described the first applications of such flaps. Perforatorflaps, whether free or pedicled, gained a high popularity due to their main advantages:decreasing donor-site morbidity and improving aesthetic outcome. The use as local perforatorflaps in lower leg was possible due to a better understanding of the cutaneous circulation, legvascular anatomy, angiosome and perforasome concepts, as well as innovations in flaps design.This review will describe the evolution, anatomy, flap design, and technique of the main distallypedicled propeller perforator flaps used in the reconstruction of defects in the distal third ofthe lower leg and foot.

  1. Propeller Perforator Flaps in Distal Lower Leg: Evolution and Clinical Applications

    Science.gov (United States)

    2012-01-01

    Simple or complex defects in the lower leg, and especially in its distal third, continue to be a challenging task for reconstructive surgeons. A variety of flaps were used in the attempt to achieve excellence in form and function. After a long evolution of the reconstructive methods, including random pattern flaps, axial pattern flaps, musculocutaneous flaps and fasciocutaneous flaps, the reappraisal of the works of Manchot and Salmon by Taylor and Palmer opened the era of perforator flaps. This era began in 1989, when Koshima and Soeda, and separately Kroll and Rosenfield described the first applications of such flaps. Perforator flaps, whether free or pedicled, gained a high popularity due to their main advantages: decreasing donor-site morbidity and improving aesthetic outcome. The use as local perforator flaps in lower leg was possible due to a better understanding of the cutaneous circulation, leg vascular anatomy, angiosome and perforasome concepts, as well as innovations in flaps design. This review will describe the evolution, anatomy, flap design, and technique of the main distally pedicled propeller perforator flaps used in the reconstruction of defects in the distal third of the lower leg and foot. PMID:22783507

  2. Clinical Observation of Maternal Perineal Laceration Reduction Control of Fetal Head Delivery Speed Midwifery Law%控制胎头娩出速度助产法减少产妇会阴裂伤的临床观察

    Institute of Scientific and Technical Information of China (English)

    陈瑞

    2015-01-01

    目的:探讨应用控制胎头娩出速度助产法减少产妇会阴裂伤的临床效果。方法将2013年5月~2014年6月我院收治的68例阴道分娩产妇随机分为研究组和常规组,均为34例;常规组采取阴道保护法实施助产;研究组则采取控制胎头娩出速度法实施助产,对比两组的临床效果。结果研究组的产妇会阴裂伤发生率、裂伤程度均低于常规组,差异有统计意义(P<0.05);另外,研究组的平均住院时间、平均住院费用及满意度均优于常规组,差异显著,有统计意义(P<0.05)。结论为实现人性化分娩,可采取控制胎头娩出速度助产法,能有效降低产妇会阴裂伤发生率,减少住院时间和医疗费用,提高满意度,临床实践意义深远。%Objective To investigate the application of fetal head delivery speed control method to reduce the effect of midwifery clinical maternal perineal laceration. Methods 68 cases of vaginal delivery mothers in our hospital were randomly divided into study group and routine group, were 34 cases; conventional group take the implementation of the law on the protection of vagina midwifery;research group is to take control of fetal head delivery speed method implementation of midwifery, compared the clinical effects of two groups. Results The incidence of maternal perineal laceration, laceration degree were lower than the conventional group, the difference was signiifcant, with statistical signiifcance (P<0.05. Conclusion In order to realize the humanization of childbirth, can take control of fetal head delivery speed midwifery method, can effectively reduce the incidence of maternal perineal laceration, clinical practical signiifcance.

  3. Evolution of a women's clinic: an alternate system of medical care.

    Science.gov (United States)

    Gray, M J; Tyson, J

    1976-12-01

    Following the Vermont Supreme Court decision, in 1972, invalidating an old statute against abortion, the community watched for change in hospital and medical practice. When none occurred, representatives of health agencies were jointed by feminists and others dissatisfied with existing medical facilities to form the Vermont Women's Health Center. Tensions resulting from differing viewpoints were channeled into the common goal of providing optimal health care involving paramedical personnel as well as gynecologists and other physicians. In 1973, 1,255 abortions were performed. Complications were monitored by the clinic, by the state health department, and by the International Fertility Research Program and were found to compare favorably with rates in larger clinics. Abortion-related visits initially outnumbered others by 2:1 but rapidly fell, indicating acceptance of the clinic for a variety of gynecologic services. After three years, the clinic is solvent, stable, and utilized by a wide range of women, the result of cooperation between the establishment and its critics. PMID:998671

  4. Age impact in clinicopathologic presentation and the clinical evolution of prostate cancer in patients submitted to radical prostatectomy

    Directory of Open Access Journals (Sweden)

    Alberto A. Antunes

    2006-02-01

    Full Text Available OBJECTIVE: To assess the influence of age in pathological findings and clinical evolution of prostate cancer in patients treated with radical prostatectomy. MATERIALS AND METHODS: Five hundred and fifty-six patients operated on between 1991 and 2000 were selected. Patients were divided into age groups of between 10 and 49 years, 50 to 59 years, 60 to 69 years and 70 to 83 years. RESULTS: Patients having less than 60 years of age presented clinical stage (p = 0.001, PSA (p = 0.013 and biopsy Gleason score (p = 0.013 more favorable than older patients. Age groups did not show any relationship between either postoperative Gleason score or pathological stage or risk of non-confined organ disease and involvement of seminal vesicles. After a mean follow-up of 58.3 months, 149 (27% patients presented recurrence. Patients aged between 40 and 59 years presented a disease-free survival rate significantly higher when compared to patients aged between 60 and 83 years (p = 0.022. However, when controlled with clinical stage, PSA, Gleason score and percentage of positive fragments, there was no relationship between age and biochemical recurrence risk (p = 0.426. CONCLUSIONS: Even though younger patients presented more favorable preoperative characteristics, postoperative pathological findings and biochemical recurrence rates did not differ between studied age groups.

  5. Maternal Control Behavior and Locus of Control: Examining Mechanisms in the Relation between Maternal Anxiety Disorders and Anxiety Symptomatology in Children

    Science.gov (United States)

    Becker, Kimberly D.; Ginsburg, Golda S.; Domingues, Janine; Tein, Jenn-Yun

    2010-01-01

    This study tested components of a proposed model of child anxiety and examined the mediational roles of (1) maternal control behavior, (2) maternal external locus of control, and (3) child external locus of control in the association between maternal and child anxiety. Thirty-eight clinically anxious mothers and 37 nonanxious mothers participated…

  6. [Historical evolution of some clinical and epidemiological knowledge of coccidioidomycosis in the Americas].

    Science.gov (United States)

    Negroni, R

    2008-01-01

    Coccidioidomycosis is a systemic endemic mycosis caused by two dimorphic fungi of the Coccidioides genus: Coccidioides immitis and Coccidioides posadasii. This fungal infection is only endemic in the American Continent. The majority of the epidemiological, pathogenic, clinical, mycological and therapeutical findings were obtained in the U.S.A. Coccidioidomycosis was discovered in Argentina, at the end of the XIXth century by Alejandro Posadas. In the last two decades, a new endemic zone was found in the northeast of Brazil. Several countries of the region such as Mexico, Guatemala, Honduras, Venezuela and Argentina have performed epidemiological studies which allowed a better knowledge of the endemic areas and of the clinical characteristics of this mycosis.

  7. Evolution and Diversity of Listeria monocytogenes from Clinical and Food Samples in Shanghai, China.

    Science.gov (United States)

    Zhang, Jianmin; Cao, Guojie; Xu, Xuebin; Allard, Marc; Li, Peng; Brown, Eric; Yang, Xiaowei; Pan, Haijian; Meng, Jianghong

    2016-01-01

    Listeria monocytogenes is a significant foodborne pathogen causing severe systemic infections in humans with high mortality rates. The objectives of this work were to establish a phylogenetic framework of L. monocytogenes from China and to investigate sequence diversity among different serotypes. We selected 17 L. monocytogenes strains recovered from patients and foods in China representing serotypes 1/2a, 1/2b, and 1/2c. Draft genome sequences were determined using Illumina MiSeq technique and associated protocols. Open reading frames were assigned using prokaryotic genome annotation pipeline by NCBI. Twenty-four published genomes were included for comparative genomic and phylogenetic analysis. More than 154,000 single nucleotide polymorphisms (SNPs) were identified from multiple genome alignment and used to reconstruct maximum likelihood phylogenetic tree. The 41 genomes were differentiated into lineages I and II, which consisted of 4 and 11 subgroups, respectively. A clinical strain from China (SHL009) contained significant SNP differences compared to the rest genomes, whereas clinical strain SHL001 shared most recent common ancestor with strain SHL017 from food. Moreover, clinical strains SHL004 and SHL015 clustered together with two strains (08-5578 and 08-5923) recovered from an outbreak in Canada. Partial sequences of a plasmid found in the Canadian strain were also present in SHL004. We investigated the presence of various genes and gene clusters associated with virulence and subgroup-specific genes, including internalins, L. monocytogenes pathogenicity islands (LIPIs), L. monocytogenes genomic islands (LGIs), stress survival islet 1 (SSI-1), and clustered regularly interspaced short palindromic repeats (CRISPR)/cas system. A novel genomic island, denoted as LGI-2 was identified. Comparative sequence analysis revealed differences among the L. monocytogenes strains related to virulence, survival abilities, and attributes against foreign genetic elements. L

  8. Maternal health in fifty years of Tanzania independence: Challenges and opportunities of reducing maternal mortality.

    Science.gov (United States)

    Shija, Angela E; Msovela, Judith; Mboera, Leonard E G

    2011-12-01

    High rate of maternal death is one of the major public health concerns in Tanzania. Most of maternal deaths are caused by factors attributed to pregnancy, childbirth and poor quality of health services. More than 80% of maternal deaths can be prevented if pregnant women access essential maternity care and assured of skilled attendance at childbirth as well as emergency obstetric care. The objective of this review was to analyse maternal mortality situation in Tanzania during the past 50 years and to identify efforts, challenges and opportunities of reducing it. This paper was written through desk review of key policy documents, technical reports, publications and available internet-based literature. From 1961 to 1990 maternal mortality ratio in Tanzania had been on a downward trend from 453 to 200 per 100,000 live births. However, from 1990's there been an increasing trend to 578 per 100,000 live births. Current statistics indicate that maternal mortality ratio has dropped slightly in 2010 to 454 per 100,000 live births. Despite a high coverage (96%) in pregnant women who attend at least one antenatal clinic, only half of the women (51%) have access to skilled delivery. Coverage of emergence obstetric services is 64.5% and utilization of modern family planning method is 27%. Only about 13% of home deliveries access post natal check-up. Despite a number of efforts maternal mortality is still unacceptably high. Some of the efforts done to reduce maternal mortality in Tanzania included the following initiatives: reproductive and child survival; increased skilled delivery; maternal death audit; coordination and integration of different programs including maternal and child health services, family planning, malaria interventions, expanded program on immunization and adolescent health and nutrition programmes. These initiatives are however challenged by inadequate access to maternal health care services. In order to considerably reduce maternal deaths some of recommended

  9. 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.

  10. Total pregnancy-associated plasma protein A--a first trimester maternal serum marker for Down's syndrome: clinical and technical assessment of a poly-monoclonal enzyme immunoassay.

    Science.gov (United States)

    Christiansen, M; Jaliashvili, I

    2003-01-01

    Pregnancy-associated plasma protein A (PAPP-A) is a maternal serum marker of fetal chromosomal disease and a risk marker for adverse outcome. PAPP-A in the circulation exists both as a 2:2 complex (PAPP-A/proMBP) with the proform of eosinophil major basic protein (proMBP) and as dimeric PAPP-A. Non-PAPP-A containing proMBP complexes constitute the bulk of proMBP in maternal serum. We developed and characterized a sandwich enzyme immunoassay for PAPP-A using a polyclonal rabbit anti-PAPP-A/proMBP antibody (SSI 6823) and a monoclonal murine anti-PAPP-A/proMBP antibody (HYB 234-3), reactive with the PAPP-A part of PAPP-A/proMBP. The assay range was 2 mIU/L-500 mIU/L, intra- and inter-assay coefficients of variation Mr 669 kDa, in gel filtration and bound to a heparin column. Serum concentrations of PAPP-A were determined in gestational weeks 5-13 in 167 pregnant women with normal fetuses and 39 women with Down's syndrome (DS) fetuses. The median PAPP-A MoM (multiples of the median in normal controls) in DS pregnancies was 0.30 (quartile range: 0.17-0.54). The PAPP-A logMoMs in DS pregnancies were normally distributed with a mean of -0.5927 and SD of 0.3639. When simulating the performance of PAPP-A and age as markers for DS in population screening a detection rate (DR) of 62% was found for a screen positive rate (SPR) of 5%. Together with beta-HCG and nuchal translucency, two other first trimester markers for fetal DS, a DR 90% could be obtained for an SPR of 5%. PMID:14594321

  11. Evaluation of Parasiticide Treatment with Benznidazol in the Electrocardiographic, Clinical, and Serological Evolution of Chagas Disease.

    Directory of Open Access Journals (Sweden)

    Abilio Augusto Fragata-Filho

    2016-03-01

    Full Text Available Chagas disease is one of the most important endemic parasitic diseases in Latin America. In its chronic phase, progression to cardiomyopathy has high morbidity and mortality. The persistence of a normal electrocardiogram (ECG provides a similar prognosis to that of a non-diseased population. Benznidazole (BNZ is the only drug with trypanocidal action available in Brazil.A group of 310 patients with chronic Chagas disease who had normal ECGs at the first medical visit performed before 2002 were included. There were 263 patients treated with BNZ and 47 untreated. The follow-up period was 19.59 years. Univariate analyses showed that those treated were younger and predominantly male. As many as 79.08% of those treated and 46.81% of those untreated continued with normal electrocardiograms (p <0.0001. The occurrence of electrocardiographic abnormalities and relevant clinical events (heart failure, stroke, total mortality, and cardiovascular death was less prevalent in treated patients (p <0.001, p: 0.022, p: 0.047 respectively. In multivariate analyses, the parasiticide treatment was an independent variable for persistence of a normal ECG pattern, which was an independent variable in the prevention of significant clinical events. The immunofluorescence titers decreased with the parasitological treatment. However, the small number of tests in untreated patients did not allow the correlation of the decrease of these titers with electrocardiographic alterations.These data suggest that treatment with benznidazole prevents the occurrence of electrocardiographic alterations. On the other hand, patients who develop ECG abnormalities present with more significant clinical events.

  12. Evolution of the clinical review station for enterprise-wide multimedia radiology reporting

    Science.gov (United States)

    Hanlon, William B.; Valtchinov, Vladimir I.; Davis, Scott D.; Lester, James; Khorasani, Ramin; Carrino, John A.; Benfield, Andrew

    2000-05-01

    Efforts to develop Picture Archiving and Communications Systems (PACS) for the last ten years have concentrated mainly on developing systems for primary interpretation of digital radiological images. Much less attention has been paid to the clinical aspects of the radiology process. Clinical radiology services are an important component of the overall care delivery process, providing information and consultation services to referring physicians, the customers of radiology, in a timely fashion to aid in care decisions. Information management systems (IMS) are playing an increasingly central role in the care delivery process. No suitable commercial PACS or IMS products were available that could effectively provide for the requirements of the clinicians. We endeavored to fill this void at our institution by developing a system to deliver images and text reports electronically on-demand to the referring physicians. This system has evolved substantially since initial deployment eight years ago. As new technologies become available they are evaluated and integrated as appropriate to improve system performance and manageability. Not surprisingly, the internet and World Wide Web (WWW) technology has had the greatest impact on system design in recent years. Additional features have been added over time to provide services for teleradiology, teaching, and research needs. We also discovered that these value-added services give us a competitive edge in attracting new business to our department. Commercial web-based products are now becoming available which do a satisfactory job of providing many of these clinical services. These products are evaluated for integration into our system as they mature. The result is a system that impacts positively on patient care.

  13. HIV and maternal mortality.

    Science.gov (United States)

    Lathrop, Eva; Jamieson, Denise J; Danel, Isabella

    2014-11-01

    The majority of the 17 million women globally that are estimated to be infected with HIV live in Sub-Saharan Africa. Worldwide, HIV-related causes contributed to 19 000-56 000 maternal deaths in 2011 (6%-20% of maternal deaths). HIV-infected pregnant women have two to 10 times the risk of dying during pregnancy and the postpartum period compared with uninfected pregnant women. Many of these deaths can be prevented with the implementation of high-quality obstetric care, prevention and treatment of common co-infections, and treatment of HIV with ART. The paper summarizes what is known about HIV disease progression in pregnancy, specific causes of HIV-related maternal deaths, and the potential impact of treatment with antiretroviral therapy on maternal mortality. Recommendations are proposed for improving maternal health and decreasing maternal mortality among HIV-infected women based on existing evidence.

  14. Locus-specific database domain and data content analysis: evolution and content maturation toward clinical use.

    Science.gov (United States)

    Mitropoulou, Christina; Webb, Adam J; Mitropoulos, Konstantinos; Brookes, Anthony J; Patrinos, George P

    2010-10-01

    Genetic variation databases have become indispensable in many areas of health care. In addition, more and more experts are depositing published and unpublished disease-causing variants of particular genes into locus-specific databases (LSDBs). Some of these databases contain such extensive information that they have become known as knowledge bases. Here, we analyzed 1,188 LSDBs and their content for the presence or absence of 44 content criteria related to database features (general presentation, locus-specific information, database structure) and data content (data collection, summary table of variants, database querying). Our analyses revealed that several elements have helped to advance the field and reduce data heterogeneity, such as the development of specialized database management systems and the creation of data querying tools. We also identified a number of deficiencies, namely, the lack of detailed disease and phenotypic descriptions for each genetic variant and links to relevant patient organizations, which, if addressed, would allow LSDBs to better serve the clinical genetics community. We propose a structure, based on LSDBs and closely related repositories (namely, clinical genetics databases), which would contribute to a federated genetic variation browser and also allow the maintenance of variation data. PMID:20672379

  15. Maternal mortality and severe maternal morbidity surveillance in Canada.

    Science.gov (United States)

    Allen, Victoria M; Campbell, Melanie; Carson, George; Fraser, William; Liston, Robert M; Walker, Mark; Barrett, Jon

    2010-12-01

    The Canadian Perinatal Surveillance System has provided a comprehensive review of maternal mortality and severe maternal morbidity in Canada, and has identified several important limitations to existing national maternal data collection systems, including variability in the detail and quality of mortality data. The Canadian Perinatal Surveillance System report recommended the establishment of an ongoing national review and reporting system, as well as consistency in definitions and classifications of maternal mortality and severe maternal morbidity, in order to enhance surveillance of maternal mortality and severe maternal morbidity. Using review articles and studies that examined maternal mortality in general as opposed to maternal mortality associated with particular management strategies or conditions, maternal mortality and severe morbidity classifications, terminology, and comparative statistics were reviewed and employed to evaluate deficiencies in past and current methods of data collection and to seek solutions to address the need for enhanced and consistent national surveillance of maternal mortality and severe maternal morbidity in Canada.

  16. [Maternal mortality and perinatal mortality].

    Science.gov (United States)

    Boutaleb, Y; Mesbahi, M; Lahlou, D; Aderdour, M

    1982-01-01

    94 maternal deaths and 1546 fetal and neonatal deaths were registered among 28,706 births at the CHU Averroes in Casablanca between 1978-80. 45% of women who deliver at the clinic are very poor and only 10% are relatively well off. Obstetrical antecedents were noted in 27% of the fetal deaths. 70% of the maternal deaths occurred in women aged 20-34. 32 maternal deaths occurred among 16,232 women with 1-2 children, 30 among 6514 women with 3-5 children, and 32 among 5960 women with 6-14 children. 11,027 of the 28,706 were primaparas. Perinatal mortality was 4.46% among primaparas, 8.24% among grand multiparas, and 4.1% among secondiparas. In 58 of the 94 cases of maternal mortality the woman was hospitalized after attempting delivery at home or in a village clinic. Among women with 1 or 2 children, hemorrhage was the cause of death in 8 cases, infection in 7 cases, eclampsia in 3 cases, thromboembolism in 2 cases, uterine inversion in 2 cases, pulmonary tuberculosis in 1 case, embolism in 5 cases, and other causes 1 case each. Among women with 3-5 children hemorrhage was the cause of death in 10 cases, septicemia in 3 cases, uterine rupture in 3 cases, eclampsia in 3 cases, uterine inversion in 2 cases, viral hepatitis in 2 cases, emboli in 2 cases, and other reasons 1 case each. Among grand multiparas hemorrhage was the cause of death in 11 cases, uterine rupture in 12 cases, peritonitis in 2 cases, eclampsia in 2 cases, emboli in 2 cases, and other causes 1 case each. 19 of the maternal deaths were judged to have been avoidable with better management. Prematurity and birth weight of 1000-2500 g associated or not with other pathology were found in 714 of 1546 perinatal deaths. Of 390 cases of death in utero with retention and maceration, 68 were caused by reno-vascular syndromes, 76 by maternal infections, 33 by maternal syphilis, 26 by fetal malformation, 18 by maternal diabetes, 10 by Rh incompatability, and 159 by indeterminate causes. In 795 cases of

  17. Maternal mortality in Sirur.

    Science.gov (United States)

    Shrotri, A; Pratinidhi, A; Shah, U

    1990-01-01

    The research aim was 1) to determine the incidence of maternal mortality in a rural health center area in Sirur, Maharashtra state, India; 2) to determine the relative risk; and 3) to make suggestions about reducing maternal mortality. The data on deliveries was obtained between 1981 and 1984. Medical care at the Rural Training Center was supervised by the Department of Preventive and Social Medicine, the B.J. Medical College in Pune. Deliveries numbered 5994 singleton births over the four years; 5919 births were live births. 15 mothers died: 14 after delivery and 1 predelivery. The maternal mortality rate was 2.5/1000 live births. The maternal causes of death included 9 direct obstetric causes, 3 from postpartum hemorrhage of anemic women, and 3 from puerperal sepsis of anemic women with prolonged labor. 2 deaths were due to eclampsia, and 1 death was unexplained. There were 5 (33.3%) maternal deaths due to indirect causes (3 from hepatitis and 2 from thrombosis). One woman died of undetermined causes. Maternal jaundice during pregnancy was associated with the highest relative risk of maternal death: 106.4. Other relative risk factors were edema, anemia, and prolonged labor. Attributable risk was highest for anemia, followed by jaundice, edema, and maternal age of over 30 years. Maternal mortality at 30 years and older was 3.9/1000 live births. Teenage maternal mortality was 3.3/1000. Maternal mortality among women 20-29 years old was lowest at 2.1/1000. Maternal mortality for women with a parity of 5 or higher was 3.6/1000. Prima gravida women had a maternal mortality rate of 2.9/1000. Parities between 1 and 4 had a maternal mortality rate of 2.3/1000. The lowest maternal mortality was at parity of 3. Only 1 woman who died had received more than 3 prenatal visits. 11 out of 13 women medically examined prenatally were identified with the following risk factors: jaundice, edema, anemia, young or old maternal age, parity, or poor obstetric history. The local

  18. The evolution of the major hepatitis C genotypes correlates with clinical response to interferon therapy.

    Directory of Open Access Journals (Sweden)

    Phillip S Pang

    Full Text Available BACKGROUND: Patients chronically infected with hepatitis C virus (HCV require significantly different durations of therapy and achieve substantially different sustained virologic response rates to interferon-based therapies, depending on the HCV genotype with which they are infected. There currently exists no systematic framework that explains these genotype-specific response rates. Since humans are the only known natural hosts for HCV-a virus that is at least hundreds of years old-one possibility is that over the time frame of this relationship, HCV accumulated adaptive mutations that confer increasing resistance to the human immune system. Given that interferon therapy functions by triggering an immune response, we hypothesized that clinical response rates are a reflection of viral evolutionary adaptations to the immune system. METHODS AND FINDINGS: We have performed the first phylogenetic analysis to include all available full-length HCV genomic sequences (n = 345. This resulted in a new cladogram of HCV. This tree establishes for the first time the relative evolutionary ages of the major HCV genotypes. The outcome data from prospective clinical trials that studied interferon and ribavirin therapy was then mapped onto this new tree. This mapping revealed a correlation between genotype-specific responses to therapy and respective genotype age. This correlation allows us to predict that genotypes 5 and 6, for which there currently are no published prospective trials, will likely have intermediate response rates, similar to genotype 3. Ancestral protein sequence reconstruction was also performed, which identified the HCV proteins E2 and NS5A as potential determinants of genotype-specific clinical outcome. Biochemical studies have independently identified these same two proteins as having genotype-specific abilities to inhibit the innate immune factor double-stranded RNA-dependent protein kinase (PKR. CONCLUSION: An evolutionary analysis of all

  19. Clinical commentary of the evolution of the treatment for chronic painful mid-portion Achilles tendinopathy

    Directory of Open Access Journals (Sweden)

    Håkan Alfredson

    2015-10-01

    Full Text Available ABSTRACTThe chronic painful Achilles tendon mid-portion was for many years, and still is in many countries, treated with intratendinous revision surgery. However, by coincidence, painful eccentric calf muscle training was tried, and it showed very good clinical results. This finding was unexpected and led to research into the pain mechanisms involved in this condition. Today we know that there are very few nerves inside, but multiple nerves outside, the ventral side of the chronic painful Achilles tendon mid-portion. These research findings have resulted in new treatment methods targeting the regions with nerves outside the tendon, methods that allow for a rapid rehabilitation and fast return to sports.

  20. [Radiotherapy for soft tissue sarcomas: Technical evolution and impact on clinical benefit].

    Science.gov (United States)

    Llacer-Moscardo, C; Bourgier, C; Morel, A; Fenoglietto, P; Carrère, S; Firmin, N; Azria, D

    2016-10-01

    The standard treatment for extremity soft tissue sarcomas is based on the association of surgery and radiotherapy. This strategy allows local control improvement with the risk of increased toxicity. There is therefore a growing interest to identify those patients who will benefit from radiotherapy and those who will have the same local control with surgery alone. Furthermore, the development of toxicity has been correlated with the extension of the irradiated volume and the volume receiving high doses. Technological development as intensity modulated radiotherapy and image-guided radiotherapy allows limited irradiated volume improving the protection of the organs at risk leading to clinical benefit improvement. Moreover, efforts are being done to improve local control for the patients at high risk of local relapse. In this paper, we discuss all these mentioned aspects. PMID:27614501

  1. A RETROSPECTIVE ANALYSIS OF CLINICAL DIAGNOSIS, PREDICTABILITY AND FETO MATERNAL OUTCOME IN A CRITICAL PATIENT S ADMITTED IN OBSTETRIC INTENSIVE CARE UNIT IN A TERTIARY CARE CENTRE

    Directory of Open Access Journals (Sweden)

    Vijayasree

    2014-01-01

    Full Text Available INTRODUCTION: Care of the critically ill parturient is a unique challenge in obstetrics particularly because of its unpredictability. Hemorrhage , toxemia , anemia and septicemia are common causes of mortality and morbidity in these patients. Obstetric critical care in developing countries continues to be ra dically different from developed countries. AIMS AND OBJECTIVES: To analyze all cases of critically ill obstetric patients admitted to an obstetric intensive care unit in relation to causes for admissions, interventions required, course during their ICU st ay and fetal maternal outcome. MATERIALS AND METHODS : A one year retrospective analysis of all obstetric admissions to the ICU at our referral hospital was conducted, observations made and results were analyzed . RESULTS AND ANALYSIS : There were 24 ICU admi ssions with mean age of 25.21±4.075 years and mean gestational age of 36.04±3.862 weeks. Postpartum admissions were significantly higher (83.33%, n=20, P <0.05 with more patients presenting with obstetric complications (91.66%, n=22, P <0.01 as compared to medical complications (8.32%, n=2. Obstetric hemorrhage (n=15, 62.5% and hemodynamic instability (n=20, 83.33% were considered to be significant risk factors for ICU admission ( P =0.000. Inotropic support was required in 22 patients (91.66% while 17 p atients (70.83% required ventilatory support. The mean duration of ventilation (30.17±21.65 h and ICU stay (39.42±33.70 h were of significantly longer duration in survivors ( P =0.01, P =0.00 respectively versus non - survivors. The observed mortality n=10, 41.67% was significantly higher since ours is a referral tertiary center and delay in reaching the tertiary center from the place of occurrence of the mishap is a usual occurrence. CONCLUSION: Obstetric hemorrhage leading to hemodynamic instability remains the leading cause of ICU admissions and maternal mortality.

  2. The ongoing evolution of the core curriculum of a clinical fellowship in pathology informatics

    Directory of Open Access Journals (Sweden)

    Andrew M Quinn

    2014-01-01

    Full Text Available The Partners HealthCare system′s Clinical Fellowship in Pathology Informatics (Boston, MA, USA faces ongoing challenges to the delivery of its core curriculum in the forms of: (1 New classes of fellows annually with new and varying educational needs and increasingly fractured, enterprise-wide commitments; (2 taxing electronic health record (EHR and laboratory information system (LIS implementations; and (3 increasing interest in the subspecialty at the academic medical centers (AMCs in what is a large health care network. In response to these challenges, the fellowship has modified its existing didactic sessions and piloted both a network-wide pathology informatics lecture series and regular "learning laboratories". Didactic sessions, which had previously included more formal discussions of the four divisions of the core curriculum: Information fundamentals, information systems, workflow and process, and governance and management, now focus on group discussions concerning the fellows′ ongoing projects, updates on the enterprise-wide EHR and LIS implementations, and directed questions about weekly readings. Lectures are given by the informatics faculty, guest informatics faculty, current and former fellows, and information systems members in the network, and are open to all professional members of the pathology departments at the AMCs. Learning laboratories consist of small-group exercises geared toward a variety of learning styles, and are driven by both the fellows and a member of the informatics faculty. The learning laboratories have created a forum for discussing real-time and real-world pathology informatics matters, and for incorporating awareness of and timely discussions about the latest pathology informatics literature. These changes have diversified the delivery of the fellowship′s core curriculum, increased exposure of faculty, fellows and trainees to one another, and more equitably distributed teaching responsibilities among

  3. The ongoing evolution of the core curriculum of a clinical fellowship in pathology informatics.

    Science.gov (United States)

    Quinn, Andrew M; Klepeis, Veronica E; Mandelker, Diana L; Platt, Mia Y; Rao, Luigi K F; Riedlinger, Gregory; Baron, Jason M; Brodsky, Victor; Kim, Ji Yeon; Lane, William; Lee, Roy E; Levy, Bruce P; McClintock, David S; Beckwith, Bruce A; Kuo, Frank C; Gilbertson, John R

    2014-01-01

    The Partners HealthCare system's Clinical Fellowship in Pathology Informatics (Boston, MA, USA) faces ongoing challenges to the delivery of its core curriculum in the forms of: (1) New classes of fellows annually with new and varying educational needs and increasingly fractured, enterprise-wide commitments; (2) taxing electronic health record (EHR) and laboratory information system (LIS) implementations; and (3) increasing interest in the subspecialty at the academic medical centers (AMCs) in what is a large health care network. In response to these challenges, the fellowship has modified its existing didactic sessions and piloted both a network-wide pathology informatics lecture series and regular "learning laboratories". Didactic sessions, which had previously included more formal discussions of the four divisions of the core curriculum: Information fundamentals, information systems, workflow and process, and governance and management, now focus on group discussions concerning the fellows' ongoing projects, updates on the enterprise-wide EHR and LIS implementations, and directed questions about weekly readings. Lectures are given by the informatics faculty, guest informatics faculty, current and former fellows, and information systems members in the network, and are open to all professional members of the pathology departments at the AMCs. Learning laboratories consist of small-group exercises geared toward a variety of learning styles, and are driven by both the fellows and a member of the informatics faculty. The learning laboratories have created a forum for discussing real-time and real-world pathology informatics matters, and for incorporating awareness of and timely discussions about the latest pathology informatics literature. These changes have diversified the delivery of the fellowship's core curriculum, increased exposure of faculty, fellows and trainees to one another, and more equitably distributed teaching responsibilities among the entirety of the

  4. 母源性苯丙酮尿症的临床特征与干预%Clinical characteristics and intervention in maternal phenylketonuria

    Institute of Scientific and Technical Information of China (English)

    何玺玉

    2016-01-01

    Maternal phenylketonuria(MPKU) is a syndrome caused by high phenylalanine concentrations in serum of pregnant women with phenylketonuria.MPKU results in neonatal microcephaly,facial dysmorphism,congenital heart defects,mental retardation,intrauterine growth restriction,behavior and emotional problems.To control serum Phe level of pregnant phenylketonuria women and maintain Phe concentration between 120 to 360μmol/L will prevent offspring poor outcomes such as intellectual disabilities and microcephaly.Three level interventions are best ways in MPKU management.%母源性苯丙酮尿症是由于苯丙酮尿症孕妇在孕前及孕中苯丙氨酸水平持续升高导致的综合征,其表现为小头及面部畸形、先天性心脏病、智力低下和行为及情感异常.合理控制苯丙酮尿症孕妇血苯丙氨酸水平并保持在120~360μmol/L,能够降低和避免胎儿畸形不良结局的发生.母源性苯丙酮尿症应倡导三级干预.

  5. Risk factors for maternal death in the highlands of rural northern Tanzania: a case-control study

    OpenAIRE

    Lie Rolv; Hinderaker Sven; Evjen-Olsen Bjørg; Bergsjø Per; Gasheka Peter; Kvåle Gunnar

    2008-01-01

    Abstract Background Tanzania has one of the highest maternal mortality ratios in sub-Saharan Africa. Due to the paucity of epidemiological information on maternal deaths, and the high maternal mortality estimates found earlier in the study area, our objective was to assess determinants of maternal deaths in a rural setting in the highlands of northern Tanzania by comparing the women dying of maternal causes with women from the same population who had attended antenatal clinics in the same tim...

  6. Current State of Clinical Application of Acupuncture Therapy in Maternity Department in Countries Outside China%针灸在国外产科中的应用现状分析

    Institute of Scientific and Technical Information of China (English)

    陈滢如; 李春华; 刘玉祁; 苑鸿雯; 朱江

    2012-01-01

    In the present review, the authors sumarrize current situations about application of acupuncture and moxibustion therapies in the maternity department in countries outside China in accordance with 68 articles in English published from 2000 to 2011. The clinical application includes: 1) dilivery processing, 2) lumbc-sacrodynia, 3) dilivery pain. 4) pregnancy problems, 5) problems of post-dilivery, 6) conversion of fetal breech presentation. 7) nausea and vomitting during early pregnancy, 8) safety, 9) depression during pregnancy, and 10) blood supply of fetus. In addition, the retrieved papers include 13 review papers, 4 survey papers and one animal study. Although the purposes of those clinical trials are different, most of them focus on acupuncture analgesia. Despite most of those clinical trials achieved positive results particularly in pain relief, nausea remission, etc., and majority of the pregnant women were willing to accept acupuncture intervention, most systematic reviews or meta-analysis do not show conclusively positive results, and stress that further well designed researches are warranted for providing convincing evidence%计算机检索Ovid平台联机的Medline、Maternity and Infant Care数据库及单独检索Medline(Pubmed)数据库中2000-2011年在国外英文杂志发表的针刺在产科应用的文献,获得文献122篇,其中相关文献68篇.国外针刺用于产科的研究以临床疗效观察为主,针灸治疗主要应用于干预产程,治疗孕妇腰骶痛、分娩痛,辅助受孕,解决产后问题等,针刺镇痛为研究重点.虽然大部分研究结果为阳性,且绝大数产妇对针刺满意度较高,但多数系统评价目前仍未给出肯定结论,认为尚需进一步设计严谨合理的相关研究为针刺在产科的应用提供证据支持.

  7. The effects of maternal depression and maternal selective serotonin reuptake inhibitor exposure on the offspring

    Directory of Open Access Journals (Sweden)

    Jocelien DA Olivier

    2013-05-01

    Full Text Available It has been estimated that 20% of pregnant women suffer from depression and it is well documented that maternal depression can have long-lasting effects on the child. Currently, common treatment for maternal depression has been the selective serotonin reuptake inhibitor medications (SSRIs which are used by 2-3% of pregnant women in the Nordic countries and by up to 10% of pregnant women in the United States. Antidepressants cross the placenta and are transferred to the fetus, thus, the question arises as to whether children of women taking antidepressants are at risk for altered neurodevelopmental outcomes and, if so, whether the risks are due to SSRI medication exposure or to the underlying maternal depression. This review considers the effects of maternal depression and SSRI exposure on offspring development in both clinical and preclinical populations. As it is impossible in humans to study the effects of SSRIs without taking into account the possible underlying effects of maternal depression (healthy pregnant women do not take SSRIs, animal models are of great value. For example, rodents can be used to determine the effects of maternal depression and/or perinatal SSRI exposure on offspring outcomes. Unraveling the joint (or separate effects of maternal depression and SSRI exposure will provide more insights into the risks or benefits of SSRI exposure during gestation and will help women make informed decisions about using SSRIs during pregnancy.

  8. Acute polyhydramnios after maternal status epilepticus

    OpenAIRE

    Shindo, Ryosuke; Aoki, Shigeru; Kasai, Michi; Takahashi, Tsuneo; Hirahara, Fumiki

    2015-01-01

    Key Clinical Message Maternal status epilepticus can cause fetal hypoxic ischemic encephalopathy that in turn results in acute polyhydramnios caused by fetal dysphagia; thus, acute polyhydramnios is a symptom that should lead to a suspicion of fetal dysphagia caused by hypoxic ischemic encephalopathy.

  9. Depression, Sensation Seeking, and Maternal Smoking as Predictors of Adolescent Cigarette Smoking

    OpenAIRE

    Judy van de Venne; Kay Bradford; Catherine Martin; Megan Cox; Hatim A. Omar

    2006-01-01

    The purpose of this study was to examine maternal and adolescent depression, maternal and teen sensation seeking, and maternal smoking, and their associations with adolescent smoking. Data were collected from a sample of 47 male and 66 female adolescents (ages 11—18 years) and their mothers from three different health clinics. The findings indicated that maternal sensation seeking was linked indirectly with adolescent smoking through teen sensation seeking, both of which were significantly as...

  10. Aggressive tumor growth and clinical evolution in a patient with X-linked acro-gigantism syndrome.

    Science.gov (United States)

    Naves, Luciana A; Daly, Adrian F; Dias, Luiz Augusto; Yuan, Bo; Zakir, Juliano Coelho Oliveira; Barra, Gustavo Barcellos; Palmeira, Leonor; Villa, Chiara; Trivellin, Giampaolo; Júnior, Armindo Jreige; Neto, Florêncio Figueiredo Cavalcante; Liu, Pengfei; Pellegata, Natalia S; Stratakis, Constantine A; Lupski, James R; Beckers, Albert

    2016-02-01

    X-linked acro-gigantism (X-LAG) syndrome is a newly described disease caused by microduplications on chromosome Xq26.3 leading to copy number gain of GPR101. We describe the clinical progress of a sporadic male X-LAG syndrome patient with an Xq26.3 microduplication, highlighting the aggressive natural history of pituitary tumor growth in the absence of treatment. The patient first presented elsewhere aged 5 years 8 months with a history of excessive growth for >2 years. His height was 163 cm, his weight was 36 kg, and he had markedly elevated GH and IGF-1. MRI showed a non-invasive sellar mass measuring 32.5 × 23.9 × 29.1 mm. Treatment was declined and the family was lost to follow-up. At the age of 10 years and 7 months, he presented again with headaches, seizures, and visual disturbance. His height had increased to 197 cm. MRI showed an invasive mass measuring 56.2 × 58.1 × 45.0 mm, with compression of optic chiasma, bilateral cavernous sinus invasion, and hydrocephalus. His thyrotrope, corticotrope, and gonadotrope axes were deficient. Surgery, somatostatin analogs, and cabergoline did not control vertical growth and pegvisomant was added, although vertical growth continues (currently 207 cm at 11 years 7 months of age). X-LAG syndrome is a new genomic disorder in which early-onset pituitary tumorigenesis can lead to marked overgrowth and gigantism. This case illustrates the aggressive nature of tumor evolution and the challenging clinical management in X-LAG syndrome.

  11. Aggressive tumor growth and clinical evolution in a patient with X-linked acro-gigantism syndrome.

    Science.gov (United States)

    Naves, Luciana A; Daly, Adrian F; Dias, Luiz Augusto; Yuan, Bo; Zakir, Juliano Coelho Oliveira; Barra, Gustavo Barcellos; Palmeira, Leonor; Villa, Chiara; Trivellin, Giampaolo; Júnior, Armindo Jreige; Neto, Florêncio Figueiredo Cavalcante; Liu, Pengfei; Pellegata, Natalia S; Stratakis, Constantine A; Lupski, James R; Beckers, Albert

    2016-02-01

    X-linked acro-gigantism (X-LAG) syndrome is a newly described disease caused by microduplications on chromosome Xq26.3 leading to copy number gain of GPR101. We describe the clinical progress of a sporadic male X-LAG syndrome patient with an Xq26.3 microduplication, highlighting the aggressive natural history of pituitary tumor growth in the absence of treatment. The patient first presented elsewhere aged 5 years 8 months with a history of excessive growth for >2 years. His height was 163 cm, his weight was 36 kg, and he had markedly elevated GH and IGF-1. MRI showed a non-invasive sellar mass measuring 32.5 × 23.9 × 29.1 mm. Treatment was declined and the family was lost to follow-up. At the age of 10 years and 7 months, he presented again with headaches, seizures, and visual disturbance. His height had increased to 197 cm. MRI showed an invasive mass measuring 56.2 × 58.1 × 45.0 mm, with compression of optic chiasma, bilateral cavernous sinus invasion, and hydrocephalus. His thyrotrope, corticotrope, and gonadotrope axes were deficient. Surgery, somatostatin analogs, and cabergoline did not control vertical growth and pegvisomant was added, although vertical growth continues (currently 207 cm at 11 years 7 months of age). X-LAG syndrome is a new genomic disorder in which early-onset pituitary tumorigenesis can lead to marked overgrowth and gigantism. This case illustrates the aggressive nature of tumor evolution and the challenging clinical management in X-LAG syndrome. PMID:26607152

  12. Mom knows best: the universality of maternal microbial transmission.

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    Lisa J Funkhouser

    Full Text Available The sterile womb paradigm is an enduring premise in biology that human infants are born sterile. Recent studies suggest that infants incorporate an initial microbiome before birth and receive copious supplementation of maternal microbes through birth and breastfeeding. Moreover, evidence for microbial maternal transmission is increasingly widespread across animals. This collective knowledge compels a paradigm shift—one in which maternal transmission of microbes advances from a taxonomically specialized phenomenon to a universal one in animals. It also engenders fresh views on the assembly of the microbiome, its role in animal evolution, and applications to human health and disease.

  13. Clinical features and maternal and neonatal outcomes of severe preeclampsia%80例重度子痫前期的临床特点和妊娠结局分析

    Institute of Scientific and Technical Information of China (English)

    梅吉; 于红

    2012-01-01

    Objective: To explore clinical features and maternal and neonatal outcomes of early and late onset severe preeclampsia. Methods: Clinical data of 80 cases of severe preeclampsia in Southeast University Jiangyin Hospital from January 2010 to February 2012, were collected and then analyzed. The patients were divided into two groups, 20 cases of early onset severe preeclampsia group (onset gestational weeks < 34) and 60 cases of later onset severe preeclampsia group (onset gestational weeks 3= 34). Results: The rates of complications of early onset severe preeclampsia group were higher than that of later onset severe preeclampsia group , and the rate of cesarean section in early onset severe preeclampsia group were higher than that of later onset severe preeclampsia group with an obvious differences ( all P < 0. 05 ). Significant difference of two groups were found in the rate of fetal distress, dead fetus in uterus, FGR, neonatal asphyxia and neonatal death(P <0. 01). Conclusions: Clinical symptoms of early onset severe preeclampsia are more serious, and have a higher incidence of abnormal maternal and neonatal outcomes. The suitable duration of expectant management can improve maternal- prenatal prognosis. Cesarean section is the major method of terminating severe preeclampsia.%目的:探讨早发型及晚发型重度子痫前期的临床特点及围产结局.方法:回顾性分析东南大学附属江阴医院产科2010年1月至2012年2月收治的重度子痫前期80例患者的临床资料,将其分为早发型重度子痫前期组(早发型组,妊娠<34周,20例)和晚发型重度子痫前期组(晚发型组,妊娠≥34周,60例).结果:孕产妇并发症早发型组高于晚发型组,终止妊娠的孕周早于晚发型组,终止妊娠的方式剖宫产率高于晚发型组,差异均具有统计学意义(P<0.05);胎儿窘迫、死胎、胎儿生长受限、新生儿窒息、新生儿死亡等发生率早发型组显著高于晚发型组(P<0.01).结论

  14. 子痫前期分娩方式及母婴结局的临床观察%Clinical observation of preeclampsia mode of delivery and maternal and child outcomes

    Institute of Scientific and Technical Information of China (English)

    李志红

    2015-01-01

    ObJective To investigate the influence of mode of delivery of maternal preeclampsiaon outcome . Methods The clinical data of 150 patients with preeclampsia from January 2012 to January 2014 were selected,they were divided into group A and group B according to the manner of termination of pregnancy. Group A(n=44)received double-balloon abortion by vaginal delivery,group B(n=106)received termination of pregnancy by cesarean section,the progno-sis of mothers and children between the two groups were compared. Results Forty cases of vaginal delivery,four cases of cesarean section in group A,106 cases of cesarean section in group B . Probability neonatal asphyxia and death as well as the probability of maternal complications had no significant differences between the two groups( P﹥0. 05),but the proba-bility of bleeding and the cost of hospitalization occur in the postpartum in group A were significantly lower than that in group B,the differences were statistically significant( P﹤0. 05). Conclusions Preeclampsia double balloon vaginal deliv-ery method not only does not make maternal complications increased,but can aslo reduce maternal postpartum hemorrhage and hospital costs.%目的:探讨子痫前期分娩方式对母婴结局的影响。方法选取2012年1月至2014年1月收治的150例子痫前期患者的临床资料,按照终止妊娠的方式将其分成A、B两组。A组44例,采用双球囊引产经阴道分娩;B组106例,通过剖宫产终止妊娠,对两组母儿预后的状况进行比较。结果 A组40例阴道分娩,4例进行剖宫产;B组106例剖宫产。两组新生儿发生窒息和死亡的概率以及孕妇出现并发症的概率比较差异均未见统计学意义(P﹥0.05),A组在产后发生出血的概率以及住院的费用较B组低,差异有统计学意义(P﹤0.05)。结论子痫前期采用双球囊进行阴道分娩方式不但不会使母婴增加并发症,反而能够让孕妇产后出血量减少、住院费用也随之降低。

  15. 52例低位产钳助产对母婴影响的临床探讨%Clinical Study of 52 Cases of Low Forceps Delivery on Maternal Effects

    Institute of Scientific and Technical Information of China (English)

    张丽珍; 苏秀球; 骆小辉; 张宝卫; 黄笑媚

    2014-01-01

    目的:分析经阴道分娩施行低位产钳助产对母婴的影响,探讨有效施行低位产钳助产是否会增加母婴已存在的风险。方法:回顾性分析于笔者所在医院经阴道分娩进行低位产钳助产的52例产妇的临床资料,分析施行低位产钳助产对母婴预后的影响。结果:52例均经阴道施行低位产钳助产顺利分娩,发生轻度窒息4例,重度窒息2例;新生儿头颅血肿10例,第二产程延长发生头颅血肿率高(P<0.05)。产后出血8例,宫缩乏力及第二产程延长发生率高(P<0.05)。产妇会阴侧剪基础上并发软产道裂伤5例,宫缩乏力及第二产程延长发生率高(P<0.05);会阴伤口甲级愈合51例,会阴伤口愈合不良1例。结论:掌握施行低位产钳助产对母婴较为安全,具有操作简单快捷,损伤小,是目前较好的经阴道分娩的助产方法。%Objective:Analysis by vaginal delivery of low forceps midwifery impact on maternal and infant, investigate the low effective forceps midwifery would increase the risk of maternal and infant had been in existence.Method: In the author’s hospital were retrospectively analyzed by vaginal delivery were low forceps midwifery, the clinical data of 52 cases of maternal analysis of low forceps midwifery effects on mcaternal and infant prognosis.Result:Enforcement of 52 cases were transvaginal low forceps midwifery easy childbirth, mild asphyxia (4 cases), severe asphyxia in 2 cases; the second 10 cases of neonatal head haematoma, prolonged labor, high head haematoma rate (P<0.05). Postpartum hemorrhage in 8 cases, high contractions fatigue and the second prolonged labor rate (P<0.05). Based on the maternal side of perineum cut and soft birth canal laceration in 5 cases, contractions fatigue and second high prolonged labor rate (P<0.05). Perineum wounds healed at the first 51 cases, perineum wound healing in 1 case.Conclusion: The Low-Forceps Delivery (LFD) was much

  16. Food availability and maternal immunization affect transfer and persistence of maternal antibodies in nestling pigeons.

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    Ahmad Ismail

    Full Text Available The ability of mothers to transfer antibodies (Abs to their young and the temporal persistence of maternal Abs in offspring constitute important life-history traits that can impact the evolution of host-parasite interactions. Here, we examined the effects of food availability and parental immunization on the transfer and persistence of maternal antibodies in nestling pigeons (Columba livia. This species can transmit maternal Abs to offspring before hatching through the egg yolk and potentially after hatching through crop milk. However, the role of this postnatal substance in immunity remains elusive. We used a full cross-fostering design to disentangle the effects of food limitation and parental immunization both before and after hatching on the levels and persistence of maternal Abs in chicks. Parents were immunized via injection with keyhole limpet hemocyanin antigens. Using an immunoassay that specifically detected the IgY antibodies that are known to be transmitted via the yolk, we found that the levels of anti-KLH Abs in newly hatched chicks were positively correlated with the levels of anti-KLH Abs in the blood of their biological mothers. However, this correlation was not present between chicks and their foster parents, suggesting limited IgY transfer via crop milk to the chick's bloodstream. Interestingly, biological mothers subjected to food limitation during egg laying transferred significantly fewer specific maternal Abs, which suggests that the transfer of antibodies might be costly for them. In addition, the persistence of maternal Abs in a chick's bloodstream was not affected by food limitation or the foster parents' anti-KLH Ab levels; it was only affected by the initial level of maternal anti-KLH Abs that were present in newly hatched chicks. These results suggest that the maternal transfer of Abs could be costly but that their persistence in an offspring's bloodstream may not necessarily be affected by environmental conditions.

  17. The Turkish version of Maternal Attachment Inventory

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    Oya Kavlak

    2009-01-01

    Full Text Available Objective: The research has been designed as methodological with purpose of the validity and the reliability of the Turkish language version of Maternal Attachment Inventory on mothers within one and four months postpartum. Method: This study was carried out with mothers registered at 19 Health Clinics and three Maternal-Child Health and Family Planning Clinics in which connected to Bornova Health Presidency in Izmir. The sample of research has been composed three clinics in which determined with the purposive sampling technique. First stage, the research was studied on 165 mothers when their babies were approximately 30-40 days old in these registered clinics.At the second stage of research has been interviewed again with 78 mothers when their babies were approximately 90-105 days old.Results: It is determined that experts consensuses about content of items as a result of analysis (Kendall’s W=0.274, p=0.001

  18. Short-term benefits, but transgenerational costs of maternal loss in an insect with facultative maternal care.

    Science.gov (United States)

    Thesing, Julia; Kramer, Jos; Koch, Lisa K; Meunier, Joël

    2015-10-22

    A lack of parental care is generally assumed to entail substantial fitness costs for offspring that ultimately select for the maintenance of family life across generations. However, it is unknown whether these costs arise when parental care is facultative, thus questioning their fundamental importance in the early evolution of family life. Here, we investigated the short-term, long-term and transgenerational effects of maternal loss in the European earwig Forficula auricularia, an insect with facultative post-hatching maternal care. We showed that maternal loss did not influence the developmental time and survival rate of juveniles, but surprisingly yielded adults of larger body and forceps size, two traits associated with fitness benefits. In a cross-breeding/cross-fostering experiment, we then demonstrated that maternal loss impaired the expression of maternal care in adult offspring. Interestingly, the resulting transgenerational costs were not only mediated by the early-life experience of tending mothers, but also by inherited, parent-of-origin-specific effects expressed in juveniles. Orphaned females abandoned their juveniles for longer and fed them less than maternally-tended females, while foster mothers defended juveniles of orphaned females less well than juveniles of maternally-tended females. Overall, these findings reveal the key importance of transgenerational effects in the early evolution of family life. PMID:26490790

  19. Maternal mortality from hemorrhage.

    Science.gov (United States)

    Haeri, Sina; Dildy, Gary A

    2012-02-01

    Hemorrhage remains as one of the top 3 obstetrics related causes of maternal mortality, with most deaths occurring within 24-48 hours of delivery. Although hemorrhage related maternal mortality has declined globally, it continues to be a vexing problem. More specifically, the developing world continue to shoulder a disproportionate share of hemorrhage related deaths (99%) compared with industrialized nations (1%). Given the often preventable nature of death from hemorrhage, the cornerstone of effective mortality reduction involves risk factor identification, quick diagnosis, and timely management. In this monograph we will review the epidemiology, etiology, and preventative measures related to maternal mortality from hemorrhage.

  20. An autopsy study of maternal mortality: A tertiary healthcare perspective

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    Panchabhai T

    2009-01-01

    Full Text Available Background: An audit of autopsies of maternal deaths is important for the establishment of accurate cause of maternal deaths and to determine the contribution of various etiologies responsible in a given community. Aim: To study the causes of maternal deaths as determined by a pathological autopsy. Settings and Design: A retrospective study of all the cases of maternal deaths that underwent a pathological autopsy in a tertiary healthcare center from January 1998 to December 2006. Materials and Methods: The autopsy records with clinical notes were retrieved; gross and histopathology specimens and slides were studied to establish the accurate cause of maternal deaths. The variables like age (years, stay in the hospital, gravidity, trimester of pregnancy and method of delivery were used to classify and analyze the data from the autopsies. The causes of maternal deaths were divided in to direct and indirect; each being classified into subgroups based on the most evident pathology on autopsy. Results: The Maternal Mortality Rate (MMR over a nine-year period (1998-2006 was 827/100000 live births (471 maternal deaths against 56944 live births. An autopsy was performed in 277 cases (58.8%. In the autopsy group, the most common causes of maternal mortality were pre-ecclampsia/ecclampsia (40 of 277, 14.44% and hemorrhage (32 of 277; 11.55%; However, indirect causes like infectious diseases (27 of 277; 9.75% and cardiac (27 of 277; 9.75% disease also contributed to maternal deaths. Conclusion: Indirect causes like rheumatic heart disease and infections like tuberculosis, malaria or leptospirosis and nutritional anemia are still major causes of maternal mortality in developing countries like India. Intensive efforts need to be taken in these areas to reduce the maternal mortality in developing countries like India.

  1. Insulinoterapia, controle glicêmico materno e prognóstico perinatal: diferença entre o diabetes gestacional e o clínico Insulinotherapy, maternal glycemic control and perinatal prognosis: difference between clinical and gestational diabetes

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    Neusa Aparecida de Sousa Basso

    2007-05-01

    Full Text Available OBJETIVO: avaliar protocolo de insulinoterapia e conseqüentes resultados maternos e perinatais, no diabetes gestacional e clínico, num serviço de referência para gravidez de alto risco. MÉTODOS: estudo prospectivo e descritivo, incluindo 103 gestantes portadoras de diabetes gestacional ou clínico, tratadas com insulina e acompanhadas no serviço, no período de outubro de 2003 a dezembro de 2005. Foram excluídos casos de gemelaridade, abortamento, abandono do pré-natal e parto fora do serviço. Compararam-se idade gestacional no início do tratamento; dose, aplicações/dia e incremento de insulina (UI/kg; média glicêmica e resultados perinatais. Utilizaram-se ANOVA e testes de Fisher e Goodman, considerando p25 kg/m² (88 versus 58,5%, o ganho de peso PURPOSE: to evaluate the insulin therapy protocol and its maternal and perinatal outcome in patients with clinical or gestational diabetes in a high risk reference service. METHODS: descriptive and prospective study including 103 pregnant women with gestational or clinical diabetes treated with insulin and attended by the reference service from October 2003 to December 2005. Gemellarity, miscarriages, unfinished prenatal care and deliveries not attended by the service were excluded. The gestational age at the beginning of the treatment, dosage, doses/day, increment of insulin (UI/kg, glycemic index (GI and perinatal outcomes were compared. ANOVA, Fisher’s exact test and Goodman’s test considering p25 kg/m² (88 versus 58.5%, weight gain (WG <8 kg (36 versus 17% and a high increment of insulin characterized the gestational diabetes. For the patients with clinical diabetes, despite the highest GI (120 mg/dL (39.2 versus 24% at the end of the gestational period, insulin therapy started earlier (47.2 versus 4%, lasted longer (56.6 versus 6% and higher doses of insulin (92 versus 43 UI/day were administered up to three times a day (54.7 versus 16%. Macrosomia was higher among newborns

  2. Maternal psychological impact of fetal echocardiography.

    Science.gov (United States)

    Sklansky, Mark; Tang, Alvin; Levy, Denis; Grossfeld, Paul; Kashani, Iraj; Shaughnessy, Robin; Rothman, Abraham

    2002-02-01

    The maternal psychological impact of fetal echocardiography may be deleterious in the face of newly diagnosed congenital heart disease. This questionnaire-based study prospectively examined the psychological impact of both normal and abnormal fetal echocardiography. Normal fetal echocardiography decreased maternal anxiety, increased happiness, and increased the closeness women felt toward their unborn children. In contrast, when fetal echocardiography detected congenital heart disease, maternal anxiety typically increased, and mothers commonly felt less happy about being pregnant. However, among women who had recently delivered infants with congenital heart disease, those who had had fetal echocardiography during the pregnancy felt less responsible for their infants' defects and tended to have improved their relationships with the infants' fathers after the prenatal diagnosis of congenital heart disease. Further study of the psychological and medical impact of fetal echocardiography will be necessary to define and optimize the clinical value of this powerful diagnostic tool.

  3. Maternal Dietary Patterns and Pregnancy Outcome

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    Xuyang Chen

    2016-06-01

    Full Text Available Maternal nutritional status during pregnancy will affect the outcomes for the mother and the baby. Many analyses of the relationship between diet and outcome are often based on a single or a few food items or nutrients. However, foods are not consumed in isolation and dietary patterns can be used to assess the whole diet consumed. The use of dietary pattern analysis to understand nutritional intake and pregnancy outcome is becoming more and more popular. Many published studies have showed the association between maternal dietary patterns and pregnancy outcome. This review examined articles about the relationship between maternal dietary patterns and pregnancy outcome. As a modifiable factor, dietary patterns may be more applicable to clinical and pregnant health interventions.

  4. Cues of maternal condition influence offspring selfishness.

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    Janine W Y Wong

    Full Text Available The evolution of parent-offspring communication was mostly studied from the perspective of parents responding to begging signals conveying information about offspring condition. Parents should respond to begging because of the differential fitness returns obtained from their investment in offspring that differ in condition. For analogous reasons, offspring should adjust their behavior to cues/signals of parental condition: parents that differ in condition pay differential costs of care and, hence, should provide different amounts of food. In this study, we experimentally tested in the European earwig (Forficula auricularia if cues of maternal condition affect offspring behavior in terms of sibling cannibalism. We experimentally manipulated female condition by providing them with different amounts of food, kept nymph condition constant, allowed for nymph exposure to chemical maternal cues over extended time, quantified nymph survival (deaths being due to cannibalism and extracted and analyzed the females' cuticular hydrocarbons (CHC. Nymph survival was significantly affected by chemical cues of maternal condition, and this effect depended on the timing of breeding. Cues of poor maternal condition enhanced nymph survival in early broods, but reduced nymph survival in late broods, and vice versa for cues of good condition. Furthermore, female condition affected the quantitative composition of their CHC profile which in turn predicted nymph survival patterns. Thus, earwig offspring are sensitive to chemical cues of maternal condition and nymphs from early and late broods show opposite reactions to the same chemical cues. Together with former evidence on maternal sensitivities to condition-dependent nymph chemical cues, our study shows context-dependent reciprocal information exchange about condition between earwig mothers and their offspring, potentially mediated by cuticular hydrocarbons.

  5. Cues of maternal condition influence offspring selfishness.

    Science.gov (United States)

    Wong, Janine W Y; Lucas, Christophe; Kölliker, Mathias

    2014-01-01

    The evolution of parent-offspring communication was mostly studied from the perspective of parents responding to begging signals conveying information about offspring condition. Parents should respond to begging because of the differential fitness returns obtained from their investment in offspring that differ in condition. For analogous reasons, offspring should adjust their behavior to cues/signals of parental condition: parents that differ in condition pay differential costs of care and, hence, should provide different amounts of food. In this study, we experimentally tested in the European earwig (Forficula auricularia) if cues of maternal condition affect offspring behavior in terms of sibling cannibalism. We experimentally manipulated female condition by providing them with different amounts of food, kept nymph condition constant, allowed for nymph exposure to chemical maternal cues over extended time, quantified nymph survival (deaths being due to cannibalism) and extracted and analyzed the females' cuticular hydrocarbons (CHC). Nymph survival was significantly affected by chemical cues of maternal condition, and this effect depended on the timing of breeding. Cues of poor maternal condition enhanced nymph survival in early broods, but reduced nymph survival in late broods, and vice versa for cues of good condition. Furthermore, female condition affected the quantitative composition of their CHC profile which in turn predicted nymph survival patterns. Thus, earwig offspring are sensitive to chemical cues of maternal condition and nymphs from early and late broods show opposite reactions to the same chemical cues. Together with former evidence on maternal sensitivities to condition-dependent nymph chemical cues, our study shows context-dependent reciprocal information exchange about condition between earwig mothers and their offspring, potentially mediated by cuticular hydrocarbons. PMID:24498046

  6. Clinically abnormal case with paternally derived partial trisomy 8p23.3 to 8p12 including maternal isodisomy of 8p23.3: a case report

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    Thieme Heike

    2009-06-01

    Full Text Available Abstract Background Because of low copy repeats (LCRs and common inversion polymorphisms, the human chromosome 8p is prone to a number of recurrent rearrangements. Each of these rearrangements is associated with several phenotypic features. We report on a patient with various clinical malformations and developmental delay in connection with an inverted duplication event, involving chromosome 8p. Methods Chromosome analysis, multicolor banding analysis (MCB, extensive fluorescence in situ hybridization (FISH analysis and microsatellite analysis were performed. Results The karyotype was characterized in detail by multicolor banding (MCB, subtelomeric and centromere-near probes as 46,XY,dup(8(pter->p23.3::p12->p23.3::p23.3->qter. Additionally, microsatellite analysis revealed the paternal origin of the duplication and gave hints for a mitotic recombination involving about 6 MB in 8p23.3. Conclusion A comprehensive analysis of the derivative chromosome 8 suggested a previously unreported mechanism of formation, which included an early mitotic aberration leading to maternal isodisomy, followed by an inverted duplication of the 8p12p23.3 region.

  7. Mortalidade materna: 75 anos de observações em uma Maternidade Escola Maternal mortality: 75 years of observations in a teaching maternity hospital

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    Amaury Teixeira Leite Andrade

    2006-07-01

    Full Text Available OBJETIVO: avaliar as causas de todas as mortes maternas ocorridas no período de 1927 a 2001 entre 164.161 pacientes, internadas no Serviço de Obstetrícia da Universidade Federal de Juiz de Fora. MG. MÉTODOS: estudo retrospectivo das 144 mortes maternas que ocorreram na maternidade em 75 anos, com um total de 131.048 nascidos vivos, utilizando todos os prontuários de pacientes, avaliados pela história clínica e dados da certidão de óbito (não foram realizadas necropsias. Foram registrados a idade, paridade, tempo de gestação, complicações, momento e causas de morte, estabelecendo-se o índice de mortalidade materna (IMM hospitalar por cem mil nascidos vivos. Análise estatística pelo teste do chi2 e pela técnica de amortecimento exponencial (alfa =0,05. RESULTADOS: de 1927 a 1941 o IMM foi de 1544, entre 1942 e 1956 houve redução para 314 (pPURPOSE: to evaluate all maternal deaths that occurred between 1927 and 2001, among 164,161 patients admitted to the Maternidade Therezinha de Jesus, the obstetrical service of the "Universidade Federal de Juiz de Fora", Brazil. METHODS: a retrospective study of 144 maternal deaths that occurred in the maternity hospital in 75 years, with 131,048 live births in the same period of time, analyzing all patients's records regarding their clinical history and data from death certificates. Autopsies were not performed. Data obtained were age, parity, gestation length, complications, moment, and causes of death. The index of maternal mortality (IMM period 100 thousand live births was utilized. For statistical analysis the chi2 test and the exponential smoothing technique were used (alpha=0.05. RESULTS: IMM decreased from 1544 in the period 1927-1941 to 314 (p<0.001 between 1942 and 1956 and from 1957 to 1971 it was reduced to 76.4 per 100 thousand live births (p<0.001. Nevertheless, since 1972 there was no further significant improvement (IMM=46 in the last 15 years, p=0.139. Maternal mortality was

  8. HIV感染孕妇母婴阻断的16例临床效果分析%Clinical Effect Analysis of 16 Cases of Maternal and Child Blocking of HIV Infection in Pregnant Women

    Institute of Scientific and Technical Information of China (English)

    吴爱萍

    2015-01-01

    目的:分析研讨感染 HIV 病毒的孕妇母婴阻断抗病毒治疗的临床效果。方法选取我院2011~2014年内发现的16例 HIV 阳性孕妇的临床资料,针对 HIV 阳性孕妇采用抗病毒治疗,辅助其他治疗,联合应用拉米夫定及克力芝、齐多夫定,新生儿出生后给予应用齐多夫定糖浆至产后42天,新生儿出生后,1、3、6、12、18月龄进行HIV-RNA 检测。结果出生后的新生儿未发现感染 HIV 病毒,均为正常儿童,成功阻断病毒的侵入。结论采用母婴抗病毒治疗能够有效阻止 HIV 病毒母婴传播。%Objective To study the clinical effect of anti viral therapy for pregnant women with infected HIV virus. Methods The clinical data of 16 cases of HIV positive pregnant women were selected in our hospital from 2011 to 2014, according to Yang HIV positive pregnant women received antiviral treatment, other adjuvant therapies, lamivudine and kriton Shiba, Zidorf, after the birth to the application of Zidovudine Syrup to 42 days postpartum, after birth, 1, 3, 6, 12, 18 months were detected by HIV-RNA. Results After birth were found infected with HIV, were normal children, successfully blocked the invasion of the virus. Conclusion The maternal antiviral therapy can effectively prevent HIV virus transmission.

  9. 对产后抑郁症产妇护理干预的疗效观察%Clinical effect observation of nursing intervention on maternal with postpartum depression

    Institute of Scientific and Technical Information of China (English)

    吴转子

    2015-01-01

    目的:探讨护理干预对产后抑郁症的疗效。方法:2011年6月-2013年8月收治产后抑郁症产妇76例,随机分为两组,每组38例。对照组给予产后常规护理,观察组在对照组的基础上给予综合护理干预,6周后采用抑郁自评量表(SDS)评估其疗效。结果:观察组疗效优于对照组,差异具有统计学意义(P<0.05)。结论:对产后抑郁症产妇给予心理护理、社会支持和自我调节等护理干预可提高其疗效,降低产后抑郁症的发生率。%Objective:To explore the curative effect of nursing intervention on postpartum depression.Methods:76 cases of maternal with postpartum depression from June 2011 to August 2013 were randomly divided into two groups,with 38 cases in each group.The control group were given postpartum routine nursing,while the observation group were given comprehensive nursing intervention on the basis of routine nursing in the control group,the curative effect were evaluated with the depression self rating scale(SDS) after six weeks.Results:The clinical effect of the observation group was better than that of the control group.There was statistically significant difference of curative effect between the two groups(P<0.05).Conclusion:The nursing intervention including psychological care,social support and self adjusting treating maternal with postpartum depression could improve the curative effect and reduce the incidence of postpartum depression.

  10. National Partnership for Maternal Safety: Consensus Bundle on Venous Thromboembolism.

    Science.gov (United States)

    D'Alton, Mary E; Friedman, Alexander M; Smiley, Richard M; Montgomery, Douglas M; Paidas, Michael J; D'Oria, Robyn; Frost, Jennifer L; Hameed, Afshan B; Karsnitz, Deborah; Levy, Barbara S; Clark, Steven L

    2016-10-01

    Obstetric venous thromboembolism is a leading cause of severe maternal morbidity and mortality. Maternal death from thromboembolism is amenable to prevention, and thromboprophylaxis is the most readily implementable means of systematically reducing the maternal death rate. Observational data support the benefit of risk-factor-based prophylaxis in reducing obstetric thromboembolism. This bundle, developed by a multidisciplinary working group and published by the National Partnership for Maternal Safety under the guidance of the Council on Patient Safety in Women's Health Care, supports routine thromboembolism risk assessment for obstetric patients, with appropriate use of pharmacologic and mechanical thromboprophylaxis. Safety bundles outline critical clinical practices that should be implemented in every maternity unit. The safety bundle is organized into four domains: Readiness, Recognition, Response, and Reporting and Systems Learning. Although the bundle components may be adapted to meet the resources available in individual facilities, standardization within an institution is strongly encouraged. PMID:27636577

  11. 高龄孕妇产前超声筛查的临床意义%Clinical significance of prenatal ultrasound screening in pregnart women with advanced maternal age

    Institute of Scientific and Technical Information of China (English)

    阚玉琦; 范毓萍; 张兴普; 刘荣; 路宁; 尹玉良

    2011-01-01

    目的 探讨对高龄孕妇实施系统产前超声筛查的诊断价值及临床意义.方法 统计10630例接受胎儿畸形产前超声检查孕妇资料,对其中712例高龄孕妇(预产期年龄> 35周岁)实施系统产前超声筛查,并随访所有高龄孕妇妊娠结果,胎儿畸形以产后最终诊断为标准,同时以非高龄孕妇筛查作为对照组进行比较,评估产前超声诊断的价值.结果 712例高龄孕妇中,产前超声诊断胎儿畸形32例(4.49%),单发畸形15例,复合畸形17例,漏诊4例,畸形检出率88.88% (36/32).对照组9 918例孕妇产前超声诊断胎儿畸形243例(2.45%).结论 高龄孕妇畸形发生率高于低龄孕妇,对高龄孕妇根据超声筛查结果行产前诊断,可以能有效地降低畸形儿的出生率及漏诊率.%Objective To investigate the implementation of the system of older pregnant women prenatal ultrasound screening for the diagnosis and clinioal significance.Methods Clinical data from March 2004 to April 2009 a total of 10 630 cases of pregnant women receiving prenatal ultrasound examination of fetal malformation data,of which 712 cases of advanced maternal age( expected date of birth aged≥35 years) to implement the system of prenatal ultrasound screening and follow-up of all maternal age pregnancy outcome,the final post-natal diagnosis of fetal malformations in the standard,both young women screened as a control group for comparison to assess the value of prenatal ultrasound diagnosis.Results 712 cases of advanced maternal age,prenatal ultrasound diagnosis of fetal malformations in 32 cases,abnormalities occur in approximately 4.49%,single abnormal in 15 cases,complex deformity in 17 cases,missed 4 cases of malformation detection rate was 88.88% (36/32).Control group,9918 cases of prenatal ultrasound diagnosis of fetal malformations 243 cases,2.45% incidence of deformity (243/9 918 ).Conclusion Older pregnant women,prenatal ultrasound screening for malformations

  12. Clinical Analysis of Maternal and Perinatal Outcome of 44 Patients with Twin Pregnancy%双胎妊娠44例妊娠结局临床分析

    Institute of Scientific and Technical Information of China (English)

    陈凤霞

    2014-01-01

    目的:探讨改善双胎妊娠的产妇和围产儿的预后。方法回顾分析该院2001年1月-2013年10月病案资料,包括双胎妊娠孕妇基本资料、妊娠并发症、新生儿并发症及新生儿结局,数据经统计学处理。结果双胎妊娠女性年龄相对较大,有较高的平均身高和较重平均体重。虽然没有孕产妇死亡,但妊娠并发症均显着较高,其中早产发生率(36.3%),妊娠期高血压疾病(9.1%),胎膜早破(27.2%),贫血(29.5%),产后出血(15.9%),产前出血(6.8%),妊娠糖尿病(11.3%),羊水过多(4.5%),大多数患者有一个以上并发症。只有8%的患者没有任何并发症。剖宫产与阴道分娩相比没有显著减少或增加围产儿结局。产科医生及时有效的判断行紧急剖宫产可有效降低新生儿死亡率及严重并发症的发病率。结论双胎妊娠具有较高的妊娠并发症和新生儿并发症,剖宫产与阴道分娩相比没有显著减少或增加围产儿结局。%Objective To explore the measures of improving the maternal and perinatal outcome of twin pregnancy by analyzing the treatment and outcome of 44 puerperants with twin pregnancy retrospectively. Methods The clinical data during January, 2001 to October, 2013 in our hospital, including the basic data of puerperants with twin pregnancy, pregnancy complications, neonatal complications and neonatal outcome, were analyzed retrospectively and treated statistically. Results The results showed that the women with twin pregnancy were relatively older, had a higher average height and a heavier body weight. Although there was no maternal mortality, pregnancy complications were remarkably higher, pregnancy complicated by preterm labor(36.3%), hypertensive disorders in pregnancy (9.1%), premature rupture of membrane(27.2%), anaemia(29.5%), postpartum hemorrhage (15.9%), antepar-tum hemorrhage(6.8%), gestational diabetes(11.3%), polyhydramnios(4.5%). Most of the patients had

  13. Identification of maternally-loaded RNA transcripts in unfertilized eggs of Tribolium castaneum

    Directory of Open Access Journals (Sweden)

    Preuss Kevin M

    2012-11-01

    Full Text Available Abstract Background Maternal RNAs play a critical role in early development. Variation in the diversity and levels of maternally derived gene transcripts may be central to the origin of phenotypic novelty -- a longstanding problem in evolution and development. By studying maternal transcriptomes within and between divergent species, a better understanding of the evolutionary forces acting on maternal RNA allocation is possible. Results We present the first maternal transcriptome of the red flour beetle, Tribolium castaneum. Using a tiled whole-genome microarray, we found that 58.2% of T. castaneum genes are maternally loaded into eggs. Comparison of known Drosophila melanogaster maternal genes to our results showed widespread conservation of maternal expression with T. castaneum. Additionally, we found that many genes previously reported as having sex or tissue specific expression in T. castaneum were also maternally loaded. Identification of such pleiotropy is vital for proper modeling and testing of evolutionary theory using empirical data. The microarray design also allowed the detection of 2315 and 4060 novel transcriptionally active regions greater in length than 100 bp in unfertilized and fertilized T. castaneum eggs, respectively. These transcriptionally active regions represent novel exons of potentially unknown genes for future study. Conclusions Our results lay a foundation for utilizing T. castaneum as a model for understanding the role of maternal genes in evolution.

  14. AWARENESS ABOUT EMERGENCY CONTRACEPTIVE PILLS VERSUS CONVENTIONAL CONTRACEPTIVE METHODS AMONG MOTHERS ATTENDING MATERNAL AND CHILD HEALTH (MCH CLINIC, BAPUJI HOSPITAL, DAVANGERE, KARNATAKA

    Directory of Open Access Journals (Sweden)

    Vandana

    2015-02-01

    Full Text Available BACKGROUND: Unwanted pregnancies are a major public health problem for both developing and developed nations, which generally results from ineffective use of contraceptives and end up in induced abortions. Emergency contraception sometimes called “morning after”, “postcoital” or “second chance pills” can be used to prevent pregnancy after an unprotected sex. Attention has been focused on the potential for emergency contraception to reduce the number of unwanted pregnancies and thus abortion rate. OBJECTIVES: 1 . To compare the awareness about emergency contraceptive pills and conventional contraceptive methods among mothers attending MCH clinic, Bapuji Hospital, Davangere. 2. To study the socio - demographic profile of the above group. METHODS: A pre - tested, semi - structured questionnaire was used to know the awareness about emergency contraceptive pills versus conventional contraceptive methods among mothers attending MCH clinic, Bapuji hospital, Davangere from 1 st October 2011 to 31 st December 2011. Data was entered into Excel sheet and was analysed using SPSS software version 17. Data was described as proportions, categorical data using chi square test. RESULTS: A total of 500 mothers were included in the study for duration of 3months. Approximately 80% of the respondents were in the age group of 21 - 30yrs, 72.8% from urban background, 83.4% were Hindus, 55% were from joint family. Approximately 49% belonged to socioeconomic class II and III, 97.2% were literate and 86.6% were housewives. 31.8% had knowledge about emergency contraception which is very less when compared to 84.2% of conventional methods. 6.2% have practiced emergency contraception which is very poor when compared to 47.5% of conventional methods. 77.8% were aware of female sterilization. The most common known temporary method of contrac eption was Cu - T (71% followed by OCP (60.6%. Most common method used by couples was condom (21.8% followed by Cu - T (19

  15. Clinical application of estimating hepatitis B virus quasispecies complexity by massive sequencing: correlation between natural evolution and on-treatment evolution.

    Directory of Open Access Journals (Sweden)

    Maria Homs

    Full Text Available AIM: To evaluate HBV quasispecies (QA complexity in the preCore/Core regions in relation to HBeAg status, and explore QA changes under natural evolution and nucleoside analogue (NUC treatment. METHODS: Ultra-deep pyrosequencing of HBV preCore/Core regions in 30 sequential samples (baseline [diagnosis], treatment-free, and treatment-nonresponse from 10 retrospectively selected patients grouped according to HBeAg status over time: HBeAg+ (N = 4, HBeAg- (N = 2, and fluctuating HBeAg (transient seroreversion/seroconversion pattern (N = 4. QA complexity was defined by Shannon entropy, mutation frequency, nucleotide diversity, and mutation frequency of amino acids (MfAA in preCore and Core. RESULTS: The QA was less complex in HBeAg+ than in HBeAg- or fluctuating HBeAg. High complexity in preCore was associated with decreased viral replication (preCore MfAA negatively correlated with HBV-DNA, p = 0.005. QA complexity in the treatment-free period negatively correlated with values seen during treatment. Specific variants were mainly selected in the Core region in HBeAg- and fluctuating HBeAg patients, suggesting higher immune pressure than in HBeAg+. CONCLUSIONS: The negative correlation between QA natural evolution and on-treatment evolution indicates the importance of pre-treatment QA study to predict QA changes in NUC nonresponders. Study of QA complexity could be useful for managing HBV infection.

  16. 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

  17. Review of evolution of clinical, training and educational services and research program for autism spectrum disorders in Hong Kong.

    Science.gov (United States)

    Wong, Virginia Chun-Nei; Fung, Cheuk-Wing; Lee, So-Lun; Wong, Polly Tsz Yan

    2015-10-01

    The evolution of a local fragmented model of services for children with autism in Hong Kong emerged gradually over the past three decades with lack of government funding or support. This had been due to increasing number of children with autism being detected and referred for earlier assessment. With increasing pressure from parents due to long waiting time for assessment and training services and the increasing polarization by mass media there had been a gradual increasing public awareness over the past five years. Though still highly fragmented in the availability of services, there is a growing "business model" available in the community due to increasing need and lack of public funding for support. There is a lack of strategic planning for medical diagnostic and management issues in Hong Kong. Our University of Hong Kong based Autism Research Program was pioneered in 1985 based on the increasing load of autism cases referred for assessment for other developmental problems and diagnosed as Autism in the Duchess of Kent Children's Hospital. As the first author has been the staff of the University of Hong Kong, this program flourished as a research based program. The benefits of early identification and intervention of autism spectrum disorder (ASD) had been increasingly recognized, and with the increased public awareness and increasing trend of earlier diagnosis, there has been a continuously high demand from parents for earlier assessment and training for children suspected to have ASD. This model had not received extra funding for this integrated program for research, teaching and training in autism. We had to apply for various donations and grants to support the development of this pioneer program. The research output and organization of forums for public education and awareness are reviewed. The latter part of the paper reports the summary of clinical profile of autism cases (N=1441) assessed from 1985 to 2010 June under the University of Hong Kong. As the

  18. Second Trimester Maternal Serum Screening

    Science.gov (United States)

    ... Global Sites Search Help? Second Trimester Maternal Serum Screening Share this page: Was this page helpful? Also ... should know? How is it used? Maternal serum screening is used in the second trimester of pregnancy ...

  19. [A Maternal Health Care System Based on Mobile Health Care].

    Science.gov (United States)

    Du, Xin; Zeng, Weijie; Li, Chengwei; Xue, Junwei; Wu, Xiuyong; Liu, Yinjia; Wan, Yuxin; Zhang, Yiru; Ji, Yurong; Wu, Lei; Yang, Yongzhe; Zhang, Yue; Zhu, Bin; Huang, Yueshan; Wu, Kai

    2016-02-01

    Wearable devices are used in the new design of the maternal health care system to detect electrocardiogram and oxygen saturation signal while smart terminals are used to achieve assessments and input maternal clinical information. All the results combined with biochemical analysis from hospital are uploaded to cloud server by mobile Internet. Machine learning algorithms are used for data mining of all information of subjects. This system can achieve the assessment and care of maternal physical health as well as mental health. Moreover, the system can send the results and health guidance to smart terminals. PMID:27382731

  20. 早发型子痫前期孕妇血清sFlt-1及NO水平与临床意义%Maternal serum sFlt-1 and NO levels and clinical significance in early onset preeclampsia

    Institute of Scientific and Technical Information of China (English)

    周敏

    2016-01-01

    目的:探讨早发型子痫前期孕妇血清可溶性血管内皮生长因子受体1(sFlt -1)及一氧化氮(NO)水平与临床意义。方法选择子痫前期孕妇共78例,分为早发型子痫前期组(21例)与晚发型子痫前期组(57例),另外选择正常分娩的妊娠妇女共60例为对照组。检测各组孕妇血清 sFlt -1及 NO 水平,并进行比较分析。结果早发型子痫前期组患者血清 sFlt -1水平显著高于晚发型子痫前期组和对照组( P <0.05)。早发型子痫前期组血清 NO 水平显著低于晚发型子痫前期组和对照组( P <0.05)。Spearman 相关分析表明,在三组中,血清 sFlt -1与 NO 水平均存在较好的负相关性( r =-0.763;-0.712;-0.667,P 均<0.001)。结论 sFlt -1、NO 的变化参与了早发型子痫前期的病理生理过程,且两者有密切关系。监测两者的变化对早发型子痫前期病情评估与和治疗有重要意义。%Objective To investigate maternal serum sFlt - 1 and NO levels and clinical significance in early onset preeclampsia. Meth-ods A total of 78 cases of preeclampsia in pregnant women were collected and divided into early onset preeclampsia group(21 cases)and late on-set preeclampsia group(57 cases). In addition to this,we selected total of 60 normal delivery pregnant women the control group. Maternal serum levels of sFlt - 1and NO were detected and its clinical significance was analyzed. Results In the early onset preeclampsia group,serum sFlt -1levels were significantly higher than late onset preeclampsia group and control group. In early onset preeclampsia group,serum NO level was sig-nificantly lower than late onset preeclampsia group and the control group. Spearman correlation analysis showed that serum sFlt - 1and NO levels were negatively correlated with the presence of a good( r = - 0. 763;- 0. 712;- 0. 667,P < 0. 001)in the three groups. Conclusion sFlt -1 and NO are involved in the

  1. Maternal Depression Predicts Maternal Use of Corporal Punishment in Children with Attention-Deficit / Hyperactivity Disorder

    OpenAIRE

    Shin, Dong-Won; Stein, Mark A.

    2008-01-01

    Purpose We sought to determine if maternal depression contributed to the use of corporal punishment in children with attention-deficit/hyperactivity disorder (ADHD). Patients and Methods The data were gathered through chart review of clinic-referred children with ADHD and their mothers who were evaluated at a psychiatric clinic located in a large academic medical center in Seoul, Korea. Daily records kept by parents and 13 items from the Physical Assault of the Parent-Child Conflict Tactics S...

  2. Neuroendocrine control of maternal behaviour

    OpenAIRE

    Caughey, Sarah Dawn

    2011-01-01

    Maternal behaviour during the peri-partum period, albeit in differing forms, can be observed in all mammals, thus it must serve an important evolutionary purpose in enabling the successful raising of offspring. Maternal behaviour is comprised of a large suite of behaviours; in rodents these are generally defined as lactation, pup retrieval, maternal aggression and pup grooming. The maternal behaviour circuitry involves many brain regions including the hypothalamus and the limbi...

  3. The Clinical Value of the Influence of Maternal BMI on Birth Weight%体重指数对新生儿体重影响的临床价值分析

    Institute of Scientific and Technical Information of China (English)

    覃利美; 许建玉; 陈静芬

    2012-01-01

    目的:分析体重指数(BMI)对新生儿体重影响的临床价值.方法:收集2008年6月至2011年6月在我院产科分娩的BMI≥28的孕妇359例作为产前肥胖组,同期分娩的BMI<28的孕妇359例作为产前体重正常组,分析其分娩前BMI与新生儿体重的相关性.结果:产前肥胖组新生儿体重及巨大儿的发生率高于产前体重正常组,两者比较差异均具有显著性(P<0.05).结论:分娩前BMI与新生儿体重密切相关,高BMI增加巨大儿的发生风险.%Objective:To analyze the clinical value of the influence of maternal BMI on birth weight.Methods:359 cases of pregnant women with BMI>28 for regular prenatal care and laboring in our hospital between Mar.2008 and Jun.2011 were collected as the antenatal obesity group, 359 cases of pregnant women with BMK28 as antenatal normal weight group. Analyzing the correlation between the BMI and birth weight.Resuits:The birth weight of the antenatal obesity group were higher than that of the antenatal normal weight group, the difference were statistically significant (P<0.05); The incidence of fetal growth of the antenatal obesity group were higher than that of the antenatal normal weight group, the difference were statistically significant (P<0.05). Conclusion:The birth weight is closely related to BMI, high BMI can increase the risk of fetal growth.

  4. Maternal floor infarction: management of an underrecognized pathology.

    Science.gov (United States)

    Al-Sahan, Nada; Grynspan, David; von Dadelszen, Peter; Gruslin, Andrée

    2014-01-01

    Maternal floor infarction is a relatively rare condition characterized clinically by severe early onset fetal growth restriction with features of uteroplacental insufficiency. It has a very high recurrence rate and carries a significant risk or fetal demise. Pathological characteristics include massive and diffuse fibrin deposition along the decidua basalis and the perivillous space of the basal plate. We present a case of recurrent maternal floor infarction and propose diagnostic clues as well as potential therapeutic options.

  5. Creating a Culture of Consumer Engagement in Maternity Care

    OpenAIRE

    Romano, Amy M.

    2010-01-01

    In this column, the author reprises recent selections from the Lamaze International research blog, Science & Sensibility. Each selection discusses opportunities to establish a culture of consumer engagement in maternity care. The author demonstrates how improving health literacy, ensuring multi-stakeholder participation in the development of clinical guidelines, and supporting comparative effectiveness research of woman- and family-centered care practices may improve maternity care.

  6. Partner relationship satisfaction and maternal emotional distress in early pregnancy

    OpenAIRE

    Eberhard-Gran Malin; Slinning Kari; Røsand Gun-Mette B; Røysamb Espen; Tambs Kristian

    2011-01-01

    Background Recognition of maternal emotional distress during pregnancy and the identification of risk factors for this distress are of considerable clinical- and public health importance. The mental health of the mother is important both for herself, and for the physical and psychological health of her children and the welfare of the family. The first aim of the present study was to identify risk factors for maternal emotional distress during pregnancy with special focus on...

  7. 孕妇外周血中游离胎儿DNA检测在无创产前诊断中的临床应用%Clinical application of noninvasive prenatal diagnosis using cell free fetal DNA in maternal plasma

    Institute of Scientific and Technical Information of China (English)

    侯巧芳; 吴东; 楚艳; 康冰; 廖世秀; 杨艳丽; 张朝阳; 张菊新; 吴刚

    2012-01-01

    Objective To investigate the clinical value of non-invasive prenatal diagnosis using cell free fetal DNA(cff-DNA)in maternal blood.Methods From Sep.2010 to Mar.2012,103 pregnant women who came to Henan Province People's Hospital in the first trimestcr for prenatal diagnosis of scx-linked inherited diseases were included in the first trimester group.From Oct.2010 to Jan.2012,205 pregnant women undergoing amniotic fluid sampling for fetal karyotype analysis in the same hospital were included in the second trimester group.Real time quantitative PCR and fluorescent PCR were used to detect sex determining region of Y chromosome gene(SRY)and amelogenin gene(AML)on cff-DNA of the first trimester group.Moreover,12 Y chromosome STR loci analysis were performed for 33 male fetuses and their fathers.Massively Parallel Signature Sequencing(MPSS)was used for aneuploidy analysis in cff-DNA of the second trimester group.Results(1)In the first trimester group,there were 53 SRY positive and 50 SRY negative.Compared with the results of cff-DNA of chorionic villus samples,there was one SRY false positive and one false negative results,with a sensitivity of 98% and specificity of 98%.For the AML gene test,there were two PCR products of male fetuses:102 bp fragment originating from X chromosome(AML X)and 108 bp fragment from Y chromosome(AML Y);but only AML X was found in products from female fetuses.In the first trimester group,102 bp and 108 bp fragments were detected in 52 cases,and only 102 bp fragment was found in the other cases.Compared to AML results from chorionic villus samples,there were 2 false negative results,with a sensitivity of 96% and specificity of 100%.(2)For cff-DNA with plasma SRY over 30 copy/ml,Y STR loci were analyzed on cff-DNA of 33 fetuses and their fathers.The Y STR loci less then 200 bp were successfully detected,while Y STR loci with PCR products between 200-300 bp showed low signal or could not be amplicated;and no PCR products more than 300 bp

  8. Fetal and Maternal Effects of Vitamin D

    OpenAIRE

    Ayşenur Alper Gürz1; Füsun Ayşin Artıran İğde1; Mustafa Fevzi Dikici1

    2015-01-01

    Since in the early 1900s, the relationship between vitamin D and human health was discovered which led to a cure for rickets. In recent years, studies suggest that besides the rickets, vitamin D deficiency may also have an important role in the development of some clinical situations such as diabetes, coronary heart disease, psoriasis, multiple sclerosis and tuberculosis. In addition, many studies showed that the maternal vitamin D deficiency during pregnancy influence the development of pree...

  9. Maternal immunization efforts of the National Institutes of Health.

    Science.gov (United States)

    Rubin, Fran A; Koso-Thomas, Marion; Isaacs, Maggie Brewinski; Piper, Jeanna; Read, Jennifer; Nesin, Mirjana

    2015-11-25

    Over the last 35 years, efforts at the National Institutes of Health (NIH) to protect mothers and their infants against infectious diseases have involved a bench-to-bedside approach. Basic and translational research that provided a foundation for clinical trials of vaccines in pregnancy include natural history and vaccine antigen identification studies. Development of laboratory assays and reagents have been funded by NIAID; these are critical for the advancement of vaccine candidates through the preclinical and clinical steps along the maternal immunization research pathway to support vaccine efficacy. Animal models of maternal immunization have been developed to evaluate efficacy of vaccine candidates. Clinical studies required development of maternal immunization protocols to address specific pregnancy related issues, for enrollment and safety assessment of mothers and their infants. NIH has organized and participated in meetings, workshops and other collaborative efforts with partners have advanced maternal immunization efforts. Partners have included many institutes and offices at NIH as well as other Department of Health and Human Services agencies and offices (Food and Drug Administration, Centers for Disease Control and Prevention, National Vaccine Program Office), World Health Organization, academic investigators, Biotech and pharmaceutical companies, and nonprofit organizations such as the Bill and Melinda Gates Foundation. These research and development partnership are essential for advancing maternal immunization. Continued efforts are needed to promote maternal immunization to protect pregnant women and their infants against vaccine-preventable infectious disease, especially in resource-limited settings where the burden of infections is high. PMID:26458798

  10. Postsplenectomy sclerosing extramedullary hematopoietic tumor with unexpected good clinical evolution: morphologic, immunohistochemical, and molecular analysis of one case and review of the literature.

    Science.gov (United States)

    Gualco, Gabriela; Ojopi, Elida B P; Chioato, Lucimara; Cordeiro, Danielle Leão; Negretti, Fabio; Bacchi, Carlos E

    2010-05-01

    Sclerosing extramedullary hematopoietic tumor has been described as a rare manifestation of chronic myeloproliferative neoplasm. The lack of knowledge about this entity has caused it to be mistaken for many types of nonhematopoietic and hematopoietic tumors. We present the case of a 71-year-old lady with a long history of primary myelofibrosis, which developed multiple abdominal sclerosing extramedullary hematopoietic tumors with good clinical evolution. Nonchronic myeloid leukemia myeloproliferative neoplasm included a JAK2 mutation as part of the diagnosis algorithm. Particularly, idiopathic myelofibrosis is related with a JAK2 mutation in 50% of the cases with a pejorative prognosis. The absence of JAK2 demonstrated in the paraffin samples of the tumors may be related to the unusual evolution in this particular case. Morphologically differential diagnoses considered in the evaluation of this entity and in our case included sarcomas mainly liposarcoma, anaplastic carcinoma, and Hodgkin lymphoma.

  11. Maternal Sexuality and Breastfeeding

    Science.gov (United States)

    Bartlett, Alison

    2005-01-01

    In this paper I consider the ways in which lactation has been discussed as a form of maternal sexuality, and the implications this carries for our understanding of breastfeeding practices and sexuality. Drawing on knowledge constructed in the western world during the last half of the twentieth century, the paper identifies a shift between the…

  12. Maternal temperature during labour

    NARCIS (Netherlands)

    Schouten, F. D.; Wolf, H.; Smjt, B. J.; Bekedam, D. J.; de Vos, R.; Wahlen, I.

    2008-01-01

    Objective The aim of this study was to describe the variation of normal maternal temperature during labour. Design A prospective cohort study. Setting Two hospitals in Amsterdam, the Netherlands. Population All women with a live singleton pregnancy and a gestational age of 36 weeks or more admitted

  13. Study of maternal deaths in Kerian (1976 - 1980).

    Science.gov (United States)

    Yadav, H

    1982-06-01

    An investigation was conducted of all maternal deaths by residence which occurred in the district of Kerian, Malaysia over the 1976-1980 period. All female deaths between the years 15-45 were investigated to identify whether it was a maternal death due to obstetrical cause or otherwise. Each of the cases was investigated by the public health nurse, public health sister, and the medical officer of health before a report was made. All the maternal death reports from 1976-1980 were studied and a report compiled. The health infrastructure of Kerian district consists of 1 district hospital with 141 beds, 8 health centers, and 32 midwife clinics. The total number of deliveries in Kerian from 1976-1980 was 22,977. The hospital deliveries constituted 7040 (30.6%), the government midwives 6395 (27.8%), and traditional birth attendants (TBAs) 9505 (41.4%). The period 1976-1980 showed a decline in the various mortality rates. The infant mortality rate which is 27.11/1000 declined by 33% from 1976-1980 and toddler mortality rate declined by 37.7% from 1976-1980. The most significant decline was maternal mortality which declined from 1.89/1000 live births to 1.10/1000 live births which registered a 41.8% decline. There were a total of 35 maternal deaths registered from 1976-1980 in the district. Ethnically the Malays constituted 32 (91.4%) of all deaths and Chinese 2 (5.7%) of all deaths with Indians with 1 death (2.8%). Most of the women were from the lower income group. 19 (54.3%) of the women died at home, and 15 (42.8%) died in the hospitals. Most of the women died at gravida 6-9. Gravida 1 had 8 or 22.8% of all maternal deaths. Para 0 consisted of 9 (25.7%) of all maternal deaths and para 6 and above consisted of 11 (31.4%) of all maternal deaths. Women in the 31-40 year age group had 57.2% of the maternal deaths. PPH and PPH with retained placenta were the main causes of the maternal deaths, constituting 60% of the maternal deaths. In 1980 all 5 maternal deaths were due

  14. Aspectos clínicos e evolutivos da hidrocefalia na neurocisticercose Clinical and evolutive aspects of hydrocephalus in neurocysticercosis

    Directory of Open Access Journals (Sweden)

    Svetlana Agapejev

    2007-09-01

    Full Text Available Com o propósito de analisar os aspectos clínicos da hidrocefalia (HDC na neurocisticercose (NCC, realizou-se o estudo retrospectivo de 47 prontuários de pacientes com HDC e NCC. Verificou-se que 70,2% eram homens, entre 21 e 50 anos. A hipertensão intracraniana (HIC ocorreu em todos os pacientes, cefaléia (CEF em 89,4%, meningoencefalite (ME em 80,8% e distúrbios psíquicos (PSI em 74,5%. A síndrome liquórica da NCC foi detectada em 65,9% pacientes. Além da HDC, as tomografias computadorizadas de crânio (TC mostraram lesões císticas e edema cerebral difuso em 59,6% cada, calcificações em 55,3%. Dos 41 pacientes (87,2% com derivação ventriculoperitoneal (DVP, em 22 (53,7% deles foram necessárias uma a sete revisões/paciente (média=3. A evolução foi satisfatória em 51,1% e fatal em 31,9%. Conclui-se que a hidrocefalia é mais comum no sexo masculino em idade produtiva, tendo a HIC, CEF, MN e PSI como manifestações freqüentes e que, a necessidade de revisões de DVP, piora o prognóstico.With the purpose to verify clinical aspects of hydrocephalus (HC in patients with neurocysticercosis (NCC, a retrospective study of 47 patients was performed. The majority of patients (70.2% were men aging 21-50 years. Intracranial hypertension (ICH occurred in all patients, headache (HA in 42 (89.4%, meningoencephalitis (ME in 38 (80.8% and psychiatric disorders (PD in 34 (72.3%. The cerebrospinal fluid syndrome of NCC was detected in 31 patients (65.9%. In addition to HC, computed tomography (CT scans showed cystic lesions in 28 (59.6% patients, diffuse brain edema also in 28 (59.6%, and calcifications in 26 (55.3%. Shunts were inserted in 41 (87.2% patients and 22 (53.7% of them were submitted to 1-7 surgical revision/patient (mean=3 that were higher (mean=4 in those who died than in survivors (mean=2. Evolution was satisfactory in 24 (51.1% patients and fatal in 15 (31.9%. It is possible to conclude that, in patients with NCC, HC occurs

  15. Classification differences and maternal mortality

    DEFF Research Database (Denmark)

    Salanave, B; Bouvier-Colle, M H; Varnoux, N;

    1999-01-01

    of experts into obstetric or non-obstetric causes. An ICD-9 code (International Classification of Diseases) was attributed to each case. These were compared to the codes given in each country. Correction indices were calculated, giving new estimates of maternal mortality rates. SUBJECTS: There were....... This change was substantial in three countries (P maternal mortality rate for participating countries was 7.7 per...... and consequently affect maternal mortality rates. Differences in classification of death must be taken into account when comparing maternal mortality rates, as well as differences in obstetric care, underreporting of maternal deaths and other factors such as the age distribution of mothers....

  16. Links between maternal postpartum depressive symptoms, maternal distress, infant gender and sensitivity in a high-risk population

    Directory of Open Access Journals (Sweden)

    Eickhorst Andreas

    2011-03-01

    Full Text Available Abstract Background Maternal postpartum depression has an impact on mother-infant interaction. Mothers with depression display less positive affect and sensitivity in interaction with their infants compared to non-depressed mothers. Depressed women also show more signs of distress and difficulties adjusting to their role as mothers than non-depressed women. In addition, depressive mothers are reported to be affectively more negative with their sons than with daughters. Methods A non-clinical sample of 106 mother-infant dyads at psychosocial risk (poverty, alcohol or drug abuse, lack of social support, teenage mothers and maternal psychic disorder was investigated with EPDS (maternal postpartum depressive symptoms, the CARE-Index (maternal sensitivity in a dyadic context and PSI-SF (maternal distress. The baseline data were collected when the babies had reached 19 weeks of age. Results A hierarchical regression analysis yielded a highly significant relation between the PSI-SF subscale "parental distress" and the EPDS total score, accounting for 55% of the variance in the EPDS. The other variables did not significantly predict the severity of depressive symptoms. A two-way ANOVA with "infant gender" and "maternal postpartum depressive symptoms" showed no interaction effect on maternal sensitivity. Conclusions Depressive symptoms and maternal sensitivity were not linked. It is likely that we could not find any relation between both variables due to different measuring methods (self-reporting and observation. Maternal distress was strongly related to maternal depressive symptoms, probably due to the generally increased burden in the sample, and contributed to 55% of the variance of postpartum depressive symptoms.

  17. The Impact of Cardiac Diseases during Pregnancy on Severe Maternal Morbidity and Mortality in Brazil.

    Directory of Open Access Journals (Sweden)

    Felipe F Campanharo

    Full Text Available To evaluate maternal heart disease as a cause or complicating factor for severe morbidity in the setting of the Brazilian Network for Surveillance of Severe Maternal Morbidity.Secondary data analysis of this multicenter cross-sectional study was implemented in 27 referral obstetric units in Brazil. From July 2009 to June 2010, a prospective surveillance was conducted among all delivery hospitalizations to identify cases of severe maternal morbidity (SMM, including Potentially Life-Threatening Conditions (PLTC and Maternal Near Miss (MNM, using the new criteria established by the WHO. The variables studied included: sociodemographic characteristics, clinical and obstetric history of the women; perinatal outcome and the occurrence of maternal outcomes (PLTC, MNM, MD between groups of cardiac and non-cardiac patients. Only heart conditions with hemodynamic impact characterizing severity of maternal morbidity were considered. 9555 women were included in the Network with severe pregnancy-related complications: 770 maternal near miss cases and 140 maternal death cases. A total of 293 (3.6% cases were related to heart disease and the condition was known before pregnancy in 82.6% of cases. Maternal near miss occurred in 15% of cardiac disease patients (most due to clinical-surgical causes, p<0.001 and 7.7% of non-cardiac patients (hemorrhagic and hypertensive causes, p<0.001. Maternal death occurred in 4.8% of cardiac patients and in 1.2% of non-cardiac patients, respectively.In this study, heart disease was significantly associated with a higher occurrence of severe maternal outcomes, including maternal death and maternal near miss, among women presenting with any severe maternal morbidity.

  18. Partner relationship satisfaction and maternal emotional distress in early pregnancy

    Directory of Open Access Journals (Sweden)

    Eberhard-Gran Malin

    2011-03-01

    Full Text Available Abstract Background Recognition of maternal emotional distress during pregnancy and the identification of risk factors for this distress are of considerable clinical- and public health importance. The mental health of the mother is important both for herself, and for the physical and psychological health of her children and the welfare of the family. The first aim of the present study was to identify risk factors for maternal emotional distress during pregnancy with special focus on partner relationship satisfaction. The second aim was to assess interaction effects between relationship satisfaction and the main predictors. Methods Pregnant women enrolled in the Norwegian Mother and Child Cohort Study (n = 51,558 completed a questionnaire with questions about maternal emotional distress, relationship satisfaction, and other risk factors. Associations between 37 predictor variables and emotional distress were estimated by multiple linear regression analysis. Results Relationship dissatisfaction was the strongest predictor of maternal emotional distress (β = 0.25. Other predictors were dissatisfaction at work (β = 0.11, somatic disease (β = 0.11, work related stress (β = 0.10 and maternal alcohol problems in the preceding year (β = 0.09. Relationship satisfaction appeared to buffer the effects of frequent moving, somatic disease, maternal smoking, family income, irregular working hours, dissatisfaction at work, work stress, and mother's sick leave (P Conclusions Dissatisfaction with the partner relationship is a significant predictor of maternal emotional distress in pregnancy. A good partner relationship can have a protective effect against some stressors.

  19. Maternal near miss: an indicator for maternal health and maternal care.

    Science.gov (United States)

    Chhabra, Pragti

    2014-07-01

    Maternal mortality is one of the important indicators used for the measurement of maternal health. Although maternal mortality ratio remains high, maternal deaths in absolute numbers are rare in a community. To overcome this challenge, maternal near miss has been suggested as a compliment to maternal death. It is defined as pregnant or recently delivered woman who survived a complication during pregnancy, childbirth or 42 days after termination of pregnancy. So far various nomenclature and criteria have been used to identify maternal near-miss cases and there is lack of uniform criteria for identification of near miss. The World Health Organization recently published criteria based on markers of management and organ dysfunction, which would enable systematic data collection on near miss and development of summary estimates. The prevalence of near miss is higher in developing countries and causes are similar to those of maternal mortality namely hemorrhage, hypertensive disorders, sepsis and obstructed labor. Reviewing near miss cases provide significant information about the three delays in health seeking so that appropriate action is taken. It is useful in identifying health system failures and assessment of quality of maternal health-care. Certain maternal near miss indicators have been suggested to evaluate the quality of care. The near miss approach will be an important tool in evaluation and assessment of the newer strategies for improving maternal health.

  20. Maternal near miss: An indicator for maternal health and maternal care

    Directory of Open Access Journals (Sweden)

    Pragti Chhabra

    2014-01-01

    Full Text Available Maternal mortality is one of the important indicators used for the measurement of maternal health. Although maternal mortality ratio remains high, maternal deaths in absolute numbers are rare in a community. To overcome this challenge, maternal near miss has been suggested as a compliment to maternal death. It is defined as pregnant or recently delivered woman who survived a complication during pregnancy, childbirth or 42 days after termination of pregnancy. So far various nomenclature and criteria have been used to identify maternal near-miss cases and there is lack of uniform criteria for identification of near miss. The World Health Organization recently published criteria based on markers of management and organ dysfunction, which would enable systematic data collection on near miss and development of summary estimates. The prevalence of near miss is higher in developing countries and causes are similar to those of maternal mortality namely hemorrhage, hypertensive disorders, sepsis and obstructed labor. Reviewing near miss cases provide significant information about the three delays in health seeking so that appropriate action is taken. It is useful in identifying health system failures and assessment of quality of maternal health-care. Certain maternal near miss indicators have been suggested to evaluate the quality of care. The near miss approach will be an important tool in evaluation and assessment of the newer strategies for improving maternal health.

  1. Maternal depression and the learning-promoting effects of infant-directed speech: Roles of maternal sensitivity, depression diagnosis, and speech acoustic cues.

    Science.gov (United States)

    Kaplan, Peter S; Danko, Christina M; Cejka, Anna M; Everhart, Kevin D

    2015-11-01

    The hypothesis that the associative learning-promoting effects of infant-directed speech (IDS) depend on infants' social experience was tested in a conditioned-attention paradigm with a cumulative sample of 4- to 14-month-old infants. Following six forward pairings of a brief IDS segment and a photographic slide of a smiling female face, infants of clinically depressed mothers exhibited evidence of having acquired significantly weaker voice-face associations than infants of non-depressed mothers. Regression analyses revealed that maternal depression was significantly related to infant learning even after demographic correlates of depression, antidepressant medication use, and extent of pitch modulation in maternal IDS had been taken into account. However, after maternal depression had been accounted for, maternal emotional availability, coded by blind raters from separate play interactions, accounted for significant further increments in the proportion of variance accounted for in infant learning scores. Both maternal depression and maternal insensitivity negatively, and additively, predicted poor learning.

  2. The Impact of Cardiac Diseases during Pregnancy on Severe Maternal Morbidity and Mortality in Brazil

    Science.gov (United States)

    Campanharo, Felipe F.; Cecatti, Jose G.; Haddad, Samira M.; Parpinelli, Mary A.; Born, Daniel; Costa, Maria L.; Mattar, Rosiane

    2015-01-01

    Background To evaluate maternal heart disease as a cause or complicating factor for severe morbidity in the setting of the Brazilian Network for Surveillance of Severe Maternal Morbidity. Methods and Findings Secondary data analysis of this multicenter cross-sectional study was implemented in 27 referral obstetric units in Brazil. From July 2009 to June 2010, a prospective surveillance was conducted among all delivery hospitalizations to identify cases of severe maternal morbidity (SMM), including Potentially Life-Threatening Conditions (PLTC) and Maternal Near Miss (MNM), using the new criteria established by the WHO. The variables studied included: sociodemographic characteristics, clinical and obstetric history of the women; perinatal outcome and the occurrence of maternal outcomes (PLTC, MNM, MD) between groups of cardiac and non-cardiac patients. Only heart conditions with hemodynamic impact characterizing severity of maternal morbidity were considered. 9555 women were included in the Network with severe pregnancy-related complications: 770 maternal near miss cases and 140 maternal death cases. A total of 293 (3.6%) cases were related to heart disease and the condition was known before pregnancy in 82.6% of cases. Maternal near miss occurred in 15% of cardiac disease patients (most due to clinical-surgical causes, pnear miss, among women presenting with any severe maternal morbidity. PMID:26650684

  3. Maternal depression during pregnancy and offspring depression in adulthood:role of child maltreatment

    OpenAIRE

    Plant, Dominic T; Pariante, Carmine M.; Sharp, Deborah; Pawlby, Susan

    2015-01-01

    Background: Studies have shown that maternal depression during pregnancy predicts offspring depression in adolescence. Child maltreatment is also a risk factor for depression.Aims: To investigate (a) whether there is an association between offspring exposure to maternal depression in pregnancy and depression in early adulthood, and (b) whether offspring child maltreatment mediates this association.Method: Prospectively collected data on maternal clinical depression in pregnancy, offspring chi...

  4. Is Maternal PTSD Associated with Greater Exposure of Very Young Children to Violent Media?

    OpenAIRE

    Schechter, Daniel S.; Gross, Anna; Willheim, Erica; McCaw, Jaime; Turner, J. Blake; Myers, Michael M.; Zeanah, Charles H.; Gleason, Mary Margaret

    2009-01-01

    This study examined media-viewing by mothers with violence-related posttraumatic stress disorder (PTSD) and related media exposure of their preschool-age children. Mothers (N = 67) recruited from community pediatric clinics participated in a protocol involving a media-preference survey. Severity of maternal PTSD and dissociation were significantly associated with child exposure to violent media. Family poverty and maternal viewing-behavior were also associated. Maternal viewing-behavior media...

  5. Mother-Child Disagreement in Reports of Child Anxiety: Effects of Child Age and Maternal Anxiety

    OpenAIRE

    Niditch, Laura A.; Varela, R. Enrique

    2010-01-01

    The present study examined effects of maternal anxiety, child age, and their interaction on mother-child anxiety reporting disagreement while taking into account the direction of each informant's report relative to the other. Participants were 41 dyads of mothers and clinically anxious children aged 7-13. A hierarchical regression revealed a significant interaction between maternal anxiety and child age (β = .30, p < .05). A graph of this interaction indicated that when maternal anxiety is hi...

  6. [New data on maternal mortality in India].

    Science.gov (United States)

    Bhatia, J C

    1990-01-01

    A survey was carried out in urban and rural areas of the district of Anantapur, Andhra Pradesh state, India, between July 1, 1984-June 30, 1985 by a team of 6 interviewers and 1 supervisor to identify investigate, and study the causative factors/characteristics of the causes of maternal deaths. They visited each of the 15 hospitals in the district collecting information about maternal deaths that occurred in the reproductive age range of 15-49 years. 22 health centers and 50% of subcenters were also visited, registers were examined, and staff and families were also interviewed. The hospitals and centers served 569,500 people. During the 1st phase in the rural area all main village centers, 181 village subcenters, and 1192 other villages in the district with a total population of 1,090,640 were covered. During the 2nd phase all towns in the urban zones, 10 primary centers, 65 subcenters, and 135 others were visited. The maternal mortality rate was 7.9/1000 live births, well above the national average. 36% of female mortality occurred in women in reproductive age, but fewer than 1/2 of these deaths were registered and only 1/3 figured in center and subcenter records. In rural areas maternal mortality was 8.3/1000, ahead of the urban rate of 5.4/1000. 63% of 284 deaths detailed were related to live births, 14% to stillbirths, 10% to abortions, and 13% to obstructed labor. 19% of total maternal deaths occurred before birth, 12% during labor, and 69% after delivery. Among clinical causes of death sepsis accounted for 36%, hemorrhage for 12%, eclampsia for 9%, retention of placenta for 7%, and infectious hepatitis for 10%. 80% of these deaths could have been avoided by timely antenatal care, treatment of previous complaints, and medical attention and hospitalization at the right time. PMID:12179349

  7. Maternal obesity and pregnancy.

    Science.gov (United States)

    Johnson, S R; Kolberg, B H; Varner, M W; Railsback, L D

    1987-05-01

    We examined the risk of maternal obesity in 588 pregnant women weighing at least 113.6 kilograms (250 pounds) during pregnancy. Compared with a control group matched for age and parity, we found a significantly increased risk in the obese patient for gestational diabetes, hypertension, therapeutic induction, prolonged second stage of labor, oxytocin stimulation of labor, shoulder dystocia, infants weighing more than 4,000 grams and delivery after 42 weeks gestation. Certain operative complications were also more common in obese women undergoing cesarean section including estimated blood loss of more than 1,000 milliliters, operating time of more than two hours and wound infection postoperatively. These differences remained significant after controlling for appropriate confounding variables. We conclude that maternal obesity should be considered a high risk factor.

  8. Evolução clínica e laboratorial de recém-nascidos de mães HIV positivas Clinical and laboratory evolution of children born to HIV positive mothers

    Directory of Open Access Journals (Sweden)

    Cristina Erico Yoshimoto

    2005-04-01

    Full Text Available A transmissão vertical do HIV (vírus da imunodeficiência humana tornou-se o principal alvo da profilaxia com zidovudina (AZT, utilizada durante a gestação, parto e no recém-nascido (RN. OBJETIVO: Caracterizar a evolução clínica e laboratorial de RN de mães portadoras do HIV. MÉTODOS: Estudo prospectivo entre 64 RN de mães portadoras do HIV classificados em dois grupos: grupo A constituído de 23 pares de mães e RN que não receberam o AZT, grupo B constituído de 41 pares que receberam AZT em alguma fase da profilaxia. RESULTADOS: A média de idade materna foi de 26,8 anos, o uso de drogas ilícitas ocorreu em 17,2% das gestantes, 20 (31,3% das gestantes apresentavam doenças. Não houve diferenças significativas entre os grupos quanto a freqüência de pré-natal, doenças maternas, antropometria de nascimento e do crescimento durante o seguimento. Os grupos de estudo apresentaram hemogramas e contagens de linfócitos semelhantes. A negativação sorológica ocorreu em média aos 16 meses. A transmissão vertical ocorreu em seis crianças (9,3% e nenhuma criança foi infectada no subgrupo que recebeu a profilaxia em todas as fases. CONCLUSÃO: A profilaxia com AZT em todos os períodos recomendados e o seguimento a longo prazo dos RN de mães HIV positivas constitui uma das melhores estratégias para prevenção da Aids na infância.The vertical transmission of HIV (Human Immunodeficiency Virus has become the main target of prophylactic Zidovudina (AZT therapy during gestation, parturition as well as for the newborn. BACKGROUND: To characterize the clinical and laboratory evolution of HIV exposed children. METHODS: Prospective study of 64 HIV exposed children, classified into two groups. Group A, made up of 23 pairs of mothers and newborns, who did not receive AZT; Group B, made up of 41 pairs, who received AZT at some stage of prophylaxis. RESULTS: The average maternal age was 26.8 years, the use of illicit drugs occurred in 17

  9. AN AUDIT OF MATERNAL DEATHS

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    Basavana Gowda

    2015-03-01

    Full Text Available OBJECTIVES: A study of maternal death conducted to evaluate various factors responsible for maternal deaths. To identify complications in pregnancy, a childbirth which result in maternal death, and to identify opportunities for preventive intervention and understand the events leading to death; so that improving maternal health and reducing maternal mortality rate significantly. To analyze the causes and epidemiological amounts maternal mortality e.g. age parity, socioeconomic status and literacy. In order to reduce maternal mortality and to implement safe motherhood program and complications of pregnancy and to find out safe motherhood program. METHODS: The data collected was a retrograde by a proforma containing particulars of the diseased, detailed history and relatives were interviewed for additional information. The data collected was analysed. RESULTS: Maternal mortality rate in our own institution is 200/ 100,000 live births. Among 30 maternal deaths, 56% deaths (17 were among low socio - economic status, groups 60% deaths among unbooked 53.5% deaths more along illiterates evidenced by direct and indirect deaths about 25% of deaths were preventable. CONCLUSION: Maternal death is a great tragedy in the family life. It is crusade to know not just the medical cause of the death but the circumstances what makes these continued tragic death even more unacceptable is that deaths are largely preventable

  10. Maternal mortality in Bijapur district

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    Vidya A. Thobbi

    2015-04-01

    Full Text Available Objectives: The objectives of this study is to evaluate the incidence of maternal deaths, causes responsible for maternal mortality, direct and indirect factors, and various preventable methods to reduce maternal mortality rate. Background: 95% of maternal deaths occur in Asia and Africa. The need for undertaking this study is to know the maternal mortality rate, analyze the causes and preventable factors of death occurring in the district of Bijapur, Karnataka, India. Methodology: It is a study of 2years from the Records of District Health Office and Institutions on maternal mortality from June 2011 to May 2013 in Bijapur. Results: In two years there were fifty eight maternal deaths and seventy nine thousand five hundred and sixty six live births, hence maternal mortality ratio was seventy three per lakh live births. Eighty two percent of maternal deaths occurred in families who belonged to Below Poverty Line. Prevalence of anemia in pregnancy was 79.3%. Severe anemia (Hemoglobin <7g% seen in 5.1% was the most common indirect cause of death. Forty three percent of the deaths occurred at private setups. Hemorrhage, Septicemia and Preeclampsia & Eclampsia were responsible for 44.82%, 15.51% and 6.89% respectively. Conclusion: Majority of the maternal deaths are preventable if these four delays are avoided: a Delay in identifying the problem. b Delay in seeking care. c Delay in reaching the referral institute. d Delay in getting treatment on reaching the referral institute.

  11. Identification and Evolution of Drug Efflux Pump in Clinical Enterobacter aerogenes Strains Isolated in 1995 and 2003

    OpenAIRE

    Jacqueline Chevalier; Céline Mulfinger; Eric Garnotel; Pierre Nicolas; Anne Davin-Régli; Jean-Marie Pagès

    2008-01-01

    BACKGROUND: The high mortality impact of infectious diseases will increase due to accelerated evolution of antibiotic resistance in important human pathogens. Development of antibiotic resistance is a evolutionary process inducing the erosion of the effectiveness of our arsenal of antibiotics. Resistance is not necessarily limited to a single class of antibacterial agents but may affect many unrelated compounds; this is termed 'multidrug resistance' (MDR). The major mechanism of MDR is the ac...

  12. Embryo-maternal communication

    DEFF Research Database (Denmark)

    Østrup, Esben; Hyttel, Poul; Østrup, Olga

    2011-01-01

    Communication during early pregnancy is essential for successful reproduction. In this review we address the beginning of the communication between mother and developing embryo; including morphological and transcriptional changes in the endometrium as well as epigenetic regulation mechanisms dire...... directing the placentation. An increasing knowledge of the embryo-maternal communication might not only help to improve the fertility of our farm animals but also our understanding of human health and reproduction....

  13. The Maternal Heroine

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    Jane Messer

    2013-08-01

    Full Text Available There is a Chinese curse quoted in glib desk calendars that have a phrase for each day: ‘May you live in interesting times’. In fiction, maternity has not often been seen as terribly interesting, and in the real world having babies often stops a mother from writing, off and on and even for years. The story of mothers and babies seems elusive, not fit for the imagination, for where’s the story? The ‘maternal heroine’, a protagonist and main character whose actions and identity are closely bound up with her work and experience of herself as a mother of young and dependent children, is rare. How could she not be? She’s busy giving off strong whiffs of routine. Where’s the drama in that? And what are babies? They’re not thinking, arguing agents for change—hardly protagonists—even if antagonistic at the cocktail hour. At least, that is one way of opening up the question of the maternal heroine.

  14. Clinical evolution of hyperthyroid patients treated with radioactive iodine and/or propylthiouracil, at Hospital Nacional de Geriatria y Gerontologia: January 2005 - August 2010

    International Nuclear Information System (INIS)

    The epidemiological and clinical characteristics of the elderly population with hyperthyroidism disorders are presented. The integral valuation was performed in the external consultation endocrinology of Hospital Nacional de Geriatria y Gerontologia. The approach to 81 patients with radioactive iodine and/or propylthiouracil is determined, its clinical evolution and possible side adverse effects to established treatment. An instrument was designed for the collection of data in the clinical records of the patients studied. The ANOVA analysis and Bonferroni Post Hoc test is performed to compare quantitative variables. The crossing of qualitative variables has used the Chi square with a confidence level of 95%. The toxic multinodular goiter has resulted the main etiology of the disease. The 24.7% of patients have presented cognitive impairment, 27.2% have showed suspicion of depressive disorders. Weight loss has been the most frequent suggestive clinical symptom and propylthiouracil the main antithyroid treatment. Better detection in such patients is obtained and has helped to establish in a timely manner the best available therapeutic. Likewise, morbidity is reduced

  15. Alarmingly High Maternal Mortality in 21st Century

    Directory of Open Access Journals (Sweden)

    Dilpreet Kaur, Vaneet Kaur, Veronica Irene Yuel

    2007-07-01

    Full Text Available The study was conducted to determine the maternal mortality rate (MMR, various factors affecting itand possible prevention of maternal deaths in Christian Medical College & Hospital, a tertiary careinstitute during the past five years (2001- 2005. The individual record of maternal deaths was studiedregarding their socio-demographic features, causes, modes of management and ultimate outcome. TheMaternal Mortality rate was 1470 per lac live births. The major obstetrical complications accounted formore than three fourth of maternal deaths with hemorrhage (33%, sepsis (21.7% and eclampsia (7.5%playing an important role. Anemia (44.3% and jaundice (16.0% were two important indirect causes ofmaternal deaths. Un-booked cases accounted for majority of maternal deaths. Only two maternal mortalitypatients were showing regularly in our institute, rest all of the patients either had no antenatal check-up orwere having ANC in private clinics and were referred as an emergency in critical condition. More than90% of maternal deaths hailed from rural and urban slum areas. 61 (57.8% cases received primary carefrom untrained birth attendants and 11 (10.4% did not receive primary care in any form. There wasdelayed referral by the untrained personnel, 49 (46.2% patients were referred after more than 48 hours ofacute emergency, 51 (48.1% died between 24 to 48 hours and 25 (23.6% died within 24 hours ofadmission in spite of all resuscitative measures. It is concluded that providing good antenatal care, findingappropriate ways of preventing and dealing with the consequences of unwanted pregnancies, and improvingthe way society looks after pregnant women are three most important ways to reduce maternal mortality.

  16. Fetal microchimerism and maternal health: a review and evolutionary analysis of cooperation and conflict beyond the womb.

    Science.gov (United States)

    Boddy, Amy M; Fortunato, Angelo; Wilson Sayres, Melissa; Aktipis, Athena

    2015-10-01

    The presence of fetal cells has been associated with both positive and negative effects on maternal health. These paradoxical effects may be due to the fact that maternal and offspring fitness interests are aligned in certain domains and conflicting in others, which may have led to the evolution of fetal microchimeric phenotypes that can manipulate maternal tissues. We use cooperation and conflict theory to generate testable predictions about domains in which fetal microchimerism may enhance maternal health and those in which it may be detrimental. This framework suggests that fetal cells may function both to contribute to maternal somatic maintenance (e.g. wound healing) and to manipulate maternal physiology to enhance resource transmission to offspring (e.g. enhancing milk production). In this review, we use an evolutionary framework to make testable predictions about the role of fetal microchimerism in lactation, thyroid function, autoimmune disease, cancer and maternal emotional, and psychological health. Also watch the Video Abstract.

  17. Increased maternal T cell microchimerism in the allogeneic fetus during LPS-induced preterm labor in mice

    Science.gov (United States)

    Wegorzewska, Marta; Le, Tom; Tang, Qizhi; MacKenzie, Tippi C

    2014-01-01

    Fetal surgery is a promising strategy to treat fetuses with severe congenital abnormalities but its clinical applications are often limited by preterm labor. In normal pregnancy, multiple mechanisms protect the semi-allogeneic fetus from attack by maternal T cells. Maternal microchimerism (the presence of maternal cells in the fetus) has been suggested to be one mechanism of maternal-fetal tolerance in that it exposes the fetus to non-inherited maternal antigens and leads to the generation of fetal regulatory T cells that can suppress a maternal T cell response. Preterm labor may represent a breakdown of this robust tolerance network. We hypothesized that during inflammation-associated preterm labor, maternal leukocytes cross the maternal-fetal interface and enter the fetal circulation. Consistent with this hypothesis, we found that during preterm labor in mice, the percentage of maternal microchimerism in fetal blood increased and the frequency of fetuses with high levels of trafficking (greater than 0.5%) also increased. Finally, we showed that the maternal leukocytes trafficking into the fetus are primarily Gr-1+ cells in both syngeneic and allogeneic pregnancy, while T cell trafficking into the fetus specifically increases during allogeneic pregnancies. Our results demonstrate that trafficking of maternal leukocytes during pregnancy is altered during preterm labor. Such alterations may be clinically significant in affecting maternal-fetal tolerance. PMID:25779065

  18. Maternal mortality due to trauma.

    Science.gov (United States)

    Romero, Vivian Carolina; Pearlman, Mark

    2012-02-01

    Maternal mortality is an important indicator of adequacy of health care in our society. Improvements in the obstetric care system as well as advances in technology have contributed to reduction in maternal mortality rates. Trauma complicates up to 7% of all pregnancies and has emerged as the leading cause of maternal mortality, becoming a significant concern for the public health system. Maternal mortality secondary to trauma can often be prevented by coordinated medical care, but it is essential that caregivers recognize the unique situation of providing simultaneous care to 2 patients who have a complex physiologic relationship. Optimal management of the pregnant trauma victim requires a multidisciplinary team, where the obstetrician plays a central role. This review focuses on the incidence of maternal mortality due to trauma, the mechanisms involved in traumatic injury, the important anatomic and physiologic changes that may predispose to mortality due to trauma, and finally, preventive strategies that may decrease the incidence of traumatic maternal death.

  19. Severe maternal outcome: a review

    OpenAIRE

    Suparna Grover; Harbhajan Kaur Shergill; Ajay Chhabra

    2016-01-01

    Maternal mortality ratio (MMR) is considered an indicator of obstetric care available in a society and reduction in MMR has been one of the important millennium development goals defined by World Health Organization (WHO) but it has always been recognized that maternal mortality is just the tip of iceberg. WHO has now defined maternal near-miss cases thus broadening the focus on life threatening conditions encountered by pregnant women. A study was started at our obstetric unit based on near-...

  20. Listeria monocytogenes: maternal-foetal infections in Denmark 1994-2005

    DEFF Research Database (Denmark)

    Smith, Birgitte; Kemp, Michael; Ethelberg, Steen;

    2009-01-01

    Maternal-foetal infection by Listeria monocytogenes is a rare complication in pregnancy. In the period 1994-2005, 37 culture-confirmed cases of maternal-foetal Listeria monocytogenes infections were reported in Denmark. We examined 36 patients' files in order to evaluate risk factors, clinical...

  1. Elevated plasma urokinase receptor predicts low birth weight in maternal malaria

    DEFF Research Database (Denmark)

    Ostrowski, S R; Shulman, C E; Peshu, N;

    2007-01-01

    The blood level of soluble urokinase receptor (suPAR) is increased and associated with a poor clinical or fatal outcome in children with acute malaria. This study hypothesized that the suPAR level would be associated with foetal outcome in maternal malaria. suPAR was measured by ELISA in maternal...

  2. Evolution and Development of Dual Ingestion Systems in Mammals: Notes on a New Thesis and Its Clinical Implications

    Science.gov (United States)

    Alberts, Jeffrey R.; Pickler, Rita H.

    2012-01-01

    Traditionally, the development of oral feeding is viewed as a continuous, unitary process in which reflex-dominated sucking behavior gives rise to a more varied and volitional feeding behavior. In contrast, we consider the thesis that the infant develops two separable ingestive systems, one for suckling and one for feeding. First, we apply an evolutionary perspective, recognizing that suckling-feeding is a universal, mammalian developmental sequence. We find that in mammalian evolution, feeding systems in offspring were established prior to the evolution of lactation, and therefore suckling is a separable feature that was added to feeding. We next review an experimental literature that characterizes suckling and feeding as separable in terms of their topography, sensory controls, physiological controls, neural substrates, and experience-based development. Together, these considerations constitute a view of “dual ingestive systems.” The thesis, then, is that suckling is not a simple precursor of feeding but is a complete behavior that emerges, forms, and then undergoes a dissolution that overlaps with the emergence of independent feeding. This thesis guides us to focus differently on the challenges of properly managing and facilitating oral ingestion in infants, especially those born preterm, prior to the developmental onset of suckling. PMID:23028391

  3. Evolution and Development of Dual Ingestion Systems in Mammals: Notes on a New Thesis and Its Clinical Implications

    Directory of Open Access Journals (Sweden)

    Jeffrey R. Alberts

    2012-01-01

    Full Text Available Traditionally, the development of oral feeding is viewed as a continuous, unitary process in which reflex-dominated sucking behavior gives rise to a more varied and volitional feeding behavior. In contrast, we consider the thesis that the infant develops two separable ingestive systems, one for suckling and one for feeding. First, we apply an evolutionary perspective, recognizing that suckling-feeding is a universal, mammalian developmental sequence. We find that in mammalian evolution, feeding systems in offspring were established prior to the evolution of lactation, and therefore suckling is a separable feature that was added to feeding. We next review an experimental literature that characterizes suckling and feeding as separable in terms of their topography, sensory controls, physiological controls, neural substrates, and experience-based development. Together, these considerations constitute a view of “dual ingestive systems.” The thesis, then, is that suckling is not a simple precursor of feeding but is a complete behavior that emerges, forms, and then undergoes a dissolution that overlaps with the emergence of independent feeding. This thesis guides us to focus differently on the challenges of properly managing and facilitating oral ingestion in infants, especially those born preterm, prior to the developmental onset of suckling.

  4. Maternal nutrition, health, and survival.

    Science.gov (United States)

    Christian, Parul

    2002-05-01

    The burden of maternal morbidity and mortality in developing countries is high. Each year, 600,000 women die from pregnancy-related causes and 62 million women suffer from morbidity and complications of pregnancy. The extent to which maternal nutrition can improve maternal health and survival is not well understood. Excluding deaths due to induced abortions, the other four main causes of maternal mortality (preeclampsia, hemorrhage, obstructed labor, and infection) may be amenable to nutrition interventions. The role of calcium in reducing the incidence of preeclampsia and hypertension is promising, but more research in deficient populations is urgently needed. Antenatal iron supplementation, although frequently recommended to prevent anemia during pregnancy, has had little program success. Severe anemia may be an important cause of maternal mortality, but convincing evidence is lacking on the health consequences of mild-to-moderate maternal anemia. Knowledge of the etiology of anemia is important in identifying effective strategies for combating it. Other vitamins such as folate, B12, and vitamin A may enhance the effect of iron supplementation in populations where multiple nutrition deficiencies exist. Maternal night blindness is widespread in South Asian women. In Nepal, this condition is associated with markedly increased risks of vitamin A deficiency, anemia, morbidity, and maternal and infant mortality. These findings need to be replicated elsewhere in South Asia. One study has shown vitamin A and beta carotene supplementation to reduce maternal mortality and morbidity. These findings need testing in different settings with emphasis on investigating the mechanisms of the effect. The area of prepregnancy nutrition and its influence on prolonged and obstructed labor is wide open for investigation. The scope for research in the area of maternal nutrition and health is large and the onus is on nutritionists to bring to the forefront the role of nutrition in

  5. Gender Is a Major Determinant of the Clinical Evolution and Immune Response in Hamsters Infected with Leishmania spp.

    OpenAIRE

    Bruno L. Travi; Osorio, Yaneth; Melby, Peter C.; CHANDRASEKAR, BYSANI; Arteaga, Lourdes; Saravia, Nancy G.

    2002-01-01

    In regions where leishmaniasis is endemic, clinical disease is usually reported more frequently among males than females. This difference could be due to disparate risks of exposure of males and females, but gender-related differences in the host response to infection may also play a role. Experimental studies of the influence of gender on Leishmania infection have not included parasites of the subgenus Viannia, which is the most common cause of cutaneous leishmaniasis in the Americas. Mice a...

  6. Effects of pregnancy on maternal work tolerance.

    Science.gov (United States)

    Wolfe, Larry A; Charlesworth, Sarah A; Glenn, Nicole M; Heenan, Aaron P; Davies, Gregory A L

    2005-04-01

    This review summarizes current information on the tolerance of healthy pregnant women and their fetuses to acute strenuous exertion. Maximal aerobic power, expressed in L x min(-1), is not significantly affected in women who maintain an active lifestyle, whereas values expressed in ml x kg(-1) x min(-1) decline with advancing gestational age in relation to maternal/fetal weight gain. Efficiency during standard exercise testing and the ventilatory anaerobic threshold (Tvent) also appear to be unaffected by pregnancy, but the ability to utilize carbohydrate and exercise anaerobically during brief strenuous exercise may be reduced. Fetal responses to short strenuous exercise are usually moderate and revert to baseline values within approximately 30 min postexercise. Future studies should examine alveolar gas exchange kinetics at the start of exercise and during recovery from both moderate and strenuous exertion. Existing studies of the responses of pregnant women to prolonged exercise have focused primarily on substrate utilization and glucose homeostasis. Other maternal responses to prolonged exercise that should be examined include acid-base regulation, temperature regulation, fluid and electrolyte balance, and perception of effort. Fetal reactions should also be examined in relation to maternal responses. Until evidence-based, occupation-specific guidelines become available, it is recommended that pregnant women use the Joint SOGC/CSEP Clinical Practice Guideline: Exercise in Pregnancy and the Postpartum Period, published by the Society of Obstetricians and Gynaecologists of Canada and the Canadian Society for Exercise Physiology (2003). PMID:15981789

  7. Adolescent mental health: Challenges with maternal noncompliance

    Directory of Open Access Journals (Sweden)

    Vicki A Nejtek

    2010-03-01

    Full Text Available Vicki A Nejtek, Sarah Hardy, Scott WinterUniversity of North Texas Health Science Center, Fort Worth, TX, USAAbstract: The leading cause of suicide ideation, attempts, and completion in adolescents is persistent and unresolved parental conflict. National statistics show extremely high rates of childhood neglect and abuse are perpetrated most often by single mothers. Psychiatric disorders arising from maternal–child dysfunction are well-documented. However, resources to prevent offspring victimization are lacking. Here, we report maternal neglect of a 15-year-old male brought to the psychiatric emergency room for suicidal ideation. An inpatient treatment plan including pharmacotherapy, family therapy and psychological testing was initiated. The patient’s mother failed to attend clinic appointments or family therapy sessions. Clinician attempts to engage the mother in the treatment plan was met with verbal assaults, aggression, and threatening behavior. The patient decompensated in relation to the mother’s actions. Child Protective Services were contacted and a follow-up assessment with the patient and mother is pending. Psychiatric treatment of the mother may be a necessary intervention and prevention regimen for both the adolescent and the mother. Without consistent Child Protective Services oversight, medical and psychosocial follow-up, the prognosis and quality of life for this adolescent is considered very poor. Stringent mental health law and institutional policies are needed to adequately intercede and protect adolescents with mental illness.Keywords: adolescent, suicide, maternal treatment noncompliance, maternal neglect

  8. Maternal filicide in Turkey.

    Science.gov (United States)

    Eke, Salih Murat; Basoglu, Saba; Bakar, Bulent; Oral, Gokhan

    2015-01-01

    Filicide occurs in every socioeconomic stratum around the world. This study was conducted to evaluate motives, psychopathological aspects, and socio-demographic factors of 74 filicide cases of women in Turkey. Mean age of mothers, most of whom committed infanticide, was 26 years, and breakdown of criminal offenses are as follows: "to get rid of unwanted babies" (24.3%), "acute psychotic-type filicide" (21.6%), "fatal child abuse and neglect" (17.6%), "to get revenge" (12.2%), "protect the lonely child from the harm and badness after suicide" (10.8%), and "pity" (9.5%) motives. Results showed that maternal filicide cannot be reduced to only mental instability or environmental factors and indicates deficiencies in the capacity of the mothers' role in connecting with their child and with parenting skills. Finally, with regard to defendants' motives, similar factors that contribute to committing maternal filicide should be considered while making an assessment of the data and determining employee risk groups. PMID:25066272

  9. The influence of maternal body composition on birth weight.

    LENUS (Irish Health Repository)

    Farah, Nadine

    2012-02-01

    OBJECTIVE: To identify the maternal body composition parameters that independently influence birth weight. STUDY DESIGN: A longitudinal prospective observational study in a large university teaching hospital. One hundred and eighty-four non-diabetic caucasian women with a singleton pregnancy were studied. In early pregnancy maternal weight and height were measured digitally in a standardised way and the body mass index (BMI) was calculated. At 28 and 37 weeks\\' gestation maternal body composition was assessed using segmental multifrequency bioelectrical impedance analysis. At delivery the baby was weighed and the clinical details were recorded. RESULTS: Of the women studied, 29.2% were overweight and 34.8% were obese. Birth weight did not correlate with maternal weight or BMI in early pregnancy. Birth weight correlated with gestational weight gain (GWG) before the third trimester (r=0.163, p=0.027), but not with GWG in the third trimester. Birth weight correlated with maternal fat-free mass, and not fat mass at 28 and 37 weeks gestation. Birth weight did not correlate with increases in maternal fat and fat-free masses between 28 and 37 weeks. CONCLUSIONS: Contrary to previous reports, we found that early pregnancy maternal BMI in a non-diabetic population does not influence birth weight. Interestingly, it was the GWG before the third trimester and not the GWG in the third trimester that influenced birth weight. Our findings have implications for the design of future intervention studies aimed at optimising gestational weight gain and birth weight. CONDENSATION: Maternal fat-free mass and gestational weight gain both influence birth weight.

  10. Etiology of community-acquired pneumonia in a population-based study: Link between etiology and patients characteristics, process-of-care, clinical evolution and outcomes

    Directory of Open Access Journals (Sweden)

    Capelastegui Alberto

    2012-06-01

    Full Text Available Abstract Background The etiologic profile of community-acquired pneumonia (CAP for each age group could be similar among inpatients and outpatients. This fact brings up the link between etiology of CAP and its clinical evolution and outcome. Furthermore, the majority of pneumonia etiologic studies are based on hospitalized patients, whereas there have been no recent population-based studies encompassing both inpatients and outpatients. Methods To evaluate the etiology of CAP, and the relationship among the different pathogens of CAP to patients characteristics, process-of-care, clinical evolution and outcomes, a prospective population-based study was conducted in Spain from April 1, 2006, to June 30, 2007. Patients (age >18 with CAP were identified through the family physicians and the hospital area. Results A total of 700 patients with etiologic evaluation were included: 276 hospitalized and 424 ambulatory patients. We were able to define the aetiology of pneumonia in 55.7% (390/700. The most frequently isolated organism was S. pneumoniae (170/390, 43.6%, followed by C. burnetti (72/390, 18.5%, M. pneumoniae (62/390, 15.9%, virus as a group (56/390, 14.4%, Chlamydia species (39/390, 106%, and L. pneumophila (17/390, 4.4%. The atypical pathogens and the S. pneumoniae are present in pneumonias of a wide spectrum of severity and age. Patients infected by conventional bacteria were elderly, had a greater hospitalization rate, and higher mortality within 30 days. Conclusions Our study provides information about the etiology of CAP in the general population. The microbiology of CAP remains stable: infections by conventional bacteria result in higher severity, and the S. pneumoniae remains the most important pathogen. However, atypical pathogens could also infect patients in a wide spectrum of severity and age.

  11. Postpartum depression: Etiology, treatment and consequences for maternal care.

    Science.gov (United States)

    Brummelte, Susanne; Galea, Liisa A M

    2016-01-01

    This article is part of a Special Issue "Parental Care". Pregnancy and postpartum are associated with dramatic alterations in steroid and peptide hormones which alter the mothers' hypothalamic pituitary adrenal (HPA) and hypothalamic pituitary gonadal (HPG) axes. Dysregulations in these endocrine axes are related to mood disorders and as such it should not come as a major surprise that pregnancy and the postpartum period can have profound effects on maternal mood. Indeed, pregnancy and postpartum are associated with an increased risk for developing depressive symptoms in women. Postpartum depression affects approximately 10-15% of women and impairs mother-infant interactions that in turn are important for child development. Maternal attachment, sensitivity and parenting style are essential for a healthy maturation of an infant's social, cognitive and behavioral skills and depressed mothers often display less attachment, sensitivity and more harsh or disrupted parenting behaviors, which may contribute to reports of adverse child outcomes in children of depressed mothers. Here we review, in honor of the "father of motherhood", Jay Rosenblatt, the literature on postnatal depression in the mother and its effect on mother-infant interactions. We will cover clinical and pre-clinical findings highlighting putative neurobiological mechanisms underlying postpartum depression and how they relate to maternal behaviors and infant outcome. We also review animal models that investigate the neurobiology of maternal mood and disrupted maternal care. In particular, we discuss the implications of endogenous and exogenous manipulations of glucocorticoids on maternal care and mood. Lastly we discuss interventions during gestation and postpartum that may improve maternal symptoms and behavior and thus may alter developmental outcome of the offspring.

  12. Postpartum depression: Etiology, treatment and consequences for maternal care.

    Science.gov (United States)

    Brummelte, Susanne; Galea, Liisa A M

    2016-01-01

    This article is part of a Special Issue "Parental Care". Pregnancy and postpartum are associated with dramatic alterations in steroid and peptide hormones which alter the mothers' hypothalamic pituitary adrenal (HPA) and hypothalamic pituitary gonadal (HPG) axes. Dysregulations in these endocrine axes are related to mood disorders and as such it should not come as a major surprise that pregnancy and the postpartum period can have profound effects on maternal mood. Indeed, pregnancy and postpartum are associated with an increased risk for developing depressive symptoms in women. Postpartum depression affects approximately 10-15% of women and impairs mother-infant interactions that in turn are important for child development. Maternal attachment, sensitivity and parenting style are essential for a healthy maturation of an infant's social, cognitive and behavioral skills and depressed mothers often display less attachment, sensitivity and more harsh or disrupted parenting behaviors, which may contribute to reports of adverse child outcomes in children of depressed mothers. Here we review, in honor of the "father of motherhood", Jay Rosenblatt, the literature on postnatal depression in the mother and its effect on mother-infant interactions. We will cover clinical and pre-clinical findings highlighting putative neurobiological mechanisms underlying postpartum depression and how they relate to maternal behaviors and infant outcome. We also review animal models that investigate the neurobiology of maternal mood and disrupted maternal care. In particular, we discuss the implications of endogenous and exogenous manipulations of glucocorticoids on maternal care and mood. Lastly we discuss interventions during gestation and postpartum that may improve maternal symptoms and behavior and thus may alter developmental outcome of the offspring. PMID:26319224

  13. 高龄孕产妇妊娠与分娩结局的临床分析%Clinical analysis of the consequences of the advanced maternal age and delivery

    Institute of Scientific and Technical Information of China (English)

    张爱荣

    2016-01-01

    Objective:To explore the consequences of the advanced maternal age and delivery.Methods:230 pregnant women over 35 years old (the advanced maternal age group) and 230 pregnant women with one fetus (the controlled group) were analyzed retrospectively from April 2013 to April 2014.Results:The incidence rates for the complications and comorbidiies of pregnancy such as gestational hypertension, prolonged pregnancy, hysteromyoma, diabetes and heart disease in the advanced maternal age group are all higher than those in the controlled group( P <0. 05); The incidence rates for the complications of delivery such as placental abruption, intrauterine fetal distress, premature rupture of fetal mem-branes, postpartum hemorrhage in the advanced maternal age group are all higher than those in the controlled group( P <0.05).Conclusion:The incidence rates for the complications of pregnancy and the complications and comorbidities of delivery are so high that maternal health care should be taken to prevent or reduce the incidence of complications and comorbidities .%目的:探讨高龄孕产妇妊娠与分娩的结局. 方法:回顾性分析2013年4月至2014年4月安庆市两家三甲医院住院分娩的高龄孕产妇230例和同期单胎孕产妇230例的临床资料. 结果:高龄组孕产妇妊娠期高血压病、前置胎盘、早产、过期妊娠、子宫肌瘤、糖尿病、以及心脏病等妊娠并发症或合并症的发生率均高于对照组( P <0.05);高龄组胎盘早剥、胎儿宫内窘迫、胎膜早破、产后出血等分娩并发症的发生率均高于对照组( P <0.05). 结论:高龄孕产妇妊娠、分娩并发症或合并症发生率高,因此要加强高龄孕产妇的孕产期保健,预防或减少并发症和合并症的发生.

  14. Towards elimination of maternal deaths: maternal deaths surveillance and response

    Directory of Open Access Journals (Sweden)

    Hounton Sennen

    2013-01-01

    Full Text Available Abstract Current methods for estimating maternal mortality lack precision, and are not suitable for monitoring progress in the short run. In addition, national maternal mortality ratios (MMRs alone do not provide useful information on where the greatest burden of mortality is located, who is concerned, what are the causes, and more importantly what sub-national variations occur. This paper discusses a maternal death surveillance and response (MDSR system. MDSR systems are not yet established in most countries and have potential added value for policy making and accountability and can build on existing efforts to conduct maternal death reviews, verbal autopsies and confidential enquiries. Accountability at national and sub-national levels cannot rely on global, regional and national retrospective estimates periodically generated from academia or United Nations organizations but on routine counting, investigation, sub national data analysis, long term investments in vital registration and national health information systems. Establishing effective maternal death surveillance and response will help achieve MDG 5, improve quality of maternity care and eliminate maternal mortality (MMR ≤ 30 per 100,000 by 2030.

  15. [Maternal arrhythmias during pregnancy. Practical review].

    Science.gov (United States)

    Kornacewicz-Jach, Zdzisława; Peregud-Pogorzelska, Małgorzata

    2014-01-01

    Pregnancy is accompanied by a variety of cardiovascular changes in normal women, and these changes can increased incidence of maternal cardiac arrhythmias. Supraventricular and ventricular arrhythmias reguiring treatment are rarely seen during pregnancy in healthy women. Structural cardiac defects or residual defects after repair may contribute to the occurrence of clinically relevant arrhythmias. Arrhythmias during pregnancy include a wide spectrum. The most common are simple ventricular and atrial ectopy, sinusal tachycardia and supraventricular tachycardia. The foetus may suffer both haemodynamic alternations and adverse effects of the treatment (teratogenic risk, foetal growth and development). The management of arrhythmias in pregnant women is similar to that taken in patients who are not pregnant.

  16. The evolution of nonimmune histological injury and its clinical relevance in adult-sized kidney grafts in pediatric recipients.

    Science.gov (United States)

    Naesens, M; Kambham, N; Concepcion, W; Salvatierra, O; Sarwal, M

    2007-11-01

    To describe the evolution, risk factors and impact of nonimmune histological injury after pediatric kidney transplantation, we analyzed 245 renal allograft protocol biopsies taken regularly from the time of transplantation to 2 years thereafter in 81 consecutive rejection-free pediatric recipients of an adult-sized kidney. Isometric tubular vacuolization was present early after transplantation was not progressive, and was associated with higher tacrolimus pre-dose trough levels. Chronic tubulo-interstitial damage and tubular microcalcifications were already noted at 3 months, were progressive and had a greater association with small recipient size, male donor gender, higher donor age and female recipient gender, but not with tacrolimus exposure. Renal function assessment showed that older recipients had a significant increase in absolute glomerular filtration rate with time after transplantation, which differed from small recipients who showed no increase. It is concluded that progressive, functionally relevant, nonimmune injury is detected early after adult-sized kidney transplantation in pediatric recipients. Renal graft ischemia associated with the donor-recipient size discrepancy appears to be a greater risk factor for this chronic histological injury, suggesting that the exploration of additional therapeutic approaches to increase allograft perfusion could further extend the graft survival benefit of adult-sized kidneys transplanted into small children.

  17. Maternal Vitamin D Levels and the Autism Phenotype among Offspring

    Science.gov (United States)

    Whitehouse, Andrew J. O.; Holt, Barbara J.; Serralha, Michael; Holt, Patrick G.; Hart, Prue H.; Kusel, Merci M. H.

    2013-01-01

    We tested whether maternal vitamin D insufficiency during pregnancy is related to the autism phenotype. Serum 25(OH)-vitamin D concentrations of 929 women were measured at 18 weeks' pregnancy. The mothers of the three children with a clinical diagnosis of autism spectrum disorder had 25(OH)-vitamin D concentrations above the population mean.…

  18. Conquering maternal mortality: skill development in medical curriculum

    Directory of Open Access Journals (Sweden)

    Parimala A

    2016-02-01

    Conclusion: Skill Development in conduct of labour helps medical students to understand the clinical implications better. A well trained medical student can thus help to reduce maternal mortality rate in developing countries. [Int J Reprod Contracept Obstet Gynecol 2016; 5(2.000: 441-444

  19. 探索母血胎儿游离DNA无创大规模平行测序用于筛查胎儿染色体数目异常中的临床效果%Exploring clinical effect of non-invasive massive parallel sequencing of maternal fetal cell-free DNA to screen fetal chromosome abnormality

    Institute of Scientific and Technical Information of China (English)

    王雪涛; 林佳静; 王立胜

    2015-01-01

    Objective To explore clinical effect of non-invasive massive parallel sequencing of maternal fetal cell-free DNA to screen fetal chromosome abnormality.Methods choose 1000 pregnant women received in our hospital from Sep, 2014 to Sep 2015 randomly and analyze their maternal fetal cell-free DNA, and further screen fetal chromosomes numbers.Results among all pregnant women, 19 pregnant women have abnormal chromosome by non-invasive massive parallel sequencing of maternal fetal cell-free DNA, 15 of them received karyotype comparison, and coincidence rate of 21 trisome reached 100.00%, and that of 18 trisome reached 66.67%, and coincidence rate of sex chromosome abnormality reached 30.00%.Conclusion non-invasive massive parallel sequencing of maternal fetal cell-free DNA has remarkable clinical effect for screening fetal chromosome abnormality, which is worthy of being spreaded.%目的:探索母血胎儿游离DNA无创大规模平行测序用于筛查胎儿染色体数目异常中的临床效果。方法采取随机法选择本院2014年09月至2015年09月接收的1000名孕妇,对其母血胎儿游离DNA进行分析,并对其胎儿染色体数目进行进一步筛查。结果本次研究的所有入选孕妇中,母血胎儿游离DNA无创大规模平行测序发现有19名孕妇的染色体出现异常,其中有15名接受核型对比,发现21三体的符合率已经达到100.00%,18三体的符合率达到66.67%,而性染色体出现异常状况的符合率则达到30.00%。结论母血胎儿游离DNA无创大规模平行测序用于筛查胎儿染色体数目异常中的临床效果突出,可推广。

  20. Radionuclides and maternal lactation

    International Nuclear Information System (INIS)

    The increase in the number of nuclear medicine centers, both official and private in the country, as well as the increase in the number of patients, due to the effectiveness of their diagnostic and therapeutic procedures, brings out new situations that must be studied from the point of view of radioprotection. This work makes a revision in the medical literature about procedures with radioisotopes during the maternal nursing period. In general, it is recommended to stop nursing for 24 hours for 99mtc test, and to resume it after the draining of the milky content. This can be done in spite of the sensitivity of the target organ of the baby, because the dosage will be below permissible limits accepted by international agencies with respect to diagnostic test and I-131 treatment, and if continuing nursing is desired, it is recommended to use other diagnostic or therapeutic procedures before discontinuing the most important nutritional resource at this age

  1. Inflammation and Epidural-Related Maternal Fever: Proposed Mechanisms.

    Science.gov (United States)

    Sultan, Pervez; David, Anna L; Fernando, Roshan; Ackland, Gareth L

    2016-05-01

    Intrapartum fever is associated with excessive maternal interventions as well as higher neonatal morbidity. Epidural-related maternal fever (ERMF) contributes to the development of intrapartum fever. The mechanism(s) for ERMF has remained elusive. Here, we consider how inflammatory mechanisms may be modulated by local anesthetic agents and their relevance to ERMF. We also critically reappraise the clinical data with regard to emerging concepts that explain how anesthetic drug-induced metabolic dysfunction, with or without activation of the inflammasome, might trigger the release of nonpathogenic, inflammatory molecules (danger-associated molecular patterns) likely to underlie ERMF.

  2. Maternal employment, breastfeeding, and health: Evidence from maternity leave mandates

    OpenAIRE

    Michael Baker; Kevin S. Milligan

    2007-01-01

    Public health agencies around the world have renewed efforts to increase the incidence and duration of breastfeeding. Maternity leave mandates present an economic policy that could help achieve these goals. We study their efficacy focusing on a significant increase in maternity leave mandates in Canada. We find very large increases in mothers' time away from work post-birth and in the attainment of critical breastfeeding duration thresholds. However, we find little impact on the self-reported...

  3. Analgesia after cesarean section and epidural anaesthesia clinical study of the impact of maternal lactation%护理干预对剖宫产及硬膜外麻醉术后产妇泌乳的影响

    Institute of Scientific and Technical Information of China (English)

    温艳艳

    2014-01-01

    目的:观察剖宫产、硬膜外吗啡术后镇痛产妇的泌乳状况及血清泌乳素(PRL)变化。方法:足月产妇240例均分为四组:Ⅰ组术毕行硬膜外吗啡镇痛;Ⅱ组术毕行硬膜外吗啡镇痛,24h后追加一次;Ⅲ组未行术后镇痛;阴道自然分娩60例为Ⅳ组。240例产妇产前、产后均进行护理干预、科学宣传,实行母婴同室和纯母乳喂养。结果:产后5min、24h及48h内开始泌乳及72h泌乳分泌不足发生率与剖宫产组相比无差异。结论:由于护理干预,剖宫产及硬膜外吗啡术后镇痛不影响产妇母乳喂养的成功率。%objective:To observe the cesarean section, epidural morphine postoperative analgesia maternity lactation status and serum prolactin (PRL) change.Methods:The240 cases of maternal term are divided into four groups:Ⅰ group operation BiHang epidural morphine analgesia;Ⅱ group operation BiHang epidural morphine analgesia, 24 h after additional one time.Ⅲ group do not postoperative analgesia; Vaginal natural childbirth sixty cases ofⅣ group. 240 cases were performed antenatal, postpartum nursing intervention, scientific propaganda, the maternal and child inmates and pure breastfeeding.Results:Postpartum 5 min, 24 h and h and start within lactation and 72 h lactation hyposecretion incidence and cesarean section group compared with indifference.Conclusion:Due to the nursing intervention, and cesarean section and epidural morphine postoperative analgesia does not affect maternal breastfeeding success rate.

  4. A novel approach of groupwise fMRI-guided tractography allowing to characterize the clinical evolution of Alzheimer's disease.

    Directory of Open Access Journals (Sweden)

    Maria Giulia Preti

    Full Text Available Guiding diffusion tract-based anatomy by functional magnetic resonance imaging (fMRI, we aim to investigate the relationship between structural connectivity and functional activity in the human brain. To this purpose, we introduced a novel groupwise fMRI-guided tractographic approach, that was applied on a population ranging between prodromic and moderate stages of Alzheimer's disease (AD. The study comprised of 15 subjects affected by amnestic mild cognitive impairment (aMCI, 14 diagnosed with AD and 14 elderly healthy adults who were used as controls. By creating representative (ensemble functionally guided tracts within each group of participants, our methodology highlighted the white matter fiber connections involved in verbal fluency functions for a specific population, and hypothesized on brain compensation mechanisms that potentially counteract or reduce cognitive impairment symptoms in prodromic AD. Our hope is that this fMRI-guided tractographic approach could have potential impact in various clinical studies, while investigating white/gray matter connectivity, in both health and disease.

  5. Placental cadmium as an additional noninvasive bioindicator of active maternal tobacco smoking.

    Science.gov (United States)

    Piasek, Martina; Jurasović, Jasna; Sekovanić, Ankica; Brajenović, Nataša; Brčić Karačonji, Irena; Mikolić, Anja; Grgec, Antonija Sulimanec; Stasenko, Sandra

    2016-01-01

    Tobacco smoke (TS) is a mixture of chemicals that is known to exert carcinogenic and endocrine-disrupting effects, as well as adverse effects on various systems. In TS nicotine is the major alkaloid and cadmium (Cd) the most abundant metal ion. The aim of this investigation was to assess exposure to Cd attributed to TS in healthy postpartum subjects (mean age 28 years) after term vaginal delivery in a clinical hospital by determining metal levels in maternal blood, placenta, and cord blood in relation to nicotine in maternal hair (12-cm-long samples). Two study groups were compared based upon self-reporting data: smokers (n = 32; continual cigarette smoking 3 months before and 9 months during pregnancy) and nonsmokers (n = 54; including passive smokers whose parameters did not differ from unexposed nonsmokers). In smokers compared to nonsmokers maternal hair nicotine concentrations increased approximately sevenfold, while Cd levels rose fourfold in maternal blood and up to twofold in placenta. Significant positive correlations were noted between maternal hair nicotine and placental Cd, maternal hair nicotine and maternal blood Cd, and placental Cd and maternal blood Cd. Levels of cord blood Cd were low in both study groups (<0.1 ng/ml). Data indicate that Cd in placenta may serve as a noninvasive bioindicator in addition to commonly used noninvasive hair nicotine in maternal TS assessment, especially in cases where unavailable or inappropriate (short or chemically treated) hair samples occur. PMID:27210017

  6. Emotion: empirical contribution. Maternal borderline personality pathology and infant emotion regulation: examining the influence of maternal emotion-related difficulties and infant attachment.

    Science.gov (United States)

    Gratz, Kim L; Kiel, Elizabeth J; Latzman, Robert D; Elkin, T David; Moore, Sarah Anne; Tull, Matthew T

    2014-02-01

    Evidence suggests that maternal borderline personality (BP) pathology increases offspring risk. This study examined the relations between maternal BP pathology and related emotional dysfunction (including emotion regulation [ER] difficulties and emotional intensity/reactivity) and infant ER difficulties. Specifically, we examined both self-focused and caregiver-focused ER behaviors and the modulation of emotional expressions (one indicator of ER in young children) in response to fear- and anger-eliciting stimuli among 101 infants (12 to 23 months old) of mothers with and without clinically relevant BP pathology. The authors also examined the moderating role of mother-infant attachment. Findings of a series of multiple regression mediation analyses revealed an indirect effect of maternal BP pathology on infant ER difficulties through maternal emotional dysfunction, with maternal ER difficulties facilitating an indirect effect of maternal BP pathology on expressivity-related indicators of infant ER difficulties and maternal emotional intensity/reactivity linking maternal BP pathology to lower self-focused ER for infants in insecure-resistant attachment relationships. PMID:24344887

  7. Maternal mortality and morbidity. Zimbabwe's birth force.

    Science.gov (United States)

    Jacobson, J L

    1991-01-01

    . Disruptions in medical supplies handicap TBAs in carrying out their work. Some of the solutions are to utilize bicycles for transporting supplies to remote areas, or mobile clinics which provide supplies and training. If more countries followed Zimbabwe's lead, other countries would benefit from reduced birth rates and improved infant and maternal mortality in a cost effective and culturally compatible way. PMID:12284525

  8. Autopsy-certified maternal mortality at Ile-Ife, Nigeria

    Directory of Open Access Journals (Sweden)

    Dinyain A

    2013-12-01

    Full Text Available Amatare Dinyain,1 G Olutoyin Omoniyi-Esan,2 Olaejirinde O Olaofe,3 Donatus Sabageh,3 Akinwumi O Komolafe,2 Olusegun S Ojo21Department of Anatomic Pathology, Niger Delta University Teaching Hospital, Okolobiri, Bayelsa State, Nigeria; 2Department of Morbid Anatomy and Forensic Medicine, Obafemi Awolowo University, Ile-Ife, Osun State, Nigeria; 3Department of Morbid Anatomy and Histopathology, Ladoke Akintola University of Technology, Ogbomoso, Oyo State, NigeriaAim: Maternal mortality is a major health problem, especially in Nigeria, where accurate autopsy-based data on the prevalent causes are not readily available. The aim of this study was therefore to accurately determine the causes of maternal death as seen in a tertiary health facility in Nigeria.Materials and methods: This was a descriptive, retrospective review of the postmortem autopsy findings from cases of maternal death at the Obafemi Awolowo University Teaching Hospitals Complex, Ile-Ife, Nigeria over a 5-year period. Analyses were performed for differences in proportions using PEPI computer programs for epidemiologists (P is significant at <0.05.Results: A total of 84 cases of maternal deaths were used for the study. Approximately 71.4% of the maternal deaths were due to direct causes and 28.6% were due to indirect causes. The mean age at the time of death was 27.9±7.5 years. Overall, the three leading causes of death were obstetric hemorrhage (30.9%, complications of abortion (23.8%, and nongenital (nonobstetric infections (14.2%. Of the direct causes of maternal death, obstetric hemorrhage (43.3% was the leading cause, with postpartum hemorrhage accounting for most (65.0% of such deaths; other causes included complications of unsafe induced abortion (33.3% and of labor (11.7%. Of the indirect causes, nongenital infections (50.0%, anemia (25.0%, and preexisting hypertension (20.8% accounted for the majority of the maternal deaths. There was disparity between the clinical and

  9. Oxytocin and Maternal Brain Plasticity.

    Science.gov (United States)

    Kim, Sohye; Strathearn, Lane

    2016-09-01

    Although dramatic postnatal changes in maternal behavior have long been noted, we are only now beginning to understand the neurobiological mechanisms that support this transition. The present paper synthesizes growing insights from both animal and human research to provide an overview of the plasticity of the mother's brain, with a particular emphasis on the oxytocin system. We examine plasticity observed within the oxytocin system and discuss how these changes mediate an array of other adaptations observed within the maternal brain. We outline factors that affect the oxytocin-mediated plasticity of the maternal brain and review evidence linking disruptions in oxytocin functions to challenges in maternal adaptation. We conclude by suggesting a strategy for intervention with mothers who may be at risk for maladjustment during this transition to motherhood, while highlighting areas where further research is needed. PMID:27589498

  10. Fetal-maternal erythrocyte distribution

    Science.gov (United States)

    ... this page: //medlineplus.gov/ency/article/003407.htm Fetal-maternal erythrocyte distribution To use the sharing features ... unborn baby is leaking into the mother's blood circulation. The more of the baby's cells there are, ...

  11. Maternal Care Determinant of Longevity?

    Science.gov (United States)

    Giorgio, Marco; Renzi, Chiara; Oliveri, Serena; Pravettoni, Gabriella

    2016-04-01

    Maternal care is an essential early environment in mammals that ensures emotional regulation and adaptive fitness of progeny. Longevity and healthy aging are associated with favorable environmental factors including fitting social and behavioral features. In the present review, we discuss the findings that link rearing conditions and early maternal care with life span and aging from an evolutionary, psychological, and molecular perspective. The quality of maternal care may influence internal adaptation through a variety of parallel mechanisms including emotional regulation, stress sensitivity, coping and other behavioral strategies in response to events requiring adaptation. From a biological perspective, it regulates physiological pathways that may persist in adulthood through epigenetic mechanisms, influencing disease susceptibility and, potentially, longevity. Abnormal maternal care induces maladaptation that persists over the life span, may accelerate the onset of aging associated diseases, and shorten life span. This may have important implications in the development of preventive approaches and early interventions. PMID:27548096

  12. Influence of maternal dysmetabolic conditions during pregnancy on cardiovascular disease.

    Science.gov (United States)

    Palinski, Wulf; Nicolaides, Eric; Liguori, Antonio; Napoli, Claudio

    2009-09-01

    Pathogenic factors associated with maternal hypercholesterolemia, obesity, and diabetic conditions during pregnancy influence fetal development and predispose offspring to cardiovascular disease. Animal models have established cause-effect relationships consistent with epidemiological findings in humans and have demonstrated, in principle, that interventions before or during pregnancy can reduce or prevent pathogenic in utero programming. However, little is known about the mechanisms by which maternal dysmetabolic conditions enhance disease susceptibility in offspring. Identification of these mechanisms is rendered more difficult by the fact that programming effects in offspring may be latent and may require conventional risk factors and inherited genetic co-factors to become clinically manifest. Given the increasing prevalence of maternal risk factors, which is expected to lead to a wave of cardiovascular disease in the coming decades, and the length of prospective studies on developmental programming in humans, greater-than-usual emphasis on experimental models and translational studies is necessary. PMID:19655024

  13. Maternal Employment and Childhood Obesity

    DEFF Research Database (Denmark)

    Gwozdz, Wencke; Sousa-Poza, Alfonso; Reisch, Lucia;

    2013-01-01

    The substantial increase in female employment rates in Europe over the past two decades has often been linked in political and public rhetoric to negative effects on child development, including obesity. We analyse this association between maternal employment and childhood obesity using rich...... on obesity's main drivers: calorie intake and physical activity. Our analysis provides little evidence for any association between maternal employment and childhood obesity, diet or physical activity....

  14. Maternal effects in the magpie

    OpenAIRE

    Pihlaja, Marjo

    2006-01-01

    Maternal effects are suggested to be an efficient way to adapt offspring to variable and changing environments with consequent effects on variation in offspring fitness. In birds, mothers are able to affect the quality of their offspring through egg quality and through their incubation and parental care behaviour. Maternal effects via egg quality and hatching asynchrony, caused by incubation behaviour, may incur costs for both the mother and her offspring. For my thesis, I investigated the ad...

  15. Maternal Employment and Childhood Obesity

    DEFF Research Database (Denmark)

    Gwozdz, Wencke; Sousa-Poza, Alfonso; Reisch, Lucia;

    The substantial increase in female employment rates in Europe over the past two decades has often been linked in political and public rhetoric to negative effects on child development, including obesity. We analyse this association between maternal employment and childhood obesity using rich...... on obesity's main drivers: calorie intake and physical activity. Our analysis provides little evidence for any association between maternal employment and childhood obesity, diet or physical activity....

  16. Impact of a pharmaceutical care program on clinical evolution and antiretroviral treatment adherence: a 5-year study

    Directory of Open Access Journals (Sweden)

    Hernández Arroyo MJ

    2013-08-01

    Full Text Available María Jesús Hernández Arroyo,1 Salvador Enrique Cabrera Figueroa,2 Rosa Sepúlveda Correa,3 María de la Paz Valverde Merino,1 Alicia Iglesias Gómez,4 Alfonso Domínguez-Gil Hurlé5 On behalf of the Tormes Team 1Pharmacy Service, University Hospital of Salamanca, Salamanca, Spain; 2Pharmacy Institute, University Austral of Chile, Valdivia, Chile; 3Department of Statistics, University of Salamanca, Salamanca, Spain; 4Infectious Disease Service, University Hospital of Salamanca, Salamanca, Spain; 5Department of Pharmacy and Pharmaceutical Technology, University of Salamanca, Salamanca, Spain Background: Antiretroviral treatments (ART form the basis of adequate clinical control in human immunodeficiency virus-infected patients, and adherence plays a primary role in the grade and duration of the antiviral response. The objectives of this study are: (1 to determine the impact of the implementation of a pharmaceutical care program on improvement of ART adherence and on the immunovirological response of the patients; and (2 to detect possible correlations between different adherence evaluation measurements. Methods: A 60-month long retrospective study was conducted. Adherence measures used were: therapeutic drug monitoring, a simplified medication adherence questionnaire, and antiretroviral dispensation records (DR. The number of interviews and interventions related to adherence made for each patient in yearly periods was related to the changes in the adherence variable (measured with DR in these same yearly periods. The dates when the laboratory tests were drawn were grouped according to proximity with the study assessment periods (February–May, 2005–2010. Results: A total of 528 patients were included in the study. A significant relationship was observed between the simplified medication adherence questionnaire and DR over the 60-month study period (P < 0.01. Improvement was observed in the mean adherence level (P < 0.001, and there was a

  17. Maternal immune transfer in mollusc.

    Science.gov (United States)

    Wang, Lingling; Yue, Feng; Song, Xiaorui; Song, Linsheng

    2015-02-01

    Maternal immunity refers to the immunity transferred from mother to offspring via egg, playing an important role in protecting the offspring at early life stages and contributing a trans-generational effect on offspring's phenotype. Because fertilization is external in most of the molluscs, oocytes and early embryos are directly exposed to pathogens in the seawater, and thus maternal immunity could provide a better protection before full maturation of their immunological systems. Several innate immune factors including pattern recognition receptors (PRRs) like lectins, and immune effectors like lysozyme, lipopolysaccharide binding protein/bacterial permeability-increasing proteins (LBP/BPI) and antioxidant enzymes have been identified as maternally derived immune factors in mollusc eggs. Among these immune factors, some maternally derived lectins and antibacterial factors have been proved to endue mollusc eggs with effective defense ability against pathogen infection, while the roles of other factors still remain untested. The physiological condition of mollusc broodstock has a profound effect on their offspring fitness. Many other factors such as nutrients, pathogens, environment conditions and pollutants could exert considerable influence on the maternal transfer of immunity. The parent molluscs which have encountered an immune stimulation endow their offspring with a trans-generational immune capability to protect them against infections effectively. The knowledge on maternal transfer of immunity and the trans-generational immune effect could provide us with an ideal management strategy of mollusc broodstock to improve the immunity of offspring and to establish a disease-resistant family for a long-term improvement of cultured stocks.

  18. [Epidemiology of maternal mortality by infectious cause in France, 2007-2009, using data from confidential maternal mortality report].

    Science.gov (United States)

    Ghesquière, L; Deruelle, P; Charbonneau, P; Puech, F

    2015-01-01

    Although deaths caused by infection during pregnancy and the postpartum period are rare in France, mortality rates have increased in several countries of the European community. In France, the rate of maternal mortality by infectious cause has decreased over the last 12 years. Infectious causes are currently in fifth place of maternal deaths. Over the period 2007-2009, 18 deaths occurred, eight by direct infectious causes and 10 by indirect infectious causes. Among the 18 deaths, 17 were examined by the National Expert Committee on Maternal Mortality (CNEMM) with the objectives to determine the direct or indirect link with pregnancy, the adequacy of care and the preventability of death. Among 8 deaths from direct infectious causes, four deaths were deemed "preventable" or "possibly preventable" because of inadequate care. Among nine deaths from indirect infectious causes, preventability could not be established in two deaths, five were non-preventable and two were preventable due to non-optimal care. These cases of puerperal septicemia show that when sepsis is clinically manifest, infection is already well established and widespread deterioration is therefore often irreversible. Maternal mortality is preventable in most cases if several points are observed: early diagnosis, probabilistic antibiotics targeting most frequently involved bacteria including Escherichia coli and Streptococcus A, early transfer to ICU, control septic portal entry, simple preventive measures, influenza vaccination. A "microbiological clinical diagnosis" approach must be initiated at the first clinical signs.

  19. Transfer entropy analysis of maternal and fetal heart rate coupling.

    Science.gov (United States)

    Marzbanrad, Faezeh; Kimura, Yoshitaka; Endo, Miyuki; Palaniswami, Marimuthu; Khandoker, Ahsan H

    2015-01-01

    Although evidence of the short term relationship between maternal and fetal heart rates has been found in previous model-based studies, knowledge about the mechanism and patterns of the coupling during gestation is still limited. In this study, a model-free method based on Transfer Entropy (TE) was applied to quantify the maternal-fetal heart rate couplings in both directions. Furthermore, analysis of the lag at which TE was maximum and its changes throughout gestation, provided more information about the mechanism of coupling and its latency. Experimental results based on fetal electrocardiograms (fECGs) and maternal ECG showed the evidence of coupling for 62 out of 65 healthy mothers and fetuses in each direction, by statistically validating against the surrogate pairs. The fetuses were divided into three gestational age groups: early (16-25 weeks), mid (26-31 weeks) and late (32-41 weeks) gestation. The maximum TE from maternal to fetal heart rate significantly increased from early to mid gestation, while the coupling delay on both directions decreased significantly from mid to late gestation. These changes occur concomitant with the maturation of the fetal sensory and autonomic nervous systems with advancing gestational age. In conclusion, the application of TE with delays revealed detailed information about the changes in fetal-maternal heart rate coupling strength and latency throughout gestation, which could provide novel clinical markers of fetal development and well-being.

  20. Maternal HCV infection is associated with intrauterine fetal growth disturbance

    Science.gov (United States)

    Huang, Qi-tao; Hang, Li-lin; Zhong, Mei; Gao, Yun-fei; Luo, Man-ling; Yu, Yan-hong

    2016-01-01

    Abstract Since the evidence regarding the association between maternal hepatitis C virus (HCV) infection and impaired intrauterine fetal growth had not been conclusive, the aim of the present study was to evaluate the risk of maternal HCV infection in association with intrauterine fetal growth restriction (IUGR) and/or low birth weight infants (LBW). We performed an extensive literature search of PubMed, MEDLINE, and EMBASE through December 1, 2015. The odds ratios (ORs) of HCV infection and IUGR/LBW were calculated and reported with 95% confidence intervals (95% CIs). Statistical analysis was performed using RevMen 5.3 and Stata 10.0. Seven studies involving 4,185,414 participants and 5094 HCV infection cases were included. Significant associations between HCV infection and IUGR (OR = 1.53, 95% CI: 1.40–1.68, fixed effect model) as well as LBW were observed (OR = 1.97, 95% CI: 1.43–2.71, random effect model). The results still indicated consistencies after adjusting for multiple risk factors which could affect fetal growth, including maternal age, parity, maternal smoking, alcohol abuse, drugs abuse, coinfected with HBV/HIV and preeclampsia. Our findings suggested that maternal HCV infection was significantly associated with an increased risk of impaired intrauterine fetal growth. In clinical practice, a closer monitoring of intrauterine fetal growth by a series of ultrasound might be necessary for HCV-infected pregnant population. PMID:27583932

  1. The role of the maternal-fetal medicine subspecialist in review and prevention of maternal deaths.

    Science.gov (United States)

    Brown, Haywood; Small, Maria

    2012-02-01

    The maternal-fetal medicine subspecialist plays a critical role in the evaluation and management of women with obstetrical and medical comorbidities. These women have a higher risk for obstetrical morbidity, "near miss," and maternal mortality. Maternal death surveillance is essential to understand the factors that contribute to maternal mortality. Maternal-fetal medicine subspecialists' involvement and leadership in peer review of maternal deaths can provide guidance in developing and supporting management protocols to the obstetrical community and health care facilities. PMID:22280862

  2. Maternal adjustment and maternal attitudes in adolescent and adult pregnant women

    OpenAIRE

    Figueiredo, Bárbara; Tendais, Iva; Dias, Cláudia Castro

    2014-01-01

    Study Objective: This study analyzes differences between adolescent and adult pregnant women and the contribution of maternal age to maternal adjustment and maternal attitudes during pregnancy. Design, Setting, and Participants: A sample of 398 Portuguese pregnant women (111 younger than 19 years) was recruited in a Portuguese Maternity Hospital and completed the Maternal Adjustment and Maternal Attitudes Questionnaire between the 24th and 36th weeks of gestation. Main Outcome Measures: Mater...

  3. 颅脑损伤患者进展性颅内血肿增多196例诊治体会%Clinical experience of 196 patients of craniocerebral injury with intracranial hematoma increasing evolution-ally

    Institute of Scientific and Technical Information of China (English)

    张国栋; 徐雅彪; 张萌; 姜晓玲; 郑建辉; 黄春刚; 刘维田; 常久魁; 李建华; 刘全良; 周晋

    2013-01-01

    目的:探讨颅脑损伤患者入院后颅内血肿进展性增多的诊断及治疗方法,总结如何尽量降低死亡率和致残率。方法回顾性分析2005-07-2013-07我院收治的颅脑损伤患者196例,住院时首次CT扫描未见颅内血肿23例,颅内已形成血肿173例,血肿量为12~32 mL,观察1.5~72 h内病情变化,再次复查CT见颅内出现血肿和原有血肿不同程度增多,及时采取相应的治疗措施。结果患者出院后6个月,根据格拉斯哥预后评分( GOS)评订预后,其中恢复良好124例,中残40例,重残19例,植物生存5例,死亡8例。结论因外伤性致颅内血肿的患者住院后,颅内血肿短时间有继续增多的可能,注意观察病情变化,及时诊断并采取治疗措施,患者能得到较好的治疗效果。%Objective To summarize the diagnosis and treat method about intracranial hematoma increasing evolutionally after patients with craniocerebral injury admitting to hospital and about how to reduce the mortality and morbidity to the greatest extent .Methods The clinical data of 196 patients with craniocerebral injury from July 2005 to July 2013 in Fengrun District people's hospital was analyzed retrospectively .There are 173 cases of intracranial he-matoma by brain CT scan on 196 patients admitting to hospital , with 12~32 mL of hematoncus ;Not 23 cases of in-tracranial hematoma.After observing conditions in 1.5~72 hours, relevant treatments were carried on when observ-ing the emerging and Original hematoma increasing to some degree by reviewing brain CT scan .Results All cases were followed up for more than half an year .According to GOS , 124 cases were in good recovery , 40 cases in moder-ate disability, 19 cases in severe disability, 5 cases in plants survived and 8 cases in death.Conclusion After pa-tients with craniocerebral injury admit to hospital , there is possibillity of intracranial hematoma increasing evolutional-ly, so it

  4. 胎盘早剥延误诊治致母婴不良结局45例临床分析%Clinical Analysis of 45 Cases of Maternal and Fetal Adverse Outcomes Caused by Delayed Diagnosis and Treatment of Placental Abruption

    Institute of Scientific and Technical Information of China (English)

    刘静; 刘晓巍

    2016-01-01

    Objective To analyze the cause of the missed diagnosis and misdiagnosis of placental abruption to im-prove maternal and fetal outcomes. Methods We performed a retrospective study on 45 women with adverse maternal and fe-tal outcome due to delay of diagnosis and treatment of placental abruption during January 2009 and December 2014. Results In this group, 20 cases (44. 4%) were irregular abdominal pain, 2 cases were diarrhea, 3 cases were vaginal bleeding. 13 cases (28. 9%) showed hypertension and the legs edema, 6 cases (13. 3%) were without any clinical manifestations, 5 cases (11. 1%) were fetal movement disappearing or reduced. Adverse maternal and fetal outcomes included severe neonatal as-phyxia (14 cases), diffuse intravascular coagulation (11 cases), stillbirth (10 cases), fetal death (9 cases) . There were predisposing factors, which accounted for 93. 3%(42/45). The causes of the missed diagnosis and misdiagnosis of placental abruption were uncoordinated contractions, atypical symptoms and signs, umbilical cord and placental factors and older preg-nant women. Conclusion The atypical clinical symptoms and the placenta attached to the rear wall is the main cause of delay in diagnosis and treatment. We should pay attention to the predisposing factors and quickly discover slight abnormal fetal heart rate in monitoring. With the help of laboratory tests, we should make diagnosis of atypical placental abruption and give treat-ment as soon as possible so as to improve maternal and fetal outcomes. We must judge women with adverse maternal and fetal outcome due to delayed diagnosis and treatment of placental abruption as early as possible for the purpose of better outcome.%目的:探讨胎盘早剥延误诊治的原因。方法回顾性分析2009年1月—2014年12月因胎盘早剥延误诊治而致母婴不良结局45例的临床资料。结果本组20例(44.4%)表现为不规律腹痛,其中2例伴腹泻、3例伴阴道少许出血,13例(28.9%)表现

  5. Feto-maternal heart rate ratio in pregnant bitches: effect of gestational age and maternal size.

    Science.gov (United States)

    Alonge, S; Mauri, M; Faustini, M; Luvoni, G C

    2016-10-01

    Few information is available on parameters that can be used to objectively assess the foetal health during canine pregnancy. To identify a reliable parameter for the evaluation of foetal well-being, the effect of pre-gestational maternal bodyweight and gestational age on foetal heart rate (FHR) and on feto-maternal heart rate ratio (FHR/MHR) was investigated. Seventeen client-owned pregnant bitches of different pre-gestational maternal bodyweight were examined by serial echo colour Doppler. Only data from 11 uncomplicated pregnancies were included in the statistical analysis. The relationship between FHR, and FHR/MHR, and independent variables was analysed by polynomial regression (p ≤ .05). The FHR and the FHR/MHR significantly fitted a multiple quadratic regression for all independent variables. They both increased from 35 to 20 days before parturition and then a decreasing pattern followed. Higher values of both parameters were observed in bitches of lowest and highest bodyweight. Patterns of FHR and FHR/MHR were similar, but the ratio better describes the effect of the independent variables on the data. Thus, the highest significance of FHR/MHR compared to FHR alone encourages the application of this ratio to evaluate foetal well-being. The equation derived by the regression analysis of FHR/MHR could be applied in clinical practice to obtain its expected values in healthy pregnancies. PMID:27440379

  6. Maternal scaffolding behavior: links with parenting style and maternal education.

    Science.gov (United States)

    Carr, Amanda; Pike, Alison

    2012-03-01

    The purpose of this study was to specify the relationship between positive and harsh parenting and maternal scaffolding behavior. A 2nd aim was to disentangle the effects of maternal education and parenting quality, and a 3rd aim was to test whether parenting quality mediated the association between maternal education and scaffolding practices. We examined associations between positive and harsh parenting practices and contingent and noncontingent tutoring strategies. Ninety-six mother-child dyads (49 boys, 47 girls) from working- and middle-class English families participated. Mothers reported on parenting quality at Time 1 when children were 5 years old and again approximately 5 years later at Time 2. Mother-child pairs were observed working together on a block design task at Time 2, and interactions were coded for contingent (contingent shifting) and noncontingent (fixed failure feedback) dimensions of maternal scaffolding behavior. Positive and harsh parenting accounted for variance in contingent behavior over and above maternal education, whereas only harsh parenting accounted for unique variance in noncontingent scaffolding practices. Our findings provide new evidence for a more differentiated model of the relation between general parenting quality and specific scaffolding behaviors. PMID:22004338

  7. The pattern of maternal mortality at maternity hospital Kuala Lumpur.

    Science.gov (United States)

    Nafisah Adeeb

    1983-01-01

    National data on maternal health status in Malaysia is minimal. These data, from Maternity Hospital, Kuala Lumpur, are presented toward the goal of accumulation of basic information. From 1978-81, there were 74,105 deliveries and 9,899 abortion admissions in this hospital, which serves as a referral center for areas within a 100-mile radius. 39 maternal mortalities were recorded in this time. Maternal mortality excluding that associated with abortions was 29.27/100,000 births; when abortions are included, the figure increases to 70.54. 50% of the women who died were under 30 years of age. 28.2% of deaths occurred among primigravida, and 25.64% were associated with parity 5 or above. Malays had a mortality rate double that of Chinese or Indians. Major causes of death were toxemia, hemorrhage, embolism, medical disease, and sepsis. These causes accounted for 89% of deaths, while the remaining 11% were due to uterine inversion, obstetric trauma, and pulmonary edema. Avoidable factors were isolated in all the deaths except 3, 1 due to infective hepatitis, and 2 due to cardiac disease. Inefficient hospital care occurred in 17 patients, defective care before admission in 2, and 4 death were associated with patients' failure to seek or accept medical attention. The need for documenting all maternal mortalities is a priority in Malaysia.

  8. Emotional Disclosure Through Journal Writing: Telehealth Intervention for Maternal Stress and Mother-Child Relationships.

    Science.gov (United States)

    Whitney, Rondalyn V; Smith, Gigi

    2015-11-01

    This study examines emotional disclosure through the activity of journaling as a means of coping with maternal stress associated with parenting a child with disruptive behaviors. Through a randomized control and pre-test post-test study design of an online journal writing intervention, change to maternal stress and quality of mother-child relationship for children with ASD, ADHD and SPD was addressed. Behavioral symptoms were found to be the primary source of parenting stress for mothers and a significant relationship between child characteristics and maternal stress was identified. Emotional disclosure through the online journal writing program (especially in the presence of high disclosure of negative emotions) was shown to reduce maternal stress and improve the quality of mother-child relationship. These findings suggest cost-effective telehealth interventions may support maternal health. Important clinical implications are discussed. PMID:25503483

  9. A review of maternal mortality in Malaysia

    Directory of Open Access Journals (Sweden)

    Hematram Yadav

    2012-07-01

    Full Text Available There has been a significant decline inmaternal mortality from 540 per 100,000 live birthsin I957 to 28 per 100,000 in 2010. This decline is dueto several factors. Firstly the introduction of the ruralhealth infrastructure which is mainly constructing healthcentres and midwife clinics for the rural population.This provided the accessibility and availability ofprimary health care and specially, antenatal care forthe women. This also helped to increase the antenatalcoverage for the women to 98% in 2010 and it increasedthe average number of antenatal visits per women from6 in 1980 to 12 visits in 2010 for pregnant women.Along with the introduction of health centres,another main feature was the introduction of specificprogrammes to address the needs of the women andchildren. In the 1950s the introduction of Maternaland Child Health (MCH programme was an importantstep. Later in the late 1970s there was the introductionof the High Risk Approach in MCH care and SafeMotherhood in the 1980s. In 1990, an important stepwas the introduction of the Confidential Enquiry intoMaternal Deaths (CEMD. Another significant factor inthe reduction is the identification of high risk mothersand this is being done by the introduction of the colourcoding system in the health centres. Other factorsinclude the increase in the number of safe deliveries byskilled personnel and the reduction in the number ofdeliveries by the Traditional Birth Attendants (TBAs.The reduction in fertility rate from 6.3 in 1960 to 3.3 in2010 has been another important factor. To achieve the2015 Millennium Development Goals (MDG to furtherreduce maternal deaths by 50%, more needs to be doneespecially to identify maternal deaths that are missed byomission or misclassification and also to capture the latematernal deaths.

  10. Fetal Tachycardia Treated Successfully with Maternally Administered Propylthiouracil

    Directory of Open Access Journals (Sweden)

    Barbara V. Parilla

    2014-01-01

    Full Text Available Background. Fetal tachycardia may result from the transplacental passage of thyroid stimulating immunoglobulins in a patient with hypothyroidism secondary to ablation of Graves’ disease. Case. A 32-year-old woman, gravida 4, para 2, and abortus 1, with hypothyroidism and a history of Graves’ disease, presented at 23 6/7 weeks of gestation with a persistent fetal tachycardia. The treatment of the fetal tachycardia with maternally administered digoxin and Sotalol was unsuccessful. Maternal thyroid stimulating immunoglobulins were elevated, and treatment with maternally administered propylthiouracil (PTU resulted in a normal sinus rhythm for the remainder of the pregnancy. An induction of labor was performed at 37 weeks. Four to five days after delivery, the neonate exhibited clinical signs of hyperthyroidism necessitating treatment. Conclusion. Fetal tachycardia resulting from the transplacental passage of thyroid stimulating immunoglobulins can be successfully treated with maternally administered PTU. The neonate needs to be followed up closely as clinical signs of hyperthyroidism may occur as thyroid stimulating immunoglobulins continue to circulate in the neonate, while the serum levels of PTU decline.

  11. Severe maternal outcome: a review

    Directory of Open Access Journals (Sweden)

    Suparna Grover

    2016-03-01

    Full Text Available Maternal mortality ratio (MMR is considered an indicator of obstetric care available in a society and reduction in MMR has been one of the important millennium development goals defined by World Health Organization (WHO but it has always been recognized that maternal mortality is just the tip of iceberg. WHO has now defined maternal near-miss cases thus broadening the focus on life threatening conditions encountered by pregnant women. A study was started at our obstetric unit based on near-miss maternal mortality concept in March 2015 and is currently underway. We analyzed the initial data of the first few months and recognized four of such special cases which find mention in this review. We decided to review the literature with special reference to these cases as every such case is a lesson in itself for the health care provider, highlighting the acts of omission or interventions that may make the difference between a high risk pregnancy terminating without complication or ending as a near-miss or mortality. We reviewed the literature about various causes of maternal mortality and morbidity. In addition to the sincere efforts done by the doctors from different specialities, a good blood bank facility, ICU care as well as government provided transport facility played important roles in these cases. A long term analysis of this data can certainly guide the policy makers about the areas that need more stress and financial support. [Int J Reprod Contracept Obstet Gynecol 2016; 5(3.000: 596-602

  12. [Neural basis of maternal behavior].

    Science.gov (United States)

    Noriuchi, Madoka; Kikuchi, Yoshiaki

    2013-01-01

    Maternal love, which may be the core of maternal behavior, is essential for the mother-infant attachment relationship and is important for the infant's development and mental health. However, little has been known about these neural mechanisms in human mothers. We examined patterns of maternal brain activation in response to infant cues using video clips. We performed functional magnetic resonance imaging (fMRI) measurements while 13 mothers viewed video clips, with no sound, of their own infant and other infants of approximately 16 months of age who demonstrated two different attachment behaviors (smiling at the infant's mother and crying for her). We found that a limited number of the mother's brain areas were specifically involved in recognition of the mother's own infant, namely orbitofrontal cortex (OFC). and periaqueductal gray, anterior insula, and dorsal and ventrolateral parts of putamen. Additionally, we found the strong and specific mother's brain response for the mother's own infant's distress. The differential neural activation pattern was found in the dorsal region of OFC, caudate nucleus, right inferior frontal gyrus, dorsomedial prefrontal cortex (PFC), anterior cingulate, posterior cingulate, posterior superior temporal sulcus, and dorsolateral PFC. Our results showed the highly elaborate neural mechanism mediating maternal love and diverse and complex maternal behaviors for vigilant protectiveness.

  13. Improving maternal nutrition for better pregnancy outcomes.

    Science.gov (United States)

    Nnam, N M

    2015-11-01

    Much has been learned during the past several decades about the role of maternal nutrition in the outcome of pregnancy. While the bulk of the data is derived from animal models, human observations are gradually accumulating. There is need to improve maternal nutrition because of the high neonatal mortality rate especially in developing countries. The author used a conceptual framework which took both primary and secondary factors into account when interpreting study findings. Nutrition plays a vital role in reducing some of the health risks associated with pregnancy such as risk of fetal and infant mortality, intra-uterine growth retardation, low birth weight and premature births, decreased birth defects, cretinism, poor brain development and risk of infection. Adequate nutrition is essential for a woman throughout her life cycle to ensure proper development and prepare the reproductive life of the woman. Pregnant women require varied diets and increased nutrient intake to cope with the extra needs during pregnancy. Use of dietary supplements and fortified foods should be encouraged for pregnant women to ensure adequate supply of nutrients for both mother and foetus. The author concludes that nutrition education should be a core component of Mother and Child Health Clinics and every opportunity should be utilised to give nutrition education on appropriate diets for pregnant women. PMID:26264457

  14. MATERNAL MORTALITY IN A TERTIARY CARE CENTRE

    Directory of Open Access Journals (Sweden)

    Harpreet

    2013-06-01

    Full Text Available ABSTRACT: Maternal Mortality in A Tertiary Care Centre. OBJECTIVE: To study maternal mortality and the complications leading to maternal death. METHODS: A retrospective study of hospital record to study maternal mortality and its causes over 3 years from January 2010 to December 2012. RESULTS: There were a total of 58 maternal deaths out of 2823 live births giving a maternal mortality ratio of 2054.55 per one lakh live births. Unbooked and late referrals account for 77.58% of maternal deaths. The majority of deaths around 75.86% were in 20-30 years age group. Haemorrhage was the commonest causes of death (24.12% followed by sepsis (18.96% and pregnancy induced hypertension 15.51% Anemia contributed to the most common indirect cause of maternal morality. CONCLUSION: Haemorrhage, sepsis and pregnancy induced hypertension including eclampsia were the direct major causes of death. Anaemia and cardiac diseases were other indirect causes of death.

  15. Maternal postpartum distress and childhood overweight

    DEFF Research Database (Denmark)

    Adeltoft, Teresa Ajslev; Andersen, Camilla S; Ingstrup, Katja Glejsted;

    2010-01-01

    We investigated associations between maternal postpartum distress covering anxiety, depression and stress and childhood overweight.......We investigated associations between maternal postpartum distress covering anxiety, depression and stress and childhood overweight....

  16. Maternal Transmission of Alzheimer Disease

    OpenAIRE

    Heggeli, Kristin; Crook, Julia; Thomas, Colleen; Graff-Radford, Neill

    2012-01-01

    Some propose maternal Alzheimer disease (1) inheritance. We compared dementia family histories in AD cases and cognitively normal controls. We expected more mothers to have AD in both groups. If maternal risk was not only due to female longevity more AD cases’ than controls’ mothers should be demented. We matched 196 AD cases to 200 controls by gender and age. We obtained parent dementia status and age of death for 348 AD and 319 control parents. 24 (12%) controls’ fathers, 26 (13%) AD patien...

  17. Maternity telehealth: ringing the changes.

    Science.gov (United States)

    Finlay, Dorothy; Brown, Sheona

    2013-12-01

    This article describes NHS Scotland's Maternity telehealth options project and the implementation of the recommendations made. This 17-month project resulted in the development of national documentation for recording telehealth calls; the development of a self-directed eLearning tool on maternity telehealth call structure which was made available to all health boards in Scotland; a comprehensive programme of training on telehealth for student midwives; a programme of 'Train-the-trainer' events for qualified midwives to enable the cascade of learning throughout the service. The project also involved collaboration with Health Scotland, signposting for women to contact the appropriate caregiver at the appropriate time. PMID:24386706

  18. Maternal mortality and severe maternal morbidity from acute fatty liver of pregnancy in the Netherlands

    NARCIS (Netherlands)

    Dekker, Ruth R.; Schutte, Joke M.; Stekelenburg, Jelle; Zwart, Joost J.; van Roosmalen, Jos

    2011-01-01

    Objective: To assess maternal death and severe maternal morbidity from acute fatty liver of pregnancy (AFLP) in the Netherlands. Study design: A retrospective study of all cases of maternal mortality in the Netherlands between 1983 and 2006 and all cases of severe maternal morbidity in the Netherlan

  19. Maternal Symptoms of Attention-Deficit/Hyperactivity Disorder and Maternal Language: Implications for Infant Language Development

    Science.gov (United States)

    Kryski, Katie R.; Mash, Eric J.; Ninowski, Jerilyn E.; Semple, Deborah L.

    2010-01-01

    The relationship between maternal ADHD symptoms and maternal language was examined in a community sample of 50 mothers of infants age 3-12 months. It was hypothesized that higher maternal symptoms of ADHD would be related to lower quality of maternal language use. Recordings of mothers' speech were coded for complexity and elaboration of speech…

  20. Problems of contemporary maternity: psychological aspect

    Directory of Open Access Journals (Sweden)

    I. V. Puz

    2013-08-01

    Full Text Available This article deals with the problems of modern motherhood and studies the phenomenon of deviant maternal behavior. Based on the literature, present study analyzes such forms of violation of maternal behavior as mother's refusal from a baby; mother's cruel treatment of a baby; frequent abortions; maternity in the early reproductive age; conscious maternity postponement for a later reproductive age. Also the factors that contribute to various manifestations of deviant motherhood are described.

  1. Early Maternal Employment and Family Wellbeing

    OpenAIRE

    Pinka Chatterji; Sara Markowitz; Jeanne Brooks-Gunn

    2011-01-01

    This study uses longitudinal data from the NICHD Study on Early Child Care (SECC) to examine the effects of maternal employment on family well-being, measured by maternal mental and overall health, parenting stress, and parenting quality. First, we estimate the effects of maternal employment on these outcomes measured when children are 6 months old. Next, we use dynamic panel data models to examine the effects of maternal employment on family outcomes during the first 4.5 years of children's ...

  2. The role of lupus nephritis in development of adverse maternal and fetal outcomes during pregnancy

    OpenAIRE

    Alimohammad Fatemi; Reyhaneh Motamedi Fard; Zahra Sayedbonakdar; Ziba Farajzadegan; Mina Saber

    2013-01-01

    Background: We aimed to investigate the relationship of lupus nephritis (LN) with fetal and maternal outcomes of pregnant patients with systemic lupus erythematosus (SLE). Methods: In a retrospective study, profiles of pregnant women with SLE were selected. Before pregnancy and at the end of first, second and third trimesters, SLE disease activity index-2K was assessed. Clinical and laboratory evaluations were carried out regularly. Maternal and fetal outcomes were recorded. Assessments o...

  3. Rise in maternal mortality in the Netherlands

    NARCIS (Netherlands)

    J.M. Schutte; E.A.P. Steegers; N.W.E. Schuitemaker; J.G. Santema; K. de Boer; M. Pel; G. Vermeulen; W. Visser; J. van Roosmalen

    2010-01-01

    Objective To assess causes, trends and substandard care factors in maternal mortality in the Netherlands. Design Confidential enquiry into the causes of maternal mortality. Setting Nationwide in the Netherlands. Population 2,557,208 live births. Methods Data analysis of all maternal deaths in the pe

  4. Prenatal Maternal Stress Programs Infant Stress Regulation

    Science.gov (United States)

    Davis, Elysia Poggi; Glynn, Laura M.; Waffarn, Feizal; Sandman, Curt A.

    2011-01-01

    Objective: Prenatal exposure to inappropriate levels of glucocorticoids (GCs) and maternal stress are putative mechanisms for the fetal programming of later health outcomes. The current investigation examined the influence of prenatal maternal cortisol and maternal psychosocial stress on infant physiological and behavioral responses to stress.…

  5. Physiotherapy in brest cancer: life quality and function clinical evolution Fisioterapia em oncologia mamária: qualidade de vida e evolução clínico funcional

    OpenAIRE

    Verônica Baptista Frison; Felipe Pereira Zerwes; Caroline Helena Lazzarotto de Lima; Mara Regina Knorst; Gabriela Tomedi Leites

    2010-01-01

    Purpose: to assess physiotherapy intervention impact on quality of life and functional evolution of women who underwent clinical treatment of breast cancer. Methods: almost-experimental study of the type before and after, carried out from March to June of 2009. We have included 10 patients subjected to surgical treatment of breast cancer and who underwent adjuvant treatment. We performed functional evaluation and a quality life questionnaire application, and a intervention protocol proposal w...

  6. Neurocysticercosis in pregnancy: maternal and fetal outcomes.

    Science.gov (United States)

    D'Cruz, Rebecca F; Ng, Sher M; Dassan, Pooja

    2016-07-01

    Neurocysticercosis (NCC) is a parasitic infection with the larvae of Taenia solium from contaminated pork. It is a leading cause of seizures in the developing world. Symptoms may be secondary to live or degenerating cysts, or previous infection causing calcification or gliosis. Diagnosis is based on clinical presentation, radiological confirmation of intracranial lesions and immunological testing. Management involves symptom control with antiepileptics and antiparasitic agents. Few cases have been described of maternal NCC during pregnancy. We describe a 25-year-old female presenting to a London hospital with secondary generalized seizures. MRI of the brain confirmed a calcified lesion in the right parietal lobe, and she gave a corroborative history of NCC during her childhood in India. She was stabilized initially on antiepileptics, but during her pregnancy presented with breakthrough seizures and radiological evidence of NCC reactivation. She was managed symptomatically with antiepileptics and completed the pregnancy to term with no fetal complications. PMID:27471595

  7. Neurocysticercosis in pregnancy: maternal and fetal outcomes

    Science.gov (United States)

    D'Cruz, Rebecca F.; Ng, Sher M.; Dassan, Pooja

    2016-01-01

    Neurocysticercosis (NCC) is a parasitic infection with the larvae of Taenia solium from contaminated pork. It is a leading cause of seizures in the developing world. Symptoms may be secondary to live or degenerating cysts, or previous infection causing calcification or gliosis. Diagnosis is based on clinical presentation, radiological confirmation of intracranial lesions and immunological testing. Management involves symptom control with antiepileptics and antiparasitic agents. Few cases have been described of maternal NCC during pregnancy. We describe a 25-year-old female presenting to a London hospital with secondary generalized seizures. MRI of the brain confirmed a calcified lesion in the right parietal lobe, and she gave a corroborative history of NCC during her childhood in India. She was stabilized initially on antiepileptics, but during her pregnancy presented with breakthrough seizures and radiological evidence of NCC reactivation. She was managed symptomatically with antiepileptics and completed the pregnancy to term with no fetal complications. PMID:27471595

  8. Tightly Linked Systems: Reciprocal Relations Between Maternal Depressive Symptoms And Maternal Reports of Adolescent Externalizing Behavior

    OpenAIRE

    Allen, Joseph P.; Manning, Nell; Meyer, Jess

    2010-01-01

    The frequently observed link between maternal depressive symptoms and heightened maternal reporting of adolescent externalizing behavior was examined from an integrative, systems perspective using a community sample of 180 adolescents, their mothers, fathers, and close peers, assessed twice over a three-year period. Consistent with this perspective, the maternal depression-adolescent externalizing link was found to reflect not simply maternal reporting biases, but heightened maternal sensitiv...

  9. Obstetric near-miss and maternal mortality in maternity university hospital, Damascus, Syria: a retrospective study

    OpenAIRE

    Al Chamat Ahmad; Shahrour Yasser; Matar Hosam E; Almerie Muhammad Q; Almerie Yara; Abdulsalam Asmaa

    2010-01-01

    Abstract Background Investigating severe maternal morbidity (near-miss) is a newly recognised tool that identifies women at highest risk of maternal death and helps allocate resources especially in low income countries. This study aims to i. document the frequency and nature of maternal near-miss at hospital level in Damascus, Capital of Syria, ii. evaluate the level of care at maternal life-saving emergency services by comparatively analysing near-misses and maternal mortalities. Methods Ret...

  10. Maternal and Child Health Bureau

    Science.gov (United States)

    ... Health Topics Programs & Initiatives Funding Opportunities Data, Research & Epidemiology About MCHB Maternal and Child Health Bureau  News & Announcements HHS Awards more than $742,000 to Health Centers in American Samoa and the Virgin Islands to Fight Zika (6/23/16) Approved on June 6, 2016 -- ...

  11. Multigenerational effects of maternal undernutrition

    Science.gov (United States)

    Einstein, Francine H.

    2014-01-01

    Intrauterine exposure to reduced nutrient availability can have major effects in determining susceptibility to chronic disease later in life. Martínez et al. (2014) demonstrate multigenerational effects of poor maternal nutrition and evidence of germ-line transmission through alterations in DNA methylation. PMID:24896533

  12. Androgyny and the Maternal Principle

    Science.gov (United States)

    Johnson, Miriam M.

    1977-01-01

    Discusses the movement toward androgyny based upon and fostered by an increasing societal emphasis upon "femininity" in its maternal (as opposed to its heterosexual) aspects. Argues that the masculine paradigm promotes differentiation between the sexes, especially the sex objectification of women. (Author/RK)

  13. Knowledge gaps in scientific literature on maternal mortality: a systematic review.

    Science.gov (United States)

    Gil-González, Diana; Carrasco-Portiño, Mercedes; Ruiz, Maria Teresa

    2006-11-01

    Issues related to maternal mortality have generated a lot of empirical and theoretical information. However, despite the amount of work published on the topic, maternal mortality continues to occur at high rates and solutions to the problem are still not clear. Scientific research on maternal mortality is focused mainly on clinical factors. However, this approach may not be the most useful if we are to understand the problem of maternal mortality as a whole and appreciate the importance of economical, political and social macrostructural factors. In this paper, we report the number of scientific studies published between 2000 and 2004 about the main causes of maternal death, as identified by WHO, and compare the proportion of papers on each cause with the corresponding burden of each cause. Secondly, we systematically review the characteristics and quality of the papers on the macrostructural determinants of maternal mortality. In view of their burden, obstructed labour, unsafe abortion and haemorrhage are proportionally underrepresented in the scientific literature. In our review, most studies analysed were cross-sectional, and were carried out by developed countries without the participation of researchers in the developing countries where maternal mortality was studied. The main macrostructural factors mentioned were socioeconomic variables. Overall, there is a lack of published information about the cultural and political determinants of maternal mortality. We believe that a high-quality scientific approach must be taken in studies of maternal mortality in order to obtain robust comparative data and that study design should be improved to allow causality between macrostructural determinants and maternal mortality to be shown.

  14. Personality Profiles of Adult Males Sexually Molested by Their Maternal Caregivers: Preliminary Findings.

    Science.gov (United States)

    Roys, Deloris T.; Timms, Robert J.

    1995-01-01

    Examined two groups of adult males who had been sexually abused as children by female maternal caregivers: those in treatment at a clinic specializing in sexual abuse survivor work, and those in treatment at a clinic specializing in sexual offender work. These groups show greater psychological disruption than adult males who as children had not…

  15. National data system on near miss and maternal death: shifting from maternal risk to public health impact in Nigeria

    Directory of Open Access Journals (Sweden)

    Oladapo Olufemi T

    2009-06-01

    potentially fatal maternal complications. For every woman enrolled, the health service events (care pathways within the facility will be evaluated to identify areas of substandard care/avoidable factors through clinical audit by the local research team. A summary estimate of the frequencies of MNM and maternal deaths will be determined at intervals and indicators of quality of care (case fatality rate, both total and cause-specific and mortality index will be evaluated at facility, regional and country levels. Management Overall project management will be from the Centre for Research in Reproductive Health (CRRH, Sagamu, Nigeria. There will be at least two meetings and site visits for efficient coordination of the project by regional coordinators and central coordinating staff. Data will be transferred electronically by hospital and regional coordinators and managed at the Data Management Unit of CRRH, Sagamu, Nigeria. Expected outcomes The outcome of the study would provide useful information to the health practitioners, policy-makers and international partners on the strengths and weaknesses of the infrastructures provided for comprehensive emergency obstetric care in Nigeria. The successful implementation of this project will pave way for the long-awaited Confidential Enquiries into Maternal Deaths that would guide the formulation and or revision of obstetric policies and practices in Nigeria. Lessons learnt from the establishment of this data system can also be used to set up similar structures at lower levels of healthcare delivery in Nigeria.

  16. Comprehensive approach to improving maternal health and achieving MDG 5: report from the mountains of Lesotho.

    Directory of Open Access Journals (Sweden)

    Hind Satti

    Full Text Available BACKGROUND: Although it is now widely recognized that reductions in maternal mortality and improvements in women's health cannot be achieved through simple, vertical strategies, few programs have provided successful models for how to integrate services into a comprehensive program for maternal health. We report our experience in rural Lesotho, where Partners In Health (PIH in partnership with the Ministry of Health and Social Welfare implemented a program that provides comprehensive care of pregnant women from the community to the clinic level. METHODS: Between May and July 2009, PIH trained 100 women, many of whom were former traditional birth attendants, to serve as clinic-affiliated maternal health workers. They received performance-based incentives for accompanying pregnant women during antenatal care (ANC visits and facility-based delivery. A nurse-midwife provided ANC and delivery care and supervised the maternal health workers. To overcome geographic barriers to delivering at the clinic, women who lived far from the clinic stayed at a maternal lying-in house prior to their expected delivery dates. We analyzed data routinely collected from delivery and ANC registers to compare service utilization before and after implementation of the program. RESULTS: After the establishment of the program, the average number first ANC visits increased from 20 to 31 per month. The clinic recorded 178 deliveries in the first year of the program and 216 in the second year, compared to 46 in the year preceding the program. During the first two years of the program, 49 women with complications were successfully transported to the district hospital, and no maternal deaths occurred among the women served by the program. CONCLUSIONS: Our results demonstrate that it is possible to achieve dramatic improvements in the utilization of maternal health services and facility-based delivery by strengthening human resource capacity, implementing active follow-up in the

  17. Prenatal maternal anxiety and early childhood temperament.

    Science.gov (United States)

    Blair, Megan M; Glynn, Laura M; Sandman, Curt A; Davis, Elysia Poggi

    2011-11-01

    The consequences of exposure to prenatal maternal anxiety for the development of child temperament were examined in a sample of 120 healthy, 2-year-old children. Prenatal maternal state and pregnancy-specific anxiety (PSA) were measured five times during pregnancy, and maternal state anxiety was measured again at 2 years post partum. Child temperament was measured at 2 years using the Early Childhood Behavior Questionnaire. The relationship between the trajectory of maternal anxiety across gestation and negative affectivity was evaluated using hierarchical linear growth curve modeling. Higher maternal PSA between 13 and 17 weeks of gestation was associated with increased negative temperament in the children. This association could not be explained by postnatal maternal anxiety, demographic, or obstetric factors. Prenatal maternal state anxiety was not associated with child temperament. These findings demonstrate that PSA early in gestation has a distinctive influence on the developing fetus.

  18. Incidence of maternal near miss in hospital childbirth and postpartum: data from the Birth in Brazil study.

    Science.gov (United States)

    Dias, Marcos Augusto Bastos; Domingues, Rosa Maria Soares Madeira; Schilithz, Arthur Orlando Corrêa; Nakamura-Pereira, Marcos; Diniz, Carmen Simone Grilo; Brum, Ione Rodrigues; Martins, Alaerte Leandro; Theme Filha, Mariza Miranda; Gama, Silvana Granado Nogueira da; Carmo Leal, Maria do

    2014-08-01

    This study evaluated data on the incidence of maternal near miss identified on World Health Organization (WHO) criteria from the Birth in Brazil survey. The study was conducted between February 2011 and October 2012. The results presented are estimates for the study population (2,337,476 births), based on a sample of 23,894 women interviewed. The results showed an incidence of maternal near miss of 10.21 per 1,000 live births and a near-miss-to-mortality ratio of 30.8 maternal near miss to every maternal death. Maternal near miss was identified most prevalently by clinical criteria, at incidence of 5.2 per 1,000 live births. Maternal near miss was associated with maternal age 35 or more years (RR=1.6; 95%CI: 1.1-2.5), a history of previous cesarean delivery (RR=1.9; 95%CI: 1.1-3.4) and high-risk pregnancy (RR=4.5; 95%CI: 2.8-7.0). incidence of maternal near miss was also higher at hospitals in capital cities (RR=2.2; 95%CI: 1.3-3.8) and those belonging to Brazil's national health service, the Brazilian Unified National Health System (SUS) (RR=3.2; 95%CI: 1.6-6.6). Improved quality of childbirth care services can help reduce maternal mortality in Brazil.

  19. Postpartum bonding: the impact of maternal depression and adult attachment style.

    Science.gov (United States)

    Nonnenmacher, N; Noe, D; Ehrenthal, J C; Reck, C

    2016-10-01

    Maternal depression poses a risk for the developing mother-infant relationship. Similarly, maternal insecure attachment styles may limit the ability to adequately connect with the newborn during the postpartum period. The aim of this study was to investigate the effect of maternal depression and insecure attachment (insecure and dual/disorganized) on maternal bonding in a sample of n = 34 women with depression according to DSM-IV and n = 59 healthy women. Maternal depression was assessed 3 to 4 months postpartum with the Structured Clinical Interview for DSM-IV Axis I Disorders (SCID-I), bonding with the Postpartum Bonding Questionnaire, and maternal attachment style with the Attachment Style Interview. Women with current and lifetime depression as well as women with dual/disorganized attachment style reported lower bonding. Explorative analysis revealed that depression partially mediated the link between dual/disorganized attachment style and bonding with a medium-sized mediation effect. The combination of maternal depression and dual/disorganized attachment style may pose a special risk constellation for the developing mother-infant bond that should be addressed in prevention and early intervention programs.

  20. Current Concepts of Maternal Nutrition

    Science.gov (United States)

    Lowensohn, Richard I.; Stadler, Diane D.; Naze, Christie

    2016-01-01

    Background A nutrient-rich maternal diet before and during pregnancy is associated with improved fetal health, more appropriate birth weight, and increased rates of maternal and infant survival. Physicians need a better understanding of the role of diet in shaping fetal outcomes. Given this background, we reviewed and summarized articles on maternal nutrition found in MEDLINE since 1981, written in English, and limited to human subjects. For the Offspring Maternal diets high in sugar and fat lead to an increased incidence of metabolic syndrome, diabetes, and cardiovascular disease later in life. Folic acid should be supplemented prior to conception and continued through at least the first 28 days of fetal life to prevent neural tube defects, and vitamin C should be given to women who smoke to lower the incidence of asthma and wheezing in the children. Iodine deficiency is increasing, and iodine should be included in prenatal supplements. If the maternal hemoglobin is 7 g/dL or more, there is no evidence that iron supplementation is needed. Fish intake during pregnancy is protective against atopic outcomes, whereas high-meat diets contribute to elevated adult blood pressure and hypersecretion of cortisol. For the Mother Calcium supplementation lowers the risk of preeclampsia and hypertensive disease in pregnancy. Conclusions Given the limits of our current knowledge, a diet rich in whole grains, fruits, vegetables, and selected fish is desirable for the best outcomes. Diets high in sugar and fat lead to higher rates of diabetes, metabolic syndrome, and cardiovascular disease. Folic acid, iodine, and calcium in all pregnant women and vitamin C in smokers are the only supplements so far shown to be of value for routine use. The physician treating a pregnant woman should be ready to advise a healthy diet for the benefit of the fetus. Target Audience Obstetricians and gynecologists, family physicians Learning Objectives After participating in this activity, the

  1. Modern Management of Clinical Chorioamnionitis

    Directory of Open Access Journals (Sweden)

    Thomas Westover

    1995-01-01

    Full Text Available Clinical chorioamnionitis continues to contribute to fetal and maternal morbidity and mortality. Significant advances have been made in the last 20 years in understanding the pathophysiologic processes leading to chorioamnionitis. This review addresses the history, incidence, pathophysiology, host defenses, risk factors, diagnosis, and maternal and neonatal management of clinically evident chorioamnionitis. After a detailed review of the physiologic processes leading to clinical chorioamnionitis and sepsis, we present a modern management scheme designed to optimize perinatal outcome for both mother and fetus.

  2. The effects of maternal passive smoking on maternal milk lipid.

    Directory of Open Access Journals (Sweden)

    Azam Baheiraei

    2014-04-01

    Full Text Available Passive smoking was long overlooked by those in the medical and legal professions as being harmful to one's health, but in recent years the negative effect of passive smoking has come to the fore in the media and laws have been changed so that less people are obliged to unwillingly suffer from passive smoking, particularly in the workplace and in indoor settings. To study the effects of environmental tobacco smoking exposure during the breast-feeding period on maternal milk lipids. This cohort study was conducted on 45 mothers environmental tobacco smoking exposure and 40 non-exposed post-partum mothers referred to the Shahid Ayat health center, Tehran, Iran. Socioeconomic conditions and the demographic characteristics of exposed and non-exposed groups were recorded. Milk samples were collected twice--at baseline (5-7 days after delivery and four months after delivery. The samples were reserved at -20°C until assay. Milk lipids including cholesterol, triglyceride (TG, high density lipoprotein (HDL and low density lipoprotein (LDL were evaluated. Dietary intake assessment was performed by means of the 24-hour dietary recall questionnaire both times. Maternal occupation status and education levels were significantly different between the two groups. Lipids profiles of milk were significantly higher 5-7 days after delivery in the non-exposed group and four months after delivery. Dietary intake was not significantly different between the two groups. Maternal environmental tobacco smoking exposure affects milk lipids which are essential for infant growth.

  3. The effects of maternal passive smoking on maternal milk lipid.

    Science.gov (United States)

    Baheiraei, Azam; Shamsi, Azar; Khaghani, Shahnaz; Shams, Sedigheh; Chamari, Maryam; Boushehri, Hoda; Khedri, Azam

    2014-01-01

    Passive smoking was long overlooked by those in the medical and legal professions as being harmful to one's health, but in recent years the negative effect of passive smoking has come to the fore in the media and laws have been changed so that less people are obliged to unwillingly suffer from passive smoking, particularly in the workplace and in indoor settings. To study the effects of environmental tobacco smoking exposure during the breast-feeding period on maternal milk lipids. This cohort study was conducted on 45 mothers environmental tobacco smoking exposure and 40 non-exposed post-partum mothers referred to the Shahid Ayat health center, Tehran, Iran. Socioeconomic conditions and the demographic characteristics of exposed and non-exposed groups were recorded. Milk samples were collected twice--at baseline (5-7 days after delivery) and four months after delivery. The samples were reserved at -20°C until assay. Milk lipids including cholesterol, triglyceride (TG), high density lipoprotein (HDL) and low density lipoprotein (LDL) were evaluated. Dietary intake assessment was performed by means of the 24-hour dietary recall questionnaire both times. Maternal occupation status and education levels were significantly different between the two groups. Lipids profiles of milk were significantly higher 5-7 days after delivery in the non-exposed group and four months after delivery. Dietary intake was not significantly different between the two groups. Maternal environmental tobacco smoking exposure affects milk lipids which are essential for infant growth. PMID:24901858

  4. Association of clinical features with mitochondrial DNA 3243 A to G mutation heteroplasmy levels in patients with maternally inherited diabetes and deafness%母系遗传伴耳聋糖尿病患者线粒体DNA 3243 A>G突变与临床特点之间的关系

    Institute of Scientific and Technical Information of China (English)

    周美岑; 闵锐; 纪建军; 张饰; 童安莉; 许建萍; 李曾一; 张化冰; 李玉秀

    2016-01-01

    Objective To summarize the clinical phenotype profiles and mitochondrial DNA mutation in maternally inherited diabetes and deafness ( MIDD ) , and to improve the diagnosis and treatment of this disease in clinical practice. Methods Sixteen patients with MIDD in six families from Peking Union Medical College from 2007 to Dec 2014 were confirmed as carrying the mitochondrial ( mt) DNA 3243 A to G mutation. Sanger sequencing was used to detect the mt DNA 3243 A to G mutation. The peak height G/A ratio was used to determine mutation heteroplasmy levels. Results The patients with early onset of diabetes (35. 0 ± 14. 6 years), deafness, normal or lower body mass index ( BMI) , and maternal hereditary tendency suggested the diagnosis of MIDD. The peak height G/A ratio was significantly different according to the onset age of MIDD [≤25 years (61. 6 ± 20. 17)%;25-45 years (16.59±8.64)%;>45 years(6.37±0.59)%;PG突变导致线粒体糖尿病的6个家系共16例患者的临床特点进行分析总结,通过外周血DNA直接测序( Sanger法)对线粒体DNA 3243位点A>G突变进行鉴定,突变程度用G峰值高度比A峰值高度( G/A)表示。结果早发糖尿病[起病年龄(35.0±14.6)岁]伴耳聋、体型正常或偏瘦、母系遗传倾向者可提示存在线粒体糖尿病。不同发病年龄层间线粒体DNA 3243位点A>G突变G/A峰值比存在显著性差异[≤25岁(61.6±20.17)%;25~45岁(16.59±8.64)%;>45岁(6.37±0.59)%,PG突变G/A峰值比一定程度上可对存在突变者线粒体糖尿病起病年龄及严重程度进行简单预测。

  5. Maternal environment affects the genetic basis of seed dormancy in Arabidopsis thaliana.

    Science.gov (United States)

    Postma, Froukje M; Ågren, Jon

    2015-02-01

    The genetic basis of seed dormancy, a key life history trait important for adaptive evolution in plant populations, has yet been studied only using seeds produced under controlled conditions in greenhouse environments. However, dormancy is strongly affected by maternal environmental conditions, and interactions between seed genotype and maternal environment have been reported. Consequently, the genetic basis of dormancy of seeds produced under natural field conditions remains unclear. We examined the effect of maternal environment on the genetic architecture of seed dormancy using a recombinant inbred line (RIL) population derived from a cross between two locally adapted populations of Arabidopsis thaliana from Italy and Sweden. We mapped quantitative trait loci (QTL) for dormancy of seeds produced in the greenhouse and at the native field sites of the parental genotypes. The Italian genotype produced seeds with stronger dormancy at fruit maturation than did the Swedish genotype in all three environments, and the maternal field environments induced higher dormancy levels compared to the greenhouse environment in both genotypes. Across the three maternal environments, a total of nine dormancy QTL were detected, three of which were only detected among seeds matured in the field, and six of which showed significant QTL × maternal environment interactions. One QTL had a large effect on dormancy across all three environments and colocalized with the candidate gene DOG1. Our results demonstrate the importance of studying the genetic basis of putatively adaptive traits under relevant conditions.

  6. Prenatal Screening Using Maternal Markers

    Directory of Open Access Journals (Sweden)

    Howard Cuckle

    2014-05-01

    Full Text Available Maternal markers are widely used to screen for fetal neural tube defects (NTDs, chromosomal abnormalities and cardiac defects. Some are beginning to broaden prenatal screening to include pregnancy complications such as pre-eclampsia. The methods initially developed for NTDs using a single marker have since been built upon to develop high performance multi-maker tests for chromosomal abnormalities. Although cell-free DNA testing is still too expensive to be considered for routine application in public health settings, it can be cost-effective when used in combination with existing multi-maker marker tests. The established screening methods can be readily applied in the first trimester to identify pregnancies at high risk of pre-eclampsia and offer prevention though aspirin treatment. Prenatal screening for fragile X syndrome might be adopted more widely if the test was to be framed as a form of maternal marker screening.

  7. Trajectories of parenting behavior and maternal depression.

    Science.gov (United States)

    Azak, Schale; Raeder, Sabine

    2013-06-01

    This study investigated trajectories of maternal parenting behavior across the infants' first 18 months of life in relation to maternal depression. Furthermore, predictors of the quality of the mother-infant relationship at 18 months were examined. Participants consisted of three types of mother-infant dyads: mothers with comorbid depression and anxiety (n=19), mothers with depression (n=7) and nondepressed mothers (n=24). Maternal behaviors and the quality of relationship were rated on a global scale (NICHD) from video-taped mother-infant interactions. Maternal behaviors rated at six, 12 and 18 months were collapsed into a composite variable maternal style. The quality of the relationship captured as dyadic mutuality was rated at 18 months. Comorbid and depressed mothers showed lower quality in maternal style compared with the nondepressed mothers at six months. Over the follow-up the comorbid mothers were lower in maternal style compared to the nondepressed mothers, but the comorbid mothers increased significantly in maternal style despite elevated depression symptoms. Mean maternal style and infant cognitive skills predicted the quality in relationship at 18 months suggesting that the mother-toddler relationship depends on contributions from the mother and the child. Higher growth in maternal style despite of depression symptoms among comorbid mothers was interpreted against the background that the majority of the comorbid mother-infant dyads received several treatments.

  8. Maternal feeding controls fetal biological clock.

    Directory of Open Access Journals (Sweden)

    Hidenobu Ohta

    Full Text Available BACKGROUND: It is widely accepted that circadian physiological rhythms of the fetus are affected by oscillators in the maternal brain that are coupled to the environmental light-dark (LD cycle. METHODOLOGY/PRINCIPAL FINDINGS: To study the link between fetal and maternal biological clocks, we investigated the effects of cycles of maternal food availability on the rhythms of Per1 gene expression in the fetal suprachiasmatic nucleus (SCN and liver using a transgenic rat model whose tissues express luciferase in vitro. Although the maternal SCN remained phase-locked to the LD cycle, maternal restricted feeding phase-advanced the fetal SCN and liver by 5 and 7 hours respectively within the 22-day pregnancy. CONCLUSIONS/SIGNIFICANCE: Our results demonstrate that maternal feeding entrains the fetal SCN and liver independently of both the maternal SCN and the LD cycle. This indicates that maternal-feeding signals can be more influential for the fetal SCN and particular organ oscillators than hormonal signals controlled by the maternal SCN, suggesting the importance of a regular maternal feeding schedule for appropriate fetal molecular clockwork during pregnancy.

  9. Hepatitis E and Maternal Deaths

    Centers for Disease Control (CDC) Podcasts

    2012-11-06

    Dr. Alain Labrique, assistant professor in the Department of International Health and Department of Epidemiology at the Bloomberg School of Public Health, gives us his perspective on hepatitis E and maternal deaths.  Created: 11/6/2012 by National Center for Emerging and Zoonotic Infectious Diseases (NCEZID); National Center for Immunization and Respiratory Diseases (NCIRD).   Date Released: 11/7/2012.

  10. Partnership Transitions and Maternal Parenting

    OpenAIRE

    Beck, Audrey N.; Cooper, Carey E.; McLanahan, Sara; Brooks-Gunn, Jeanne

    2010-01-01

    We use data from the Fragile Families and Child Wellbeing Study (N = 1,975) to examine the association between mothers’ partnership changes and parenting behavior during the first five years of their children’s lives. We compare coresidential with dating transitions, and recent with more distal transitions. We also examine interactions between transitions and race/ethnicity, maternal education and family structure at birth. Findings indicate that both coresidential and dating transitions were...

  11. Maternal Employment and Overweight Children

    OpenAIRE

    Patricia M. Anderson; Kristin F. Butcher; Levine, Phillip B.

    2002-01-01

    This paper investigates whether children are more or less likely to be overweight if their mothers work. The prevalence of both overweight children and working mothers has risen dramatically over the past few decades, although these parallel trends may be coincidental. The goal of this paper is to help determine whether a causal relationship exists between maternal employment and childhood overweight. To accomplish this, we mainly utilize matched mother/child data from the National Longitudin...

  12. A Model for Maternal Depression

    OpenAIRE

    Connelly, Cynthia D.; Baker-Ericzen, Mary J.; Hazen, Andrea L.; Landsverk, John; Horwitz, Sarah Mccue

    2010-01-01

    With the awareness of maternal depression as a prevalent public health issue and its important link to child physical and mental health, attention has turned to how healthcare providers can respond effectively. Intimate partner violence (IPV) and the use of alcohol, tobacco, and other drugs are strongly related to depression, particularly for low-income women. The American College of Obstetricians and Gynecologists (ACOG) recommends psychosocial screening of pregnant women at least once per t...

  13. PERINATAL AND MATERNAL OUTCOME IN PRELABOUR RUPTURE OF MEMBRANES

    Directory of Open Access Journals (Sweden)

    Nesam Susana

    2015-12-01

    Full Text Available Prelabour Rupture of Membranes (PROM is one of the most common complications of pregnancy that has major impact on fetal and maternal outcome. It occurs in 1 out of every 10 pregnancies; 80% of women who present with PROM are term. It is also one of the commonest event where a normal pregnancy can turn into a high risk situation for the mother as well as for the fetus. Despite the relative frequency of this event, clinical management is one issue unresolved by the clinical research till date. A prospective study was designed to know the incidence, etiology, risk factors, fetal and maternal outcomes of prelabour rupture of membrane in Government Chengalpattu Medical College Hospital. One hundred mothers with singleton pregnancy in the age group of 19 to 35 years with leaking per vaginum and without maternal complications interfering with active management of PROM like heart disease, Pregnancy Induced Hypertension (PIH were chosen and assessed with a standardized protocol. The data was collected and analysed statistically.

  14. 母系遗传伴耳聋糖尿病患者线粒体DNA 3243 A>G突变与临床特点之间的关系%Association of clinical features with mitochondrial DNA 3243 A to G mutation heteroplasmy levels in patients with maternally inherited diabetes and deafness

    Institute of Scientific and Technical Information of China (English)

    周美岑; 闵锐; 纪建军; 张饰; 童安莉; 许建萍; 李曾一; 张化冰; 李玉秀

    2016-01-01

    目的:对线粒体家系临床特点及基因突变结果进行分析总结,以提高临床对线粒体糖尿病的认识和诊治。方法对北京协和医院2007年至2014年12月间收治的线粒体DNA 3243位点A>G突变导致线粒体糖尿病的6个家系共16例患者的临床特点进行分析总结,通过外周血DNA直接测序( Sanger法)对线粒体DNA 3243位点A>G突变进行鉴定,突变程度用G峰值高度比A峰值高度( G/A)表示。结果早发糖尿病[起病年龄(35.0±14.6)岁]伴耳聋、体型正常或偏瘦、母系遗传倾向者可提示存在线粒体糖尿病。不同发病年龄层间线粒体DNA 3243位点A>G突变G/A峰值比存在显著性差异[≤25岁(61.6±20.17)%;25~45岁(16.59±8.64)%;>45岁(6.37±0.59)%,PG突变G/A峰值比一定程度上可对存在突变者线粒体糖尿病起病年龄及严重程度进行简单预测。%Objective To summarize the clinical phenotype profiles and mitochondrial DNA mutation in maternally inherited diabetes and deafness ( MIDD ) , and to improve the diagnosis and treatment of this disease in clinical practice. Methods Sixteen patients with MIDD in six families from Peking Union Medical College from 2007 to Dec 2014 were confirmed as carrying the mitochondrial ( mt) DNA 3243 A to G mutation. Sanger sequencing was used to detect the mt DNA 3243 A to G mutation. The peak height G/A ratio was used to determine mutation heteroplasmy levels. Results The patients with early onset of diabetes (35. 0 ± 14. 6 years), deafness, normal or lower body mass index ( BMI) , and maternal hereditary tendency suggested the diagnosis of MIDD. The peak height G/A ratio was significantly different according to the onset age of MIDD [≤25 years (61. 6 ± 20. 17)%;25-45 years (16.59±8.64)%;>45 years(6.37±0.59)%;P<0.01]. The peak height G/A ratio was negatively correlated with the onset age of MIDD(r=-0. 785,P=0. 001). Conclusion Early onset of diabetes with deafness, normal/lower BMI, and maternal

  15. Development, maternal effects, and behavioral plasticity.

    Science.gov (United States)

    Mateo, Jill M

    2014-11-01

    Behavioral, hormonal, and genetic processes interact reciprocally, and differentially affect behavior depending on ecological and social contexts. When individual differences are favored either between or within environments, developmental plasticity would be expected. Parental effects provide a rich source for phenotypic plasticity, including anatomical, physiological, and behavioral traits, because parents respond to dynamic cues in their environment and can, in turn, influence offspring accordingly. Because these inter-generational changes are plastic, parents can respond rapidly to changing environments and produce offspring whose phenotypes are well suited for current conditions more quickly than occurs with changes based on evolution through natural selection. I review studies on developmental plasticity and resulting phenotypes in Belding's ground squirrels (Urocitellus beldingi), an ideal species, given the competing demands to avoid predation while gaining sufficient weight to survive an upcoming hibernation, and the need for young to learn their survival behaviors. I will show how local environments and perceived risk of predation influence not only foraging, vigilance, and anti-predator behaviors, but also adrenal functioning, which may be especially important for obligate hibernators that face competing demands on the storage and mobilization of glucose. Mammalian behavioral development is sensitive to the social and physical environments provided by mothers during gestation and lactation. Therefore, maternal effects on offspring's phenotypes, both positive and negative, can be particularly strong. PMID:24820855

  16. Maternal analgosedation and breastfeeding: guidance for the pediatrician

    Directory of Open Access Journals (Sweden)

    Karel Allegaert

    2015-03-01

    Full Text Available As part of analgosedative treatment modalities after delivery (e.g. caesarean related pain, birth related trauma, pre-existing pain syndromes, mothers are treated with different analgosedatives that may also affect the nursing infant. This review aims to summarize the available knowledge on commonly prescribed analgosedatives (opioids, intravenous and inhalational anesthetics, benzodiazepines, non-opioid analgesics, and local anesthetics during breastfeeding. We propose that the use of systemic non-opioid analgesics, local anesthetics, inhalational or intravenous anesthetics is safe when mothers are nursing. When systemic opioids are used, we recommend pediatricians to consider clinical monitoring of the infant for sedation. The duration of maternal exposure (> 4 days and the presence of maternal signs of somnolence are hereby of additional relevance. We encourage research groups to report on their specific observations and expertise in order to further validate the current practices and guidance.

  17. [Maternal mortality among black women in Brazil].

    Science.gov (United States)

    Martins, Alaerte Leandro

    2006-11-01

    Every minute a woman dies in the world due to labor or complications of pregnancy. Maternal mortality is a public health problem in Brazil and affects the country's various regions unequally. Researchers agree that maternal death occurs mainly in women with lower income and less schooling. The racial issue emerges in the midst of socioeconomic issues. The analysis is hampered by the difficulty in understanding Brazil's official classification of race/color, which often impedes recording this information. Various Maternal Mortality Committees are applying the color item and reviewing their data. The current article analyzes various Maternal Mortality Committee reports, showing that the risk of maternal mortality is greater among black women (which encompasses two census categories, negra, or black, and parda, or brown), thus representing a major expression of social inequality. The article concludes with a review of political and technical recommendations to decrease maternal mortality.

  18. Reconstructing human evolution

    CERN Document Server

    Cavalli-Sforza, M

    1999-01-01

    One can reconstruct human evolution using modern genetic data and models based on the mathematical theory of evolution and its four major factors : mutation, natural selection, statistical fluctuations in finite populations (random genetic drift), and migration. Archaeology gives some help on the major dates and events of the process. Chances of studying ancient DNA are very limited but there have been a few successful results. Studying DNA instead of proteins, as was done until a few years ago, and in particular the DNA of mitochondria and of the Y chromosome which are transmitted, respectively, by the maternal line and the paternal line, has greatly simplified the analysis. It is now possible to carry the analysis on individuals, while earlier studies were of necessity based on populations. Also the evolution of ÒcultureÓ (i.e. what we learn from others), in particular that of languages, gives some help and can be greatly enlightened by genetic studies. Even though it is largely based on mechanisms of mut...

  19. The Neuroendocrinology of Primate Maternal Behavior

    OpenAIRE

    Saltzman, Wendy; Maestripieri, Dario

    2010-01-01

    In nonhuman primates and humans, similar to other mammals, hormones are not strictly necessary for the expression of maternal behavior, but nevertheless influence variation in maternal responsiveness and parental behavior both within and between individuals. A growing number of correlational and experimental studies have indicated that high circulating estrogen concentrations during pregnancy increase maternal motivation and responsiveness to infant stimuli, while effects of prepartum or post...

  20. Determinants of maternal healthcare utilization in Zimbabwe

    OpenAIRE

    2012-01-01

    Zimbabwe and other developing countries struggle to achieve millennium development goals originally set for 2015. To assist health policy making, there was an investigation of how demographic, socioeconomic and cultural factors determine maternal healthcare services use in Zimbabwe. A logistic model for four different maternal healthcare services using data from the 2005/6 Zimbabwe Demographic Health Survey was estimated. Secondary education increases the odds of use of maternal health servic...

  1. THE MATERNAL-FETAL MEDICINE: AN UPDATE

    OpenAIRE

    Vincenzo Berghella; Alessandro Ghidini; Giancarlo Mari; Mariarosaria Di Tommaso; Silvia Vannuccini; Filiberto Maria Severi; Felice Petraglia

    2013-01-01

    The development of Maternal-Fetal Medicine is contributing to an improvement of maternal well-being and of neonatal health, introducing a number of new and useful technologies. Advances in genomics in the field of prenatal screening and diagnosis allowed the discovery of fragments of cell-free fetal DNA in the maternal circulation and the use of chromosomal microarrays, which can test for microdeletions and microduplications in addition to aneuploidies. Color Doppler applications during pregn...

  2. Maternal Employment and Adolescent Self-Care

    OpenAIRE

    LOPOO, LEONARD M.

    2004-01-01

    Mounting evidence shows that self-care produces deleterious consequences for adolescents in the U.S. Since desscriptive evidence suggests that maternal employment is the primary explanation for adolescent self-care, maternal employment, it is frequently argued, is harming children. Heretofore, very little empirical research has actually investigated the impact of maternal employment on adolescent self-care, however, calling into question this assertion. This paper aims to fill this gap. The a...

  3. Maternal Health and Fertility: An International Perspective

    OpenAIRE

    Albanesi, Stefania

    2013-01-01

    This paper examines the impact of the decline in maternal mortality on fertility and women's human capital. Fertility theory suggests that a permanent decline in maternal mortality initially increases fertility and generates a permanent rise in women's human capital, relative to men. The resulting rise in the opportunity cost of children leads to a subsequent decline in desired fertility, generating a boom-bust response. We assess these predictions using newly digitized data on maternal morta...

  4. Maternity or catastrophe: a study of household expenditure on maternal health care in India

    OpenAIRE

    2013-01-01

    Using data from 60th round of the National Sample Survey, this study attempts to measure the incidence and intensity of ‘catastrophic’ maternal health care expenditure and examines its socio-economic correlates in urban and rural areas separately. Additionally, it measures the effect of maternal health care expenditure on poverty incidence and examines the factors associated with such impoverishment due to maternal health care payments. We found that maternal health care expenditure in urban ...

  5. Association between Maternal Smoking during Pregnancy and Low Birthweight: Effects by Maternal Age

    OpenAIRE

    Zheng, Wei; Suzuki, Kohta; Tanaka, Taichiro; Kohama, Moriyasu; Yamagata, Zentaro; ,

    2016-01-01

    Background Maternal smoking during pregnancy has been consistently related to low birthweight. However, older mothers, who are already at risk of giving birth to low birthweight infants, might be even more susceptible to the effects of maternal smoking. Therefore, this study aimed to examine the modified association between maternal smoking and low birthweight by maternal age. Methods Data were obtained from a questionnaire survey of all mothers of children born between 2004 and 2010 in Okina...

  6. Maternal Dispositional Empathy and Electrodermal Reactivity: Interactive Contributions to Maternal Sensitivity with Toddler-Aged Children

    OpenAIRE

    Emery, Helen T.; McElwain, Nancy L.; Groh, Ashley M.; Haydon, Katherine C.; Roisman, Glenn I.

    2014-01-01

    The present study investigated maternal dispositional empathy and skin conductance level (SCL) reactivity to infant emotional cues as joint predictors of maternal sensitivity. Sixty-four mother-toddler dyads (31 boys) were observed across a series of interaction tasks during a laboratory visit, and maternal sensitivity was coded from approximately 55 minutes of observation per family. In a second, mother-only laboratory visit, maternal SCL reactivity to infant cues was assessed using a cry-la...

  7. 临床护理路径在围生期孕产妇中的应用研究%Application of clinical nursing pathway in maternal women during perinatal period

    Institute of Scientific and Technical Information of China (English)

    廖玉联; 关小玲

    2009-01-01

    Objective To explore the proper service mode during perinatal period in obstetric de-partment through application of clinical nursing pathway theory. Methods 2597 outpatient and inpatient pregnant women were randomly chosen. The experimental group (1332 cases): the clinical nursing pathway in different stages of perinatal period was designed, nurses completed their tasks according to the standard process. The control group (1265 cases): accepted the routine healthcare education and ordinary delivery method. The delivery outcome and the delivery time of the two groups were observed and recorded, satisfac-tion degree with the nursing service and nurses' mental condition before and after the application of clinical nursing pathway were also investigated. Results The rate of cesarean operation of the experimental group was lower than that of the control group. The difference of total delivery time in the two groups was signifi-cant. The satisfaction degree to the nursing service improved obviously in the experimental group. The dif-ference of nurses' self- confidence, self- determination, working satisfaction, sense of competence before and after the application of clinical nursing pathway was significant. Conclusions Application of clinical nursing pathway in pregnant and lying-in women during perinatal period can improve the confidence of natural delivery, shorten the delivery time, reduce the cesarean operation rate, improve satisfaction degree to nurses' work, mental condition, and their general diathesis.%目的 在产科中运用临床护理路径理论,探索适宜围生期服务的方式.方法 选择在我院产科门诊就诊并建卡的孕妇和住院分娩的孕产妇2597例作为研究对象.实验组1332例,设计围生期各阶段临床护理路径,医护人员按路径的标准化流程合作完成各项内容.对照组1265例,接受常规围生保健教育并按常规分娩方式分娩.2组均观察记录分娩结局,阴道分娩各产程时间,了

  8. Maternal Mortality Among Migrants in Western Europe

    DEFF Research Database (Denmark)

    Pedersen, Grete Skøtt; Grøntved, Anders; Mortensen, Laust Hvas;

    2013-01-01

    To examine whether an excess risk of maternal mortality exists among migrant women in Western Europe. We searched electronic databases for studies published 1970 through 2013 for all observational studies comparing maternal mortality between the host country and a defined migrant population......-analysis provides evidence that migrant women in Western European countries have an excess risk of maternal mortality........ Results were derived from a random-effects meta-analysis, and statistical heterogeneity assessed by the I (2) statistic. In sub-analyses we also calculated summary estimates stratified by direct and indirect death causes. We included 13 studies with more than 42 million women and 4,995 maternal deaths...

  9. Maternal bereavement and cryptorchidism in offspring

    DEFF Research Database (Denmark)

    Ingstrup, Katja Glejsted; Olsen, Jørn; Wu, Chunsen;

    2015-01-01

    BACKGROUND: Cryptorchidism (undescended testis) is a common anomaly with largely unexplained etiology. Animal studies have suggested maternal emotional stress as a potential risk factor, but this has not been studied in humans. We aimed to investigate whether maternal bereavement due to the death...... interval = 0.92-1.14]). Results were similar when the diagnosis was verified with surgery. We adjusted for maternal and paternal age, birth year, and family history of cryptorchidism. CONCLUSION: We observed no association between maternal bereavement before and during pregnancy and the occurrence...

  10. Migraine, daily chronic headache and fibromyalgia in the same patient: an evolutive "continuum" of non organic chronic pain? About 100 clinical cases.

    Science.gov (United States)

    Centonze, V; Bassi, A; Cassiano, M A; Munno, I; Dalfino, L; Causarano, V

    2004-10-01

    Aim of this study is to evaluate if migraine, daily chronic headache and fibromyalgia in the same patient can be considered as an evolutive continuum of non organic chronic pain. Therefore, migraine, daily chronic headache and fibromyalgia should be considered the expression of chronic antinociceptive system alteration. PMID:15549565

  11. Evidence from Maternity Leave Expansions of the Impact of Maternal Care on Early Child Development

    Science.gov (United States)

    Baker, Michael; Milligan, Kevin

    2010-01-01

    We study the impact of maternal care on early child development using an expansion in Canadian maternity leave entitlements. Following the leave expansion, mothers who took leave spent 48-58 percent more time not working in their children's first year of life. This extra maternal care primarily crowded out home-based care by unlicensed…

  12. The Effect of Marital Violence on Maternal Parenting Style and Maternal Stress.

    Science.gov (United States)

    Niesman, Cindy S.

    A study examined the effect of extreme marital discord, involving abuse of the mother, on maternal parenting style and level of maternal stress. It was hypothesized that battered women experience a higher level of maternal stress and choose an authoritarian parenting style as a consequence of marital discord. Subjects were 30 mothers of children…

  13. Maternal Psychiatric Disorders, Parenting, and Maternal Behavior in the Home during the Child Rearing Years

    Science.gov (United States)

    Johnson, Jeffrey G.; Cohen, Patricia; Kasen, Stephanie; Brook, Judith S.

    2006-01-01

    Data from the Children in the Community Study, a community-based longitudinal study, were used to investigate associations between maternal psychiatric disorders and child-rearing behaviors. Maternal psychiatric symptoms and behavior in the home were assessed in 782 families during the childhood and adolescence of the offspring. Maternal anxiety,…

  14. Maternal and Child Anxiety: Do Attachment Beliefs or Children's Perceptions of Maternal Control Mediate Their Association?

    Science.gov (United States)

    Costa, Natalie M.; Weems, Carl F.

    2005-01-01

    This study tested a model of the association between maternal and child anxiety that views mother and child attachment beliefs and children's perceptions of maternal control as mediators of the association. The study was conducted with mothers and their children aged 6 to 17 (N = 88). Maternal anxiety was significantly associated with child…

  15. The genetics of maternal care: direct and indirect genetic effects on phenotype in the dung beetle Onthophagus taurus.

    Science.gov (United States)

    Hunt, John; Simmons, Leigh W

    2002-05-14

    While theoretical models of the evolution of parental care are based on the assumption of underlying genetic variance, surprisingly few quantitative genetic studies of this life-history trait exist. Estimation of the degree of genetic variance in parental care is important because it can be a significant source of maternal effects, which, if genetically based, represent indirect genetic effects. A major prediction of indirect genetic effect theory is that traits without heritable variation can evolve because of the heritable environmental variation that indirect genetic effects provide. In the dung beetle, Onthophagus taurus, females provide care to offspring by provisioning a brood mass. The size of the brood mass has pronounced effects on offspring phenotype. Using a half-sib breeding design we show that the weight of the brood mass females produce exhibits significant levels of additive genetic variance due to sires. However, variance caused by dams is considerably larger, demonstrating that maternal effects are also important. Body size exhibited low additive genetic variance. However, body size exerts a strong maternal influence on the weight of brood masses produced, accounting for 22% of the nongenetic variance in offspring body size. Maternal body size also influenced the number of offspring produced but there was no genetic variance for this trait. Offspring body size and brood mass weight exhibited positive genetic and phenotypic correlations. We conclude that both indirect genetic effects, via maternal care, and nongenetic maternal effects, via female size, play important roles in the evolution of phenotype in this species.

  16. The genetics of maternal care: direct and indirect genetic effects on phenotype in the dung beetle Onthophagus taurus.

    Science.gov (United States)

    Hunt, John; Simmons, Leigh W

    2002-05-14

    While theoretical models of the evolution of parental care are based on the assumption of underlying genetic variance, surprisingly few quantitative genetic studies of this life-history trait exist. Estimation of the degree of genetic variance in parental care is important because it can be a significant source of maternal effects, which, if genetically based, represent indirect genetic effects. A major prediction of indirect genetic effect theory is that traits without heritable variation can evolve because of the heritable environmental variation that indirect genetic effects provide. In the dung beetle, Onthophagus taurus, females provide care to offspring by provisioning a brood mass. The size of the brood mass has pronounced effects on offspring phenotype. Using a half-sib breeding design we show that the weight of the brood mass females produce exhibits significant levels of additive genetic variance due to sires. However, variance caused by dams is considerably larger, demonstrating that maternal effects are also important. Body size exhibited low additive genetic variance. However, body size exerts a strong maternal influence on the weight of brood masses produced, accounting for 22% of the nongenetic variance in offspring body size. Maternal body size also influenced the number of offspring produced but there was no genetic variance for this trait. Offspring body size and brood mass weight exhibited positive genetic and phenotypic correlations. We conclude that both indirect genetic effects, via maternal care, and nongenetic maternal effects, via female size, play important roles in the evolution of phenotype in this species. PMID:11983863

  17. Maternal Responsiveness Predicts Child Language at Ages 3 and 4 in a Community-Based Sample of Slow-to-Talk Toddlers

    Science.gov (United States)

    Hudson, Sophie; Levickis, Penny; Down, Kate; Nicholls, Ruth; Wake, Melissa

    2015-01-01

    Background: Maternal responsiveness has been shown to predict child language outcomes in clinical samples of children with language delay and non-representative samples of typically developing children. An effective and timely measure of maternal responsiveness for use at the population level has not yet been established. Aims: To determine…

  18. Accuracy of serum uric acid as a predictive test for maternal complications in pre-eclampsia: Bivariate meta-analysis and decision analysis

    NARCIS (Netherlands)

    C.M. Koopmans; M.G. van Pampus; H. Groen; J.G. Aarnoudse; P.P. van den Berg; B.W.J. Mol

    2009-01-01

    The aim of this study is to determine the accuracy and clinical value of serum uric acid in predicting maternal complications in women with pre-eclampsia. An existing meta-analysis on the subject was updated. The accuracy of serum uric acid for the prediction of maternal complications was assessed w

  19. Accuracy of serum uric acid as a predictive test for maternal complications in pre-eclampsia : Bivariate meta-analysis and decision analysis

    NARCIS (Netherlands)

    Koopmans, C.M.; van Pampus, Maria; Groen, H.; Aarnoudse, J.G.; van den Berg, P.P.; Mol, B.W.J.

    2009-01-01

    The aim of this study is to determine the accuracy and clinical value of serum uric acid in predicting maternal complications in women with pre-eclampsia. An existing meta-analysis on the subject was updated. The accuracy of serum uric acid for the prediction of maternal complications was assessed w

  20. "We never ate like that, not fast food, or junk foods": accounts of changing maternal diet in a tourist community in rural Costa Rica.

    Science.gov (United States)

    Cantor, Allison; Peña, Jenny; Himmelgreen, David

    2013-01-01

    This investigation examines maternal diet in rural Costa Rica in the context of recent political economic changes. Results show that increased availability of non-local food items, (i.e., pizza and processed foods) has influenced maternal dietary choices. Information pathways, which have traditionally provided women with knowledge about maternal diet from family members, are also shifting. Younger women turn to the local clinic and the media for information about maternal diet, and traditional practices, such as cuarentena (40-day postpartum period), are no longer being observed. Changing practices may be linked with shifting information pathways, as well as self-reported weight gain among women.

  1. Maternal mortality in southern India.

    Science.gov (United States)

    Rao, P S; Amalraj, A

    1994-01-01

    In a 4 year prospective community survey of 20,000 women randomly selected in North Arcot District of Tamil Nadu State in South India, the maternal mortality rates per 1,000 liveborn were estimated to be 17.4 and 16.6 for rural and semi-urban areas, respectively. The rates based only on direct causes were 11.9 in rural and 14.4 in semi-urban areas. As expected, these figures are considerably higher than those based on official or hospital statistics. Factors associated with such high mortality and the implications for programme planning and implementation are discussed. PMID:7855917

  2. [Maternal mortality: levels, trends, and differentials].

    Science.gov (United States)

    Langer, A; Lozano, R; Hernandez, B

    1993-01-01

    Maternal mortality in Mexico has declined significantly over the past half century. The maternal mortality rate was 53/10,000 live births in 1940 and 5.1 in 1990. The greatest and most rapid decline occurred in the 1940s. The maternal mortality rate is still too high, and in addition the differential between Mexican rates and those of the developed countries has increased. The average age at maternal death is 29 years, a full 40 years less than potential life expectancy. The risk of death from causes related to reproduction varies substantially by educational level. Of all maternal deaths between 1986 and 1991, 26% were in illiterate women, 33% in women with incomplete primary, and 24% in those with complete primary. In 1990, the average female school attainment was complete primary. The maternal mortality rate was eight times higher among illiterate women and five times higher in those not completing primary than in those finishing preparatory. Geographically, states with low maternal mortality rates of under 3.1 are mainly located in the north and those with high maternal mortality of over 6.0 are in the south. The central zone is an intermediate area. The 1991 maternal mortality rates of Oaxaca, Puebla, Tlaxcala, Veracruz, and the state of Mexico are similar to those of Nuevo Leon 30 years ago or Aguascalientes, Sonora, and Baja California 20 years ago. 72% of maternal deaths in the 1980s occurred in rural areas. The rates were 6.5/10,000 in rural areas and 4.1/10,000 in urban areas. The maternal mortality rate also increases with marginalization. An index of marginalization constructed with census data using multivariate techniques showed that fertile aged women in very marginalized municipios had maternal mortality rates of 11.5/10,000, or a risk of death three times greater than women in municipios scoring low for marginalization. Maternal mortality continues to be a priority public health problem in Mexico. Because so many maternal deaths are preventable

  3. Maternity Disseminated Intravascular Coagulation Early Diagnosis of Clinical Curative Effect Analysis%产科弥漫性血管内凝血早期诊治的临床疗效探析

    Institute of Scientific and Technical Information of China (English)

    陆玲军; 苏敏君

    2013-01-01

    目的:分析探讨产科弥漫性血管内凝血早期诊治的临床效果。方法:选取本院收治的共28例弥漫性血管内凝血患者,根据患者早期诊断标准不同得出的诊断结果分为两组,其中根据一般弥漫性血管内凝血诊断标准诊断出的7例为A组,根据早期弥漫性血管内凝血标准诊断出的21例为B组,根据患者的病情严重性给予相应的治疗,比较两组患者临床效果。结果:A组治愈率为28.57%,B组的治愈率为80.95%,两组相比有明显的差异,B组的治愈率远远高于A组(P<0.05)。结论:根据早期弥漫性血管内凝血标准诊断出的患者可以及时得到治疗,提高治愈率,有效保障患者生命安全。%Objective:To analyze the obstetric disseminated intravascular coagulation of early diagnosis and clinical effect. Methods: Select treated at our hospital, A total of 28 patients with disseminated intravascular coagulation,according to different patients early diagnosis standard of diagnosis is divided into two groups, which according to the general diagnostic criteria diagnosis of disseminated intravascular coagulation of 7 cases of group A, according to the early diagnosis of disseminated intravascular coagulation standard 21 cases in group B, according to the patient's illness severity give corresponding treatment, compared two groups of patients clinical effect. Results:The cure rate of group A was 28.57%, the cure rate of group B was 80.95%, compared two groups have significant difference, the cure rate of group B is higher than group A (P<0.05).Conclusion:According to the early diagnosis of disseminated intravascular coagulation standard patients can receive timely treatment, improve the cure rate, effective guarantee patient safety.

  4. Clinical analysis of maternal intracranial venous sinus thrombosis in 24 cases%孕产妇合并颅内静脉窦血栓形成24例临床分析

    Institute of Scientific and Technical Information of China (English)

    刘静; 马英; 马爽; 丛琳; 高凤彤; 郭阳

    2011-01-01

    Objective To explore the clinical, imaging features and prophylaxis of patients with cerebral venous sinus thrombosis(CVST) during pregnancy and puerperium. Methods A retrospective study was performed in 24 cases of pregnant women with CVST. Results Totally 7 cases after cesarean section. Early pregnancy:3 cases,and 2 cases had the history of oral contraceptives. 13 patients underwent MRI,MRV and DSA at the same time,and 11 were diagnosed by MRI and MRV in which 10 patients were positive of DSA. The coincidence of MRV and DSA was 90. 9%. Superior sagittal sinus thrombosis was more common. Altogether, there were 23 patients underwent systemic anticoagulant therapy after which 15 were fully recovered ,6 left with dysfunction and 3 died. Conclusions CVST during pregnancy and puerperium, short of clinical specificiy, are more common in puerperium than during pregnancy. MRI and MRV are main diagnostic methods. Anticoagulant therapy is effective in the treatment of CVST. Prompt diagnosis and treatment ensure a better outcome for pregnant women complicated with CVST.%目的 探讨孕产妇合并颅内静脉窦血栓形成(CVST)的临床和影像学特点、诊治及预防.方法 回顾性分析24例孕产妇合并CVST的临床资料.结果 发生于妊娠期7例,自然分娩后5例,剖宫产后12例.孕早期3例,2例有口服避孕药物史.13例同时行MRI、MRV、DSA检查,11例MRI及MRV检查阳性的患者中10例DSA检查也呈阳性,两者符合率为90.9%.发病部位以上矢状窦多见.抗凝治疗23例,痊愈15例,存留功能缺损6例,死亡3例.结论 孕产妇合并CVST临床表现缺乏特异性,多发生于产褥期.MRI及MRV检查为主要的诊断方法.全身抗凝治疗有较好疗效.及时诊断并治疗孕产妇合并颅内静脉窦血栓可改善其结局.

  5. Effects of maternal postpartum depression in a well-resourced sample

    DEFF Research Database (Denmark)

    Smith-Nielsen, Johanne; Tharner, Anne; Krogh, Marianne Thode;

    2016-01-01

    This study examined early and long-term effects of maternal postpartum depression on cognitive, language, and motor development in infants of clinically depressed mothers. Participants were 83 mothers and their full-term born children from the urban region of Copenhagen, Denmark. Of this group, 28...... mothers were diagnosed with postnatal depression three to four months postpartum in a diagnostic interview. Cognitive, language, and motor development was assessed with the Bayley Scales of Infant and Toddler Development third edition, when the infants were 4 and 13 months of age. We found that maternal...... (79%) of the clinical mothers were no longer, or not again, depressed. These results may indicate that maternal depression can have an acute, concurrent effect on infant cognitive development as early as at four months postpartum. At the same time, in the absence of other risk factors, this effect may...

  6. Nature, nurture or nutrition? Impact of maternal nutrition on maternal care, offspring development and reproductive function.

    Science.gov (United States)

    Connor, K L; Vickers, M H; Beltrand, J; Meaney, M J; Sloboda, D M

    2012-05-01

    We have previously reported that offspring of mothers fed a high fat (HF) diet during pregnancy and lactation enter puberty early and are hyperleptinaemic, hyperinsulinaemic and obese as adults. Poor maternal care and bonding can also impact offspring development and disease risk.We therefore hypothesized that prenatal nutrition would affect maternal care and that an interaction may exist between a maternal HF diet and maternal care, subsequently impacting on offspring phenotype.Wistar rats were mated and randomized to control dams fed a control diet (CON) or dams fed a HF diet from conception until the end of lactation (HF). Maternal care was assessed by observing maternal licking and grooming of pups between postnatal day (P)3 and P8. Postweaning (P22), offspring were fed a control (–con) or HF (–hf) diet. From P27, pubertal onset was assessed. At ∼P105 oestrous cyclicity was investigated. Maternal HF diet reduced maternal care; HF-fed mothers licked and groomed pups less than CON dams.Maternal fat:lean ratio was higher in HF dams at weaning and was associated with higher maternal plasma leptin and insulin concentrations, but there was no effect of maternal care on fat:lean ratio or maternal hormone levels. Both female and male offspring of HF dams were lighter from birth to P11 than offspring of CON dams, but by P19, HF offspring were heavier than controls. Prepubertal retroperitoneal fat mass was greater in pups from HF-fed dams compared to CON and was associated with elevated circulating leptin concentrations in females only, but there was neither an effect of maternal care, nor an interaction between maternal diet and care on prepubertal fat mass. Pups from HF-fed dams went into puberty early and this effect was exacerbated by a postweaning HF diet.Maternal and postweaning HF diets independently altered oestrous cyclicity in females: female offspring of HF-fed mothers were more likely to have prolonged or persistent oestrus, whilst female offspring fed

  7. A Needs Assessment of Health Issues Related to Maternal Mortality Rates in Afghanistan: A Pilot Study.

    Science.gov (United States)

    Naim, Ali; Feldman, Robert; Sawyer, Robin

    2015-01-01

    Maternal death rates in Afghanistan were among the highest in the world during the reign of the Taliban. Although these figures have improved, current rates are still alarming. The aim of this pilot study was to develop a needs assessment of the major health issues related to the high maternal mortality rates in Afghanistan. In-depth interviews were conducted with managerial midwives, clinical midwives, and mothers. Results of the interviews indicate that the improvement in the maternal mortality rate may be attributed to the increase in the involvement of midwives in the birthing process. However, barriers to decreasing maternal mortality still exist. These include transportation, access to care, and sociocultural factors such as the influence of the husband and mother-in-law in preventing access to midwives. Therefore, any programs to decrease maternal mortality need to address infrastructure issues (making health care more accessible) and sociocultural factors (including husbands and mother-in-laws in maternal health education). However, it should be noted that these findings are based on a small pilot study to help develop a larger scale need assessment.

  8. The WHO maternal near miss approach: consequences at Malawian District level.

    Directory of Open Access Journals (Sweden)

    Thomas van den Akker

    Full Text Available INTRODUCTION: WHO proposes a set of organ-failure based criteria for maternal near miss. Our objective was to evaluate what implementation of these criteria would mean for the analysis of a cohort of 386 women in Thyolo District, Malawi, who sustained severe acute maternal morbidity according to disease-based criteria. METHODS AND FINDINGS: A WHO Maternal Near Miss (MNM Tool, created to compare disease-, intervention- and organ-failure based criteria for maternal near miss, was completed for each woman, based on a review of all available medical records. Using disease-based criteria developed for the local setting, 341 (88% of the 386 women fulfilled the WHO disease-based criteria provided by the WHO MNM Tool, 179 (46% fulfilled the intervention-based criteria, and only 85 (22% the suggested organ-failure based criteria. CONCLUSIONS: In this low-resource setting, application of these organ-failure based criteria that require relatively sophisticated laboratory and clinical monitoring underestimates the occurrence of maternal near miss. Therefore, these criteria and the suggested WHO approach may not be suited to compare maternal near miss across all settings.

  9. Depression, Sensation Seeking, and Maternal Smoking as Predictors of Adolescent Cigarette Smoking

    Directory of Open Access Journals (Sweden)

    Judy van de Venne

    2006-01-01

    Full Text Available The purpose of this study was to examine maternal and adolescent depression, maternal and teen sensation seeking, and maternal smoking, and their associations with adolescent smoking. Data were collected from a sample of 47 male and 66 female adolescents (ages 11—18 years and their mothers from three different health clinics. The findings indicated that maternal sensation seeking was linked indirectly with adolescent smoking through teen sensation seeking, both of which were significantly associated with teen smoking (β = 0.29, p < 0.001 and β = 0.32, p < 0.001, respectively. Teen depression was associated positively with teen smoking (β = 0.24, p < 0.01 when controlling for sensation seeking behaviors. Maternal smoking was also directly linked to adolescent smoking (β = 0.20, p < 0.05. These findings underscore a potentially important role of sensation seeking in the origins of adolescent smoking, and clarify pathways of influence with regard to maternal attitudes and behaviors in subsequent teenage nicotine use.

  10. The influence of maternal glycaemia and dietary glycaemic index on pregnancy outcome in healthy mothers.

    LENUS (Irish Health Repository)

    McGowan, Ciara A

    2010-07-01

    Infant birth weight has increased in Ireland in recent years along with levels of childhood overweight and obesity. The present article reviews the current literature on maternal glycaemia and the role of the dietary glycaemic index (GI) and its impact on pregnancy outcomes. It is known that maternal weight and weight gain significantly influence infant birth weight. Fetal macrosomia (birth weight >4000 g) is associated with an increased risk of perinatal trauma to both mother and infant. Furthermore, macrosomic infants have greater risk of being obese in childhood, adolescence and adulthood compared to normal-sized infants. There is evidence that there is a direct relationship between maternal blood glucose levels during pregnancy and fetal growth and size at birth, even when maternal blood glucose levels are within their normal range. Thus, maintaining blood glucose concentrations within normal parameters during pregnancy may reduce the incidence of fetal macrosomia. Maternal diet, and particularly its carbohydrate (CHO) type and content, influences maternal blood glucose concentrations. However, different CHO foods produce different glycaemic responses. The GI was conceived by Jenkins in 1981 as a method for assessing the glycaemic responses of different CHO. Data from clinical studies in healthy pregnant women have documented that consuming a low-GI diet during pregnancy reduces peaks in postprandial glucose levels and normalises infant birth weight. Pregnancy is a physiological condition where the GI may be of particular relevance as glucose is the primary fuel for fetal growth.

  11. Productivity cost due to maternal ill health in Sri Lanka.

    Directory of Open Access Journals (Sweden)

    Suneth Agampodi

    Full Text Available BACKGROUND: The global impact of maternal ill health on economic productivity is estimated to be over 15 billion USD per year. Global data on productivity cost associated with maternal ill health are limited to estimations based on secondary data. Purpose of our study was to determine the productivity cost due to maternal ill health during pregnancy in Sri Lanka. METHODS AND FINDINGS: We studied 466 pregnant women, aged 24 to 36 weeks, residing in Anuradhapura, Sri Lanka. A two stage cluster sampling procedure was used in a cross sectional design and all pregnant women were interviewed at clinic centers, using the culturally adapted Immpact tool kit for productivity cost assessment. Of the 466 pregnant women studied, 421 (90.3% reported at least one ill health condition during the pregnancy period, and 353 (83.8% of them had conditions affecting their daily life. Total incapacitation requiring another person to carry out all their routine activities was reported by 122 (26.1% of the women. In this study sample, during the last episode of ill health, total number of days lost due to absenteeism was 3,356 (32.9% of total loss and the days lost due to presenteeism was 6,832.8 (67.1% of the total loss. Of the 353 women with ill health conditions affecting their daily life, 280 (60% had coping strategies to recover loss of productivity. Of the coping strategies used to recover productivity loss during maternal ill health, 76.8% (n = 215 was an intra-household adaptation, and 22.8% (n = 64 was through social networks. Loss of productivity was 28.9 days per episode of maternal ill health. The mean productivity cost due to last episode of ill health in this sample was Rs.8,444.26 (95% CI-Rs.6888.74-Rs.9999.78. CONCLUSIONS: Maternal ill health has a major impact on household productivity and economy. The major impact is due to, generally ignored minor ailments during pregnancy.

  12. Regional differences in Dutch maternal mortality.

    NARCIS (Netherlands)

    Graaf, J. de; Schutte, J.; Poeran, J.; Roosmalen, J. van; Bonsel, G.; Steegers, E.

    2012-01-01

    Please cite this paper as: de Graaf J, Schutte J, Poeran J, van Roosmalen J, Bonsel G, Steegers E. Regional differences in Dutch maternal mortality. BJOG 2012;119:582-588. Objective To study regional differences in maternal mortality in the Netherlands. Design Confidential inquiry into the causes of

  13. Infant Communicative Behaviors and Maternal Responsiveness

    Science.gov (United States)

    DiCarlo, Cynthia F.; Onwujuba, Chinwe; Baumgartner, Jennifer I.

    2014-01-01

    Background: This study applies attachment and transactional theories in evaluating the dyadic interactions observed between a mother and her infant. Infant communication and maternal responsivity are highlighted as the medium for positive interaction. Objective: The impact of individualized maternal training on mother infant communicative…

  14. First trimester bleeding and maternal cardiovascular morbidity

    DEFF Research Database (Denmark)

    Lykke, Jacob A; Langhoff-Roos, Jens

    2012-01-01

    First trimester bleeding without miscarriage is a risk factor for complications later in the pregnancy, such as preterm delivery. Also, first trimester miscarriage has been linked to subsequent maternal ischemic heart disease. We investigated the link between maternal cardiovascular disease prior...... to and subsequent to first trimester bleeding without miscarriage....

  15. Cryptorchidism and maternal alcohol consumption during pregnancy

    DEFF Research Database (Denmark)

    Damgaard, Ida N; Jensen, Tina Kold; Petersen, Jørgen H;

    2007-01-01

    Prenatal exposure to alcohol can adversely affect the fetus. We investigated the association between maternal alcohol consumption during pregnancy and cryptorchidism (undescended testis) among newborn boys.......Prenatal exposure to alcohol can adversely affect the fetus. We investigated the association between maternal alcohol consumption during pregnancy and cryptorchidism (undescended testis) among newborn boys....

  16. Postpartum haemorrhage: a preventable cause of maternal mortality

    International Nuclear Information System (INIS)

    To assess the preventable predictors of severe postpartum haemorrhage and the adverse outcome associated with it. All the admitted patients who developed severe postpartum haemorrhage (>1500 ml) were included in the study. Clinical and sociodemographic data was obtained along with results of investigations to categorize the complications encountered. Odds ratio (OR) and 95% confidence intervals were determined. During the study period, 75 out of 4683 obstetrical admissions, developed severe postpartum haemorrhage (1.6 %). About 65% of the patients were admitted with some other complications including obstructed labour, antepartum haemorrhage and eclampsia. The risk factors were grand multiparity (OR=3.4), pre-eclampsia (OR=2.75), antepartum haemorrhage (OR=13.35), active labour of more than 10 hours (OR=46.92), twin delivery (OR=3.25), instrumental delivery (OR=8.62) and caesarean section (OR=9.74). Maternal mortality in these cases was 2.66% and residual morbidity being 40%. Birth attendant other than doctor and delivery outside the study unit were significantly associated with the adverse outcome in these patients. Maternal outcome associated with postpartum haemorrhage is a function of care given during labour and postnatal period with early diagnosis and management of the complication and its risk factors, being the key of good maternal outcome. (author)

  17. Maternal presence, childrearing practices, and children's response to an injection.

    Science.gov (United States)

    Broome, M E; Endsley, R C

    1989-08-01

    The purpose of the study was to investigate the effects of maternal presence or absence and childrearing practices on young children's response to an injection. One hundred thirty-eight mothers and their children, who were attending health screening clinic, were assigned to one of four groups in which mothers were either present or absent during an interview and an immunization. Mothers were asked to fill out a questionnaire about their childrearing practices. Child behavior was observed during both the interview and the immunization. Results indicated that while maternal presence was associated with the children behaving more distressed during the interview, maternal presence had no effect on child behavior during the immunization. Children whose mothers reported high levels of both control and warmth in their relationship (authoritative parents) were found to be significantly less distressed during the immunization than children of either the low-control, high-warmth (permissive), high-control, low-warmth (authoritarian) or low-control, low-warmth (nonresponsive) parent groups.

  18. Maternal ability to take care of children exposed to HIV

    Directory of Open Access Journals (Sweden)

    Julyana Gomes Freitas

    2013-07-01

    Full Text Available OBJECTIVE: to assess the ability of mothers to take care of children exposed to HIV, using the Assessment Scale of Care Skills for Children Exposed to HIV at Birth and to check the association between the scale dimensions and maternal characteristics. METHOD: this cross-sectional study involved 62 HIV+ mothers whose children of up to one year old had been exposed to the virus at birth. The Assessment Scale of Care Skills for Children Exposed to HIV at Birth consists of 52 items and five dimensions, indicating high, moderate or low care ability. RESULTS: 72.7% of the mothers appropriately offered zidovudine syrup; 86.0% were highly skilled to prepare and administer milk formula; 44.4% were moderately able to prepare and administer complementary feeding; 76.5% revealed high ability to administer prophylactic treatment against pneumonia and 95.3% demonstrated high abilities for clinical monitoring and immunization. Significant associations were found between some maternal variables and the scale dimensions. CONCLUSION: the scale permits the assessment of maternal care delivery to these children and the accomplishment of specific child health interventions.

  19. Reducing maternal mortality on a countrywide scale: The role of emergency obstetric training.

    Science.gov (United States)

    Moran, Neil F; Naidoo, Mergan; Moodley, Jagidesa

    2015-11-01

    Training programmes to improve health worker skills in managing obstetric emergencies have been introduced in various countries with the aim of reducing maternal mortality through these interventions. In South Africa, based on an ongoing confidential enquiry system started in 1997, detailed information about maternal deaths is published in the form of regular 'Saving Mothers' reports. This article tracks the recommendations made in successive Saving Mothers reports with regard to emergency obstetric training, and it assesses the impact of these recommendations on reducing maternal mortality. Since 2009, South Africa has had its own training package, Essential Steps in the Management of Obstetric Emergencies (ESMOE), which the last three Saving Mothers reports have specifically recommended for all doctors and midwives working in maternity units. A special emphasis has been placed on the need for the simulation training component of ESMOE, also called obstetric 'fire drills', to be integrated into the clinical routines of all maternity units. The latest Saving Mothers report (2011-2013) suggests there has been little progress so far in improving emergency obstetric skills, indicating a need for further scale-up of ESMOE training in the country. The example of the KwaZulu-Natal province of South Africa is used to illustrate the process of scale-up and factors likely to facilitate that scale-up, including the introduction of ESMOE into the undergraduate medical training curriculum. Additional factors in the health system that are required to convert improved skills levels into improved quality of care and a reduction in maternal mortality are discussed. These include intelligent government health policies, formulated with input from clinical experts; strong clinical leadership to ensure that doctors and nurses apply the skills they have learnt appropriately, and work professionally and ethically; and a culture of clinical governance.

  20. Reducing maternal mortality on a countrywide scale: The role of emergency obstetric training.

    Science.gov (United States)

    Moran, Neil F; Naidoo, Mergan; Moodley, Jagidesa

    2015-11-01

    Training programmes to improve health worker skills in managing obstetric emergencies have been introduced in various countries with the aim of reducing maternal mortality through these interventions. In South Africa, based on an ongoing confidential enquiry system started in 1997, detailed information about maternal deaths is published in the form of regular 'Saving Mothers' reports. This article tracks the recommendations made in successive Saving Mothers reports with regard to emergency obstetric training, and it assesses the impact of these recommendations on reducing maternal mortality. Since 2009, South Africa has had its own training package, Essential Steps in the Management of Obstetric Emergencies (ESMOE), which the last three Saving Mothers reports have specifically recommended for all doctors and midwives working in maternity units. A special emphasis has been placed on the need for the simulation training component of ESMOE, also called obstetric 'fire drills', to be integrated into the clinical routines of all maternity units. The latest Saving Mothers report (2011-2013) suggests there has been little progress so far in improving emergency obstetric skills, indicating a need for further scale-up of ESMOE training in the country. The example of the KwaZulu-Natal province of South Africa is used to illustrate the process of scale-up and factors likely to facilitate that scale-up, including the introduction of ESMOE into the undergraduate medical training curriculum. Additional factors in the health system that are required to convert improved skills levels into improved quality of care and a reduction in maternal mortality are discussed. These include intelligent government health policies, formulated with input from clinical experts; strong clinical leadership to ensure that doctors and nurses apply the skills they have learnt appropriately, and work professionally and ethically; and a culture of clinical governance. PMID:26363737

  1. Maternal dental radiography during pregnancy is not associated with term low birth weight

    International Nuclear Information System (INIS)

    Complete text of publication follows. Objective: In a report published in JAMA in 2004, Hujoel and colleagues indicated that maternal dental radiography during pregnancy may be associated with term low birth weight. Interestingly, they concluded that dental radiographies cause measurable radiation doses to the hypothalamus-pituitary-thyroid axis and the radiation effects on this axis is the reason for term low birth weight. On the other hand, low birth weight is the second leading cause of infant death. In this paper the results obtained in a 2 year study conducted at a midwifery hospital in Rafsanjan, IR Iran are reported. Methods: Four hundred seventy-five singleton infants with gestational periods of 37-44 wk born between 2006 and 2007 at the Niknafs Teaching Hospital affiliated with Rafsanjan University of Medical Sciences and met the inclusion criteria were enrolled in the study. Demographic data and clinical findings at birth including gestation age, sex of infant, birth order, season of birth, maternal age, and maternal education were collected from maternal and newborn hospital records and by interviews with parents. Maternal history of exposure to common sources of man-made ionizing and non-ionizing (exposure to radiations emitted by mobile phones, CRTs, cordless phones) radiation before and during pregnancy were carefully recorded. Results: Among the 475 infants who were studied, there were only 15 cases with a history of maternal dental radiography during pregnancy. The average newborn infants' birth weight in non-exposed and exposed (maternal dental radiography during pregnancy) groups were 3166.69±481.31 g and 3118.67±341.42 g respectively. This difference was not statistically significant. Conclusions: In this study, low birth weight was not associated with maternal dental radiography during pregnancy. These results are generally inconsistent with those reported by Hujoel and colleagues.

  2. Effect on mortality of community-based maternity-care programme in rural Bangladesh.

    Science.gov (United States)

    Fauveau, V; Stewart, K; Khan, S A; Chakraborty, J

    1991-11-01

    Various community-based interventions have been proposed to improve maternity care, but hardly any studies have reported the effect of these measures on maternal mortality. In this study, the efficacy of a maternity-care programme to reduce maternal mortality has been evaluated in the context of a primary health-care project in rural Bangladesh. Trained midwives were posted in villages, and asked to attend as many home-deliveries as possible, detect and manage obstetric complications at onset, and accompany patients requiring referral for higher-level care to the project central maternity clinic. The effect of the programme was evaluated by comparison of direct obstetric maternal mortality ratios between the programme area and a neighbouring control area without midwives. Random assignment of the intervention was not possible but potentially confounding characteristics, including coverage and use of other health and family planning services, were similar in both areas. Maternal mortality ratios due to obstetric complications were similar in both areas during the 3 years preceding the start of the programme. By contrast, during the following 3 years, the ratio was significantly lower in the programme than in the control area (1.4 vs 3.8 per 1000 live births, p = 0.02). The findings suggest that maternal survival can be improved by the posting of midwives at village level, if they are given proper training, means, supervision, and back-up. The inputs for such a programme to succeed and the constraints of its replication on a large scale should not be underestimated. PMID:1682600

  3. Maternal deaths in Denmark 2002-2006

    DEFF Research Database (Denmark)

    Bødker, Birgit; Hvidman, Lone; Weber, Tom;

    2009-01-01

    and indirect deaths. MAIN OUTCOME MEASURES: Maternal mortality ratio, causes of death and suboptimal care. RESULTS: In the study period, 26 women died during pregnancy or within 42 days from direct or indirect causes, leading to a maternal mortality ratio of 8.0/100,000 live births. Causes of death were......OBJECTIVE: To describe a method for identification, classification and assessment of maternal deaths in Denmark and to identify substandard care. DESIGN: Register study and case audit based on data from the Registers of the Danish Medical Health Board, death certificates and hospital records....... SETTING: Denmark 2002-2006. POPULATION: Women who died during a pregnancy or within 42 days after a pregnancy. METHODS: Maternal deaths were identified by notification from maternity wards and data from the Danish National Board of Health. A national audit committee assessed hospital records of direct...

  4. Maternal death and the Millennium Development Goals

    DEFF Research Database (Denmark)

    Rasch, Vibeke

    2007-01-01

    Maternal health is one of the main global health challenges and reduction of the maternal mortality ratio, from the present 0.6 mio. per year, by three-quarters by 2015 is the target for the fifth Millennium Development Goal (MDG 5). However this goal is the one towards which the least progress has...... been made. There is not a simple and straight-forward intervention, which by itself will bring maternal mortality significantly down; and it is commonly agreed on that the high maternal mortality can only be addressed if the health system is strengthened. There is a common consensus about...... the importance of skilled attendance at delivery to address the high, maternal mortality. This consensus is also reflected in the MDG 5, where the proportion of births attended by skilled health personnel is considered a key indicator. But even if countries invest massive efforts to increase skilled care...

  5. Maternal coping styles and adjustment in children.

    Science.gov (United States)

    Atlas, J G; Rickel, A U

    1988-06-01

    A comprehensive examination of children's social-emotional adjustment as related to maternal coping styles was performed. Subjects were 186 black mothers from lower-income families, and their children who were enrolled in the Detroit Public Schools Area F, Title I Preschool Program. Maternal nurturant and restrictive child rearing practices, life stress, locus of control and marital status were evaluated with respect to each of the child variables of school adjustment, self-concept and social problem solving skills. Maternal life stress was significantly related to children's lower self-concept, higher aggression, use of finagling and nondirective problem-solving strategies. Significant negative relationships were found between maternal nurturance and child moodiness and learning problems in school, further validating the Modified Child Rearing Practices Report. These findings provide support for expanding the current child developmental focus of preventive parenting programs to include maternal coping strategies such as improved communication and assertiveness training.

  6. Striving for Respectful Maternity Care Everywhere.

    Science.gov (United States)

    Molina, Rose L; Patel, Suha J; Scott, Jennifer; Schantz-Dunn, Julianna; Nour, Nawal M

    2016-09-01

    Purpose The mistreatment of women during childbirth in health facilities is a growing area of research and public attention. Description In many countries, disrespect and abuse from maternal health providers discourage women from seeking childbirth with a skilled birth attendant, which can lead to poor maternal and neonatal outcomes. This commentary highlights examples from three countries-Kenya, Mexico and the United States-and presents different forms of mistreatment during childbirth, which range from physical abuse to non-consented care to discriminatory practices. Assessment Building on the momentum from the United Nations Sustainable Development Goals, the International Federation of Gynecology and Obstetrics, and the Global and Maternal Neonatal Health Conference, the global community has placed respectful maternity care at the forefront of the maternal and neonatal health agenda. Conclusion Research efforts must focus on context-specific patient satisfaction during childbirth to identify areas for quality improvement.

  7. Commentary: Parental care and the proximate links between maternal effects and offspring fitness.

    Science.gov (United States)

    Dugas, Matthew B

    2015-04-01

    Maternal effects influence the phenotype of offspring through non-genetic mechanisms, and thus are important components of individual life-histories and act as drivers of and/or constraints on phenotypic evolution. A maternal effect common in egg-laying vertebrates is provisioning of the yolk with carotenoids, organic pigments that often color sexual ornaments and are hypothesized to play positive and substantial physiological roles. In a recent study, yolks of great tit (Parus major) eggs were directly supplemented with carotenoids, and the effects on offspring fitness proxies measured (Marri and Richner in Oecologia 176:371-377, 2014a). Nestlings from supplemented broods were heavier early in development and more likely to fledge, but otherwise equivalent to control nestlings. The authors consider in detail the potential physiological mechanisms that might underlie this result, and here I expand on their Discussion by considering a non-exclusive explanation: that parents provided higher quality care to broods that received supplemental carotenoids. I discuss the general non-independence of pre- and post-hatching/parturition maternal effects when parents care for offspring, and then briefly review evidence that carotenoids specifically are tied to the intensity of avian begging displays. Finally, I detail how inclusive fitness opportunities and constraints shape the adaptive landscape in which maternal effects operate, highlighting both theoretical and applied concerns surrounding questions about the adaptiveness of maternal effects. PMID:25694043

  8. The Association of Postpartum Maternal Mental Health With Breastfeeding Status of Mothers: A Case-Control Study

    OpenAIRE

    Assarian, Fatemeh; Moravveji, Alireza; Ghaffarian, Hamideh; Eslamian, Reihaneh; Atoof, Fatemeh

    2014-01-01

    Background: Maternal health status might have an important effect on breastfeeding, growth, and general health of the infants. Objectives: This study was conducted to assess the association between maternal mental health and breastfeeding status of mothers in Kashan province. Patients and Methods: This case-control study was conducted on 458 mothers in two groups of unsuccessful breastfeeding (case) and successful breastfeeding (control) attending Kashan province health clinics. In this study...

  9. Factors influencing caries status and treatment needs among pregnant women attending a maternity hospital in Udaipur city, India

    OpenAIRE

    Kumar, Santhosh; Tadakamadla, Jyothi; Tibdewal, Harish; Duraiswamy, Prabu; Kulkarni, Suhas

    2013-01-01

    Objectives: To estimate the prevalence and severity of dental caries along with the treatment needs; to determine the factors that influence dental caries status among pregnant women attending a district maternity hospital in Udaipur, India. Study design: Study sample comprised of 206 pregnant women attending a district maternity hospital in Udaipur, India. Clinical data were collected on dental caries by DMFT and treatment needs as described in World Health Organization Dentition status and ...

  10. Using audit to enhance quality of maternity care in resource limited countries: lessons learnt from rural Tanzania

    OpenAIRE

    Nyamtema Angelo S; de Jong Alise; Urassa David P; van Roosmalen Jos

    2011-01-01

    Abstract Background Although clinical audit is an important instrument for quality care improvement, the concept has not yet been adequately taken on board in rural settings in most resource limited countries where the problem of maternal mortality is immense. Maternal mortality and morbidity audit was established at Saint Francis Designated District Hospital (SFDDH) in rural Tanzania in order to generate information upon which to base interventions. Methods Methods are informed by the princi...

  11. Retrospective Comparative Study of Obstetric complications and Maternal Mortality in Registered and Unregistered women at Tertiary Care Hospital.

    OpenAIRE

    Kruti Deliwala; Rajal Thaker; M M Jadav

    2013-01-01

    Background: At tertiary care hospital, many women with obstetric complications are referred not only from private clinics/hospitals, but also from nearby primary health centers and urban health centers. There are women who come for delivery, who have not taken any ante natal care (ANC). Complication can arise at any time during pregnancy, childbirth and postnatal period and in absence of intervention, there is a high feto-maternal morbidity and mortality. With every maternal death there are m...

  12. Maternal perception regarding child care and development

    Directory of Open Access Journals (Sweden)

    Mirna Albuquerque Frota

    2011-09-01

    Full Text Available Objective: To investigate the perception of mothers regarding the care and development of their children. Methods: This was a descriptive and qualitative study, conducted in a Basic Health Unit (UBS in Fortaleza-CE, Brazil, in the period from July to October, 2008. The subjects were twenty mothers who accompanied their children in childcare consultation and met with favorable clinical conditions. Data collection techniques used free observation and semistructured interview consisting of questions involving the perception of child development and care. Results: By means of data analysis the following categories emerged: “Smile and play: mother’s perception regarding the development of the child”; “Take care: emphasis on breastfeeding and body hygiene”. The main source of nonverbal communication that the child has to convey affection and love is the smile, being an essential activity to child development. We verified that the care with breastfeeding and body hygiene suggest behavioral indicators of maternal sensitivity. Final considerations: The childcare consultation held in UBS is essential, because it allows integration of ideas and actions shared with the professional-parent dyad, thus providing the arousal of new experiences in care and the influence on child development.

  13. 牙周病与早产低出生体重儿关系的临床研究%Clinical study on correlation between maternal periodontal diseases and preterm-low-birth-weight delivery

    Institute of Scientific and Technical Information of China (English)

    崔巍巍; 刘英奇; 朱曚曚; 张学强; 史东晔; 巩兰平; 刘红霞

    2012-01-01

    目的 比较分娩早产低出生体重儿(PLBW)的孕妇与足月妊娠正常分娩新生儿(NBW)孕妇的牙周状况及牙周病的发生率,探讨牙周病与PLBW的关系.方法 随机选取分娩PLBW的孕妇206例为研究组,选取同期分娩NBW的孕妇209例为对照组,检测两组孕妇的牙周状况,记录菌斑指数( PLI)、探诊深度(PD),临床附着丧失(CAL)和出血指数(BI),并计算牙周炎位点率(PD >3 mm,CAL>2 mm)及牙周病的发生率.结果 分娩早产低出生体重儿的孕妇牙周炎位点率(3.3%)和牙周病发生率(81.1%)明显高于对照组(1.4%,35.9%),差异有显著性(P<0.01);牙周炎位点率与孕周和新生儿体重均呈负相关系(P<0.05).结论 牙周病可能是PLBW发生的危险因素.%Objective To evaluate periodontal conditions and prevalence of periodontal diseases in pregnant women who had normal-birth-weight(NBW) and preterm-low-birth-weight(PLBW) delivery outcomes. Methods 206 women who gave birth to PLBW and 209 women who had normal delivery were recruited postpartum in this case-control study. Periodontal measurements included plaque index ( PI), probing pocket depth(PD) , clinical attachment loss(CAL), bleeding index(BI) , the percentage of periodontitis sites(PD >3 m m,C AL-2mm) and prevalence of periodontal diseases. Results The percentage of periodontitis sites (3.3% ) and prevalence of periodontal diseases (81.1% ) were significantly higher in the PLBW group than those in the NBW group (1.4% ,35.9% )(P<0.01). Significant negative correlations were observed between percentage of periodontitis sites and the gestational age at delivery as well as neonatal body weight (P <0 .05 ). Conclusions There may be a possible link between periodontal diseases and preterm-low-birth-weight delivery outcomes.

  14. 妇幼保健机构开展胎儿系统产前超声筛查的临床意义%Clinical significance of prenatal fetal systematic ultrasound screening in maternal and children health institutions

    Institute of Scientific and Technical Information of China (English)

    李晓红; 钟少卫; 吴婧; 朱巧灵; 李晓琴

    2014-01-01

    目的:探讨开展胎儿系统超声产前筛查的重要性。方法应用西门子S-2000彩色多普勒超声诊断仪及VOLUOSENE 8、E6彩色多普勒超声诊断仪对孕20~26周1825例孕妇进行系统超声产前筛查。结果胎儿发育异常38例,畸形发生率占2%(38/1825)。产前超声诊断、经引产或出生后证实的胎儿畸形病例共在我院住院引产29例,外院追踪符合病例9例,漏诊1例(晚孕时发现手指缺陷),诊断符合率为98%(38/39)。结论超声产前系统筛查有效降低了畸形儿的出生率,对临床有重要指导意义。%Objective To explore the importance of prenatal fetal systematic ultrasound screening. Methods Siemens S-2000 color Doppoler ultrasonic diagnosis system and VOLUOSENE8, E6 color Doppoler ultrasonic diagnosis system were applied for prenatal systematic ultrasound screening on 1825 pregnant women with pregnancy froun 20 to 26 weeks. Results 38 cases of abnormal fetal development were observed, with malformation rate of 2%(38/1825). As for fetal malformation cases confirmed by prenatal ultrasonic diagnosis, induced labor or postnatal diagnosis, 29 cases were hospitalized and born in our hospital, 9 cases were traced in other hospitals, and 1 case had missed diagnosis(finger defect detected at late pregnancy), with diagnostic accordance rate of 98%(38/39). Conclusion Prenatal sys-tematic ultrasound screening can effectively reduce the rate of children with birth defects, which is of important guid-ance for clinical practice.

  15. The calming effect of maternal carrying in different mammalian species

    Science.gov (United States)

    Esposito, Gianluca; Setoh, Peipei; Yoshida, Sachine; Kuroda, Kumi O.

    2015-01-01

    Attachment theory postulates that mothers and their infants possess some basic physiological mechanisms that favor their dyadic interaction and bonding. Many studies have focused on the maternal physiological mechanisms that promote attachment (e.g., mothers’ automatic responses to infant faces and/or cries), and relatively less have examined infant physiology. Thus, the physiological mechanisms regulating infant bonding behaviors remain largely undefined. This review elucidates some of the neurobiological mechanisms governing social bonding and cooperation in humans by focusing on maternal carrying and its beneficial effect on mother–infant interaction in mammalian species (e.g., in humans, big cats, and rodents). These studies show that infants have a specific calming response to maternal carrying. A human infant carried by his/her walking mother exhibits a rapid heart rate decrease, and immediately stops voluntary movement and crying compared to when he/she is held in a sitting position. Furthermore, strikingly similar responses were identified in mouse rodents, who exhibit immobility, diminished ultra-sonic vocalizations and heart rate. In general, the studies described in the current review demonstrate the calming effect of maternal carrying to be comprised of a complex set of behavioral and physiological components, each of which has a specific postnatal time window and is orchestrated in a well-matched manner with the maturation of the infants. Such reactions could have been evolutionarily adaptive in mammalian mother–infant interactions. The findings have implications for parenting practices in developmentally normal populations. In addition, we propose that infants’ physiological response may be useful in clinical assessments as we discuss possible implications on early screening for child psychopathology (e.g., autism spectrum disorders and perinatal brain disorders). PMID:25932017

  16. Challenges posed to the maternal circulation by pregnancy

    Directory of Open Access Journals (Sweden)

    Valdés G

    2011-08-01

    Full Text Available Gloria Valdés, Jenny CorthornCentro de Investigaciones Médicas y Departamento Nefrología, Escuela Medicina, Pontificia Universidad Católica, Santiago, ChileAbstract: In primates, adequate growth of the fetus depends on the development of the uteroplacental unit. On the fetal side, this is achieved by the creation of the vascular network of the placenta. On the maternal side, the transformation of the spiral arteries into saccular nonreactive vessels by the trophoblast provides high blood flow to the intervillous space. Apart from the changes in the uterine arteries, the mother expands her plasma volume – at the expense of stimulating the renin-angiotensin-aldosterone system – and her cardiac output. In the maintaining of normotension in the face of an increased cardiac output and plasma volume, the renin-angiotensin-aldosterone system requires an enhanced vasodilator synthesis. Finally, in the late stages of pregnancy, a normal endothelial function is required to provide an ample margin to the activation provoked by deportation of syncytiotrophoblast fragments/factors to the maternal circulation. These four adaptative processes require various interrelated vasodilator systems. Deficient adaptations cause isolated or proteinuric arterial hypertension, intrauterine growth restriction, preterm delivery, and stillbirths, among others. Moreover, a normal or a defective adaptation to pregnancy influences maternal cardiovascular health in later life, as evidenced by various studies, most of them epidemiological; thus, pregnancy is now considered a stress test to the maternal cardiovascular system. Because of this, women planning to become pregnant should be screened for clinical and biochemical cardiovascular risks. Inversely, women presenting with hypertension in pregnancy should be thoroughly studied to detect and correct cardiovascular risks. The incorporation of the predictive value of a hypertensive pregnancy should help reduce

  17. Maternal child-centered attributions and harsh discipline: the moderating role of maternal working memory across socioeconomic contexts.

    Science.gov (United States)

    Sturge-Apple, Melissa L; Suor, Jennifer H; Skibo, Michael A

    2014-10-01

    Cognitive models of parenting give emphasis to the central role that parental cognitions may play in parental socialization goals. In particular, dual process models suggest that parental attribution styles affect the way parents interpret caregiving situations and enact behaviors, particularly within the realm of discipline. Although research has documented the negative behavioral repercussions of dysfunctional child-centered responsibility biases, there is heterogeneity in the level of these associations. Research has also demonstrated that parental working memory capacity may serve as an individual difference factor in influencing caregiving behaviors. Thus, our first aim was to document how maternal working memory capacity may moderate the association between mother's dysfunctional child-oriented attributions and use of harsh discipline. In addition, from an ecological perspective, a second aim was to examine how socioeconomic risk may further potentiate the impact of maternal working memory. To accomplish these aims, a socioeconomically diverse sample of 185 mothers and their 3-year old children were recruited to participate in a laboratory-based research assessment. Findings revealed that lower maternal working memory capacity may operate as a risk factor for attributional biases and harsh discipline, and higher working memory may serve as a protective factor in this relationship. Socioeconomic risk further moderated these findings. Results suggest that the moderating role of working memory may be particularly pronounced under conditions of socioeconomic risk. The theoretical and clinical implications of these findings are discussed. PMID:25221969

  18. A correlation analysis on maternal BMI and clinical fetal weight estimation%孕妇体质指数与临床胎儿体重估测的相关分析

    Institute of Scientific and Technical Information of China (English)

    姚琳; 黄菲菲; 惠宁

    2013-01-01

    Objective:To evaluate the value of clinical fetal weight estimation in forecasting the complications of childbirth for obese patients.Methods:392 patients and their neonates were retrospectively reviewed who enrolled from Jan.2010 to Dec.2011 in Shanghai Changhai hospital.Patients were grouped according to their pre-pregnant body mass index (BMI) into 78 normal (18.5 ~ 23.9kg/m2),185 overweight (24.0 ~ 27.9kg/m2),88 obesity (28.0 ~ 34.9kg/m2),41 morbid obesity (≥35.0kg/m2).Result:With the increasing of BMI of the pregnant women before pregnancy,the probability of absolute percentage error estimated fetal weight within 10% decreased.The accuracy of estimated fetal weight of overweight and obese patients was significantly lower than that of the normal weight patients (66.4% 、65.9% vs 82.5%,P<0.05).Univariate analysis showed that BMI and absolute error or absolute percentage error of fetal weight estimation had a significant positive correlation (β =0.101,0.124,P<0.05).Conclusion:For obese pregnant women,the accuracy of clinical fetal weight estimation reduced.Obese pregnant women should have ultrasound fetal weight estimation.Therefore the clinicians and patients can better understand the relative risk between vaginal delivery and cesarean section in order to improve the obstetric outcome of the obese pregnant women and their neonates.%目的:通过分析孕妇体质指数(BMI)用于估测胎儿体重的准确度,为优化临床处置提供科学佐证.方法:回顾分析2010年1月至2011年12月在长海医院产科住院分娩的392例孕妇的临床资料,按孕前BMI分组:体重正常78例(18.5 ~23.9kg/m2),超重185例(24.0 ~ 27.9kg/m2),肥胖88例(28.0 ~34.9kg/m2),病态肥胖41例(≥35.0kg/m2).比较临床估计胎儿体重的记录与实际出生体重的差异,衡量估计胎儿体重的准确性.结果:随着孕妇孕前BMI的增加,估计胎儿体重的绝对百分比误差在10%之内的比率明显下降;超重及肥

  19. Recombinant chromosome 18 resulting from a maternal pericentric inversion

    Energy Technology Data Exchange (ETDEWEB)

    Ayukawa, Hiroshi; Tsukahara, Masato; Fukuda, Masamichi; Kondoh, Osamu [Yamaguchi Univ. School of Medicine (Japan)

    1994-05-01

    We report on a newborn girl with duplication of 18q12.2{yields}18 qter and deficiency of 18p11.2{yields}18pter which resulted from meiotic recombination of the maternal pericentric inversion, inv(18)(p11.2q12.2). Her clinical manifestations were compatible with those of partial trisomy 18q syndrome. We review the previously reported 9 cases in 8 families of rec(18) resulting from recombination of a parental pericentric inversion. 8 refs., 3 figs., 1 tab.

  20. Male and female helper effects on maternal investment and adult survival in red-winged fairy-wrens

    NARCIS (Netherlands)

    Lejeune, Léa; van de Pol, Martijn; Cockburn, Andrew; Louter, Marina; Brouwer, Lyanne

    2016-01-01

    Despite its importance for the evolution of cooperative breeding, it has proven difficult to determine whether helpers improve their recipients’ fitness. Helpers affect fitness in multiple ways, both positive and negative, but their effects can also be concealed through reduced maternal investment.

  1. Exercise Intolerance and Myoglobinuria Associated with a Novel Maternally Inherited MT-ND1 Mutation

    DEFF Research Database (Denmark)

    Rafiq, Jabin; Duno, Morten; Østergaard, Elsebet;

    2016-01-01

    The most common clinical phenotype caused by a mtDNA mutation in complex I of the mitochondrial respiratory chain is Leber hereditary optic neuropathy. We report a family with a novel maternally inherited homoplasmic mtDNA m.4087A>G mutation in the ND1 gene (MT-ND1) associated with isolated...

  2. [Clinical research evolution. In parallel with the current changes in welfare expectations and information technology incorporation, study designs and data collection and analysis are quickly changing as well].

    Science.gov (United States)

    Tavazzi, Luigi

    2015-10-01

    The development of both technology, biological, and clinical knowledge leads to remarkable changes of scientific research methodology, including the clinical research. Major changes deal with the pragmatic approach of trial designs, an explosive diffusion of observational research which is becoming a usual component of clinical practice, and an active modelling of new research design. Moreover, a new healthcare landscape could be generated from the information technology routinely used to collect clinical data in huge databases, the management and the analytic methodology of big data, and the development of biological sensors compatible with the daily life delivering signals remotely forwardable to central databases. Precision medicine and individualized medicine seem to be the big novelties of the coming years, guiding to a shared pattern of patient/physician relationship. In healthcare, a huge business related mainly, but not exclusively, to the implementation of information technology is growing. This development will favor radical changes in the health systems, also reshaping the clinical activity. A new governance of the research strategies is needed and the application of the results should be based on shared ethical foundations. This new evolving profile of medical research and practice is discussed in this paper. PMID:26442975

  3. Severe maternal morbidity for 2004-2005 in the three Dublin maternity hospitals.

    LENUS (Irish Health Repository)

    Murphy, Cliona M

    2012-02-01

    OBJECTIVE: To assess the prevalence and causes of severe maternal morbidity in Dublin over a two year period from 2004 to 2005. STUDY DESIGN: A prospective cohort study from January 2004 to December 2005 was undertaken in the three large maternity hospitals in Dublin, which serve a population of 1.5 million people. All are tertiary referral centres for obstetrics and neonatology and have an annual combined delivery rate of circa 23,000 births. Cases of severe maternal morbidity were identified. A systems based classification was used. The primary cause of maternal morbidity and the number of events experienced per patient was recorded. RESULTS: We identified 158 women who fulfilled the definition for severe maternal morbidity, giving a rate of 3.2 per 1000 maternities. There were two maternal deaths during the time period giving mortality to morbidity ratio of 1:79. The commonest cause of severe morbidity was vascular dysfunction related to obstetric haemorrhage. Eclampsia comprised 15.4% of cases. Intensive care or coronary care admission occurred in 12% of cases. CONCLUSION: The prevalence of severe maternal morbidity in this population is 3.2\\/1000 maternities. Obstetric haemorrhage was the main cause of severe maternal morbidity.

  4. Maternal age at Holocaust exposure and maternal PTSD independently influence urinary cortisol levels in adult offspring

    Directory of Open Access Journals (Sweden)

    Heather N Bader

    2014-07-01

    Full Text Available Background: Parental traumatization has been associated with increased risk for the expression of psychopathology in offspring, and maternal PTSD appears to increase the risk for the development of offspring PTSD. In this study, Holocaust-related maternal age of exposure and PTSD were evaluated for their association with offspring ambient cortisol and PTSD-associated symptom expression. Method: 95 Holocaust offspring and Jewish comparison subjects received diagnostic and psychological evaluations, and 24 hour urinary cortisol was assayed by RIA. Offspring completed the Parental PTSD Questionnaire to assess maternal PTSD status. Maternal Holocaust exposure was identified as having occurred in childhood, adolescence or adulthood and examined in relation to offspring psychobiology. Results: Urinary cortisol levels did not differ for Holocaust offspring and comparison subjects but differed significantly in offspring based on maternal age of exposure and maternal PTSD status. Increased maternal age of exposure and maternal PTSD were each associated with lower urinary cortisol in offspring, but did not exhibit a significant interaction. In addition, offspring PTSD-associated symptom severity increased with maternal age at exposure and PTSD diagnosis. A regression analysis of correlates of offspring cortisol indicated that both maternal age of exposure and maternal PTSD were significant predictors of lower offspring urinary cortisol, whereas childhood adversity and offspring PTSD symptoms were not. Conclusions: Offspring low cortisol and PTSD-associated symptom expression are related to maternal age of exposure, with the greatest effects associated with increased age at exposure. These effects are relatively independent of the negative consequences of being raised by a trauma survivor. These observations highlight the importance of maternal age of exposure in determining a psychobiology in offspring that is consistent with increased risk for stress

  5. Elevated maternal cortisol leads to relative maternal hyperglycemia and increased stillbirth in ovine pregnancy

    Science.gov (United States)

    Feng, Xiaodi; Wood, Charles E.; Richards, Elaine; Anthony, Russell V.; Dahl, Geoffrey E.; Tao, Sha

    2014-01-01

    In normal pregnancy, cortisol increases; however, further pathological increases in cortisol are associated with maternal and fetal morbidities. These experiments were designed to test the hypothesis that increased maternal cortisol would increase maternal glucose concentrations, suppress fetal growth, and impair neonatal glucose homeostasis. Ewes were infused with cortisol (1 mg·kg−1·day−1) from day 115 of gestation to term; maternal glucose, insulin, ovine placental lactogen, estrone, progesterone, nonesterified free fatty acids (NEFA), β-hydroxybutyrate (BHB), and electrolytes were measured. Infusion of cortisol increased maternal glucose concentration and slowed the glucose disappearance after injection of glucose; maternal infusion of cortisol also increased the incidence of fetal death at or near parturition. The design of the study was altered to terminate the study prior to delivery, and post hoc analysis of the data was performed to test the hypothesis that maternal metabolic factors predict the fetal outcome. In cortisol-infused ewes that had stillborn lambs, plasma insulin was increased relative to control ewes or cortisol-infused ewes with live lambs. Maternal cortisol infusion did not alter maternal food intake or plasma NEFA, BHB, estrone, progesterone or placental lactogen concentrations, and it did not alter fetal body weight, ponderal index, or fetal organ weights. Our study suggests that the adverse effect of elevated maternal cortisol on pregnancy outcome may be related to the effects of cortisol on maternal glucose homeostasis, and that chronic maternal stress or adrenal hypersecretion of cortisol may create fetal pathophysiology paralleling some aspects of maternal gestational diabetes. PMID:24920731

  6. The impact of maternal characteristics, infant temperament and contextual factors on maternal responsiveness to infant.

    Science.gov (United States)

    Tester-Jones, Michelle; O'Mahen, Heather; Watkins, Edward; Karl, Anke

    2015-08-01

    Postnatal maternal depressive symptoms are consistently associated with impairments in maternal attunement (i.e., maternal responsiveness and bonding). There is a growing body of literature examining the impact of maternal cognitive factors (e.g., rumination) on maternal attunement and mood. However, little research has examined the role of infant temperament and maternal social support in this relationship. This study investigated the hypothesis that rumination would mediate (1) the relationship between depressive symptoms and attunement and (2) the relationship between social support and attunement. We further predicted that infant temperament would moderate these relationships, such that rumination would demonstrate mediating effects on attunement when infant difficult temperament was high, but not low. Two hundred and three mothers completed measures on rumination, depressive symptoms, attunement, perceived social support and infant temperament. Rumination mediated the effect of postnatal maternal depressive mood on maternal self-reported responsiveness to the infant when infants were low, but not high, in negative temperament. When infants had higher negative temperament, there were direct relationships between maternal depressive symptoms, social support and maternal self-reported responsiveness to the infant. This study is limited by its cross-sectional and correlational nature and the use of self-report measures to assess a mother's awareness of her infant needs and behaviours, rather than observational measures of maternal sensitivity. These findings suggest potentially different pathways to poor maternal responsiveness than those expected and provide new evidence about the contexts in which maternal cognitive factors, such as rumination, may impact on the mother-infant relationship.

  7. Maternal irradiation and Down Syndrome

    International Nuclear Information System (INIS)

    The role of preconception irradiation in the etiology of Down Syndrome was examined using the techniques of record linkage. Although 909 cases of Down Syndrome, born in B.C. between 1952-70, were ascertained through a system of linked vital and health registrations, interest was restricted to the 348 case/control pairs born in the greater Vancouver area. The maternal identifying information routinely recorded on birth and ill-health registrations was used to link 155 Down Syndrome mothers and 116 control mothers to patient files at the Vancouver General Hospital. Only 28 of the case and 25 of the control mothers were subjected to diagnostic irradiation at the Vancouver Ganeral Hospital. The difference was not significant at the 5% level

  8. Controversial issues of maternity substitution

    Directory of Open Access Journals (Sweden)

    Andy Pușcă

    2009-06-01

    Full Text Available Substitute maternity consists in a woman carrying a pregnancy (the implant of an embryo, at therequest of a sterile couple, most of the times in exchange of a sum of money, with her commitment tounconditionally give away the newborn after birth to the couple she concluded the agreement with. Manycontroversies emerged in what concerns the contract between the sterile couple and the carrying mother,especially when this contract is by onerous title, which happens in most of the cases. In that a civil contract? Is ita sales contract for the child? Is it a contract to provide services? Is it body marketing? Between total prohibitionand excessive liberalism, the middle way, which is the regulation according to ethical religious, cultural andsocial norms of each community, represents a realistic solution.

  9. A model for maternal depression.

    Science.gov (United States)

    Connelly, Cynthia D; Baker-Ericzen, Mary J; Hazen, Andrea L; Landsverk, John; Horwitz, Sarah McCue

    2010-09-01

    With the awareness of maternal depression as a prevalent public health issue and its important link to child physical and mental health, attention has turned to how healthcare providers can respond effectively. Intimate partner violence (IPV) and the use of alcohol, tobacco, and other drugs are strongly related to depression, particularly for low-income women. The American College of Obstetricians and Gynecologists (ACOG) recommends psychosocial screening of pregnant women at least once per trimester, yet screening is uncommonly done. Research suggests that a collaborative care approach improves identification, outcomes, and cost-effectiveness of care. This article presents The Perinatal Mental Health Model, a community-based model that developed screening and referral partnerships for use in community obstetric settings in order to specifically address the psychosocial needs of culturally diverse, low-income mothers. PMID:20718624

  10. Maternal and infant sleep postpartum.

    Science.gov (United States)

    McGuire, Elizabeth

    2013-07-01

    New parents should be aware that infants' sleep is unlike that of adults and that meeting their infant's needs is likely to disrupt their own sleep. They will need to adjust their routine to manage their own sleep needs. Parental sleep patterns in the postpartum period are tied to the infant's development of a circadian sleep-wake rhythm, and the infant's feeds. Close contact with the mother and exposure to light/dark cues appear to assist in the development of the infant's circadian rhythm. The composition of breastmilk varies over the course of 24 hours and some components produced at night are likely to contribute to the infant's day/night entrainment. There is no clear evidence that using artificial feeds improves maternal sleep. Most infants need night feeds but requirements for nighttime feeds vary with the individual.

  11. Maternal immunoglobulin E and childhood leukemia.

    Science.gov (United States)

    Chang, Jeffrey S; Buffler, Patricia A; Metayer, Catherine; Chokkalingam, Anand P; Patoka, Joe; Kronish, Daniel; Wiemels, Joseph L

    2009-08-01

    Childhood leukemia, particularly acute lymphoblastic leukemia (ALL), has long been hypothesized to be affected by abnormal immune responses to microbial challenges stemming from a lack of immune modulation in early childhood. Studies of allergies suggest that a child's immune development may be modulated by maternal immune status. We conducted a study to explore the relationship between maternal immunoglobulin E (IgE) and childhood leukemia and to investigate whether maternal immune status can influence childhood leukemia risk. Serum total and specific IgE (respiratory and food) were measured in biological mothers of 352 children (193 healthy controls and 159 leukemia cases, including 139 ALL cases) ages <8 years who were enrolled in the Northern California Childhood Leukemia Study. Odds ratios associated with maternal IgE were calculated using unconditional logistic regression adjusted for child's age, sex, race/ethnicity, and annual household income. A positive association between childhood leukemia or ALL and elevated levels of maternal serum total IgE was observed, especially among Hispanics. In addition, a positive association was observed between childhood leukemia or ALL and maternal respiratory or food IgE status. These results suggest that maternal immune function may play a crucial role in the etiology of childhood leukemia, although additional studies need to be conducted to confirm the results of this study and provide a perspective on mechanisms. PMID:19622720

  12. Maternal haemoglobin and perinatal outcome

    Directory of Open Access Journals (Sweden)

    Bharathi Anjanappa

    2015-10-01

    Full Text Available Background: Maternal anaemia is common medical disorder in developing countries. WHO defines anaemia as haemoglobin concentration of and #8804;11 g/dl. However, in developing countries like India, the lower limit is accepted as 10 g/dl. Results: Of 218 women, 69 had anaemia. The prevalence of anaemia was 31.65%; of which 84% had mild anaemia, 14.6% had moderate and only 1.4% had severe anaemia. Mean Hb levels were 12.04% among non-anaemic mothers and mean birth weight was 2.89 Kg whereas 9.14%, 2.18 kg in anaemic mothers respectively. In our study, 21% in anaemic group has birth weight <2.5 kg and only 0.06% in non-anaemic mothers (p<0.0012 3.6 times higher. The risk of IUGR was 3.77 times higher, low APGAR score at 1 min was 3.8 times higher (p<0.0001, meconium stained liquor was 2.3 times higher and NICU admissions 2.96 times higher in anaemic mothers than non-anaemic mothers. Conclusions: Anaemia in pregnancy is one of the causes of poor perinatal outcome. Maternal anaemia is associated with the high risk of low birth weight, IUGR babies, low APGAR scores and NICU admissions and overall increase in perinatal morbidity. Hence proper antenatal care and counseling can reduce occurrence of anaemia in pregnancy. [Int J Reprod Contracept Obstet Gynecol 2015; 4(5.000: 1335-1338

  13. KEMATIAN MATERNAL DI NUSA TENGGARA TIMUR

    Directory of Open Access Journals (Sweden)

    Emiliana Tjitra

    2012-09-01

    Full Text Available A prospective study was carried out in villages around health centers, which were distributed over 10 regencies in Timor island of East Nusa Tenggara province. All deaths occurring in 1986 were recorded and reported to the health centers. Each case was investigated by the health center doctor to identify the multiple causes of death as well as its related factors. Pregnancy and delivery histories of maternal deaths were analysed. In the study area, the maternal mortality ratio was found to be 1346 per 100,000 live births, and the maternal mortality rate was 101 per 100,000 women aged 15-49 years. The maternal mortality ratio, among women under 20 years of age, was 3390 per 100,000 live births; and 4545 per 100,000 live births among women aged 40 years and over. The predominant factor as a risk of maternal deaths was attributable to delivery assistance by non medical personnel, which was 71%. Maternal deaths attributable to the first parities was 40%, and to pregnancies without antenatal care was 20.1%}. The most prevalent disease causing maternal deaths were haemorrhage 46.2%}, postpartum infections 30.8% and retained placenta 30.8%. To reduce maternal mortality, the most important intervention is to provide qualified delivery assistants especially for the first parities, and the provision of accessible delivery centers for emergency cases in addition to provision of appropriate antenatal care for early detection of high risk pregnancies. Family planning programs will have to be more specified towards high risk groups, i.e women aged under 20 years or 35 years and over, as well as women of high parity. A similar study is recommended to be conducted throughout the other parts of East Nusa Tenggara islands in order to evaluate the general maternal health status of the province.

  14. Campus Clinical: simulation-based curriculum designed to meet clinical course learning outcomes.

    Science.gov (United States)

    Jarvis, Michelle; Rivers, Julie

    2014-01-01

    Campus Clinical is a simulation-based curriculum designed to meet the challenge of decreasing clinical spaces in maternal-child units. The curriculum framework is situated in a constructivist, experiential learning context, integrating Chickering and Gamson's principles for good practice in education. This innovative approach to meeting clinical course learning outcomes is transferable to a variety of settings.

  15. The WHO maternal near-miss approach and the maternal severity index model (MSI: tools for assessing the management of severe maternal morbidity.

    Directory of Open Access Journals (Sweden)

    Joao Paulo Souza

    Full Text Available OBJECTIVES: To validate the WHO maternal near-miss criteria and develop a benchmark tool for severe maternal morbidity assessments. METHODS: In a multicenter cross-sectional study implemented in 27 referral maternity hospitals in Brazil, a one-year prospective surveillance on severe maternal morbidity and data collection was carried out. Diagnostic accuracy tests were used to assess the validity of the WHO maternal near-miss criteria. Binary logistic regression was used to model the death probability among women with severe maternal complications and benchmark the management of severe maternal morbidity. RESULTS: Of the 82,388 women having deliveries in the participating health facilities, 9,555 women presented pregnancy-related complications, including 140 maternal deaths and 770 maternal near misses. The WHO maternal near-miss criteria were found to be accurate and highly associated with maternal deaths (Positive likelihood ratio 106.8 (95% CI 99.56-114.6. The maternal severity index (MSI model was developed and found to able to describe the relationship between life-threatening conditions and mortality (Area under the ROC curve: 0.951 (95% CI 0.909-0.993. CONCLUSION: The identification of maternal near-miss cases using the WHO list of pregnancy-related life-threatening conditions was validated. The MSI model can be used as a tool for benchmarking the performance of health services managing women with severe maternal complications and provide case-mix adjustment.

  16. Maternal Obesity: Consequences and Prevention Strategies

    OpenAIRE

    Emre Yanikkerem; Selviye Mutlu

    2012-01-01

    Obesity is a medical condition in which excess body fat that it may have an adverse effect on health, leading to life expectancy and increased health problems. In keeping with the general international trend of rising prevalence of obesity, maternal obesity prevalence is rising. According to WHO, the prevalence of obesity in pregnancy ranges from 1.8 to 25.3%. Maternal obesity has been identified to be a risk factor for maternal and perinatal mortality. The aim of this article was reviewed in...

  17. Doubts and Concerns about Isolated Maternal Hypothyroxinemia

    Directory of Open Access Journals (Sweden)

    Mariacarla Moleti

    2011-01-01

    Full Text Available There is evidence that isolated maternal hypothyroxinemia may have detrimental effects on both mother and foetus. Nonetheless, this condition is still far from being universally accepted as a separate thyroid disease, and a standard definition of this state of mild thyroid underfunction is still lacking. We will review the biochemical criteria used to define isolated maternal hypothyroxinemia, together with current methodological issues related to FT4 assays. We will also discuss its epidemiological impact in both iodine-deficient and-sufficient areas, and the effectiveness of iodine prophylaxis on maternal thyroid function and neuropsychomotor development in offspring.

  18. Emerging lessons from the FIGO LOGIC initiative on maternal death and near-miss reviews.

    Science.gov (United States)

    Lewis, Gwyneth

    2014-10-01

    This short paper describes some early findings from an overview of the maternal death or severe morbidity "near-miss" reviews that have been undertaken to improve clinical care by the eight societies participating in the FIGO Leadership in Obstetrics and Gynecology for Impact and Change (LOGIC) Initiative in Maternal and Newborn Health aimed at strengthening the role of professional obstetric associations. While it is expected that each will publish its own report, generalizable lessons emerged and valuable solutions were implemented that will help others planning such reviews and audits in future. PMID:25128930

  19. The closure of rural and remote maternity services: Where are the midwives?

    Science.gov (United States)

    Barclay, Lesley; Kornelsen, Jude

    2016-07-01

    Decisions to close small maternity units in rural and remote communities have often precipitated a community response as women and families rally to save local services. But where are the midwives? We argue here that professional bodies such as colleges of midwives have a responsibility to advocate more strongly at a political level for evidence-based decisionmaking regarding the allocation of rural services. We suggest that adopting a comprehensive definition of maternity services risk that considers both social and health services risks and their impact on clinical risk, could provide a solid basis for effective advocacy by professional bodies. PMID:27046265

  20. Substandard emergency obstetric care - a confidential enquiry into maternal deaths at a regional hospital in Tanzania

    DEFF Research Database (Denmark)

    Sorensen, Bjarke Lund; Elsass, Peter; Nielsen, Brigitte Bruun;

    2010-01-01

    OBJECTIVE: (i) To identify clinical causes of maternal deaths at a regional hospital in Tanzania and through confidential enquiry (CE) assess major substandard care and make a comparison to the findings of the internal maternal deaths audits (MDAs); (ii) to describe hospital staff reflections...... in 46 (74%) of the 62 cases reviewed. During the same time period MDA identified substandard care in 18 cases. Staff perceived poor organization of work and lack of training as important causes for substandard care. Local MDA was considered useful although time-consuming and sometimes threatening...

  1. Severe maternal morbidity associated with maternal birthplace in three high-immigration settings

    DEFF Research Database (Denmark)

    Urquia, Marcelo L; Glazier, Richard H; Mortensen, Laust;

    2015-01-01

    BACKGROUND: Maternal mortality and morbidity vary substantially worldwide. It is unknown if these geographic differences translate into disparities in severe maternal morbidity among immigrants from various world regions. We assessed disparities in severe maternal morbidity between immigrant women...... provided aggregate data according to standardized definitions of the outcome, maternal regions of birth and covariates for pooled analyses. We used random effects and stratified logistic regression to obtain odds ratios (ORs) with 95% confidence intervals (95% CIs), adjusted for maternal age, parity...... and comparability scores. RESULTS: We retrieved 2,322,907 deliveries in all three receiving countries, of which 479,986 (21%) were to immigrant women. Compared with non-immigrants, only Sub-Saharan African women were consistently at higher risk of severe maternal morbidity in all three receiving countries (pooled...

  2. Maternal intake of energy, macronutrients and fiber during pregnancy, and relation to maternal anthropometry

    OpenAIRE

    2007-01-01

    Summary Background: The evidence for a relationship between maternal nutritional status during pregnancy and future health of her unborn child is now ample. The different factors that may link fetal development and growth to later health of the fetus are currently gaining increasing attention. Composition of maternal gestational weight gain may be one of the factors that have an impact on this relationship. The purpose of this thesis was to investigate whether maternal intake of energy, ma...

  3. The relations among maternal depressive disorder, maternal Expressed Emotion, and toddler behavior problems and attachment

    OpenAIRE

    Gravener, Julie A.; Rogosch, Fred A.; Oshri, Assaf; Narayan, Angela J.; Cicchetti, Dante; Toth, Sheree L.

    2012-01-01

    Direct and indirect relations among maternal depression, maternal Expressed Emotion (EE: Self- and Child-Criticism), child internalizing and externalizing symptoms, and child attachment were examined. Participants were mothers with depression (n = 130) and comparison mothers (n = 68) and their toddlers (M age = 20 mo.; 53% male). Assessments included the Diagnostic Interview Schedule (maternal depression); the Five Minute Speech Sample (EE); the Child Behavior Checklist (toddler behavior prob...

  4. Evidence From Maternity Leave Expansions of the Impact of Maternal Care on Early Child Development

    OpenAIRE

    Michael Baker; Kevin Milligan

    2008-01-01

    We study the impact of maternal care on early child development using an expansion in Canadian maternity leave entitlements. Following the leave expansion, mothers who took leave spent between 48 and 58 percent more time not working in the first year of their children's lives. We find that this extra maternal care primarily crowded out home-based care by unlicensed non-relatives, and replaced mostly full-time work. However, the estimates suggest a weak impact of the increase in maternal care ...

  5. Maternal death audit in Rwanda 2009–2013: a nationwide facility-based retrospective cohort study

    Science.gov (United States)

    Sayinzoga, Felix; Bijlmakers, Leon; van Dillen, Jeroen; Mivumbi, Victor; Ngabo, Fidèle; van der Velden, Koos

    2016-01-01

    Objective Presenting the results of 5 years of implementing health facility-based maternal death audits in Rwanda, showing maternal death classification, identification of substandard (care) factors that have contributed to death, and conclusive recommendations for quality improvements in maternal and obstetric care. Design Nationwide facility-based retrospective cohort study. Settings All cases of maternal death audited by district hospital-based audit teams between January 2009 and December 2013 were reviewed. Maternal deaths that were not subjected to a local audit are not part of the cohort. Population 987 audited cases of maternal death. Main outcome measures Characteristics of deceased women, timing of onset of complications, place of death, parity, gravida, antenatal clinic attendance, reported cause of death, service factors and individual factors identified by committees as having contributed to death, and recommendations made by audit teams. Results 987 cases were audited, representing 93.1% of all maternal deaths reported through the national health management information system over the 5-year period. Almost 3 quarters of the deaths (71.6%) occurred at district hospitals. In 44.9% of these cases, death occurred in the post-partum period. Seventy per cent were due to direct causes, with post-partum haemorrhage as the leading cause (22.7%), followed by obstructed labour (12.3%). Indirect causes accounted for 25.7% of maternal deaths, with malaria as the leading cause (7.5%). Health system failures were identified as the main responsible factor for the majority of cases (61.0%); in 30.3% of the cases, the main factor was patient or community related. Conclusions The facility-based maternal death audit approach has helped hospital teams to identify direct and indirect causes of death, and their contributing factors, and to make recommendations for actions that would reduce the risk of reoccurrence. Rwanda can complement maternal death audits with other

  6. The world health organization multicountry survey on maternal and newborn health: study protocol

    Directory of Open Access Journals (Sweden)

    Souza João

    2011-10-01

    Full Text Available Abstract Background Effective interventions to reduce mortality and morbidity in maternal and newborn health already exist. Information about quality and performance of care and the use of critical interventions are useful for shaping improvements in health care and strengthening the contribution of health systems towards the Millennium Development Goals 4 and 5. The near-miss concept and the criterion-based clinical audit are proposed as useful approaches for obtaining such information in maternal and newborn health care. This paper presents the methods of the World Health Organization Multicountry Study in Maternal and Newborn Health. The main objectives of this study are to determine the prevalence of maternal near-miss cases in a worldwide network of health facilities, evaluate the quality of care using the maternal near-miss concept and the criterion-based clinical audit, and develop the near-miss concept in neonatal health. Methods/Design This is a large cross-sectional study being implemented in a worldwide network of health facilities. A total of 370 health facilities from 29 countries will take part in this study and produce nearly 275,000 observations. All women giving birth, all maternal near-miss cases regardless of the gestational age and delivery status and all maternal deaths during the study period comprise the study population. In each health facility, medical records of all eligible women will be reviewed during a data collection period that ranges from two to three months according to the annual number of deliveries. Discussion Implementing the systematic identification of near-miss cases, mapping the use of critical evidence-based interventions and analysing the corresponding indicators are just the initial steps for using the maternal near-miss concept as a tool to improve maternal and newborn health. The findings of projects using approaches similar to those described in this manuscript will be a good starter for a more

  7. Major risk factors of maternal adverse outcome in women with two or more previous cesarean sections

    Directory of Open Access Journals (Sweden)

    Egić Amira

    2016-01-01

    Full Text Available Background/Aim. Maternal morbidity is defined as any condition that is attributed to or aggravated by pregnancy and childbirth that has a negative impact on the woman's wellbeing. In recent years, a growing trend of cesarean section rates can be seen throughout the world. The aim of this study was to assess factors that might have major impact on maternal adverse outcome in women with two or more previous cesarean sections. Methods. This retrospective study included women with single term pregnancy after two or more cesarean deliveries in a 10-year period (2004−2013 in the University Clinic “Narodni front” in Belgrade, Serbia. Medical records were reviewed for clinical data for maternal intraoperative and early postoperative complications regarding gestational age at delivery, the number of previous cesarean sections and mode of surgery (elective or emergency. Results. A total of 551 patients were included in the study. At 37 completed weeks delivered 14.1%, at 38 delivered 45.2% and at 39 completed weeks 40.7% patients. Women younger than 35 years more often delivered after 39 completed weeks compared with those over 35 years (69.2% vs 30.8%, p < 0.05. The overall rate of maternal complications in the study group was 16.5% with no statistical difference by gestational age at delivery. The overall rate of maternal adverse outcome was significantly less in the patients with three as compared with those with four or more cesareans (10.4% vs 66.7%, p < 0.05. There was a statistically significant difference between these groups of women regarding complications: scar dehiscence, the presence of adhesions, blood transfusion and admission in intensive care unit. Elective cesarean delivery was with less maternal complications compared with emergency cesarean deliveries (12.9% vs 27.3%, p < 0.05. Conclusion. Termination of pregnancy before completed 39 weeks does not decrease maternal morbidity. The major impact on maternal complications has the

  8. Maternal mortality in Riyadh, Saudi Arabia.

    Science.gov (United States)

    Chattopadhyay, S K; Sengupta, B S; Chattopadhyay, C; Zaidi, Z; Showail, H

    1983-09-01

    The maternal mortality in the Maternity and Children Hospital, Riyadh, during the years 1978-1980 was 52 per 100 000 births, when the total births were 55 428. This is higher than the rate reported from the hospitals in developed countries but lower than rates reported by the university hospitals of developing countries such as India, Thailand and Nigeria. Haemorrhage, associated disease, pulmonary embolism and infection, in that order, were the main causes of maternal deaths. The main avoidable factor was failure by the patient to seek the medical care. Much could be done in reducing deaths due to haemorrhage by improving blood transfusion facilities in the peripheral hospitals. Adequate health education, especially of rural women and their midwives, is a crucial factor in improving the maternal death rate for the country as a whole. PMID:6615737

  9. Current trend of maternal health in Indonesia

    Directory of Open Access Journals (Sweden)

    Noviyani Sugiarto

    2012-08-01

    Full Text Available Background: Achievement of Millennium Development Goals (MDGs will be assessed in the next three years (2015. Several parameters in the area of maternal health are evaluated continuously. The aim of this paper is to formally summarize and report the state of maternal health in Indonesia based on the data from Basic Health Survey (Riskesdas 2010.Methods: This paper utilizes tertiary data obtained from the latest Riskesdas (2010.Results: Data that is available in the report covers data about marriage, reproduction health, abortion, access to health care for pregnancies, place of labor, health care provider, as well as rate of the first postpartum period visit.Conclusion: The latest data shows improvement in the maternal health area, nevertheless large effort in maintaining and improving the condition is still needed. Continuous evaluation is also proven to be essential in achieving the goals. (Med J Indones. 2012;21:179-83Keywords: Indonesia, maternal health, millennium development goals

  10. Maternal Insomnia and Children's Family Socialization Environments

    Science.gov (United States)

    Gregory, Alice M.; Moffitt, Terrie E.; Ambler, Antony; Arseneault, Louise; Houts, Renate M.; Caspi, Avshalom

    2012-01-01

    Study Objectives: To examine concurrent associations between maternal insomnia and different aspects of the family socialization environment. Design: Mothers reported on their symptoms of insomnia in a private standardized interview and interviewers evaluated the family socialization environment using the Coder's Inventory. Setting: Assessments were conducted in participants' homes within the U.K. Patients or Participants: One thousand one hundred sixteen mothers of British children enrolled in the Environmental Risk (E-Risk) study were invited to participate when their children were aged 12 years. Interventions: N/A. Measurements and Results: After controlling for family socioeconomic status (SES), mothers' relationship status, and maternal depression, maternal insomnia was associated with a poorer family socialization environment (β = −0.10, [95% confidence intervals (CI) = −0.16, −0.04], P Moffitt TE; Ambler A; Arseneault L; Houts RM; Caspi A. Maternal insomnia and children's family socialization environments. SLEEP 2012;35(4):579-582. PMID:22467996

  11. Quantifying the Interactions between Maternal and Fetal Heart Rates by Transfer Entropy.

    Directory of Open Access Journals (Sweden)

    Faezeh Marzbanrad

    Full Text Available Evidence of the short term relationship between maternal and fetal heart rates has been found in previous studies. However there is still limited knowledge about underlying mechanisms and patterns of the coupling throughout gestation. In this study, Transfer Entropy (TE was used to quantify directed interactions between maternal and fetal heart rates at various time delays and gestational ages. Experimental results using maternal and fetal electrocardiograms showed significant coupling for 63 out of 65 fetuses, by statistically validating against surrogate pairs. Analysis of TE showed a decrease in transfer of information from fetus to the mother with gestational age, alongside the maturation of the fetus. On the other hand, maternal to fetal TE was significantly greater in mid (26-31 weeks and late (32-41 weeks gestation compared to early (16-25 weeks gestation (Mann Whitney Wilcoxon (MWW p<0.05. TE further increased from mid to late, for the fetuses with RMSSD of fetal heart rate being larger than 4 msec in the late gestation. This difference was not observed for the fetuses with smaller RMSSD, which could be associated with the quiet sleep state. Delay in the information transfer from mother to fetus significantly decreased (p = 0.03 from mid to late gestation, implying a decrease in fetal response time. These changes occur concomitant with the maturation of the fetal sensory and autonomic nervous systems with advancing gestational age. The effect of maternal respiratory rate derived from maternal ECG was also investigated and no significant relationship was found between breathing rate and TE at any lag. In conclusion, the application of TE with delays revealed detailed information on the fetal-maternal heart rate coupling strength and latency throughout gestation, which could provide novel clinical markers of fetal development and well-being.

  12. Quantifying the Interactions between Maternal and Fetal Heart Rates by Transfer Entropy.

    Science.gov (United States)

    Marzbanrad, Faezeh; Kimura, Yoshitaka; Palaniswami, Marimuthu; Khandoker, Ahsan H

    2015-01-01

    Evidence of the short term relationship between maternal and fetal heart rates has been found in previous studies. However there is still limited knowledge about underlying mechanisms and patterns of the coupling throughout gestation. In this study, Transfer Entropy (TE) was used to quantify directed interactions between maternal and fetal heart rates at various time delays and gestational ages. Experimental results using maternal and fetal electrocardiograms showed significant coupling for 63 out of 65 fetuses, by statistically validating against surrogate pairs. Analysis of TE showed a decrease in transfer of information from fetus to the mother with gestational age, alongside the maturation of the fetus. On the other hand, maternal to fetal TE was significantly greater in mid (26-31 weeks) and late (32-41 weeks) gestation compared to early (16-25 weeks) gestation (Mann Whitney Wilcoxon (MWW) pheart rate being larger than 4 msec in the late gestation. This difference was not observed for the fetuses with smaller RMSSD, which could be associated with the quiet sleep state. Delay in the information transfer from mother to fetus significantly decreased (p = 0.03) from mid to late gestation, implying a decrease in fetal response time. These changes occur concomitant with the maturation of the fetal sensory and autonomic nervous systems with advancing gestational age. The effect of maternal respiratory rate derived from maternal ECG was also investigated and no significant relationship was found between breathing rate and TE at any lag. In conclusion, the application of TE with delays revealed detailed information on the fetal-maternal heart rate coupling strength and latency throughout gestation, which could provide novel clinical markers of fetal development and well-being.

  13. Weight stigma in maternity care: women’s experiences and care providers’ attitudes

    Directory of Open Access Journals (Sweden)

    Mulherin Kate

    2013-01-01

    Full Text Available Abstract Background Weight stigma is pervasive in Western society and in healthcare settings, and has a negative impact on victims’ psychological and physical health. In the context of an increasing focus on the management of overweight and obese women during and after pregnancy in research and clinical practice, the current studies aimed to examine the presence of weight stigma in maternity care. Addressing previous limitations in the weight stigma literature, this paper quantitatively explores the presence of weight stigma from both patient and care provider perspectives. Methods Study One investigated associations between pre-pregnancy body mass index (BMI and experiences of maternity care from a state-wide, self-reported survey of 627 Australian women who gave birth in 2009. Study Two involved administration of an online survey to 248 Australian pre-service medical and maternity care providers, to investigate their perceptions of, and attitudes towards, providing care for pregnant patients of differing body sizes. Both studies used linear regression analyses. Results Women with a higher BMI were more likely to report negative experiences of care during pregnancy and after birth, compared to lower weight women. Pre-service maternity care providers perceived overweight and obese women as having poorer self-management behaviours, and reported less positive attitudes towards caring for overweight or obese pregnant women, than normal-weight pregnant women. Even care providers who reported few weight stigmatising attitudes responded less positively to overweight and obese pregnant women. Conclusions Overall, these results provide preliminary evidence that weight stigma is present in maternity care settings in Australia. They suggest a need for further research into the nature and consequences of weight stigma in maternity care, and for the inclusion of strategies to recognise and combat weight stigma in maternity care professionals’ training.

  14. Clinical characterisation of the multiple maternal hypomethylation syndrome in siblings

    DEFF Research Database (Denmark)

    Boonen, Susanne E; Pörksen, Sven; Mackay, Deborah Jg;

    2008-01-01

    manifestations of both TNDM and BWS in common. The family is highly consanguineous, and the parents are first cousins. We suggest that the genetic defect in this family is a novel, most likely autosomal recessive defect of methylation mechanisms, either in the sisters or in their mother, affecting her oocyte...

  15. Effects of maternal postpartum depression in a well-resourced sample

    DEFF Research Database (Denmark)

    Smith-Nielsen, Johanne; Væver, Mette Skovgaard; Tharner, Anne

    depression three to four months postpartum did not differ from infants of non-clinical mothers. However, regardless of depression group membership boys scored lower on the language scale at 13 months of age. Discussion: These results suggest that maternal depression can have an acute, concurrent effect......Background: It is well documented that maternal postpartum depression (PPD) has the potential to disrupt aspects of caregiving known to be critical for healthy child development. However, with regard to long term effects of PPD on global indices of infant development measured by standardized...... postpartum, it is possible that potential adverse effects of PPD on infant development for a large part have diminished or buffered by protective factors at the time when infant development is measured. However, little is known about how the concurrent exposure to maternal depressed mood impacts on infant...

  16. Integrating Public Data Sets for Analysis of Maternal Airborne Environmental Exposures and Stillbirth

    Science.gov (United States)

    Hall, Eric S.; Connolly, Natalia; Jones, David E.; DeFranco, Emily A.

    2014-01-01

    Efforts to study relationships between maternal airborne pollutant exposures and poor pregnancy outcomes have been frustrated by data limitations. Our objective was to report the proportion of Ohio women in 2006–2010 experiencing stillbirth whose pregnancy exposure to six criteria airborne pollutants could be approximated by applying a geospatial approach to vital records and Environmental Protection Agency air monitoring data. In addition, we characterized clinical and socio-demographic differences among women who lived within 10 km of monitoring stations compared to women who did not live within proximity of monitoring stations. For women who experienced stillbirth, 10.8% listed a residence within 10 km of each type of monitoring station. Maternal race, education, and marital status were significantly different (p<0.0001) comparing those within proximity to monitoring stations to those outside of monitoring range. No significant differences were identified in maternal age, ethnicity, smoking status, hypertension, or diabetes between groups. PMID:25954365

  17. Noninvasive Prenatal Paternity Testing (NIPAT) through Maternal Plasma DNA Sequencing: A Pilot Study.

    Science.gov (United States)

    Jiang, Haojun; Xie, Yifan; Li, Xuchao; Ge, Huijuan; Deng, Yongqiang; Mu, Haofang; Feng, Xiaoli; Yin, Lu; Du, Zhou; Chen, Fang; He, Nongyue

    2016-01-01

    Short tandem repeats (STRs) and single nucleotide polymorphisms (SNPs) have been already used to perform noninvasive prenatal paternity testing from maternal plasma DNA. The frequently used technologies were PCR followed by capillary electrophoresis and SNP typing array, respectively. Here, we developed a noninvasive prenatal paternity testing (NIPAT) based on SNP typing with maternal plasma DNA sequencing. We evaluated the influence factors (minor allele frequency (MAF), the number of total SNP, fetal fraction and effective sequencing depth) and designed three different selective SNP panels in order to verify the performance in clinical cases. Combining targeted deep sequencing of selective SNP and informative bioinformatics pipeline, we calculated the combined paternity index (CPI) of 17 cases to determine paternity. Sequencing-based NIPAT results fully agreed with invasive prenatal paternity test using STR multiplex system. Our study here proved that the maternal plasma DNA sequencing-based technology is feasible and accurate in determining paternity, which may provide an alternative in forensic application in the future.

  18. Maternal Risk Factors for Congenital Cerebral Palsy

    OpenAIRE

    Streja, Elani

    2012-01-01

    Congenital Cerebral Palsy (CP) is the most common physical disability in children. In spite of major advances in medical technology, the etiology of CP is still not well understood. There is growing evidence that brain damage leading to CP development occurs during pregnancy and that maternal phenotype contributes to this intrauterine environment. We hypothesized that maternal factors such as infections, smoking, comorbidities and genetics can increase the risk of CP in children. Additionally...

  19. Maternal perceptions of partner support during breastfeeding

    OpenAIRE

    Mannion, Cynthia A; Hobbs, Amy J; Sheila W McDonald; Tough, Suzanne C

    2013-01-01

    Background Many women find breastfeeding challenging to sustain beyond the first three postpartum months. Women rely on a variety of resources to aid and encourage breastfeeding, including ‘partner support’. Women’s perception of partner support during breastfeeding may influence maternal satisfaction and confidence but it remains understudied. We asked women about their perceptions of partner support during breastfeeding and measured the effect on maternal confidence, commitment, and satisfa...

  20. Maternal affection and motivation for breastfeeding

    OpenAIRE

    Pinto, Edite; Chaves, Cláudia; Duarte, João; Nelas, Paula; Coutinho, Emília

    2016-01-01

    Several studies by UNICEF, OMS and other childhood protection institutions have concluded that the breastfeeding is considered an important strategy for infantile survival. Thus, the motivation for breastfeeding is an important variable which should be considered, given that motivation is the agent propeller of all action. To identify whether maternal affection conditions the motivation for maternal breast feeding. Quantitative, transverse, descriptive-correlational and explanatory study, usi...

  1. Julia Kristeva’s Maternal Passions

    Directory of Open Access Journals (Sweden)

    Kelly Oliver

    2010-01-01

    Full Text Available This article critically engages Julia Kristeva’s latest work on maternal passion as an antidote to what she calls “feminine fatigue.”  Oliver elaborates, criticizes, and expands Kristeva’s view that maternity can be a model for thinking about passion and its relation to creativity and even to ethics.  She relates Kristeva’s thinking about feminine fatigue to contemporary feminism in the United States. 

  2. Supporting Maternal Transition: Continuity, Coaching, and Control

    OpenAIRE

    Rowe, Jennifer; Barnes, Margaret; Sutherns, Stephanie

    2013-01-01

    The transition from maternity services to community child health services on discharge from hospital occurs at a potentially vulnerable time for women in their transition through the childbearing/early parenting continuum. Their experiences contribute to their developing maternal efficacy and parenting skill. The ideal attributes of services that aim to support women and their families during this time include continuity of care, service integration, and birth in accessible, community-based c...

  3. Maternal Intensive Care’: a systematic literature review

    OpenAIRE

    Van Parys, A.S.; Verstraelen, H.; Roelens, K.; Temmerman, M.

    2010-01-01

    Objective: The objective of this systematic literature review is to review current scientific knowledge on the definition of and the indications for maternal/obstetric intensive care (MIC). Methods: We conducted a extensive search in OVID MEDLINE, EMBASE, COCHRANE, CINHAL and CEBAM using the keywords: maternal/obstetric intensive care, subacute care, intermediate care, postacute care, critical care, sub intensive care, progressive patient care, postnatal care, perinatal care, obstetrical nurs...

  4. The Still-Face Paradigm and bidirectionality: associations with maternal sensitivity, self-esteem and infant emotional reactivity.

    Science.gov (United States)

    Mastergeorge, Ann M; Paschall, Katherine; Loeb, Sophie R; Dixon, Ashley

    2014-08-01

    The Still-Face Paradigm (SFP) is a structured stressful event within which researchers have investigated the influence of maternal psychological and behavioral characteristics on infant behavior. The present investigation contributes to this body of work by examining the joint contributions of maternal and child behavioral and affective characteristics on subsequent behaviors and affectations following the SFP. A sample of non-clinically depressed mothers and their infants (n=31) engaged in a modified Still-Face Paradigm (SFP), followed by a period of toy play. These interactions were videotaped and behaviorally coded along the following dimensions: maternal sensitivity prior to the SFP and during toy play, infant negative emotional reactivity during the still-face, and infant resistance during the reunion phase. Additionally, mothers reported global self-esteem and this was examined as a predictor of infant behavior. Results revealed significant bidirectional influences such that maternal self-esteem predicted infant emotional reactivity, maternal sensitivity pre-SFP predicted infant resistance during the reunion phase, and infant resistance predicted subsequent levels of maternal sensitivity. Indirect effects were also examined, and provided additional support for bidirectionality in mother-infant interactions. Implications for clinical practice are discussed in light of these findings. PMID:24950466

  5. Maternal admixture and population structure in Mexican-Mestizos based on mtDNA haplogroups.

    Science.gov (United States)

    Martínez-Cortés, Gabriela; Salazar-Flores, Joel; Haro-Guerrero, Javier; Rubi-Castellanos, Rodrigo; Velarde-Félix, Jésus S; Muñoz-Valle, José F; López-Casamichana, Mavil; Carrillo-Tapia, Eduardo; Canseco-Avila, Luis M; Bravi, Claudio M; López-Armenta, Mauro; Rangel-Villalobos, Héctor

    2013-08-01

    The maternal ancestry (mtDNA) has important applications in different research fields, such as evolution, epidemiology, identification, and human population history. This is particularly interesting in Mestizos, which constitute the main population in Mexico (∼93%) resulting from post-Columbian admixture between Spaniards, Amerindians, and African slaves, principally. Consequently, we conducted minisequencing analysis (SNaPshot) of 11 mitochondrial single-nucleotide polymorphisms in 742 Mestizos of 10 populations from different regions in Mexico. The predominant maternal ancestry was Native American (92.9%), including Haplogroups A, B, C, and D (47, 23.7, 15.9, and 6.2%, respectively). Conversely, European and African ancestries were less frequent (5.3 and 1.9%, respectively). The main characteristics of the maternal lineages observed in Mexican-Mestizos comprised the following: 1) contrasting geographic gradient of Haplogroups A and C; 2) increase of European lineages toward the Northwest; 3) low or absent, but homogeneous, African ancestry throughout the Mexican territory; 4) maternal lineages in Mestizos roughly represent the genetic makeup of the surrounding Amerindian groups, particularly toward the Southeast, but not in the North and West; 5) continuity over time of the geographic distribution of Amerindian lineages in Mayas; and 6) low but significant maternal population structure (FST  = 2.8%; P = 0.0000). The average ancestry obtained from uniparental systems (mtDNA and Y-chromosome) in Mexican-Mestizos was correlated with previous ancestry estimates based on autosomal systems (genome-wide single-nucleotide polymorphisms and short tandem repeats). Finally, the comparison of paternal and maternal lineages provided additional information concerning the gender bias admixture, mating patterns, and population structure in Mestizos throughout the Mexican territory.

  6. Carpal tunnel syndrome in the Clínica Universitaria San Juan de Dios de Cartagena, Colombia. Epidemiological, clinical profile and therapeutic evolution

    Directory of Open Access Journals (Sweden)

    Bedoya-Mosquera Jaddy Sandrey

    2012-06-01

    Full Text Available Introduction: carpal tunnel syndrome (CTS is one of the major health problems ofworkers who carry out tasks related to intense manual effort and repetitive movementsof the upper limb.Objectives: to determine the epidemiological and clinical profile of patientsattending a pain unit, identify job, clinical and therapeutic characteristicsto compare the clinical course of patients before and after surgery.Methods: a prospective descriptive study. The study population consisted of allworkers who were diagnosed with carpal tunnel syndrome as an occupational diseaseand looked at the Pain Unit at the San Juan de Dios Clinic in Cartagena, Colombia,from 2008 to 2010. Personal or telephone interview was conducted and clinical historyreview. Hypothesis tests were performed for quantitative variables (Student’s test or signtest and qualitative variables (Chi2 or Fisher’s test to compare the initial findings andafter interventions.Results: the incidence of work-related CTS is 10.7% in the Pain Unit at the San Juande Dios Clinic. We found that people who work in companies of shrimp or tuna are themost affected, with average time of absence from work for three years. We found thatin patients undergoing surgical treatment, most improve in early post-operative, but thesymptoms reappear again subjected to the same occupational hazard. We found delayeddiagnosis and therefore treatment.RESUMEN:Introducción: el síndrome del túnel carpiano (STC es uno de los principales problemasde salud de los trabajadores, que desarrollan tareas relacionadas con esfuerzosmanuales intensos y movimientos repetitivos del miembro superior.Objetivos: determinar el perfil epidemiológico y clínico de los pacientes que consultana una unidad de dolor, identificar las características laborales, clínicas y terapéuticas,comparar la evolución clínica de los pacientes antes y después de la intervenciónquirúrgica.Métodos: estudio observacional descriptivo prospectivo. La poblaci

  7. Emotions, stress, and maternal motivation in primates.

    Science.gov (United States)

    Maestripieri, Dario

    2011-06-01

    Recent research conducted with nonhuman primates confirms that adaptive emotional processes, such as maternal attraction arousability and maternal anxiety arousability, enhance and sustain female motivation to interact with infants, invest in them, and protect them during the postpartum period. Changes in these emotional processes, and concomitant changes in maternal motivation, facilitate the reduction and eventual termination of maternal investment associated with infant weaning. Although laboratory studies of rodents and socially deprived rhesus monkeys have suggested that nulliparous females are neophobic and find infant stimuli aversive, recent primate research indicates that neophobia or aversion to infant stimuli do not occur in females with normal developmental experience. Furthermore, although some rodent and human studies have shown that lactation is accompanied by physiological hyporesponsiveness to stress, other studies of rodents, nonhuman primates, and humans indicate that mothers are highly vulnerable to stress and that stress-induced dysregulation of emotions can interfere with maternal motivation and parenting behavior. It is possible that some aspects of the emotional and experiential regulation of maternal motivation and parental behavior are different in different mammalian species. However, variation in the environments in which subjects are tested and in their developmental experience may also be responsible for the some discrepancies between the results of different studies.

  8. Noninvasive prenatal molecular karyotyping from maternal plasma.

    Directory of Open Access Journals (Sweden)

    Stephanie C Y Yu

    Full Text Available Fetal DNA is present in the plasma of pregnant women. Massively parallel sequencing of maternal plasma DNA has been used to detect fetal trisomies 21, 18, 13 and selected sex chromosomal aneuploidies noninvasively. Case reports describing the detection of fetal microdeletions from maternal plasma using massively parallel sequencing have been reported. However, these previous reports were either polymorphism-dependent or used statistical analyses which were confined to one or a small number of selected parts of the genome. In this report, we reported a procedure for performing noninvasive prenatal karyotyping at 3 Mb resolution across the whole genome through the massively parallel sequencing of maternal plasma DNA. This method has been used to analyze the plasma obtained from 6 cases. In three cases, fetal microdeletions have been detected successfully from maternal plasma. In two cases, fetal microduplications have been detected successfully from maternal plasma. In the remaining case, the plasma DNA sequencing result was consistent with the pregnant mother being a carrier of a microduplication. Simulation analyses were performed for determining the number of plasma DNA molecules that would need to be sequenced and aligned for enhancing the diagnostic resolution of noninvasive prenatal karyotyping to 2 Mb and 1 Mb. In conclusion, noninvasive prenatal molecular karyotyping from maternal plasma by massively parallel sequencing is feasible and would enhance the diagnostic spectrum of noninvasive prenatal testing.

  9. Enhanced surveillance of maternal mortality in Texas.

    Science.gov (United States)

    Estes, Larissa J; Lloyd, Linda E; Selwyn, Beatrice J

    2012-12-01

    Maternal mortality is often used to measure health and well-being for women. Improved surveillance efforts can improve maternal mortality estimates and inform the development of strategies to address the needs of maternal and child health populations. The purpose of this study was to provide better estimates of maternal mortality in Texas by using enhanced surveillance methods. Results from our analyses of fetal death and live birth records in Texas from 2000 through 2006 were then linked to pregnancy-related death records and death records of women of childbearing age (15-44 years) in Texas from 2001 through 2006. Enhanced surveillance identified almost 3.5 times as many deaths that might be associated with pregnancy than do current methods and confirmed a persistent race/ethnicity trend in maternal mortality. The leading cause of these 2001-2006 pregnancy-associated deaths was accidents. Enhanced surveillance allows the identification of additional deaths possibly associated with pregnancy and provides a stable foundation to investigate trends further and to review maternal mortality cases systematically.

  10. An efficient unsupervised fetal QRS complex detection from abdominal maternal ECG.

    Science.gov (United States)

    Varanini, M; Tartarisco, G; Billeci, L; Macerata, A; Pioggia, G; Balocchi, R

    2014-08-01

    Non-invasive fetal heart rate is of great relevance in clinical practice to monitor fetal health state during pregnancy. To date, however, despite significant advances in the field of electrocardiography, the analysis of abdominal fetal ECG is considered a challenging problem for biomedical and signal processing communities. This is mainly due to the low signal-to-noise ratio of fetal ECG and difficulties in cancellation of maternal QRS complexes, motion and electromyographic artefacts. In this paper we present an efficient unsupervised algorithm for fetal QRS complex detection from abdominal multichannel signal recordings combining ICA and maternal ECG cancelling, which outperforms each single method. The signal is first pre-processed to remove impulsive artefacts, baseline wandering and power line interference. The following steps are then applied: maternal ECG extraction through independent component analysis (ICA); maternal QRS detection; maternal ECG cancelling through weighted singular value decomposition; enhancing of fetal ECG through ICA and fetal QRS detection. We participated in the Physionet/Computing in Cardiology Challenge 2013, obtaining the top official scores of the challenge (among 53 teams of participants) of event 1 and event 2 concerning fetal heart rate and fetal interbeat intervals estimation section. The developed algorithms are released as open-source on the Physionet website.

  11. Pathogenic effects of maternal antinuclear antibodies during pregnancy in women with lupus

    Directory of Open Access Journals (Sweden)

    Rafael Herrera-Esparza

    2014-11-01

    Full Text Available Lupus is an autoimmune disease that primarily affects young women of childbearing age. Fertility rates in lupus patients depend on various factors, including disease activity, nephritis, and the presence of antiphospholipid antibodies; however, after lupus patients become pregnant, different factors may affect the course of pregnancy, such as the production of autoantibodies, pre-existing renal disease, and eclampsia, among others. The placenta is a temporary hemochorial organ that prevents immunological conflict due to exposure to alloantigens at the maternal-fetal interface; placental regulatory T cells play a major role in maternal-fetal tolerance. Typically, significant amounts of maternal IgG class antibodies cross the placenta and enter the fetal circulation. This transition depends on the distribution of Fc receptors along the syncytiotrophoblast. The production of antinuclear antibodies (ANA is a hallmark of lupus, and these autoantibodies can form immune complexes that are typically trapped in the placenta during gestation. However, the entry of ANA into the fetal circulation depends on the IgG-ANA concentration and the FcR placental density. Maternal antinuclear antibodies with anti-Ro or anti-La specificity might be pathogenic to the fetus if transfused by the placental pathway and could induce neonatal pathologies, such as neonatal lupus and congenital heart block. Here, we review the experimental and clinical data supporting a pathogenic role for maternal autoantibodies transmitted to the fetus

  12. Maternal PTSD associates with greater glucocorticoid sensitivity in offspring of Holocaust survivors.

    Science.gov (United States)

    Lehrner, Amy; Bierer, Linda M; Passarelli, Vincent; Pratchett, Laura C; Flory, Janine D; Bader, Heather N; Harris, Iris R; Bedi, Aarti; Daskalakis, Nikolaos P; Makotkine, Iouri; Yehuda, Rachel

    2014-02-01

    Intergenerational effects of trauma have been observed clinically in a wide range of populations, and parental PTSD has been associated with an increased risk for psychopathology in offspring. In studies of Holocaust survivor offspring, parental PTSD, and particularly maternal PTSD, has been associated with increased risk for PTSD, low basal urinary cortisol excretion and enhanced cortisol suppression in response to dexamethasone. Such findings implicate maternally derived glucocorticoid programming in the intergenerational transmission of trauma-related consequences, potentially resulting from in utero influences or early life experiences. This study investigated the relative influence of Holocaust exposure and PTSD in mothers and fathers on glucocorticoid sensitivity in offspring. Eighty Holocaust offspring and 15 offspring of non-exposed Jewish parents completed evaluations and provided blood and urine samples. Glucocorticoid sensitivity was evaluated using the lysozyme suppression test (LST), an in vitro measure of glucocorticoid receptor sensitivity in a peripheral tissue, the dexamethasone suppression test (DST), and 24-h urinary cortisol excretion. Maternal PTSD was associated with greater glucocorticoid sensitivity in offspring across all three measures of glucocorticoid function. An interaction of maternal and paternal PTSD on the DST and 24-h urinary cortisol showed an effect of decreased glucocorticoid sensitivity in offspring with paternal, but not maternal, PTSD. Although indirect, these findings are consistent with the hypothesis that epigenetic programming may be involved in the intergenerational transmission of trauma-related effects on glucocorticoid regulation. PMID:24485493

  13. Point-of-Care Diagnostics for Improving Maternal Health in South Africa.

    Science.gov (United States)

    Mashamba-Thompson, Tivani P; Sartorius, Benn; Drain, Paul K

    2016-01-01

    Improving maternal health is a global priority, particularly in high HIV-endemic, resource-limited settings. Failure to use health care facilities due to poor access is one of the main causes of maternal deaths in South Africa. "Point-of-care" (POC) diagnostics are an innovative healthcare approach to improve healthcare access and health outcomes in remote and resource-limited settings. In this review, POC testing is defined as a diagnostic test that is carried out near patients and leads to rapid clinical decisions. We review the current and emerging POC diagnostics for maternal health, with a specific focus on the World Health Organization (WHO) quality-ASSURED (Affordability, Sensitivity, Specificity, User friendly, Rapid and robust, Equipment free and Delivered) criteria for an ideal point-of-care test in resource-limited settings. The performance of POC diagnostics, barriers and challenges related to implementing POC diagnostics for maternal health in rural and resource-limited settings are reviewed. Innovative strategies for overcoming these barriers are recommended to achieve substantial progress on improving maternal health outcomes in these settings. PMID:27589808

  14. Stellar evolution

    CERN Document Server

    Meadows, A J

    2013-01-01

    Stellar Evolution, Second Edition covers the significant advances in the understanding of birth, life, and death of stars.This book is divided into nine chapters and begins with a description of the characteristics of stars according to their brightness, distance, size, mass, age, and chemical composition. The next chapters deal with the families, structure, and birth of stars. These topics are followed by discussions of the chemical composition and the evolution of main-sequence stars. A chapter focuses on the unique features of the sun as a star, including its evolution, magnetic fields, act

  15. Why are women so intelligent? The effect of maternal IQ on childhood mortality may be a relevant evolutionary factor.

    Science.gov (United States)

    Charlton, Bruce G

    2010-03-01

    Humans are an unusual species because they exhibit an economic division of labour. Most theories concerning the evolution of specifically human intelligence have focused either on economic problems or sexual selection mechanisms, both of which apply more to men than women. Yet while there is evidence for men having a slightly higher average IQ, the sexual dimorphism of intelligence is not obvious (except at unusually high and low levels). However, a more female-specific selection mechanism concerns the distinctive maternal role in child care during the offspring's early years. It has been reported that increasing maternal intelligence is associated with reducing child mortality. This would lead to a greater level of reproductive success for intelligent women, and since intelligence is substantially heritable, this is a plausible mechanism by which natural selection might tend to increase female intelligence in humans. Any effect of maternal intelligence on improving child survival would likely be amplified by assortative mating for IQ by which people tend to marry others of similar intelligence - combining female maternal and male economic or sexual selection factors. Furthermore, since general intelligence seems to have the functional attribute of general purpose problem-solving and more rapid learning, the advantages of maternal IQ are likely to be greater as the environment for child-rearing is more different from the African hunter-gatherer society and savannah environment in which ancestral humans probably evolved. However, the effect of maternal IQ on child mortality would probably only be of major evolutionary significance in environments where childhood mortality rates were high. The modern situation is that population growth is determined mostly by birth rates; so in modern conditions, maternal intelligence may no longer have a significant effect on reproductive success; the effect of female IQ on reproductive success is often negative. Nonetheless, in the

  16. Relationship between GDM maternal advanced glycation end products level and fetal birth defects and it's clinical significance%GDM孕妇血清晚期糖基化终产物水平与其胎儿出生缺陷的关系及临床意义

    Institute of Scientific and Technical Information of China (English)

    汤栩文; 林斯; 谢晓斌

    2012-01-01

    目的:检测妊娠期糖尿病(GDM)孕妇血清及脐血血清中晚期糖基化终产物(AGE)的水平,并观察胎盘组织中AGE受体(RAGE)的表达,探讨AGE与胎儿出生缺陷的关系及其在产前筛查中的临床意义.方法:选择经产前筛查诊断为胎儿畸形或胎死宫内的GDM孕妇作为病例组(42例),随机选择GDM无胎儿异常孕妇作为GDM组(30例),无妊娠合并症的健康孕妇作为健康对照组(30例).采用酶联免疫法检测孕妇血清及脐血血清AGE水平;采用免疫组化方法检测胎盘组织中RAGE蛋白的表达.结果:病例组、GDM组、健康对照组脐血血清AGE水平分别为(223.9±54.6),(160.7±37.2),(108.3+15.8) μg/L,三组差异显著(P<0.05);病例组、GDM组、健康对照组孕妇血清AGE水平分别为(169.1±14.3),(105.4±17.2),(80.6±11.4) μg/L,三组亦有显著差异(P<0.05);病例组孕妇血清与脐血血清中AGE水平呈正相关(r=0.863,P<0.01);病例组、GDM组及健康对照组胎盘组织中RAGE的阳性表达率分别为87.5%、53.1%、29.6%,三组差异显著(P<0.05).结论:GDM孕妇高AGE血症是导致出生缺陷的危险因素,孕妇血清AGE水平可作为GDM出生缺陷的产前筛查指标.%Objective:To detect serum advanced glycation end products(AGE) level in gestation diabetic mother( GDM) gestational period and fetal cord blood, and observe the RAGE protein expression in placenta. To explore the clinical significance of relationship be-tween fetal birth defects and AGE levels in prenatal screening. Methods: Gestational diabetes pregnant woman confirmed fetalmalformation or fetal death by prenatal diagnosis were enrolled as the study group, total of 42 cases; Randomly selected the GDM fetal normalities pregnant women,as the GDM group,30 cases;another 30 cases of the normal pregnant women wre select-ed randomly as healthy control group. Maternal peripheral blood and the specimens of fetal cord blood specimens were collected to detect AGE

  17. Evolutionary genetics of maternal effects.

    Science.gov (United States)

    Wolf, Jason B; Wade, Michael J

    2016-04-01

    Maternal genetic effects (MGEs), where genes expressed by mothers affect the phenotype of their offspring, are important sources of phenotypic diversity in a myriad of organisms. We use a single-locus model to examine how MGEs contribute patterns of heritable and nonheritable variation and influence evolutionary dynamics in randomly mating and inbreeding populations. We elucidate the influence of MGEs by examining the offspring genotype-phenotype relationship, which determines how MGEs affect evolutionary dynamics in response to selection on offspring phenotypes. This approach reveals important results that are not apparent from classic quantitative genetic treatments of MGEs. We show that additive and dominance MGEs make different contributions to evolutionary dynamics and patterns of variation, which are differentially affected by inbreeding. Dominance MGEs make the offspring genotype-phenotype relationship frequency dependent, resulting in the appearance of negative frequency-dependent selection, while additive MGEs contribute a component of parent-of-origin dependent variation. Inbreeding amplifies the contribution of MGEs to the additive genetic variance and, therefore enhances their evolutionary response. Considering evolutionary dynamics of allele frequency change on an adaptive landscape, we show that this landscape differs from the mean fitness surface, and therefore, under some condition, fitness peaks can exist but not be "available" to the evolving population. PMID:26969266

  18. Schumpeter's Evolution

    DEFF Research Database (Denmark)

    Andersen, Esben Sloth

    reworking of his basic theory of economic evolution in Development from 1934, and this reworking was continued in Cycles from 1939. Here Schumpeter also tried to handle the statistical and historical evidence on the waveform evolution of the capitalist economy. Capitalism from 1942 modified the model...... originally developed his evolutionary research programme in Wesen from 1908 by studying the inherent limitations of Neoclassical Economics. He presented core results on economic evolution and sketched an extension evolutionary analysis to all social sciences in Entwicklung from 1912. He made a partial...... of economic evolution and added evolutionary contributions to other social sciences. History, which was published by his widow, was based on his evolutionary theory of the history of economic analysis. This sequential analysis of Schumpeter's six books demonstrates the progress he within his research...

  19. New aspects in the clinical spectrum of neonatal lupus

    DEFF Research Database (Denmark)

    Laurinaviciene, Rasa; Christesen, Henrik Thybo; Bygum, Anette

    2012-01-01

    Neonatal lupus erythematosus (NLE) is a rare, passively acquired autoimmune disease, caused by maternal autoantibodies. Characteristic clinical features of NLE are transient rash and congenital heart block (CHB), but also hematological abnormalities and hepatobiliary dysfunction may occur...

  20. Maternal Mortality and Serious Maternal Morbidity in Jehovah's Witnesses in The Netherlands EDITORIAL COMMENT

    NARCIS (Netherlands)

    Van Wolfswinkel, M. E.; Zwart, J. J.; Schutte, J. M.; Duvekot, J. J.; Pel, M.; Van Roosmalen, J.

    2009-01-01

    Refusal of blood by women with major obstetric hemorrhage who are Jehovah's witnesses increases their risk of maternal death. This retrospective study of case notes assessed the risk of maternal morbidity and mortality from major obstetric hemorrhage in Jehovah's witnesses. The data was obtained fro

  1. Maternal mortality and serious maternal morbidity in Jehovah's witnesses in the Netherlands

    NARCIS (Netherlands)

    M.E. van Wolfswinkel; J.J. Zwart; J.M. Schutte; J.J. Duvekot; M. Pel; J. van Roosmalen

    2009-01-01

    To determine the risk of maternal mortality and serious maternal morbidity because of major obstetric haemorrhage in Jehovah's witnesses in the Netherlands. A retrospective study of case notes. All tertiary care centres, general teaching hospitals and other general hospitals in the Netherlands. All

  2. Exploring the effects of maternal eating patterns on maternal feeding and child eating.

    Science.gov (United States)

    Morrison, Halley; Power, Thomas G; Nicklas, Theresa; Hughes, Sheryl O

    2013-04-01

    Recent research has demonstrated the importance of maternal feeding practices and children's eating behavior in the development of childhood obesity. The purpose of this study was to examine the relations between maternal and child eating patterns, and to examine the degree to which these relationships were mediated through maternal feeding practices. Two hundred and twenty-two low-income mothers and their preschool children participated. About half of the families were African American and half were Latino. Mothers completed questionnaires assessing maternal eating patterns, maternal feeding practices, and children's eating patterns. Maternal external eating (eating in response to outside stimuli, not internal hunger/thirst cues) was positively correlated with two child eating scores: picky eating and desire to eat. Mediational analyses showed that external eating in mothers was related to picky eating in children through high maternal control in feeding; the relationship between mothers' external eating and desire to eat in children was not mediated through maternal control. Picky eating and desire to eat in children were related to emotional eating in mothers as well. The implications of these results for understanding the development of childhood obesity are considered.

  3. Maternal Attachment Representations, Maternal Sensitivity, and the Infant-Mother Attachment Relationship.

    Science.gov (United States)

    Pederson, David R.; Gleason, Karin E.; Moran, Greg; Bento, Sandi

    1998-01-01

    Examined the mediating role of maternal sensitivity for the association between maternal attachment representations and the quality of infant-mother attachment. Found that autonomous mothers and mothers in secure relationships were more sensitive at home than nonautonomous mothers and mothers in nonsecure relationships, respectively. Infants in…

  4. Maternal passive smoking and its effect on maternal, neonatal and placental parameters.

    Science.gov (United States)

    Ramesh, K N; Vidyadaran, M K; Goh, Y M; Nasaruddin, A A; Jammal, A B E; Zainab, S

    2005-08-01

    A study was undertaken to 1) determine the effects of tobacco smoke exposure on maternal and neonatal weight and body mass index (BMI) and placental weight, volume and surface area and 2) establish any correlations between the placental surface area, volume and weight with maternal and neonatal body weight and BMI in mothers exposed to cigarette smoke. A total of 154 full-term placentae, 65 from mothers exposed to tobacco smoke and 89 from non-exposed mothers were collected from Kuala Lumpur Maternity Hospital. The placental surface area was determined using a stereological grid, the volume by Scherle's method and the weight by using an electronic weighing machine. In general there were no differences in maternal, placental and neonatal parameters between the exposed and non-exposed groups. However, there were significant correlations between placental weight with maternal weight and maternal BMI in both exposed (r = 0.315; p = 0.013) and (r = 0.265; p = 0.038), and non-exposed (r = 0.224; p = 0.035) and (r = 0.241; p = 0.023) mothers. It was also found that the maternal weight on admission correlated significantly with placental weight in both Malay (r = 0.405; p = 0.020) and Indian (r = 0.553; p = 0.050) passive smokers. Correcting the placental parameters for the maternal weight had no effect on the results. PMID:16379184

  5. Maternal Psychopathology and Infant Development at 18 Months: The Impact of Maternal Personality Disorder and Depression

    Science.gov (United States)

    Conroy, Susan; Pariante, Carmine M.; Marks, Maureen N.; Davies, Helen A.; Farrelly, Simone; Schacht, Robin; Moran, Paul

    2012-01-01

    Objective: No previous longitudinal study has examined the impact of comorbid maternal personality disorder (PD) and depression on child development. We set out to examine whether maternal PD and depression assessed at 2 months post partum would be independently associated with adverse developmental outcomes at 18 months of age. Method: Women were…

  6. Associations between Parents' Marital Functioning, Maternal Parenting Quality, Maternal Emotion and Child Cortisol Levels

    Science.gov (United States)

    Pendry, Patricia; Adam, Emma K.

    2007-01-01

    Associations between family functioning and children's stress hormone levels are explored, by examining how aspects of the interparental relationship (parents' marital satisfaction and parent conflict styles), the mother-child relationship (maternal involvement and warmth) and maternal emotional functioning (depression, anxiety and self-esteem)…

  7. Maternal Preconceptions About Parenting Predict Child Temperament, Maternal Sensitivity, and Children's Empathy

    Science.gov (United States)

    Kiang, Lisa; Moreno, Amanda J.; Robinson, JoAnn L.

    2004-01-01

    This study examined the influence of maternal preconceptions on child difficult temperament at 6 months and maternal sensitivity at 12-15 months and whether all 3 variables predicted children's empathy at 21-24 months. Within a low-income, ethnically diverse sample of 175 mother-child dyads, path models were tested with 3 empathy indices…

  8. Relations among Intimate Partner Violence, Maternal Depressive Symptoms, and Maternal Parenting Behaviors

    Science.gov (United States)

    Gustafsson, Hanna C.; Cox, Martha J.

    2012-01-01

    The authors examined the relations among intimate partner violence (IPV), maternal depressive symptoms, and maternal harsh intrusive parenting. Using a cross-lagged, autoregressive path model, they sought to clarify the directionality of the relations among these 3 variables over the first 2 years of the child's life. The results indicated that,…

  9. The effects of maternal depression and maternal selective serotonin reuptake inhibitor exposure on offspring

    NARCIS (Netherlands)

    Olivier, J D A; Akerud, H; Kaihola, H; Pawluski, J L; Skalkidou, A; Högberg, U; Sundström-Poromaa, I

    2013-01-01

    It has been estimated that 20% of pregnant women suffer from depression and it is well-documented that maternal depression can have long-lasting effects on the child. Currently, common treatment for maternal depression has been the selective serotonin reuptake inhibitor medications (SSRIs) which are

  10. The Relations among Maternal Depressive Disorder, Maternal Expressed Emotion, and Toddler Behavior Problems and Attachment

    Science.gov (United States)

    Gravener, Julie A.; Rogosch, Fred A.; Oshri, Assaf; Narayan, Angela J.; Cicchetti, Dante; Toth, Sheree L.

    2012-01-01

    Direct and indirect relations among maternal depression, maternal Expressed Emotion (EE: Self- and Child-Criticism), child internalizing and externalizing symptoms, and child attachment were examined. Participants were mothers with depression (n = 130) and comparison mothers (n = 68) and their toddlers (M age = 20 mo.; 53% male). Assessments…

  11. Maternal hormones meet environmental variability : Context-dependent effects of maternal hormones in avian egg yolks

    NARCIS (Netherlands)

    Hsu, Bin-Yan

    2016-01-01

    In the past few decades, maternal effects have been widely recognized as an important way through which mothers can modify offspring phenotypes above and over direct genetic effects. As a wide variety of animals are prenatal exposed to maternal hormones, accumulating evidences also suggest that mate

  12. The Contributions of Maternal Sensitivity and Maternal Depressive Symptoms to Epigenetic Processes and Neuroendocrine Functioning

    Science.gov (United States)

    Conradt, Elisabeth; Hawes, Katheleen; Guerin, Dylan; Armstrong, David A.; Marsit, Carmen J.; Tronick, Edward; Lester, Barry M.

    2016-01-01

    This study tested whether maternal responsiveness may buffer the child to the effects of maternal depressive symptoms on DNA methylation of "NR3C1," "11ß-HSD2," and neuroendocrine functioning. DNA was derived from buccal epithelial cells and prestress cortisol was obtained from the saliva of 128 infants. Mothers with depressive…

  13. Poverty and Maternal Responsiveness: The Role of Maternal Stress and Social Resources

    Science.gov (United States)

    Evans, Gary W.; Boxhill, Louise; Pinkava, Michael

    2008-01-01

    One of the main reasons poverty is bad for children's development is because it reduces maternal responsiveness. This study addresses a heretofore unanswered question: why do low-income children experience diminished maternal responsiveness compared with their more affluent counterparts? In addition, we examine this question among a largely…

  14. Factors Affecting The Adoption Of Mhealth In Maternal Health Care In Nakuru Provincial General Hospital

    Directory of Open Access Journals (Sweden)

    Simon Munyua

    2015-08-01

    Full Text Available Abstract Access to timely and quality maternal health care remains to be a major development challenge in many developing economies particularly in Kenya. The countrys system of providing maternal health care also continue to be anchored on conventional methods of physical presence of the patient and the doctor in a hospital setup. The countrys ICT and health policies also place very little emphasis on the use of these platforms. This study therefore sought to establish the factors affecting the adoption of mHealth by focusing on maternal health in Nakuru Provincial General Hospital. Objectives of the study were to determine the extent to knowledge and awareness affects the adoption of mHealth in maternal health care at Nakuru PGH to identify the government policies affecting the adoption of mHealth in maternal health care at Nakuru PGH to assess how access to technology affects the adoption of mHealth in maternal healthcare to establish the effects of ICT infrastructure on the adoption of mHealth in maternal health care and to identify the cost aspects affecting the adoption of mHealth in maternal health care at Nakuru Provincial General Hospital. It is envisaged that the study could provide useful information on the adoption of mHealth in managing maternal health care in Nakuru Provincial General Hospital. Descriptive survey research design will be used where all the medical staff and patients of Nakuru Provincial General Hospital was surveyed. The study population therefore was made up of 24 medical staff and 3460 mothers visiting the antenatal clinic selected using clustered random sampling technique. The main instrument for primary data collection was the questionnaire. Data analysis was then done using both descriptive and inferential statistics. Descriptive statistics to be used include frequency counts percentages and measures of central tendency. Inferential statistics on the other hand include t-test analysis and spearman correlation

  15. Trends in maternal mortality in the United States.

    Science.gov (United States)

    Neggers, Yasmin H

    2016-09-01

    Maternal mortality is a major global concern. Although a notable decline in maternal mortality in the United States occurred during the mid-20th century, this progress stalled during the late 20th century. Furthermore, maternal mortality rates have increased during the early 21st century. Around the year 2000 the maternal mortality rate began to rise and has since nearly doubled. Given that at least half of maternal deaths in the U.S. are preventable, the rise in maternal deaths in the U.S. is historic and worrisome. This overview will try to provide a context for understanding the problem of this rise in maternal mortality in the U.S. by briefly discussing how maternal mortality rates are reported from National Vital Statistics data and from a National Surveillance system. Trends and causes of maternal deaths and the difficulty with interpreting these trends will be discussed.

  16. Maternal Expression Relaxes Constraint on Innovation of the Anterior Determinant, bicoid.

    Directory of Open Access Journals (Sweden)

    2005-11-01

    Full Text Available The origin of evolutionary novelty is believed to involve both positive selection and relaxed developmental constraint. In flies, the redesign of anterior patterning during embryogenesis is a major developmental innovation and the rapidly evolving Hox gene, bicoid (bcd, plays a critical role. We report evidence for relaxation of selective constraint acting on bicoid as a result of its maternal pattern of gene expression. Evolutionary theory predicts 2-fold greater sequence diversity for maternal effect genes than for zygotically expressed genes, because natural selection is only half as effective acting on autosomal genes expressed in one sex as it is on genes expressed in both sexes. We sample an individual from ten populations of Drosophila melanogaster and nine populations of D. simulans for polymorphism in the tandem gene duplicates bcd, which is maternally expressed, and zerknüllt (zen, which is zygotically expressed. In both species, we find the ratio of bcd to zen nucleotide diversity to be two or more in the coding regions but one in the noncoding regions, providing the first quantitative support for the theoretical prediction of relaxed selective constraint on maternal-effect genes resulting from sex-limited expression. Our results suggest that the accelerated rate of evolution observed for bcd is owing, at least partly, to variation generated by relaxed selective constraint.

  17. Maternal expression relaxes constraint on innovation of the anterior determinant, bicoid.

    Directory of Open Access Journals (Sweden)

    Michael S Barker

    2005-11-01

    Full Text Available The origin of evolutionary novelty is believed to involve both positive selection and relaxed developmental constraint. In flies, the redesign of anterior patterning during embryogenesis is a major developmental innovation and the rapidly evolving Hox gene, bicoid (bcd, plays a critical role. We report evidence for relaxation of selective constraint acting on bicoid as a result of its maternal pattern of gene expression. Evolutionary theory predicts 2-fold greater sequence diversity for maternal effect genes than for zygotically expressed genes, because natural selection is only half as effective acting on autosomal genes expressed in one sex as it is on genes expressed in both sexes. We sample an individual from ten populations of Drosophila melanogaster and nine populations of D. simulans for polymorphism in the tandem gene duplicates bcd, which is maternally expressed, and zerknüllt (zen, which is zygotically expressed. In both species, we find the ratio of bcd to zen nucleotide diversity to be two or more in the coding regions but one in the noncoding regions, providing the first quantitative support for the theoretical prediction of relaxed selective constraint on maternal-effect genes resulting from sex-limited expression. Our results suggest that the accelerated rate of evolution observed for bcd is owing, at least partly, to variation generated by relaxed selective constraint.

  18. Development of the Barkin Index of Maternal Functioning

    Science.gov (United States)

    Wisner, Katherine L.; Bromberger, Joyce T.; Beach, Scott R.; Terry, Martha A.; Wisniewski, Stephen R.

    2010-01-01

    Abstract Background Maternal functional status is important to capture in the 12 months after childbirth, as this period marks a critical window for both mother and child. In most cases, mothers are the primary caregivers and are, therefore, responsible for the majority of the work related to infant care tasks, such as feeding, diaper changes, and doctor's appointments. Additionally, the quality of mother-child interaction in the year after childbirth affects child development. To date, postpartum functioning has exacted scarce coverage, with only one instrument claiming to measure the concept explicitly. This necessitated the development of the Barkin Index of Maternal Functioning (BIMF), which was designed to measure functioning in the year after childbirth. Methods Three focus groups comprised of 31 new mothers were held to elicit women's concept of functioning in the first postpartum year. Women were asked to discuss the responsibilities associated with new motherhood as well as the circumstances surrounding high and low functioning periods. Results The qualitative data produced by the focus groups were coded by emotive tone and content and translated into item construction for the BIMF, a 20-item self-report measure of functioning intended for use in the year after childbirth. Before implementation into the screening study, the BIMF was critiqued by a panel of experts and cross-checked with the literature to ensure that no major contextual domains were absent. Psychometric testing revealed adequate internal reliability and construct validity, and the BIMF has been implemented successfully in clinical settings. Conclusions The high level of patient engagement and psychometric properties associated with the BIMF are indicative of its potential to become a valuable tool for assessing maternal wellness. PMID:21054183

  19. Developing evidence-based maternity care in Iran: a quality improvement study

    Directory of Open Access Journals (Sweden)

    Mohammad Kazem

    2008-06-01

    Full Text Available Abstract Background Current Iranian perinatal statistics indicate that maternity care continues to need improvement. In response, we implemented a multi-faceted intervention to improve the quality of maternity care at an Iranian Social Security Hospital. Using a before-and-after design our aim was to improve the uptake of selected evidence based practices and more closely attend to identified women's needs and preferences. Methods The major steps of the study were to (1 identify women's needs, values and preferences via interviews, (2 select through a process of professional consensus the top evidence-based clinical recommendations requiring local implementation (3 redesign care based on the selected evidence-based recommendations and women's views, and (4 implement the new care model. We measured the impact of the new care model on maternal satisfaction and caesarean birth rates utilising maternal surveys and medical record audit before and after implementation of the new care model. Results Twenty women's needs and requirements as well as ten evidence-based clinical recommendations were selected as a basis for improving care. Following the introduction of the new model of care, women's satisfaction levels improved significantly on 16 of 20 items (p Conclusion The introduction of a quality improvement care model improved compliance with evidence-based guidelines and was associated with an improvement in women's satisfaction levels and a reduction in rates of caesarean birth.

  20. Pregnancy-associated deaths: a 15-year retrospective study and overall review of maternal pathophysiology.

    Science.gov (United States)

    Christiansen, Lydia R; Collins, Kim A

    2006-03-01

    Pregnancy-related death is defined by the International Classification of Diseases, Tenth Revision (ICD-10) as the death of a woman while pregnant or within 42 days of termination of pregnancy, irrespective of the cause of death. In the year 2000, a collaborative effort involving World Health Organization (WHO), UNICEF, and UNFPA estimated 660 maternal deaths in the United States. This averages 11 maternal deaths per 100,000 live births reported. Many pregnancy-associated deaths are not easily identified as such since the presence of a recent or current pregnancy may not be listed on the death certificate. Thus, the WHO estimates that in the United States, the maternal mortality is approximately 17/100,000 pregnancies. This is significantly higher than the goal set by the US Department of Health and Human Services in Healthy People 2010, which sets the target for maternal mortality at less than 3.3/100,000 live births. The most common causes of maternal death vary somewhat from region to region in the United States. They include pulmonary thromboembolism, amniotic fluid embolism, primary postpartum uterine hemorrhage, infection, and complications of hypertension including preeclampsia and eclampsia. Pulmonary disease, complications of anesthesia, and cardiomyopathy also are significant contributors to maternal mortality in some populations. The death of a pregnant or recently pregnant individual poses a wide scope of challenges to the forensic pathologist and investigator. The pathologist must have a broad knowledge of the physiologic and biochemical changes that occur during pregnancy, as well as the clinical and pathological manifestation of these changes. Conditions that may be "benign" in the nonpregnant individual may be lethal in the puerperal period. In addition, it should be kept in mind that deaths during pregnancy may be due to unnatural causes. Accident, homicide, and suicide must be ruled out in each case. The authors reviewed all forensic cases

  1. Maternal postpartum distress and childhood overweight.

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    Teresa A Ajslev

    Full Text Available OBJECTIVE: We investigated associations between maternal postpartum distress covering anxiety, depression and stress and childhood overweight. METHODS: We performed a prospective cohort study, including 21,121 mother-child-dyads from the Danish National Birth Cohort (DNBC. Maternal distress was measured 6 months postpartum by 9 items covering anxiety, depression and stress. Outcome was childhood overweight at 7-years-of age. Multiple logistic regression analyses were performed and information on maternal age, socioeconomic status, pre-pregnancy BMI, gestational weight gain, parity, smoking during pregnancy, paternal BMI, birth weight, gestational age at birth, sex, breastfeeding and finally infant weight at 5 and 12 month were included in the analyses. RESULTS: We found, that postpartum distress was not associated with childhood risk of overweight, OR 1.00, 95%CI [0.98-1.02]. Neither was anxiety, depression, or stress exposure, separately. There were no significant differences between the genders. Adjustment for potential confounders did not alter the results. CONCLUSION: Maternal postpartum distress is apparently not an independent risk factor for childhood overweight at 7-years-of-age. However, we can confirm previous findings of perinatal determinants as high maternal pre-pregnancy BMI, and smoking during pregnancy being risk factors for childhood overweight.

  2. Effects of maternal basking and food quantity during gestation provide evidence for the selective advantage of matrotrophy in a viviparous lizard.

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    Keisuke Itonaga

    Full Text Available The evolution of matrotrophy (i.e., direct supply of nutrients by the mother during gestation may be associated with high maternal energy availability during gestation. However, we lack knowledge about the selective advantages of matrotrophic viviparity (live-bearing in reptiles. In reptiles, the interaction between body temperature and food intake affect maternal net energy gain. In the present study, we examined the effects of basking and food availability (2 by 2 factorial design during gestation on offspring phenotype in a matrotrophic viviparous lizard (Pseudemoia entrecasteauxii. Subsequently, we investigated if the maternal effects were context-dependent using offspring growth rate as an indicator of the adaptive significance of matrotrophy. Offspring were exposed either to the same thermal conditions as their mothers experienced or to thermal conditions different from those experienced by their mothers. We provide the first evidence that an interaction between maternal thermal and maternal food conditions during gestation strongly affects offspring phenotype, including date of birth, body size and performance ability, which affect offspring fitness. Offspring growth rate was dependent on offspring thermal conditions, but was not influenced by maternal effects or offspring sex. Matrotrophic viviparity provided gravid females with the means to enhance offspring fitness through greater energetic input to offspring when conditions allowed it (i.e., extended basking opportunity with high food availability. Therefore, we suggest that selective advantages of matrotrophic viviparity in P. entrecasteauxii may be associated with high maternal energy availability during gestation.

  3. Effects of maternal basking and food quantity during gestation provide evidence for the selective advantage of matrotrophy in a viviparous lizard.

    Science.gov (United States)

    Itonaga, Keisuke; Jones, Susan M; Wapstra, Erik

    2012-01-01

    The evolution of matrotrophy (i.e., direct supply of nutrients by the mother during gestation) may be associated with high maternal energy availability during gestation. However, we lack knowledge about the selective advantages of matrotrophic viviparity (live-bearing) in reptiles. In reptiles, the interaction between body temperature and food intake affect maternal net energy gain. In the present study, we examined the effects of basking and food availability (2 by 2 factorial design) during gestation on offspring phenotype in a matrotrophic viviparous lizard (Pseudemoia entrecasteauxii). Subsequently, we investigated if the maternal effects were context-dependent using offspring growth rate as an indicator of the adaptive significance of matrotrophy. Offspring were exposed either to the same thermal conditions as their mothers experienced or to thermal conditions different from those experienced by their mothers. We provide the first evidence that an interaction between maternal thermal and maternal food conditions during gestation strongly affects offspring phenotype, including date of birth, body size and performance ability, which affect offspring fitness. Offspring growth rate was dependent on offspring thermal conditions, but was not influenced by maternal effects or offspring sex. Matrotrophic viviparity provided gravid females with the means to enhance offspring fitness through greater energetic input to offspring when conditions allowed it (i.e., extended basking opportunity with high food availability). Therefore, we suggest that selective advantages of matrotrophic viviparity in P. entrecasteauxii may be associated with high maternal energy availability during gestation.

  4. One in Five Maternal Deaths in Bangladesh Associated with Acute Jaundice: Results from a National Maternal Mortality Survey.

    Science.gov (United States)

    Shah, Rupal; Nahar, Quamrun; Gurley, Emily S

    2016-03-01

    We estimated the proportion of maternal deaths in Bangladesh associated with acute onset of jaundice. We used verbal autopsy data from a nationally representative maternal mortality survey to calculate the proportion of maternal deaths associated with jaundice and compared it to previously published estimates. Of all maternal deaths between 2008 and 2010, 23% were associated with jaundice, compared with 19% from 1998 to 2001. Approximately one of five maternal deaths was preceded by jaundice, unchanged in 10 years. Our findings highlight the need to better understand the etiology of these maternal deaths in Bangladesh.

  5. Maternal mortality in Denmark, 1985-1994

    DEFF Research Database (Denmark)

    Andersen, Betina Ristorp; Westergaard, Hanne Brix; Bødker, Birgit;

    2008-01-01

    OBJECTIVES: In Denmark, maternal mortality has been reported over the last century, both locally through hospital reports and in national registries. The purpose of this study was to analyze data from national medical registries of pregnancy-related deaths in Denmark 1985-1994 and to classify them......: This is the first systematic report on deaths in Denmark based on data from national registries. The maternal mortality rate in Denmark is comparable to the rates in other developed countries. Fortunately, statistics are low, but each case represents potential learning. Obstetric care has changed and classification...... methods differ between countries. Prospective registration and registry linkage seem to be a way to ensure completion. This retrospective study has provided the background for a prospective study on registration and evaluation of maternal mortality in Denmark....

  6. Maternal Obesity, Inflammation, and Developmental Programming

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    Stephanie A. Segovia

    2014-01-01

    Full Text Available The prevalence of obesity, especially in women of child-bearing age, is a global health concern. In addition to increasing the immediate risk of gestational complications, there is accumulating evidence that maternal obesity also has long-term consequences for the offspring. The concept of developmental programming describes the process in which an environmental stimulus, including altered nutrition, during critical periods of development can program alterations in organogenesis, tissue development, and metabolism, predisposing offspring to obesity and metabolic and cardiovascular disorders in later life. Although the mechanisms underpinning programming of metabolic disorders remain poorly defined, it has become increasingly clear that low-grade inflammation is associated with obesity and its comorbidities. This review will discuss maternal metainflammation as a mediator of programming in insulin sensitive tissues in offspring. Use of nutritional anti-inflammatories in pregnancy including omega 3 fatty acids, resveratrol, curcumin, and taurine may provide beneficial intervention strategies to ameliorate maternal obesity-induced programming.

  7. Thrombosis in pregnancy and maternal outcomes.

    Science.gov (United States)

    James, Andra H

    2015-09-01

    Pregnancy increases the risk of thrombosis four- to five-fold. Seventy-five to eighty percent of pregnancy-related thrombotic events are venous and twenty to -twenty-five percent are arterial. The main reason for the increased risk is hypercoagulability. Women are hypercoagulable because they have evolved so that they are protected against the bleeding challenges of pregnancy, miscarriage, or childbirth. Both genetic and acquired risk factors can further increase the risk of thrombosis. The maternal consequences of thrombosis of pregnancy include permanent vascular damage, disability, and death. While the maternal outcomes of thrombosis can be modified by anticoagulation therapy, management of thrombosis during pregnancy is the subject of another paper in this issue (see paper by B. Konkle). This review will focus on the epidemiology, pathophysiology, risk factors, and maternal consequences of thrombosis in pregnancy.

  8. Social factors determining maternal and neonatal mortality in South Africa: A qualitative study

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    Rose M.M. Mmusi-Phetoe

    2016-02-01

    Full Text Available Background: South Africa’s maternal mortality ratio has increased from 150/100 000 in 1990 to 269/100 000 live births in 2015 against the Millennium Development Goals 5 (MDG5 target of 38/100 000, indicating slow progress in improving maternal health. The neonatal mortality rate was 14/1000 live births against the MDG4 target of 7/1000. The purpose of the article was to outline the socio-economic factors that determine maternal and neonatal mortality in South African communities.Objectives: To identify and describe the social determinants of maternal and neonatal mortality in South Africa. Method: A qualitative study using audio-taped individual interviews was conducted. The interviews included 10 pregnant women who were purposefully recruited from the antenatal clinic attendees in a public hospital. The interviews were conducted in isiZulu and later translated into English by the researcher who is fluent in both. Data were analysed using the World Health Organization’s (WHO Commission on Social Determinants of Health framework.Results: Findings revealed that poverty was an underlying factor to the vulnerability to illness and death of the mothers and their neonates. Other determinants were found to be the nutritional inadequacies, neglect and abuse by male partners, HIV or AIDS, inattention to reproductive health and violation of reproductive rights, and powerlessness of women and health system issues such as poor quality and incompetent health care.Conclusion: It is apparent that poverty plays a major role in determining the health of mothers and neonates. This requires more coordinated multi-sectorial interventions to address both the social determinants and direct causes of maternal and neonatal deaths.Keywords: maternal mortality, neonatal mortality, social determinants of health

  9. Effects of early life social stress on endocrinology, maternal behavior, and lactation in rats.

    Science.gov (United States)

    Carini, Lindsay M; Nephew, Benjamin C

    2013-09-01

    Exposure to early life stress is a predictor of mental health disorders, and two common forms of early life stress are social conflict and impaired maternal care, which are predominant features of postpartum mood disorders. Exposure of lactating female rats to a novel male intruder involves robust social conflict and induces deficits in maternal care towards the F1 offspring. This exposure is an early life social stressor for female F1 pups that induces inefficient lactation associated with central changes in oxytocin (OXT), prolactin (PRL), and arginine vasopressin (AVP) gene expression in adult F1 females. The mothers of the rats in the current study were either allowed to raise their pups without exposure to a social stressor (control), or presented with a novel male intruder for 1h each day on lactation days 2-16 (chronic social stress). The effects of this early life chronic social stress (CSS) exposure on subsequent peripheral endocrinology, maternal behavior, and physiology were assessed. Exposure of female pups to early life CSS resulted in persistent alterations in maternal endocrinology at the end of lactation (attenuated prolactin and elevated corticosterone), depressed maternal care and aggression, increased restlessness and anxiety-related behavior, impaired lactation, and decreased saccharin preference. The endocrine and behavioral data indicate that early life CSS has long-term effects which are similar to changes seen in clinical populations of depressed mothers and provide support for the use of the chronic social stress paradigm as an ethologically relevant rodent model for maternal disorders such as postpartum depression and anxiety.

  10. An Advanced Model to Precisely Estimate the Cell-Free Fetal DNA Concentration in Maternal Plasma

    Science.gov (United States)

    Xu, Huixin; Jiang, Haojun; Xie, Weiwei; Chen, Fang; Zeng, Peng; Li, Xuchao; Xie, Yifan; Liu, Hongtai; Huang, Guodong; Chen, Dayang; Liu, Ping; Jiang, Hui; Zhang, Xiuqing

    2016-01-01

    Background With the speedy development of sequencing technologies, noninvasive prenatal testing (NIPT) has been widely applied in clinical practice for testing for fetal aneuploidy. The cell-free fetal DNA (cffDNA) concentration in maternal plasma is the most critical parameter for this technology because it affects the accuracy of NIPT-based sequencing for fetal trisomies 21, 18 and 13. Several approaches have been developed to calculate the cffDNA fraction of the total cell-free DNA in the maternal plasma. However, most approaches depend on specific single nucleotide polymorphism (SNP) allele information or are restricted to male fetuses. Methods In this study, we present an innovative method to accurately deduce the concentration of the cffDNA fraction using only maternal plasma DNA. SNPs were classified into four maternal-fetal genotype combinations and three boundaries were added to capture effective SNP loci in which the mother was homozygous and the fetus was heterozygous. The median value of the concentration of the fetal DNA fraction was estimated using the effective SNPs. A depth-bias correction was performed using simulated data and corresponding regression equations for adjustments when the depth of the sequencing data was below 100-fold or the cffDNA fraction is less than 10%. Results Using our approach, the median of the relative bias was 0.4% in 18 maternal plasma samples with a median sequencing depth of 125-fold. There was a significant association (r = 0.935) between our estimations and the estimations inferred from the Y chromosome. Furthermore, this approach could precisely estimate a cffDNA fraction as low as 3%, using only maternal plasma DNA at the targeted region with a sequencing depth of 65-fold. We also used PCR instead of parallel sequencing to calculate the cffDNA fraction. There was a significant association (r = 98.2%) between our estimations and those inferred from the Y chromosome. PMID:27662469

  11. MATERNAL AND PERINATAL OUTCOME IN PREGNANCIES COMPLICATED BY PLACENTA PREVIA

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    Rajendra

    2015-06-01

    Full Text Available AIMS AND OBJECTIVES: To evaluate the maternal and perinatal outcome of pregnancies complicated with placenta previa at tertiary care centre and to evaluate the potential risk factors involved in pregnancies complicated with placenta previa at tertiary care C ent re. METHOD: We carried out 2 year retrospective observational study during period from November 2009 to October 2011 Tertiary care hospital and medical college. ANC cases with history of bleeding per vaginum after 28 weeks attending ANC clinic and emergenc y ward were included in study with appropriate age parity matched controls with other complications like pregnancy induced hypertension, abruption placentae, multiple gestation were excluded. Demographic data, medical and surgical histories, all the events regarding maternal and perinatal mortality were recorded. Data was analysed by using appropriate software . RESULTS: 136 cases of placenta previa were analysed and found prevalence of placenta previa was 1.36%. During the present study 41.80% cases were bo oked and 58.20% cases were unbooked. Maximum number of cases in present study were in the age group of 18 - 24 years. Previous caesarean (57.49% and previous abortion (42.53% found important risk factors.41.04% cases were delivered at 33 - 36 weeks of gestat ion followed by 33.58% in 28 - 32 weeks of gestation. Expectant management was given to 37.32% of cases while 62.68% cases were managed on active basis. In present study maternal morbidity were postpartum hemorrhage (56.71%, sepsis (37.31%, urinary tract i nfection (5.22%, wound infection (5.22%,wound gape (4.47%, hysterectomy (2.23%, prolonged hospital stay >10 days (17.91%. There were two (1.49% maternal mortality in present study. Maximum number of infants i.e . 58.20% had bir th eight between 1.6 to 2.4kg. O ut of this 16.41% were of 1.6 - 2kg and 41.79% comprised of 2.1 - 2.4 kg. 39.55% infant required NICU admission and 60.45% of cases were with mother. Perinatal

  12. Mortalidade materna na cidade do Recife Maternal mortality in Recife

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    Aurélio Antônio Ribeiro Costa

    2002-08-01

    . Methods: a descriptive population-based study was conducted and all death certificates of women aged 10-49 years were analyzed and classified as declared or presumed (Laurenti criteria. Clinical records and autopsy data, when available, were studied and basic cause and underreporting rate were determined. Maternal Mortality Ratio was calculated using information on live births from SINASC ("Sistema de Informações dos Nascidos Vivos". Results: a total of 144 maternal deaths were identified (declared=104; presumed and confirmed after investigation=44. The Maternal Mortality Ratio was 75.5 per 100,000 live births. The underreporting rate was 27.8%. A predominance of direct causes was observed (about 69% and the most frequent causes of death were hypertension (19%, hemorrhage (16% and infection (11%. About 82% of the deaths were considered avoidable by adequate antenatal, delivery and post-partum care. Conclusions: Maternal Mortality Ratio is high in the city of Recife, Brazil and the underreporting rate is still high. Direct obstetric causes and avoidable deaths are predominant. There is a lack of adequate antenatal, delivery and post-partum care.

  13. National Maternal and Child Oral Health Resource Center

    Science.gov (United States)

    ... OHRC on Twitter Tweets by @OHRC_GU With funding from the Maternal and Child Health Bureau, Health Resources and Services Administration National Maternal and Child Oral Health Resource Center • Georgetown ...

  14. Maternal Lifestyle and Pregnancy Complications: The Generation R Study

    NARCIS (Netherlands)

    R. Bakker (Rachel)

    2011-01-01

    textabstractAdverse maternal lifestyle habits during pregnancy are important modifiable risk factors for pregnancy complications in Western countries. Most common adverse maternal lifestyle habits include smoking, alcohol consumption, and caffeine consumption. Although not directly lifestyle related

  15. Maternal body mass index in outcome of pregnancy

    Directory of Open Access Journals (Sweden)

    G. Sharmila

    2016-08-01

    Conclusions: Maternal BMI shows strong associations with pregnancy complications and outcome. Both maternal and fetal complications are increased. [Int J Reprod Contracept Obstet Gynecol 2016; 5(8.000: 2652-2656

  16. Maternal Infections during Pregnancy and Cerebral Palsy

    DEFF Research Database (Denmark)

    Miller, Jessica; Pedersen, Lars Henning; Streja, Elani;

    2013-01-01

    BACKGROUND: Cerebral palsy (CP) is a common motor disability in childhood. We examined the association between maternal infections during pregnancy and the risk of congenital CP in the child. METHODS: Liveborn singletons in Denmark between 1997 and 2003 were identified from the Danish National...... the Danish Cerebral Palsy Registry. Adjusted hazard ratio (HR) and 95% confidence interval (CI) were estimated by Cox proportional hazard models. RESULTS: Of the 440 564 singletons with follow-up data, 840 were diagnosed with congenital CP. Maternal genito-urinary tract infections (HR 2.1, 95% CI 1.4, 3...

  17. Human Maternal Brain Plasticity: Adaptation to Parenting.

    Science.gov (United States)

    Kim, Pilyoung

    2016-09-01

    New mothers undergo dynamic neural changes that support positive adaptation to parenting and the development of mother-infant relationships. In this article, I review important psychological adaptations that mothers experience during pregnancy and the early postpartum period. I then review evidence of structural and functional plasticity in human mothers' brains, and explore how such plasticity supports mothers' psychological adaptation to parenting and sensitive maternal behaviors. Last, I discuss pregnancy and the early postpartum period as a window of vulnerabilities and opportunities when the human maternal brain is influenced by stress and psychopathology, but also receptive to interventions. PMID:27589497

  18. Fetal Heart Rate Response to Maternal Exercise.

    Science.gov (United States)

    Monga, Manju

    2016-09-01

    Current guidelines regarding recommended exercise in pregnancy appear consistent with reported research regarding fetal heart changes in response to maternal exercise. Fetal heart rate increases during pregnancy, but maternal exercise appears well tolerated if performed in uncomplicated pregnancies and not in the supine position. Maximal levels of exercise that are well tolerated by the fetus have not yet been well defined; however, recent literature suggests that sustained exercise during pregnancy may have beneficial effects on autonomic control of fetal heart rate and variability that may lead to long-term health benefits. PMID:27388963

  19. A scoping review of geographic information systems in maternal health

    OpenAIRE

    Makanga, Prestige T.; Schuurman, Nadine; von Dadelszen, Peter; Firoz, Tabassum

    2016-01-01

    Background Geographic information systems (GIS) are increasingly recognized tools in maternal health. Objectives To evaluate the use of GIS in maternal health and to identify knowledge gaps and opportunities. Search strategy Keywords broadly related to maternal health and GIS were used to search for academic articles and gray literature. Selection criteria Reviewed articles focused on maternal health, with GIS used as part of the methods. Data collection and analysis Peer reviewed articles (n...

  20. Prenatal Care and Maternal Age, Education and Reproductive Behaviour

    OpenAIRE

    Z.Pouranssari; P Kamali; H.Eftekhar Ardbili; A.Komarizadeh

    1987-01-01

    Reproductive behavior of 1525 pregnant woman were studied in the time of termination of pregnancy in relation to maternal age, education, prenatal care and the number of previous pregnancies. The results show that the frequency of maternal attendance at the centers of prenatal care is significantly related to maternal education. And the total pregnancies per woman are inversely correlated with maternal education. The kind of termination of pregnancy which resulted in live births or abortion h...